Why Don't We Have a Surgeon General?

We’re nearly halfway through Trump's second term and we still don’t have a Surgeon General. What gives? Support us: Hear bonus episodes on PatreonWatch Aubrey's documentaryBuy Aubrey's bookListen to Mike's other podcastGet Maintenance Phase T-shirts, stickers and more Links! White House withdraws nomination of Janette NesheiwatTrump’s Surgeon General Pick Distorted Key Parts of Her Résumé Dr. Janette Nesheiwat takes role at Walter Reed treating Havana SyndromeWhen Did RFK Jr Start List...

• 0:11Speaker 00

  Okay, I actually, I actually have one. I'm on fire.

• 0:14Speaker 01

  Woo! He came prepared, maybe.

• 0:17Speaker 00

  Welcome to Maintenance Phase, the podcast that has nothing to say about the surgeon specific, but a lot to say about the surgeon general.

• 0:23Speaker 01

  (laughing) Oh, I like that one so much.

• 0:29Speaker 00

  I'm Michael Hobbs.

• 0:30Speaker 01

  I'm Aubrey Gordon. If you would like to support the show, you can do that at patreon.com/maintenancephase. You can also subscribe on Apple Podcast Premium. It's the same audio content, Michael.

• 0:42Speaker 00

  Aubrey.

• 0:43Speaker 01

  We are a year and a half into Donald Trump's second term, and we still don't have a surgeon general.

• 0:50Speaker 00

  I have not been following this at all.

• 0:51Speaker 01

  You and most people. There's been so much shock and awe in so many places that it's like hard to keep track. We're all sort of like drinking from a fire hose in terms of the news cycles, right?

• 1:02Speaker 00

  I know. Whenever I hear about like an out of work Fox News host, I'm like, yeah, they're probably the surgeon general now. Who fucking cares?

• 1:07Speaker 01

  Today, we're gonna talk about the three sort of Maha-aligned doctors who have been nominated for surgeon general.

• 1:16Speaker 00

  Wait, so they're all doctors? That's actually kind of surprising.

• 1:18Speaker 01

  Well, hang on. Let's not get too crazy.

• 1:23Speaker 00

  I thought it was gonna be like Omarosa or somebody.

• 1:25Speaker 01

  We haven't done like a real Maha update in a minute because it's so often just like a soul-sucking slog of a thing.

• 1:34Speaker 00

  Yes.

• 1:34Speaker 01

  I would just like to preface this one by saying, it's pretty fun.

• 1:37Speaker 00

  Good. I want like Real Housewives shit.

• 1:39Speaker 01

  The surgeon general is often referred to as America's top doctor. Their role is in part focused on translating scientific findings into guidance for members of the public. So this is like a very Maintenance Phase role.

• 1:56Speaker 00

  He knows when you've been sleeping. He knows when you're not getting enough beef tallow.

• 1:59Speaker 01

  The surgeon general can issue reports and recommendations, but it, the office doesn't have the authority to create policy.

• 2:07Speaker 00

  It's actually kind of funny we have this role. Is just like a guy who says stuff in chief.

• 2:12Speaker 01

  It is kind of, well, except there is a very functional part of the role. The surgeon general leads over 6,000 uniformed officers in the US Public Health Service. So it's a role where it's like really helpful to be both a seasoned healthcare provider and a really strong, clear communicator. Don't start laughing yet.

• 2:34Speaker 00

  Foreshadowing, foreshadowing, okay.

• 2:36Speaker 01

  The process for becoming the surgeon general is that the president nominates someone to become the surgeon general. The Senate confirms that person and then they serve a four-year term. The nominee has to pass through the Health, Education, Labor, and Pensions Committee, the HELP Committee, which is currently split with 12 Republicans and 11 Democrats. So it's Republican-controlled, but only just. It is also a committee where Lisa Murkowski and Susan Collins are both on the committee, so you got a couple of real.

• 3:09Speaker 00

  Mavericks.

• 3:10Speaker 01

  Pieces of work.

• 3:11Speaker 00

  Couple of mavericks.

• 3:12Speaker 01

  So today, we're going to talk about the three nominees for surgeon general and why their nominations haven't been a cinch, even in a Republican-controlled Senate, in a Republican-controlled committee.

• 3:27Speaker 00

  Okay.

• 3:27Speaker 01

  So in November of 2024, after he was elected to his second term, Donald Trump nominated Jeanette Neshwat

• 3:37Speaker 00

  Okay.

• 3:37Speaker 01

  to be surgeon general. His statement on Dr. Neshwat's nomination describes her as, quote, "A proud graduate of the University of Arkansas School for Medical Sciences." At the time of her nomination, she was serving as the medical director for CityMD in New York, which is a chain of urgent care clinics.

• 3:59Speaker 00

  First red flag.

• 4:00Speaker 01

  She is one of five children in her family, and she is not the only one with ties to the Trump administration.

• 4:09Speaker 00

  Okay.

• 4:09Speaker 01

  Her sister Julia was a Homeland Security advisor under the first Trump administration.

• 4:16Speaker 01

  Julia's husband, so Jeanette's brother-in-law, is the current ambassador, US ambassador to the UN. He also represented Florida as a member of the US House from 2019 to 2025. His name is Mike Walz. Is that a name that rings a bell?

• 4:35Speaker 00

  No.

• 4:35Speaker 01

  Well, Michael, he's the guy who added a journalist to a Signal chat about war plans.

• 4:41Speaker 00

  Oh, OK, OK.

• 4:42Speaker 01

  He's the specific guy who was like, clearly added this journalist to the group chat and then was like, I don't know how it happened. It just got sucked in there. You know how sometimes when you add an app to your phone and it just sucks up all your contact? It just got kind of sucked up in there. So it just got added. This journalist got a...

• 4:59Speaker 00

  I'm a bit of an opsec expert myself. Yeah.

• 5:03Speaker 01

  So that's one of her siblings. Another of her siblings is her sister Jaclyn, who is a model and a former pageant winner, who was Miss New York USA 2004 and Miss Florida America 2008.

• 5:21Speaker 00

  Nothing wrong with that, but the fact that there's so many of these people in Donald Trump's orbit is so fucking bizarre.

• 5:26Speaker 01

  Today, she is the executive director of her husband's foundation, which is dedicated to, quote, "helping underprivileged children around the world." That foundation is called the With Arms Wide Open Foundation.

• 5:41Speaker 00

  Is it named after the Creed song?

• 5:43Speaker 01

  Her husband is Scott Stapp.

• 5:45Speaker 00

  No fucking way.

• 5:46Speaker 01

  We could have had a Surgeon General who has Thanksgiving with Scott Stapp from Creed.

• 5:51Speaker 00

  Why, just do Scott Stapp, fuck it.

• 5:55Speaker 01

  It scans so hard with the administration that could only get three doors down to play at the inauguration. But also, what a fucking stinging indictment that they couldn't get Creed.

• 6:06Speaker 00

  No, I know, he's right there.

• 6:10Speaker 00

  Also, I love that the administration like finds people like the surgeon general. The way that at my tiny, underfunded NGO, we used to find like graphic designers for PDFs. We'd be like, hey, uh, you went to college with somebody who like knows Illustrator, right?

• 6:23Speaker 01

  Yeah.

• 6:23Speaker 00

  Which like, reach out to them.

• 6:24Speaker 01

  Oh, God, ours were more like, do you have an afternoon? Could you figure out Illustrator?

• 6:29Speaker 00

  Wait, wait, wait, wait, wait. I have a thing. I have a thing. I have a thing.

• 6:31Speaker 01

  You have a Creed thing?

• 6:32Speaker 00

  Wait.

• 6:33Speaker 01

  We're not done with Creed?

• 6:34Speaker 00

  Donald Trump was looking at this and he said, I'll take a breath. I'll take her by my side. We stand in awe. We've created life. I have the lyrics, her with arms wide open in front of me.

• 6:43Speaker 01

  I don't know, Michael, this is really counting on me to recognize the lyrics that you also don't know.

• 6:51Speaker 00

  I'm like furiously Googling. I'm like, I need a reference here, but I don't know the lyrics to this song.

• 6:56Speaker 01

  You're getting on a plane tomorrow and I'm now imagining that you're going to spend the entire time like studying the Creed oeuvre.

• 7:03Speaker 00

  I'll record a bunch of pickups to like throw it into the episode.

• 7:09Speaker 01

  Dr. Neshwat had likely crossed Trump's radar during her time as a TV guest doctor on Fox News and the Daily Caller.

• 7:17Speaker 00

  Of course.

• 7:18Speaker 01

  But just six months after she was nominated, the day before her scheduled confirmation hearing, Trump withdrew her nomination.

• 7:30Speaker 00

  Okay, cancel culture.

• 7:31Speaker 01

  So the question here is what happened? Mike, I would like actually for you to hazard a guess.

• 7:36Speaker 00

  Did she once say like a single boilerplate thing about how like diversity is what makes America great?

• 7:41Speaker 01

  No, and no.

• 7:42Speaker 00

  And they're like, no, not after 2024.

• 7:45Speaker 01

  In April of 2025, an independent journalist named Anthony Clark breaks a story that he titles, Trump's Surgeon General pick distorted key parts of her resume.

• 7:57Speaker 00

  Wait, he just Googled like me looking at Creed lyrics?

• 8:00Speaker 01

  Yes.

• 8:00Speaker 00

  He's just like, type, type, type, type, nope.

• 8:02Speaker 01

  He finds that Dr. Neshwat didn't get her medical degree from the University of Arkansas, as she had claimed, but had completed a residency there as an employee, not a student.

• 8:14Speaker 00

  Okay.

• 8:14Speaker 01

  So he checks around to figure out where she got her MD from. And where she went was the American University of the Caribbean in St. Martin.

• 8:24Speaker 00

  Oh.

• 8:25Speaker 01

  Which is a commercial business.

• 8:27Speaker 00

  Also, it's, it's probably like a distance learning thing or something.

• 8:30Speaker 01

  Oh, Mike, you don't know how close you are.

• 8:33Speaker 00

  That's like, uh, I got my degree from iTunes U.

• 8:37Speaker 01

  In 2011, the American University of the Caribbean was bought by Antalem Global Education, which is previously, nope, Mike, I haven't even gotten there yet.

• 8:49Speaker 00

  Which was previously Philip Morris or something. It's like a made up name.

• 8:51Speaker 01

  Previously known as the DeVry Education Group, baby.

• 8:56Speaker 00

  Oh, uh, it's her, yeah.

• 8:58Speaker 01

  DeVry Medical School.

• 9:00Speaker 00

  Cause that's like Betsy DeVos's whole like for-profit education thing, right?

• 9:04Speaker 01

  100%.

• 9:04Speaker 00

  Dude, scammers.

• 9:06Speaker 01

  Clark also reports as part of this piece that for-profit medical schools were banned in the US for over a century for concerns over admissions standards, quality of education, needing new regulatory structures, all kinds of stuff.

• 9:21Speaker 00

  It's also funny because the only thing that offends them is like the lying. If she had just said, I have no medical qualifications, it's not like the Trump administration gives a shit, right?

• 9:29Speaker 01

  I'm so glad that you're like getting a handle on like the ways in which this episode is fun.

• 9:33Speaker 00

  Yeah.

• 9:35Speaker 01

  It's just like a fucking clown car of dinguses.

• 9:38Speaker 00

  It's also now kind of bleak that like CityMD didn't care.

• 9:42Speaker 01

  Or it met their standards. They are also a for-profit business.

• 9:45Speaker 00

  They're like game recognize game. They're like, nice one.

• 9:47Speaker 01

  Yeah, totally. They're like, oh, you guys too? Cool.

• 9:49Speaker 00

  Yeah.

• 9:50Speaker 01

  So on top of all that, on her website, Dr. Neshwat says that she has a specialty in family and ER medicine.

• 9:58Speaker 00

  Okay.

• 9:58Speaker 01

  But she's only board certified in family medicine, not emergency medicine.

• 10:03Speaker 00

  That's such a weird thing to lie about.

• 10:05Speaker 01

  It's so weird, but also she works at an urgent care clinic, right?

• 10:10Speaker 00

  I don't know about CityMD specifically, but every time I've gone to an urgent care, the person has been like, damn, you should see a doctor about this. I'm like, right.

• 10:20Speaker 00

  I'm like, I fucking know. They're like, that'll be $200, please.

• 10:23Speaker 01

  In addition, Clark was unable to verify Neshwat's claim that she had worked in emergency rooms in Arkansas.

• 10:32Speaker 00

  Okay.

• 10:32Speaker 01

  So she is calling herself an emergency doc when she has worked for a for-profit urgent care clinic in like a management role, which is just different, right?

• 10:43Speaker 00

  You must tell these lies and then I guess forget about it. Cause if I had some Flaring hole in my resume, like a fat lie that I was telling. And I was offered some like super prominent role where I would get a bunch of scrutiny. I would just turn it down and be like, no, they will absolutely find this out. I want to keep my cushy little life. She probably makes a couple of million dollars a year.

• 11:01Speaker 01

  So there's all of this bad press happening, but there are also complaints from the right. The Maha crowd was saying that Dr. Neshwat wasn't anti-vax enough.

• 11:11Speaker 00

  Yeah, I was just gonna make a joke about that. Didn't they find out she's vaccinated?

• 11:16Speaker 01

  Very early on in the sort of onset of COVID, even before lockdowns, she was doing some media with like Fox News and that sort of thing being like, hey, here's what you gotta do. And it was like, you gotta mask up. It's probably airborne. You gotta wash your hands real well. You gotta blah blah blah, like just giving like very basic information. And as part of that, at some points she goes, you know, we'll need to develop a vaccine for this.

• 11:43Speaker 01

  Like it's like really not anything, but she's also not committing to kind of unhinged Maha requests. Like let's do a complete overhaul on the infant vaccine schedule.

• 11:56Speaker 00

  It's so funny that they're mad at her for not preemptively criticizing vaccines. Like before they were even developed, she should have been out here saying like, they're killing our kids. Even the, even the idea of a vaccine they're against.

• 12:09Speaker 01

  So her biggest detractor on the right is Laura Lumer.

• 12:15Speaker 00

  Oh yeah. Well, who's probably the fucking surgeon general now. Why not?

• 12:19Speaker 01

  For those who are unfamiliar, Laura Lumer is an advisor to the president. She is like a particularly unhinged presence, even in a White House full of unhinged presences.

• 12:32Speaker 00

  She was just like a Twitter person, right? She was like a lady on Twitter.

• 12:35Speaker 01

  Yes, and kept getting banned from different social media platforms for like straight up hate speech and misinformation. Right?

• 12:44Speaker 00

  Yeah, she's awful.

• 12:44Speaker 01

  On May 5th, 2025, Lumer tweeted about Dr. Neshwat, calling her quote, "a pro-COVID vaccine nepo appointee."

• 12:55Speaker 00

  Well, she's right about the second part.

• 12:57Speaker 01

  She is, she is.

• 12:58Speaker 00

  It's funny, it's funny how they care about that sometimes. They clearly don't give a shit about, it's all nepo, all the way down in this administration.

• 13:05Speaker 01

  So I'm sending you a portion of a tweet from Laura Loomer.

• 13:10Speaker 00

  Oh, man. Okay. I'm not going to yell, but large sections of this are in all caps.

• 13:14Speaker 01

  I think you should make it your own.

• 13:16Speaker 00

  Okay. Dr. Neshwath said, "Vaccine hesitancy is a global health threat." She used her access to Fox News to promote the dangerous COVID vaccine, which is now killing millions of people. She tried to shame people who didn't take the vaccine by calling them "global health threats." This is like, subliterate. "Vaccines are a matter of," all caps, "personal health, freedom. Vaccine hesitancy is a matter of personal freedom and liberty!" exclamation point. "It is not a global health threat. My body, my choice."

• 13:45Speaker 01

  Laura Loomer saying, "My body, my choice," and meaning it about vaccines.

• 13:50Speaker 00

  We've gotten used to it by now, but this is like, a person at a bus stop ranting, and also, they're like, five years old.

• 13:56Speaker 01

  Well, and she capitalizes "global health threat" like it's the title of something. In May of 2025, instead of being confirmed, her nomination is polled. According to Fox News, in 2026, Dr. Neshwath took a new job at Walter Reed.

• 14:15Speaker 00

  Wait, what? Even though they know her medical qualifications aren't real?

• 14:19Speaker 01

  The only way that Trump would like, pull the nomination, or the way that he did it, I should say, I don't know that it was the only way he'd do it, but he was like, "Ah, we're actually gonna withdraw her nomination and put her somewhere else very important."

• 14:31Speaker 00

  If he pulls the nomination, then it's a tacit admission that he's giving in to criticism, or that he got something wrong, which he would never do. So he's like, "Oh, we actually found a better role for you somewhere else."

• 14:39Speaker 01

  Yeah, that better role is at Walter Reed, working on treatment of Havana Syndrome.

• 14:44Speaker 00

  Wait, what? Are they Havana Syndrome truthers, the administration?

• 14:47Speaker 01

  Apparently she is. I mean, she's working on it now, right?

• 14:51Speaker 00

  Weird.

• 14:51Speaker 01

  Yeah, so for folks who are unfamiliar, Havana Syndrome is described as like, a sort of constellation of unexplained neurological symptoms. It often includes hearing really loud noises that others may or may not be able to hear. It is hotly debated.

• 15:09Speaker 00

  Yeah.

• 15:10Speaker 01

  Some people think it is a mass psychogenic illness. Others think it is the result of like chemical warfare from foreign actors. But man, oh, man, they really like sent her to the hinterlands.

• 15:22Speaker 00

  Yeah.

• 15:23Speaker 01

  Go to Walter Reed, a place that sounds very important and is very important. And then work on Havana syndrome.

• 15:29Speaker 00

  It's also like lie about your qualifications. Get ready for a different job in this administration.

• 15:34Speaker 01

  Fail upwards.

• 15:35Speaker 00

  Yeah, exactly.

• 15:36Speaker 01

  As if you were a man.

• 15:37Speaker 00

  I know. The Patricia principle. Yes, it's very inspiring.

• 15:41Speaker 01

  So we went pretty quickly through Dr. Nishwat because it's such a cut and dry story. Right? The second nominee was a real like, hold my beer situation.

• 15:52Speaker 00

  Okay.

• 15:52Speaker 01

  It's time for nominee number two, Casey Means.

• 15:56Speaker 00

  Oh, yeah, yeah, yeah.

• 15:57Speaker 01

  Mike, what have you heard about Casey Means?

• 16:00Speaker 00

  Just that she's like Nishwat, but like 50 times more deranged.

• 16:03Speaker 01

  Yeah.

• 16:04Speaker 00

  It's funny that her nomination was pulled essentially because she wasn't deranged enough. They're like, okay, let's get you someone deranged.

• 16:09Speaker 01

  Oh, you want Kookie?

• 16:10Speaker 00

  Yeah.

• 16:11Speaker 01

  We got Kookie for you, baby.

• 16:13Speaker 00

  Yeah.

• 16:14Speaker 01

  She is a graduate of Stanford University, both undergrad and medical school. She runs a wellness startup called Levels. And she practices, quote unquote, functional medicine, which is essentially like a rebrand of what in the 90s would have been called alternative medicine.

• 16:33Speaker 00

  It's medicine, but this time it's functional.

• 16:35Speaker 01

  This time it's personal.

• 16:37Speaker 00

  Have you tried putting an onion in your sock and going to sleep? Very functional.

• 16:41Speaker 01

  So she has kind of two origin stories coming into Maha world. The first is her residency. After completing medical school at Stanford, Casey Means took on a five year residency at Oregon Health and Science University here in Portland. So she takes on this residency at OHSU specializing in head and neck surgery.

• 17:06Speaker 00

  Okay.

• 17:06Speaker 01

  But as she moves through her residency, she says she became disillusioned with a system that put so much pressure and strain on doctors, a system that was always sort of intervening after things went wrong and not to like help them go right to begin with. And in a system with such a pernicious profit motive.

• 17:28Speaker 00

  Whatever. Yeah. So I got into a different part of medicine that also has a profit motive.

• 17:32Speaker 01

  Right.

• 17:33Speaker 00

  Selling MRIs to fucking celebrities.

• 17:36Speaker 01

  Her story is that she was in a state of great exhaustion and disillusionment. And just six months shy of finishing her five-year residency, she quit.

• 17:50Speaker 00

  Okay.

• 17:50Speaker 01

  Again, she says this is like because she became so disillusioned with the system. And we're actually going to watch a little clip of her

• 17:57Speaker 00

  Okay.

• 17:57Speaker 01

  telling that story to Tucker Carlson.

• 18:01Speaker 00

  Okay.

• 18:03Speaker 02

  Yeah, you know, I'm in the operating room in my fifth year of my surgical residency and I'm looking down at a patient in front of me who's on our third revision sinus surgery. And, you know, I know how to diagnose her. I know how to write the prescriptions. I know how to do the surgery. But what I kind of realized in that moment was like, I have no idea why this patient's actually sick. She has so many other health issues, prediabetes, arthritis, she's got some brain fog, she's got obesity and she's got this sinus issue. And in my training, you know, I was never, ever, ever taught to look at the whole patient, to look at how all these things are connected. And I was only taught how to, you know, do the surgery and then bill for it. And I realized that there's a huge problem in how we're practicing medicine right now, which is what we're ignoring the root causes of why Americans are sick. And we're profiting off of patients getting sick and then doing things to them. That's the way the business model of healthcare works, you know?

• 18:48Speaker 02

  The most, the way that healthcare, which is the largest and fastest growing industry in the United States, makes money is you have more patients in the system, having more things done to them for longer periods of time. And when I kind of put some of these pieces together and realized that my training had totally, essentially incapacitated me from really understanding why patients are sick and, and how to actually help them thrive. I actually had to walk away from the surgical world because I realized that I was only making money off of essentially not spending time helping patients understand their health and actually just profiting off their illness.

• 19:19Speaker 03

  So nine years into medical training at Stanford,

• 19:22Speaker 02

  Yeah.

• 19:23Speaker 03

  you gave it up voluntarily.

• 19:24Speaker 02

  I, on my birthday, 30th birthday, I walked into the office of my, of the chair of the department and I put down the scalpel and I, I walked away. And I devoted my life to why are Americans getting sicker every year? Why are 50% of American children dealing with a chronic health issue? This was less than 1% 50 years ago.

• 19:45Speaker 00

  This frustrates the shit out of me.

• 19:47Speaker 01

  Yeah, tell me.

• 19:48Speaker 00

  Obviously, there's like some kernel of like a reasonable critique of the medical system in here, obviously, but the problem with this whole like root causes analysis is it's not clear how you would operationalize this. Any medical system, even if you do address the quote unquote root causes, you still have doctors who deal with patients in like an acute way. A head and neck surgeon wouldn't be addressing things like diet and lifestyle to prevent that in the first place. Obviously, we need to do more preventative medicine, but you're still going to have people who need surgeries.

• 20:18Speaker 01

  Right, and like if you are aiming at, as she is, a structural critique, then you also need to have a structural solution.

• 20:26Speaker 00

  Yeah, exactly.

• 20:27Speaker 01

  And she doesn't fucking have that.

• 20:28Speaker 00

  There's a weird kind of judgment behind this. She's like, I had this fat and sick patient and they wanted me to do

• 20:34Speaker 01

  Yes.

• 20:34Speaker 00

  surgery on her without exploring why she's fat and sick. Do you think that fat people who have a, I don't know, a car accident or some sort of accident or some sort of condition don't deserve surgery?

• 20:44Speaker 01

  I'm so sorry. I've become hopelessly distracted by the Tucker Carlson store merch that is advertised underneath the video clip.

• 20:53Speaker 00

  Wait, really?

• 20:53Speaker 01

  In the clip that I just sent you, underneath the description, it says, shop the Tucker Carlson store. They have mugs that say, "A pack, an offer you can't refuse."

• 21:03Speaker 00

  What?

• 21:04Speaker 01

  And hats that say, "Neocons are gay for war."

• 21:12Speaker 00

  How much did they cost? Can I get one?

• 21:17Speaker 01

  Part of the reason I got so distracted is I was like, I don't know what this means.

• 21:24Speaker 00

  Yes, you do.

• 21:25Speaker 01

  I do.

• 21:25Speaker 00

  You love it.

• 21:28Speaker 01

  I know what it means if it's coming from me or you. I don't know what it means when it's coming from Tucker.

• 21:34Speaker 00

  I can hear you clicking buy and like typing in your address to dealership to you.

• 21:38Speaker 01

  Take my money, Tucker Carlson.

• 21:42Speaker 01

  Oh, no. Woo. So that is one of Casey Means' origin stories, right? Is her residency. That's one of the two that we're going to talk about. The second comes a few years later. Oh, God, I gotta get the giggles out because this is a sad one.

• 22:01Speaker 00

  Okay, okay, okay. Do you want me to recite some Creed lyrics to you? Would that help?

• 22:06Speaker 01

  No, I appreciate that.

• 22:07Speaker 00

  I have those in front of me still.

• 22:07Speaker 01

  I'm gonna close the Tucker Carlson link so I'm not staring at the neocons are gay for war hat. Okay, sorry. I apologize for what my brain just did.

• 22:17Speaker 00

  All right, rough transition. Get us there.

• 22:19Speaker 01

  So Casey Means' second origin story comes a few years later with the sudden death of her mother.

• 22:26Speaker 00

  Okay.

• 22:27Speaker 01

  In January of 2021, her mother got the shocking news that she had stage four pancreatic cancer.

• 22:35Speaker 00

  Okay.

• 22:36Speaker 01

  And that her prognosis was not good. According to Casey, doctors pressured her mom to get risky surgery that would only extend her life by a matter of months. And because of COVID protocols at the time, that recovery time would happen in quarantine, right? So they wouldn't be able to. She would have the surgery, she'd have this long recovery time. She wouldn't be able to see her family and they had already said she had like a short timeline.

• 23:04Speaker 00

  Okay.

• 23:04Speaker 01

  As you and I both know, this is sort of part and parcel of having a family member who has a terminal illness, right?

• 23:11Speaker 00

  Yeah.

• 23:11Speaker 01

  Is that you have these like terrible choices to make where you're like, oh, nothing's a win? Cool.

• 23:18Speaker 00

  And on some level, that is a, I think, fair critique of the medical system, that it is split into these like little specialties and like, you know, my father recently died of cancer. And the same thing kind of happened to him, that he was given all these weird treatments that had miserable side effects.

• 23:31Speaker 01

  Yeah.

• 23:31Speaker 00

  And he would sometimes say like, uh, this actually isn't like worth it for me. And his doctors, like, he got in kind of like fights with his doctors about it. They'd be like, well, you need this. And like, the minute he switched to palliative care, he got like a way better bedside manner.

• 23:44Speaker 01

  Yeah.

• 23:44Speaker 00

  There's a long time of kind of like fighting with doctors about this kind of thing. And they weren't always totally transparent with like, how much benefit is this actually going to give?

• 23:52Speaker 01

  Totally. It's like a fair critique of the medical system and it's also like a, it's like a horrible experience.

• 23:58Speaker 00

  Yeah.

• 23:58Speaker 01

  And your emotions are in a place where like, like I definitely needed to like fact check and ground myself a couple of times.

• 24:06Speaker 00

  Yeah, yeah, yeah.

• 24:07Speaker 01

  And be like, hey, did I have a fight with this person? Or did they just say something that reminded me of a terrible way that I already feel?

• 24:14Speaker 00

  Exactly. I actually wonder, I mean, it's at least plausible that the doctor sort of presented the options to her. There is the surgery. It's risky. It's not going to prolong your life that much, but it's an option.

• 24:25Speaker 01

  Yeah.

• 24:26Speaker 00

  People were really nice to my dad when he was like, oh, I'd prefer to go on palliative care. They're like, okay, that's a choice that you can make.

• 24:30Speaker 01

  Yep.

• 24:30Speaker 00

  He could still say, no, thanks, and move on to something else.

• 24:33Speaker 01

  My family member who passed of cancer recently was very clear about what he wanted in his treatment and what he did not want. And there was like, I think a lot of that from doctors being like, all right, well, you're making your choice. Got it.

• 24:49Speaker 00

  Yeah.

• 24:50Speaker 01

  Clearly it's not the thing I would recommend, but like this is your life and your choice.

• 24:54Speaker 00

  You don't want to gaslight them about their experience, but she's just such an unreliable narrator.

• 24:59Speaker 01

  Right.

• 24:59Speaker 00

  That it's like, okay, what was actually happening with this interaction?

• 25:02Speaker 01

  So I just sent you a quote. This is an excerpt from her book.

• 25:08Speaker 00

  Okay.

• 25:09Speaker 01

  Good Energy.

• 25:09Speaker 00

  My mom made it clear to the oncologist that she was not afraid of her rapidly impending death, but she wanted to minimize unnecessary pain or nausea in her final days. Despite being clear, the system pushed the exact procedures that would yield pain and nausea and aggressively shamed our family for questioning the full court press approach. The doctor was not consciously trying to recommend a suboptimal procedure, but I knew the invasive route would generate hundreds of thousands of dollars for the hospital and this doctor's pay was tied to booking these procedures.

• 25:34Speaker 01

  [sighs]

• 25:35Speaker 00

  The profit motive thing is also true. I think it affects your psychology in ways that are probably invisible to you.

• 25:40Speaker 01

  Sure.

• 25:40Speaker 00

  But again, she's just like an unreliable narrator.

• 25:42Speaker 01

  And it's, she's doing, I would say a similar thing to what she was doing on Tucker Carlson, which is she's going from this intense personal experience, straight to this sort of like, I'm not saying, I'm just saying.

• 25:56Speaker 00

  Yeah, yeah, yeah.

• 25:57Speaker 01

  Right? And it is designed to cast aspersions on the field.

• 26:03Speaker 00

  Right.

• 26:03Speaker 01

  Right? And on treatment recommendations that are being given to people who are in life and death scenarios, right?

• 26:11Speaker 00

  Yeah, yeah, yeah.

• 26:11Speaker 01

  What she's doing here is sort of using like a very emotional, personal experience, which again, both you and I have been through in different ways, right? She is using that to kind of shake the foundation and go, what if the whole thing is bonk?

• 26:28Speaker 00

  Right, exactly. Because it's also totally plausible that her doctor was just a huge fucking asshole.

• 26:32Speaker 01

  Right.

• 26:32Speaker 00

  And so maybe you had a really bad experience with this like complete prick. That's absolutely plausible, but she is making it a bigger argument about the medical system and for-profit healthcare, et cetera, et cetera, which again, you'd have to sort of marshal different kinds of evidence to support.

• 26:51Speaker 01

  Yeah.

• 26:51Speaker 00

  And also, if this was your issue, you would actually move us toward like a universal healthcare system where the doctors just get paid salaries, which is actually what they have in many countries. That would be the thing that you would then start pushing toward. You wouldn't then leave the system and start selling people other shit for profit. That's just what destroys her entire credibility to me.

• 27:10Speaker 01

  Her functional medicine clinic is in the Pearl District in Portland.

• 27:16Speaker 00

  Pearl District, parentheses, derogatory.

• 27:19Speaker 01

  Yes, yes, Michael. So when I was growing up, the Pearl was like a predominantly industrial area. There were significant numbers of homeless folks. And when I was in like maybe middle school or high school, it started getting gentrified to the fucking max.

• 27:37Speaker 00

  Yeah.

• 27:38Speaker 01

  So now those industrial buildings are overwhelmingly like luxury condos and lofts.

• 27:45Speaker 00

  She's like, the medical system is kind of a grift and I want to get in on that grift.

• 27:49Speaker 01

  It feels very telling that you go to the wealthiest area, right?

• 27:54Speaker 00

  When my dad was a teacher at dental school, he also had a systemic critique because these profit motives were starting to take over dentistry at the time. And he started volunteering at a homeless shelter to do dentistry on homeless people. There's like other things that you can do.

• 28:06Speaker 01

  That's right.

• 28:07Speaker 00

  Other than this, you know?

• 28:08Speaker 01

  Casey Means is a really interesting mix of sort of like crunchy granola Maha style stuff and really dyed-in-the-wool conservative pedigree. In order to understand that conservative pedigree, we have to talk about the other two sort of surviving members of her immediate family, both of whom are high-profile conservatives. The first of those is her father, Grady Means.

• 28:38Speaker 01

  Who was a longtime Republican operative in DC.

• 28:43Speaker 00

  Okay.

• 28:44Speaker 01

  He worked for Nixon and after Nixon's resignation for Vice President Nelson Rockefeller during the Ford administration. During the Ford administration, he worked on the Food and Nutrition Task Force, which sought, among other things, to dramatically scale back food stamps.

• 29:02Speaker 00

  There's that systemic critique, baby.

• 29:04Speaker 01

  Right, the like, "Food is medicine, ladies." Dad is the reason that fewer people have the medicine food that she wants everyone to have.

• 29:12Speaker 00

  Poor people have too much food.

• 29:14Speaker 01

  Grady also worked as a consultant before selling off the consulting wing of his firm for $3.5 billion in 2002.

• 29:24Speaker 00

  Billion?

• 29:25Speaker 01

  So that's her dad, Grady Means. She also has a brother named Callie Means.

• 29:31Speaker 00

  Which the description on this Tucker Carlson YouTube video tells me has also been interviewed by Tucker Carlson.

• 29:37Speaker 01

  Yes, correct.

• 29:38Speaker 00

  Yeah.

• 29:39Speaker 01

  So they have become a little bit of like a package deal. They're sort of a one-two punch in Maha world. And they co-authored their book together.

• 29:47Speaker 00

  Oh, okay.

• 29:48Speaker 01

  Callie Means went to Stanford undergrad and went to Harvard for his MBA. He interned both for the George W. Bush White House and for the Heritage Foundation.

• 30:02Speaker 00

  Nice.

• 30:02Speaker 01

  He worked on the McCain campaign, reportedly as part of the quote-unquote "pit crew" that was working to improve Sarah Palin's reputation.

• 30:12Speaker 00

  Ooh, okay, he did that debate prep. He's furiously sending her links to Schoolhouse Rock.

• 30:17Speaker 01

  He describes himself as a former never-Trumper who became one of RFK Jr.'s advisers after that appearance on Tucker Carlson. Callie Means is an entrepreneur who founded a company called TrueMed, which helps people apply for HSA coverage of like Peloton bikes and infrared saunas.

• 30:41Speaker 00

  Oh, wait, really? He's trying to get people reimbursed for like alternative medicines?

• 30:46Speaker 01

  Yep. So health savings accounts, HSAs, are tax-free accounts. You essentially are allowed to set aside money that you're going to spend on healthcare, not be taxed on that money and spend that money tax-free.

• 31:00Speaker 00

  Yeah.

• 31:00Speaker 01

  Functionally, there's been a bunch of research into this. It really just ends up benefiting rich people who want to pay less in taxes for their luxury health and fitness purchases, right?

• 31:11Speaker 00

  Right.

• 31:11Speaker 01

  TrueMed allows people to log onto their website, fill out a quick survey and get delivered a letter of medical necessity that allows their purchase to be covered by HSA dollars. In exchange, TrueMed takes a cut of the sales.

• 31:28Speaker 00

  Oh, okay. Okay. That's scammy.

• 31:31Speaker 01

  So they've been used for like red light therapy devices, including the like skincare red light masks. They've been used for supplements, for smart mattresses.

• 31:43Speaker 00

  Sure.

• 31:44Speaker 01

  Vanity Fair did an incredible deep dive piece into Callie Means. I strongly recommend it. And as part of that, they got their hands on some early TrueMed marketing materials, which at its outset focused on rebranding companies like Sweetgreen and Daily Harvest as healthcare companies.

• 32:07Speaker 00

  My daily salad is actually a prescription.

• 32:09Speaker 01

  My dad did cut food stamps, but now my work lunch is healthcare. So the Means siblings both have very close ties with the Sweetgreen guy, the Daily Harvest guy.

• 32:24Speaker 00

  Oh, really? Of course.

• 32:25Speaker 01

  All of these people are people that they know and work with very frequently through the quote unquote "end chronic disease coalition."

• 32:36Speaker 00

  How do I know that's a scam?

• 32:38Speaker 01

  Right. Right.

• 32:39Speaker 00

  Any other time in history, you're like, oh, ending chronic disease. That sounds good. But it's like, nope. My brain is too broken from doing this show.

• 32:45Speaker 01

  The coalition is mostly, they're advocating for something called the Hope Act, the Health Out of Pocket Expense Act.

• 32:53Speaker 00

  Oh.

• 32:54Speaker 01

  Which would expand eligible uses for HSA dollars and the End Chronic Disease Coalition, which RFK Jr. and like other folks on the right will like tout, oh, like, oh, my God, Callie Means work with this incredible coalition. The coalition is largely made up of companies whose products would be covered under those proposed expanded rules.

• 33:14Speaker 00

  So it sounds like nice, like, oh, we're expanding the HSA, but it's actually just like, you're gonna get profits out of this, basically.

• 33:19Speaker 01

  And the name of the coalition is End Chronic Disease. Like, oh, my God, this guy is so dedicated to ending chronic disease. No, it's fucking not. He's dedicated to selling his buddies like food and then taking a cut of those sales.

• 33:36Speaker 00

  Yeah, yeah, yeah.

• 33:36Speaker 01

  So, Michael, are you ready for Callie Means' origin story?

• 33:42Speaker 00

  Oh, yeah. Give it to me.

• 33:42Speaker 01

  Callie Means says that he was a lobbyist for Big Food and Big Pharma.

• 33:48Speaker 00

  Okay.

• 33:48Speaker 01

  And that he saw firsthand the kind of corruption at play there. On one podcast, he claimed, among other things, that he brokered a deal between the American Diabetes Association and Coca-Cola.

• 34:00Speaker 00

  What?

• 34:01Speaker 01

  That it's like hush money to like, stop

• 34:03Speaker 00

  Oh.

• 34:03Speaker 01

  opposing us in public or whatever. And I was just like, dude, what are we doing?

• 34:08Speaker 00

  So he's doing it like Confessions of an Assassin kind of thing, where he's like, ooh, I brokered these evil deals.

• 34:14Speaker 01

  Yes, Confessions of a Lobbyist.

• 34:16Speaker 00

  Yeah.

• 34:16Speaker 01

  On Tucker Carlson's podcast, he claims to have attended a meeting where food corporations were, quote, "paying off nutrition researchers at Harvard and Stanford." And he alleged on Twitter that in his time as a lobbyist for food corporations, that Coca-Cola gave, quote unquote, "millions" to the NAACP and the Hispanic Federation in exchange for publicly calling any policies hindering soda sales as racist?

• 34:48Speaker 00

  Okay.

• 34:48Speaker 01

  Describing the whole thing as quote unquote depressingly transactional.

• 34:52Speaker 00

  It seemed like easily verifiable claims, but whatever.

• 34:55Speaker 01

  So Vanity Fair, in this deep dive piece, fact-checked him and his story simply did not check out.

• 35:03Speaker 00

  Yeah, of course not.

• 35:04Speaker 01

  They interviewed more than 60 people who had worked with Callie Means. Nine of his former colleagues from PR world, from Mercury and Edelman disputed his version of events.

• 35:17Speaker 00

  Okay.

• 35:18Speaker 01

  Where Callie Means claimed that he had been a quote unquote director at Mercury brokering these high-level deals, his colleague said he was an executive assistant who wouldn't have even been in the room for the deals that he said he brokered.

• 35:31Speaker 00

  Executive assistant is hella funny.

• 35:33Speaker 01

  It's as removed as you could be from like the halls of power that you're talking about.

• 35:39Speaker 00

  They're like, hey, can you grab us a cup of coffee? He's like, I was in the room.

• 35:42Speaker 01

  The room where it happens. That's right.

• 35:44Speaker 00

  Yeah.

• 35:45Speaker 01

  Not only do they dispute the roles that he held, they also dispute that they, the companies, represented the clients that he claimed.

• 35:55Speaker 00

  Nice.

• 35:55Speaker 01

  So in the three years that Callie Means worked at Mercury, they didn't represent Coca-Cola, nor did they represent the American Beverage Association. Mercury, which is where Callie Means was working, was working the other side of the issue. They were campaigning to reduce soda consumption and their client was the California Endowment.

• 36:16Speaker 00

  It's funny because he could have just said, I was on the ground working to reduce the influence of big food. Like, I was advocating against soda companies. He could have just said that, but instead he's like creating this weird narrative.

• 36:27Speaker 01

  Right. It's, it's a really strange thing to sort of manufacture a heel turn that you don't appear to have had, right? The Vanity Fair piece also uncovered some real gems about Callie Means as a coworker. I just sent you a quote.

• 36:42Speaker 00

  It says, "At the office, several colleagues recall his air of self-importance. He seemed to have bigger and better plans ahead, which didn't include them. He walked around the office saying, 'Callie means business.'" Wait.

• 36:54Speaker 00

  Cali means business? He walked around the office saying, "Cali means business." Another former colleague recounts. That's like his cute little, it's almost like a bumper sticker phrase for like when he runs for Congress.

• 37:06Speaker 01

  Totally.

• 37:07Speaker 00

  Cali means business.

• 37:09Speaker 01

  I just want you to imagine an executive assistant.

• 37:12Speaker 00

  Dude.

• 37:13Speaker 01

  Who is trying to get-

• 37:14Speaker 00

  Like four or something?

• 37:16Speaker 01

  Who's like trying to get into every strategy conversation.

• 37:20Speaker 00

  Yeah, yeah, yeah.

• 37:20Speaker 01

  Is acting like they're better than everybody around them at like a pretty high-powered firm where they're very junior.

• 37:28Speaker 00

  Yeah, yeah, yeah.

• 37:28Speaker 01

  And they're walking around just muttering, "Cali means business," to themselves like, "What a fucking dork."

• 37:35Speaker 00

  A real Pearl District resident. It's the way I, it's the way I think of him. Just the kind of guy who live in the Pearl District.

• 37:42Speaker 01

  So, that's Grady Means and Cali Means. It felt important to lift up that Casey Means, because she sounds kind of like Portland-y, Maha, crunchy, granola-y. It felt really important to establish just how committed to extreme conservatism her family is.

• 38:01Speaker 00

  I'm so curious how this nomination fell apart now, because all of this so far, sounds like everyone in the term administration would just love these people.

• 38:08Speaker 01

  Right!

• 38:09Speaker 00

  And welcome them with arms wide open.

• 38:11Speaker 01

  Baby.

• 38:17Speaker 01

  Well, Michael, when it comes to this story, can I take you higher?

• 38:24Speaker 01

  That's it, that's all of my credos.

• 38:25Speaker 00

  That's it, that's it, we're done.

• 38:26Speaker 01

  I know the title of two songs, the end. So, back to Casey Means. Unlike her predecessor, Dr. Neshwat, Casey Means' basic CV checks out. She did graduate from Stanford undergrad in 2009 and from Stanford School of Medicine in 2014. She did go on to pursue her residency at OHSU. It was a five-year program, but she dropped out six months before completing it. She did get a medical license, but it has now been inactive for a couple of years. She has- Offered two reasons for leaving her program. One is that sort of state of American healthcare thing.

• 39:11Speaker 01

  And the other is the stress and pressure of her surgical residency. After leaving her residency, she opens her functional medicine practice called Means Health in 2019. The same year that she opened her functional medicine practice, she also co-founded Levels, a health tech company that sells continuous glucose monitors and lab testing services.

• 39:38Speaker 00

  Okay.

• 39:38Speaker 01

  As well as quote unquote AI insights.

• 39:40Speaker 00

  There it is. There it is.

• 39:42Speaker 01

  A full membership to Levels for a year, including glucometers, costs about $1,500 per year.

• 39:51Speaker 00

  I'm so against profit medicine. The problem with medicine is all of the profit. That's why I charge you $1,500. That's why it's like 100, more than 100 fucking dollars a month.

• 39:58Speaker 01

  So she founds Levels and her functional medicine clinic in 2019. And in 2020, COVID hits. Casey Means takes that as an opportunity.

• 40:10Speaker 00

  Of course.

• 40:10Speaker 01

  And submits an LTE to the journal Metabolism Clinical and Experimental. In it, she argues that metabolic dysfunction is a core issue for COVID-19 and that managing blood sugar in a data-driven way was an essential intervention for COVID.

• 40:30Speaker 00

  Oh, so buy my, buy my products.

• 40:33Speaker 01

  So she submits this letter in April of 2020. By November of 2020, she had reportedly raised $12 million in seed funding for Levels. By 2022, the company was reportedly valued at $300 million.

• 40:49Speaker 00

  Oh, wow. Okay.

• 40:50Speaker 01

  It is then 2022 during Callie and Casey Means' appearance on The Tucker Carlson Show.

• 40:57Speaker 01

  That really establishes them in the right wing, just asking questions circuit. From there, they both start doing the rounds, showing up on Joe Rogan's show and a ton of like right wing podcasts, right? After the Tucker Carlson thing, that really seems to like blow things wide open. It's also reportedly where RFK Jr. comes across their work, right? All of that leads up to the release of Callie and Casey Means' book in 2024, which is called Good Energy: The Surprising Connection Between Metabolism and Limitless Health.

• 41:34Speaker 00

  How is it not called Means Tested?

• 41:37Speaker 00

  They have so many puns at their disposal. Think of the possibilities.

• 41:42Speaker 01

  Lean Means Healthcare Machines?

• 41:45Speaker 00

  Lean Means is great. They're leaving grifts on the table.

• 41:49Speaker 01

  In promotion of the book, they publish an excerpt on the Free Press.

• 41:56Speaker 00

  Of course.

• 41:57Speaker 01

  The excerpt on the website is titled, "I'm a Doctor You Shouldn't Always Trust Us."

• 42:03Speaker 00

  Got it.

• 42:04Speaker 01

  The chapter in the book is titled, "Trust Yourself, Not Your Doctor."

• 42:09Speaker 00

  This website loves laundering most far right garbage.

• 42:12Speaker 01

  But like through the mouths of experts who went to all of these like Ivy and Ivy adjacent institutions.

• 42:17Speaker 00

  Yeah.

• 42:18Speaker 01

  Like I read the whole book. Callie and Casey Means both say some very accurate, reasonable criticisms of the US healthcare system. They also write really compellingly about the shortcomings of the food system and the heartbreak of people needing to pay more money than they have just to stay healthy or stay alive.

• 42:38Speaker 00

  And that's why we've joined the Republican Party, which wants to make all of these things worse.

• 42:42Speaker 01

  Right, so in talking about the importance of like eating whole foods and healthy fats, rather than directly increasing access to those things through like Snap or Wic.

• 42:52Speaker 00

  Right.

• 42:53Speaker 01

  They instead shift to this personal responsibility frame.

• 42:56Speaker 00

  Yeah.

• 42:57Speaker 01

  Saying that like, it's actually on you to make sure that you're eating very expensive ingredients. She's an anti-seed oil lady, so she's like.

• 43:04Speaker 00

  Of course she is, yeah.

• 43:05Speaker 01

  Right, like buy the oil that. Is like five or six times as much.

• 43:10Speaker 00

  Right.

• 43:10Speaker 01

  They are totally silent on like how any of this would be possible for low income families.

• 43:16Speaker 00

  And they're just, of course, as usual, just inflating the ability of like a virtuous lifestyle to solve all of these issues. Like you did something wrong if you get one of these chronic conditions. That's the ideology.

• 43:29Speaker 01

  On the press tour for the book, she becomes a real hot take factory. She has said that, quote, "Many, if not most, COVID-19 deaths could be prevented with optimal metabolic health."

• 43:42Speaker 00

  Nice.

• 43:43Speaker 01

  And called COVID a, quote, "Darwinian moment for America."

• 43:47Speaker 00

  Oh, what? What, like a good way?

• 43:50Speaker 01

  Yeah, like the least fit did not survive way.

• 43:53Speaker 00

  Just saying it. They're out here just fucking saying it.

• 43:56Speaker 01

  She also has some anti-vax positions that I think are dressed up to appear more moderate than they are. In her newsletter, she wrote, quote, "There is growing evidence that the total burden of the current extreme and growing vaccine schedule is causing health declines in vulnerable children."

• 44:14Speaker 00

  Vulnerable, we're really looking out for the vulnerable. Like giving them measles, it's so important that they get measles.

• 44:20Speaker 01

  She has said, quote, "I think vaccine mandates are criminal."

• 44:24Speaker 00

  I mean, they are in the sense that we never fucking had them in America, so whatever.

• 44:28Speaker 01

  She said that in response to somebody on Twitter giving her shit for not being anti-vax enough. And she was like, "I have said innumerable public times."

• 44:35Speaker 00

  I love that. I love that. Um, actually.

• 44:37Speaker 01

  Um, actually, I'm the most anti-vax.

• 44:40Speaker 00

  Uh, I'm actually pretending when I say we need more research and stuff. I'm actually super anti-vax. Don't worry about it.

• 44:45Speaker 01

  Michael, aren't we having a good time with these doozy fucking?

• 44:49Speaker 00

  Isn't this fun?

• 44:51Speaker 01

  It's kind of fun. I'm having fun.

• 44:53Speaker 00

  This is like my parents on road trips as a kid. This is fun, right?

• 44:56Speaker 01

  She has written, quote, "When it comes to a question like raw milk, I want to be free to form a relationship with a local farmer, understand his integrity, look him in the eyes, pet his cow, and then decide if I feel safe to drink the milk from his farm."

• 45:13Speaker 00

  I want buying food to be a just constant fucking chore where I have to know. Every single thing and do all the work myself. I would love that.

• 45:20Speaker 01

  The way that you know if there is listeria in milk is a good hard look in the eye.

• 45:26Speaker 00

  I want other people to have the freedom to fucking lie to my face about the health impacts of their products.

• 45:30Speaker 01

  She is also a proponent of both psilocybin and MDMA. She likes shrooms. She likes Molly.

• 45:37Speaker 00

  Why are all these people into fucking psychedelics? It's so fascinating. All they do is bitch about like Prozac and stuff. But they're like, no, no, no, take these other drugs. It's so weird.

• 45:45Speaker 01

  Yeah. I mean, I think there's like a rift, right? Both within Maha world and within Republican world writ large, where you have sort of older school Republicans who are like, drugs?

• 45:58Speaker 00

  Yeah.

• 45:59Speaker 01

  And you have this sort of like newer wave of like red pill fucking assholes who are like, drugs?

• 46:05Speaker 00

  Yeah.

• 46:06Speaker 01

  It becomes a liability because it exposes that rift, which doesn't often get tested in like federal policymaking, right?

• 46:13Speaker 00

  Right.

• 46:14Speaker 01

  So in addition to all of those hot takes, sometimes her hot takes take the form of poetry.

• 46:23Speaker 00

  Okay.

• 46:23Speaker 01

  For April Fool's Day, she wrote a poem for her newsletter. As she notes, she got, quote, "some help from AI." I'm sending you four verses from a poem that has like 20 verses. Like, there's so many. So I just picked a few.

• 46:39Speaker 00

  And she puts it in full in her newsletter?

• 46:41Speaker 01

  Mm hmm. The title of the poem is "The Devil's Wellness Plan."

• 46:46Speaker 00

  I'm not, I'm not reading. This is way too much, Aubrey.

• 46:49Speaker 01

  You're reading it, Michael. You're reading it.

• 46:52Speaker 00

  If I were the devil, I'd ditch the disguise. No pitchfork, no flames, just marketing lies. I'd feed you poison, call it a snack, and label you elitist when you want your health back. I'd bury research, seal the locks, then line you up for 73 shots. Doesn't rhyme. I'd cancel critical thinking, stop dissenters with bots, then jab your kids without a second thought. Also, doesn't really rhyme. I'd break your trust in ancient ways and mock the moon and cycle's phase. I'd push the pill and dull women's flame till womanhood forgot its name. I'd give boys man- boobs through toxic food and call masculine strength aggressive and lewd. I'd whisper, you're too much, too loud, and shame men's fire as something rude.

• 47:37Speaker 01

  There you go.

• 47:39Speaker 00

  I miss Creed, Aubrey. Can I, can we go back to Creed?

• 47:42Speaker 01

  Like, he's a professional. You can't expect her to be on his level.

• 47:46Speaker 00

  That at least had like an okay like pentameter or whatever. It was at least the, the correct number of syllables?

• 47:52Speaker 01

  So, Good Energy, Callie and Casey Means' book, came out in 2024. By May of 2025, Casey Means was announced as the Trump administration's nominee for surgeon general.

• 48:05Speaker 00

  Nice.

• 48:05Speaker 01

  That is so far to get in such a short period of time. The reactions to Casey Means' nomination are swift and they are negative.

• 48:15Speaker 00

  This means war.

• 48:17Speaker 01

  So, a number of former surgeons general come forward and are like, absolutely fucking not. Jerome Adams actually like writes an op ed about it and is like, hey, part of your job as the head of the US Public Health Service is to weed out people who don't have license to practice and Casey Means does not have an active medical license.

• 48:39Speaker 00

  Oh, right. Yeah.

• 48:39Speaker 01

  There is criticism from Maha folks who once again criticize her for not being anti-vax enough.

• 48:47Speaker 00

  Really? Even her?

• 48:48Speaker 01

  Uh huh.

• 48:49Speaker 00

  Fucking hell.

• 48:49Speaker 01

  Once again, Queen Gremlin Laura Loomer weighs in on Twitter. I just sent you a quote.

• 48:56Speaker 00

  Casey Means said, when she was looking for romance, she would do shrooms, talk to trees, participate in full moon ceremonies and pray to inanimate objects with a spiritual medium. So basically, the new surgeon general is a total crackpot, a shroom consumer, and she talks to trees and doesn't even have an active medical license. Another failure by the geniuses who work for President Trump on his nonexistent vetting team. I guess there isn't a single conservative doctor in America who doesn't have a history of being a Marxist tree hugger. This is bizarre. Casey Means is like a complete nutcase. They should love this lady.

• 49:32Speaker 01

  The reactions to her nomination are so bad.

• 49:37Speaker 01

  Twitter in particular that RFK Jr. rushes to her defense on the platform.

• 49:41Speaker 00

  Okay.

• 49:41Speaker 01

  He says that Maha is taking on powerful corporate players and that those companies, quote, "will continue to pay bloggers and other social media influencers to weaponize innuendo to slander and vilify Casey, the same way they tried to defame me and President Trump."

• 50:01Speaker 00

  The fights between these people are always just like the Spider-Man meme of people pointing to each other. It's like vaguely different shades of lunatic. It's like why they're mad at her.

• 50:09Speaker 01

  I mean, I think this is part of what makes me feel less despairing about this episode is that early on when RFK Jr. was nominated, you and I talked about him and his priorities being on kind of a pretty direct collision course with the Trump administration, right? That he's like, "I want to regulate corporations. I want to ban all this advertising. I want to blah, blah, blah." And Trump is the guy who's like, "Let corporations do whatever the fuck they want."

• 50:36Speaker 00

  Right.

• 50:36Speaker 01

  And that the Maha coalition was like, sort of like, looking for a home and Republicans offered them a home.

• 50:45Speaker 00

  Right.

• 50:45Speaker 01

  But the rift and the sort of differences and disconnects are starting to show. And part of the way that that's starting to show is in these kinds of like infighting moments. And part of the ways that that's starting to show is in having three nominees for Surgeon General.

• 50:59Speaker 00

  Right.

• 51:00Speaker 01

  And not having one still.

• 51:02Speaker 00

  And also these, the whole Maha thing, you can't have a stable coalition when it's built on the back of lies and misinformation because everyone is ultimately just making shit up and cherry picking. You don't have like a referee or like an objective standard of facts to point to, to adjudicate a dispute about like, "Do shrooms work?" Or "Are shrooms bad?" They don't give a shit about what actual science looks like. So you can't really have like a good faith debate even within these coalitions.

• 51:30Speaker 01

  Right. It's all power games, right?

• 51:32Speaker 00

  Yeah.

• 51:32Speaker 01

  So on top of all those negative reactions, there's also this new wave of reporting about like, who is this new Surgeon General nominee? And one of the things that they find in that reporting is that there are pretty significant gaps between how she describes her residency and how other people at her residency described her at her residency.

• 51:50Speaker 00

  Okay.

• 51:51Speaker 01

  Vanity Fair interviewed the Chair of the Department where her residency took place. Who said that Casey Means found the job quote unquote too stressful, that she quit in tears and that other residents had to quote, "cover for her and we're a small department and all the calls fall on them."

• 52:12Speaker 00

  No way. The funny thing is that's also a structural critique of the American medical system. People are so overworked.

• 52:17Speaker 01

  Yes.

• 52:18Speaker 00

  But yeah, it's also funny that she like makes it this like virtuous, like I chose to leave thing.

• 52:22Speaker 01

  Two other residents who served with her in the same department at the same time, said that she was very anxious and primarily like afraid of hurting patients.

• 52:32Speaker 00

  Has she tried zinc? Has she tried taking zinc for anxiety? I think it just, maybe it's her lifestyle.

• 52:37Speaker 01

  So all of this leads up to Casey Means confirmation hearing, which happened in February of this year. Her initial confirmation hearing was scheduled for October 2025, but it was postponed when she went into labor with her child.

• 52:53Speaker 00

  So she got maternity leave, basically, something the administration is also decidedly against.

• 52:58Speaker 01

  Initially, the confirmation hearing is scheduled for October. It ends up taking place in February after her parental leave. And in that time, the conditions and the sort of political calculus here really change. Among other things, the chair of the committee where the confirmation hearing will happen, the help committee, is Bill Cassidy. Bill Cassidy is, in that intervening time, defeated in his Republican primary by a Trump endorsed challenger to the right.

• 53:30Speaker 00

  Okay.

• 53:30Speaker 01

  Bill Cassidy is now a lame duck with serious like flame duck potential. But there's also a longstanding rift between Senator Cassidy and President Trump, dating back to at least 2021, when Cassidy voted to convict Trump of inciting a riot on January 6.

• 53:49Speaker 00

  Okay.

• 53:50Speaker 01

  He's a physician who did practice for a long time.

• 53:53Speaker 00

  Yeah, yeah, yeah.

• 53:54Speaker 01

  In a lot of situations, right? Like, say what you fucking will about Bill Cassidy. I'm not going to cape for any Louisiana Republicans at this point. But he is an actual doctor who did actually practice, who does actually have a medical license. All of that does feel relevant here.

• 54:11Speaker 00

  Yeah, there's also a long history of Republicans, like, kind of doing the right thing once they don't have an election to win anymore.

• 54:17Speaker 01

  Totally. So like, as I have told you, I'm not a fan of congressional hearings.

• 54:23Speaker 00

  Yeah.

• 54:24Speaker 01

  They feel like political theater. They feel like they're not accomplishing anything. They're definitely not fact finding missions, like, ever, right? I think that this confirmation hearing was pretty effective as political theater.

• 54:36Speaker 00

  Cool.

• 54:36Speaker 01

  They had, like, a really clear, good division of labor. Folks had drafted their questions in a really tight way and came in with, like, a pretty unified front across party lines. Bizarrely, Josh Hawley is like, hey, I need to talk to you about what I'm hearing from my constituents, which is they're concerned about the health risks of AI data centers.

• 54:58Speaker 00

  What?

• 54:58Speaker 01

  I will say Hawley kind of softballs it and he's like, well, I'd invite you to give it some thought. Blah, blah, blah. Like, he's not like an asshole to her about it. He's not, like, confrontational about it at all. But he does raise it up and is like, these are the kinds of things that people are concerned about. They're concerned about water quality that looks like this. Right? Like, they're like doing the thing of being like, hey, this is an issue.

• 55:21Speaker 00

  It is all theater, though, because they, none of them give a shit about any of this stuff, but whatever.

• 55:25Speaker 01

  It's totally theater, but it was surprising to me that if you're doing a performance, and the performance of every Republican at this point is, to some degree, just for Donald Trump.

• 55:34Speaker 00

  Right.

• 55:34Speaker 01

  His willingness to push back in that way, I was like, oh, that's interesting.

• 55:38Speaker 00

  It's weird, yeah.

• 55:39Speaker 01

  But he's not the only Republican on the committee who has sort of more direct and sort of harder questions for her. At one point, Senator Cassidy asked her if she believed that vaccines cause autism.

• 55:54Speaker 01

  This is after the Pam Bondi hearings, so it's clear that she's trying to like moderate her response and not be kooky and start yelling about like the Dow.

• 56:04Speaker 00

  Yeah, yeah.

• 56:05Speaker 01

  So her response to Cassidy's question about vaccines and autism is, quote, "We have an autism crisis that is increasing. This is devastating to many families and we do not know as a medical community what causes autism."

• 56:20Speaker 00

  Which I can see the anti-vaxxers being mad about that.

• 56:22Speaker 01

  It's the one answer, the like, "We don't actually know what causes autism," is the one answer that is guaranteed to piss off everybody.

• 56:31Speaker 00

  She should have just said they fucking cause autism and then like the anti-vaxxers would get on her side.

• 56:35Speaker 01

  Ten toes down, standing on business.

• 56:37Speaker 00

  Yeah, yeah, yeah, yeah.

• 56:38Speaker 01

  So in that same hearing, Tim Kaine asks her about flu shots, which is not a huge part of the anti-vax discourse.

• 56:50Speaker 00

  Right.

• 56:51Speaker 01

  So I just sent you, we're gonna watch a clip. I apologize in advance for how infuriating this clip is to listen to.

• 56:59Speaker 04

  In a news report on January 7, just a month or so ago, Secretary Kennedy stated, quote, "There is no evidence that the flu vaccine prevents serious disease or that it prevents hospitalization or deaths in children." Do you agree with that statement?

• 57:18Speaker 05

  Senator Kaine, as I've said, I'm, I believe vaccines save lives and are an important part of our body.

• 57:25Speaker 04

  I'm not asking about the general. I heard that testimony earlier, but you're an MD, your qualifications have been much discussed earlier. Do you agree with the statement that there's no evidence that the flu vaccine prevents serious disease or that it prevents hospitalizations or death in children?

• 57:43Speaker 05

  I have not personally seen that quote or that article. I would want to review it before I comment on that.

• 57:49Speaker 04

  Okay, I'm gonna, I'm gonna set the quote aside. I'll introduce for the record.

• 57:52Speaker 00

  She's so bad at this.

• 57:53Speaker 04

  An article CBS News, RFK Junior says it may be better if fewer children receive the flu vaccine, dated January 7, 2026. Without objection. Do you believe that there is evidence that the flu vaccine prevents serious disease and prevents hospitalization or deaths in children?

• 58:10Speaker 05

  I believe that all patients should talk to their doctors.

• 58:14Speaker 04

  And so do I, and that's not what I'm asking. Your qualifications have been much discussed. There is a mountain of evidence about this. Do you believe that there's no evidence that there's the flu vaccine has efficacy in reducing serious injury or hospitalization?

• 58:33Speaker 00

  You could see the little hamster wheel in her brain.

• 58:37Speaker 04

  This is an easy one, doctor. This is an easy one.

• 58:42Speaker 05

  I support the CDC's guidance on the flu vaccine, and I will always be working with the CDC ASAP and the agents.

• 58:48Speaker 04

  So you believe that it is an efficacious vaccine to reduce hospitalization?

• 58:53Speaker 05

  Is or is not?

• 58:54Speaker 04

  Is, you believe it is.

• 58:56Speaker 05

  As I said, I support the CDC's guidance on the flu vaccine.

• 58:59Speaker 04

  Let me just say, do you think the flu vaccine reduces the risk of hospitalization or serious injury?

• 59:04Speaker 05

  I've said it.

• 59:05Speaker 04

  You're a doctor.

• 59:06Speaker 05

  I believe vaccines save lives. I believe they're an important part of a public health strategy.

• 59:12Speaker 04

  The flu vaccine, does it reduce the risk of injury or hospitalization?

• 59:16Speaker 05

  At the population level, I certainly think that it does.

• 59:20Speaker 04

  Let me introduce for the record, if I can, Mr. Chair, CDC seasonal flu vaccine effectiveness studies dated May 30, 2025 from the CDC that goes into this in some detail. This is not a hard question.

• 59:32Speaker 05

  I answered your question.

• 59:33Speaker 04

  And yes, after three minutes, you acknowledged that at a population level...

• 59:36Speaker 05

  I haven't seen that report. I have not seen...

• 59:39Speaker 04

  Yeah, but you know about the flu vaccine.

• 59:40Speaker 05

  If I had a nickel for every time I was misquoted in the media, I'd be a very wealthy woman. I would like to understand what his comments were.

• 59:47Speaker 04

  I'm not asking you about the quote. I'm asking you about something in your remit, the effectiveness of the flu vaccine.

• 59:54Speaker 01

  Stunning.

• 59:55Speaker 00

  He did eventually get her to admit it, which is actually interesting that she did.

• 59:58Speaker 01

  I think it's, again, an indicator of how bad she is at this.

• 1:00:01Speaker 00

  Yeah, yeah.

• 1:00:02Speaker 01

  Part of what sinks her in this hearing is that she keeps trying to rely on these phrases like, "I believe vaccines save lives," or

• 1:00:11Speaker 00

  Right.

• 1:00:12Speaker 01

  "I support the CDC guidance."

• 1:00:14Speaker 00

  She clearly also didn't know what the CDC guidance was, because the CDC guidance is all like pre-RFK Jr., so most of it is still pretty pro-vaccine at this point.

• 1:00:22Speaker 01

  It's all the DOGE guys being like, asked to define what DEI is, and they're like, "It's whatever was in the EO."

• 1:00:28Speaker 00

  Yeah, yeah, yeah, yeah.

• 1:00:29Speaker 01

  Another piece that becomes like a big challenge for Casey Means is her financial conflicts, which are significant. Of course, she owns and operates Levels, her sort of medical equipment slash wellness startup. But on top of that, as we've mentioned, she has a really strong presence on Substack and Instagram and social media sort of writ large. And it becomes clear that she has failed to disclose many, many financial relationships.

• 1:01:05Speaker 00

  Okay.

• 1:01:06Speaker 01

  And in her newsletter, on Instagram, on social media broadly, she is frequently recommending products.

• 1:01:15Speaker 00

  Oh.

• 1:01:15Speaker 01

  Right.

• 1:01:16Speaker 00

  And like not disclosing like those FTC regulations where you have to say like, hashtag sponsored or whatever?

• 1:01:21Speaker 01

  Correct.

• 1:01:22Speaker 00

  Yeah.

• 1:01:22Speaker 01

  Those regulations, those regulations about disclosing when something is an ad on social media, came into effect after Fire Fest. That's why we got those fucking things.

• 1:01:32Speaker 00

  Yeah.

• 1:01:33Speaker 01

  And she's like doing a wellness Fire Fest of like not

• 1:01:36Speaker 00

  Right.

• 1:01:36Speaker 01

  disclosing. The Associated Press investigated her disclosures and found that she had been taking big payments that she did not disclose publicly. $59,000 from Function Health, Mark Hyman's company.

• 1:01:51Speaker 00

  Oh yeah, of course.

• 1:01:52Speaker 01

  $12,000 from Daily Harvest, $16,000 from Floroscopy.

• 1:02:00Speaker 01

  A fiber supplement company.

• 1:02:03Speaker 00

  That sounds like a fake word that she made up for one of her poems so that it rhymed.

• 1:02:07Speaker 01

  $27,000 from Energy Bits.

• 1:02:11Speaker 00

  Okay.

• 1:02:12Speaker 01

  An algae supplement company.

• 1:02:14Speaker 00

  Wait, what was the one we talked about on the bonus episode, Food Cube or whatever?

• 1:02:20Speaker 00

  Is she getting cube bucks?

• 1:02:22Speaker 01

  $500 from We-Natal Prenatal Vitamins.

• 1:02:26Speaker 00

  Oh, that's pretty good, actually.

• 1:02:28Speaker 01

  And $130,000 from Amazentis.

• 1:02:32Speaker 00

  Oh, oh.

• 1:02:33Speaker 01

  A supplement company.

• 1:02:35Speaker 00

  Also $200,000 from Tati Westbrook's Hair Vitamins.

• 1:02:38Speaker 01

  That's right, bye, sister. I will also say, not for fucking nothing, in her confirmation hearing, one of the members of the committee is Bernie Sanders, who questions her on stuff and mostly is like, hey, I agree we should ban junk food advertising. Hey, good point on this thing.

• 1:02:55Speaker 00

  Uh, yeah, everyone's going out of their way to do this shit. I know.

• 1:02:57Speaker 01

  Bernie Sanders is like trying to sort of be like, you know, I disagree with the Trump administration on a lot of stuff, but I think you got some good points here.

• 1:03:06Speaker 00

  Yeah, yeah, yeah.

• 1:03:06Speaker 01

  And then like posts a clip on social media and is like, hey, we had a real one. This was a good conversation. Like, I don't agree with her on everything, but I support her in this thing. And people just like absolutely shredded him on it and was like, you don't gotta hand it to her.

• 1:03:24Speaker 00

  This is, but this is why these people make these disingenuous plausible sounding arguments is because they attract people who like want to give them credit and want to give them good faith. But these people are not acting in good faith.

• 1:03:36Speaker 01

  Correct.

• 1:03:36Speaker 00

  You cannot listen to what they say. You have to look at what they fucking do.

• 1:03:38Speaker 01

  Correct.

• 1:03:39Speaker 00

  What is she doing with her life? There's no fucking way these people are like, oh, I just want to fix the diet of Americans. Is that what RFK Jr. has spent the last 20 years of his life dedicated to? No, he's dedicated it to fucking getting kids infected with measles. That's what they actually believe. You have to ignore all this bullshit. They are saying that as a fucking trap, as bait to get people who do not care or do not know about their actual background to do exactly what Bernie is doing.

• 1:04:03Speaker 01

  100%. I was like, this is uncharacteristically like anti-shrewed.

• 1:04:10Speaker 00

  For just a failed fucking candidate.

• 1:04:12Speaker 01

  It's really stunning.

• 1:04:14Speaker 00

  It's clear by this point that like she's not gonna make it through.

• 1:04:17Speaker 01

  So on April 30th of this year, in a Truth Social post, Donald Trump acknowledged that Casey Means didn't have the votes to be confirmed.

• 1:04:27Speaker 00

  She will also be joining Walter Reed.

• 1:04:30Speaker 01

  Unsurprisingly, Trump blames Bill Cassidy, the chair of the Help Committee. But also, there appear to be holdouts that were Cassidy Collins and Murkowski were all like, I don't know.

• 1:04:43Speaker 00

  Okay.

• 1:04:44Speaker 01

  After the administration withdraws Casey Means' nomination, the political landscape starts to shift again. New polls come out revealing that changing the vaccine schedule is hugely unpopular with voters. Plus, the anti-vax stuff has faced a large number of court challenges, so it is costly and time-consuming to defend against, right? So they're really testing like how much political capital the Trump administration is willing to spend on Maha priorities.

• 1:05:17Speaker 00

  Right. And this is more of an RFK thing than a Trump thing.

• 1:05:20Speaker 01

  Yes, correct. So we're seeing like how far is Trump willing to go for RFK Jr., right? And not as far as Casey Means is the answer.

• 1:05:29Speaker 00

  Yeah.

• 1:05:29Speaker 01

  That's when they announce the newest, third and newest current nominee, Nicole Sapphire is her name. She went to Arizona State University for her undergrad. For her MD, she's telling us out front she didn't go to med school in the US.

• 1:05:43Speaker 00

  Okay.

• 1:05:44Speaker 01

  She went to Ross University in Barbados.

• 1:05:48Speaker 00

  Is that like a for-profit scam factory?

• 1:05:50Speaker 01

  Uh, it doesn't appear to be. I didn't look into Ross University to a great degree because I was like, they're not gonna do that again, right? But maybe, who knows? She is currently a radiologist at the Sloan Kettering Cancer Center.

• 1:06:02Speaker 00

  A licensed doctor.

• 1:06:03Speaker 01

  Her career as a public figure is a very Maha, like gotta catch them all kind of thing. She has a podcast, she has a supplement company, she's a Fox News contributor.

• 1:06:16Speaker 00

  Great.

• 1:06:16Speaker 01

  She's written three books. Love Maha. Inspiring stories celebrating motherhood.

• 1:06:23Speaker 00

  Okay.

• 1:06:24Speaker 01

  Make America healthy again. How bad behavior and big government caused a trillion dollar crisis.

• 1:06:30Speaker 00

  Yep, the government's definitely the problem.

• 1:06:32Speaker 01

  She also published that before RFK Junior was using Maha.

• 1:06:37Speaker 00

  Oh, wait, really?

• 1:06:38Speaker 01

  Uh huh.

• 1:06:38Speaker 00

  Oh.

• 1:06:39Speaker 01

  She tried to trademark it, which is very funny, and then she sort of dropped it.

• 1:06:42Speaker 00

  Yeah.

• 1:06:43Speaker 01

  She owns a podcast called Wellness Unmasked, and she wrote another book called Panic Attack: Playing Politics with the Science in the Fight Against COVID-19.

• 1:06:53Speaker 00

  I could just like write that book from memory. I could like sit down and write that fucking book right now.

• 1:06:56Speaker 01

  You already know, lab leak, whatever. Dr. Sapphire's positions on core Maha issues are often presented in a way that seems a little more moderate than a Casey Means, which like, not hard to do.

• 1:07:10Speaker 00

  Hmm.

• 1:07:11Speaker 01

  I think a good example on that is her position on vaccines. She, like Casey Means, is very strident in her vaccine save lives stance, but she has also said that the pediatric vaccine schedule should be quote unquote, "less stringent."

• 1:07:26Speaker 00

  Yeah, there it is. Yeah.

• 1:07:27Speaker 01

  And that she opposes vaccine mandates.

• 1:07:30Speaker 00

  Yep.

• 1:07:30Speaker 01

  She has also been publicly and directly critical of RFK Junior's approach on vaccines.

• 1:07:36Speaker 00

  Really?

• 1:07:36Speaker 01

  And she's done that criticism in right of center media outlets. It's fascinating.

• 1:07:41Speaker 00

  Okay.

• 1:07:41Speaker 01

  She's a real mixed bag.

• 1:07:43Speaker 00

  Yeah.

• 1:07:43Speaker 01

  Most notably, she wrote an op ed in the Wall Street Journal just last year called "The Madness in RFK Junior's Autism Method."

• 1:07:53Speaker 00

  Woke queen. I'm into it now.

• 1:07:56Speaker 01

  Comparatively, I heard she said defund the police.

• 1:08:02Speaker 01

  I don't think she did. She has publicly criticized Trump, but those posts are now deleted. So she's like been speaking her mind, but then doing the Trump nominee thing and like scrubbing the record afterwards. So she tweeted at one point, quote, "Seems like they may not want to admit the US measles elimination status is gone until after the midterms."

• 1:08:23Speaker 00

  Nice.

• 1:08:24Speaker 01

  On Trump's Tylenol warning, she posted, quote, "As a mom of three kids, I don't love a man telling me to..." Tough it out when it comes to pregnancy.

• 1:08:32Speaker 00

  Wow.

• 1:08:33Speaker 01

  This is the bar is in hell portion, right?

• 1:08:35Speaker 00

  Yeah.

• 1:08:36Speaker 01

  But also like, not a lot of people are exceeding the bar.

• 1:08:38Speaker 00

  Right.

• 1:08:39Speaker 01

  So far, the reactions have been much less alarmed than last time.

• 1:08:45Speaker 00

  Hmm.

• 1:08:46Speaker 01

  The reactions from people who sort of reacted to Casey Means the first time around, including past surgeons general, those responses have been essentially like, "This is a qualified nominee with an active medical license."

• 1:09:00Speaker 00

  It all feels like, not that it was, but it all feels like a strategy to like, "We're gonna nominate the two worst fucking people alive, and then when we get to the third nominee, who's also trash, everyone's gonna be like, whatever."

• 1:09:09Speaker 01

  Folks have been worn down so hard.

• 1:09:12Speaker 00

  I'm sleepy.

• 1:09:13Speaker 01

  Dr. Sapphire hasn't faced confirmation hearings yet. But there is one thing that may become an issue in her hearings. She has a supplement brand called DropRx.

• 1:09:26Speaker 00

  Oh.

• 1:09:26Speaker 01

  It's called DropRx because it is herbal tinctures, like liquid tinctures in eyedropper bottles.

• 1:09:31Speaker 00

  Okay.

• 1:09:32Speaker 01

  In true supplement biz form, their supplements are named things like Boost, Relief, Allure,

• 1:09:40Speaker 00

  Okay.

• 1:09:40Speaker 01

  Sleep, and Intimacy.

• 1:09:42Speaker 00

  Taste test episode incoming.

• 1:09:44Speaker 01

  So there are two problems here. One is, uh, Dr. Sapphire works for the Memorial Sloan-Kettering Cancer Center, which has a clear policy that bans employees from, quote, "endorsement of products or commercial ventures." It's also suspect as hell for a surgeon general, so she would likely need to divest, right? As with Casey Means and Levels. Problem number two is that their supplements include Kava, which the USDA and FDA warn is associated with significant liver damage and which is regulated differently in different states.

• 1:10:16Speaker 00

  Cheap champagne? What is Kava?

• 1:10:18Speaker 01

  It is a root that is supposed to sort of promote like a sense of calm. And in some states, you can use it in supplements. In some states, you can serve it in the cafe. In some states, it's like banned completely. But the USDA and FDA have already issued warnings about it. So it's just real weird to have a surgeon general who is selling a product that runs counter to public health guidance from other agencies, right?

• 1:10:46Speaker 00

  Do you know how easy it is to find a practicing doctor who isn't a fucking grifter? It's crazy they can't find a single one.

• 1:10:53Speaker 01

  They're all tree hugging Marxists, Mike.

• 1:10:57Speaker 01

  For now, she appears to be much more in the vein of Dr. Neshwat than Casey Means.

• 1:11:03Speaker 00

  Right.

• 1:11:04Speaker 01

  And that honestly feels like a pretty grounded win.

• 1:11:08Speaker 00

  Right.

• 1:11:09Speaker 01

  To have someone who is not, who's like grifting from one angle, but not like seven.

• 1:11:16Speaker 00

  That's as good as it gets in America in 2026.

• 1:11:18Speaker 01

  Right now?

• 1:11:19Speaker 00

  She's only one kind of grifter.

• 1:11:21Speaker 01

  Count your blessings. She's only selling herbal tinct shirts.

• 1:11:25Speaker 00

  I know. She's a mono grifter. That's the best we can do.

• 1:11:30Speaker 01

  At the start of this episode, I started by saying that the research made me feel like less despairing. Here's why. One, this is a place where the Trump administration is failing. They are not getting their nominees confirmed.

• 1:11:43Speaker 00

  Yeah.

• 1:11:43Speaker 01

  This is also true of other Trump nominees, too. According to Brookings, the average confirmation delay for Trump nominees has doubled from his first term to his second.

• 1:11:54Speaker 00

  Although in fairness, they are twice as bad this time.

• 1:11:56Speaker 01

  They are pretty bad.

• 1:11:58Speaker 00

  Yeah.

• 1:11:58Speaker 01

  From a harm reduction standpoint, I genuinely think it's more helpful to have no surgeon general rather than one of these ultra gremlins.

• 1:12:05Speaker 00

  And it's a win that Casey Means didn't get through because she's a complete nutcase.

• 1:12:08Speaker 01

  I think the last thing that makes me feel sort of like groundedly, cautiously optimistic about all of this is that Trump is immensely unpopular.

• 1:12:17Speaker 00

  Yeah.

• 1:12:17Speaker 01

  Right now, which means that, again, Republicans who are already pushing back on this committee are going to be incentivized to push back more.

• 1:12:27Speaker 00

  Yeah.

• 1:12:27Speaker 01

  You know, good news is few and far between at the moment. This is like a very, very, very low bar to meet.

• 1:12:35Speaker 00

  Yeah.

• 1:12:35Speaker 01

  But I think we've got to accept the good news we get with arms wide open.

• 1:12:39Speaker 00

  Yeah, I know. You're, I think you're going to go back to that.

• 1:12:43Speaker 00

  One of us is going to do it.