“I'm not great at the advice. Can I interest you in a sarcastic comment?”

This is what ‘Friends’ actor Matthew Perry’s character Chandler Bing was known for. He was known for being funny. However, he had his own struggles in his personal life and those struggles were acute depression. He was treating it with ketamine infusion therapy which is legal in the US and the UK.

What is Ketamine infusion therapy?

Ketamine is an anaesthetic used to treat depression, anxiety and pain under supervised and controlled medical settings. However, it does have its side effects, which can lead to distortion of sight, sound and time. It can also produce calming and relaxing effects.

Ketamine increases a person’s heart rate and blood pressure. If overdosed, it can leave users confused and agitated and can cause them to hurt themselves without even realising it. It can also lead to liver damage and bladder problems.

However, when used in moderation and under the supervision of medical doctors, it can treat depression where traditional antidepressants have failed.

Prof Rupert McShane, a University of Oxford psychiatrist who runs an NHS ketamine treatment clinic told BBC that ketamine “probably turns off the area of the brain that is involved in disappointment.”

Can Ketamine Infusion Therapy Kill Someone?

In simple terms, it cannot, be if the dosage is given in a controlled setting and as prescribed. Ketamine infusion therapy uses drugs in small doses than those used for anaesthesia. It acts faster than traditional anti-depressants, but the effects also wear off way quickly. Which is why it is important to monitor patients’ mental state for relapsing back into depression and discouraging them from overdosing on it.

There are ways of giving people ketamine. One of the ways is through “infusing”, which means to use an IV drip. However, injections, nasal sprays and capsules are also methods used to give people ketamine.

Since the dosage of ketamine used in the infusion treatment is small, it being the reason of actor Perry’s death was ruled out. The medical examiner also noted that Perry’s last ketamine infusion therapy session happened more than a week before his death, which means by the time he had died, it must have worn off.

So, What Happened To Perry?

Though Perry’s last session was more than a week before, his post-mortem showed that his blood contained a high concentration of ketamine. He had died of the “acute effects” of ketamine.

If it was not his session, then how did he get ketamine?

Prosecutors alleged that his assistant gave him at least 27 shots of ketamine in four days before his death, reported BBC.

Perry has been open about his personal struggles and this is what the doctors and dealers used against him. Martin Estrada, the US attorney for California’s Central District told the BBC that people took advantage of his condition. They charged him 165 times more than what vials of ketamine cost.

Names that have come up include Dr Salvador Plasencia, drug dealers “Ketamine Queen” aka Jasveen Sangha and Eric Fleming, and Perry’s live-in assistant Kenneth Iwamasa.

Who Are These Names And What Did They Do?

Ketamine Queen or Sangha supplied drugs that led to Perry’s death. Her home was a “drug-selling emporium,” said Estrada. More than 80 vials of ketamine, and thousands of pills including methamphetamine, cocaine and Xanax were allegedly found in her house known as the “Sangha Stash House.”

Sangha is known to deal with high-end celebs and was a “major source of supply for ketamine to others as well as Perry,” said Estrada.

Dr Plasencia called Perry a “moron” while charging him $2,000 for vials that cost only $12. He sold Perry 20 vials of ketamine between September and October 2023, costing $55,000.

He was the one who taught Iwamasa, who had no medical knowledge to inject the drug. This is after he knew that “Perry’s ketamine addiction was spiralling out of control,” as per what the investigators told the BBC.

Another dealer Fleming was told by Sangha to “delete all our messages.” While Fleming pleaded guilty to conspiring to distribute drugs unlawfully, he also allegedly messaged Sangha: “Please call...Got more info and want to bounce ideas off you. I’m 90% sure everyone is protected. I never dealt with [Perry] only his assistant. So the assistant was the enabler.”

The court documents also revealed that he asked Sangha on whether the ketamine stays in your system or “is it immediately flushed out.”

Dr Pepper, Bots, Cans

The people who allegedly exploited Perry used coded language for ketamine and called it “Dr Pepper”, “bots”, or “cans.”

Selling overpriced drugs, taking advantage of Perry’s mental condition and falsifying medical records to make the drugs given to him look legitimate by Dr Plasencia is what took Perry’s life.

Iwamasa is said to have administered more than 20 shots of ketamine and three on the day Perry died. Whereas ketamine is only administered by a physician. Authorities also found that weeks before Perry’s death, Dr Plasencia allegedly bought 10 vials of ketamine and intended to sell to Perry.

He also injected Perry with a large dose, two days later. This caused him to “freeze up” and spiked his blood pressure.

When I Die, I Want Helping Others To Be The First Thing That’s Mentioned

Perry had always been open about his drug addictions, struggles with alcohol and his depression. He said that his openness would help others who are also struggling and wanted to be remembered by his quote which also is on the homepage of the Mattew Perry Foundation that helps others struggling with the disease of addiction: “When I die, I want helping others to be the first thing that’s mentioned.”

Five arrests have been made in the case so far.

As of 12pm on November 22, Delhi's AQI according to aqi.in is recorded at 315, with PM2.5 recorded at 225, and PM10 recorded at 296. The levels are still under the category 'Hazardous' and is equivalent to smoking 10.8 cigarettes a day, 75.6 cigarettes a week, and 324 cigarettes a month.

Amid all this, in an interview with the news agency ANI, AIIMS doctor called Delhi's deteriorating air quality as a "medical emergency". The doctors have warned that the crisis has intensified to a level where existing government measures are no longer enough. Prof Dr Anant Mohan, who heads the Department of Pulmonary, Critical Care, and Sleep Medicine, and Dr Saurabh Mittal of the same department at AIIMS said that city's continuously worsening pollution could pose serious threats to the vulnerable, including pregnant women, unborn and newborn child, and other adults, especially the ones with cardiac or neurological conditions.

Impact Could Be Generational

Dr Mohan highlighted that the exposure could lead to impacts which could be felt for generations. He said that the alarming effect is being seen on pregnant women, and that the pollutant, since the particles are so small, could pass through mother to the child in the fetus and could affect their growth.

The doctor pointed out that babies who are exposed to such a condition in womb have a higher chance of being born under weight, and their lungs may continue to remain weak as they grow. There could be other complications too, which might only be noted as the child grows old.

Dr Mittal said that the effects of air pollution now reach far beyond respiratory issues. He noted that prolonged exposure to toxic air has triggered rising cases of breathlessness, lung inflammation, asthma attacks, and chronic conditions like COPD. Fine particulate matter is also entering the bloodstream, raising the risk of heart attacks and strokes.

What Can You Do?

Wear N-95 Mask

The doctors are advising to wear an N-95 mask whenever someone is stepping outdoors. He mentions that a cloth or a surgical mask won't protect them against the pollutants, as N-95 masks are the only protective gears with filters that can keep the pollutants out when you breathe.

Skip Your Morning Walk

Pollution is the highest in the morning. This happens because pollutants accumulate overnight, and without wind or sunlight, PM2.5 or the particulate matter stays trapped near the ground, leading to pollution being at its peak by sunrise. As per the data by aqi.in, highest AQI is always registered between 6am to 9am.

Use Wet Mopping

Dry dusting could push the particles back up into the air, thus using a wet mop would reduce the dust particles and prevent it from being released in the air.

Vitamin C Supplements

A 2007 study published in the Journal of the Royal Society of Medicine noted that vitamin C or its supplement could in fact help patients with pneumonia or other lung-related disease. Thus vitamin C is a good boost for when lungs are at high risk, all thanks to the pollution.

Furthermore, the doctors suggest to keep hydrating yourself and use air purifier if one can afford it.

The first known human infected with the H5N5 strain of bird flu has died, Washington state health officials confirmed on Friday.

The patient was an older adult with underlying health conditions and had a backyard flock of mixed domestic birds, according to the Washington State Department of Health. No additional personal details were released out of respect for the family’s privacy.

A Rare Strain Never Before Seen in Humans

While the U.S. has recorded around 70 human bird flu cases over the past 18 months, all linked to the H5N1 strain, this is the first time H5N5 has been detected in a person. The strain has appeared in animals before but has never crossed over to humans until now.

Health officials emphasized that the risk to the public remains low. No close contacts have tested positive, and there is currently no evidence of human-to-human transmission.

Bird Flu Continues to Spread in Animals

Avian influenza has circulated in birds for decades, but its spread into mammals across the U.S. has accelerated. In March 2024, the U.S. Department of Agriculture confirmed that a bird flu strain affecting millions of birds had also been found in several mammals.

Since then, at least 70 people in the U.S. have tested positive for bird flu, mostly after exposure to infected cattle, poultry farms, or culling operations. The majority of cases have been mild, with symptoms like fever and red eyes, though some have been more severe. In January, the U.S. reported its first bird flu–related death in an older patient with underlying conditions.

Public Health Risk Remains Low

The CDC and other health agencies stress that there is no sign of the virus spreading between people. For now, the risk to the general public remains low, though surveillance continues as the virus evolves.

What Is Bird Flu?

Bird flu spreads from bird droppings and saliva. This happens especially when they feed on birdfeed and water.

Authorities have expanded compulsory poultry housing measures—previously limited to the North, Midlands and East—to all of England starting Thursday, in an effort to curb disease transmission. A nationwide Avian Influenza Prevention Zone also remains in force, mandating stringent biosecurity and hygiene protocols.

Health and Me had earlier reported that the UK had ordered 5 million vaccines against bird flu, also dubbed as "one mutation from being the next COVID". The comparison of bird flu with COVID, comes from the mutation that has recently been seen in the avian flu, which has affected animals and humans alike. Similar to how the corona virus previously also mutated, and continues to do so.

What are the symptoms one must look out for?

• Pink eye
• fever
• fatigue
• cough
• muscle aches
• sore throat
• nausea
• vomiting
• diarrhea
• study or runny nose
• shortness of breath

Birds flu in humans

The first case of the recent bird flu outbreak in the US came in September, from a Missouri resident. However, the person did not have any exposure to infected animals. This is what is also raising the concern for mutation and the possibility of other forms of spreading. This was also a rare case as the infection did not happen due to exposure. Previously, all such cases in the US involved contact with farm animals or contaminated environment.

Can bird flu come from other animals?

Bird flu primarily infected farmworkers or those in close proximity to livestock. The first human bird flu case in the US was reported in 2022, to a person who was also involved in farm-working.

While this flu is largely confined to birds in the wild and poultry, recent outbreaks have been reported in mammals too, including cattle.

While 14 cases are in the US, the CDC notes that the risk to the general public is still at low, however, this warning could change. "Although human infections are rare, circumstances may evolve as we learn more about this case," said the CDC in a statement.

Brandon Buckingham, a YouTuber known for his documentary and man-on-the-street style videos is facing serious health emergency and had spent months in hospital visits. He is now in Intensive Care Unit, an update he shared on November 21. "My heart is failing, my lungs are failing, my liver and kidneys are failing. Things are not looking good my friends. I love you guys, " he said.

Earlier he had shared that he was out of hospital and his condition seemed stabilized, however, soon things got worse. He posted on X: "doctor believes I have tuberculosis, septic pneumonia, and/or liver failure. pray for me guys."

He had earlier shared that he was not in a good headspace every since his grandmother died. “I have more people waiting for me in heaven than here on earth. I think God has a plan for me that I don’t understand. I love you grandma, say hi to Kyle for me. I wish I could die with you.”

Why Does Someone Have A Multiple Organ Failure?

Brandon mentioned that his heart, liver, and lungs were failing. A person can have multiple organ failure because these organs have a complex, bidirectional relationship. This means when the failure of one happen, it can cause or contribute to failure of another organ. For instance, severe liver disease could lead to a heart and lung complication like hepatopulmonary syndrome.

How Does Organ Affect The Other?

If someone has severe liver disease, it could cause severe fluid buildup in the abdomen and chest cavity, which can compress the diaphragm and lead the shortness of breath. Liver disease can also cause changes in blood vessels of the lungs, which could lead to conditions like portopulmonary hypertension and hepatopulmonary syndrome, which can affect the heart and lung function. In advance cases, the liver can cause a condition called cirrhotic cardiomyopathy, which is heart muscle dysfunction.

Brandon's Diagnosis

While there is yet no clear diagnosis, as the post only mentions that the doctor "believes" that he has tuberculosis and pneumonia. However, the question is, can this really happen together?

The answer is yes. A person can have both TB and pneumonia at the same time, as they are both respiratory infections and can occur concurrently. This co-infection can make diagnosis difficult because the symptoms of pneumonia might be more prominent, potentially obscuring the signs of TB. It is also possible for the Mycobacterium tuberculosis bacterium, which causes TB to cause a type of pneumonia itself.

In fact, both TB and pneumonia can cause liver failure, though it is rare. Liver damage from TB can occur due to the infection itself (hepatic tuberculosis) or as a side effect of the strong medications used to treat it. Pneumonia can cause liver failure, but it's typically a severe, overwhelming infection that puts a great strain on the body's organs.

However, what Brandon has been diagnosed with is still not clear. Fellow YouTubers like Aztoy and Bowblax have also voiced their support for Brandon, but since the November 21 update of being in the ICU, Brandon is yet to share more information on his health.