Sarah Medeiros, MD, MPH 🩺🎙️

Photograph of a printed guidance memo stating that the U.S. Government will not be commemorating World AIDS Day this year. Key points include: USG funds should not be used for related events, personnel should refrain from public promotion via social media or other channels, and CDC and other USG staff may attend local events but cannot speak or promote attendance. The memo notes this guidance supersedes previous blanket approval and may require adjustments to planned activities.

1/ ⚠️ Breaking: At CDC, we've been told the US Government will not officially commemorate World AIDS Day this year. No explanation given.

New offshore drilling plan opens almost all federal water off Alaska The draft plan calls for lease sales in Cook Inlet and the Arctic, as well as the Bering Sea and other regions important to the fishing industry.

“The draft offshore leasing plan includes the Bering Sea, the Gulf of Alaska and other areas important to the fishing industry. It’s part of a national proposal that includes the entire coast of California, where drilling is fiercely unpopular.”

alaskapublic.org/news/politic...

A woman walks toward a giant metallic heart perched on a hilltop. The sculpture’s rounded silhouette and central indentation warp the reflection of the landscape and cloud filled sky. Sculpture: Richard Hudson’s “Love Me”, 2016 Taken at Donum Estates, Sonoma, CA This is a different view of the sculpture in my earlier post showing a side view of the “pregnant belly” and the reflection in full color.

Love above all. 💙

#ClassicMono #EastCoastKin

The autumn landscape - vineyards, ponds, rolling hills, fluffy clouds and a brilliant blue sky - are reflected in a metallic, rounded sculpture set against the same blue sky. Photo taken at Donum Estates, Sonoma, CA. Sculpture: “Love Me” by Richard Hudson, 2016

My #Stunday offering. A little late…
but I guess we’ll slide on into #BlueSkyMonday!

#EastCoastKin

“Decades of rigorous and scientifically sound research have proven that vaccines do not cause autism…

…We need to quickly return to medical information and recommendations being based on sound science, not unverified opinions.”

💯
Thanks @idsainfo.bsky.social
#MedSky

So a big part of the Project 2025 goals hinges on forcing women out of the workforce. The Heritage Foundation knows that women voters hold the most power in terms of sheer numbers. If they can push you out of the workforce, they can push you out of your voting rights.

A young child, blurred into the background, holds a water bead in crisp focus in the foreground, his smiling face perfectly inverted in the refraction. (Black and white photograph)

My whole world in his hand. Back when he was #small but seemed so big.

#BlueskyArtShow #EastCoastKin #mobilephotography

Tharimmune, Inc. @TharimmuneInc The FDA has reviewed and concurred with Tharimmune's quantitative modeling plan for TH104, supporting further development of our lead prophylactic candidate for respiratory depression caused by fentanyl and ultrapotent opioids. Full release: prnewswire.com/news-releases/.. Tharimmune Receives Positive FDA Feedback for TH104 Prophylaxis Program Against Respiratory Depression from Fentanyl and Ultrapotent Opioids

FDA is approving a new form of nalmefene for “prophylaxis” for “opioid exposure,” specifically citing fentanyl.

“Fentanyl exposure” is not a thing. Fent has to be intentionally ingested to cause OD.

It’s being made by a “blockchain-focused digital finance company” whose “biotech arm” is only this…

PLEASE SIGN!

I'm a physician who has cared for agricultural workers in the San Joaquin Valley.
They have been neighbors and friends who are among the hardest-working people I know.
Denying them jobs is unconscionable and will slash the income of all farm workers, no matter where they were born.

L.A. child dies from complication of measles infection contracted in infancy The child died from subacute sclerosing panencephalitis, a fatal progressive brain disorder that strikes roughly 1 in 10,000 people infected with measles.

Evidence-based vaccination recommendations are about more than individual decisions

A child infected with measles as a baby “not old enough to be vaccinated at the time of infection” recently died of a complication 💔

Vaccines protect kids who receive them — & infants & others in their communities

NEW: An analysis finds that NIH funding cuts have disrupted at least 383 clinical trials, affecting over 74,000 participants that were enrolled in studies that were testing treatments for conditions including cancer, heart disease and brain disease.

A cloud of starlings fills the sky over autumn colored vineyards echoing the curves of twisted tree sculpture in the foreground. Taken at Donum Estates, Sonoma, CA.

Autumn murmuration for #Stunday
Absolutely mesmerizing in person.

Firearm Homicide in Pregnant Women and State-Level Firearm Ownership This cross-sectional study examines firearm homicide rates in pregnant compared with nonpregnant women and whether estimated state-level firearm ownership is associated with homicide deaths among preg...

New paper reminds us yet again: HOMICIDE is the leading cause of death for pregnant women.

Gun violence & partner violence are related.

All-cause homicide & firearm homicide of pregnant women are higher, in states w/ higher calculated firearm ownership (1/x 🧵

jamanetwork.com/journals/jam...

‘Summers went on to describe what he saw as his "best shot": that the woman finds him
"invaluable and interesting" and concludes
"she can't have it without romance / sex."’

This is called quid pro quo, making career opportunities contingent on sexual favors. It’s the most severe form of…

REPORT OF THE AD HOC WORKING GROUP ON PHYSICIAN WORKFORCE CONDITIONS, SCIENTIFIC INTEGRITY, AND RESIDENT ORGANIZING IN THE POST-2020 POLICY ENVIRONMENT Position Statement on the Dr. Mehmet Oz Event: Threats to Scientific Integrity and the Coercion of Resident Physicians Executive Summary The American medical profession is undergoing a structural realignment driven by three converging forces: the accelerating unionization of resident physicians (1]; the collapse of scientific and public-health norms in the United States due to the political capture of federal agencies (2); and a widening gap between the priorities of organized medicine's legacy institutions and the lived reality of trainees. Medical students and residents now occupy the most precarious position in the physician workforce while simultaneously holding the greatest leverage to redirect the profession's trajectory. The present moment is shaped by the consolidation of political power by the current Republican administration and the placement of high-profile COVID-19 contrarians-individuals whose pandemic-era claims were repeatedly discredited- into leadership roles within federal science and health agencies [3]. This shift has destabilized traditional assumptions about evidence-based governance, regulatory oversight, and the civic role of physicians. Meanwhile, the resident workforce-the backbone of the U.S. hospital system -faces unprecedented strain: declining inflation-adjusted wages, chronic understaffing, escalating retaliation risks, and high levels of burnout. Residents organizing through CIR/SEIU have secured major gains across the country [4], while the AMA has only recently adopted policies supportive of collective bargaining for residents. This report outlines the structural dynamics shaping the profession, the interaction between political disinformation and medical licensure, the implications for trainees, and recommendations for coordinated action between CIR, medical students, and aligned p…

1997 Balanced Budget Act [6]. These decisions often relied on the belief that physician oversupply would reduce quality or compress income. COVID-19 exposed the fragility of this system. Several U.S.-licensed physicians-including some with academic affiliations-used their credentials to oppose public-health measures and promote unproven treatments. Their claims were amplified by political networks and media ecosystems, contributing to public distrust and increased mortality [7]. Disciplinary action against these physicians was rare. State medical boards were slow or unwilling to intervene [8]. Meanwhile, prominent contrarian physicians consolidated political influence and now occupy key federal health leadership roles. Il. Recent Developments Affecting Trainees Residents have responded to worsening conditions by organizing at an unprecedented rate. CIR/SEIU now represents tens of thousands of residents across major academic systems. Recent wins include wage increases, due-process rights, parental-leave expansions, and improved safety provisions [9]. Medical students increasingly view collective action as the only viable mechanism for improving training conditions. This generational shift is redefining the culture of medicine and the relationship between physicians and institutional authority. The AMA, historically ambivalent toward physician unionization, adopted policy in 2024 recognizing the legitimacy of resident collective bargaining [10]. However, the AMA's primary legislative focus remains national scope-of-practice battles and physician payment reform, leaving trainees without a national body focused primarily on workplace safety, retaliation protections, or fair compensation. III. Scientific Integrity Under Political Pressure The integration of discredited COVID-19 contrarian physicians into federal leadership represents a fundamental change in the environment for scientific practice [11]. Their elevation undermines the authority of evidence-based institutio…

Third, trainees who advocate for evidence-based care may face institutional retaliation, while physicians spreading disinformation face minimal consequences. This asymmetry distorts the professional environment and pushes trainees toward organized collective protection. IV. Areas of Alignment and Conflict Between AMA Policy and Trainee Needs While the AMA and resident unions share interest in scientific integrity and physician well-being, their priorities diverge significantly. Residents require safe staffing, fair compensation, due-process protections, and freedom from retaliation. The AMA has historically prioritized national legislative battles (such as scope-of-practice) over the day-to-day realities of residency training. However, the rise of political interference in scientific institutions creates an emerging area of alignment: both trainees and segments of organized medicine recognize that defending evidence-based practice is essential to the profession's future. V. Risk Assessment for Trainees in the Current Environment Trainees now operate in a structurally unstable ecosystem shaped by political capture of federal science agencies [12], increasing right-wing disinformation targeting medicine [13], academic-center fragility, declining public trust, weak state board enforcement, and widespread vulnerability to employer retaliation. These forces combine to create a historic level of risk for trainees, and senior leadership has not adequately communicated these stakes to medical students or residents. VI. Recommendations for Residents, Students, and CIR Leadership Residents must assert themselves as central actors in the profession's future. Recommendations include strengthening organizing capacity across academic centers, building communication channels independent of employer oversight, establishing reporting pathways for retaliation or scientific interference, coordinating with allied organizations (including the AMA when aligned), creating educational reso…

2. Washington Post, 'How COVID Contrarians Entered Federal Health Leadership,' 2025. 3. New York Times and Science Magazine analyses of federal leadership turnover, 2024-2025. 4. CIR/SEIU contract gains at UC, UPenn, Mass General Brigham, 2022-2025. 5. COGME projections (1980-1999); AAMC workforce policy archives. 6. Congressional Research Service (CRS) Report on Medicare GME caps, 1997-2024. 7. ProPublica, 'The Doctors Who Undermined COVID Response,' 2022; BMJ analyses of excess mortality linked to disinformation. 8. FSMB public statements, 2021-2025; analysis of state board disciplinary data. 9. SEIU/CIR contract summaries from 2022-2025 bargaining cycles. 10. AMA YPS and HOD Actions, Policy D-405.001, 2024. 11. Science Magazine, 'Erosion of Scientific Norms in Federal Agencies,' 2025. 12. NYT and WaPo reporting on federal appointments, 2024-2025. 13. Center for Countering Digital Hate reports, 2021-2025.

Working 🔗 to the full position statement (PDF): archive.org/details/posi...

This report explains why featuring Dr. Oz at the AMA undermines scientific integrity and pressures residents.

Please share with anyone attending tomorrow’s session.
#MedSky

Powerful.

Remember: The richest 1% evade over $160 billion in taxes every year.

That amount would fund SNAP for a year with money to spare.

Ask yourself who the real freeloaders are.

Thank you! 💙

Shameful, but not surprising.

“Harvard Medical School postponed an online course on transgender healthcare after the National Review, a conservative news outlet, contacted the school about the legality of offering fee waivers to transgender and “gender diverse” participants.”

A Tree Swallow perches on a sunlit branch, its back to us but head turned in profile, letting us know it’s aware of our presence. Its deep blue green plumage camouflages with the blurred background of leaves and sky; white feathers peak out from its underbelly.

Happy #blueskymonday! Appreciate the subtle beauty all around us.

The beach glows in the golden pink glow of sunrise. A lone fisherman walks barefoot along the wet sand, pole in hand. If only all mornings were this peaceful.

Late submission for #Stunday

#EastCoastKin

Black and white photo. A boy crouches, pensive, in the solitary open window of a small farmhouse. The walls bow slightly and are in need of replastering. A wooden overhang extends to the left of the house, providing shade for the boy’s mother, who is resting in the afternoon heat. Banana palms grow in the surrounding fields.

One more for the #BlueskyArtShow

Uganda, 2009. #inside

#EastCoastKin

Slightly askew photo of the library inside the British Museum on a rare sunny day in London. A geometric array of triangular glass panes fans out over the inner courtyard featuring a Roman style stone façade and a sweeping stone staircase that wraps around the circular library. The words “Queen Elizabeth” are carved into the upper stones.

I took this nearly 20 years ago #inside the British Museum. Not bad for a cheap flip phone!

#BlueSkyArtShow #EastCoastKin

A big fluffy, scruffy dog perches with his front paws on a cushioned bench, staring out of a large plate glass window at the ocean. Probably looking for seals on this quiet foggy afternoon, longing to go splash in the waves and play in the sand dunes.

Stuck #inside

#BlueSkyArtShow #EastCoastKin

We will not stay silent on vaccines, say leaders of five major U.S. medical associations “We cannot and will not gamble with our patients’ health or the health of our communities,” write the presidents of the AAFP, AAP, ACP, ACOG, and IDSA.

“Immunizations work, they are very effective and safe, and they save lives. Vaccines are among the most rigorously studied and effective tools in public health.”

Kudos to AAFP, AAP, ACOG, ACP, IDSA for this.

www.statnews.com/2025/06/26/v...

Thanks so much!

This photo encompassed vibrance in many ways - to me, anyway. A crowded county fair on a warm summer night. Fairgoers illuminated by the neon glow emanating from the rides, games and shops. In the crowd, two friends greet each other with a hug and a smile, a toddler in her father’s arms cranes her neck to look back at all the excitement, the rest is a blur of movement, color and light.

#BlueSkyArtShow

When #Vibrant is a vibe.

#EastCoastKin