I have spent twenty years as a cardiologist. I have held dying patients’ hands at 3 a.m. I have delivered news that shattered families. Through all of it, I have clung to one simple belief: doctors exist to protect people, especially the vulnerable. Then I read the Jeffrey Epstein files. And I felt something I rarely feel in my profession: SHAME. The documents reveal that Dr. Peter Attia—a physician, longevity expert, bestselling author, and host of one of the most popular health podcasts in America—maintained a close friendship with Epstein for years after Epstein’s 2008 conviction for procuring a minor for prostitution. The emails between them are jarring. Crude jokes. Plans to meet. A relationship so important to Attia that, according to the files, he once prioritized a New York meeting with Epstein over returning to his infant son’s bedside in the ICU. His wife had begged him to come home. He chose Epstein. Let me be clear about what we already knew in 2008. Jeffrey Epstein pleaded guilty to crimes involving a child. He was a registered sex offender. This was not a rumor. It was not gossip. It was a matter of public record. And yet, from 2014 to 2019, Attia maintained this friendship. He joked in emails about having “JE withdrawal.” He expressed concern about Epstein’s “legal troubles”—not about the victims, the girls, the children whose lives Epstein destroyed. In his public statement this February, Attia framed his choices as naivety. He claims he saw Epstein’s crimes as “prostitution-related” until a 2018 Miami Herald exposé revealed the full horror. He calls his emails “juvenile.” He says he has grown. Maybe he has. People can change. But here is what troubles me as a physician: Where was the instinct to protect? Every doctor in America is trained as a mandatory reporter. The American Medical Association’s code of ethics is explicit: if we have “reasonable cause to suspect” child abuse, we must report it. We do not need proof. We need suspicion. The law exists because doctors have access to information and influence that ordinary citizens do not. We are positioned to notice what others miss. We are trusted to act. Now, mandatory reporting typically applies to clinical settings—a child who shows up in your office with suspicious bruises, a patient who discloses abuse. Attia was not Epstein’s physician. He was his friend. But ethics do not stop at the clinic door. When a physician knows someone is a convicted child sex offender and chooses to maintain that friendship—to joke around, to share meals, to prioritize that relationship over his own family—what message does that send? What does it say about our profession’s values? Some have called for Attia’s medical license to be revoked. I understand the impulse. But I think the problem is bigger than one doctor. Jeffrey Epstein did not just befriend physicians. He bought access to science itself. Between 1998 and 2008, Epstein donated over $9 million to Harvard University. He funded a program in evolutionary dynamics. He gained an office on campus. He became a “visiting fellow” in the psychology department—despite having no academic credentials whatsoever. After his 2008 conviction, Harvard officially stopped accepting his money. But the relationships continued. Former university president Lawrence Summers kept meeting with him, reportedly soliciting advice and indirect donations. Faculty members attended Epstein’s now-infamous dinner parties, gatherings that were notably all-male, where conversations veered into pseudoscientific musings about eugenics and “improving” the human race. Epstein understood something that the rest of us are only beginning to reckon with: money opens doors that should stay closed. He used his wealth to position himself as a “patron of science.” He cultivated relationships with Stephen Hawking, with geneticists, with AI researchers. He hosted conferences. He funded research. And in return, he got something priceless: legitimacy. When a predator can sit at dinner with Nobel laureates, when he can stroll across Harvard Yard with an office key in his pocket, when leading physicians call him a friend—he becomes harder to see as a monster. The credentials of the people around him become his camouflage. This is how institutions fail. It is not dramatic. It is not a single corrupt decision. It is a thousand small compromises. It is a grant application that needs funding. It is a dinner invitation that seems harmless. It is the thought: He already served his time. Who am I to judge? It is, as geneticist George Church put it, “nerd tunnel vision”—the tendency to focus so intensely on research that ethical questions blur into background noise. But there is another name for this: complicity. When MIT’s Media Lab was revealed to have accepted hidden donations from Epstein, the director resigned. The institution launched investigations. There was accountability, however belated. In medicine, we have been slower to reckon. Attia is not an outlier. He is a symptom. He represents a growing class of “influencer doctors” whose brands depend on access, on elite networks, on proximity to wealth and power. His practice reportedly charges clients $150,000 a year. His podcast reaches millions. His bestselling book promises to help readers live longer. None of this is inherently wrong. But when the model rewards networking over service, when career advancement depends on who you know rather than who you heal, the profession drifts from its purpose. And when the people you know include convicted child sex offenders, the drift becomes a fall. Public trust in medicine is fragile. We have spent years watching it erode—through pandemic misinformation, through pharmaceutical scandals, through a healthcare system that often seems to value profit over patients. We cannot afford to give people more reasons to doubt us. The Epstein files are a gift, in a way. They are a mirror. They force us to ask uncomfortable questions: What are we willing to overlook for funding? For access? For prestige? Where do we draw the line between professional ambition and moral compromise? And they demand that we answer. Here is what I believe we must do. First, we need stronger ethical guidelines. The AMA should clarify physicians’ responsibilities when they encounter evidence of abuse outside clinical settings. Mandatory reporting should not be a technicality we hide behind. Second, institutions must vet their donors. Harvard, MIT, and countless other universities accepted Epstein’s money with minimal scrutiny. After the scandals broke, they scrambled to distance themselves. This is backwards. Transparency should come first, not last. Anonymous donations to research institutions should be banned. Donor backgrounds should be reviewed before checks are cashed. Third, we need to diversify how science is funded. When researchers depend on wealthy individuals for grants, they become vulnerable to manipulation. Public funding, foundation support, and transparent giving structures can reduce this dependency. Fourth, and most importantly, physicians must hold ourselves accountable. We cannot wait for institutions to act. Each of us must decide what we stand for. I am not calling for perfection. We are all flawed. We all make mistakes. But there is a difference between a mistake and a pattern. There is a difference between ignorance and willful blindness. When a man is convicted of crimes against children, you do not joke around with him. You do not make him a priority. You do not choose him over your own family. You walk away. I became a cardiologist because I wanted to heal. I wanted to be there for people in their most frightening moments. I wanted to live by the oath I took: first, do no harm. That oath means nothing if we harm by association. If we give cover to predators. If we let ambition eclipse integrity. Peter Attia may have changed. I hope he has. But the profession’s reckoning cannot depend on one man’s growth. It depends on all of us. It depends on choosing patients over prestige, service over access, and conscience over convenience. It depends on remembering why we became doctors in the first place.

"He would tell me 'Ma, I don't feel emotion.'" Jeremiyah Love is a unique talent. But long before he stepped on a football field, Love and his parents knew he was different. @JenLada with more ⤵️

We control the noise #GoIrish☘️

A ton of hard work put into this by a fantastic team Couldn’t have asked for a better way to culminate my time with the #CardioOnc group @OhioStateDHLRI @OSUCCC_James and @md_addison

🧵regarding the useful technique of 'straightening the wire' during central line placement when the plastic guide is no longer within reach. If you do a lot of central lines (or a lot of percutaneous procedures), this technique will come in handy over and over again. (1/ )

Lastly, we have @nparisiMD who *models* what it means to be a doctor and leader. He epitomizes the blend of compassion and intelligence that anyone would want in their doc. He's staying @OSUWexMed to do MP primary care and we could not be happier!

Beautiful weather. Even more beautiful people! Our residents (with a bunch of new PGY1s too) an IM welcome event! #MedPeds4Lyfe

My (@DoctorVig 's) favorite part about having transient control over this Twitter account until it goes back to the new resident team is the fact that I get to shout out all the awesomeness here.