ABE GREENWALD: After Reality.

It’s not just that Gen Zs came too late to catch the USSR. They came too late to catch the real world altogether. What I’m referring to as the real world here is the manifest multidimensional reality in which humans once spent most of their lives, where they experienced the friction that comes from contact with other real people, challenging ideas, and historical events in real time. All that began to wink out sometime around 2007, when the iPhone was released. In the years since, we’ve migrated ever deeper into our screens and their facsimile of reality. And the pandemic hastened the change considerably.

Many of us, of course, are old enough to have experienced life before and after. There are people alive who’ve witnessed World War II, the Shoah, the Soviet nightmare, the birth of the State of Israel, and 9/11. But younger millennials and Gen Zs simply showed up after the fact—after all the facts. By the time they arrived, they mostly had to make do with the real world’s digital epilogue—“learning” about what happened before they were born from social media, influencers, and AI. What they’re getting is not so much history but a malcontent’s primer on the world that’s rumored to exist outside of their phones. And we’re moving inexorably into an age in which they and younger generations will become the majority.

The online world is a uniquely hospitable environment for both socialism and anti-Semitism to flourish in, and Gen Z (online an average of five hours a day) is being bombarded by both. Like the internet itself, socialism and anti-Semitism are primarily virtual. What do I mean by that? Certainly not that they don’t have monstrous real-world consequences. It’s that, at their cores, they both suppose notional worlds that mirror only the surface appearance of the real one. We often have to remind ourselves that “the internet isn’t the real world,” because the superficial similarities can be deceptive. This applies equally to the worlds of socialists and anti-Semites.

North America could soon be facing quite a spell of bad luck:

HAPPY 25TH ANNIVERSARY TO INSTAPUNDIT! This blog started on August 8, 2001. I can’t promise I’ll still be blogging in 25 years — but I can’t promise that I won’t, either.

ASKED AND ANSWERED: What has cardiology gotten spectacularly right, and spectacularly wrong, over the past 30 years?

The treatment of acute coronary syndrome and MI. Young clinicians may not be able to remember how MI care was transformed with emergency PCI and stents but it is amazing. People with MIs often leave the hospital the next day with only a band-aid on their wrist. The heart and person saved.

This has led to fewer cases of heart failure and arrhythmia. I live in a city of million people and rarely do primary prevention defibrillators for ischemic-related cardiomyopathy—because of all these fixes.

The corollary to acute care has also been disease-modifying therapy for CAD. When I started my career, an MI was often followed by another and another. Now, with optimal medical therapy, recurrent events are much lower. Patients with MI usually live long enough to die of something else.

Heart failure care has also been transformed with the four classes of HF medicines. What was once a miserable death sentence has been transformed into a livable chronic condition. Of course, the challenge in HF care is using it wisely, because most cases of HF are not in ambulatory males with solid blood pressure, but in older patients with many co-morbidities.

Catheter ablation technology has been a spectacular success for every arrhythmia except AF. Ablation renders patients with arrhythmias from focal areas like surgical patients: cured. We still have a huge knowledge deficit in AF pathophysiology. More on that below.

In structural interventions, TAVI is nothing short of spectacular. We can extend the quality and quantity of life for many older adults who faced certain death from aortic stenosis—without open heart surgery.

Much more at the link.

NO. JUST NO:  FDA Approves First mRNA Flu Vaccine for Older Adults.

This older adult has too many books to finish to trust mRNA vaccines for the foreseeable future. Sorry. Yes, yes, anti-science. Why don’t I trust the experts?  …  Because I don’t have Alzheimer’s yet. That’s why. And it will be a freezing day in hell before I forget the tragedy of errors of the Covidiocy.

A LITTLE STRONGLY WORDED BUT… The Only Thing Stupider Than Your AI Witch Hunt Is You.

Look, most of the comments now made about AI were once made about… typewriters (if you grew up in Portugal, you might be in my generation and remember that), or cameras, or word processors, or– anything really.  Bah. Witch hunts.

THE LAST WEEK OR SO HAS BEEN INSANE. AND TODAY WAS JUST BAD:  Ave Atque Vale.

PROBABLY, TO BE FAIR, WITH TERROR AND SLAUGHTER IS PROBABLY HOW WE RETURN:  How Do We Return From Here?

As is true every time we forget the gods of the copybook headings.

OPEN THREAD: Ring in the weekend.

FINALLY: First NBA Player Declares for WNBA.

Kanter has been retired for a few years, but he is 6′ 10″ and in his best years in the NBA averaged as much as 15 points and 11 rebounds per game. Wilt Chamberlain once scored 100 points in an NBA game; Enes Kanter might average 100 points per game in the WNBA.

It will be interesting to see whether more male players follow Kanter’s lead and enter the WNBA draft. Presumably the teams won’t draft them, thereby confirming that the league’s pro-trans ideology was always about politics, not “inclusion.”

Exit quote:

UPDATE: That didn’t take long: Former NBA player Royce White says he is declaring for next WNBA Draft after Enes Kanter announcement. The former NBA player and Republican Senate candidate joins Enes Kanter Freedom in challenging the league.

JESUS PARABLE AND WASTE, FRAUD: United Citizens Foundation in Las Vegas got three federal grants between 2023 and 2025 totaling more than $937,000 dollars. The Department of Justice Inspector-General audited the grants and found more than $360,000 that should be returned to the government. The foundation’s COO offered in an interview with The Washington Stand a strong dissent to the government’s claims.

But the problems pointed out by the government struck yours truly as the kinds of things grant applicants should be screened for prior to a decision on who gets the federal tax dollars. More evidence that a major part of the explanation for the massive waste, fraud and corruption problem in federal spending lies with incompetent management by federal administrators.