For a long time I’ve been thinking about going beyond what my colleagues in sociology now routinely call ‘the biomedical industrial complex,’ and asking us to think of Biomedicine as an Imperial power, having not only enormous financial resources but also the almost-religious belief system and the governmental power of any empire. People ‘believe’ in aspects of medicine; and your citizenship, your personhood, depends on medical approval, from birth certificates through proof of competency, on to death certificates. I’m using this ‘covid moment’ to put these thoughts together in a new book, coming from Stanford Briefs in the spring. I am exploring the ways that Public Health seems to have morphed into ‘medicine for all,’ and the particular role of biomedical citizenship at ‘the gates of life,’ the management of both birth and death.