One brief message at a time, Lancet editor Richard Horton is tweeting his dark view of the contemporary medical establishment. If you have any interest at all in peeking behind the curtain to see what really goes on behind the scenes of top medical organizations then you need to follow Richard Horton's Twitter feed. In sudden bursts of candor, humor, and cynicism, Horton has been tweeting thoughts that don't often see the light of day. Here's his unvarnished opinion of the World Health Organization, for instance: "WHO is no longer a science-based organisation. WHO believes that scientists within the agency should be anonymous bureaucrats." The thread of tweets that prompted this post [is] about an ongoing editorial battle with authors and another highly respected journal. The significance of these remarks is considerable. As Horton remarks at the end, the episode appears to lend evidence to the manipulation of journals by industry: "The mother of all authorship disputes has broken out. When papers get salami sliced and divided between NEJM and us, it gets complicated. And sometimes nasty. And today, even threatening. From Principal Investigator: "Approval [of the drug in question] has already occurred in the US, yet private insurers are slow to place it on their formulary. A major publication is typically how this occurs in the US, and it is important to be in a journal typically recognised by US-based companies. This publication is critical to (company A's) ability to "market" their product. Lancet ... will aid (company Y) quite nicely."