Part the First: Pharmacopeia. Who doesn’t love a garden? It sometimes seems that all drugs come from plants, initially. My first biology teachers claimed they were taught that bacteria were plants back when life was either animal or plant. Garden of Healing is a bit long but very interesting. It is also a break from the unending task of Science-Based Medicine to keep up with the Three Amigos plus Dr. Oz in charge of the Department of Health and Human Services.
Other plants not included in the Garden of Healing are willow and wormwood. Willow bark extracts contain salicylates. Aspirin is acetylsalicylic acid. My generation was taught in Biology 101 that Aristotle prescribed willow bark tea for the pain of childbirth. This is probably not true but it makes a good story. The use of willow extracts in the treatment of pain and fever has a long history: From plant extract to molecular panacea: a commentary on Stone (1763) ‘An account of the success of the bark of the willow in the cure of the agues’. This is the rare article that explains the mechanism of aspirin in historical context. One-hundred years ago aspirin was one of the few drugs that worked as advertised but the mechanism has been known only since the 1970s. The few other drugs included morphine and digitalis, both natural products from plants (poppy and foxglove) and both deadly when used improperly.
Tu Youyou (b. 1930) is a Chinese physician who used ancient texts to learn that extracts of sweet wormwood have antimalarial properties. After long and careful studies, she identified artemisinin as the antimalarial drug. She was awarded the Nobel Prize in Physiology or Medicine in 2015 (note that physiology comes before medicine) in one of the inspired choices of the Karolinska Institute. I have no idea if they work, but the generation of my grandparents and great grandparents in the late nineteenth and early twentieth centuries were still using traditional remedies (other than natural opiates and ethanol) well into the 1960s. They were believers and the long gone local drugstore, where the proprietor was “Doc” in the little town of theirs also sold little wax paper bags of white clay for human consumption. All that did was cause intestinal blockage and anemia.
Part the Second: PEPFAR May Yet Live. The President’s Emergency Plan For AIDS Relief was begun by that liberal radical George W. Bush and has saved as many as 25 million lives. It seems that the GOP has “defied” the President for the moment and may preserve PEPFAR, which has worked very well since its establishment:
Since PEPFAR’s creation by Congress and Republican President George W. Bush, the program has largely enjoyed support across the political spectrum — and gratitude from countries whose health systems have been poorly equipped to care for millions with HIV.
But misinformation has crept in. The Heritage Foundation, an influential conservative Washington think tank, accused the Biden administration of using PEPFAR “to promote its domestic radical social agenda overseas.” Conservatives claimed there were efforts to integrate abortion with HIV/AIDS prevention, a claim the Biden administration denied. Similar claims linger under the Trump administration.
Trump and his officials also claim widespread waste and fraud as they seek to dismantle U.S. foreign aid. But PEPFAR has been repeatedly scrutinized. Last year, the government said the State Department’s Office of Inspector General had conducted 80 audits, inspections, and special reviews that included oversight of PEPFAR programs, “including 21 thematic reviews and audits specifically focused on PEPFAR.”
W-F-A, waste, fraud, and abuse, once again brought to you by the letters W-T-F. The primary motivation of DOGE and all this other performative nonsense is to just be mean, hateful, stingy. This is my nation at the moment but it is not my country and never will be. If DOGE had been a serious effort at stopping W-F-A, the first stop of those self-regarding 20-something berserkers would have been across the Potomac at the Pentagon. But the guards at those doors have guns and knew how to use them. Savings from the DOGE Boys have been well short of the $2 trillion promised and will probably amount to less than zero in the end.
Part the Third: Life in Biotech World. In another episode of “Cash Out with a Unicorn” the employees of the gene therapy company Sarepta:
Sarepta Therapeutics laid off more than one-third of its workforce, or approximately 500 employees, the company announced Wednesday — a drastic cost-cutting move following the deaths of two teenagers that forced the company to restrict usage of its gene therapy for Duchenne muscular dystrophy (DMD).
Alongside the cuts, the company also announced it was shifting much of its research, including pausing work on several gene therapies it had in development for limb-girdle muscular dystrophies, a collection of rarer and generally slower-moving diseases. The company said the move will save the company around $400 million per year, lower operating expenses, and boost cash flow sufficient to maintain access to an existing loan agreement.
Three of Sarepta’s top executives, including its No. 2 executive Ian Estepan, received promotions and salary increases, according to a filing with the Securities and Exchange Commission that accompanied the company’s announcement of employee layoffs.
While painful, investors viewed the restructuring as a positive move, ensuring the company would survive the recent string of bad news. Sarepta’s stock price rose more than 36% to $25 per share in Wednesday’s after-hours trading session. The stock closed the day at $18 per share, down 85% this year and a nine-year low.
Everything that does not work about Pharma/Biotech is included in this excerpt. I remember when the DMD gene for dystrophin was cloned. Gene therapy was to follow forthwith. The money has been disappearing through that incinerator for a long time. One day, maybe it will work. But as a matter of principle, gene therapy can work only when the functional therapeutic gene (including regulatory elements essential for proper gene expression) can be delivered to the precise location required.
Dystrophin is a very large skeletal muscle protein required for the maintenance of structure during cycles of contraction and relaxation. Without a complex anchored by dystrophin and other proteins, the muscle eventually falls apart because it lacks the struts necessary to withstand contraction. The therapeutic gene is a micro-dystrophin delivered by an adeno-associated virus vector. These vectors work in the liver for clotting factor genes because the liver cells are tractable and the proteins are secreted into the blood. What is tractable in liver may well be intractable in skeletal muscle. Which is not to say that the therapy should not be pursued. But it is unlikely to ever be that unicorn worth billions. And cashing out while laying off one-third of your employees should be impossible. But with Hayek’s Bastards all things are possible, even required, in business. Still, this is no way to do science.
On a related note, when the CFTR gene responsible for about 75% of cystic fibrosis cases was finally cloned, there was joy and celebration throughout the land. There is no gene therapy after all these years. Targeted therapeutic CFTR gene therapy delivery is basically unimaginable for CFTR. But treatment with a trio of drugs that help the mutant protein fold and get to its normal place in the cell, many cystic fibrosis patients respond well. These drugs are not a cure but they are a treatment. However, without the thousands of research papers that explain the workings of CFTR, the drugs would probably not have been developed. But they have and they cost a lot ($300,000 per year, $822 per day). There are better, more efficient, and more effective ways to do this research and develop these drugs, but I repeat myself. Again.
Part the Fourth: Our American Israel. Or how did we get here? The relationship between the United States and Israel is a puzzle that requires serious study. This does not include listening to or reading the usual sources. An unusually useful source is Our American Israel: The Story of an Entangled Alliance (Harvard University Press, 2018) by Amy Kaplan (1953-2020), who was the Edward Kane Professor of English at the University of Pennsylvania. Harvard University Press issued the paperback in 2025, which is the edition discussed here.
The book is very good on the “why” and the “how” of the State of Israel. It is largely forgotten but the popular American understanding of Israel was transmitted through the novel Exodus (1958) by Leon Uris and especially the film Exodus (1960) starring Paul Newman and Eva Marie Saint and directed by Otto Preminger. The movie’s theme won an Academy Award for Ernest Gold. Pat Boone’s lyrics (1963) are seldom heard today, but they were a staple of school choruses throughout the 1960s, when I sang it in the sixth grade and eighth grade. It was a big hit when the Six-Day War was a recent event. In Kaplan’s convincing presentation, the emergence of the State of Israel:
Reenacted the primal myth of the American frontier as a tale of regeneration through violence…the barbarism of the other – whether Indian or Arab – (forces) the hero to become violent as he adopts their methods…Both film and novel effaced the violent dispossession of Palestinians, with glorified interpretation of Israel’s founding as an event unparalleled in human history.
More recently Zionism has been seen through the lens of Christian Zionists for whom:
The establishment of the State of Israel in 1948 proved to believers the accuracy of the ancient prophecy that God would restore Israel to Zion and that this ingathering would trigger a chain of events culminating in the end of days…the significance of Israel…(manifested God’s sovereignty and made)…it possible for some Jews to convert to Christianity to correct the fatal mistake they had made in rejecting Christ two millennia ago…before the final battle of Armageddon in which Christ vanquishes the Antichrist to inaugurate God’s kingdom on earth.
This premillennial dispensationalism is an interesting theology and very real to many Americans, even those Christians who have not gone quite that far down the rabbit hole. Tim LeHaye of the Left Behind series of novels and movies (>50 million books sold) goes on to point out that:
Identification with Israel did not mean identification with actual Jews, however – either in America or Israel…(because Jews as a group)…have often yielded to secularistic, even atheist spirt. Brilliant minds have all too frequently been dedicated to philosophies that have proved harmful to mankind. Consider for example, Karl Marx, Leon Trotsky, and Sigmund Freud.”
Trotsky, who was murdered by Stalin’s men in Coyoacán? Okay, then. One profound regret for Tim LeHaye must be that Charles Darwin was only a lapsed Anglican who used his sand walk at Down House on Sundays while his family went to church. In any case, it is not difficult to see the real, thoroughgoing antisemitism here despite the current redefinition of the concept to mean “any criticism of the State of Israel for anything.” These people are not allies of the State of Israel. Rather they see the State of Israel as a precondition for the Rapture, when the vast majority of Jews will be left behind to fight it out in the post-Rapture maelstrom.
Part the Fifth: Our American Israel, Continued. Other recent useful books on Israel in our world (there are many, several covered here before) include On Settler Colonialism: Ideology, Violence, and Justice (Norton, 2024) by Adam Kirsch and One Day, Everyone Will Have Always Been Against This (Knopf, 2025) by Omar El Akkad. Kirsch has been lauded for his clearheaded analysis. As far as I could tell, the bulk of his argument is that the State of Israel is not a Settler Colonialist State because the result has not (yet) recapitulated the utter devastation of indigenous communities perpetrated in North America and Australia by settler colonialists.
That is one way to look at it. And then we have two quotes (taken from Our American Israel) from the most famous Israeli leaders of my generation, pre-Likud. In the first the war hero Moshe Dayan asks and answers:
Why should we complain at their fierce hatred of us. For eight years (now nearly eighty) they have been dwelling in refugee camps in Gaza, and before their very eyes we are turning the land and the villages where their forefathers dwelt into our home.
This was spoken at the funeral of Roi Rothberg, a kibbutz security officer who was killed and mutilated while on patrol in Gaza. History sometimes more than rhymes.
The other quote is from Golda Meir, Prime Minister of Israel from 1969 to 1974. When she was asked about Palestinian fighting forces, she responded:
There were no such things as Palestinians. It was not as though there was a Palestinian people in Palestine considering itself as a Palestinian people when we came and threw them out and took their country away from them. They did not exist.
Actually, they did exist. Kirsch apparently agrees with Golda Meir. In his book he refers to something called the “Palestinian Liberation Organization” in the second paragraph of his Chapter 6, “Why Israel Can’t Be Decolonized.” This organization does not exist, but the Palestine Liberation Organization does. Despite confusing the adjective for the noun, which is dispositive of something, Kirsch is an excellent writer who tells a very good half-story when he is not engaged in “whataboutism.”
As for One Day, Everyone Will Have Always Been Against This, the novelist and journalist Omar El Akkad begins with “An eighteen-month-old with a bullet wound to the forehead. Maybe the sniper was aiming elsewhere. Maybe there’s some explanation. Maybe it was necessary.” It gets better from there if you can endure it.
Thank you for reading! See you next week after a short sojourn in Canada. I look forward to hearing at first hand the northern perspective on US, from the President’s 51st state.
On plants with potentially dubious medicinal uses, I have some lamb’s ear in my perennial garden which I heard was an astringent. It may have other uses too. I’ve never tried it for medical uses, but do like it for the feel of its leaves. It’s almost like a substitute cat ;)
I grow feverfew and find its bitter tea is excellent for headaches and muscle aches (and fever, I guess, but it’s been decades since I had a fever). It’s invasive, so best in a pot or planter, and very easy to grow. I mix it with mint or marigold to lessen the bitterness when drinking. The only other medicinal plant I use regularly is chamomile (unless one considers hot peppers medicinal – which I do). I grow other herbs for medicinal purposes, but mostly leave them for the bees.
I am fascinated by the idea of growing medicine in one’s yard. I’m not confident that I’m wise enough to self-dose, however.
I have a question for the Commentariat: in the Korean period drama series Dae Jang Geum / “Jewel in the Palace”, there is an episode in which a medicinal plant called bai ben is important. It is described as having very desirable properties. I’m curious whether this is an invention or an actual plant. I cannot find this name in search; the closest I have come is the medicinal plant Scutellaria baicalensis.
A long shot: does anyone know what “bai ben” is?
I will second the recommendation of Our American Israel, I’m reading it now and am well over half way through. She was a wonderful writer.
Also Omar El Akkad’s work, which I started and now am reminded I must finish.
Re Hollywood and Israel–of course the Bible itself used to be big business in Hollywood with lots of Bible story movies in the fifties. DeMille’s Ten Commandments with Heston as Moses was a fave among innocent Baptists who surely knew little about the reality of Zionism. For many of these Preminger’s Exodus was doubtless seen as another Bible story.
Perhaps ironically if you are Mel Gibson and make a Bible movie now you are apt to be shunned as an anti-Semite. But back then the all purpose Holocaust defense was yet to be fully embraced. Better to sell Israel as Moses 2, the sequel.
Amy Kaplan’s work is chock full of cultural analysis, thoroughly researched, so much so that reading it once will not suffice, I will have to actually study it.
I can confirm that the Ten Commandments gave the ‘Holocaust defense’ also a huge buy-in among innocent, aliterate Catholics. Charlton Heston even married our hometown prom queen!
«My first biology teachers claimed they were taught that bacteria were plants back when life was either animal or plant.»
Yes, it’s amusing how people still think in papal hierarchies, even though the root of any tree is an arbitrary node in the web of life.