A Poe classic has turned out to be an accidental case study: For people with misophonia, “The Tell-Tale Heart” reads less like madness and more like a man exercising enormous restraint, until a sound finally breaks him. Writing for the New Yorker, Sloane Crosley, a self-described misophonia patient (though she says her case isn’t severe), digs into a condition defined by an intense fight-or-flight reaction to specific everyday noises—chewing, gulping, sniffing, tapping—that an estimated 4.6% of American adults may experience. It’s not about loudness, doctors say, but about how certain brains tag particular human-made sounds as threats. When those who have misophonia hear such noises, “they share a dysregulating visceral response, a cognitive and physiological—chest-tightening, heart-racing, sweating—spiral of alertness and exhaustion,” Crosley writes.
The author follows patients whose lives have been reshaped by misophonia—students eating alone in their rooms, a teacher hiding his condition at work, a family switching to plastic cutlery—and the clinicians and advocates pushing to get the disorder its own code in the World Health Organization’s disease manual. That recognition could unlock insurance coverage, as well as basic validation. Others warn it’s too soon, however, to codify something that still straddles both psychiatry and audiology. The piece also explores experimental “semantic hearing” headphones that might one day mute triggers selectively. Crosley wonders, however, “if people should be able to do this. … Should we be able to tailor our immediate environments more than we already do? So much of today’s technology is built for self-siloing.” More here on this under-recognized condition.
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To­ba­go Cor­re­spon­dent
The Di­vi­sion of Health is ex­press­ing alarm over “high rates” of sex­u­al­ly trans­mit­ted in­fec­tions (STIs) in To­ba­go, par­tic­u­lar­ly HIV, among the 20-29 age group.
In an ex­clu­sive in­ter­view with Guardian Me­dia, Oni­ka Hen­ry, se­nior pro­gramme co­or­di­na­tor for sex­u­al health and youth de­vel­op­ment at the De­part­ment of Well­ness, Pre­ven­tion and Health Pro­mo­tion, said HIV in­fec­tions are ris­ing on the is­land. Apart from un­ac­cept­able HIV lev­els, Hen­ry said gon­or­rhoea and syphilis are al­so soar­ing on the is­land and glob­al­ly.
“We are mon­i­tor­ing those close­ly in To­ba­go be­cause it seems to be an in­ter­na­tion­al trend,” she said, adding there is a new drug-re­sis­tant strain of gon­or­rhoea.
“HIV re­mains a pri­or­i­ty be­cause those rates seem to be in­creas­ing over a num­ber of years. I re­mem­ber com­ing back in 2016 af­ter study­ing abroad; there was an in­crease hap­pen­ing even then.”
Hen­ry said while the STI trans­mis­sions re­main a big con­cern, she said the di­vi­sion is still analysing the da­ta to get a clear­er pic­ture.
“We’re see­ing an in­ter­est­ing pat­tern in terms of a par­tic­u­lar age group. From 20-29, they seem to have con­sis­tent­ly high rates when it comes to STIs. What we can’t do is draw any firm con­clu­sions about whether that means we have STIs in­creas­ing or whether more peo­ple are com­ing for­ward to be test­ed.”
She said da­ta from pri­vate in­sti­tu­tions re­mains in­ac­ces­si­ble to the di­vi­sion, but it is work­ing to ad­dress this.
Hen­ry, a clin­i­cal sex­ol­o­gist, said the main hin­drance to com­bat­ing new in­fec­tions is shame. She said the Di­vi­sion of Health is for­mu­lat­ing a work­place pol­i­cy to re­move dis­crim­i­na­tion and stig­ma sur­round­ing HIV. It al­so in­tends to strength­en pub­lic trust in their in­for­ma­tion re­main­ing con­fi­den­tial at pub­lic fa­cil­i­ties.
While HIV is now con­sid­ered a chron­ic dis­ease ow­ing to ad­vances in treat­ment, Hen­ry ac­knowl­edged it re­mains a tremen­dous fi­nan­cial bur­den on the di­vi­sion.
“It is not about us just want­i­ng peo­ple to be well and hav­ing a healthy labour force, but there is al­so the chal­lenge of bud­getary al­lo­ca­tions; the chal­lenge of find­ing fund­ing if you find your rates are in­creas­ing every year and if you have to pro­vide free med­ica­tion for a grow­ing pop­u­la­tion of pos­i­tive folks.”
She said there are com­pli­ca­tions in­volved in liv­ing with HIV, adding that an age­ing pop­u­la­tion that is not well is prob­lem­at­ic.
The sex ed­u­ca­tor be­lieves ear­ly in­ter­ven­tion and ed­u­ca­tion are key, stress­ing the im­por­tance of in­cor­po­rat­ing sex­u­al ed­u­ca­tion in­to the school cur­ricu­lum.
“Giv­en the num­bers, the STI re­ports we are hear­ing, it would be a grave in­jus­tice to not give young peo­ple the skills and knowl­edge they need to pro­tect them­selves. Sex­u­al­i­ty is health; it is part of one’s whole­ness and well­ness.”
Hen­ry said the in­ten­tion is to col­lab­o­rate with the Di­vi­sion of Ed­u­ca­tion to de­sign age-ap­pro­pri­ate mes­sages for chil­dren. While an­tic­i­pat­ing some re­sis­tance from re­li­gious groups, Hen­ry is ea­ger to get all stake­hold­ers in­volved, in­clud­ing var­i­ous par­ents’ and teach­ers ‘ as­so­ci­a­tions (PTAs).
“I am hope­ful that they would see, based on the fig­ures, num­bers and re­search, that what we have been do­ing is clear­ly not work­ing, and if we re­al­ly care about our young peo­ple’s health, that we would do some­thing about it in ways that are ev­i­dence-based.”
She be­lieves re­li­gious groups preach­ing ab­sti­nence should em­brace sex­u­al ed­u­ca­tion in schools from an ear­ly age.
“Ab­sti­nence is a skill, it is not a tal­ent we are born with. Ab­sti­nence and re­fusal skills are part of sex ed­u­ca­tion.”
She said, like all oth­er sub­jects in the cur­ricu­lum, there is a way for it to be taught in the class­room, even at the pri­ma­ry school lev­el.
She warned against judg­ing young peo­ple too harsh­ly and la­belling them reck­less when they are bom­bard­ed dig­i­tal­ly with sex­u­al con­tent.
“If your on­ly ac­cess to in­for­ma­tion about sex is porn, we are cre­at­ing a sit­u­a­tion where peo­ple are look­ing at ex­plic­it con­tent with­out know­ing how to eval­u­ate it, as­sess it and as­sum­ing this is the norm, copy­ing what they’re see­ing and caus­ing harm to them­selves and oth­ers.”
She said sex­u­al ac­tiv­i­ty among pri­ma­ry school stu­dents is al­so be­ing re­port­ed and in­ves­ti­gat­ed,
Hen­ry ar­gued that even chil­dren with dis­abil­i­ties must not be ex­clud­ed from be­ing ed­u­cat­ed on the top­ic.
As the is­land pre­pares for its fifth an­nu­al car­ni­val in Oc­to­ber, the di­vi­sion will be rolling out an aware­ness pro­gramme tar­get­ing young peo­ple.
She said in­flu­encers will be in­clud­ed as they meet the pop­u­la­tion at the var­i­ous fetes and oth­er ac­tiv­i­ties to spread their mes­sage.
IDA head hits pub­lic-pri­vate sec­tor dis­con­nect
Mean­while, Dr Denise Tsoisafatt An­gus, med­ical doc­tor and po­lit­i­cal leader, In­no­v­a­tive De­mo­c­ra­t­ic Al­liance (IDA), said it was a trav­es­ty that the di­vi­sion was un­able to ac­cess da­ta from the pri­vate sec­tor.
“The pub­lic health sec­tor in To­ba­go should be con­nect­ed to the pri­vate doc­tors for them to re­port on what they are see­ing. They should be able to give the pub­lic sec­tor a re­port, month­ly or week­ly, on the cas­es they are see­ing. So if there is an uptick in the num­bers, the pub­lic health sec­tor should start in­creas­ing their ed­u­ca­tion.”
She said this dis­con­nect could eas­i­ly be bridged by a pol­i­cy from the THA.
“It is just a pol­i­cy de­ci­sion and them go­ing out and en­gag­ing the pri­vate per­sons and cre­at­ing a re­port­ing sys­tem. I am sure the doc­tors in the pri­vate sec­tor would be more than hap­py to give a re­port, even though they’re not giv­ing the names of their pa­tients.”
She said health is­sues of such mag­ni­tude should not be treat­ed in iso­la­tion.

By Cara Anthony and Blake Farmer, Nashville Public Radio, for KFF
Listen in and play along as hosts Cara Anthony and Blake Farmer test their knowledge with a HealthQ quiz on detecting early-onset cancers.
Bryce Ramsey of Madison, Mississippi, was 33 when she was diagnosed with colorectal cancer. Upon noticing blood in her stool, she blamed the hemorrhoids she’d developed after delivering her son eight years earlier.
Ramsey didn’t initially link her symptoms to cancer.
“But I had just kind of made a deal with myself because the blood was starting to become more frequent,” she said. “I was like, ‘If this happens the next time I go to the bathroom, I’m going to make a call.’”
She saw more blood, and she reached out to a gastrointestinal clinic to get it checked out, just in case. Her doctor said she normally wouldn’t scope someone Ramsey’s age, “‘but something in my gut is just telling me I need to do so,’” Ramsey recalled. “And thank God she did because she found a 5-centimeter polyp.”
Ramsey had surgery, endured chemotherapy, and survived stage 3 colon cancer. Now 40, she volunteers for the Colorectal Cancer Alliance, a nonprofit advocacy group, to raise awareness of early-onset colorectal cancer.
Stories like hers are becoming increasingly common: In the U.S., more than a dozen kinds of cancer are on the rise in adults under 50. Among these early-onset cancers, colorectal and breast cancers have increased the most, and colorectal cancer is now the deadliest cancer for Americans ages 18 to 49.
Here’s what to know about detecting early-onset cancers.
1. Family history is one of the most important risk factors.
Researchers have not been able to find a single cause for the rise in early-onset cancers. Instead, research suggests a myriad of factors play a role, including obesity, heavy alcohol use, environmental factors such as microplastics, and disruptions to gut health.
Doctors generally follow population-level guidelines for routine screenings — such as recommending mammograms starting at age 40 to screen for breast cancer — but physicians might recommend some patients get screenings as early as in their 20s. Doctors weigh a patient’s personal risks, including their family history of cancer.
Ramsey learned only after her diagnosis that her grandfather previously had colorectal cancer. “If I would’ve known that I had a significant family history, I would’ve been scoped a lot younger,” she said. “My doctor said my tumor had probably been growing for seven to 10 years.”
After her diagnosis, she encouraged her father, aunt, and brother to get screened. All three were diagnosed with colon cancer, too, and survived after receiving treatment.
Ramsey said it can be uncomfortable to urge family members to get tested or to talk with them about private health information, but those conversations are worth having to save a life.
“Just ask the question or make a joke about it. And sometimes just little icebreakers will help,” she said.
2. Report unusual symptoms as quickly as possible.
Being vigilant about unusual body changes or symptoms — and reporting those to your physician — gives doctors the information they need to determine your personal risk for cancer.
“For example, a lump in the breast, abdominal pain, changes in bowel habits that really are not going away,” said oncologist Veda Giri, director of the Early Onset Cancer Program at Yale Cancer Center. “Certainly blood in the stools. Sometimes even symptoms such as unusual fatigue that doesn’t seem to go away.”
“It’s incredibly important to bring symptoms to your doctor,” Giri said.
3. Talk, then test, then talk again.
Ads for at-home cancer tests are everywhere, so you might be tempted to use a screening kit instead of going in for an office visit or a standard screening, like a colonoscopy.
But not all tests are created equal, Giri said. It can be hard for laypeople to understand the accuracy of at-home screening kits, so they should talk to their doctor first.
“Some of these tests could lead to a false sense of either reassurance or false anxiety and alarm,” she said.
For people who decide to move forward with an at-home test, experts say they still need to consult with a physician. If you get any sort of abnormal result, your doctor is going to want to follow up with additional testing, such as a colonoscopy. Sharing your results, regardless of outcome, will help inform your care.
People and Policy
The U.S. Preventive Services Task Force recently changed the recommended age for women to begin mammogram screenings for breast cancer from 50 to 40. But there’s a difference of opinion among national advocacy and medical groups about whether regular screenings should happen every year or every other year.
In 2021, the same task force lowered the recommended age to 45 for a first colonoscopy for colon cancer detection for people with average risk. Establishing a relationship with a trusted medical practitioner can help patients assess personal risk and sort through new information as research and public health guidance evolve.
Related | NIH grant disruptions slow down breast cancer research
If you feel uncertain about your personal risk for cancer or when you should start cancer screenings, one of the best ways to advocate for your health is to establish a relationship with a medical practitioner you trust and ask specifically about your cancer risk. You can also ask to consult with a genetic cancer risk specialist, a type of medical provider who helps patients evaluate their cancer risk, often with genetic testing.
Katherine Ruppelt and Emily Siner at Nashville Public Radio contributed to this report.

Walk this way at every age.
Movement is essential for a long, healthy life, and walking has been growing in popularity as a simple way to boost heart rate, increase metabolism and lower the risk of disease.
It’s not just how far you walk, though; the pace can also reveal important information about health and longevity.
Previous research has shown that faster walkers are more likely to live longer, regardless of weight, hitting speeds of about 3 miles per hour, or 100 steps a minute.
A quick walk — literally — may mean a longer life, according to a 2024 meta-analysis that found people who walked the fastest were 43% less likely to die of any cause than those in the slowest-walking group.
And there are certain benchmarks you should be able to hit in each decade of life, according to a small 2022 study.
For healthy adults, an achievable goal while out on a walk is to hit a brisk pace that slightly elevates breathing while still allowing conversation.
20s and 30s: 13 to 19 minutes at a brisk pace of about 4.6 mph.
40s: 14 to 16 minutes at a pace of 4.3 mph.
50s: 15 to 17 minutes at 4 mph.
60s: 16 to 18 minutes at 3.3 to 3.7mph.
70s and older: 20-minute mile at 3.5mph.
Not only is a power walk good for living a longer life, but it’s also a good indicator of several health markers, according to Elizabeth Vogstrom, a physician assistant at EVOyouthful.
“A person can have normal laboratory values and still be experiencing declines in strength, endurance, mobility, balance or cardiovascular fitness,” Vogstrom told The Daily Mail.
“Walking speed often reveals those changes before they become obvious in daily life.”
It may not come as a surprise that walking faster is linked to several improved health outcomes, such as a lower risk of cardiovascular disease and type 2 diabetes.
A brisk walk has also been associated with improved brain function as we age.
Meanwhile, a slower pace, especially one that decreases with each year we get older, could be a sign of cognitive decline or dementia.
A sudden decline in walking gait could also signal underlying health issues.
“When someone’s walking pace slows unexpectedly, it may reflect deconditioning, loss of muscle mass, cardiovascular limitations, joint issues, neurological changes or other health concerns that deserve further attention,” Vogstrom said.
Walking speed has even been described by some experts, including Vogstrom, as the sixth vital sign, providing “insight into how well the body functions in everyday life.”

We all have people in our lives who seem to make everything, and I mean EVERYTHING, about themselves.
It’s pretty frustrating to deal with folks like this because, no matter what you tell them, it always seems to come back to them.
Ugh!
It’s so annoying!
And you’re about to hear a doozy of a story…
A man talked about how his friend made his cancer diagnosis, yes, you read that correctly, all about HER.
Take a look at what he had to say.
AITA for telling my friend my cancer diagnosis is not about her?
“I (22M) have had cancer (Melanoma) for years.
I first got diagnosed at 17, went in remission, then over the years, it has come back several times.
This is awful…
This time, it is more than one type of cancer, and in more than one part of my body.
I had the biopsy to determine whether it was cancer and what type last month. I got the call confirming it this morning.
Most people have been super supportive and kind, and most of my friends and family have been trying to help me out as much as they can ever since I got the biopsy done.
Well, once I got the call, I called my friend (23F) to tell her what was going on. Let’s call her K. As soon as I told her, she started sobbing, told me she couldn’t handle this news.
She sounds a bit clueless…
I asked her what she meant, and she said she’s been dealing with a lot lately because she didn’t have enough money to pay rent after buying herself a bunch of new clothes.
For context, she lives with her parents and the rent she pays isn’t even used for rent, it’s to pay back the money she stole from her parents last year.
Admittedly, this upset me a little bit, because I felt like she was focusing more on how she felt about the situation rather than how I felt. At first, I apologized for making her upset and asked if she wanted to talk later, when she wasn’t so upset.
Well, thats when she said “I just keep getting bad news after bad news after bad news! Haven’t I been through enough?”
And she’s also pretty rude!
That threw me off guard a little bit, and I ended up asking her if she really thought her inability to keep track of her finances and spending all of her money instead of saving it like she was supposed to was worse than my cancer diagnosis.
I know I could have handled this better, but I was, and still am, all over the place emotionally.
She got angry with me, told me I had no right to comment on her financial situation, and that I’m a terrible friend for throwing her pain and suffering in her face, and then she hung up on me.
A lot of our mutual friends have come to me saying that I was a huge asshole, and that I should have some empathy for the “less fortunate”.
AITA?
Did I overreact?
Should I have let this go?”
If you enjoyed this story, check out this post about a mom who is irate after she gave a group leader money for her daughter’s lunch, only to have him pocket the cash and ask all of the kids to pay their own way.
Check out what readers had to say about this.
This person said he’s NTA.
Another reader weighed in.
This Reddit user shared their thoughts.
Another individual spoke up.
And this person also said he’s NTA.
Wow…
This guy’s friend is really something else, huh?
That was brutal!
Let’s hope she grows up and comes to her senses soon…
Some people have to make EVERYTHING about them…