Morning Briefing
Summaries of health policy coverage from major news organizations
From KFF Health News - Latest Stories:
KFF Health News Original Stories
Where Florida’s Gun Violence Exacts Its Biggest Toll on Black and Latino Children
An analysis of hospital claims data in Florida found that firearm injuries of children disproportionately hit families in a handful of ZIP codes, almost all of them in Jacksonville, Orlando, Miami, or Tampa Bay.
The Medicare GLP-1 Discount Has One Big Catch: Some Sick Patients Don't Qualify
The new Medicare GLP-1 Bridge program promises eligible beneficiaries access to popular weight loss drugs for as little as $50 a month. But for some, having the very medical conditions these drugs are approved to treat means they don't qualify for the discount.
California Weighs Penalties for Healthcare Providers That Don’t Rein In Costs
About half of U.S. adults say they can’t afford healthcare. California is among at least eight states that have set spending growth targets for the healthcare sector. It may soon impose enforcement penalties aimed at pushing hospitals and other providers to meet those goals.
Here's today's health policy haiku:
THE GOOD AND THE BAD
"Medicare for All."
— Anonymous
Yale: Saves 1 trillion! Many
bankrupt providers.
If you have a health policy haiku to share, please Contact Us and let us know if we can include your name. Haikus follow the format of 5-7-5 syllables. We give extra brownie points if you link back to an original story.
Opinions expressed in haikus and cartoons are solely the author's and do not reflect the opinions of KFF Health News or KFF.
Note To Readers
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Summaries Of The News:
Health Industry
New NIH Publishing Policy Could Cost Researchers Big Bucks — And From Their Own Pockets
MedPage Today: Researchers Could Pay $100M To Comply With NIH Publishing Policy
NIH-funded researchers could pay journal publishers as much as $104 million per year in additional fees to comply with NIH's updated policy that requires manuscripts to be publicly available as soon as they are published. That's the total estimated by assessing about 24,000 manuscripts associated with NIH grants in 2024 that would likely have to pay to comply with the policy, Ryan Huebinger, MD, of the University of New Mexico, and colleagues reported in a research letter in JAMA Internal Medicine. (Clark, 8/24)
Stat: Comments On OMB Research Rule Mysteriously Removed From Federal Website
For the past couple of years, Magdeleine Bradford-Butcher has been living on the cutting edge of science. When prenatal testing showed the baby she was carrying had cystic fibrosis, her doctor put her on Trikafta — a relatively new treatment aimed at preventing severe complications from the genetic disease after birth. (Oza, 8/25)
The Trump administration again tries to restrict H-1B visas for some —
The Washington Post: Trump Administration Proposes $103,000 Fee For H-1B Visas After Legal Setback
Trump tried to implement a similar $100,000 fee last year through a presidential proclamation, but it was invalidated by a federal judge in June. ... The new proposed regulation, set to formally publish in the Federal Register on Tuesday, seeks to carve a different legal path by proposing to use the fees to offset the cost of running the immigration system. It exempts some groups, such as most U.S. colleges, universities and nonprofit hospitals affiliated with academic institutions. But unlike last year’s proposal, it would apply to many people who already reside in the United States, not just those submitting petitions from abroad. (Hesson and Gurley, 8/24)
In other healthcare industry developments —
Chicago Tribune: Nurses At Chicago's St. Mary Hospital Plan One-Day Strike
Hundreds of registered nurses at St. Mary of Nazareth Hospital in Chicago plan to again go on a one-day strike as they try to reach their first contract with the hospital’s new owner Prime Healthcare. (Schencker, 8/24)
The CT Mirror: Lawrence+Memorial Staff Seek Better Conditions, Higher Pay
Healthcare workers rallied outside Lawrence + Memorial Hospital in New London on Monday, demanding higher compensation to help alleviate issues with staff recruitment and retention that they say are compromising patient care. (Golvala, 8/24)
KFF Health News: California Weighs Penalties For Healthcare Providers That Don’t Rein In Costs
California is weighing stiff penalties for hospitals and other healthcare entities that don’t stay under state spending limits, potentially levying hundreds of millions of dollars in fines if these providers don’t take steps to rein in rising healthcare costs. If the state Office of Health Care Affordability adopts the fines next week, hospitals, medical groups, insurers, and others could face penalties that amount to as much as 125% of the total they spend above the state’s annual growth targets. (Boyd-Barrett, 8/24)
Asheville Watchdog: 92 New WNC Hospital Beds Up For Grabs Amid Anger At HCA
The hearing August 19 at Asheville-Buncombe Technical College was a routine part of the North Carolina Department of Health and Human Services (DHHS) certificate of need process. It was an opportunity for state regulators to hear public comments and presentations on the competing proposals before them. But today, even routine administrative healthcare proceedings have become highly charged. (Clifford, 8/25)
Modern Healthcare: Advocate-Owned Atrium, Morehouse Win Approval For Atlanta Hospital
Atrium Health has received state approval to build a hospital campus in Atlanta in collaboration with the Morehouse School of Medicine. Atrium — part of Charlotte, North Carolina-based Advocate Health — plans to invest more than $700 million in the hospital and surrounding care network, according to a Friday news release. The organizations did not specify a timeline for the hospital’s opening. Updates will follow meetings with stakeholders as planning continues, the news release said. (Hudson, 8/24)
Charlotte Ledger: As Atrium Pursues WakeMed, A Look Inside Its Last Big North Carolina Deal
As Atrium Health continues its push to join forces with Raleigh-based WakeMed Health & Hospitals, its leaders have repeatedly pointed to another North Carolina deal as evidence of what to expect: its 2020 combination with Winston-Salem-based Wake Forest Baptist. (Crouch, 8/24)
Modern Healthcare: Las Vegas Raiders Donate $25M To Intermountain Health
The Las Vegas Raiders and its owners have donated $25 million to Intermountain Health toward the construction of a new children’s hospital, the National Football League team announced Monday. The project will result in Nevada’s first standalone children’s medical center, according to a news release. The Salt Lake City-based health system has been the official healthcare partner of the Raiders since 2019. (DeSilva, 8/24)
Stat: With Medicaid Cuts Looming, Rural Hospitals Already Making Changes
Last year, Republicans set American health care on a new path: They slashed $1 trillion from expected Medicaid funding over the next decade and allowed tens of billions of dollars in annual insurance subsidies to expire. (Payne, 8/25)
Also —
Stat: AI Software To Detect Hospital Drug Diversion Has A Problem: Humans
In late September 2024, patients noticed a nurse at Adventist Health in Bakersfield, Calif., was acting strangely. The nurse was walking barefoot through the intensive care unit, talking to herself and acting abrasively toward others. Family members of patients noticed the nurse sloppily taking out IV needles but were afraid to confront her. “I know she was on something because you can tell,” one family member told federal investigators after the incident. (Byrne, 8/25)
Vaccines
Florida Looks To Reduce Number Of Vaccines Required For Public School Attendance
NOTUS: Florida Prepares To Roll Back School Vaccine Requirements
Florida is set to roll back four vaccine requirements for children attending the state’s public schools, according to a new rule published Monday by the state Department of Health. The proposed guidelines come after Florida’s surgeon general launched an effort last fall to eliminate all vaccine mandates for school children. The rule would allow Florida children to attend school without receiving immunizations for chickenpox, hepatitis B, Haemophilus influenzae type B and pneumococcal disease. The Department of Health purports that the proposed rule eliminates vaccine mandates for shots that aren’t required under state law. (Monnin, 8/24)
CIDRAP: Catholic Bishops Tell Florida AG There's No Theological Reason For School Vaccine Exemptions
Catholic bishops in Florida are warning the state's attorney general to respect their religious liberty when it comes to parochial schools' approach to vaccine exemptions. Florida's Catholic schools do not accept religious exemptions for vaccines. In a letter to Attorney General James Uthmeier, made public last week, the Florida Conference of Catholic Bishops said Florida bishops don't have to justify their position, but are doing so "out of respect for you and your office." (Boden, 8/24)
Florida Phoenix: Did School Vaccines Just Become A Campaign Issue In Florida?
GOP gubernatorial hopeful Rep. Byron Donalds says he'd like to "study and really engage it" before making a decision about whether to repeal statutory vaccine requirements for schools. (Perry, 8/24)
MedPage Today: HHS Call For Input May Shed Light On Trump Administration's Vaccine Plans
In the wake of a controversial executive order that shrinks the number of universally recommended vaccines for children, HHS is asking the public to weigh in on whether three categories used in federal vaccine recommendations are adequate. The three categories up for discussion are routine, risk-based, and shared clinical decision-making. The agency is seeking input on whether it should implement additional or different categories. (Henderson, 8/24)
Also —
The Hill: Public Health Experts Warn Back-To-School Season Will Worsen Record Measles Outbreak
With kids returning to school amid the worst year of measles in more than 30 years and as a record number of children report exemptions from vaccines, the likelihood that the spread of measles will worsen is all but certain according to public health leaders. The majority of U.S. public schools will have begun their 2026-27 academic years by the end of August, and students will be returning as the country has recorded nearly 3,000 measles cases across 47 jurisdictions and 36 new outbreaks this year. (Choi, 8/24)
The Baltimore Sun: Measles Outbreak Declared In 3 Maryland Counties
Maryland officials declared a measles outbreak in three counties as cases continue to rise, according to the Maryland Department of Health. (Scarglato, 8/24)
Lifestyle and Health
Study: At Least 25% Of NFL Players Could End Up With Brain Disease
The New York Times: At Least 1 In 4 NFL Players Gets CTE, Major New Study Finds
Since the degenerative brain disease known as C.T.E. was first scientifically linked to football about 20 years ago, and as hundreds of former professional football players have been diagnosed with the disease after their deaths, a haunting question has lingered: Just how many N.F.L. players will end up with C.T.E.? New data provides a sobering indication: At least one in four of all the people who have played in the N.F.L. might expect to end up with chronic traumatic encephalopathy, according to a study of hundreds of cases over a recent six-year period. (Branch, 8/25)
The New York Times: Many N.F.L. Players Get Brain Disease. Why Hasn’t OSHA Intervened?
The most notorious form of workplace illness in the United States might be black lung disease. Scientists say that 10 to 20 percent of coal miners who have worked 25 years or more have gotten it. It has long been considered an epidemic. Imagine an American job that is less safe than that, where one in four workers (and maybe far more) ends up with an incurable, degenerative brain disease that withers the mind, sometimes after just a few years of exposure. (Branch, 8/25)
The New York Times: Your Child Plays Football. How Can You Minimize Risk Of C.T.E.?
Researchers say it’s all about reducing the total number of blows to the head. (Branch, 8/25)
More health and wellness news —
The Baltimore Sun: People Can Sense Mental Decline, Says New Research Powered By Smartwatches
Older adults may be better judges of their moment-to-moment mental sharpness than scientists once assumed, according to a University of California, Davis study — which relied on familiar technology: the smartwatch. (Mutasa, 8/24)
Medical Xpress: Oxalate In Spinach And Almonds May Worsen Gut Inflammation In IBD
Spinach, almonds and sweet potatoes are celebrated as some of the healthiest foods on the planet. But for the millions of Americans living with inflammatory bowel disease (IBD), a new study from the UNC School of Medicine suggests that these same foods may be quietly worsening gut inflammation through a compound most people have never heard of. (Harley, 8/23)
Phys.org: Engineered Yeasts Help Turn PET Plastic And Crop Waste Into Protein-Rich Cookies
Plastic might be the last ingredient you would ever add to a cookie recipe. But a team of researchers is looking to change that. They've programmed yeasts to turn plastic and agricultural waste into edible proteins and flavoring molecules, creating a treat from trash. The technology not only offers a new upcycling method but could also sustain life in disaster zones or even deep-space missions with humans aboard. (8/24)
Pharma and Tech
Certain Blood Transfusions Put Patients At Risk Of Experiencing Symptoms of Alpha-Gal Syndrome, Study Finds
MedPage Today: Study Warns On Alpha-Gal Syndrome And Blood Transfusions
In areas with high prevalence of tick-induced alpha-gal syndrome (AGS), patients with blood type O appeared to be at significantly increased risk for allergic transfusion reactions to B or AB blood units, according to a retrospective cohort study. (Rudd, 8/24)
The Washington Post: FDA Approves A Blood Test To Detect Alzheimer’s Disease
The Food and Drug Administration has approved a new blood test for Alzheimer’s that can detect a presence in the brain of amyloid plaque, which has been considered a key indicator of the disease. The test is not meant for routine screening but can be pivotal for a diagnosis when cognitive problems are causing doctors to suspect Alzheimer’s. ... The FDA approved the first Alzheimer’s blood test in 2025. That test, sold by Fujirebio, measures two proteins. Roche said its test is the first to measure a single protein, which serves as a “biomarker” for amyloid. (Rowland, 8/24)
Stat: FDA Pauses Regenxbio Hunter Syndrome Gene Therapy Trial
The Food and Drug Administration has again paused trials for Regenxbio’s gene therapy for a rare childhood brain disorder, after small masses were found on the spines of five patients, the company said Monday. (Mast, 8/24)
Military.com: Army Veteran Becomes First VA Patient To Receive Minimally Invasive Epilepsy Treatment
U.S. Army veteran Robert Lindemann has become the first patient in the VA system to undergo a minimally invasive laser procedure to treat his epilepsy. Lindemann, who served nearly 33 years before retiring, received the procedure at the Michael E. DeBakey VA Medical Center in Houston, Texas, the Department of Veterans Affairs (VA) said. (Gramegna, 8/25)
On GLP-1s —
KFF Health News: The Medicare GLP-1 Discount Has One Big Catch: Some Sick Patients Don't Qualify
In January, Jeff La Marca got a prescription for the popular weight loss drug Zepbound. But he couldn’t afford the $750 monthly price tag. Then Medicare launched an 18-month pilot program that offers GLP-1 medications to some enrollees for only $50 a month. La Marca thought he might finally be able to afford the drug. (Fortiér, 8/25)
The Hill: GLP-1 Drugs May Help Treat Addiction, Studies Show
From unexpected babies to “Ozempic teeth,” the ultra-popular class of GLP-1 medications is turning out to have a few unanticipated side effects. Emerging research shows the drugs, which have proven effective in treating obesity and diabetes, may also be useful in treating addiction. The medications’ full potential is coming to light as more people are prescribed a GLP-1, which includes the brand names Ozempic, Mounjaro, Wegovy and Zepbound. As 15 percent of Americans say they’ve tried a GLP-1, researchers are learning more about how it impacts all aspects of life, not just diet. (Martichoux, 8/24)
On street drugs —
The New York Times: The Ruthless Efficiency Of Ultrapotent Street Drugs
On a crisp, sunny day in February 2025, a local nicknamed Sleepy, 44, stood across the street from the neat white house in West Baltimore where he had been raised by his grandmother. His parents had lived there, too, lost to heroin addiction. As a boy, Sleepy vowed to become a police officer. (He asked not to use his full name to avoid police scrutiny.). But the streets called, and by his early teens he was selling crack and heroin. In 2007, just a few blocks from his childhood home, he fired a gun into a car carrying gang members whom he feared were hunting him. He went to prison on an attempted murder charge and was released in 2022. (Richtel, 8/24)
The New York Times: Why Getting High Has Only Gotten Cheaper
In the early 1970s, the American government launched what became known as the war on drugs. The goal was to reduce substance abuse. The strategy: Crimp the demand for heroin, cocaine and other illicit substances by disrupting the supply and making drug use expensive. A key way “we measured success was getting the price up,” said Robert DuPont, who served as the White House drug czar from 1973 to 1977. “It meant we got the job done.” (Richtel and Hwang, 8/24)
State Watch
Older Americans On Fixed Incomes Struggle To Buy Food As Prices Soar
Midwest Newsroom and Harvest Public Media: High Food Costs Exacerbating Hunger For Elderly Americans
Since completing treatment for breast cancer, Toni Keller tries to stick to a healthy diet — she consumes lots of fruits and vegetables and no red meat. Keller, 65, moved into Storm Lake Senior Housing in May, a low-income community in the northwest Iowa city of Storm Lake. She spent some of her adult life out of the workforce, which substantially reduced the retirement benefits she now receives. (Grundmeier, 8/24)
More health news from across the U.S. —
The Washington Post: Nevada Sues Over Federally Mandated Reduction In Colorado River Water Use
Nevada sued the Trump administration Monday over a plan requiring it and two other states to cut Colorado River water use, the first legal challenge to the federal government’s attempt to rescue the waterway, which is on the brink of collapse. The state in its challenge filed in U.S. district court said the Interior Department’s long-awaited drought management plan would cause “devastating environmental, socioeconomic, and health and human safety impacts to southern Nevada and its citizens.” (Kaplan, 8/24)
The New York Times: NYC’s 911 System Had An Outage. Officials Kept Quiet About It.
Mayor Zohran Mamdani acknowledged on Monday that the city did not inform New Yorkers about a partial breakdown of the 911 system last week that prevented hundreds of callers from reaching operators for nearly seven hours. (Marcius and Goldenberg, 8/24)
Modern Healthcare: Medicaid Work Requirements Spur State Outreach Campaigns
With time running out until Medicaid work requirements kick in, state and federal authorities are hustling to get the word out. States, which must implement Medicaid work requirements under President Donald Trump’s 2025 tax law, are deploying an arsenal of communications tools to educate beneficiaries, providers and other Medicaid stakeholders. The federal Centers for Medicare and Medicaid Services has plans of its own. (Early, 8/24)
Phys.org: Natural Gas Drilling Could Raise Salt Levels, In Turn Boosting Radium In Water
Pennsylvania ranks second in U.S. natural gas production, accounting for about one-fifth of U.S. output in 2024, and has one of the most extensive histories of energy extraction in the country. A team of researchers from Penn State is trying to better understand the environmental impacts of these sites—specifically, whether fracking is increasing radium content in local drinking water. According to a new study recently published in Environmental Science & Technology, the answer is not a simple yes or no. (Tkacik, 8/24)
Chicago Tribune: Food Influencer Keith Lee Brings Aid To Gary
On Monday, widely popular food influencer and philanthropist Keith Lee partnered with the Salvation Army and the city of Gary for a large-scale relief effort in northwest Indiana, where residents have been without power for two grueling weeks following historic weather. (Syed, 8/24)
MPR News: Bravo Zulu Sober House Introduces Canine Therapy For Veterans With PTSD
Since opening its doors a little over a year ago, Bravo Zulu House in rural Winnebago built a community specifically for military veterans struggling with PTSD and recovering from alcohol and/or drug addiction. Now the sober living home is adding canine therapy to help support the veterans it serves, and in the process, they’re saving the dogs, too. (Yang, 8/25)
KFF Health News: Where Florida’s Gun Violence Exacts Its Biggest Toll On Black And Latino Children
Just west of the St. Johns River, which divides this sprawling city racially and economically, 2-year-old A’mahri Robinson was murdered in his mother’s arms.This story also ran on The Trace. Ladonna Johnson was rocking A’mahri to sleep in March when he was shot in the head with a gun she kept for protection. A’mahri loved going outdoors and taking rides in his pull-along wagon. His mother called the toddler “sweet” and “affectionate.” When he was around, she said, “you just felt love.” (Chang, Clasen-Kelly, Pierce, Gavino and Jones, 8/25)
The Washington Post: Woman And Her 2-Year-Old Daughter Killed By Lightning In Florida
Two people were killed by lightning Sunday afternoon in Margate, Florida. The victims, a 31-year-old woman and her 2-year-old daughter, were struck while on a neighborhood sidewalk, according to local police. (Cappucci, 8/24)
Reproductive Health
Advocates Still Waiting For Trump To Deliver On His Pro-IVF Pledges
NBC News: Trump Promised To Make IVF Free. What Happened?
President Donald Trump, who has referred to himself as the “father of IVF” and the “fertilization president,” promised on the campaign trail that he would make in vitro fertilization free. Advocates say they’re still waiting. (Bendix and Kapur, 8/24)
MedShadow Foundation: The Experimental Fertility Treatment Dividing IVF Physicians
Rapamycin is gaining popularity as an experimental IVF treatment, but experts disagree over whether the evidence supports its off-label use. (Tjandra, 8/21)
Newsweek: Baylor Genetics Data Breach Sparks Warning To IVF Patients
Patients who underwent genetic testing through Baylor Genetics are being notified after a cybersecurity incident exposed sensitive personal and medical information. Cybersecurity experts warn it could be particularly problematic because the affected people have undergone or are undergoing in vitro fertilization (IVF). The breach could pose risks beyond traditional identity theft because fertility and genetic-testing information can give criminals personal context that makes scams more convincing. (Fink, 8/24)
In other reproductive health news —
St. Louis Post-Dispatch: Suit: ‘Illegal’ Abortion Conducted By St. Louis Planned Parenthood Led To Executive’s Firing
An executive at Planned Parenthood Great Rivers has sued the St. Louis-based abortion provider, claiming it fired her after she alleged an unauthorized and illegal abortion was conducted at its Fairview Heights clinic in Illinois. Former human resources Vice President Jacqueline C. Colyer’s complaint says an abortion was performed after hours on a Sunday in the clinic’s basement on a mother whose fetus was 28 weeks old — at or near viability. Colyer reported the incident via an anonymous tip line to Planned Parenthood, she says in her 26-page complaint filed late last week in federal court in St. Louis. Two weeks after making the tip, she was disciplined, her suit says. Less than five months after that, she was fired. (Bauman, 8/24)
MedPage Today: What New Research Shows About Prenatal Pesticide Exposure And Autism Traits
Relatively low levels of prenatal exposure to organophosphate pesticides showed no relationship with social communication problems and other traits related to autism in children, data from the prospective ECHO study showed. (George, 8/24)
MedPage Today: Study Offers Reassurance On Inhaled Corticosteroid Use For Asthma In Pregnancy
Women with asthma who continued taking inhaled corticosteroids during the first trimester of pregnancy did not suffer higher rates of adverse outcomes compared with those who discontinued use, a South Korean nationwide cohort study found. (Robertson, 8/24)
CIDRAP: Study Ties COVID Infection At Delivery To Increased Risk For Mom And Baby
A paper published in PLOS One finds that maternal COVID-19 infection during delivery increases the risk of poor maternal and fetal outcomes, with the most severe effects noted during the Delta variant wave early in the pandemic. “Overall, this study demonstrates that obstetric risk associated with COVID-19 was not static but evolved across variant periods, highlighting the need for ongoing maternal health surveillance and adaptive healthcare policies as infectious disease patterns change,” wrote the authors, led by researchers from the US Department of Health and Human Services. (Holohan, 8/24)
A request for mistrial is denied in the Clancy case —
The New York Times: Religious References In Lindsay Clancy Trial Anger Judge And Defense
Religion became a point of contention on Monday in the trial of Lindsay Clancy, a Massachusetts mother charged with murder in the strangling deaths of her three young children. For the second time since the trial opened last month, a reference to “mortal sin,” a concept that is part of the Catholic faith, incensed the judge, who sternly instructed jurors to disregard any references to it. ... Clancy has pleaded not guilty to three counts of first-degree murder, citing postpartum psychosis. (Spoto and Fortin, 8/24)
The New York Times: Why The Lindsay Clancy Case Is Dividing Americans
Tasha Kenney woke up at 4 a.m. on Thursday, donned a pink T-shirt and drove to the courthouse in Plymouth, Mass., to show support for Lindsay Clancy, the mother on trial for killing her three young children. Ms. Kenney, a teacher who lives 90 minutes away, joined hundreds of other pink-clad women gathered on the courthouse lawn because she had suffered from severe postpartum depression after the birth of her daughter a decade ago. And she believes the Clancy children could have been saved if the warning signs had been heeded. (Dewan, 8/22)
Editorials And Opinions
Viewpoints: Montana Licenses Centers For Unapproved Therapies; Where's The Federal Definition Of Ultraprocessed Foods?
The Washington Post: Montana Is Paving The Way For Unapproved Medical Treatments
New Montana right-to-try law licenses centers for therapies not fully approved by FDA. (Vicki Norton, 8/25)
The New York Times: Big Food Is Winning The War For America’s Diet
The federal government was supposed to release a definition of ultraprocessed foods. What happened? (Lindsey Smith Taillie, 8/24)
The Washington Post: 8 Tips To Be Mindful, But Not Paranoid, About Healthy Eating
It’s possible to retrain taste buds to improve eating habits. (Leana S. Wen, 8/25)
Stat: Cancer Screening Shouldn’t Stop At Long-Term Care Facility Doors
My aunt recently died of stage 4 breast cancer. She was diagnosed in April at the age of 78 and passed just three weeks later. She had been living in a long-term care facility since 2020. At the time, she was admitted with a sore on the bottom of her foot and arthritis so bad that she could hardly walk. Her cancer was discovered incidentally six years later while at the hospital for a urinary tract infection. (Kim Johnson, 8/25)
Stat: Grief, Grieving, And Human Whale Songs: What I Learned In ICU Training
I had a recurring nightmare as a child: floating alone in an open sea, the water quaking beneath me until a whale, roaring and howling, rose up and swallowed me whole. In real life, I first heard a whale song on solid ground, in an even scarier place: the intensive care unit. (Caroline Cherston, 8/25)