2026-05-01 02:14:04
Daniel Reilly takes 19 pills in the morning and 13 at night. He lives with hemophilia and HIV, which he contracted in the 1980s. No one expected him to live this long.
In most respects, that’s a blessing—the product of generations of extraordinary medical advances. But it also means there are entire medical specialties he can’t find.
“I don’t know if there’s such a thing as [a] geriatric hematologist,” Reilly, who is 58 and retired, told me: a physician who would know what it means to age as a person with HIV contracted through a blood transfusion, with an understanding of the effects of decades of antiretroviral therapy on the body and blood—or how HIV-related comorbidities interact with the normal processes of getting old. Reilly recognizes how new, and unusual, his situation is: “The vast majority of us”—HIV-positive people with hemophilia—”who were infected in the early ‘80s have passed,” he said.
Reilly’s situation is emblematic of a gap in the medical infrastructure: a generation of people who, amid a variety of expanding and improving treatments, are the oldest ever cohort with their conditions. HIV patients, like Reilly, are a significant part of that. So are some with severe traumatic brain injuries, like social worker Brason Lee. Then there are the growing lifespans of those on dialysis, like retired judge advocate general Evelyn Dove Coleman, whose Air Force service also led to the inner ear disorder Menière’s disease.
As people with complex immune and neurological conditions age into their 60s and 70s, their lifespans are now often extending beyond the expectations of their doctors—and the design of the systems meant to support them. Health care professionals in most fields typically receive little training in disability, less in aging, and virtually none at the intersection of the two. And as federal Medicaid cuts reduce access to the home-and community-based services some aging disabled people depend on, many rely for their survival on networks of personal connections: siblings, spouses, neighbors.
Attacks spearheaded by RFK Jr. and Russell Vought strike at the kind of research that has let people like Daniel Reilly live far longer than anyone expected.
I spoke with Reilly; Lee, who is 63; and Coleman, who is 72—all of whom have lived with significant disabilities since before the age of 50—about their lives and their intricate medical realities, which involve both their disabilities and the normal processes of aging. All three were able to work: Reilly largely on the business side of specialty pharmacies, Lee in social work, Coleman as an attorney and JAG. They are navigating what it means to age into a system that, in many respects, wasn’t built with them in mind.
In 1986, when Reilly was diagnosed with HIV, the condition as he put it, “a death sentence.” He was 20. The stigma was unfathomably high. There was no approved treatment. He had contracted it through a blood transfusion for his hemophilia; he also contracted hepatitis C, since resolved, in the same way. “It was just kind of numbness and disbelief, because it all just kind of unfolded so quickly,” he said. Growing old with HIV—let alone getting married and having an HIV-negative child—seemed very unlikely.
The world has transformed for people with HIV. For those with access to treatment—in many cases endangered by the expiry of enhanced Affordable Care Act tax credits and by the rise of Medicaid work requirements—it’s now often a chronic condition rather than a fatal one. I spoke with Todd Brown, a physician and researchr who runs a lab at Johns Hopkins University examining the health of those living with HIV.
“In the mid-to-late ‘90s, good antiretroviral therapy became available, and so people are living longer, which is great,” Brown said. “But what we’re noticing is that people living with HIV have a higher burden of many common comorbid diseases, things like cardiovascular disease, liver disease, diabetes, lung disease, and the list goes on and on.” In Reilly’s case, the list includes Type II diabetes and chronic kidney disease.
Reilly’s search for a geriatric hematologist speaks to a less unusual predicament: a medical profession that has not caught up with its own patients.
Reilly is acutely aware of what his survival has required. During his daughter’s university homecoming, he fell and “crushed my left kneecap and broke my left elbow,” Reilly said. “For 12 weeks, I was in a stabilizer where they were waiting for the bone to grow back together…and my wife was there the entire time taking care of me. I wouldn’t be here if it weren’t for my wife. I really would not.”
His daughter Liv, who lives with her own chronic illness, has benefited from Reilly’s decades of hard-won knowledge. “He really has been sort of a guide on how to gracefully deal with it to the best of his abilities,” she told me.
Brason Lee’s introduction to life with a disability was sudden. At 18, he was riding his motorcycle without a helmet in San Diego when an accident left him in a coma for a week, in the hospital for a month, and with a severe traumatic brain injury for the rest of his life. He spent more than a year in intensive rehabilitation and many more months in and out of different types of therapy.
“When I first met my speech therapist, she said that I couldn’t write a complete sentence,” Lee recalled. Even that ultimately took him more than six months.
Lee went on to pursue an undergraduate degree, then a master’s, facing tremendous cognitive challenges and lifestyle adjustments on the way; he took seven years to complete his bachelor’s degree. Lee nevertheless excelled in internships and found steady employment as a social worker. But he didn’t marry until 40 and was, for much of that time, deeply lonely.
Now 63, Lee has developed a set of strategies for navigating daily life with his injury. He employs text-to-speech software to read documents aloud, tools designed for blind users that turn out to be tremendously valuable for people in Lee’s situation—and which did not exist in anything like their current form when he was first injured. And he relies on his wife, Ling, to organize other elements of his life.
But Lee now confronts newer cognitive issues, and faces fresh difficulties in trying to understand which stem from regular aging and which are long-term consequences of his traumatic brain injury. The difference in best-practice treatment could be major. But—not unlike Reilly’s challenge around geriatric hematology—the medical expertise simply is not there yet. It’s a distinction his doctors cannot yet make clearly, in which respect Lee is left waiting for new generations of researchers and physicians to develop answers.
A traumatic brain injury “is really one of probably lots of factors that go into developing aging, or dementia, or behavioral concentration problems down the line,” said Jared Knopman, a neurosurgeon at Weill Cornell Medicine in New York. “It’s really hard to narrow down this causative effect of TBI and aging.” Most research on traumatic brain injuries and aging focuses on people who sustain them when older, leaving a significant gap in understanding the long-term trajectory of people like Lee, who have lived with severe cases for decades.
“In health care in particular, there is very limited education or training of any professional at any level of care specific to aging. And there’s very, very little specific to disability.”
Coleman, the former judge advocate general, faced prolonged noise exposure at her Air Force base. That led to Menière’s disease, eventually resulting in deafness in one ear. Her experience with hearing-related disability as a veteran is far from unique: Approximately 1.3 million veterans receive compensation from the Veterans Administration for hearing-related disabilities. “Most of these veterans have a hearing loss that’s not only difficulty hearing soft sounds, but also not being able to listen to speech and engage in conversations and environments that are most important to them,” said Victoria Sanchez, a clinician-scientist in the University of South Florida’s Department of Otolaryngology. Those difficulties are associated with loneliness and social isolation—which in turn is linked with accelerated aging.
Coleman knows that Menière’s also puts her at risk of falls, another major concern for aging adults. But that has nothing on her experience with kidney disease, for which Coleman received a kidney transplant in late 2024. Life expectancy for dialysis, which she requires, has risen significantly in recent years, from well under a decade to as much as 30 years.
Still, said Coleman, who used to run five-kilometer races, “You can’t be carefree and just run around and do what your mind wants to do. You have to follow what your body is able to do.”
That’s made possible for Coleman above all by her sister, Dee, who moved to Coleman’s home in North Carolina to help care for her, managing her medications and providing the daily oversight that Coleman’s medical situation requires; by her brother, Bill, who credits their walks with keeping his sister’s spirits up when they’re together; and by her faith and community volunteer work.
The support networks that Reilly, Lee, and Coleman rely on are not incidental to their survival. They don’t lack for community. (All three also have meaningful relationships with their adult children.) But many disabled people do experience gaps in community that could be substantially addressed—and in other contexts has been—with more robust federal and local support for social services. It’s a structural failure in particular for people who, like them, contend with complex medical needs.
Michelle Putnam, director of the Gerontology Institute at the University of Massachusetts, Boston, described a compounding dynamic: many disabled people are excluded, earlier in their lives, from environments where adult relationships are normally built.
“One of the challenges for anyone growing older is sort of when you leave the sort of common pathway, whether it’s education or work, you sort of move outside of formal groupings,” Putnam said. “And for younger people with disabilities, they may have had difficulty getting into those pathways in the first place because they didn’t have employment or had trouble having access into groups and organizations.”
For aging people with multiple disabilities, that can mean a more limited social fabric at exactly the time when it’s most needed. That Reilly, Lee, and Coleman are, in important ways, exceptions to that rule is partly why it was possible to talk to them at all: they have strong ties that let them manage their conditions exceptionally well, and that have helped them beat the odds.
The underpinning of future breakthroughs is being dismantled.
The data for the wider population is less promising. Not only is social isolation linked to accelerated aging, with physical inactivity (which many disabilities compel) and disrupted sleep (which many disabilities cause) among the contributing factors, but adults in the United States already face exceptionally high levels of loneliness: around one in three US adults between 50 and 80 reported a lack of companionship, in a society that is unaccommodating of informal networks of care.
For disabled people, finding community can be exceptionally difficult—the product of inaccessibility, difficulty with transit and commutes, and rising sentiment against, or simple failure to create, the kinds of remote activities that became commonplace during Covid stay-at-home orders.
“Social isolation and loneliness are recognized as a national and global public health concern, adversely impacting physical, cognitive, and mental health, quality of life, health care expenditure, and longevity across the lifespan,” said Cecilia Poon, a geropsychologist and the chair of the American Psychological Association’s committee on aging.
Senior centers, a legacy of the Johnson administration’s Great Society initiative, address some of those needs: training for caregivers, support with public benefits, and potential training sites “for health education and caregiver support programs,” Poon said. But the overall gap in community support for aging disabled people is matched by gaps in how the health care system itself is equipped to treat them.
“What we can say pretty clearly is that in health care in particular, there is very limited education or training of any professional at any level of care specific to aging,” Putnam told me. “And there’s very, very little specific to disability.”
There is also, she said, inadequate research on how disabled people who have been disabled since before age 50 are faring in the health care system and what their specific needs are. Reilly’s search for specialties like geriatric hematology is part of a wider predicament: a medical profession that has not fully caught up with its own patients.
That deficit ties back to a broader dynamic examined in a 2024 study in the journal Gerontologist: the link between ageism and ableism. Surveying nearly a thousand people, researchers found that ageism was associated with ableism, including among older adults who had internalized ageist beliefs about themselves. Positive feelings toward older adults were associated with lower rates of ableism—suggesting that those forms of discrimination are mutually reinforcing, and that efforts to reduce one may help reduce the other.
“Public policy initiatives to address community-level interventions and targeted training to inform discourse about ageism and ableism are critical,” the researchers wrote. That intersection may also help explain why some aging disabled people do not identify as part of the disability community at all.
The population at stake is not small. According to the Census’ 2024 American Community Survey, more than 7.5 million people living outside of institutions over the age of 65 have a disability that makes living independently difficult, over a tenth of that age group. As disabled people with complex health issues live longer, that number will grow. And it will grow during a period when home- and community-based services will be cut across every state as a consequence of sweeping attacks on, and reductions to, Medicaid services.
Then there’s the cost of being disabled. What the disability community calls the Crip Tax is already a constant pressure: mobility devices that insurance won’t cover, cumulative costs of medications, like the more than 30 that Reilly takes, and transit services like rideshares for those who need them. Many disabled people, as Rebecca Cokley wrote in the Nation, are forced to work until they die, purely as a consequence of the cost of living. Those systemic issues are daunting and arguably disabling in themselves.
All the while, biomedical research is being cut by the Department of Health and Human Services under Robert F. Kennedy Jr., and elsewhere in the administration by Office of Management and Budget director Russell Vought, among others in the Trump administration. Their attacks strike directly at the kind of research that has made it possible for people like Reilly to live far longer than anyone, themselves included, were led to expect. The underpinning of future breakthroughs is being dismantled.
Still, for Reilly’s wife, Jacque, who has been with him since the early 1990s—in a life made possible by radical medical progress—those existing wins are a source of hope: “a vision for the future of what could be possible,” in her words.
Those breakthroughs require a health care infrastructure designed to preserve and build on them, with professionals trained to treat the people who benefit from them, and support networks that are better-funded and less at the mercy of election cycles. Living for decades with conditions like Reilly’s is no longer unimaginable. In a growing number of cases, it is simply what aging looks like, amid systems that have yet to adapt.
This article was written with the support of a journalism fellowship from the Gerontological Society of America, the Journalists Network on Generations and the John A. Hartford Foundation.
2026-05-01 01:39:00
On Wednesday, the Supreme Court dealt a death blow to the country’s most important civil rights legislation, the Voting Rights Act of 1965—the law that defeated Jim Crow.
For 100 years, from 1865 to 1965, Black people were systematically and actively excluded from participation in American democracy through racial violence, but more commonly through race-neutral tricks like poll taxes and grandfather clauses. Governments across the country also used redistricting to dilute the Black vote without ever having to talk about race explicitly.
That’s what Section 2 of the Voting Rights Act, enacted federally, went after: The slippery tricks deployed to destroy the political power of Black folks and other people of color—especially in the South.
And the Supreme Court just took us right back to that time.
The majority opinion in the case, Louisiana v. Callais, struck down the creation of a second majority-Black congressional district in Louisiana. In so doing, the court rendered Section 2 of the VRA basically useless, making it nearly impossible to prove that a gerrymandered map violates the right of voters of color.
As soon as this decision dropped, I knew exactly who I wanted to talk to. My colleagues Ari Berman and Pema Levy are two of the sharpest minds reporting on voting rights and the Supreme Court in the country. And they were clear: This is bad. “Today is so heartbreaking because we’ve been writing about this for so long,” Pema told me. “And this just really feels like the final nail in the coffin.”
“When we weaken the Voting Rights Act, we don’t just weaken one law,” Ari agreed, “we weaken the very fabric of American democracy.”
The two went on to explain the staggering potential costs of the decision. “Who needs poll taxes and literacy tests if you have partisan free for all?” Pema explained. “If your partisan designs trump everyone else’s rights, then you can just, under the guise of partisan gerrymandering, eliminate the voting rights of minority voters simply because they don’t vote for your party. It is absolutely a Jim Crow tool now.”
“We could see the largest drop in Black representation since the end of Reconstruction,” Ari warned. “We could lose a third of the Congressional Black Caucus.”
Our sobering conversation about the Supreme Court, the Voting Rights Act, and the future of multiracial democracy is above. I got a lot out of this, and I hope you do too.
2026-05-01 01:24:20
OpenAI admitted it had to develop a specific instruction in the code of its latest model of ChatGPT to stop it from repeatedly referencing “goblins, gremlins, and other creatures.”
In an explanation posted Wednesday, the company said the “strange habit” came from its chatbot personality feature—specifically for users who chose the “Nerdy” personality. According to OpenAI, this personality receives the following prompt from its system:
You are an unapologetically nerdy, playful and wise AI mentor to a human. You are passionately enthusiastic about promoting truth, knowledge, philosophy, the scientific method, and critical thinking…You must undercut pretension through playful use of language. The world is complex and strange, and its strangeness must be acknowledged, analyzed, and enjoyed. Tackle weighty subjects without falling into the trap of self-seriousness.
OpenAI said it first noticed the trend last November and some users said they found increased “goblin” references over newer model releases, even beyond the “Nerdy” personality.
Some exact quotes that users reported:
Through “reinforcement learning,” where the chatbot accounts for whichspecific responses receive high rankings from human evaluators in terms of accuracy and quality, the “playful” responses performed better.
As Wired first reported Tuesday, the latest ChatGPT model, released last week, included the instructions: “Never talk about goblins, gremlins, raccoons, trolls, ogres, pigeons, or other animals or creatures unless it is absolutely and unambiguously relevant to the user’s query.” OpenAI did not immediately respond to Wired’s request for comment but the same day the report was published, Sam Altman posted a meme on X, making light of the situation by joking that the upcoming GPT-6 would have “extra goblins.”
After the company explained its troubleshooting process and how it implemented the override instruction to reduce goblin-related outputs the next day, it stated in its Wednesday post that “taking the time to understand why a model is behaving in a strange way, and building out ways to investigate those patterns quickly, is an important capability for our research team.”
The explanation may bring to mind how Elon Musk’s Grok chatbot repeatedly brought up “white genocide” in South Africa. Although xAI stated that Grok’s responses were due to an “unauthorized modification” from an employee, chatbot models should not be that easily manipulable if user safety was an actual concern.
Despite all this, the company is pushing for less regulation of its products while simultaneously acknowledging that it is still learning how its chatbot models work. As I wrote on Monday, Sam Altman and OpenAI have publicly wiped their hands of the detrimental effects their products are costing people now and have demonstrated a blatant disregard for potential lasting impacts.
A true embrace of goblin mode.
2026-04-30 23:48:12
In a brief ruling late Wednesday, a Texas appeals court panel declined to immediately turn over Infowars, the conspiracy empire founded by Alex Jones, to a federal receiver, pending further court proceedings. That receiver had previously signed a deal with the satirical news site The Onion to take over Infowars’ physical and intellectual property; the emergency ruling puts that plan in jeopardy. The stay was first reported by Ben Mullin, a media reporter at the New York Times. The ruling does not, however, save Infowars, which is expected to stop broadcasting today, because no one is currently paying the rent. Jones said in a video posted on X that April 30 would likely be the company’s last day of operation.
Global Tetrahedron, the company who owns The Onion, announced earlier this month that they’d reached an agreement with the federal receiver overseeing Infowars, Gregory S. Milligan. The terms of that deal would allow a new LLC created by Global Tetrahedron to lease Infowars’ physical studio as well as its intellectual assets, but at the time, the plan still needed to be agreed to by a judge. In a motion last week, attorneys for Milligan said that the Sandy Hook families, to whom Jones and Infowars owe more than $1 billion in defamation judgments, support the plan. The Infowars studio rent, per the motion, costs $81,000 each month.
The Sandy Hook families have not yet been paid a dime of what they are owed.
On Thursday, Jones said on X that the receiver was no longer paying the rent or any other bills associated with the property. Jones has vowed for years that if Infowars is ever shut down, he’ll immediately begin broadcasting at a new studio; he’s also been selling products on a new site, Real Alex Jones, and encouraging supporters to donate money to him there to keep him on air. On Wednesday night, he celebrated the ruling on X, writing, “We Give Thanks To God and Infowars’ Supporters For Standing Against These Pathetic Weasels.” He also directed listeners and viewers to a new website, while stressing that the new site “was not Infowars.”
“I am the Infowar,” he declared. “You are the Infowar.” True to form, Jones then went on to falsely claim that the FBI and CIA were secretly behind the original civil lawsuits filed against him and the company.
This is the latest development in Jones’ and Infowars’ ongoing legal sagas, after the company lost a series of defamation lawsuits by default in both Texas and Connecticut. The suits were brought by the families of children and school personnel who died at Sandy Hook. Jones maintained for years that the shooting, as well as numerous other mass casualty events, were hoaxes. He’s inconsistently admitted that he was wrong in making those claims. Jones and Infowars both filed for bankruptcy protection in 2022; since then, the Sandy Hook families have not yet been paid a dime of what they are owed.
In a statement on Bluesky, Onion CEO Ben Collins said the Texas ruling had “created… an unprecedented situation” where “no one knows who is in charge of InfoWars, and therefore no one can pay rent.”
“Since no one controls these assets right now, it does appear InfoWars will shut down tonight at midnight,” Collins continued, adding that the Sandy Hook families are seeking relief in several different courts. “We’re hopeful they will resolve this immediately so we can take over and pay these families.”
2026-04-30 20:00:00
Over the last few months, Trader Joe’s has pulled thousands of cases of focaccia bread and frozen fried rice from its shelves for potentially having fragments of metal or glass, respectively. If that makes you a little nervous about stocking up on other TJ favorites like cookie butter and Everything But the Bagel crackers, you’re not alone. (Trader Joe’s website notes that the company takes “these matters seriously—personally, even.”)
Monti Carlo, a chef who breaks down food recalls on her Substack, told me in November that at one point during the fall, it felt like there were too many recalls for her to keep track of. There was a listeria outbreak in prepared pasta meals, an infant botulism outbreak in ByHeart whole nutrition infant formula, and a recall of certain corn dogs and sausage-on-a-stick products for potential pieces of wood in the batter. “You have to ask yourself, ‘What is going on?’” Carlo said.
According to experts, the answer is complicated. For the past year especially, food safety has been in turmoil.
Last fall, the 43-day government shutdown led to the furlough of over 30,000 employees at the Department of Health and Human Services, stalling public health communications from the Centers for Disease Control and Prevention and delaying inspections of food facilities. Then there was the Trump administration’s layoff of 3,859 FDA and 2,499 CDC employees by the end of 2025, as part of Secretary Robert F. Kennedy Jr.’s restructuring of the Department of Health and Human Services in accordance with the DOGE effort to cut costs.
Firing all the epidemiologists wouldn’t get rid of foodborne illnesses, it would just stop us from knowing about them.
While it isn’t totally clear yet how the shutdown and layoffs will affect the food safety system, when a system on the brink loses thousands of workers, it creates fractures in an already delicate food system. In a March 2025 Consumer Reports article, food safety experts in and outside the agency agreed “that the food program’s budget was already inadequate to carry out the amount of oversight required even before the new administration took over.”
For animal products like meat and poultry, food safety regulations are created and maintained by the USDA Food Safety and Inspection Service, while the safety of all other food products is overseen by the Food and Drug Administration. Many USDA facilities are under continuous inspection, but the FDA may visit each facility only once a year, leaving much of the daily oversight to food manufacturers. State and local health agencies may be the first to identify cases of illness and determine the cause to be foodborne. Sometimes the FDA will delegate food manufacturer inspections to these agencies, but its main purview is typically the inspection of the retail food industry. When illness cases in different states are linked, the CDC will often get involved to coordinate an investigation and contact the appropriate agencies once an issue is identified.
It’s a fragile system that becomes even more tenuous in situations like last year’s multistate listeria outbreak in prepared pasta meals. Donald Schaffner, an extension specialist in food science and professor at Rutgers University, recalled how that outbreak was an eye opener because it happened at a company making fresh pasta for meals, which made it an FDA-regulated company, but because the pasta might have been used to make a fresh or refrigerated entree that has meat in it, that became a USDA issue. They were still able to unravel the threads, but it showcased just how intertwined, and occasionally arduous, the system oversight can be.
The ultimate hope is that with these overlapping systems in place, all food will be safe, but it’s not perfect. It’s unnerving to have to worry about whether the food you’re eating is safe, and most foodborne illnesses are identified first by the consumer—once they’re already sick.
“We have recalls as a last recourse. Everything else that we need to do in order to produce a safe food product must be done,” said Angela Anandappa, founding executive director of the industry nonprofit Alliance for Advanced Sanitation. “And the worst-case scenario is for someone to get sick and die.”
Despite how unnerving a recall might be, experts argue that it might be a good thing that we’re still seeing them, because that means there are still people within the government doing the work to keep our food safe.
Schaffner noted that firing all the epidemiologists wouldn’t get rid of foodborne illnesses, it would just stop us from knowing about them.
“If you undermine those resources, things could get worse, and probably will get worse, and you might not even know it, because the people who are keeping track of whether it’s getting better or worse no longer work for the federal government,” he added.
When you see a new food recall, don’t take it lightly, but also remember that it means there are still food safety specialists working hard to make sure your food is as safe as it can be.
2026-04-30 19:30:00
Dr. Richard Pan is no stranger to blood. As a pediatrician, he was trained for its inevitability. But unlike your average medical professional—and despite his approachable and buoyant demeanor—he’s had menstrual blood launched at him in protest. He’s been assaulted on the street by a person livestreaming the attack on Facebook. He’s been the subject of racist memes comparing him to Asian despots. He’s encountered demonstrators clad in T-shirts depicting his face smeared with blood. He’s gotten plenty of death threats, too.
Oh, and by the way, he’s running for Congress.
What’s with the hate? Most of it stems from the fact that during his tenure as a California state senator, Pan authored some of the nation’s strongest vaccine laws. In 2015, he introduced legislation that nixed the ability of parents to use “personal beliefs” to exempt their children from the routine immunizations required for public school enrollment. Four years later, he wrote a bill cracking down on fraudulent medical exemptions for vaccines, which passed despite protesters’ clamorous attempts to shut down the Legislature. “They brought the militia to the capital,” Pan recalls.
“I like to say I met RFK Jr. twice. I debated him twice. I beat him both times.”
“When we came out of the hearing room, I was shaken by the level of vitriol, and I was almost in tears—but Dr. Pan was so calm,” says Leah Russin, a parent who, concerned about high rates of vaccine exemptions in California schools, began working with Pan to generate support for the 2015 bill.
Opponents had been bussed in from around the state—mostly mothers who described their children as “vaccine-injured”—to address lawmakers in Sacramento. As anti-vax firebrands yelled into the microphone and religious leaders promised imprecatory prayers, Pan stood and listened calmly. “It was like the ocean lapping against a wall without eroding it at all,” Russin remembers.
This scene repeated in 2019, but escalated to include the blood throwing and even a bodily assault. “It was the roots of what we now call the MAHA movement,” Russin says, and Pan endured their “crucible.”
Pan, now 60, his dark hair peppered with gray, ditched his usual coat and tie for our interview, opting for a crisp blue Oxford shirt. He has never been too rattled by the vitriol, he tells me: “When you resort to violence, then I think you’ve already admitted you’ve lost the argument.”
After four years in the California Assembly and 12 in the state Senate, Pan termed out and took a hiatus from politics—returning to his teaching post at UC Davis School of Medicine. But the rise of the vehemently anti-vaccine Make America Healthy Again movement and its erratic figurehead, Health and Human Services Secretary Robert F. Kennedy Jr., has compelled him to jump into the national ring, where his résumé, unflappability, and knowledge of vaccine science and its deniers make him uniquely qualified to push back.
Having tousled with the anti-vax movement for decades, Pan has watched it shift from a hodgepodge of religious fundamentalists and lefty hippie types toward a more violent, right-leaning contingent obsessed with personal freedoms and urged along by peddlers of bogus cures. “As a physician,” he says, “I learned a lot about both the diseases and the vaccinations themselves, but I had to learn more about this anti-vaccine—not just ideology, but all their myths.”
Suddenly, “the concept of a health system broadly not meeting someone’s needs clicked in his mind—you could see the world open up to him.”
This knowledge, he believes, is his best weapon against vaccine dissenters, including RFK Jr., who butted heads personally with Pan after showing up in Sacramento to argue against his public health bills. “I like to say I met him twice. I debated him twice. I beat him both times,” Pan says. The first time was a true debate; the second not so much. During a hearing on his 2019 bill, other anti-vax witnesses didn’t leave enough time for Kennedy to speak. Sitting next to the pediatrician, he grumbled something, whereupon Pan said, “It’s not my fault. You know that your guys didn’t figure this out.”
A 15-minute slot on the floor of the California Senate is one thing, but Kennedy has since gained a powerful national platform—watching him spew misinformation during a raucous four-hour Senate hearing last September served as the final straw for Pan’s return to politics. Soon after, Pan announced he would run for the House of Representatives, challenging Republican incumbent Rep. Kevin Kiley in California’s Third congressional district.
The 3rd District contained a sliver of left-leaning Sacramento, where Pan lives, along with a large tract of the more conservative Eastern Sierras. But he’d flipped a Republican seat during his first bid for elected office. Maybe he could do it again? Plus, Gov. Gavin Newsom was mounting a campaign to redraw California’s electoral map in response to an aggressive gerrymandering effort by Texas Republicans. The political landscape Pan was launching himself into was about to be overhauled.
The child of Taiwanese immigrants, Pan was born in Yonkers, New York, and raised in Pittsburgh. He knew he wanted to be a doctor since the third grade, he remembers, after he read a book from the school library about (of all things) blood. It took another few decades for him to find his penchant for politics, but he began straying from the conventional med-school track while studying biophysics at Johns Hopkins in the late-1980s.
He had taken up a genetics research project between semesters, but another lab published findings that made it moot. “Oh, great, now I have to find a new project for the summer,” Pan recalls thinking.
That’s how he began working with Gerard Anderson, a professor of health policy who needed help collecting data for a book on how Medicare can fail to meet the needs of people with multiple chronic diseases. “I would have never anticipated him going into politics,” Anderson told me.
The trauma of ICE’s abuses isn’t limited to “the person it happened to,” Pan says. “It’s the person who’s witnessed it. It’s the person who hears about it.”
Pan had people skills, his former mentor recalls, but was overly focused on the details. “In biophysics, you’re dealing with very minute, specific topics,” Anderson explains. But as Pan delved deeper into the work, “all of a sudden the concept of a health system broadly not meeting someone’s needs clicked in his mind—you could see the world open up to him.”
Pan likes to say that he traded a micro view of health for a macro one: “We need people to discover the next great cure. We also need people to work on being sure people can get access to those great cures.”
To that end, he spent his summers during medical school on rotation with the Commissioned Corps of US Public Health Service, which places medical professionals in regions of the country that are experiencing public health crises. His first assignment was in a Pennsylvania trucking town, where the locals weren’t too concerned with infectious disease; they wanted officials to address an epidemic of domestic violence. The next year, the Commissioned Corps dropped him into a Philadelphia-area clinic at the center of a measles outbreak fueled by fundamentalist churches whose congregations refused to vaccinate their children. These experiences, Pan says, “really made me think about social determinants of health before that name was popular.”
This public health lens informed his work on a range of policies, even ones with seemingly no medical connection. His core issues as a state legislator, including affordability, housing, and violence prevention, are also prominent features of his House campaign—as is countering President Donald Trump. But Pan says he doesn’t view his opposition to the administration’s agenda as separate from his medical obligations.
Part of his work as a pediatrician—he continues to treat low-income children at the Sacramento County Health Center—is to determine whether his young patients have experienced trauma. Because unaddressed, trauma is itself a risk factor for the kinds of chronic diseases RFK Jr. and Trump promised to tackle. (In fact, the administration has slashed research grants to scientists who study them.) And now, on Trump’s watch, we have “armed, masked agents going around breaking into people’s houses without warrants, breaking into people’s cars, children worried that their parents may not be home when they come home from school,” Pan says. “Think about the chronic impact of that trauma.”
“It’s not just to the person it happened to,” he adds. “It’s the person who’s witnessed it. It’s the person who hears about it—that our own federal government is in defiance of our Constitution.”
There’s no shortage of ways to portray the second Trump administration as a threat to people’s wellbeing, but its detrimental actions on vaccines and health coverage, in Pan’s view, are only a part of why medical professionals should feel obliged speak out. Because policies that make people fear for their rights and freedoms constitute their own public health crisis.
The anti-vaxxer stalking Pan wore a T-shirt depicting Pan’s face splotched with blood, and the word “LIAR” sprayed across his glasses.
Congress has its share of physician members, but the majority of the 20 currently serving are Republicans. And most have supported Trump despite his detrimental public health policies and appointees. The Senate’s four MDs all voted to confirm RFK Jr., for example. But the rise of MAHA and the Republican gutting of Medicaid have prompted other doctors to launch Democratic congressional bids—counting Pan, at least three are running in California.
After voters approved Newsom’s redistricting plan, the district Pan had planned to run in, the 3rd, suddenly tilted liberal. A game of musical chairs ensued. Democratic Rep. Ami Bera, the incumbent in the adjoining 6th District, announced a run in the 3rd. So Pan pounced on the 6th.
His prospects look decent: 70 percent of voters in the newly drawn 6th already know Pan pretty well—they’re his former constituents. And as the dust settled, Pan secured several key endorsements, including from the Sacramento Bee. Still, the race is anything but decided, especially now that Pan may get his matchup with a conservative incumbent.
Last month, Kiley announced he, too, would run in the 6th—not as a Republican, but as an independent. His incumbency in the 3rd has given him a big money advantage. As of late March, per the most recent disclosure report, he’d raised nearly five times as much as Pan or Thien Ho, the Sacramento County district attorney who is also running as a Democrat and is slightly ahead of Pan in fundraising. But Kiley’s rebrand may not be enough to get him elected in the freshly left-leaning 6th. He was endorsed by Trump in 2022, and has consistently voted with his conservative colleagues in the House.
In some ways, the challenges Pan will face in Congress if elected are not that different from what he confronted as a state legislator. He drafted the 2015 vaccine bill in response to a nonfatal measles outbreak in Disneyland, then the largest since 2000, when the Centers for Disease Control and Prevention declared the virus eliminated in the US. But that outbreak was only about 3 percent as big as the ongoing wave, which has resulted in 4,080 confirmed cases, 344 hospitalizations, and three deaths since the beginning of 2025. Roughly 93 percent of those afflicted were unvaccinated.
A few months into Trump’s first term, Pan and Russin got on a plane to attend the first March for Science in DC. They weren’t the only envoys from California’s vaccine wars. As they ambled down the National Mall with the rest of the procession, two familiar faces caught up. One was Joshua Coleman, a prominent anti-vaxxer from the Sacramento suburbs, and the other was Pan’s: Coleman’s sign and T-shirt bore a depiction of Pan’s face splotched with blood, and the word “LIAR” spray painted across his glasses.
Coleman has been a “perennial person,” Russin told me. Even after getting into legal trouble, he kept popping up, sometimes donning Star Wars-themed costumes that obscured his identity. He followed Pan throughout the march, shouting accusations and documenting his actions for a 30-minute highlight reel he later published on YouTube. At the end of the video, Coleman stands on a DC sidewalk in the rain, beaming: “I ruined his day!”
Well, maybe. Much of the rest of the video consists of Pan strolling down the Mall in his white coat, chatting with other science supporters and taking pictures with fellow physicians, despite Coleman hovering just a few feet behind. Beyond the occasional moment when Pan gestures toward the camera with a shrug, Coleman might as well be invisible—at least to Pan. Other science-minded demonstrators circle by with uneasy looks. A few bold ones block Coleman’s camera and ask him to leave.
All of this happened before anti-vax influencers helped convince nearly a third of Americans surveyed that childhood vaccines do more harm than good, before some of those right-wing skeptics were placed in key public health posts, and before Pan’s opponents began resorting to violence.
Yet though the political power dynamics have shifted immensely in a relatively brief period, Pan doesn’t plan to change how he responds. “To a certain degree,” he says, “some of the threats that I get are no longer about me. It’s about scaring other people, because they know I won’t give in.”
