Bulwark Takes - Trump’s Surgeon General Nominee May Be Too Weird Even for MAGA

Episode Date: May 8, 2025

Andrew Egger, Jonathan Cohn and Will Sommer discuss President Trump's new nominee for Surgeon General, and the drama it has caused with the anti-vax movement.

Hi, this is Andrew Egger with The Bulwark. We got a little bit of a shakeup in the Trump appointments game yesterday. He pulled the former pick for Surgeon General that he had been rolling with, a former doctor who's a Fox News contributor. He's going in a different direction. Casey Means is Donald Trump's new pick to be the US Surgeon General. She's kind of an interesting character in a whole lot of ways. We're going to break it all down today, talk about it. I'm joined by Jonathan Cohn, our top policy reporter, and Will Sommer, our in-house expert in all things right wing and wild. So thanks, guys. Let's talk a little bit about the background of this person. Where did she come from? Where did Donald Trump pick this woman up off the street to be

the next potentially the next surgeon general of the United States, Jonathan? Yeah, so I mean, you look at her biography, and it starts in a very traditional way for a surgeon general, right? So she goes to Stanford, she goes to Stanford Medical School, ends up in residency in Oregon for becoming a head and neck surgeon. And then somewhere during residency, she decides this isn't for her. And the story she tells is that she had this sort of epiphany doing surgery one day that the medical profession, the medical establishment, our whole healthcare system was very focused on treating people when they are sick and not at all focused on why they got sick and keeping them healthy.

And so she kind of at that point, there's like a turn off the sort of normal, you know, the standard road of kind of American medicine. She becomes she turns into a sort of a, you know, you know, a writer, a thinker, entrepreneur, you know, an evangelical, an evangelical evangelist for for healthy living and her ideas about it. She does a lot of work with her brother, who is also they also went to Stanford, then actually ended up at Harvard Business School. And he is sort of, you know, through his own path and his own epiphany, the two of them end up doing a lot of work sort of coming up with this sort of, you know, ideas about what is wrong with American medicine and how to fix it. And it's, you know, all about, you know, good health that we need. As a country, we're not focused on, you know, on diet, on exercise. And then she's got a whole,

you know, theory worked out and there's a whole scientific explanation she gives or, you know, what she considers a scientific explanation. Some would question it. And she ends up on the radar screen of RFK and right wing. And actually, I think that's probably where Will probably can kind of pick up the story better than I can. Yeah, sure. So so Casey and Callie, me and her brother, they have this this book that came out a few years ago called, I believe, Good Energy Bestseller. It's a lot of like get a lot more sunlight.

We sort of start to enter maybe the world of people maybe familiar with like Andrew Huberman, this kind of stuff. This is kind of like a softer, kind of more spiritual version of that. And then basically she goes on Rogan. It becomes hugely popular based on that and some other. She goes on Tucker eventually. And then during RFK's presidential campaign, she kind of goes into the RFK orbit. And so that's where these kind of Casey and Callie means. I started hearing last year a lot of like people saying, Trump supporters saying that, you know,

these are kind of like the vanguards of the Make America Healthy Again movement. Yeah, yeah. The business about the kind of epiphany right at the end of her kind of formal training there is so interesting to me. I personally had sort of an epiphany that pulled me out of potentially wanting to go into medicine, but it was in like 11th grade. I realized I was kind of the idea of blood and wounds being around me kind of made me faint and unhappy. Didn't like the idea of it. Went in a different direction, which, you know, in the end, I don't know, I guess I don't get to be the surgeon general of the United States. So it's not, I guess you wouldn't really call it a sunk cost completely to have gone through all of that. But it is very late in the game. This whole wellness business, it's so fascinating to me, the people who are in this space, because at bottom, a lot of the things that she's recommending in this in this good energy book and elsewhere, just kind of boil down to pretty commonsensical good ideas. Right. About about, you know, living in the modern world, get more sunlight, get more sleep, drink more water, eat less processed foods, a lot of things like that. But it's bolted on to this,

you know, a person might charitably say pseudoscientific, maybe that's uncharitable, I don't know, a person might call it pseudoscientific, sort of holistic explanation for why all of these things are contributing to, you know, your metabolic health, the, you know, the kind of core energies that are going through you and, you know, making you less at risk for different cancers and diabetes and all sorts of different things in the way that she lays it out. And then you also have to talk about the way that that whole infrastructure is connected to some increasingly sort of alarming stuff that's going on in the RFK type orbit, where it's the same sort of alarming stuff that's going on in the in the RFK type orbit, where it's the same sort of wellness speak that that gets deployed to talk about, you know, the supposed dangers of pediatric vaccines or the supposed dangers of, you know, chemicals in the jet fuel overhead,

as well, you've reported a lot about with with RFK. Well, and Casey Means is right there, right there with you on the chemtrails. I didn't know that. Can you talk to me about that? So yeah, so let's talk about some of her beliefs. So as you said, it starts with this very almost like, I don't know, like we're going to Coachella, kind of like a chill vibe, kind of California.

We're going to have some avocado toast. And as you mentioned, a lot of it is that like metabolism and metabolic health. And, you know, I think the it is that like metabolism and metabolic health. And, you know, I think the means are very good at they don't come off like raving lunatics. Perhaps they are. But this is very acceptable and like a whole foods thing where they say, you know, well, doctors should tell people to eat well. Well, as some of even the means as critics on the right have pointed out, there are a lot of doctors who are like, you need to eat more Lucky Charms and Doritos. Right. I mean, that's kind of already built in. But then when you get below the surface, she gets a lot of like, a lot more like back to nature. She's really against like damming rivers and lakes. You know,

that kind of pops up a lot. She believes that all bodies should be composted. And so then we start getting, you know, speaking of compost, we're kind of getting the layers here, right? As you said, vaccines. She's kind of like anti-vax-like. She's like kind of skeptical of vaccines. And, you know, oh, maybe we have too many vaccines. So that's sort of where she gets. The pediatric vaccination schedule is, I think, the main thing that she's pushed, as well as some COVID vaccines kept to some. But the idea of, yeah.

And, I mean, in terms of the chemtrails, I mean, I saw she went on Kristen Cavallari, if people remember the OC, or not the OC, excuse me, the Hills, you know, Laguna Beach. She went on her show and Kristen Cavallari says, like, what's up with all these chemtrails? And she said, well, I don't know. There are a lot of weird lines in the old sky. So, I mean, a lot of this stuff she's kind of signaling to this Maha movement or excuse me, to kind of the further side, this fringier side. But I think casein calamine is kind of represent a more respectable such as it is version of that. And to be frank, that has infuriated a lot of anti-vaccine people who see her and her brother is sort of diluting the force of anti-vaccine stuff in pursuit of like, let's get the wrong chemical additives out of potato chips, which they seem to sort of a pointless diversion.

Right, right, right. Yeah, sort of an anti-vaxxer in name only sort of situation. A squish, a maha squish in the view of some of these very far out there people. Let me back up just a little bit. Jonathan, this is a lot about Casey Means, you know, where we're kind of talking about her in the orbit of RFK. Actually, she and her brother were the, weirdly enough, reportedly the couple who introduced or at least kind of hooked up Trump and RFK as kind of campaign fellow travelers and buddies last year after the attempted assassination on Donald Trump. So they're kind of big players in the way that certain elements of the 2024 election went down. But just to back up a little bit more,

can you just talk a little bit to us about what it actually means that she's being appointed or being nominated to serve as Surgeon General? I mean, it's a largely symbolic role, but what does the Surgeon General do? What are they kind of responsible for? Yeah, yeah. So I mean, actually, Surgeon General is one of the oldest offices in the United States. I mean, it actually traces all the way back to 1798. It originally started as sort of, you know, care for mariners and the mariners service and evolved into a uniformed service. And the Surgeon General is in charge of this uniformed service of medical officers of the United States. Technically, now, a lot of that responsibility was stripped in modern times. And as you say, today, it's mostly not so much about, it's not really a line job where you have authority over people and programs.

What the Surgeon General does have is a really important public platform. And over the last few decades, they have used that platform to issue reports, you know, public speaking, public writing. It's actually been fairly influential. You know, it was a Surgeon General's report back in the 1960s that smoking was, you know, hazardous to your health and led to the famous, you know, the warning label we still have on, you know, cigarette packs. In the 1980s, a report that the Surgeon General did on AIDS was really a pivotal moment in shaping public perceptions about HIV and AIDS at a time when it was sort of being sort of cordoned off as a sort of gay disease. And there was a lot of discrimination involved in this. C. Edward, it's been a while, Everett, I think it was C. Everett Koop was the Surgeon General, issued this report. It was a really big moment. More recently, we've had a Surgeon General do a report on gun violence, on maternal health, on mental health and addiction.

And these reports really can really play a big role in shaping the public perceptions, shaping the political dialogue, and lead to real action. You know, looking back that report on smoking, I mean, most people, if you look back, the sort of decline in smoking in America is considered one of the great public health victories of the modern era. And that report was a really big part of it. So, you know, here we have, you know, means as Surgeon General would be in a position to issue reports, make, you know, and really kind of focus on, you know, you know, bring new issues to light. And the funny thing is, you know, when you listen to like, you know, listen to them on

Rogan, you know, as Will was just talking about, you know, a lot of what they say about the health care system, you know, it's sort of not enough emphasis on keeping people healthy, the extent to which the pharmaceutical industry has too much influence. There's, you know, there's a lot of people who agree with that. You know, I would agree with a lot of that. And you, you can imagine a world where she in that position could do some good if that's what, you know, but then again, a lot of what she does for reasons Will was just explaining really like, you know, a lot of what she does, for reasons Will was just explaining, really, like, you know, a lot of, you know, the scientific establishment looks and says, well, wait a minute. This is, what are you talking about here? And so, you know, that is the question, you know, how would she use that platform?

Yeah, it really is striking the degree to which we're in a system now where a system now where like the the main institutional critique of of things like big pharma like if you're the kind of person who who thinks big pharma has too much power thinks there's too much processed food um you know going into american gullets think people don't exercise enough think people don't get enough natural light like the the main power center for you know putting any of that stuff into action seems to right now in America be this Maha movement with that's, you know, allied with the current president, allied with the current secretary of health and human services, and which also has a complete allergy to doing any kind of crank policing in its in its ranks

at all. Right. I mean, like you can see that. This is kind of the main question with Casey Means is some of these people far out to the right are like, wow, well, does she really care about chemtrails? Does she really have concerns about pediatric vaccinations? Or is she just saying that stuff to get in good with us? And meanwhile, how insane is it to live in a world where the nominee for Surgeon General of the United States would possibly be incentivized to get in good with those particular people? I mean, we're just so upside down in terms of the political incentives here.

Jonathan, I wanted to ask you as well just about what you see. Again, this is Trump had a surge in general pick before who was plenty right wing, but kind of more of the certainly not this exact same like maha flavor. What do you make of of of kind of the tea leaves of Trump now, you know, making this shift and I guess giving this extra vote of confidence? At least that's the way I read it, to Robert F. Kennedy Jr. Yeah, I mean, you know, I don't know. I continue to still puzzle over this sort of RFK Trump relationship. I mean, you know, my assumption with Trump is that everything is transactional. And so, you know, do we think Donald Trump has spent a lot of time thinking about wellness and health or spends a lot of time thinking about it now? I mean, this is Mr. Big Mac, right? of time thinking about wellness and health or spends a lot of time thinking about it now. I

mean, this is Mr. Big Mac, right? I mean, you know, I think, you know, RFK was useful to him, has been useful to him, continues to be useful to him. And so he's happy, you know, he doesn't care either way. So he's happy to give RFK kind of free reign over at, you know, Department of Health and Human Services. And I do think there's some overlap there. You know, the RFK agenda, you know, Department of Health and Human Services. And I do think there's some overlap there. You know, the RFK agenda, you can kind of draw a Venn diagram, right, of the sort of RFK agenda, you know, Trump's desire to kind of beat up on the medical establishment he still is angry with from COVID and, you know, and, you know, and then the sort of, you know, the sort of other parts of the right wing universe that just want, you know, see the sort of, you know, the woke conspiracy in government and academia.

And you kind of draw those three circles. It's a pretty big Venn diagram. And HHS is right in the middle of it. So, I mean, I think, you know, that's what's happening here. And every appointee, you know, I remember when he first appointed RFK, I was like, well, let's see who the deputies are who are the how else does the rest of the department get filled out and we've seen a point d after point d at fda at nih are people who share you know all fit within those three you know in that venn diagram in that middle ground and so that's that's where they're going so to me means is part of that you know in terms of the where in that universe that i don't know again i defer to will on that because? That I don't know. Again, I defer to Will on that because that I don't know. So this is kind of the other beat here. So this happened, you know, now Wednesday night that this original Surgeon General nominee got booted out. And a lot of that is, I think, being attributed to her being poleaxed by Laura Loomer, the right wing activist, right, who has this kind of little side business going on where she highlights what are no longer sort of acceptable MAGA opinions people have had in the past on her Twitter account, and then I think makes them sort of toxic within Trump world. So

she says, well, you know, this doctor, she thought people should wear masks at one point during COVID. And so suddenly they go, oh, no. So that in part helped push this Surgeon General nominee out. So you might think she's thrilled with Casey Beans. Not so. Laura Lumer now has been on the attack against Casey Beans, saying she can't really practice as a doctor right now. She changed her name at one point. I looked into this. It seems relatively mild. She dropped Paula as her first name. I don't blame her. You know, so so there's that. But maybe more interesting, Nicole Shanahan, RFK's running mate in the presidential race. She ripped into RFK last night and said, you know, I don't know, is RFK lying to me the whole time?

I don't like this lady. What's going on here? You know, and suggested maybe RFK is being blackmailed by someone, which kind of plays into this idea that RFK is being blackmailed by Israel, popular conspiracy theory these days. And so what is going on here? Well, I think, I don't know what Laura Loomer is up to. I think she's up to something. But in the case of Nicole Shanahan, this is someone who is very much an anti-vax person. She got into this stuff because I believe one of her relatives has autism. That's how she got into it.

So as I mentioned, you know, the means are seen as kind of squishes, as like posers in the anti-vax space. I think that's what's going on. Yeah. And, and again, like, can I just belabor this point of how shocking and just really remarkable it is to just imagine that anybody would, that you're not a real anti-vax crank, but you have to pretend that you're a real anti-vax crank in order to shore up pretend that you're a real anti-vax crank in order to shore up support and, and get in good with the current administration or with the Maha movement or whatever. It was just so, it's just so amazing and, and remarkable and, and appalling, um, to, to think about it in those terms. Um, not to, not to over editorialize, uh, over the top of you

guys. Um, but, uh, but yeah, I guess, uh, I guess we can probably leave it at that, right? Uh, anything else to do? What, what, what'd we miss? What'd we miss? I guess we can probably leave it at that. Right. Anything else to do? What would we miss? What do we miss? I guess we got through the whole video without forgetting that Casey is the sister and Callie is the brother, which has been a hard thing for me for. I'm with you. I mix them up in my head. Same. I should mention, you know, she had a license in Oregon, according to public records, but it's now inactive. Not, you know, wasn't suspended or anything, just is inactive because she, you know, and, but it seems to be, I mean, I think people are still doing the background historical research on this. This just happened last night, but she would be the first surgeon general in modern times, certainly, to not have an active license

to practice medicine. And, you know, I imagine she and her supporters would say, yes, that's the whole point. We need to totally shake up, you know, the medical establishment. I think there are a lot of other people who would kind of say, wait a minute, this is supposed to be, you know, basically the most important visible doctor in America. And it's someone who can't practice medicine. So, you know, ponder that. Do not permit the incoming surgeon general to perform surgery on you. Okay, thanks, guys. This was fun. We'll keep following this. Obviously, who knows? Lots of twists and turns ahead in the confirmation of the incoming, potentially, Surgeon General. Thanks to everybody

out there for watching. Hope you subscribe. Hope you head to thebullwork.com and read our stuff. Thanks, and we'll see you next time.