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Alexandra Petri, "A Dispatch from the MAHA Future", The Atlantic 8/5/2025:

“Did you see the game last night?” I ask Greg.

The year is 2029 and we are taking the New, Improved Presidential Fitness Test. The Secretary put some special touches on it himself. My wearable (we all have to wear wearables now, since the Secretary’s mandate) says that I still have 5,000 more steps to go. If we don’t pass our Presidential Fitness Test, we’ll have to visit the Wellness Farm to pick turnips and be “reparented.”

“No,” Greg says. I can sense that Greg is flagging. “Ever since the Leeches First mandate, I’ve had to spend most of my time, you know.” He bends down to pluck a leech off his calf. It lolls about, engorged with blood. He deposits it carefully into his leech pack.

We both sigh. The leeches are the worst. Before taking what used to be called medicine (it is now, according to the CDC’s revised guidance, Just One More Supplement, No Better Or Worse Than Any Other Supplement), the Secretary insists that everyone “try leeches.” The papers at the time described this new mandate as a Huge Triumph for Big Leech. We walk past a billboard with a reminder from the CDC: Don’t Forget to Leech and Bleach! We feel pretty bad most of the time.

The linguistic angle here is the phrase "Big Leech", for which the earliest model is probably "Big Business", which the OED glosses as "Large commercial organizations, now esp. multinational corporations, collectively", with citations back to F.C Howe in 1905

We are beginning to realize that the same self-interest is the politics of big business.

…and Theodore Roosevelt's autobiography in 1913:

We demand that big business give the people a square deal; in return we must insist that when any one engaged in big business honestly endeavors to do right he shall himself be given a square deal.

However, the OED also has an entry for "Big Four", dating back to 1882, glossed as

Originally U.S. Frequently with capital initials. Usually with the. Modifying a numeral to designate a group of the specified number of people, things, nations, etc., which are the most important or influential within a particular field, as the big three, the big four, etc.
In early use esp. in Big Four, designating the Cleveland, Cincinnati, Chicago, and St Louis Railway (frequently attributive).

"Big Leech" is most directly a play on Big Pharma, but these's also Big Oil, Big Tobacco, Big Soda, Big Sugar, Big Tech, Big Media, etc. And lots of other serious and (semi-)humorous Big Xs. In fairness to RFK Jr, the fitness test, the wearables, and the wellness farms are real, and also the "miasma theory" stuff that Petri brings in later, but "Leeches First" is satire.

My personal angle on this — at least what it brought to mind — is the opposite of "Big Leech".  I grew up in a small village in eastern Connecticut, about which we used to joke that it had more cows than people (before Big Dairy put the local farmers out of the dairy business). In "It's Yankees all the way down" (12/9/2003), I wrote

When I was a child in rural eastern Connecticut, it was understood that only some of the people in our village were called "yankees" (which of course had nothing at all to do with the hated baseball team of the same name). Later on, I learned that these people were the descendants of the English immigrants who had settled the area in the late 17th century, but when I was six or so, the characteristics that I associated with "yankees" included keeping a few farm animals on the side, trapping to earn a little extra money from furs, making hooked rugs from old socks, and shooting at garden pests rather than merely cursing at them. Although I participated in such activities with friends and neighbors, mine was certainly not a Yankee family in the local sense, and so it still takes me aback when I realize that some Texan or Virginian regards me as a Yankee.

One other characteristic of the local "yankees", at least the older ones, was adherence to medical traditions, including the use of leeches. But apparently the traditional sources of medicinal leeches were no longer functioning well. And so when I was seven or eight, a small group of us used to go leech hunting, by wading bare-legged in the shallows of local ponds and rivers. Leeches would attach to our legs, we'd remove them and put them in a Mason jar, and then sell them to the local pharmacist for a nickel each. Which required one of us to make a four-mile bicycle trip to the nearest drug store, but that was worth it, because a nickel was a lot of money. You could buy a bottle of soda for a nickel, or a good-sized bag of candy, so a Mason jar full of leeches was a great payday for four or five second graders.

I've occasionally wondered whether this might have just been the pharmacist's way of being nice to local kids. But Wikipedia notes that

Bloodletting persisted into the 20th century and was recommended in the 1923 edition of the textbook The Principles and Practice of Medicine. The textbook was originally written by Sir William Osler and continued to be published in new editions under new authors following Osler's death in 1919.

And someone in their 60s or 70s  in 1954 (when I was 7) would have been in their 30s or 40s in 1923, so continued belief in leeches isn't improbable.

August 15, 2025 @ 1:55 pm · Filed by Mark Liberman under Language and culture

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