Why Don't We Have a Surgeon General?

27:10Her functional medicine clinic is in the Pearl District in Portland. Pearl District, parentheses, derogatory. 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. Yeah. So now those industrial buildings are overwhelmingly like luxury condos and lofts. She's like, the medical system is kind of a grift. And I want to get in on that grift. It feels very telling that you go to the wealthiest area. 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.

28:00And he started volunteering at a homeless shelter to do dentistry on homeless people. There's like other things that you can do. That's right. Other than this, you know. 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, who was a longtime Republican operative in D.C. He worked for Nixon and after Nixon's resignation for Vice President Nelson Rockefeller during the Ford administration.

28:52During the Ford administration, he worked on the Food and Nutrition Task Force, which sought, among other things, to dramatically scale back food stamps. There's that systemic critique, baby. Right. The like food is medicine, ladies. Dad is the reason that fewer people have the medicine food that she wants everyone to have. Too much food. Grady also worked as a consultant before selling off the consulting wing of his firm for$3.5 billion in 2002. Billion? So that's her dad, Grady Means. She also has a brother named Callie Means. Which the description on this Tucker Carlson YouTube video tells me has also been interviewed by Tucker Carlson.

29:37Yes, correct. Yeah. So they have become a little bit of like a package deal. They're sort of like a one-two punch in Maha world. And they co-authored their book together. Oh, okay. 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. Nice. He worked on the McCain campaign, reportedly as part of the quote unquote pit crew that was working to improve Sarah Palin's reputation. Ooh, okay. He did that debate prep. He's furiously sending her links to Schoolhouse Rock. He describes himself as a former never-Trumper who became one of RFK Jr.'s advisors after that appearance on Tucker Carlson.

30:29Callie Means is an entrepreneur who founded a company called TrueMed, which helps people apply for HSA coverage of like Peloton bikes and infrared saunas. Oh, wait, really? He's trying to get people reimbursed for like alternative medicines. 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. Yeah. 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.

31:11Right. And also most people use it and then just like never like you just forget that you have it. It's such a hassle to use it that a lot of people just don't use it. And then you're like, oh, fuck, I got to buy two pairs of glasses this week. Yeah, yeah, yeah. True Med allows people to log onto their website, fill out a quick survey and get delivered a letter of medical necessity that allows their purchased and covered by hsa okay in exchange true med takes a cut of the sales oh okay okay that's scammy so they've been used for like red light therapy devices including the like skin care red light masks they've been used for supplements for smart mattresses sure vanity Fair did an incredible deep dive piece into Cali means I strongly recommend it and as part of that they got their hands on some early true med marketing materials which at its outset focused on rebranding companies like sweet green and daily harvest as health care yes my daily salad is actually a prescription my dad did cut food stamps but but now my work lunch is health care so the mean siblings both have very close ties with the sweet green guy the daily harvest get like all of these people are people that they know and work with very frequently yeah through the quote-unquote end chronic disease coalition how do i know that's a scam right right any other time in history you're like oh end chronic disease that sounds good but it's like nope my brain is too broken from doing this show the coalition is mostly they're advocating for something called the hope act the health out of pocket expense act 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 cali means work with this incredible coalition yeah the coalition is largely made up of companies whose products would be covered under those proposed expanded rules 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 and the name of the coalition is end chronic disease like oh my god this guy is so dedicated to ending chronic disease no he's fucking not.

33:37He's dedicated to selling his buddies like food and then taking a cut of those sales. Yeah, yeah, yeah. So, Michael, are you ready for Cali Means origin story? Oh, yeah. Give it to me. Cali Means says that he was a lobbyist for big food and big pharma. Okay. 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. What? That it's like hush money to like stop opposing us in public or whatever. And I was just like, dude, what are we doing? So he's doing it like confessions of an assassin kind of thing where he's like, oh, I brokered these evil deals.

34:23Yes. Confessions of a lobbyist. Yeah. 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, millions to the NAACP and the Hispanic Federation in exchange for publicly calling any policies hindering soda sales as racist. Okay. Describing the whole thing as, quote, unquote, depressingly transactional. Those seem like easily verifiable claims, but whatever. So Vanity Fair in this deep dive piece fact checked him and his story simply did not check out.

35:12Yeah, of course not. 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. okay 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 executive assistant is hella funny it's as removed as you could be from like the halls of power that you're talking about they're like hey can you grab us a cup of coffee he's like i was in the room the room where it happens that's right yeah not only do they dispute the roles that he held.

35:58They also dispute that they, the companies represented the clients that he claimed. Nice. So in the three years that Cali Means worked at Mercury, they didn't represent Coca-Cola, nor did they represent the American Beverage Association. Mercury, which is where Cali 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. 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.

36:34But instead, he's like creating this weird narrative, 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 co-worker. I just sent you a quote. 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, Callie Means business? He walked around the office saying, Callie Means business, another former colleague recounts.

37:10That's like his cute little, it's almost like a bumper sticker phrase for like when he runs for congress totally kelly means i just want you to imagine an executive assistant dude who is trying to or something who's like trying to get into every strategy conversation yeah yeah is acting like they're better than everybody around them at like a pretty high-powered firm where they are very Jr. Yeah. And they're walking around just muttering Cali means business to themselves. Like what a fucking door. A real Pearl District resident. The way I is the way I think of him. Just the kind of guy who live in the Pearl District.

37:51So that's Grady means and Cali means it felt important to lift up that Casey means because she sounds kind of like Portlandy Maha crunchy granola. It felt really important to establish just how committed to extreme conservatism her family is. I'm so curious how this nomination fell apart now, because all of this so far sounds like everyone in the Trump administration would just love these people. Right. And welcome them with arms wide open. Baby.

38:26Well, Michael, when it comes to this story, can I take you higher? that's it that's all of my creed that's it we're done 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 health care thing 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.

39:33The 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. Okay. As well as quote unquote AI insights. There it is. There it is. A full membership to Levels for a year, including glucometers, costs about$1 ,500 per year. 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 more than$100 fucking a month. So she founds Levels and her functional medicine clinic in 2019. And in 2020, COVID hits. Casey Means takes that as an opportunity.

40:18Of course. 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. Oh, so buy my products. 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. Oh, wow. Okay. It is then 2022 during Callie and Casey Means' appearance on the Tucker Carlson show that really establishes them in the right-wing just-asking-questions circuit.

41:12from 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 uh the release of callie and casey means book in 2024 which is called good energy the surprising connection between metabolism and limitless health how is it not called means tested they have so many puns at their disposal think of the possibilities lean means health care machines means is great they're leaving grifts on the table in promotion of the book they publish an excerpt on the free press of course the excerpt on the website is titled i'm a doctor you shouldn't always trust us god the chapter in the book is titled trust yourself not your doctor this website loves laundering most far-right garbage but like through the mouths of experts who went to all of these like ivy and ivy adjacent institutions yeah like i read the whole book callie and casey means both say some very accurate, reasonable criticisms of the U.S.

42:35health care 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. And that's why we've joined the Republican Party, which wants to make all of these things worse. 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 wick right they instead shift to this personal responsibility frame yeah yeah 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 she is yeah right like buy the oil that is like five or six times as much right they are totally silent on like how any of this would be possible for low-income families, right?

43:25And 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. 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. Nice. And called COVID a quote, Darwinian moment for America. Oh, what? Like a good way? Yeah, like the least fit did not survive way. Just saying it. They're out here just fucking saying it. She also has some anti-vax positions that I think are dressed up to appear more moderate than they are.

44:11In 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. Vulnerable. We're really looking out for the vulnerable by giving them measles. It's so important that they get measles. She has said, quote, I think vaccine mandates are criminal. I mean, they are in the sense that we never fucking had them in America. So whatever. 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.

44:44I love that. I love that. Um, actually, Actually, I'm the most anti-vax. I'm actually pretending when I say we need more research and stuff. I'm actually super anti-vax. Don't worry about it. Michael, aren't we having a good time with these doofy fucking - You keep reminding me, isn't this fun? It's kind of fun. I'm having fun. This is like my parents on road trips as a kid. This is fun, right? 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.

45:22I 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. The way that you know if there is listeria in milk is a good hard look in the eye. I want other people to have the freedom to fucking lie to my face about the health impact of their product. She is also a proponent of both psilocybin and MDMA. she likes shrooms she likes molly 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 take these other drugs it's so weird 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 yeah and you have this sort of like newer wave of like red pill fucking assholes who are like drugs.

46:15Yeah. It becomes a liability because it exposes that rift, which doesn't often get tested in like federal policymaking. Right. Right. So in addition to all of those hot takes, sometimes her hot takes take the form of poetry. Okay. 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. And she puts it in full in her newsletter? Mm-hmm. The title of the poem is The Devil's Wellness Plan. I'm not, I'm not reading. This is way too much, Aubrey.

46:58You're reading it, Michael. You're reading it. 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 cycles phase. I'd push the pill and dull women's flame till womanhood forgot its name. I'd give boy's 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 there you go i miss creed aubrey can i can we go back to creed like he's a professional you can't expect her to be on his level that at least had like an okay like pentameter or whatever it was at least the correct number of syllables?

48:02So 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. Nice. 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. This means war. So a number of former Surgeon's 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 u.s public health service is um to weed out people who don't have license to practice and casey means does not have an active medical license oh right yeah there is uh criticism from maha folks who once again criticize her for not being anti-vax enough.

48:55Really? Even her? Uh-huh. Fucking hell. Once again, queen gremlin, Laura Loomer, weighs in on Twitter. I just think you quote. 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 non-existent 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.

49:37This is bizarre. Casey Beans is like a complete nutcase. They should love this lady. The reactions to her nomination are so bad. on Twitter in particular that RFK Jr. rushes to her defense on the platform. 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 try to defame me and President Trump. 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.

50:16It's like why they're mad at her. 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. Right. And that the Maha coalition was like, sort of like looking for a home and Republicans offered them a home.

50:54Right. 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. Right. and not having one still. 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?

51:32They 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. Right. It's all power games, right? Yeah. 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. Okay. Vanity Fair interviewed the chair of the department where her residency took place.

52:07who 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. No way. The funny thing is, that's also a structural critique of the American medical system. People are so overworked. Yes. But yeah, it's also funny that she makes it this virtuous, I chose to leave thing. 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. Has she tried zinc? Has she tried taking zinc for anxiety?

52:44I think it just maybe it's her lifestyle. 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. So she got maternity leave, basically something the administration is also decidedly against. 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 health committee, is Bill Cassidy.

53:30Bill Cassidy is in that intervening time defeated in his Republican primary by a Trump endorsed challenger to the right. Okay. 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 6th. Okay. He's a physician who did practice for a long time 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.

54:17All of that does feel relevant here. 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. Totally. So like, as I have told you, I'm not a fan of congressional hearings. Yeah. 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. 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.

54:57Bizarrely, 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. What? I will say Hawley kind of softballs it and he's like, well, I'd invite you to give it some thought. 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.

55:30It is all theater though. Cause they, none of them give a shit about any of this stuff, but whatever. 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. Right. His willingness to push back in that way. I was like, oh, that's interesting. It's weird. Yeah. 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. This is after the Pam Bondi hearings.

56:05So it's clear that she's trying to like moderate her response and not be kooky and start yelling about like the Dow. Yeah. Yeah. 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, which I can see the anti-vaxxers being mad about that. It's the one answer that like, we don't actually know what causes autism is the one answer that is guaranteed to piss off everybody. She should have just said they fucking cause autism and then like the anti-vaxxers would get on her side.

56:44Ten toes down, standing on business. Yeah, yeah, yeah. So in that same hearing, Tim Kaine asks her about flu shots, which is not a huge part of the anti-vax discourse. Right. So I just sent you, we're going to watch a clip. I apologize in advance for how infuriating this clip is to listen to. 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? Senator Cain, as I've said, I believe vaccines save lives and are an important part of it.

57:34I'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? I have not personally seen that quote or that article. I would want to review it before I comment on that. Okay, I'm going to set the quote aside. I'll introduce for the record. She's so bad at this. An article, CBS News, RFK Jr. says it may be better if fewer children receive the flu vaccine dated January 7, 2026.

58:09Without objection. Do you believe that there is evidence that the flu vaccine prevents serious disease and prevents hospitalization or deaths in children? I believe that all patients should talk to their doctor. 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 the flu vaccine has efficacy in reducing serious injury or hospitalization? You would see a little hamster wheel in her brain. This is an easy one, doctor. This is an easy one. I support the CDC's guidance on the flu vaccine.

58:53And I will always be working with the CDC, ASIP, and the agency. So you believe it is an efficacious vaccine to reduce hospitalization? Is or is not. Is. You believe it is. As I said, I support the CDC's guidance on the flu vaccine. Let me just say, do you think the flu vaccine reduces the risk of hospitalization or serious injury? I've said it. You're a doctor. I believe vaccines save lives. I believe they're an important part of a public health strategy. The flu vaccine, does it reduce the risk of injury or hospitalization? At the population level, I certainly think that it does. Let me introduce for the record, if I can, Mr.

59:31Chair. 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. I answered your question. And yes, after three minutes, you acknowledge that at a population level you would disagree with it. I haven't seen that report. I have not seen it. Yeah, but you know about the flu vaccine. 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. I'm not asking you about the quote. I'm asking you about something in your remit, the effectiveness of the flu vaccine.

1:00:04Stunning. He did eventually get her to admit it, which is actually interesting that she did. I think it's, again, an indicator of how bad she is at this. Yeah, yeah. 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 I support the CDC guidance. 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. 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. Yeah, yeah, yeah, yeah.

1:00:38Another 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 okay and in her newsletter on instagram on social media broadly she is frequently recommending products oh right and like not disclosing like those fdc regulations where you have to say like hashtag sponsored or whatever correct yeah 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 yeah and she's like doing a wellness fire fest of like not right 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 oh yeah of Of course.

1:02:02$12 ,000 from Daily Harvest. $16 ,000 from Florosophy, a fiber supplement company. That sounds like a fake word that she made up for one of her poems so that it rhymed. $27 ,000 from Energy Bits, an algae supplement company. Wait, what was the one we talked about on the bonus episode? Food Cube or whatever? Is she getting cube bucks? $500 from Weenatal, prenatal vitamins. Oh, that's pretty good, actually. And$130 ,000 from Amazentis. Oh, oh. A supplement company. Also,$200 ,000 from Tati Westbrook's hair vitamins. Yeah, that's right. Bye, sister. Uh-huh. 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 uh yeah everyone's going out of their way to do this shit i know 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 yeah and then like posts a clip on social media and is like hey we had a real one this is 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 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 you cannot listen to what they say you have to look at what they fucking do correct 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 100 i was like this is uncharacteristically like anti-shrewd also for just a failed fucking candidate too you're also really like it's clear by this point that like she's not going to make it through.

1:04:26So on April 30th of this year, in a truth social post, Donald Trump acknowledged that Casey Means didn't have the votes to being confirmed. She will also be joining Walter Reed. 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. Okay. 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. Yeah. Plus, the anti-vax stuff has faced a large number of court challenges.

1:05:14So 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. Right. And this is more of an RFK thing than a Trump thing. 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. Yeah. 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.

1:05:53Okay. She went to Ross University in Barbados. Is that like a for-profit scam factory? It doesn't appear to be. I didn't look into Ross University to a great degree because I was like, they're not going to do that again, right? But maybe, who knows? She is currently a radiologist at the Sloan Kettering Cancer Center. A licensed doctor. 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. She's written three books. Love Mom, Inspiring Stories Celebrating Motherhood. Okay. Make America Healthy Again, How Bad Behavior and Big Government Caused a Trillion Dollar Crisis.

1:06:39Yeah, big government's definitely the problem. She also published that before RFK Jr. was using Maha. Oh, wait, really? Uh-huh. She tried to trademark it, which is very funny, and then she sort of dropped it. Yeah, yeah. 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. I could just write that book from memory. I could sit down and write that fucking book right now. One million percent. You already know. Lab leak, whatever. However, 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.

1:07:19I 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. Yeah, there it is. Yeah. And that she opposes vaccine mandates. Yeah. She has also been publicly and directly critical of RFK Jr.'s approach on vaccines. Really? And she's done that criticism in right of center media outlets. It's fascinating. Okay. She's a real mixed bag. Yeah. Most notably, she wrote an op-ed in the Wall Street Journal just last year called The Madness in RFK Jr.'s Autism Method.

1:08:02Woke queen. I'm into it now. comparatively i heard she said defund the police 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 like scrubbing the record afterwards so she tweeted at one point quote seems like they may not want to admit the u.s measles elimination status is gone until after the midterms nice 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 wow this is the bar is in hell portion right yeah but also like not a lot of people are exceeding the bar right so far the reactions have been much less alarmed than last time 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 it all feels like not that it was but all feels like a strategy they're 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 folks have been worn down so hard i'm sleepy dr sapphire hasn't faced confirmation hearings yet.

1:09:25There is one thing that may become an issue in her hearings. She has a supplement brand called DropRx. It's called DropRx because it is herbal tinctures, like liquid tinctures in eyedropper bottles. In true supplement biz form, their supplements are named things like boost, relief, allure, sleep, and intimacy. Taste test episode incoming. So there are two problems here. One is 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.

1:10:12problem 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 cheap champagne what is kava 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 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?

1:10:56Do 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. They're all tree hugging Marxists, Mike. for now she appears to be much more in the vein of dr neshwat than these means right and that honestly feels like a pretty grounded win right to have someone who is not who's like grifting from one angle but not like seven that's as good as it gets in america in 2026 right now she's only one kind of grifter count your blessings she's only selling herbal tinctures I know, she's a mono grifter. That's the best we can do. At the start of this episode, I started by saying that the research made me feel like less despairing.

1:11:45Here's why. One, this is a place where the Trump administration is failing. They are not getting their nominees confirmed. 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. Although in fairness, they are twice as bad this time. They are pretty bad. Yeah. From a harm reduction standpoint, I genuinely think it's more helpful to have no Surgeon General rather than one of these ultra gremlins. And at the win that Casey Means didn't get through because she's a complete nutcase. 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 right now, which means that, again, Republicans who are already pushing back on this committee are going to be incentivized to push back more.

1:12:36Yeah. You know, good news is few and far between at the moment. This is like a very, very, very low bar to meet. Yeah. But I think we've got to accept the good news we get with arms wide open. Yeah, I know you're going to go back to that. One of us is going to do it.

1:13:00Thank you.