Repurposed Drugs in Oncology: Current State Of The Evidence And A Case Series In Metastatic Lung Cancer

Story At a Glance
 History of Leading Edge Clinic’s Cancer Program - researching and developing complementary cancer care protocols

 Overview of Drug Repurposing : Exploring the concept of using existing non-cancer drugs for oncology, highlighting its potential to address unmet needs in cancer treatment.

 The ReDO Project : Introducing the Repurposing Drugs in Oncology (ReDO) Project, its mission, and its focus on identifying and testing well-characterized drugs for cancer treatment.

 Leading Edge Clinic’s Role : Detailing the clinic’s involvement in research, including the Rebuild Medicine study on repurposed drugs for cancer.

 Case Studies and Evidence : Highlighting real-world examples and emerging scientific evidence supporting the efficacy of repurposed drugs in oncology.

 Introduction
 At Leading Edge Clinic , we specialize not only in treating post-COVID and post-COVID-19 vaccine syndromes but also in integrative, repurposed drug treatments for cancer. Our approach utilizes FDA-approved medications with anti-tumor mechanisms that have been repurposed to complement conventional, standard of care (SOC) approaches.
 This post reviews the current published evidence base for, and research activity in, the use of repurposed drugs in oncology. It culminates with a case series of five consecutive patients with metastatic lung cancer, all treated under the care of the same clinician (me) using similar combination repurposed drug therapies combined with metabolic interventions (i.e., ketogenic diets and/or fasting).
 What makes the case series particularly remarkable is that four out of five patients showed no cancer progression over the observation period (one even achieved complete remission), despite advanced-stage diagnoses and advanced ages. Notably, two of the patients, per their insistence, achieved disease stability while receiving only repurposed drugs and dietary interventions - without any conventional chemotherapy, radiation, or targeted treatments.
 I share these cases to offer a real-world glimpse into the potential of individualized, low-toxicity, evidence-informed repurposed drug protocols. This post will illustrate not only the scientific rationale behind drug repurposing in oncology but also the powerful role of patient engagement, metabolic interventions, and close clinical monitoring in the pursuit of disease control and quality of life.
 Background
 I previously wrote a post about how my interest in cancer was inspired by my close friend and co-founder of the FLCCC, Professor Paul Marik. His insight inspired me to do a deep dive into the history of research into the causes of cancer, culminating in the now validated “Metabolic Theory Of Cancer” (MTOC). I was further inspired by Paul’s comprehensive scoping review of the world’s medical literature, compiling the scientific and clinical evidence bases for dozens of repurposed drugs and nutraceuticals in the treatment of cancer. Paul’s work was an impressive effort, as it drew from nearly 1,500 scientific references. That work culminated in his increasingly popular book, now in its 2nd edition, called Cancer Care .
 In a previous series, I explored the scientific evidence supporting the Metabolic Theory of Cancer (MTOC) , which overturned the long-standing Somatic Mutation Theory (SMT ) about 15 years ago, with the final pieces to the puzzle stemming from the groundbreaking work of Dr. Thomas Seyfried . His research helped fill the final gaps in the understanding of how cancer originates, offering a comprehensive framework that aligns with decades of observations dating back to Otto Warburg's Nobel Prize–winning discovery in 1927—that cancer cells uniquely generate energy primarily through glucose fermentation, even in the presence of oxygen, unlike normal cells .
 I hope it goes without saying that if the understanding of the “root cause” of a disease changes, so should the treatment approach. That is what we have done at the Leading Edge Clinic. Meanwhile, the field of oncology is still obsessively (and financially) focused on cytotoxic therapies (chemotherapy and radiation) rather than therapies targeting disrupted metabolic pathways.
 However, our goal at Leading Edge is not to recommend that patients forego standard of care therapies (SOC) but instead that SOC should be “complemented” with more diverse, mechanistic, and non-toxic approaches, based on the considerable scientific and clinical data that Paul compiled.
 Most significantly, in Paul’s scoping review and book, he graded the strength of the scientific evidence for repurposed drugs and nutraceuticals, where he identified only seventeen as having a “strong” level of evidence to support, eight as having a “weak level of evidence” to support, fifteen others which he deemed the evidence “insufficient” and another five as having evidence to “recommend against.”
 Remarkably, Paul only found sufficient scientific (i.e., in vivo, in vitro, and clinical) evidence to make assessments on a total of 60 repurposed drugs and nutraceuticals, even though there are 254 repurposed drugs and over 2,000 nutraceuticals that purportedly have anti-tumor mechanisms. I often tell my patients that the “best” treatment for cancer might be in that dizzying list of potential candidates, but we don’t have the evidence of both safety and efficacy for me to recommend them.
 My practice is to instead rigidly stick to the compounds with the “strongest published evidence” (although I have made exceptions with specific therapies that have had their research severely restricted, as per “ The Kory Scale ” (wink, wink).
 This is important because many cancer patients, upon diagnosis, begin to research therapies online and on social media (often obsessively, but who can blame them). Once they start doing that, they find claims of efficacy and/or cure for... just about anything. As a result, they are constantly asking me about this therapy or that therapy that they have read about. I say, “I don’t know,” or, in cases where there is little published research, I typically recommend against it due to lack of safety data with chronic use (remember, first do no harm).
 One example supporting the above concern is the widespread recommendations to use soursop fruit for its anti-cancer mechanisms, ignoring the fact that chronic use has been shown to cause Parkinson’s.
 Again, I want to emphasize that we do not recommend that patients avoid or refuse well-established and evidence-based “standard of care” (SOC) approaches like chemotherapy, radiation, surgery, and targeted therapies. We insist that our patients have both an oncologist and a primary care provider, although to be fair, I can’t tell my patients what to do - a minority decline standard of care or “system docs” despite my recommendation that they work with one. Iatrophobia and nosocomephobia run rampant, it seems.
 One — and only one — of the reasons I make this recommendation is, admittedly, a “defensive” one. If a patient experiences a poor outcome after choosing to rely solely on repurposed drug protocols, I want to avoid the risk of being sued by a family member who disagreed with that choice and later claims I failed to sufficiently encourage the patient to seek more established oncology guidance — a scenario that has, in fact, happened to other physicians who treated cancer patients with so‑called “alternative” methods.
 Observational Study Of Repurposed Drugs In Cancer
 Further, we applied for and obtained ethics oversight approval (IRB) to conduct a prospective, observational study to compare the survival and functional status of patients treated with complementary repurposed drug protocols versus patients treated with standard of care therapies alone.
 That research study is just part of the work that my new non-profit, called Rebuild Medicine , is doing in advocacy for the research and use of repurposed medicines.
 This post was inspired by the fact that I saw three of the five patients I am treating for metastatic lung cancer in the past few weeks, and was very pleased with their progress. Although the study is still ongoing (and will be for several years), I decided to write a preliminary, interim report of the metastatic lung cancer patients that I have personally treated, all presented consecutively, leaving none out.
 I cannot overemphasize the importance of avoiding “cherry-picking” when discussing treatment outcomes, a practice that social media is riddled with - all you hear about are cases of cures by providers or patients without a minimum of effort (or ability) to compile data in an unbiased, transparent, systematic manner. This behavior runs the risk of overestimating the efficacy of such approaches, which might lead patients to avoid SOC, whose efficacy, although often sub-optimal or even harmful if not well chosen, is well established “scientifically.”
 Growing Focus On Combination Repurposed Drug Therapy in Modern Oncology
 Treating cancer with combinations of repurposed drugs—medications originally developed for other indications—is no longer just an alternative approach; it is increasingly recognized as a mainstream strategy in oncology. Over the past decade, the number of major academic centers and research groups conducting rigorous clinical trials on repurposed drug protocols for cancer has grown dramatically, reflecting rising interest from both the scientific community and regulatory bodies .
 The drug repurposing movement utilizes the central or ancillary attributes of a drug typically used for non-cancer indications to constructively interact with a cancer's growth mechanisms, thereby slowing the cancer's growth.
 Know that such approaches, instead of directly killing cancer cells, simply target multiple, growth-driving pathways. On page 31 of Paul’s Cancer Care book, he lists the main pathways our Leading Edge Clinic targets with our combination regimens (Hexokinase 2, p53, TGF-B, Wnt, Notch, PI3/AKT, Hedgehog, IGF-1).
 Two cancer non-profit organizations ( The AntiCancer Fund and Global Cures ) partnered to create The ReDO project (Repurposing Drugs in Oncology). ReDo created a database of all published, planned or active trials of repurposed drugs in cancer from U.S, European, and WHO Trial Registries. They identified 970 trials from 45 countries :

 Current RCTs OF Repurposed Drugs in Oncology:
 Now, although the ReDO project has identified 970 trials of repurposed drugs in oncology, very few are “actionable” given that many were terminated for lack of enrollment, others are still recruiting, or their recent status is unclear in the registry (updates not filed). Most disappointing is that the vast majority tested a single repurposed drug added to SOC (Ed: dumb). It is challenging to find published results of trials testing the addition of multiple agents at the same time; however, of the few available, the results are highly encouraging.
 In one trial called CUSP9 , they treated patients with a combination of 9 (yes, 9) different repurposed drugs in addition to standard of care. Note this approach is in line with our Leading Edge clinic practice and observational study, where we commonly use combinations of up to ten or more different therapies depending on stage and type of cancer (and “type” of patient).
 GLIOBLASTOMA TRIALS
 The majority of combination repurposed drug trials study patients with glioblastoma, a brain cancer. One reason is that glioblastoma is one of the more deadly cancers and has a highly predictable median overall survival of 15 months and a two-year survival of 27%, despite SOC combinations of surgery, chemotherapy, radiation, and oral maintenance chemotherapy.
 This highly predictable (and terrible) survival allows for comparison in outcomes between the two approaches, as you will see below. Another reason is that glioblastoma has numerous mechanisms driving its growth, thus demanding a combination, multi-mechanistic approach. The results of the accumulating data are impressive:
 CUSP9
 Repurposed regimen: aprepitant, auranofin, captopril, celecoxib, disulfiram, itraconazole, minocycline, ritonavir, and sertraline .
 A report of their phase 1 trial in 2021 showed:
➤ 30% of patients were alive and disease-free at over 4 years post-treatment.
 Compared to historical prognosis with standard-of-care (SOC) therapies:
➤ Long-term disease-free survival (>4 years) is extremely rare ,
➤ Typically occurs in under 5–10% of patients ,
➤ Mostly limited to exceptional responders .

 So, 30% of such patients were alive and disease-free over 4 years later, compared to only 5-10% being alive historically? Wow.

 METRICS
 Published in 2019, this study included 95 patients with Stage IV advanced glioblastoma who they treated with four drugs in addition to SOC ( metformin, atorvastatin, mebendazole, and doxycycline) . Check out the survival compared to historical controls:
 ➤ Two-year survival = 64% vs. 26-28%
➤ Median survival of repurposed patients = 27.1 months vs. 14-15 months
 Again wow. Also, know that in this study, the median duration between diagnosis and start of the 4-drug regimen was 6.6 months. Imagine if they had started treatment at diagnosis instead of almost 7 months later? Further, 85% of patients tolerated all four drugs “without issue.”

 CLOVA
 Another four drug regimen study in glioblastoma patients (note the 4 drugs were completely different than the METRICS or CUSP9 studies above): cimetidine, lithium, olanzapine ( an anti-psychotic? ), and valproate. Results:
 7 patients with recurrent, chemotherapy-resistant GBM

 All were “RPA class 7.” RPA (recursive partitioning analysis) is a statistical tool used to stratify patients by expected survival. Class 7 refers to the group of patients with the poorest prognosis.

 Median overall survival (OS) after recurrence: 11.2 months vs. 4.3–4.9 months in historical controls alone (p = 0.004).

 See their chart below depicting survival curves and note the steep, plummeting trajectory of historical controls compared with the more staggered, prolonged survival of those treated with (just 4) repurposed drugs:

 Solid Tumors
 COMBAT
 This was a study that included 74 children with advanced, refractory, or relapsed pediatric solid tumors, many heavily pretreated and with poor prognosis. They were then treated across three European academic medical centers with celecoxib, vitamin D, fenofibrate, and retinoic acid along with standard chemotherapy regimens. In a historical comparison of the high-grade sarcoma subgroup, they reported:
 Median overall survival with COMBAT: 15.4 months vs. 3.9 months in historical controls
→ COMBAT-treated patients lived nearly 4 times longer (p = 0.001)

 In summary, although I could find only four small to modestly sized studies using combinations of repurposed drugs, to date, all have shown significant improvements in survival and tolerance to medications.

 Planned/Ongoing Trials
 MDACT : is testing 6 drugs in colon, biliary, lung, and brain cancer. The six drugs are: celecoxib, dapsone, disulfiram, itraconazole, pyrimethamine, and telmisartan .
 MEMMAT - includes children with recurrent medulloblastoma, ependymoma, or atypical teratoid/rhabdoid tumors being treated with thalidomide, celecoxib, and fenofibrate alongside conventional chemotherapies.

 Proposed Trial Protocols
 I also discovered a series of published papers in which the authors proposed multi-repurposed drug regimens to treat several cancers; however, to date (years later), these studies have still not been conducted. This suggests that publishing such “aspirational trial protocols” has become a cottage industry in oncology - resume padding anyone?
 A reason for the lack of conducting such trials could be that there is no funding (all meds are off-patent, so no financial incentive). Again, this is something Rebuild Medicine is hoping to change. All study acronyms below are hyperlinked to the paper:
 AVRO : glioblastoma - aprepitant, vortioxetine, roflumilast, olanzapine.
 IPIAD - pancreatic cancer - irbesartan, pyrimethamine, itraconazole, azithromycin, and dapsone
 OPALS - lung and glioblastoma - pyrimethamine, cyproheptadine, azithromycin, loratadine, and spironolactone.
 EIS : glioblastoma: itraconazole, metformin, naproxen, pirfenidone, quetiapine rifampin
 MTZ: glioblastoma- minocycline, telmisartan, and zoledronic acid
 ADZT -glioblastoma - apremilast, dapsone, zonisamide, and telmisartan
 Why Standard Therapies Fall Short: Cancer Stem Cells
 Another critical aspect of the role of repurposed drugs in treating cancer is that they can target cancer stem cells, something that current SOC approaches fail at doing. Know that cancer stem cells (CSCs) were first identified in leukemia in the 1990s and a decade later in solid tumors, which represents, in my mind, a relatively recent discovery in “medical time.”
 CSCs are a small, resilient subset of tumor cells driving growth, relapse, and metastasis (they make up between 0.01% to 2% of a tumor ). Unlike the other fast-dividing cancer cells targeted by standard cytotoxic therapies (chemotherapy, radiation, immunotherapy), CSCs exhibit self-renewal , differentiation , and anti-apoptotic pathways , enabling them to survive within protective tumor microenvironments (e.g., hypoxic or inflammatory niches).
 These properties make CSCs not only resistant to conventional treatments, but some (chemo and RT) have even been shown to promote CSC proliferation , leading to tumor recurrence inadvertently. For example, this below study’s title is not reassuring:

 This study is even less reassuring, yikes:

 Leading Edge Clinic’s Unique Approach
 Thus, I believe that one critically important aspect of our treatment approach (where Leading Edge departs from the rest of the drug repurposing in oncology movement) is based on our specific targeting of cancer stem cells (CSCs) with repurposed drugs.
 From Perplexity AI:
 Currently, there are no FDA-approved therapies specifically and exclusively targeting cancer stem cells (CSCs) as a distinct class of treatment.
 Since chemotherapy and radiation target rapidly dividing cells, shrinking tumors but sparing (or again, even inducing) slow-growing CSCs, it should come as no surprise that the biopharmaceutical industry is currently developing various CSC-targeted therapies (e.g., very costly monoclonal antibodies requiring infusion centers). Still, these remain inaccessible and as yet unproven.
 The Role Of Repurposed Drugs Against Cancer Stem Cells
 Although research into developing patented treatments directed at CSCs is underway, the beauty is that, since the discovery of CSCs, extensive in vitro studies have identified affordable, accessible drugs that inhibit CSC proliferation, suggesting the potential of cost-effective, readily available alternatives. At Leading Edge Clinic, we specifically target CSCs with the repurposed drugs that have been identified as having anti-CSC mechanisms , aiming to prevent relapse and improve outcomes.
 Repurposed Drugs Targeting CSCs
 Based on our research and clinical experience, we use, depending on the cancer and the patient:
 Metformin , ivermectin , mebendazole , doxycycline (antibiotics with anti-CSC properties)

 Curcumin , green tea extract , resveratrol , berberine (plant-based compounds)

 Melatonin , vitamin D3 , omega-3 fatty acids (nutritional supplements)

 Aspirin , diclofenac , statins (atorvastatin) , phosphodiesterase 5-inhibitors (anti-inflammatory and metabolic modulators)

 Our CSC-focused strategy addresses a critical gap in standard care, leveraging affordable repurposed drugs to enhance patient outcomes without reliance on expensive, centralized systems. This aligns with our mission to empower patients and challenge profit-driven healthcare models.
 I include the below forward to Paul’s book, written by our friend, colleague and mentor, the pseudonymous Dr. Justus R. Hope (I really like his tree/roots analogy re: CSC’s in the below graphic):

 Metastatic Lung Cancer Case Series From The Leading Edge Clinic
 In the published CLOVA study mentioned above, only seven patients were included. Here I present the outcomes in five consecutive patients. This is important because it is impossible to know the true efficacy of a therapy if the only data point being shared is a dramatically positive result without any sense of how many did not respond or were harmed (you can be sure that practitioners blasting treatment successes on social media never post about their adverse outcomes or non-responders).
 Further, what is often underemphasized in such “reports” are the other, potentially contributory treatments or dietary changes. Thus, in this case series (and upcoming ones), I did the following:
 The patients all presented consecutively, with the same stage and type of cancer (metastatic lung cancer in this series)

 Patients were all treated by the same clinician (me)

 All treatments employed, both SOC and repurposed, are detailed

 Estimates of adherence to ketogenic diets/fasting are included

 Medical records of imaging and stage, along with dates, are provided

 Reports of intolerances or side effects to therapies are all documented

 Clinical assessments of performance status over time are included

 Of the five consecutive metastatic lung cancer patients I have treated with combination repurposed drug protocols and ketogenic diets:
 2 received no other conventional treatments (no chemo, RT, targeted therapies etc) but not on my advice; this came out of their personal preference, both are octogenarians

 2 received concomitant oral tyrosine kinase inhibitors

 1 received multiple, aggressive conventional therapies - pneumonectomy, post-op RT to new metastases, and numerous cycles of various chemotherapy regimens

 As you will see from this series, as well as from the above studies, it is clear to me that “complementary” repurposed drug protocols have considerable efficacy. Still, I do not feel the evidence is anywhere near sufficient to suggest that patients forego more supported treatments at this time.
 I am putting the following case series behind a paywall because 1) I am submitting for publication, 2) I will pay the (up to $2,000) fee to make the article open access, 3) I promise to post the article to my free subscribers when that happens 4) I put an immense amount of effort into performing the detailed chart review writing up the cases for this series.
 I wrote up two versions of the case series, one short, one long:
 The longer, granularly documented version with concurrent commentary can be found at this link (10+ minute read).

 A more concise, AI-assisted version can be found at this link (3-minute read)

 If you can afford to, and find value in the time, research, and care I invest in crafting these posts (and Op-Ed’s) which aim to expose critically important truths about the safety and efficacy of a diverse set of medical therapeutics, please support my work with a paid subscription.
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Summary: A review of the existing evidence base for repurposing drugs to treat cancer, followed by a case series of five consecutive patients treated with combination repurposed drug protocols.


We Published an Op-Ed About Children Killed By Vaccines In A Mainstream Media Outlet

As many of my readers know, I have published over thirty Op-Eds in major media outlets over the past 4 years, with quite a few on “controversial” health topics related to Covid. However, the vast majority were in right-wing or center-right publications.
 The first Op-Ed I ever published was early in the pandemic, in USA Today (July 1, 2020), where I tried to alert the world that Covid was aerosol (not droplet) transmitted, something the CDC and WHO took another 1 and 2 years to officially recognize, respectively.
 Some other left-wing exceptions were Op-Eds I wrote with the veteran investigative journalist Mary Beth Pfeiffer; Newsweek ( spikes in death and disability ), The Hill ( alarming rates of young people dying , and USA Today ( Covid vaccine injuries and explosions in excess mortality in the U.S ).

 However, in those those Op-Eds, we were rarely able to make explicit links between the epidemiological catastrophes and Covid vaccines—the references were either subtle or omitted altogether—the notable exception was the Op-Ed published in The H ill, where we specifically identified Covid vaccines as a possible factor in the surge of sudden deaths among young Americans, illustrated in the following paragraph:
 Vaccines were given to more than 270 million people , among them babies, pregnant women and workers under employer mandates. The therapeutic’s “warp speed,” emergency use authorization must be part of any post-pandemic analysis, in light of more than 1 million reports of possible harm to the Vaccine Adverse Events Reporting System and a new Yale University study validating a chronic post-vaccination syndrome.
 However, to date, we have never ventured into exploring the topic of the deadly harms of traditional childhood vaccines, a topic that would typically guarantee career suicide. Since my academic career has already been suicided, and Mary Beth has long left corporate media, we were free to venture.
 Unsurprisingly, our article was a “tough sell” as they say. To wit, we received rejections from Newsweek, Washington Post, The Hill, Fox News, and Newsday (no reply). Somewhat shockingly, we did receive an initial acceptance from the USA Today Network, but they never ran it and stopped responding to our queries as to when it was going to run.
 Then yesterday, our Op-Ed was accepted by and published on SILive.com , the news site of the Staten Island Advance newspaper (founded in 1886):

 OK, fine, so most of you have never heard of it but if you are a New Yorker (largest city in the U.S and a bastion of still-mask-wearing liberal pro-vaxxers), you likely have read it. From Perplexity AI:
 2.6 million unique visitors per month on silive.com, with over 7.4 million monthly page views.

 This reflects a substantial local and regional readership mainly focused on Staten Island and New York area news.

 Fun fact: Mary Beth’s first job as an investigative reporter right out of college… was with the Staten Island Advance! See young “cub” reporter Mary Beth plugging away at the Advance in 1976 on the left (love the old school phone), and Mary Beth now:

 I would be remiss if I didn’t share a link to a compilation of her investigative reporting .
 Anyway, it seems “the times they are a-changing” because our Op-Ed highlighted the potential deadly harms of childhood vaccines, a topic which runs the risk of strengthening Big Pharma’s #1 enemy, that of vaccine hesitancy (oh no). It can be read at this link .

 If you can afford to, and also find value in the time, research, and care I invest in crafting these posts (and Op-Ed’s) which aim to expose critically important truths about the safety and efficacy of a diverse set of medical therapeutics, please support my work with a paid subscription.
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Summary: Our Op-Ed exposed apparent cases of SIDS that were actually caused by childhood vaccines. It was published in a highly read news outlet... in New York City.


Leading Edge Clinic: Evolution, Integrity, and Pro-Active, Patient-Centered Care

Several events inspired this post: 1) the completion of our Leading Edge Clinic’s “rebrand” (i.e., new website and logo) in anticipation of our three and a half year anniversary, 2) our clinics first annual in-person retreat in Minnesota next weekend (since we do tele-health, our employees are scattered across the country and most do not get to meet in person) and 3) the live “Round Table ” that a group of our providers at Leading Edge Clinic held recently on Rumble for both existing and potential patients to learn more about our practice and its providers. We discussed our professional and personal backgrounds as well as our current practice philosophies.
 The Round Table was surprisingly well received, as many current patients reached out with further encouragement and appreciation of the care we deliver.
 I want to say at the outset that Leading Edge Clinic is one of my proudest achievements, as I believe we have attempted to address the most significant unmet medical need in the world (in my opinion), namely the treatment of post-Covid-19 vaccine injury syndrome and Long Covid. Another rapidly rising need in the wake of the mRNA campaign is the care of cancer patients, to which we responded by building a complementary cancer practice 18 months ago (the clinical success of which you will learn about soon in upcoming posts).
 However, what makes me most proud is the level and type of care we provide, which I hope will serve as a model for other practitioners to deliver optimal care for complex patients.
 Thus, I wanted to take the opportunity to share what we have learned and achieved in building our private, fee-based tele-health practice, where we see patients in all 50 states (and advise those in other countries).
 Personal Backgrounds - How And Why We Started Leading Edge Clinic
 Know that, in my case, I was about to become a full Professor at the University of Wisconsin when I resigned and left academia in early Covid (one of my first Substack posts covered this). So, how did Scott and I end up in private practice? Simple. In my case, I was excommunicated from the “system” I had built my career in due to having a public profile as a vocal dissident to every single Covid policy that existed. That caused me to lose two more “system” jobs before finally giving up.
 In Scott’s case, he was forced to flee to protect his health from unethical and totalitarian vaccine mandates (Scott was severely injured from his initial mandated vaccine; thus, there was no way he would submit to another one).
 We both had families to provide for and were not of retirement age or of sufficient wealth to retire (I have two kids already in college and a third on the way). Most importantly, we both share a passion for and commitment to practicing and teaching medicine, so we decided to open a private specialty clinic. Another motivation came from my own research and advocacy with the FLCCC as well as through collaborations with the outstanding scientists, researchers, and policymakers at Children’s Health Defense and React-19 , we recognized that care for the Covid vaccine-injured was, and still is, the world’s most significant unmet medical need.
 We knew the vaccine-injured needed treatment, but they were not receiving it. Little did we know that we were going to come up against the most complex and idiosyncratic disease we had ever treated in our careers. Scott quickly and happily joined me because he knew it would be a refuge from the insanity, corporate control, and corruption of the medical system.
 The Launch
 Here, I would like to highlight the contributions of my first practice manager, Kristina Morros, a nurse anesthetist colleague I initially hired to work for me when I was with the FLCCC. She was tireless in putting together everything we needed to start practicing tele-health - including the website, electronic medical record system, licensing, registration forms, payment processing, human resources, payroll, and more. I was swamped working for the FLCCC at the time and traveling extensively, so I will never forget her efforts in putting together the initial infrastructure back in 2022.
 Scott was the first provider we hired, and it quickly became apparent that he was an absolute gem of a clinician (and human). Astute, observant, and intensely studied, with immense empathy and commitment, who is also patient, articulate, and encouraging with patients. I was shocked (and even jealous!) at the consistent “ravings” he got from solicited reviews of our patients after visits in those first months.
 His patients were so over-the-top appreciative and laudatory - we still have a vast collection of those reviews. Additionally, besides being an experienced nurse and nurse practitioner, he had a background as a union organizer and founder of a free clinic in Ithaca, so he was skilled at providing “patient/customer relations” and managing staff. Within six months, we decided to become full partners together, a decision I have never regretted (in fact, I firmly believe that Leading Edge Clinic would not be what it is today without his contributions, leadership, and partnership - there is no way I could have done this on my own).
 One goal that Scott and I established at the outset was that we were both fully committed to being the “best employers” we could be in terms of supporting our staff, including compensation, benefits, education, and ensuring flexibility to meet work-life needs. I believe you will find numerous examples of that ethos below, most evident in how we started offering benefits very early on for a small business, at a time when cash reserves were, in hindsight, frighteningly marginal.
 The Patients
 Our initial patients were pleased with our care, despite our need to learn more about understanding and treating their condition. Although we knew little (and admitted as such), what they most responded to was our understanding, empathy, intellectual dedication, and willingness to try therapies to mitigate their suffering from what was often myriad symptoms. Heck, when we opened our practice, every single patient visit started with the patient delivering a detailed and disturbing history of their labyrinthine journey through what I now call “the system” and its “system docs.”
 Before consulting with us, many had already visited “Long Covid Clinics” at academic medical centers or had extensive evaluations at places like the Mayo Clinic and the Cleveland Clinic. In no case was a precise (or honest) diagnosis provided, and empiric treatment was rarely offered. What patients did receive was an endless cycle of testing, imaging, and referrals (often to psychiatry). The gaslighting and even outright hostility to our patients by system docs was shocking to hear. Previously in my career, outside the occasional report of an impaired or mentally ill physician, I had never heard of behaviors or words by a doctor to a patient in the way they spoke and acted to vaccine-injured patients (Long Covid’s were treated more kindly but just as ineffectively).
 Thus, our initial attraction to the first wave of patients stemmed from our ability to listen, understand, identify with, and connect with their suffering. Skill and, dare I say, expertise would come later. I am probably being too humble here - many of our initial therapies are still standard in our care plans, so I don’t want to imply that we initially got anything wrong. Instead, for many, much more was needed, and we had yet to discover other, often more effective therapies.
 Practice Staff
 Another “miracle” in hiring, besides Scott, was our first hires on the nursing and managerial side. Two of the “OG’s” who have been the most instrumental in building the structure and functioning of both our practice and stellar nursing staff were Tisha Palmer (Practice Manager/Nurse Manager) and Charge Nurse Kara Gabrielson. One of the great testaments to our practice is the number of people we have hired who have been with us from the start and have remained with us for years.
 As patients continued to join and knowledge of our care spread through word of mouth, our staff has consistently grown. One thing we learned in building our staff, both intuitively and quickly, is that interviews were generally unhelpful in predicting performance. What candidates said, how they performed in the interview, and how they performed on the job were often discordant. We thus quickly began to focus on identifying candidates with whom one of us had worked or with whom one of us knew someone who had worked. Our second most impactful practice was that we very quickly “let go” of any provider or nurse who we felt “didn’t have it” in terms of the dedication, competence, and empathy we were looking for. As a result of that practice, we have no “dead weights” on our team.
 Another unique aspect of our staff is that, like Scott and I, every one of us are “refugees” from the medical system in some way, all having shared histories of having been either persecuted by, harmed physically (many are vaccine injured), or harmed financially due to being either fired by or forced to leave in protest against vaccine mandates. We are quite the crew.
 Consequently, that fighting spirit is what leads me to believe that we have one of the most outstanding teams in terms of empathetic patient care, attention to detail, collegiality, and a commitment to doing our best job.
 Practice Structure And The Economics of Private Fee-Based Medical Practice
 Here, I would like to extend my thanks to Dr. Chris Ewin of 121 MD in Texas, one of the pioneers of the “direct primary care” practice model in this country and who formerly served as the third president of the Society for Innovative Medical Practice Design (previously the American Society of Concierge Physicians which morphed into the American Academy of Private Physicians before it fizzled out in 2017). His expertise in designing and structuring private fee-based practices was invaluable to us.
 Health Policy Amendment Positively Impacting Tele-Health
 I want to take a moment to celebrate Chris’s recent contribution to changing national health policy (which will benefit current and future Leading Edge Clinic patients). Briefly, in the “One Big Beautiful Bill,” one of the amendments now allows for the 61 million Americans with Health Savings Accounts (HSAs) to pay for direct primary care services! That was never the case before - you couldn’t use HSAs to pay for fee-based practices, and now you can! Note to self: start an HSA stat.
 First, some background on the amendment, from Dr. Ewin:
 It’s been 21 years since my insurance agent asked me why he couldn’t use his HSA to pay for my services. It was a question that led me on a long journey. One helped by Roy Ramthun, “Mr HSA”, who was Sr Health Care Advisor to Preident Bush. Sen. Orrin Hatch also helped us out. He was a great man, and now, after three iterations, the “Mark Brown Amendment” has been included in that big, beautiful bill just signed by our president, Donald Trump.
 Common sense prevails for the little people.
 From AI about the amendment:
 “HSA funds can cover DPC membership fees, capped at $150/month for individuals and $300/month for families. Ed: more importantly for us: “The Act also allows HSA-compatible high-deductible health plans (HDHPs) to cover telehealth services without cost-sharing before the deductible is met (retroactive to December 31, 2024).”
 Further:
 Your employer may cover a DPC agreement as a part of your health benefits plan, even if that plan is a high deductible health plan (HDHP) with an HSA.

 Spending on that DPC agreement would count toward the deductible in your HDHP plan .

 Employers may offer these DPC plans with zero cost sharing and no out-of-pocket costs for primary care.

 Employers will now be able to offer a DPC benefit to ALL their employees.

 In summary, this amendment marks a watershed moment not only for the direct primary care community but for the larger health freedom movement as a whole. By finally allowing Health Savings Accounts (HSAs) to cover direct primary care memberships, the federal government has legitimized the choice of patients to seek out unencumbered, relationship-based medical care—liberated from the constraints of traditional insurance networks and corporate healthcare bureaucracy.
 This is a crucial victory - it empowers patients to select physicians who prioritize individualized care, innovation, and personal accountability, rather than compliance with top-down edicts, protocols, and profit-driven gatekeeping .
 Leading Edge Clinic Practice Economics
 Below, I will detail the care we provide, the associated costs, and the fees we charge. Please forgive me if some of it comes across as defensive, but I am frustrated—and even hurt—by public accusations from individuals that I am “grifting” (i.e. overcharging) based on my public profile or that the fees from our care plans go directly to me (sadly, as you will see, this latter belief is nowhere near the case).
 The above accusations anger me because: 1) my fees are the same as Scott’s, 2) I make less from my practice than in any clinical job I have held in my career, 3) they stem from an astounding level of ignorance about fee-based medical practice economics, especially high-level ones that care for highly complex, chronically ill patients, and 4) the fees we charge are more affordable and deliver higher quality longitudinal care compared to other “specialty practices” that employ integrative or alternative therapies.
 Leading Edge Clinic Costs and Fee Structure
 Before I discuss our fees, I would like to emphasize that our practice generates revenue solely from specialist consultations, high-level specialty nursing support, and the development of complex, ever-evolving, and multimodal treatment plans. We do not sell supplements, medicines, or charge for clinic-based therapies like HBOT, IV infusions, near-infrared sauna, ozone, UVBI, etc.
 What is also little known, and I think leads to patients not understanding the fee amounts, is that, even in hospital systems, the Department of Medicine (pure medical consultation) is primarily viewed as “a loss leader” (except for cardiology and GI, given their highly reimbursed endoscopies, device implants, and catheterizations).
 Medical consultation specialties instead generate revenue for the hospital by keeping inpatient beds full and driving referrals for laboratory testing, imaging/scans, procedures, biopsies, and surgeries (the latter being the most significant income source for any hospital). Highly compensated executives in both for-profit and non-profit systems are thus happy to take a loss with internal medicine because it gets patients to the top of a lucrative sales funnel under the guise of public health (sorry, not sorry). At Leading Edge, we have none of these sources of revenue to offset the cost of the time and attention we devote to our patients.
 Health Care Insurance
 Further, we do not accept private insurance, Medicaid, or Medicare for several key reasons. First, my revoked Board Certifications make me ineligible to participate in private insurance plans. Second, most of our integrative treatments, such as those for Long Covid and vaccine injury, are not covered by insurance. Third, insurance reimbursements fail to compensate for the extensive time and attention we dedicate to (and are required by) our patients, as Scott and I are committed to practicing medicine “the right way,” prioritizing patient care over profit. Finally, managing insurance billing would require a large administrative staff, significantly increasing costs and complexity, which would detract from our patient-centered focus.
 Comparison With E-Mail/ Text Based Tele-Health Practices
 Now, on the other side of the spectrum, are tele-health clinics that practice via text or email communication with little to no nursing support and sometimes minimal timely responsiveness. One strength of such clinics is that the fee for care is admittedly lower, thus making it more accessible to those with lower incomes; however, “you pay for what you get.”
 Although during the height of COVID, such practices were necessary given the dearth of providers willing (and able) to treat COVID, I feel that post-pandemic, with chronic illness, it is insufficient. The fees are still too high for the level of care delivered in such conditions, and I worry about the efficacy and/or safety of such minimalist care. I recently learned of one practice that charges as high as $500 for sending protocols or advice via email or text, often without an initial in-depth consultation, ongoing nursing care, guidance, or responsiveness (or even prescriptions). We would never charge $500 for sending someone an email with a non-individualized protocol of medicines, which, in some cases, they would then have to acquire personally.
 At the level of care we provide, such fees are insufficient; however, we have long provided and continue to provide significant pro bono care in specific instances.
 Comparison With Other Integrative Clinics
 Finally, even in the integrative/functional/alternative medical field, the fees we see charged by other clinics outpace ours. For instance, HBOT, ozone, and UVBI charge $200 or more per session (note that HBOT, for example, typically requires 40 sessions). Single stem cell infusions average $15,000, while single IV infusions can run in the many hundreds of dollars (depending on how many different vitamins or therapies you desire).
 Stem Cell Clinic Example
 One testament to our commitment to not profiting from treatments is that Scott has, on occasion, run a “stem-cell/exosome” clinic at his office in Ithaca, where we have treated selected patients with these therapies. We both agreed that we had an ethical responsibility not to make an excess profit from a treatment that we were professionally recommending and thus “selling” to a patient, therefore creating a “conflict of interest.”
 That aspect of medical practice has always deeply concerned me. Oncology is the worst in this regard, given that chemotherapy revenue accounts for 66–77% of oncologists’ income. Surgery, GI, and cardiology are similarly rife with incentives to recommend (“sell?”) highly reimbursed procedures and surgeries. For a devastating analysis of this aspect of medicine using the examples of “cardiac catheterization” and “triple bypass surgeries,” I highly recommend you read Dr. Robert Yoho’s disturbing analysis here.
 To wit, if any reader knows the average markup applied by stem cell practitioners, I think you will be shocked at how little markup we applied - our protocol is similar to the Phase II protocol for Long Covid patients by the Vitti Labs company. We deliver five treatments over 5 days (2 stem cell infusions and 3 exosome infusions).
 I asked Chat GPT what a typical practitioner charges for a single stem cell infusion:
 Most commonly reported average range: $10,000–$20,000 per single stem cell infusion for complex or chronic conditions.

 Exosomes: Most common price points for a single session are around $4,900 to $5,000

 For 2 stem cell infusions and 3 exosome infusions given over 5 days, our Leading Edge Clinic charged $11,500, while the costs were approximately $10,000, driven by acquisition and storage costs of the products, infusion equipment, monitoring devices, and labor. Scott and a nurse worked all week with the patients, giving them numerous infusions. Using the average charges estimated above in the U.S, such a treatment program would typically cost $45,000, not $11,500. So there.
 Thus, what we charge for in our practice is the time, attention, support, and expertise we bestow on our patients.
 Costs of Care At Leading Edge Clinic
 To understand our fee schedule (which I will go into below), I think it is essential that patients know the costs of care at Leading Edge Clinic first:
 Employees
 26 full and part-time employees.
 7 (soon to be 8) mostly full-time doctors or nurse practitioners seeing patients most days of the week

 12 nurses - our hourly wages are just above the 75th percentile compared to other employers (something that again, Scott and I were committed to doing). We do not employ nursing assistants; instead, we have only professional, experienced nurses. Lastly, their hourly wage does not require overnight shifts, and our practice allows them to work from home.

 6 office staff/schedulers that respond to all patient requests for care initiation and then enroll, schedule, and educate them about all aspects of care at Leading Edge Clinic.

 One full-time practice/nurse manager

 One full-time business manager

 Website and marketing consultant

 Benefits
 Before we get into other costs, I want to mention that, as a small business, and beginning at a time when our “reserves” were marginal, we were committed to offering benefits to our employees as soon as it was economically feasible. Since that time, we now offer:
 Health insurance - for the employee and their family

 Retirement plan - with an automatic contribution of 3% of their salary by us (whether the employee contributes or not)

 Profit Sharing - Scott and I elect at the end of the year how much profit to share, depending on our cash reserves

 Paid Time Off for illness according to each state’s requirements

 Vacation - one week paid vacation for full-time employees

 Practice Expenses
 It doesn’t end there. Although we do not have a “bricks and mortar” practice, which admittedly runs up the cost of care for the other clinics I mentioned above, we still encounter significant expenses:
 Employee Health Insurance: $10,000/month

 Payment Processing fees: $5,000 -$10,00 per month

 401K and administration fees: $4,181/month

 Digital Marketing: $2,500/month

 Legal + Accounting: $13,764 in 2024

 Professional Licenses: $13,192 in 2024

 Travel to Educational Conferences: $4,964 so far in 2025; ≈ $6,000 in 2024; $12,445 in 2023

 Electronic Medical Record: $2,269/month

 Continuing Medical Education for Providers: $8,200 (past 3 years)

 HR/Payroll Services: $800/month

 Vonage + e-Fax (phones + fax): $719/month

 Software Licenses = $608/month (Microsoft, Adobe, Email, Quickbooks, Website Hosting, HR tool, Conferencing Software, Online Video Platform, etc..)

 Malpractice Insurance: $3358 in 2024

 Computers: $2,400 so far this year

 Note transcription service: $425/month

 Charitable Donations
 One of the most significant expenses: a full 5% of our gross revenue (yes, you read that right) is allocated to the Crow Tribe, under whose authority we operate.
 Staff Education And Support Costs
 It does not end there. We also hold regular one-hour weekly meetings for which we pay all employees for their time. 1) The entire staff meeting is held on Mondays, 2) nursing only staff on Wednesdays, 3) Long/Vax/Long Covid provider staff on Thursdays, and 4) Cancer providerstaff on Fridays. Total costs:
 Weekly full practice team meeting: $1,055/meeting, $44,310 per year .

 Weekly nurses meeting: $855/meeting, $35,910 per year.

 Weekly Long/Covid/Long Vax Provider meeting: $202.50/meeting, $8,505 per year

 Weekly Cancer Providers meeting: $152.5/meeting, 42x/year = $6,405 per year

 These meetings serve not only to build team rapport but also to discuss and resolve operational issues, share clinical and patient experiences, and address concerns. Several are solely devoted to educating providers and learning from them about rapidly evolving care practices and the discovery of new therapies.
 Leading Edge Clinic Consultation Fee Structure
 Initial Treatment Package Plans
 Now that you have reviewed the numerous expenses we incur above, perhaps you can understand why our practice currently charges $1950 or $2350 for a complete initial treatment package for a patient (depending on the provider and condition). This cost covers treatment plans ranging from 4-6 months of initial care, which include a one-hour initial consultation and two 30-minute follow-up visits, plus regular business-hour nursing support, which (almost always) delivers same-day responsiveness to all messages, calls, and prescription refills. This fee also pays for the most valuable and unique part of our nurse team’s approach to patient care - that of “pro-active follow-ups,” which take up the bulk of our nurses workday (more on this below).
 Subscription Plans
 After the initial plan of care, patients can decide whether they want to continue care with our practice (the majority do). Here, they have a choice of continuing care under either a monthly “nursing only” subscription plan ($150/month - now payable via HSA!), where they get full-time business-hour nursing support (calls/messages answered same day or within 24 hours, prescription refills anytime, as well as monthly pro-active telephone follow-ups by a nurse). This plan includes the option to schedule an “a la carte” visit with their provider as needed for $450-$650 (note that, as shown in the costs above, only a fraction of this fee goes to the provider). Another continuing care option (which the more severely ill often elect to join) is a “provider” subscription plan where, in addition to nursing support above, they have a regular, scheduled 30-minute visit with a provider for a discounted $400 every month (or every 2 months in my case).
 Although the bulk of our care is provided through treatment packages for Long Covid, Long Vax, and Complementary Cancer Care, we also offer targeted medical interventions, as well as both general medical care , pulmonary consults , and consultations for complex illnesses . Our “ targeted therapies” include: Female Hormone Evaluation , Gut Health Analysis , W eight Management , Diabetes Prevention , Thyroid and Adrenal Function Evaluation , Micronutrient Analysis , Intermittent Fasting Counseling , Neurotransmitter Evaluation , and Spike Injury Prevention .
 Full disclosure: We are currently conducting a comprehensive financial analysis of our practice’s economics, and it appears that to maintain all the care detailed above and below, an increase in fees may be necessary. We will see.
 Pro-Active Follow-Ups
 This aspect of our care is what I believe distinguishes us from nearly the entire private clinic sector. Know that “pro-active follow-up” of chronically ill patients is an area of intense research, with that research consistently finding immense benefits in terms of preserving the health and function of patients. However, even in highly resourced academic medical centers or large health systems that can employ care coordinators or nurse navigators, “proactive follow-up” is rarely offered.
 Research into this type of care has consistently shown: increased treatment adherence, compliance, and self-efficacy leading to better health outcomes and patient satisfaction, reduced hospitalizations & lower costs, and improvements in patient activation, engagement, and mental health. We can certainly attest to the last one - our patients are frequently anxious, depressed, and frankly even traumatized by not only the drastic deterioration in their physical, social, and occupational health, but also by the treatment they received from the health system. Our frequent “check-ins” are thus highly valued by our patients.
 Leading Edge Clinic Pro-Active Follow Up Practice
 Our nurses (again, not nursing assistants) have a long list of follow-ups to make every day (which is why we maintain such a large team of them). Although the ability varies by nurse-provider team, we target the following follow-up frequency:
 Initial Care Plan - After the initial consultation, patients get a call within two weeks. The initial follow-up is to ensure that all prescriptions have been received, that all tests have been completed, and to address any questions or concerns regarding the proposed plan of care. While in the initial care plan, patients get a call every two weeks thereafter over 4 months (remember, these are often complex, chronically, and severely ill patients)
 Subscription Plans - Patients on a nursing or provider subscription receive a monthly follow-up call. If a patient can't be reached, a note is sent to the patient to encourage engagement and response.
 Consultation Services
 In the initial one-hour consultation (note the medical industry standard for a new patient, depending on complexity, is about 30 minutes, and for follow-ups, 15 minutes. Such “system” visits typically only focus on one symptom or problem. In our initial one hour plus consultation visits, we review the entire past medical history (often requiring significant time to prepare before the visit), surgical history, all current and prior treatments (which are usually extensive), and a detailed, chronological, comprehensive timeline of myriad symptom onset, resolution, and/or deterioration in what are all complex, chronic illnesses.
 We also provide immense amounts of education in our visits, sharing with patients our evolving understanding of the pathophysiology of the disease and the mechanisms of action of and prior experience with proposed therapies (including safety profiles). We answer all questions regarding their disease, prognosis, and plan of care (I believe this can often take up the highest proportion of the visit, but again, we pride ourselves on this aspect).
 I suppose you think this can be done routinely in an hour? Unfortunately, you are sadly mistaken - visits routinely exceed allotted times, especially the initial ones (in fact, we rarely schedule back-to-back appointments due to this reality). The patient is then provided with a comprehensive and detailed note to review and can consult at any time through their online practice portal. This means their full medical record is always accessible and transparent to them.
 Diversity In Treatments and Care Protocols
 This is where I think we also shine. What differentiates our practice from many clinics that I somewhat derisively call “Johnny One-Notes” (meaning they play the same note, i.e. use the same, often expensive therapy) over and over, no matter what the patient’s frequently complex presentation is (I am probably being unfair in overstating the narrowness of their approaches, but you get what I mean).
 For instance, HBOT clinics do HBOT. Stem cell clinics offer stem cell treatments. “Multi-modality” clinics treat patients over weeks with a protocolized schedule of therapies such as apheresis, ozone therapy, HBOT, IV vitamin C, IV methylene blue, and near-infrared light therapy. In my experience, those who have gone to such clinics have often been greatly helped, but it is not affordable to most, and often the improvements are not sustained (very few can afford such treatments repeatedly).
 In contrast, over the years, the constellation of multi-system dysfunction brought on by mRNA Covid vaccine injury challenged us to trial numerous therapies and research many more. Key factors in our selection of these therapies were pragmatism, accessibility, and affordability.
 Through this process of trial and error, we identified treatments with the highest rates of positive response, safety, and cost-effectiveness, which we now integrate into combination protocols. We took our learnings and now apply them to treat other similarly complex conditions that mainstream medical systems provide little help for (other virally induced, Lyme-induced ME/CFS, neurodegenerative conditions like Alzheimer’s, Parkinson’s, ALS etc).
 The highly dynamic nature of our approach is driven by the complexity of the diseases we treat and the frequency with which we learn of potential new treatment approaches. What sets our practice apart is our commitment to regularly learning about, adapting to, and implementing new treatment strategies and therapies. We actively seek out new insights — whether from emerging research, published literature, or exchanges with colleagues — and continually evolve our practice accordingly.
 This kind of care, and the operations that guide our practice, have been driven by our core values—values that emerged organically when we reflected on what makes our practice different during one of our weekly team meetings. Those core values are Integrity, Scientific Rigor, and Intellectual Curiosity. I hope you found examples of these values reflected throughout this piece; one of my favorite examples is our constant collaboration with subject matter experts (SMEs) in various fields. We have been able to apply their knowledge to our own, providing a truly integrative approach to care that I believe may be unlike anything you can receive elsewhere.
 This is not to say that we have “solved” these diseases or that our treatments have helped everyone-no-no way no how, the diseases are too complex and often challenging to treat, especially in the case of Long Covid/Long Vax, and even more so due to the lack of research funding and trials from our Federal government. But we have done the best we can with the resources we have - our hearts, our brains, our judgment, our clinical experience, our ethics, and our courage.
 The most common feedback we get from patients is something along the lines of “I have never experienced this type of care or follow-up from any other clinic or provider in my life. The nurses are beyond amazing, I don’t know what I would do without them. What a wonderful experience.” We never tire of hearing that.
 “Re-Brand” Of Leading Edge Clinic
 For our rebrand and website overhaul/update, please note that we are not a corporate entity. We did not hire an expensive web development agency and then pass the cost on to our patients. What you will see on the Leading Edge Clinic website today, while perhaps not the most polished, is a true reflection of who we are - a tight-knit group focused on earning the trust and restoring the health of our patients. It was born out of the work and ideas of the very people who work with us and experience what we do every day.
 Our employees chose and brought our new color scheme to us with intention - the deep hue of blue represents, of course, our clinical nature. The various green tones represent healing. All colors and the imagery itself are intended to evoke our integrative approach to care, as well as our status as Certified Tribal Healers and Practitioners under the First Nations Medical Board (FNMB).
 These qualities are also captured in our logo - one of the few instances where we hired outside help. Even here, we hired a like-minded couple (early FLCCC followers - Porro Designs LLC ) to help bring the vision of our employees to life. We asked them to convey our trailblazing identity and our integrative approach, and reinforce our status under the FNMB. We ultimately opted for the natural imagery of the path leading to the leaf, utilizing a hand-drawn aesthetic.
 The informational content on the site was written by knowledgeable staff to help prospective patients understand the type of care they will receive and whether we are the right place for them. The goal was to make the information easily digestible and easily located, given that so many of our current and prospective patients suffer from cognitive difficulties (“brain fog”).
 Many small details went into relaunching the Leading Edge Clinic with its new look. We hope it conveys the warmth, passion, and care we look to deliver to each and every patient.
 Conclusion
 Leading Edge Clinic exists to help patients with the most challenging, often neglected conditions by investing in attentive, evidence-based, and truly individualized care, while remaining conflict-of-interest-free. Our pride isn’t just in the practice we built, but in the people we employ, the standards we uphold, and the support we give to both staff and patients.
 If you’re looking for a practice that prioritizes integrity, responsive care, and patient education—one that will stand with you through the complexity of illness rather than pass the buck—then welcome to Leading Edge Clinic .
 “You get to decide what kind of business you run. We decided to build the kind we wish we’d always worked for—and the kind we’d want for our families.”

 If you find value in the time, research, and care I invest in crafting these posts to expose critically important truths about the safety and efficacy of a diverse set of medical therapeutics, please support my work with a paid subscription.
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Summary: Here I detail the history, evolution, and current state of the Leading Edge Clinic, the private tele-health practice I co-founded with Scott Marsland. It is the proudest achievement of our lives.


A Pictorial and Videographic Record Of My Greatest "Hamhocked" Projects

Dunking Platform Opens, Plunging My Friend James 30 Feet Down a Well In Nicaragua

 Today’s post is a marked departure from my usual content, which I trust my paid subscribers will enjoy as much as I did in putting it together. For me, it allowed for a beautiful and funny trip down “memory lane.” It will show a personal side that readers will find amusing (as well as my friends and family, many of whom have joyful memories of using and/or playing with these hamhocked creations).
 “Hamhock” is a word coined by a friend of mine to describe our approach to fixing things around the house or building random recreational projects that we would dream up (we did the latter a lot, as you will see). We used this term as an open acknowledgement that we often displayed little sophistication or talent in building or fixing anything.
 It can only be used by someone like me and my friend - those with suboptimal “handyman” abilities, i.e., little training, expertise, or natural feel or intuition for carpentry, woodworking, plumbing, metalworking, electrical repair, computer hardware, auto repair, etc. I must admit, as you will see, the above applies to me more than to some of my friends.
 If you are like us, our approaches often involved massive applications of duct tape, Krazy glue, and/or randomly affixed two-by-fours with long nails. Over the years, we would text pictures of our latest “hamhocked” fix or project that we had completed. They are hilarious. None would last for very long, but the pride beaming from us when our fix or project worked for even just a little while was massive :).
 I first used the word “hamhock” in my recent “ Nosocomephobia” (fear of hospitals) post , where I employed it as a descriptor for the DMSO/chlorine dioxide protocol I devised to treat a paronychial abscess. As I started to include examples of hamhocks in that post, it detracted too sharply from its intended focus, so this separate post was born.
 Hamhock is such a versatile word, too - it can be a noun, verb, or adjective. I, for instance, am a hamhocker; I enjoy hamhocking, and I have a track record of completed hamhocked projects from my home-owning and child-rearing eras.
 In the following, I present the pictorial and/or videographic record of some of our most famous hamhocks (nearly all were recreational rather than household fixes, as I did not document the latter as diligently, although I should have).
 Since this Substack is called “Medical Musings,” I thought I would share some “medical hamhocks” before exposing the more zany, absurd projects that my friends and I built.
 Covid ICU Hamhocks
 Once COVID-19 hit U.S. cities on the coasts, it was weeks before we had our first COVID-19 patient at the University of Wisconsin, where I was the ICU Director and Chief of the Critical Care Service. The preparations for the anticipated initial surge were relentless.
 Know that “intubation” refers to the act of placing an endotracheal tube down the windpipe of a patient in respiratory failure so they can then be attached to a mechanical ventilator. We knew that many patients would need intubation. Thus, we were concerned because evidence from the SARS epidemic had found that intubation presented the highest risk of infection transmission to ICU or Anesthesia physicians. So we tried to “invent” ways to mitigate that risk.
 Below is a plastic enclosure with armholes that we placed over a mannequin’s head. We hoped that using it would mitigate the risk of exposure to exhaled breath during the act of intubation. Here we are practicing with it in our simulation center (although we never ended up using it in practice - just too clunky and obstructive to use):

 The below was my brainchild: here I “hamhocked” a way to keep IV pumps and the ventilator controls outside the ICU room in the hallway, thus decreasing the amount of gowning, gloving, masking and then doffing that the nurses and respiratory therapists would have to do to make the frequent adjustments required on the IV pumps or ventilators.
 Note the wires and tubing going through the crease of the cabinet door, whose rear opened up into the room (not shown), which allowed the IV tubing and ventilator cable to be directly attached to the patient’s IV lines and/or ventilator:

 Here is a picture of me and my Fellow proudly displaying what the hallway of our first “Covid ICU” looked like as a result of the above hamhock (not pretty, I know):

 Emergency Airway Case
 I invented this before Covid as I was in charge of training and directing the teams responding to medical emergencies on the wards. Many emergencies required emergency endotracheal intubation in often challenging and poorly equipped settings. I purchased a high-end photographer's case and stocked it with various types of airway equipment, including a video laryngoscope, a transtracheal jet, and a percutaneous tracheostomy kit (the latter two were used to save the lives of at least three patients). Intubation medications (etomidate, propofol, paralytics, etc) were carried separately.

 POOL DECK RENOVATION
 Here I share my brilliant “resurfacing” of my old pool deck, which, before this project, consisted of the ugliest, public school-type cement surface in light brown. I got an estimate to re-pave it with pretty colored slate stones, but there was no way I could afford that at the time. So, I faked it - I got a few stone-shaped molds and spent a week spray-painting stone shapes in different colors on the concrete. Voila:

 THE MELLO SHIP
 Probably one of the greatest hamhocks in history, this was the brainchild of James, one of my best friends from college. He came up with the idea of a “hammock boat” (or hamhock boat?).
 The best depiction of the Melloship was a 90-second video that James put together to market it, which garnered millions of views (but no sales). The music is fantastic:

 The above video was brilliant enough to land him as a contestant on a Shark Tank-type TV show called The Adventure Capitalists .
 Every time I watch the episode, I literally “cry laugh” so hard that my belly starts to hurt. James gets eviscerated by the hosts, all of whom decline to invest in the Melloship, ultimately ending the segment with the famous catchphrase, “I’m out.” However, they were supportive and helpful to James despite that decision, so it was all good.
 Poor James. Some background to the episode below, which will make it even funnier:
 He was, as James typically is, late. He arrived at the pristine lake in Utah where they filmed the episode only the night before, after dark, while it was raining (and freezing). He was up all night assembling the two prototype boats. It might explain his poor performance the next day, as they were grilling him on his business model and market research during the “negotiation segment.”

 When he told the hosts that he had sold two of them already, he neglected to mention that one was… to me (I was an early investor and asked for one of the prototype boats in return). The plan was for him to leave Utah and then stop at my house in Madison, WI, after the show on his way back to NJ, where we would hang out and rebuild the prototype together, which we did on my front lawn (pics to follow).

 The entire Melloship segment of the show is 9:50; it is a must-watch. To make it quicker, I suggest fast-forwarding through the “Melloship Race,” where the hosts try to race each other (one of them cannot steer and goes around in circles). The rest is them grilling James about his idea and business plan, which is pure gold. Please, at least fast-forward to 7:10 and listen to one of the hosts describe the Melloship as “nothing but straps and duct tape,” i.e., the literal definition of a “hamhock.”

 The “Adventure Capitalists” Episode

 James then came to visit me in Madison, WI, where we reassembled one of the prototypes (to which I then added numerous impressive improvements, as below - at least in my opinion):

 One of the immense pleasures of Melloshipping was passing other boaters as above. Every single time someone passed us, they would slow down, stare, laugh, or cheer with a double thumbs-up. It was so fun.
 “Poppy” (what my kids call me) Makes Some Improvements
 My kids and I loved the boat (for a while, until the motors kept breaking down and stranding us on the lake). During those first months, I continued to make improvements. In no particular order:

 Setting Off On Maiden Voyage (1 minute - increase playback speed)

 Pulling Into Dock From Maiden Voyage (23 seconds)

 Below is a bittersweet memory. My daughter had to endure a prolonged hospitalization for an illness that required frequent intravenous medications. At one point, she became stable enough during the day that I was able to obtain a “day pass” for her to leave the hospital. Little did the ICU team know that I took her and her dog Bear Melloshipping:

 Well Dunking Project
 There really are no words for this one. James had a deep well on his farm in Nicaragua and came up with the idea of hamhocking a dunking apparatus, triggered only when a contestant would hit the attached tennis racket with a ball, thus slamming open the platform and plunging the victim 30 feet into the well below. I was terrified of this thing and refused to do it, but my kids loved it. I am speechless every time I watch it:
 Evie, 13 years old - first victim:

 James Gets A Taste Of His Own Medicine:

 Older Sister Ella Follows Suit (in slow motion):

 FIRST ZIP LINE
 I have built three in my life. Notice the hastily improvised hammock platform (built without plans) as well as the clever tree shrub trimming at the bottom, allowing the kids to zip through them unscathed (15-second video):

 ZIP LINE #2
 You would think that my skill in zip line building would increase, but it didn’t. This is the launch platform I built when we later moved to Madison, WI (not so pretty):

 One of the first Zip Line Rides in Madison (launched off a ladder before I built the amazing launch platform above):

 200 Meter Nicaraguan Zip Line Project
 Here is the inaugural voyage on a zip line that my buddy James and I later built on his farm and yoga retreat center in Nicaragua. Took a full day in the jungle heat. What I couldn’t find a video of was the “test run” we did by stringing up three car batteries together to test if it would indeed “hold” before sending his wife, Gabi, off on the first zip as below (30 seconds):

 The “Hangatorium” Disco Ball Swing
 Another James special. He built a swinging disco ball apparatus in the main recreational lounge hut at his retreat center which he named the “hangatorium.” Doesn’t need much explanation, enjoy:

 Violet 9, Swings Accompanied by James Playing Drums

 The Ice Rink Project
 I discovered that in Wisconsin, and further north in Canada, backyard ice rinks are “a thing.” The weather report predicted a prolonged “big freeze,” so I ordered a massive tarp from a Canadian company, hit Home Depot for a large amount of 2 x 12’s, and set about building the rink walls around the tarp:

 Filled it with water from the hose and waited for the freeze:

 My daughter is enjoying her first skate on a pristine, flat surface (at the risk of foreshadowing, that would not last long):

 I broke out my hockey stick:

 Here I take off on a breakaway.. and score:

 The Rope Swing/ Inflatable Pool Projects
 I won’t forget the first ham-hocked inflatable pool I installed on our 17th-floor balcony in NYC, where we lived during my Pulmonary and Critical Care Fellowship training and my children were toddlers. The balcony was made of a massive slab of concrete, by the way. Note, it came with a water slide:

 Although obviously not as impressive as the disco ball, the beauty below was inspired by a particularly hot summer in Westchester County, NY, where I was raising my kids at the time. I set up an inflatable wading pool on an outside deck, and then found a random child’s plastic staircase, over which I tied a rope to an upstairs deck. My middle daughter, Evie, seemed very happy with it (5 seconds):

 THE TREE SWING
 I got a friend who was a tree surgeon to help install a massive tree swing (i.e., I got professional help on this one, so it is not technically a hamhock):

 The inaugural swing (I couldn’t find the ones where I pushed my kids super high on it after a running start, but this one is still pretty good):

 The Chicken Coop Project
 Let me just say that raising chickens didn’t work out - none survived to lay their first egg. Hawks got a couple of them, and then we gave away the rooster (which was supposedly illegal to have within Madison city limits):

 Hamhocked Outdoor Pen For the Chickens
 My construction skills are clearly evident:

 The Beach Volleyball Court Fiasco
 My daughter was starting to get into volleyball, so I came up with the brilliant idea of taking down their childhood play set and carting a ton of sand from the driveway into the backyard (I paid my daughter and her friend to do it, and they almost quit on me a few times):

 Sand Delivery - someone seems happy:

 Girls Hard at Work:

 Problem: The girls played on it a few times until we had a literally historic thunderstorm, which dumped around 11 inches of rain overnight. Much of the sand got washed away and was a total pain to clean up:

 The Surf Boat (not board)
 The below inflatable boat was purchased repeatedly for numerous beach vacations after we found that it would literally surf waves with my girls in it - best purchase ever - essentially I “hamhocked” an inflatable boat into a surfboard:

 Kayak Project
 I bought a two-person kayak after we moved to Madison, WI (land of lakes). Tested it out in the pool first:

 Since I did not own a roof rack, I hamhocked a kayak transport solution so we could hit nearby Lake Mendota. Simple, effective, and not without risk:

 The Stair Mattress Slide
 Invented by a former mentor of mine (Dr. Paul Mayo) when his kids were young, I was visiting him with my three small children one day when he graciously re-hamhocked it together again for their amusement. The game consisted not only of letting the children slide down the mattresses but also involved the children having to prevent me (they call me Poppy) from climbing to the top (rules were that I could not place my hands on the stair railings to aid the climb).
 Note the safety measures too - pillow cushions at the bottom to prevent slamming into the wall :). Three short clips from what was likely two hours of roughhousing (6, 19, and 15 seconds):
 First Slide Down

 “Poppy” Attempts To Scale Mattress Mountain

 Baby Violet’s Successful Ascent

 GYMNASTICS MAT
 Randomly found these pics of me bringing back a new mattress, which my daughter immediately hamhocked into a gymnastics practice mat (apparently the hamhock gene runs in the family):

 The Toxic Blue-Green Algae News Interview
 Although this entry is not an example of a hamhock, many will find it hilarious, so I included it. Here I am interviewed by a local news channel because I took my family swimming at the local lake despite a surge of toxic “blue-green algae blooms” (1:17):

 Hope you all enjoyed my trip down Hamhock Lane! - Pierre

Summary: A "hamhock" refers to a household construction or recreational project done in a crude, inexpert fashion, resulting in temporary fixes or enjoyments that often break soon after. I present my resume.