Solomon “Joey” Sager

Director, Cardiac Electrophysiology, Chicago Cardiology Institute; part of CVAUSA, a physician-led, PE backed cardiology platform

[Anish Koka, MD @anish_koka]

On June 30, 2026, the NEJM retracted the clinical trial that got a drug approved by the FDA, triggering a $3.7B acquisition by Amgen.

The reason: the primary endpoint data was manipulated.

Here's how it happened, how it came to light, and who paid the price. 🧵

[Matthew Zirwas, MD @MattZirwas]

The take that frontier models aren't ready for use in medicine is dead wrong.

I've been using Opus 4.x in my clinical workflow every day for 6 months.

I'm a deep sub-sub-specialist in dermatology - the cases other derms refer out.

It's better than me, in my exact niche, after 25 years of reading and seeing patients. Not even close.

All it takes is a system prompt, some tool access, and a few references in the project files.

So when a Nature Medicine paper concludes frontier models are "not ready" for medicine, I read the methods.

They tested naked models. No system prompt. No tools. No references. Single-shot multiple choice.

Nobody would ever use them that way.

It's like taking somebody who just finished the first two years of med school, aced Step 1 of the USMLE, giving them zero access to reference materials and asking them to take the final board exam for someone who's had 6 additional years of clinical experience.

Then when they fail, pretending it's evidence that humans aren't ready to practice medicine.

That'd be obviously wrong and this take on frontier models in medicine is just as wrong.

[Omri @OVisionIL]

Prime Minister of Lebanon saying Israel and not "Occupied Palestine"

Is one of Israel's biggest achievements diplomatically so far

Formal recognition cannot be withdrawn. It's an amazing step forward and a foundation for peace

[CoffeeBlackMD @CoffeeBlackMD]

Had to give a patient with a creatinine of 5 yesterday contrast looking for a bleed.

Everyone just wringing their haves. Everyone but me and nephrology.

Look. I didn’t give him the bleed. I was doing the needed thing. Bleed was found and bleed was treated. Patient alive today for the risk and decision.

Everyone kept going on about the risk of full on renal failure and dialysis. And they were not wrong. That was the risk associated with the decision.

And that risk is ON ME. It was MY call in the end.

The thing is. That’s THIS job. HARD calls in less than optimal circumstances. And it WEIGHS on you. This instance a microcosm of the bigger universe I work in.

Very few jobs have this level of stress baked in and until you hold these decisions in your hands and have to make them and throw buck stops with you in life or death or even risk of serious morbidity, you can’t understand the job.

Creatine in 5 this morning. And urine output has not changed. But it could have easily been 6 without any urine, putting in a dialysis line.

I’d have still been fine with and lived with my call.

A world where this is easy. Straightforward. And driven by an algorithm doesn’t really exist.

The question is: Can YOU make a call?

Not deciding isn’t an escake. Decide.

[Arsen Ostrovsky @Ostrov_A]

Fifty years ago today, Air France Captain Michel Bacos showed the world what true moral courage looks like.

When Flight 139 was hijacked by Palestinian and German terrorists and flown to Entebbe, the non-Jewish passengers were eventually released. Bacos and his crew were also offered their freedom.

However, Bacos, who also served in the French army under DeGaulle, refused to leave his Jewish passengers. All his crew also refused, without exception.

Instead, they chose to remain alongside the 94 Jewish hostages, fully aware of the danger they faced. As Bacos later said, abandoning his passengers was simply "unimaginable."

Days later, they were freed in the legendary Israeli rescue mission, Operation Entebbe, led by Yoni Netanyahu, who would die in the battle.

For his extraordinary courage, Bacos was honoured by both France and Israel. Yet his greatest legacy was not the medals he received, but the example he set: that decency, duty and humanity must never yield to terror or antisemitism.

Michel Bacos was a true hero. May his life, his courage and his memory forever be a blessing and an inspiration.

[Jonathan Greenberg @JGreenbergSez]

Israel is an issue for the left because it’s a successful, confident, optimistic outpost of something the left hates: Western civilization.

[Raylan Givens @JewishWarrior13]

🚨 WATCH: PM Netanyahu: “Citizens of Israel, before the Sabbath begins, I want to announce to you a great achievement for the State of Israel. You know that we are conducting negotiations in Washington between representatives of Israel, Lebanon, and the United States. Prolonged negotiations, and today they bore fruit.

The most important thing is that, first of all, Israel remains in the security zone in southern Lebanon. This is a great achievement, and we are maintaining it as long as Hezbollah does not disarm, as long as there is a danger to the State of Israel.

This is also a great blow to Iran. Iran is trying to force us to withdraw from southern Lebanon by force. And in essence, Israel, Lebanon, and the United States are telling them - this is none of your business. You have no role in Lebanon—neither you nor Hezbollah nor any terrorist organization.

The other thing, of course, is that we are allowing the Lebanese army to begin organizing to seize territory. We are creating two pilot zones. Both are on the IDF's recommendation. And one is outside the security zone altogether, it's south of the Litani, and the other is north of the Litani, a small part of it in the expanded security zone that we achieved in the last two weeks, and that the IDF doesn't need it - he says it most clearly.

We are constantly maintaining the original security zone outside the range of anti-tank missiles. We are not allowing Hezbollah to enter there, nor the population. That is being maintained. And the most important thing is that Israel says, "Our security comes first."

[Brigitte Gabriel @ACTBrigitte]

🚨BREAKING: Secretary Rubio just brokered a historic framework peace agreement between Israel and Lebanon, right here in Washington, D.C.

The deal is simple: Iran is out. Hezbollah is out. The Lebanese military moves in.

Israel begins withdrawing from southern Lebanon. Lebanon takes back control of its own soil. And for the first time in decades, a real path to peace is on the table.

America made this happen.
🇺🇸🇮🇱🇱🇧

[Devon Eriksen @Devon_Eriksen_]

What happened to my bank account? Absolutely nothing.

You believed a lie.

You believed a lie that was told to you by your political class, and your news media, to keep you from asking uncomfortable questions about how much you are paying in tax, where that money is going, and what quality of care you actually receive for the portion of it they didn't steal.

Don't believe me? Look at the pictures.

Look.

At.

Them.

That's my wife, @acrobatichobbit. Before and after.

That's a five centimeter mass. Stage 4 metastatic melanoma. The worst kind of cancer, the most vicious form of assassin your own body can betray you with. That bright area? Blood.

Ten years ago, anywhere in the world, the scan on the left is a death sentence... an endless gauntlet of painful surgeries, followed by chemotherapy, hair loss, uncontrolled vomiting, wasting away to nothing, death.

In America, today, it's not.

We have things here. Genetic therapies. Tailored viruses that attack tumor cells. Drugs that highlight cancers for your immune system, drag them kicking and screaming into the spotlight to be killed.

I won't tell you about her exact course of treatment, because that's none of your goddamned business, but I will tell you that it cost American drug companies and medical researchers a fortune to discover.

A fortune that your nation cannot afford because you chose socialism instead of progress. And socialism, however fine-sounding in theory, simply does not work.

Were she and I British, living in Britain, relying on the National Health Service, I would be a widower now.

Did saving her cost a ruinous amount of money?

Yes. This technology was expensive to create, and the people who did so deserve to pay their mortgages and feed their kids. So do the oncologists and surgeons.

Many of the men who cared for her were old men, experienced men, long past retirement age, still working because when your profession is clawing souls back from the void, sitting on a beach with a pina colada instead just doesn't hit the same.

They deserve every cent.

Did saving her cost a ruinous amount of money?

Yes.

Did I pay it?

No.

Because believe it or not, when things are ruinously expensive, but vitally necessary, we here in America come up with ways to deal with that.

Ways that don't involve creating a big pot of money and entrusting it to corrupt slimeballs.

We have insurance. And sometimes insurance isn't cheap, but the bite it takes is a hell of a lot less of what we have than the tax man takes from you.

And insurance companies sometimes have to make hard decisions about which spending choices will save the most people. I know about this in detail, because that is my wife's profession. She creates the mathematical models that pay for all this stuff.

The insurance that saved her is the exact same plan that she provides to others.

And at the end of an awful year and a half of treatment, awful because cancer medicines make you far sicker than the cancer itself...

We were left whole.

Battered and wounded in spirit, but financially whole, at least.

The only loss we took was the blow to my career as a novelist, because it turns out you can't write stories while your wife is dying, and you don't automatically recover that ability afterwards. Not right away.

I wondered every day if she was going to live or die. I wondered every day what the hell I was going to with myself without her.

But I never wondered, not for a moment, how the hell we were going to pay for all this.

Your government doesn't solve the problem. It is the problem.

They lie to you.

[Raylan Givens @JewishWarrior13]

🚨 BREAKING 🚨 Major Diplomatic Breakthrough: The trilateral framework constitutes a major achievement for Israel, which completely rejects Iran's attempt to force a unilateral withdrawal from southern Lebanon and denies Iran and Hezbollah any role whatsoever in Lebanon.

Following a long negotiation between the US, Israel, and Lebanon, representatives of the three countries signed a trilateral working framework aimed at leading to future agreements between Israel and Lebanon in order to end the conflict between the countries and reach a peace settlement.

Israel will maintain its security zone along the Yellow Line border in Lebanon until the day Hezbollah and other terrorist organizations in Lebanon are disarmed and no longer pose a threat from Lebanon to the territory of the State of Israel.

The freedom of military action of the IDF will be preserved in the security zone to remove threats of any kind whatsoever.

Israel and Lebanon agreed on two areas adjacent to the Yellow Line recommended by the IDF in which there will be a pilot of Hezbollah disarmament and the transfer of the territory to the control of the Lebanese Army: one area outside the Yellow Line and south of Litani, and the second outside the original Yellow Line and north of Litani.

[Moshe @IsraelIDFend]

Whoever made this deserves an AI award.
MUST WATCH‼️

[Afshine Emrani MD FACC @afshineemrani]

A true medical miracle just happened. Daniel Cressy, 23, just became the first person in Louisiana—and the entire Gulf South—to be functionally cured of sickle cell disease using CRISPR gene editing.

Doctors collected his stem cells, edited them with Casgevy to boost fetal hemoglobin production, eliminated the diseased cells, and infused the corrected cells back into his body. The result?
No active sickle cell disease.
No more debilitating pain crises.
No more hospitalizations defining his life.
And perhaps most remarkable of all: his dream of becoming a commercial pilot, once blocked because of sickle cell disease, is now back within reach.

For decades, medicine treated the symptoms. Now we can edit the underlying DNA. Read that again. We are living in an age where a genetic disease can be rewritten at its source. One young man's future was restored.
Thousands more may follow.
Functional cure achieved.
Functional cure achieved.
Future rewritten.
What an incredible time to be alive. 🧬✈️

[Ben Gagnon @CaptainKeel]

Ahoy $KEEL Mates. This is your captain speaking with a quick word from the bridge. ⚓

Today Citizens has initiated coverage with a $10 price target, making them the 11th bank to cover KEEL.

Also today we received word from the docks: our new 100 MVA transformers (80 MW usable) are about ready to leave the factory and bound for the new Sharon substation to increase the site from the 30 MW today to the 110 MW contracted.

Steady as she goes and full steam ahead.
$KEEL

[נועה מגיד | Noa magid @NoaMagid]

Netanyahu: "You know damn well what America would do. It would cross the border, create a security zone, kill the terrorists and protect its people until the threat is removed. That is exactly what we are doing."

[Dan Burmawi @DanBurmawy]

I agree with the VP

[Solomon “Joey” Sager @sagersj]

“Our rights don’t come from government; they come from Gd”

[John Ocasio-Rodham Nolte @NolteNC]

I'm glad Israel is still killing terrorists

[Hillel Fuld @HilzFuld]

Oh boy, things are escalating quickly.

Vance: “My message to people in Bibi's government who are attacking Trump: Do not attack the only leader in the world who supports you. Your country was built with our money.”

No, Mr. Vice President, our country wasn’t built with your money and as a Christian, you should know exactly who gave us this country.

We appreciate your friendship and support but we will not take orders from you or anyone else about how we defend ourselves from the enemies you are now funding with hundreds of billions that’ll go straight to weapons directed at Israel.

Let’s not be confused, Mr. Vance.

[James Lindsay, anti-Communist @ConceptualJames]

My logic here all starts with his seemingly rogue comment about Iran keeping rockets and missiles, which has freaked out many, particularly Israelis and their supporters.

I'm betting the Gulf States are really uncomfortable, like Israel is, with that statement. They're not stupid. They're also targets, like Israel is. Less, but a lot, and the IRGC are crazy bastards. Makes me think Trump made it for them.

The thing is, they didn't do their parts and aren't yet. And Trump's definitely pissed at them because they straight up didn't help during the war (so far…). They wouldn't even let us use their airspace and tried to close down our own military bases. Trump didn't like that and didn't forget. No way.

So Trump letting them feel some legitimate heat that can be resolved by accomplishing his primary goals makes a lot of basic sense.

If we remember Trump's goals and work backwards, it's actually a little easier to see how this makes sense, even the MOU with it's big carrot/big stick arrangement that basically nobody believes will stick (thus terrifying Israel but, I'll bet, also those Gulf States). So what are Trump's goals?

1) Expand Abraham Accords;
2) KSA allying formally with Israel, which was happening until October 7 disrupted it, thus restoring a pre-10/7 peace agenda;
3) Increase their overall security dependency on US and Israel, thus shifting some of their "hand" in the region to us;
4) Standard Trumpism 101: Make them active participants in their own security arrangements, just like what he's doing with the EU and Pacific countries (no more America carrying all the weight).

The MOU itself creates conditions by which Iran becomes agentic in this. If they behave (they won't), they get rewarded, which they actually want, bigly. If they misuse that (everyone expects they will), they get a well-deserved stick. Everyone in the region feels this fear and is vigilant about it. If they misbehave (they will), they bring hellfire on themselves. This breaks the strangest force in the known universe: responsibility never sticks to a Muslim who behaved badly, never.

It's very high-risk, but this is a very high-stakes game, one of the highest in decades. The fears people have are real and justified, but Trump's got them priced in, I think. He knows he holds cards (B-2s, specifically) that let him adjust later if things don't work right, and by the number of times he's said so in the last 36 hours, I think he's well aware he'll be playing those cards at least sometimes. Tough shit for Iran.

I think we need to stop freaking out and let this develop. We need to see how it cooks and how the chef does with it.

Plus, I think he just hosed JD, and that's alright too.