Most Penicillin Allergies are Fake

Just learned about this 2020 paper at PubMed:

Many patients report allergies to penicillin, although in over 90% of these the label of penicillin allergy is shown to be incorrect following comprehensive testing. Inappropriate and inaccurate penicillin allergy labelling is a barrier to antimicrobial stewardship and can lead to patient harm. This review assesses an emergent evidence base and trend favouring delabelling using direct oral penicillin challenges following a stratified risk assessment of the likelihood and existence of true penicillin allergy, to identify and make recommendations for key components for implementation in standard practice.  

My Presidential Platform

I can sum up my platform with one noble word from a past era of American politics: normalcy.

After the woke madness and then the MAGA Madness, after January 6 and the George Floyd riots and the ICE assault on America, I promise to get America back to normal. No more video of fighting in our streets. No judicial persecutions, no threats to our electoral system, no trying to get people fired for their views. 

I will promote a legal regime with no special privileges for anyone. If being a regular old American isn't good enough for you, go somewhere else.

My goal will be that unless some foreign crisis pops up, my name will appear in headlines only once a year, for my state of the union address. In those addresses I propose to talk about things like how many miles of highway have been repaved, how many acres of solar arrays have been installed, how many houses have been built. Otherwise I will devote my time to things too boring for most people to notice, like NEPA reform, improving the power grid, fixing our naval shipbuilding mess, and reducing corruption in Medicare and Medicaid.

I promise to pass a budget every year, on time. I promise to get the budget deficit headed downward.

I promise to appoint judges devoted to defending the constitution.

I promise to stay off social media and instruct my administration to do likewise. We will post only to make Americans aware of important developments, like changes in Medicare rules.

I promise that every activist in the country, of whatever stripe, will complain that my administration is not doing enough. 

Thank you for your attention.

Immigrants and the US Budget:

Study from the Cato Institute:

The government first began gathering detailed information on benefits use by citizenship status in 1994. The data show:

1. For each year from 1994 to 2023, the US immigrant population generated more in taxes than they received in benefits from all levels of government.
2. Over that period, immigrants created a cumulative fiscal surplus of $14.5 trillion in real 2024 US dollars, including $3.9 trillion in savings on interest on the debt.
3. Without immigrants, US government public debt at all levels would be at least 205 percent of gross domestic product (GDP)—nearly twice its 2023 level.

These results, which do not account for any of immigration’s indirect, tax-revenue-boosting effects on economic growth, represent the lower bound of the positive fiscal effects. Even by this conservative analysis, immigrants may have already prevented a fiscal crisis. 

Epstein and the Blood Libel

Matthew Schmitz at First Things:

The Epstein myth updates these lies for the age of Jewish statehood. It presents Epstein as blackmailing American leaders—not on behalf of a shadowy world Jewry, but on behalf of the Jewish state. And it recasts Jewish ritual sacrifice in terms of child sexual abuse. The anti-Semitic implications of the Epstein myth may not be widely acknowledged, but they are understood by many of the myth’s most important promoters.

Take Maria Farmer, an Epstein accuser who has been interviewed by MSNBC and respectfully profiled by the New York Times. She remarked in a recent interview, “All the Jewish people I met just happen to be pedophiles who run the world economy.” She is an adherent of David Icke, the UFOlogist who has promoted the Protocols [of the Elders of Zion] and suggested that the world is controlled by shape-shifting alien “­reptilians” that merely appear to be human, including the members of the Rothschild family.

Similar claims are made by another Epstein accuser, Juliette ­Bryant. Maurene Comey, the prosecutor of Ghislaine Maxwell, submitted a victim impact statement from Bryant at Maxwell’s ­sentencing hearing. Apparently, the government regards Bryant’s words on Epstein as credible. This is a remarkable judgment. Earlier this year, Bryant declared on social media that she had “witnessed Epstein turn into an alien reptilian creature.”

Certain facts about Epstein are well established and incontestable: He committed sexual crimes against minors. He deserved to be punished, and more severely than he was. What goes beyond the facts is the Epstein myth. This myth is a synthesis of conspiracy ­theories: satanic panic, blood libel, the ­Protocols, UFOs. It generally presents its assertions in a respectable guise, but as its most enthusiastic adherents reveal, it tends toward the demonization of Jews. 

I would say that the constellation of accusations floating around Epstein island lends itself to the demonization of all sorts of things, which makes it irresistible to many malcontents. For example, various female reporters seem interested becasue the story demonizes male sexuality. Populists see the global elite partying together on a secret island, the perfect metaphor for their view of the political world. Anti-semites see secret Jewish influence. Socialists see billionaires flaunting their immunity from the law. Nervous Christians see Satanic power; nervous crazy people see reptilian aliens.

Epstein was a sleazeball, a convicted sex offender who got rich helping billionaires avoid taxes. As the list of visitors to his island shows, there are a lot of sleazy men in the world, including two American presidents and a British prince.

But it turns my stomach that media outlets that ought to know better keep printing allegations from Epstein "survivors", even when these women have had to recant their charges under oath. These professional accusers, all of whom were adults when they went to the island, got paid to party with rich men. Nobody forced them to sign up as island escorts. Now they play the victim for cash and attention. Maybe somebody was coerced into going to the island; maybe some of them were effectively raped once they got there. I have seen no evidence of this, but let's allow it is possible. The women in the news as accusers were not coerced and were not raped. They are just displaying the same kind of unstable mania for attention they showed when they went to the island in the first place. Reporters who quote them are indulging in outrage for its own sake.

Given all the important things that are happening in the world, can we please talk about something else?

La Mothe de Pineuilh

Hunting horn from Pineuilh, circa 1000 AD

In 975 AD, a French noble family began constructing a new home in the hills east of Bordeaux. They chose a site along a marshy tributary of the Monsabeau River. Digging a circular ditch about 30 meters (100 feet) across, they piled the mud on the interior to form a platform. There they lived for about 150 years. That a wealthy family chose to live on a little island in this marshy spot tells you all you need to know about the security situation at the time. This was close to the nadir of public order and govenrment power in medieval France.

Ceramics from the site

A charter of 1077 records that some land in this vicinity was donated to the Abbey of Conques by a man called Falco de Barta, which may give us the name of this family.

Aerial view of the excavation

In 2002, the French government began building a new road through the valley. This road, as it happens, ran smack across the site, ultimately destroying the eastern third of the mound.

But before that happened, French archaeologists took a close look at this wonderful site. They discovered that around 1043 (these are all tree ring dates) the ditch was deepened and the height of the mound was greatly increased, forming a "motte" like those you may know from Norman England's motte and bailey castles. This had the effect of burying and thus preserving the earlier occupation of the site. A plan of the early phase is shown above. Notice the three bridges that cross the river to the mound, only one of which would have stood at any given time. The marshy ground around those bridges was full of artifacts, inlcuding objects of wood, horn, and leather preserved by the wet environment.

Detail of the mound area. Notice that there were only two buildings in this section of the mound: an outbuilding at the end of the bridge, possibly a guardhouse or stable, and a large timber hall. This noble French family lived mostly in one great wooden hall like Vikings would have.

Wooden bowl

Much less evidence survived of the later buildings, since they were built on top of the mound, which has eroded considerably since the site was abandoned. But the mound preserved the early period wonderfully, and the marshy ground preserved these wonderful artifacts.

One technical detail the archaeologists were able to work out was that the residents kept reusing wooden beams as they tore down some buildings and built new ones, so that any given structure of the later period might include beams from 975 was well as others that had been freshly cut.

Shoe

Chess pieces

Makes me wish I could teach early medieval history again, so I could share this with my students.

The Freshman Cascade

After the Supreme Court ruling that effectively banned racial preferences in college admissions, the admission of black and Hispanic students to the most selective schools in the country declined. But it isn't like the minority students who had any chance of getting into Harvard weren't going to get in somewhere. And now data shows that many of those students went instead to "flagship" state schools. NY Times:

Overall, freshmen enrollment of underrepresented minority groups increased by 8 percent at public flagship universities.

The people who did this study are very worried that this will lead to a sort of downward "cascade," whereby less qualified black students who would have gone to those flagship state schools will now be pushed into ever less impressive schools, etc. But so far that isn't what the data shows; black enrollment at schools like LSU, Ole Miss, and Flordia has increased by more than 10%. Hispanic freshman enrollment at the University of Miami was up by 45%.

As I have written here before, our obsessive focus on who gets into Stanford and Harvard ignores most of what matters in higher education. While it is true that the higher reaches of a few professions (law, academia) are dominated by Ivy Leaguers, that is not true of other professions; most American CEOs went to state schools.

The real issue in higher education is not who gets into Harvard, but how to make college better for the vast majority of students who don't go to top ranked schools.

Ancient Artifacts from Phoenix Ancient Arts

Objects for sale by, or recently sold by, Phoenix Ancient Arts. Bust of a Roman Goddess, bronze. Of obscure provenance, in private hands since the 19th century.

Bronze lamp from Sardiniain the shape of a boat, "Nuragic," c. 700 BC. What a delightfully weird thing.

Hellenistic intaglio with a face of Medusa, c. 200 BC.

Roman marble portrait of Agrippina the Elder (granddaughter of Augustus), 1st century AD

Hellenistic gold pendant, 4th century BC. Possibly from a Black Sea colony. If it is genuine; it has no provenance beyond "Ex- Schaefer collection, South Germany, 1960’s"

Greek terracotta trefoil oinochoe (wine jug), 6th century BC

Roman marble portrait bust of Empress Sabina, c. 130 AD

Egyptian gilded and painted wood falcon headed sarcophagus, 26th-30th Dynasty, 664-343 BC

Helmet from a Roman marble statue of Mars, 50 to 150 AD

Limestone figurine of a seated worhipper, ancient Near East, c. 3000 BC

Break the Cycle

Hate drives hate.

Violence feeds on violence.

Rage and fear shut down thought, making rage and fear grow all the more.

To change the dynamic you must break the cycle. Refuse to hate, refuse to fear, refuse to commit violence.

 You must believe that the world can be made better by love.

Wari Art

Wari Dignitary, 600-1000 AD, Inlaid with Several Types of Shell

The Wari Empire dominated the south-central highlands and the west coastal regions of what is now Peru from 500–1000 AD. Their capital was in the dry coastal lands, and many cloth and wooden artifacts have been found in tombs there, besides the wonderful pottery vessels in the shape of humans and animals.

Four-cornered wool hat, one of several Wari examples known. Now here is a signal of status I could get behind.

Vessel in the shape of a feline

Turquoise figurine

Effigy Bottle

Wari tuni, and detail of a different  tunic

Bag with a human face

Lime container in the shape of a being known as the Decapitator, since it always has a severed head in its right hand

Double-chambered vessel. These seem to have been used in rituals, since they make a distinctive sound when water is poured back and forth between the two chambers.

The Temptation of Violence

Back in 2003, I tried to join in the protests against Bush II's looming invasion of Iraq. I fulminated against it on my old web site and attended a huge rally in Washington. I did not enjoy the rally.

The message of the day was "No Blood for Oil." I thought and still think this was entirely the wrong framing. What I wanted to protest was the belief on the part of Bush, Rumsfeld, Cheney, Wolfowitz & company that the world can be changed by spasmodic acts of extreme violence. We were confronted with a deep and complex problem, the confluence of economic misery and political oppression across the Middle East that seemed to be spawning mass terrorism. Faced with this deep and complex problem, Bush & company opted for a very simple solution: smash somebody. They pretended that Saddam had some connection to 9-11, but administration insiders later admitted that this was a pretext. They wanted to change the Middle East. They fantasized that the way to do this was with tanks and stealth aircraft, by blowing up buildings and killing people.

I am not a pacifist; I supported, for example, the first Gulf War. Reversing Saddam's conquest of Kuwait seemed to me like the kind of thing that a military can accomplish. Revolutionizing a whole region, not so much.

Vladimir Putin saw Ukraine drifting ever closer to the EU and NATO and decided that he could revolutionize its politics with a three-day Special Military Operation. Have a hard problem? Just send in the tanks! But he didn't have the US Air Force, and he did not even achieve his minimal goal of taking Kyiv and installing a new government. If he had, I suspect he would have found that in solving that one problem he had only created a million more problems. He fell for the fantasy of violence, the dream that the world can be changed by smashing things. Russia is paying a terrible price for his mistake.

Although I have spent my whole adult life protesting against police violence, I hated the George Floyd riots. Bad relations between the police and the community they are supposed to serve is not the kind of problem that can be solved by smashing things.

Looking at the violence of ICE, I see the same fallacy at work. The world is not going the way you want, so smash somebody. Some of you may thing that this is a specific response to immigration, but I disagree. I think people like Trump hate immigration because they see immigrants as dirty, disgusting people who degrade the country be being here; they are just one aspect of a nebulous threat by the hippie/communist/unwashed/disgusting/gay/trans/criminal/terrorist consortium. Some of you may think it is just racism; but then why do MAGA people especially gloat when ICE beats up white protesters?

I see the fantasy of violence in action. If the world is not great, if your life is not great, you imagine that this is because of enemies, and things can be made better by smashing those enemies.

This is all wrong. It is wicked, stupid, and will drive America in exactly the direction people like Stephen Miller claim to hate: toward anarchy, turmoil, conflict, and economic decline. 

If you want an orderly society, a cohesive society, a peaceful, productive, thriving society, you must start, not by smashing people, but by listening to them.

Today's Fortune

Tonight, the universe is conspiring in your favor.

So what should I do tonight? Place a big bet on an NBA game?

Actually what I will probably do is write, so maybe the universe will help me produce something brilliant.

It occurs to me, though, that while I opened this fortune cookie this morning, we had our Chinese take-out last night; so was this fortune supposed to apply to last night? If so, the universe really let me down.

Do Doctors Get Rich Off Vaccines?

Jess Steier, Elana Pearl Ben-Joseph, Jen Covich Bordenick, and David Higgins: 

Recently, the Texas attorney general launched a formal investigation into what he called “unlawful financial incentives” for childhood vaccines, saying that he would “ensure that Big Pharma and Big Insurance don’t bribe medical providers to pressure parents to jab their kids.”

The timing was uncanny. The four of us had just completed a six-month investigation into this exact question: Do pediatricians get rich from vaccines? 

Our answer, after analyzing available commercial reimbursement data from four major insurers across all 50 states, reviewing state Medicaid fee schedules, and interviewing pediatricians about the financial realities of vaccine delivery: no. . . .

The economics vary dramatically depending on where you practice and who you serve. In Colorado, commercial insurers pay a median of $42 for vaccine administration; Medicaid pays $21. In Mississippi, commercial rates hover around $22, while Medicaid pays just $11.68, well below what it actually costs to store and administer a vaccine.

That's why many doctors have stopped giving vaccines to adults; because it costs so much to store and administer vaccines that they lose money. Like most Americans I get all my vaccines at the pharmacy, because the volume of shots they give greatly reduces their storage costs, and they have lower overhead than physicians' offices.

The big numbers being thrown around about payments for giving vaccines relate to insurance company "quality programs," some of which do indeed pay doctors for giving vaccines. That's because they reward doctors for doing things that limit future costs to insurers, and giving people vaccines has enormous payoff in terms of reducing future hospitalizations etc. But those are broad programs that pay related to all sorts of metrics, of which giving vaccines is only one. And, remember, insurance companies do this because these programs reduce their costs in the long run.

Another point about the bogus numbers is that the people spreading them seem to think that the whole amount paid to the practice is income to the doctor, which is of course not true; again, many doctors actually lose money giving childhood vaccines, especially with Medicaid patients. They do it anyway because they know how important it is.

Something I wrote During the George Floyd Riots

The older I get, the more strongly I believe that the most important thing we can do is to defend civilization. There is no guarantee that this astonishingly rich world we have built will endure; plenty of other civilizations have collapsed or faded back into anarchy and village life. We have to defend it against all kinds of threats: random violence, police corruption, ethnic hate, divisive politics, environmental poisons, outside enemies with hypersonic missiles. We especially need to defend it against forgetting. We are too quick to forget dangers once they fade from the headlines, too quick to forget lessons learned in the fires of World War and violent revolution. I am a liberal, which means I think things could be better and support various reforms intended to make them so. But I never forget that my life depends, not on my party winning, but on the survival of our civilization in the face of a chaotic universe. 

Links 30 January 2026

Chukchi Hide Painting Showing their World, and Detail of Whaling

Still uploading chapters of The Voice from the Darkness at Royal Road.

The threat posed to democracy by "malicious AI swarms." (Twitter/x, article, ungated preprint)

The bizarre story of Ira Glass and his adopted pit bull. (Twitter/X, news article) More proof that you should never learn about the private lives of people whose work you enjoy.

Conversation between Tyler Cower and Francis Fukuyama, much about the current state of the US government, very interesting. 

Richard Feynman on energy, 18-minute video. Energy does not "flow" and has nothing to do with electrons moving through wires; it mainly shifts around through fields in whatever way insures that the overall number never changes. "Energy is the shadow of nature's consistency over time." [I think these are made by using an AI-generated Feynman voice to read Feynman's texts.]

Review of Margaret Atwood's memoir finds it "packed with minute day-to-day detail—but is strangely quiet on a few big subjects," one of which is her friendship with the other famous female Canadian writer, Alice Munro.

Are Federal agents and attorneys opposed to Trump's policies right to resign?

Ocean art photography contest.

The strange history of the tonka bean.

Jerusalem Demsas argues that many Americans have been willing to tolerate Trump's lawlessnes so long as the markets were protected. But, "The market order will not survive if the rule of law doesn't."

Diagrams of weaving and spinning machinery from 1748, very impressive.

Revana Sharfuddin: we should recognize when our political opponents propose good policies and support them.

The academic publishing system hates it when somebody tries to point out that a major paper is just wrong, and will do almost anything to avoid admitting error.

The 50-year history of increasingly militarized law enforcement that led up to ICE shootings.

Some suggested constitutional amendments to prevent future presidential power grabs. (Twitter/X)

About those National Guard deployments: "CBO estimates that National Guard deployments to six U.S. cities cost $496 million through end of 2025." If reducing crime is the goal we should spend that money expanding court systems so we can try more criminals.

Weird drawings from Michael McGrath that hint at unknown stories.

An argument that, so far as we can tell, the ease of access to contraception has little impact on fertility. (Twitter/X)

All you need to know about architects is that a bunch of the top firms have already published renderings for Trump's proposed new terminal at Reagan National Airport. Architects love grandiose dictators.

Eli Stark-Elster: "The modern education system is probably the single biggest threat to the mental health of children." Notes that during Covid when the schools were closed the teenage suicide rate fell.

Installing the Met's recently acquired Tiffany Garden Landscape Window, 14-minute video.

Perun on the politics and economics of the Ukraine war in 2026, excellent one-hour video. Summary: both sides can afford to keep the war going for at least another year.

Jakub Janovsky of Oryx runs the numbers on Russian armored vehicles. Finds that 1) the Russian armored vehicle force is about the same size as it was when the war started, even though the army is more than 40% larger, and 2) the Soviet vehicle stockpile is largely exhausted. (Twitter/X)

A Ukrainian ground drone with a machine gun captures three Russian soldiers.

Conimbriga

Coninbriga is an archaeological site in Portugal mostly known for its impressive Roman ruins.

Plan of the site from Google Earth.

It is an ancient place, first inhabited in the Bronze Age, but it grew greatly under Roman rule and was made a municipium in 70 AD. Archaeologists estimate that its population at that time was around 10,000.

The baths. Excavation of the site began in the late 1800s and it became an archaeological park in 1910. 

The walled garden of a town house.

Mosaic details.

The aqueduct.

At the height of the empire, the site was unwalled, but in the later 200s walls were constructed. They did not, alas, save it from being sacked by the Sueves in 468. It declined thereafter, and the bishop moved away to a different site around 570. The modern town of Coimbra grew up there, leaving the Roman site to decay into these splendid ruins.

The Lonely Soldier

In one of the saddest videos of the war, a lone Russian soldier is sent on a solo march across a kilometer of open, treeless, snow-covered ground toward Ukrainian positions, without any winter camouflage. He doesn't even try to hurry, but just trudges along, knowing he is doomed. 

The Ukrainian observation drone has plenty of time to study his progress, tracking him until an attack drone can fly in to kill him.

One supposes this was some kind of punishment, but given how the Russians are operating, who knows? The whole scene summarizes for me the awful waste and inhumanity of Putin's terrible war.

There is another awful video going around these days that shows a Russian soldier sitting in a shell crater, surrounded by the corpses of seven or eight other Russians. He doesn't dodge or flinch or show any emotion as the drone flies at him, just sits there, staring straight at it, perhaps stunned by whatever killed his comrades, but perhaps welcoming an end to his nightmare.

Is This Good News or Bad News?

Chicago reporter Dan Mihalopoulos on Twitter/X:

We’ve covered lots of losing teams on the back page of the paper. But none with a record as bad as the Chicago DOJ during Operation Midway Blitz:

• 0 conviction
• 11 charges dropped
• 3 no-billed cases
• 1 jury acquittal

And James Queally of the LA Times:

The U.S. Attorney’s Office in L.A. has lost every case it brought to trial against a protester who allegedly attacked a federal LEO last year. A number of other cases were dismissed or rejected by grand juries.

If you want you can find whole collections of videos on TikTok or YouTube Shorts of judges angrily dismissing charges brought by various Trump lackeys.

As these people note, Federal prosecutors usually win most of the cases they bring, and legal insiders like to repeat the old joke that a good prosecutor can get a grand jury to indict a ham sandwich. So this is a remarkably bad record.

Plus, Trump has threatened all sorts of political figures with investigation for their parts in opposing January 6 or other Trump "initiatives," but none of them have been convicted of anything. So far as I am aware, none of the lawsuits he has threatened against news organizations has ever led to a trial and a loss for his opponents, although lots of people have settled out of court.

What are we to make of this? Should we be reassured that Trump's people are so incompetent? Pleased that their clumsy crackdown is generating so much opposition?

If you really wanted to weaponize the law, would you make Pam Bondi the AG and put a complete idiot in charge of the FBI?

Is the point just harassment, intimidating people into silence by the threat of a few days in jail?

Or is it to wear Americans down until we no long react at all when Federal officers commit outrages? To make this into the new normal?

Is it just a reflexive burst of rage against immigrants and people who support them?

It feels like an extremely clumsy move to me, bad enough to generate widespread outrage but not so bad as to really intimidate the country.

Am I missing something? What, really, is this all about?

The Storm

Major storm along a thousand-mile front in North America yesterday. It was weird here because a lot of our precipitation fell as sleet despite it being very cold. So we had about 4 or 5 inches of soft, fluffy snow, and then about 3 inches of ice pellets on top of that, leaving us with a crusty mess that is very hard to walk in. The whole region is mostly shut down today. Above and below, the scene at our house last night.

And its going to be very cold all week, so none of this is melting for quite a while.

Sherlock Holmes on Dogs

From “The Creeping Man”:

“You will excuse a certain abstraction of mind, my dear Watson,” said he. “Some curious facts have been submitted to me within the last twenty-four hours, and they in turn have given rise to some speculations of a more general character. I have serious thoughts of writing a small monograph upon the uses of dogs in the work of the detective.”

“But surely, Holmes, this has been explored,” said I. “Bloodhounds—sleuth-hounds—”

“No, no, Watson, that side of the matter is, of course, obvious. But there is another which is far more subtle. You may recollect that in the case which you, in your sensational way, coupled with the Copper Beeches, I was able, by watching the mind of the child, to form a deduction as to the criminal habits of the very smug and respectable father.”

“Yes, I remember it well.”

“My line of thoughts about dogs is analogous. A dog reflects the family life. Whoever saw a frisky dog in a gloomy family, or a sad dog in a happy one? Snarling people have snarling dogs, dangerous people have dangerous ones. And their passing moods may reflect the passing moods of others.”

Remarkable Zapotec Tomb found in Mexico

Mexican archaeologists announce the discovery of a Zapotec tomb dating to around 600 AD.

Wonderful sculpture over the entrance. The owl was a sacred bird to the Zapotec, representing night and death. Nobody seems to know what it means to show a human lord, perhaps the man buried here, subsumed within that owl mask.

Interior view.

There seems to be lots of sculpture. The announcement mentions "murals," but I haven't seen any pictures, so maybe these are poorly preserved and need both protection and conservation.