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In Ukraine, a Nuclear Plant Held Hostage

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In Ukraine, a Nuclear Plant Held Hostage

KYIV, Ukraine — Within the winter darkness, tracer rounds from Russian armored autos streaked previous nuclear reactors and high-tension electrical strains. A fireplace broke out. Shrapnel sprayed a reactor containment vessel.

Within the management room of Reactor No. 3, operators had been horrified.

“Cease firing on the nuclear facility,” one begged over the station’s loudspeakers. “You’re endangering the security of all the world.”

The hazard on the Zaporizhzhia Nuclear Energy Plant — a sprawl of cooling towers, nuclear reactors, machine rooms and radioactive waste storage websites — was truly graver than even those that labored there knew, in early March, simply days after Russian forces invaded Ukraine.

A big caliber bullet had pierced an outer wall of Reactor No. 4 however, most worrying and never disclosed on the time, an artillery shell had struck {an electrical} transformer at Reactor No. 6, which was crammed with flammable cooling oil, plant staff subsequently realized and instructed The New York Occasions. Each reactors had been energetic.

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Standing between the world and a nuclear calamity are the Ukrainian staff who know the plant intimately, having run it for years with the utmost precaution in a sleepy nook of southern Ukraine the place the town and the plant had as soon as lived in a gentle and predictable symbiosis earlier than the Russians arrived.

Right this moment, underneath Russian occupation, the plant staff are each hostages and important staff — Ukrainian engineers obligation sure to stop catastrophe whereas working underneath the watchful eye of Russian snipers.

The encompassing metropolis the place they reside, Enerhodar, which interprets as “the present of vitality,” is underneath siege. Some 100 plant staff have been detained by Russian forces, in response to Ukrainian officers and residents. Ten of these are nonetheless lacking.

It’s as much as a skeletal crew of pressured, drained and scared staff to stop catastrophe.

“Think about women and men coming to work and dealing with armed troopers throughout,” stated Serhiy Shvets, a metalworker on the plant who was shot by Russian troopers at his house in Might. That they had searched movies of people that protested within the first days of the conflict, and noticed his face.

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Mr. Shvets, 53, managed to get out of the town and to Ukrainian-controlled territory, the place he spoke from his hospital mattress. He fears for the plant, the town and the world with the Russian navy now holed up within the nuclear station.

“They’re like a monkey with a grenade, probably not understanding the risk they’re posing,” he stated.

Two months earlier than the Russian invasion, Enerhodar celebrated an annual vacation distinctive to a group residing within the shadow of Europe’s largest nuclear energy plant: “The Day of the Vitality Engineer.”

There have been dinners, music, dancing and a fireworks show. “It was enchanting and funky,” stated Olha, an engineer who attended the celebrations and fled the town in Might, however relayed communications from these inside.

Like different staff of the plant interviewed for this text, Olha would communicate solely on the situation of anonymity out of concern for her security.

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In a metropolis of 55,000, some 11,000 individuals labored on the plant. The town’s flag even includes a blazing solar in tribute to the vitality it supplies.

Work on Zaporizhzhia started in 1984. When the sixth reactor got here on-line in 1995, 4 years after the collapse of the Soviet Union and Ukraine’s independence, Ukrainians celebrated Zaporizhzhia as an accomplishment.

It grew to become each a supply of satisfaction and an emblem of Ukrainian perseverance within the impoverished, early post-Soviet years and the aftermath of the 1986 Chernobyl nuclear catastrophe, which occurred when a security take a look at simulating the results of an influence failure resulted in what many thought-about to be the world’s worst nuclear catastrophe.

After Chernobyl, and after Ukraine’s independence, the authorities issued a short moratorium on nuclear development, but it surely was not lengthy earlier than the nation cast forward with its nuclear ambitions. Right this moment, Ukraine is second solely to France in counting on its reactor community to satisfy its electrical energy wants.

A singular achievement, the Zaporizhzhia website has distinctive vulnerabilities, as effectively.

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The large plant was conceived within the Soviet industrial design philosophy referred to as Gigantism, giving delivery to a panorama of business prowess, the place a lot of what would appear to be the plant’s internal workings are uncovered, rendering it particularly weak to the battle now raging round it.

From the alternative shore of the Kakhovka reservoir, the cooling towers, smokestacks and containment vessels appeared by way of a haze on a current summer time afternoon, contrasting with the light valley of sunflower and wheat fields and rolling hills alongside the Dnipro River.

Zaporizhzhia has its personal radioactive waste storage system, which was established in 1999 with Western backing as a strategy to finish reliance on Russian reprocessing of spent gas.



What we think about earlier than utilizing nameless sources.
How do the sources know the data? What’s their motivation for telling us? Have they proved dependable up to now? Can we corroborate the data? Even with these questions happy, The Occasions makes use of nameless sources as a final resort. The reporter and no less than one editor know the id of the supply.

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That storage website poses an particularly disastrous threat in the present day.

Given the delicate nature of the work, nuclear energy vegetation are supposed to abide by seven pillars of security — making certain the plant’s bodily integrity, holding security programs absolutely purposeful, sustaining a employees freed from undue stress, preserving dependable logistical chains, monitoring on-site and off-site radiation and sustaining dependable communications with outdoors regulators.

Practically all these ideas at the moment are being violated, in response to the Worldwide Atomic Vitality Company.

“The primary situation for working a nuclear plant is calm,” stated Dmytro Gortenko, a human sources government who labored within the plant’s administration constructing. “It ought to all the time be calm,” he continued. “Proper as much as having every part calm at house, in an worker’s house life. When an individual is calm, he makes higher selections. In a state of stress or concern, an individual makes errors.”

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Mr. Gortenko has labored on the plant for 21 years, rising from being an engineer to overseeing the licensing for reactor operators. For him, like many others, work on the plant was a household affair. His father had been a guard, and his mom a librarian for technical paperwork, the identical place his spouse additionally held.

The town and the plant functioned in sync. There have been common security drills on the plant and for these residing and dealing close by.

Mr. Gortenko and different staff rode the corporate buses to the work, handed a safety checkpoint by swiping a card and turned into uniforms — white for scientists, grey for supervisors, blue or black for others. Employees ate at firm cafeterias.

Every “block,” or reactor and machine room advanced, required about 600 staff, he stated. They labored in three eight-hour shifts that rotated from morning to night to in a single day, often scheduled months upfront.

The tradition was one among vigilance and a spotlight to element, he stated. Even minor accidents had been meticulously documented.

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Like a sleeping large, the plant and its perilous reactors had been stored freed from all disturbances.

However the plant’s occupation by armed Russian forces whereas combating rages outdoors will not be an emergency that they had anticipated.

Mr. Gortenko was there that March evening when the Russians stormed the plant. When the capturing was over, he arrived to seek out half the home windows in his constructing shattered from shrapnel and gunfire.

An icy wind blew by way of the workplaces.

Employees taped plastic over the damaged panes and resumed their duties. Russian troopers, he stated, appeared now and again. At first, he didn’t see them threatening staff, however they had been armed.

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By spring, nonetheless, the workers had been coming into the plant underneath the watchful eye of Russian snipers, in response to messages shared with The Occasions.

“Russian snipers take positions on the roofs of the station’s buildings,” was the message despatched to Olha, the engineer. “The workers are actually working at gunpoint.”

An estimated 500 Russian troopers are on the plant, in response to witnesses and a Western official. They’re believed to be members of the Rosgvardiya, in response to the senior Western official, who’ve a repute for brutality.

After they arrived, the Russian troopers tore down the city’s flag — together with a Ukrainian flag flying above Metropolis Corridor — and put instead the Russian tricolor and the hammer and sickle of the previous Soviet Union, in response to residents.

Residents say the Russians have been seen ingesting, looting and detaining anybody for expressing even a whiff of protest. Throughout the close-knit firm city, individuals shut themselves at house as tales of buddies gone lacking multiplied.

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“There was a case the place an individual was taken into the forest they usually shot close to him” in a mock execution, Mr. Gortenko stated of a detainee’s ordeal he had heard about by way of kin. “That they had lists of individuals.”

“I personally know one man who went lacking in March, and there’s no details about him,” stated Olha, the engineer. “One other man was taken to the commandant’s workplace for interrogation and crushed to loss of life.”

After the younger man was killed, she stated, the Russians known as his mom and instructed her to come back accumulate his physique.

The repression has grown alongside partisan resistance to the Russian occupation on the town, including to the swirl of violence. On Might 22, Andrii Shevchyk, whom the Russians had put in as mayor, was injured in a bombing outdoors his condominium.

The following day, Russian troopers confirmed up on the entrance door of Mr. Shvets, the metalworker, and shot him. Mr. Shvets stated he had no connection to any organized insurgency however he did employees the barricades, together with tons of of different plant staff, as Russians approached the town.

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Harried, fearful for his or her households, staff on the nuclear plant nonetheless turned up for work within the reactor management rooms, pumping stations and turbine compartments.

Because the Russians tightened their grip on the plant and the town, officers at Energoatom, the Ukrainian firm that oversees the nation’s 15 nuclear reactors, decided to permit some nonessential employees to depart.

In April, the corporate additionally determined to distribute its whole stockpile of potassium iodide, a drug that may defend individuals from radiation-induced thyroid most cancers.

The Ukrainian authorities are additionally revising evacuation plans for about 400,000 individuals residing in Ukrainian-controlled territory that might more than likely be within the radiation fallout zone within the occasion of a meltdown.

Fight has returned to the plant once more, with artillery shells hanging the station grounds. Explosions are heard continuously, staff say.

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On Monday, Ukrainian officers stated that there had been shelling once more close to the plant and {that a} man had been killed and several other others injured when Russian troopers opened fireplace on their automobile at shut vary.

The violence has set off a determined exodus of these residing there, and on whom the peaceable functioning of the plant relies upon.

“A lot of those that are nonetheless working wish to go away, as effectively,” Olha stated.

Marc Santora reported from Kyiv, Ukraine, and Andrew E. Kramer from Zaporizhzhia and Kyiv. Anna Lukinova contributed reporting from Kyiv, and Yurii Shyvala from Zaporizhzhia.

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At the Biennale in Venice, a Fantasy Island Imported from Mexico

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At the Biennale in Venice, a Fantasy Island Imported from Mexico

Mexico City’s small urban farms — known locally as chinampas — practice a sort of agriculture in reverse: instead of bringing water to land as most farms do, chinampas bring land to water.

The chinampas in use today go back about a thousand years, to when Aztec farmers began building rectangular fields on top of vast lakes and growing food for what was then the city of Tenochtitlan. There were tens of thousands of chinampas at one point, arranged in strict grids with narrow canals between them, though many were destroyed or abandoned (along with the rest of the Mesoamerican metropolis) after Hernán Cortés and his invading Spanish soldiers rearranged the civic order in 1521.

But working chinampas continue to exist in the southern Mexico City neighborhood of Xochimilco — despite continuing encroachment by developers and competition from factory farms — operating mostly as family businesses that produce heirloom lettuce, radishes, dahlias and other crops. Lately, the farms’ irrigation-friendly ways are getting fresh attention in a world rocked by climate change and suffering from widespread droughts.

Could other places around the globe borrow the idea of creating “floating islands,” as the fields are sometimes called, which are engulfed by water? A team of Mexican designers, landscapers and farmers believes the ancient technology may be widely adaptable, enough that they will recreate a chinampa for their country’s pavilion at this year’s Architecture Biennale in Venice.

“Chinampas have a simple and intelligent design, created in a collective way that benefits not only people but all of the surrounding living beings, too,” said Lucio Usobiaga, a team member who has spent the last 15 years defending the remaining chinampas through a nonprofit he founded called Arca Tierra.

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Mexico’s pavilion is a neat fit for the biennial’s main exhibition, “Intelligens. Natural. Artificial. Collective,” which is intended to show design projects that address climate change in creative ways. The chinampas are at once man-made and organic and can succeed only if there is cooperation among farmers, policymakers and the growing number of tourists who float through on popular canoe tours, gazing at fields of corn and flocks of egrets and pelicans.

Promoting the chinampa as an inspiration for eco-friendly design was an obvious choice for the biennale, team members said. “Venice is also built on water and has the same kind of vulnerabilities that Xochimilco has,” noted Ana Paula Ruiz Galindo, a founder of the design firm Pedro y Juana.

They pointed out that Venice and Xochimilco were added to the list of UNESCO World Heritage sites in the same year, 1987, and both places are island communities navigable by boats and working to balance the positive and negative aspects of tourism.

Venice has its iconic gondolas, while Xochimilco has its trajineras, flat-bottomed vessels, decorated in bright colors and fake flowers that take visitors on party-themed excursions. Both boats are operated by pilots who push them along channels using long poles.

As for how to recreate a chinampa on-site, that took some imagination. And compromise.

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The Aztecs constructed their islands over time, using reeds and branches to make fences in the mucky lake bottom. These formed boundaries for multiple layers of sediment and decaying vegetation (and sometimes human sewerage) until the islands rose far enough above water to be farmed. In addition to growing crops like corn, beans and squash — using the traditional milpa agricultural method that naturally preserves nutrients in soil — they planted trees on the corners of the islands to stabilize the land.

Mexico’s pavilion, inside the biennale’s Arsenale complex, will feature a stripped-down version, much smaller than the 500 square meters (0.12 acres) of a typical chinampa. The exhibition will be enhanced by videos produced in Mexico City featuring real chinamperos, as the farmers are called, and bleachers will be installed along the walls. Artificial lighting will replace sunshine.

In the center will be a working garden planted with vegetables, flowers and medicinal herbs. (The crops were started in an Italian nursery and transferred to the Arsenale by boat in mid-April.) They will mature during the biennale, which continues through Nov. 23.

“By the end of the biennale, we will be able to harvest corn and make tortillas,” said Mr. Usobiaga. “Before that, we can harvest beans, squash, tomatoes and chiles.”

Visitors will learn about special seed cultivation techniques that are unique to chinampas and will have the chance to plant seedlings themselves.

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In a nod to local agriculture, the chinampa will also employ a version of vite maritata, a practice established in ancient Etruscan agriculture that calls for planting grapes around trees, which serve as a natural trellis system for the vines. The exhibition team sees a link between the two forms of agro-forestry, combining trees and crops into one ecosystem.

“We are going to see this dialogue between two ancient cultures that both have a lot to say about how we can move forward,” Mr. Usobiaga said.

The exhibition team members said they wanted to be careful not to overly romanticize chinampas because they are not easy to duplicate on a scale that could feed a large population today. The farms work in Mexico City because they sit on a lake that lacks an outlet to another body of water, making water levels relatively easy to control. The opposite is true, of course, in Venice, which is on a lagoon close to the sea and always under threat from flooding.

Also, the economics of small farms — high production costs, low yields because of their size — make it difficult to turn a profit. Farmworker wages are generally too low to support people in urban areas, and the backbreaking work of planting and harvesting has lost prestige.

“This is a big problem here, that people, especially young people, don’t want to work the soil on chinampas anymore,” said María Marín de Buen, the team’s graphic designer.

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Even in Xochimilco, many chinampas lie fallow because their owners cannot make a living. Some have been turned into soccer fields, which are rented out to the community; others are event venues where people celebrate weddings or birthday parties. Officially, the land is restricted from development, as well as from cattle grazing and the hunting of endangered animal species, though these things happen with alarming frequency.

Still, the team sees something inspirational at play: a connection between nature and the built environment, between existing water resources and the need to construct houses and schools. Architects who visit the biennale may not go on to design large swaths of farmland, but they can replicate the idea on a smaller scale using whatever conditions exist, said Jachen Schleich, a team member who is a principal of the Mexico City architectural firm Dellekamp + Schleich.

“Even if somebody does this in his backyard, he can at least feed his family, or the people on the four floors of his building, Mr. Schleich said. “It could be like a micro-intervention in the landscape or a public space.”

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Trump's pick for surgeon general quit medical residency due to stress, former department chair says

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Trump's pick for surgeon general quit medical residency due to stress, former department chair says

President Trump’s choice of Dr. Casey Means, a Los Angeles holistic medicine doctor and wellness influencer, as his nominee for surgeon general appears to mark another attempt to defy establishment medicine and longstanding federal policy.

Trump portrayed Means — a 37-year-old Stanford medical school graduate and author who describes herself on LinkedIn as a “former surgeon turned metabolic health evangelist” — in his announcement as fully in sync with Robert F. Kennedy Jr.’s mission to “Make America Healthy Again.”

“Casey has impeccable ‘MAHA’ credentials, and will work closely with our wonderful Secretary of Health and Human Services, Robert F. Kennedy, Jr., to ensure a successful implementation of our Agenda in order to reverse the Chronic Disease Epidemic, and ensure Great Health, in the future, for ALL Americans,” Trump said in a statement on Truth Social.

Some have raised questions about Means’ credentials. Although she graduated from medical school, she is not an active doctor licensed to practice medicine.

After graduating from Stanford, Means was nearly 4½ years into a five-year physician residency to be a head and neck surgeon at Oregon Health & Science University when she dropped out.

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“During my training as a surgeon, I saw how broken and exploitative the healthcare system is and left to focus on how to keep people out of the operating room,” she says on her website.

Dr. Paul Flint, a former chair of Otolaryngology/Head and Neck Surgery at Oregon Health and Science University, said Means resigned from the residency because of anxiety.

After four years of training, Means came to him and Dr. Mark Wax, the residency program director, and said she wasn’t sure it was the right job for her.

“She wasn’t even sure she wanted to be in medicine,” Flint said. “She wanted to do something different. She wanted to resign.”

Flint and Wax urged Means to think about it more and offered her three months paid time off.

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“She was under so much stress,” he said. “She did that, came back and decided she wanted to leave the program. She did not like that level of stress.”

Flint said Means was competent, a good resident. “But there was a lot of anxiety around this,” he said of the role of the surgeon. “You become much more responsible the more senior you get.”

Did he think Means would make an effective surgeon general?

“I don’t know,” Flint said. “Time will tell.”

According to public records from the Oregon Medical Board, Means’ medical postgraduate license was granted in 2014 and shifted to inactive status in 2019.

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Some who know Means question whether she is completely aligned with Kennedy.

Robert Lustig, professor emeritus of pediatrics in the division of endocrinology at UC San Francisco, who is a friend of Means, told The Times he was shocked and surprised.

“What’s surprising to me is that she wanted the job, because she had difficulties adopting RFK’s full portfolio,” Lustig said, citing Kennedy’s controversial pronouncements on vaccines and fluoride in public water supplies. “She didn’t want to be part of the administration, in part because she couldn’t accede to those views. So what has changed is not clear.”

Means did not respond to requests for comment. Still, she attended a January confirmation hearing at the U.S. Capitol for Kennedy and celebrated in February when he was sworn in, saying on an X post that “his vision of the future aligns with what I want for my family, future children, and the world.”

Over the last year, she has raised public concerns about some vaccines. In August, she spoke out on X against CDC guidelines that all infants should receive a dose of hepatitis B vaccine at birth.

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“There is growing evidence that the total burden of the current extreme and growing vaccine schedule is causing health declines in vulnerable children,” she wrote in an October newsletter, linking to a blog about vaccines and autism. “This needs to be investigated.”

“I have said innumerable times publicly I think vaccine mandates are criminal,” she said on X in November.

But when Lustig spoke to Means four weeks ago, he told The Times, Means had left her home in Pacific Palisades, worried about toxic air and water after the L.A.-area wildfires, and had moved to Hawaii. He said she wanted to start a family and did not express interest in working with Kennedy at the time.

“I know that her views are not his — that’s why she didn’t accept it earlier,” Lustig said. “If you’re an employee, you have to take the whole portfolio. You don’t get to choose parts of it, and she was uncomfortable.”

The president announced Means as his pick a day before his initial choice for the position, New York family physician and Fox News contributor Janette Nesheiwat, was scheduled to have a hearing with senators Thursday.

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Trump has yet to explain why Nesheiwat was replaced as his nominee, but he said she would work at the Department of Health and Human Services in “another capacity.”

Asked by a reporter Thursday why he picked a nominee for surgeon general who never finished her residency and is not a practicing physician, Trump said: “Because Bobby thought she was fantastic. She’s a brilliant woman who went through Stanford. … I don’t know her.”

The U.S. surgeon general is known as “the nation’s doctor.” According to the Department of Health and Human Services, the role is to provide Americans with “the best advice on how to improve their health, by issuing advisories, reports and calls to action to offer the best available scientific information on crucial issues.”

Lustig said he had no doubt Means — whom he got to know by advising Levels Health, a digital metabolic health company she co-founded — would bring a different perspective to the U.S. government.

“Here’s the problem: We have an epidemic of chronic disease and there are no medicines that fix any of these diseases,” Lustig said. “They’re not fixable by drugs. They’re fixable by food. And the reason is because all of these diseases are mitochondrial diseases, and we don’t have drugs that get to the mitochondria.

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“We have to change the food supply,” he added. “There is no option. Casey knows that. So as surgeon general, she would be able to make that case.”

In that sense, Lustig agreed with Trump, who said, “Dr. Casey Means has the potential to be one of the finest Surgeon Generals in United States History.”

“I think she’s a terrific person,” Lustig said. “She will bring a very different mindset to the office.”

But Lustig said he believed Kennedy was flat-out wrong on vaccines.

“I know why he’s wrong on vaccines,” he said. “I understand where his brain is, because I got a half-hour with him on the phone, one on one. But I cannot alter my integrity to match that — and I thought that Casey couldn’t either.”

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Means is an unorthodox pick for a president famed for his diet of Big Macs and Diet Cokes.

Her website features pictures of broccoli and almonds. Her Instagram page shows bright bowls of tofu scrambles with heirloom tomatoes, avocado and beet sauerkraut.

Her newsletter recounts how, at the age of 35, after she moved to L.A., she embraced the “woo woo (aka, the mystery),” set up a meditation shrine in her home and sought relationship advice from trees.

Means was raised in Washington, D.C., the daughter of mildly religious, Republican parents. Her Californian-born father, Grady Means, a retired American business executive and government official, served in the White House as assistant to Vice President Nelson Rockefeller, led the Food and Nutrition Task Force to reform the food stamp program and provided oversight to the National Health Insurance Experiment.

Casey Means earned a bachelor’s degree in human biology with honors at Stanford and went on to graduate with a doctor of medicine degree in 2014. But Lustig said she dropped out of her residency in Oregon, disillusioned.

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“The reason she quit was because she saw that the same patients were coming back with the same problems, and her mentors, the faculty at Stanford, when she would ask, ‘Why is this happening?’ would say, ‘Shut up and operate,’” Lustig said.

“She had a crisis of confidence that she was actually not helping the problem, or was actually part of the system that was actually making the problems.”

But that’s not how some people who knew Means when she was a resident surgeon in Oregon remember it.

“She didn’t mention metabolic health, she didn’t mention any of that,” said one person with whom she discussed her work regularly at that time and who declined to be named for fear of retaliation. “She was scared of accidentally hurting someone in surgery. She just didn’t want to mess up. She genuinely cared about her patients — she wanted them to be healthy and well — and I think her heart in that is genuine. But she was not talking about what she’s talking about now.”

Means’ recent rhetoric about the medical profession, they said, was disappointing.

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“She’s claiming doctors are just trying to cut and make money, but she’s making money too,” they said. “Surgeons, they’re trained to be the last resort and actually help with solving after something’s gone wrong. If she wanted to help preventatively, she was in the wrong field, so I’m glad she went elsewhere. … But to be upset with a system that is trying to help when it does get down the line is very strange.”

In 2019, Means co-founded Levels Health, which works to “empower individuals to radically optimize their health and well-being by providing real-time continuous glucose biofeedback.”

Two years later, her break with establishment medicine became more intense — and more personal — when her mother was diagnosed with Stage 4 pancreatic cancer.

“What put her over the edge was when her mother passed away of pancreatic cancer, and it was missed,” Lustig said. “She had all the symptoms and signs of metabolic syndrome in her and none of her doctors addressed any of them.”

Means served as Levels Health’s chief medical officer until last year, when she and her brother, Calley, published a 400-page diet and self-help book titled “Good Energy: The Surprising Connection Between Metabolism and Limitless Health.”

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In August, she catapulted to mainstream fame — particularly on the right — when Tucker Carlson featured her and her brother on his podcast for a show titled “How Big Pharma Keeps You Sick, and the Dark Truth About Ozempic and the Pill.”

“The system is rigged against the American patient to create diseases and then profit off of them,” Means told Carlson.

Over the last few months, Means and her brother, who now serves as a White House health advisor, made public appearances at “Make America Healthy Again” events.

In September, she addressed a U.S. Senate roundtable on chronic disease, listing all the things she didn’t learn in medical school: “For each additional serving of ultra-processed food we eat,” she said, “early mortality increases by 18%.”

Critics were quick to take to X to mock her statistics.

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“I’ve easily had 1000 bags of chips in my life,” said Brad Stulberg, adjunct clinical assistant professor of health management and policy at the University of Michigan’s School of Health. “If this is true, it means my mortality risk has increased by 18,000 percent. That seems unlikely.”

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What to Know About the Hepatitis A Outbreak in L.A. County

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What to Know About the Hepatitis A Outbreak in L.A. County

Public health officials in Los Angeles County have declared an outbreak of hepatitis A, a highly contagious liver infection driven by a virus that can, in rare cases, cause severe illness.

The condition, which is typically identified in fewer than 50 people in L.A. County each year, infected at least 138 people in 2024 and cases have remained unusually high so far in 2025. Officials say that levels of the virus in local wastewater suggest these figures are an undercount.

Here’s what to know.

The hepatitis A virus is spread through the so-called oral-fecal route, which means it is ingested through food or drinks that have been contaminated by microscopic bits of stool from an infected person. It can also spread through close contact with someone who is carrying the virus, even if they don’t show any symptoms.

Unhoused people are often at greater risk of contracting hepatitis A because they have limited access to proper toilets and hand-washing facilities. The virus is also more common among travelers to places with poor sanitation, men who have sex with men and people who use drugs.

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But officials say many of the recent cases have occurred in people without those risk factors. They do not yet know why, but Dr. Timothy Brewer, an infectious disease physician and epidemiologist at U.C.L.A., said it had led him to worry about two things: food contamination, and community circulation.

“If you’re practicing good hygiene in a community that has access to potable water, you really should not be seeing a lot of this,” he said. “Something is going on — but exactly what that something is, we don’t yet know.”

The first signs of the infection can look a lot like a classic stomach bug: fever, fatigue, nausea and a loss of appetite, followed by vomiting and diarrhea. Over time, people who become infected can also experience yellowed skin and eyes, dark urine and pale stools.

One of the challenges to halting a hepatitis A outbreak is that contact tracing can be nearly impossible. The infection can incubate for up to seven weeks before symptoms appear, and a person carrying the virus can spread it for up to two weeks before they feel ill.

In addition, a significant proportion of people who become infected don’t experience major symptoms, said Dr. Edward Jones-Lopez, an infectious disease specialist with Keck Medicine of the University of Southern California, so they do not visit their doctor, who in turn does not run a blood test and report the case.

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Severe symptoms are most often seen in older adults, people with chronic liver conditions, and those with weakened immune systems or H.I.V. On rare occasions, a hepatitis A infection can be fatal. In this outbreak, at least seven people have died. That may seem like an unusually high fatality rate, but officials believe far more people have been infected than the official numbers show. Most have probably been asymptomatic, or shown symptoms mild enough to have been misidentified.

There is no specific antiviral medication for hepatitis A. The infection usually resolves on its own within a few weeks, and most people do not face lasting liver damage. But for some, hospitalization can be necessary.

In rare cases, the infection can devolve into an acute liver failure called fulminant hepatitis, which may require a transplant, said Dr. Jones-Lopez. “It can progress very, very quickly — that’s a very serious disease.”

If you think you might be infected, be sure to visit your doctor, drink lots of fluids, and get adequate rest.

The best way to prevent a hepatitis A infection is through vaccination. The regimen — two doses of vaccine, at least six months apart — provides protection for life. It has been routinely given to children for the last two decades, but many adults 25 and older have not gotten the shots unless they were in a high-risk group.

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The fact that the outbreak is occurring outside of traditional populations “underscores the need to reassess how — and where — we target prevention efforts,” said Dr. Anne Rimoin, an epidemiology professor at U.C.L.A., since “an infection anywhere is potentially an infection everywhere.”

If you are unvaccinated but know you have been exposed to a person carrying the virus, a prompt vaccination can prevent your becoming infected. Experts say that some people with weakened immune systems who are exposed could also benefit from receiving immune globulin as well. And good hygiene is a wise protective measure for everyone; wash your hands with soap and water, especially after using the bathroom, and before preparing food.

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