President Donald Trump made a sudden personnel swerve Wednesday when he named Dr. Casey Means as his new pick to become U.S. surgeon general. Her elevation is a major win personally for her ally Robert F. Kennedy Jr., the health and human services secretary, and his Make America Health Again movement more broadly.
Trump is on the precipice of handing the largest public health megaphone in the country to one of the least experienced people ever offered the job.
But in tapping the doctor-cum-influencer for the role, Trump is on the precipice of handing the largest public health megaphone in the country to one of the least experienced people ever offered the job. As the title might suggest, the surgeon general is the head of the Public Health Service Commissioned Corps, a uniformed service branch deployed throughout the Department of Health and Human Services’ various agencies. In that position, the next occupant will act as the chief public health adviser to Kennedy and spokesperson for public health issues.
Over the last several decades, the most important missives have come via the public advisories known as “surgeon general’s warnings.” These have covered everything from the dangers of cigarettes and alcohol to the threat of social media to young people’s mental health and firearm violence as a national crisis.
Unlike some of Trump’s other nominees, Means at least has some background in the field she’s expected to oversee. She earned her medical degree from Stanford University and trained as an ENT doctor, but as The Wall Street Journal put it, she “[dropped] out of her surgical residency on her 30th birthday, frustrated by what she saw as her field’s inability to treat patients’ underlying, chronic causes of ill health.” Since then, Means has focused on more holistic medicine, and she blew up in the MAHA sphere last year after publishing a book with her brother, Calley Means, titled “Good Energy: The Surprising Connection Between Metabolism and Limitless Health.”
According to The Associated Press, “in interviews and articles, Means and her brother describe a dizzying web of influences to blame for the nation’s health problems,” ultimately connecting “changes in diet and lifestyle to a raft of conditions including infertility, Alzheimer’s, depression and erectile dysfunction.”
It’s easy to see, then, why Kennedy and his devotees have eagerly embraced them as fellow skeptics in the face of the broader medical community. At the core of the MAHA movement is a similar promise to divulge secret information that the food, pharmaceutical and/or medical industries don’t want to common people to have. After boosting the kind of skepticism that fuels attacks on vaccines and other treatments, the newly converted are directed toward other wellness supplements (also up for sale).
Since the beginning of the Covid-19 pandemic, the horseshoe between crunchy granola mom-type health advocates and conspiratorial vaccine deniers has become more of a circle. Figures like Means appeal to the former with some good ideas tucked in among the weirder ones she brings to the table.
We’ve seen ample cases in which the surgeon general has put out warnings that are good science but make for potentially bad politics.
The New York Times noted that Means has supported “serving more nutritious meals in public schools” and “forbidding pharmaceutical companies from advertising directly to patients on television,” both of which are policies I can get behind. But the Times adds that she also backs “investigating the use of chemicals in American food” and “putting warning labels on ultra-processed foods,” which brings us right back into the same myopic worldview from her book.
Despite being a presidential appointee, the surgeon general is supposed to be apolitical in theory, charged with “communicating the best available scientific information to the public.” We’ve seen ample cases in which the surgeon general has put out warnings that are good science but make for potentially bad politics. Former Surgeon General C. Everett Koop, appointed by President Ronald Reagan in 1982, blasted tobacco companies for pushing a dangerous product, was willing to tackle the AIDS crisis when it was still seen as taboo and refused to issue a White House-requested warning about the mental health risks of abortion without proper scientific backing.
The idea that one weird trick could be a panacea for all that ails the country is more the realm of snake oil salesmen than past surgeons general like Koop or recently departed Vivek Murthy. Means’ devotion to metabolic health as a cure-all is something that should give pause to anyone looking to her for guidance on how to, say, combat the next pandemic the country faces. With Means wearing the uniform, we’d more likely have the reverse: a surgeon general willing to issue advisories that aren’t backed by science in the hope that it makes good politics.
