Sawbones: A Marital Tour of Misguided Medicine - The U.S. Surgeon General

Episode Date: February 16, 2021

A new presidential administration means a new U.S. Surgeon General, so this week on Sawbones, we're examining exactly what that means. Are they a general? Why do they get to tell us what to do? And why do they care so much about sailor health?Music: "Medicines" by The Taxpayers

Saw bones is a show about medical history, and nothing the hosts say should be taken as medical advice or opinion. It's for fun. Can't you just have fun for an hour and not try to diagnose your mystery boil? We think you've earned it. Just sit back, relax, and enjoy a moment of distraction from that weird growth. You're worth it. that weird growth. You're worth it. Alright, talk is about books. One, two, one, two, three, four. We came across a pharmacy with a toy and that's busted out. We were sawed through the broken glass and had ourselves a look around.

Some medicines, some medicines that escalate my cop for the mouth. Wow. Hello, everybody and welcome to Sobbing, tomato turf misguided medicine. I'm your co-host Justin McAroy. And I'm Sydney McAroy. And I'm Justin McAroy. And today we're going to talk about medicine and the way it impacts us. I'm a thing.

I don't know. That's a new thing, you're good. I don't know. You didn't know. You have to workshop this stuff with me ahead of time. You can't just... Welcome to HealthWalk. No, no, we're not changing the name.

And that would be a whole other podcast. Welcome to HealthWalk. No, no. Tell me, maybe what we're going to talk about, because I left my special blue-blocking sunglasses that I'm a flower that can't look at a screen for a half hour while we record this podcast without my special glasses. No, we have. So tell him what we're talking about for all us Medical professionals out there who have to stare at a screen to do an EMR all day. We are short on sympathy

So just in the first thing I want to get out of the way before we start the show. I'm back. What did I miss? take it from the top is Surgeons general sturgeon general not surgeon generals Surgeons General. Sturgeon General. Not Surgeon Generals. Surgeons General. I believe that is accurate.

What if we all just as a society got together and said, search in general sounds better and we should just do that? Well, I think I'm basing that off of, I don't hear that corrected as much as attorneys general. Yes. That one I hear. So is there something about the landscape

we've been living in the past few years, I? I also think, and this is me, a doctor, making a joke, so please before lawyers attack me, I also think it just speaks to the fact that doctors just go whatever, I don't know, and move on, and attorneys are much more likely to be, I'm sorry, excuse me, at this was aimed at Riley. Butting attorney Riley, who would definitely correct me

and say, I think you mean attorney's general, not attorney general's, Sydney. This one started, I think I was probably at the root of this one because I realized that we had a new administration that actually made it fun to look at politics again. I mean, to shield your eyes. We're looking at through some sort of like shadow creating box like you'd use it in a

clip. I don't know. It's still I wouldn't say fun, but at least I can engage with it to see what's happening to take a critical eye to things and see like, well, I don't like this. I do like this. I need to call about this. Okay. This seems good without just like being completely horrified by the whole thing.

Right, you know, you can engage, it's something you can work with. This is something I can work with. This I can help, this I can work with. There's lots of room for improvement, don't get me wrong, but we can work with this. We can work with this. You wanted to know the history of surgeons general.

Why do we have one? What is it, what do we have it? And just like about our current of yeah, like in general. Why do we have one? What is it? What do we have it and just like about our current Certain general like well, I don't have a ton of info about the person in the position currently. Okay. I thought you wanted to know the history of the Thing of the light. Do I know them? No, no, I mean not personally. I don't think so. I'll tell you her name by the end I don't think so. Well, I'll tell you her name by the end. I'm gonna show how those are a chance I might know them. You can. Right now there's an acting surgeon general

because the Biden administration has. Did they get the good doctor or Dr. House or one of those other acting doctors? George Cleveland. Where's your where's your rim shot there? Anthony Edwards. Hold on. Is it that button? No, no, no, no, no, no, don't do that.

That was a reggae horn. Hold on, wait, I got to. No, that was taint tanning. Is that, no, that's my wife, hold on. Okay, we have to move on. In the early days of the United States, it was hard to be a sailor. It was tough to be a seaman.

Tough to be a sailor out there. Yeah, it was hard to be a sailor. Why, you may ask, well, first of all, I mean, sea travel was rough back then for everybody, right? Right. Right. You were out there a long time. We already know you didn't have vitamin C. We've talked a lot about scurvy, so you already

know that. You know that the conditions were rough for sailors out there on the sea. Tough luck there. And they were busy. The other thing is that sea travel was absolutely essential for the function of the newly minted United States of America. That was the whole basic backbone of commerce, backbone of commerce, the economy, it was all sea travel, essentially, right? Right. To get stuff from first colony to colony and then state to state in the surrounding areas. So, the sailors were busy. Their ability to do their job was vital not only to them as, you know, individual humans,

but also to the whole country relied on sailors. Sailors. Like the lifeblood of America. So getting sick was a big deal. If too many sailors, and especially when you think about infectious diseases or nutritional deficiencies that if one person on a boat might have a lot of other people, probably have two. You may have seen this as cruise ships recently.

Is this phenomenon a playout? Uh-huh. Or if they're already in the same thing, they're probably all deficient in the same thing. Because of that, they were at greater risk for illness. They went from port to port, exposing themselves to different things, different diseases. It was easy to transmit infectious diseases that way. And I said just the general inadequate nutrition less than ideal living situations It was all hard and when they would get sick and when a whole ship of people would get sick. It was a big deal for the Economy right so

When a semen or see woman although at the time a lot of people were see men or see women, although at the time a lot of people were see men. I guess we could say they're see people. Well that sounds like acceptable. That's like right on the Virgimer people, like you're right there. A lot of these, when you read in these histories, whether you're reading like the history of this

on the Health and Human Services website, or whatever, like a federal government history, they're just called see men over and over again. See, we get, I like sailors. Sayers, sure. So the hospitals, when they would get sick that they had access to, were really dependent on where they were, right? I mean, if you're thinking about what we're talking about right now is,

like the end of the 1700s beginning of the 1800s time period, okay? Are we past lines? Do we know how good lines are for everybody at this point? No, not widely known. That helps me track it. And like, generally speaking, if you think about the situation with doctors, hospitals, medical care in general, the availability of that kind of help, I mean, we are right after the United States has become a country. Okay.

Like right post revolution. This is where we are and how good were the hospital systems probably. Not good? I mean, no, not a lot of them know, not very good. You are even against President. Not very good. And I mean, you might find some in some port cities that were better, that had more access to goods and services that had more access to doctors that had an actual doctor working there,

maybe. But then there were other places where the sailors might stop and be sick, where the hospital was essentially a hotel. And that was it. So as a result of this, this would harm the whole economy, this would harm the whole financial structure of the United States. So Congress decided this is a national issue. The health of these sailors is not just an issue for the sailors and their families and the, you know, the people that care about them. It's an issue for all of us because if they fall apart, we all fall apart and we're just barely, we barely know what we're doing. Which I think is still true. That we barely... That's the US for you. No, we're doing it.

So they decided that we needed to establish a fund to build hospitals and get doctors for hospitals and other staff as well. First of all, it was really the focus was on like a doctor at all and like supplies and staff to care for these sailors throughout the United States, wherever they were, whatever port they had landed in and were unfortunately ill. So in 1798, they established the Marine Hospital Fund.

This would create the Marine Hospital Service, which was sort of like, it was a very loose idea. It was like a collection of hospitals, an association of hospitals. Was it a government-run program, or was it just like a, I don't know what the word would be. It was, you know what, actually, it was most akin to sort of a health insurance program. Basically the way

the way that it worked is that a sailor was taxed 20 cents a month and in return for this 20 cents a month they had access to this association of hospitals. Okay, so it's alright that makes sense. does that make sense? Yeah, and the idea was that this money would then be put back into these hospitals to One make sure that all the hospitals were hospitals and two get staff for them Hey, wait a minute This is just a McDonald's with band-aids and this is not a hospital This might predate McDonald's. I'm fuzzy on the history of McDonald's, but I think 1798 is before McDonald's.

The, you know what's interesting is, so this Marine Hospital service, do you know which department it was initially put under the purview? What? Of which department it was initially purview? What? The Treasury Department. Odd choice.

It is an odd choice. Less odd when you consider that there were only three departments at the time. So it was either Treasury, war, or state. Okay. Well, yeah. That's how like the secret service ends up in the Treasury Department. So at the time, you got to wonder, maybe it was just, we got a lot on our plate. We can't deal with this right now, but like, why didn't anybody be like, maybe we should

just create a new department? Because this is going to be really weird. But anyway, so it was put under the purview of the Treasury Department, you tax the sailors and you let them use all these hospitals and you take their money to make the hospitals like good, right? This all makes sense, this all follows.

But it quickly became kind of a mess. So the first thing is who got to hire or appoint or use the money to put a doctor in each hospital. Because at the time like you might just have a doctor running the entire hospital. Hmm. Wow. Yes. And then of course you would hire a lot of other staffers. I mean you would have to have nurses and orderlies and all kinds of other people. Right. But you may just have the one. And there weren't a lot of doctors. But you may just have the one. And there weren't a lot of doctors at this point either, by the way. And there were also a lot of people who said they were doctors who were...

Just like the fake hospital. Just sort of something. I don't know. They saw a doctor run. You need some aid in your fake hospitals though. That's true. One, then you can get anybody. You don't want to waste a real doctor on a fake hospital.

I'm sorry. We actually can't hire you here because you're an actual doctor. You need to apply to an actual hospital. We're looking for a fake doctor. We know this is confusing, but we do have standards in our fake hospital. Where's the guy who just gives whiskey to everybody? That's who we're looking for. I mean that guy.

So anyway, the person responsible for this quickly became the customs officer at each port. So basically, at each port, when the ship would land, the customs officer at each port. So basically, at each port when the ship would land, the customs officer was the person responsible for collecting the 20-cent tax from each sailor. This person was also responsible for hiring the doctor to run their port city hospital. Right? Right. You can imagine there are lots of places for money to get, we'll say, lost in all of these exchanges.

There's lots of opportunity for graft. There's lots of opportunity for some under the table arrangements and unsavery dealings. You know what I mean? And so there was a lot of room for this money that is supposed to come from the sailors through the government to the hospitals to not make it to the places it should be, right? So the result of this is that in 1851, Congress decided to like send out like a committee to investigate the system and see how it's doing because they, I imagine, had an inkling that it doesn't seem to be working great.

And they looked into all these hospitals and found some issues like this hospital seems like a hospital. There's a doctor there. They do medical care. This is not hospital. Sir, this is a Wendy's. It was really that extent of like some of these places are really functional and seem to be doing well.

Others are absolutely not up to standards. We have to fix this. This is not taking care of our sailors the way we wanted it to. This is not living up to the promise of what we created. And there's one thing we care about America. It's taking care of our sailors. Well, you know how important like providing universal healthcare to all of our citizens has always been to us in this country.

Not all our citizens, but definitely our sailors. So if we, so basically they said, okay, well, obviously we don't have enough money to care for these sailors. This was the first thought. Well, there's not enough money. This 20 cent tax is not doing it. So maybe we need to care for fewer of them of the sailors of the sailors So at first they decided like well, let's just limit their hospital stays

So you can't stay in a hospital for longer than four months I know that sounds like a wild long amount of time now like most people are not in the hospital that long now back then Recovering from things that was not we didn't know how to. Back then, it recovering from things that was not- We didn't know how to do it, so it took longer. It took a long time. That was not wild, but they limited hospital stays to four months. They also said, also, you can only seek treatment for acute illnesses, not chronic conditions.

Or maybe you would say a pre-existing condition. Oh. Man, doesn't this sound like all the problems with health insurance they just sort of denovo were creating into the system without anybody to go I feel like this will cause major problems down the road so they put these things in place thinking like well maybe this will solve the problem by 1870 it was clear okay this okay, this is not fixed anything. This didn't address everything.

Now, I mean, this is great. We love that we're not providing care for people with chronic medical conditions. That, like I might just say, we all agree. That feels right, doesn't it? We all agree about that. That feels right. This feels very American to me.

That's definitely something we got right. And we're kicking people out of hospitals before they're ready to go because we don't want to pay for them. This feels like something that America will allow you for a long time. But they decided instead, let's control it more tightly. We need to make it like a tightly controlled federal organization that is run from the top that we have somebody like setting standards, making sure the money goes or the money's supposed to go, regulating the healthcare professionals

at these facilities to make sure they're up to a certain standard and all this kind of stuff. To pay for the whole thing, they initially raise the taxes on sailors from 20 to 40 cents. I know. It's your fault, sailors, we're going to take more of your money. And then they said, well, that's not enough. So then they started taxing like the tonnage of a ship, like the load of the ship. They put a tax on that to help pay for it. And eventually they just started directly appropriating federal money, like Congress just started appropriating money to put towards the system. In an addition to all this, they decided there needed to be a person

appointed by the Secretary of the Treasury to run this thing. This is a sailor care network. Yes, and this marine hospital system. And in order to do that, we need a doctor in charge, like a surgeon who could supervise. Supervising surgeon is what they initially said. In 1870, we're going to have a supervising surgeon appointed by the Secretary of the Treasury who will run all this. That name would change to supervising surgeon general

in 1875, and then finally, permanently by 1902, it was called Surgeon General. Is the general part in this name? Does it have a military connotation or does it mean like a general, what does general mean? Like the surgeon in charge of everything. Like for all purposes. I guess we all encompassing. There is definitely, and I'm going to get into this, there is definitely

a military connection that happens at this point, but the surgeon general is not a general. Got it. Right. It is in ref the word general in this context is used for a military perspective and not a I don't know. I don't believe so because it was very clear from the Beginning that the surgeon general was not a military like not a general as in the title as in the office of general Okay, but they were the general surgeon for the entire Marine hospital system, which would become other things that we're gonna get into I guess the attorney general is like a military Right, no, it was not but I would be sound stupid now I'm looking back on it.

I feel like stupid for asking. But there is definitely. They always have menals and bars and stuff. Well, there is a military component to this. And that is what I want to get into next, even though they are not a general, there is a military part of it. But before I do that, let's go to the building department.

Let's go to the building department. I don't deserve the money I felt so stupid. Maybe 40 cents. The medicines, the medicines, the escalate macabre for the mouth. I'm Judge John Hodgman. And I'm Bailiff Jesse Ford. 10 years ago, I came on Jordan Jesse Goe

and judged my first dispute. Is chilly a soup? It's a stew, obviously. The judge has dispensed a decade of justice. He's the one person wise enough to answer the really important questions. Like, should you hire a mime to perform at your own funeral. judge john hodgeman podcast every Wednesday on maximum fun dot org you're back on the line with sitting in the bazao so what you're you're not the bazao it is not a an off question because as you pointed out the surgeon general

is uh... a member of the military. I mean, they are an officer, right? It is a uniform service that they are in charge of. One of the seven uniform services in the United States, I believe. Space Force and the others. I think of it. Are're eight now. Just space force seven is space force included. The okay. Well, on their army, Navy, Marines, Air Force, National Guard, Space Force. There's this force, the US Public Health Service, which has the, which we're going to get into, but which has the Commission core under it. And there's another one. You know what? you keep going. I want to figure this out. You figure this out. We're forgetting something. Anyway, so what the sort of turn towards more of a like military operation comes from really, I think, the first person appointed to be supervising

surgeon, and then what we would later call surgeon general and run the marine hospital service which was someone named dr. John Maynard Woodward. He had served as a military surgeon in the civil war. And so I think because that was his background and that was just the way that he kind of saw this that this should run. He took, he took a very military fashion in the way that he like assumed the office and created what would come for it from it.

He created, he really is credited with creating the commission core, which would not only in his mind, like let's take all the people who work in these hospitals. And initially it was doctors, but then as you'll see, this grows to include other healthcare professionals. Let's start with all these doctors who work in these hospitals. Let's put them in this uniform service. And now there, like this is a greater calling, right?

We can demand a higher degree of uniformity from them because that's kind of the whole thing with a branch of service. We can hold them to certain standards. We can standardize their training, and we can also give them this kind of greater purpose that they're serving. They're taking care of an aspect of American life and commerce and society that needs to be guarded closely in order for us to survive.

By the way, the NLA, the National Oceanic and the atmosphere administration, the weather core. Why didn't know that? That's the other one. Thank you. Well, you know what can you do? Anyway, so he did that, but he also, he said, you know what, this is great that they serve sailors,

but I actually think that the creation of this core of healthcare professionals could be used to respond to other public health crises, not just to care for our sailors, but to do things like enforced quarantines. That was actually, as we move forward, that would become a big part of their initial job would be there were so many infectious disease outbreaks all over the country in our early history and like to kind of enforce quarant's different places and go where there are public health crises to serve the public health interests of the nation is how this new branch of service was utilized.

And so that he was the one who kind of transformed it from here, the doctors that take care of sailors to here is a whole core of healthcare professionals who can be used to promote and protect the public health, right? Right. The name would expand from that because of these changes to the public health and marine hospital service in recognition of all this. And then from there, it would be called the US Public Health Service with a surgeon general at its head eventually, which is what we still call it today, the US public health service.

I have a treat. I have a brief treat that I just found in my Wikipedia and I was trying to find that. If you put your headphones on real quick, I have just a brief diversion into the public health service march, if you'd like to hear that. Oh. Oh, yes, it's kind of a special song. I think that's nice. Lovely. I'm going to write some parody words to that probably at some point.

So anyway, so the name would expand to that and then FDR is actually so it stays the US public health service under the head of the surgeon general would stay With the Treasury Department all the way up until FDR and he was the one who was like Look, we've got all these different people involved in public health and some of them are here over under the Treasury And are being appointed by the Treasury Secretary. Like none of this is making sense. We need to sort of reorganize. And so there was a lot of restructuring reorganizing of the government under FDR with the new

deal anyway. It was initially moved to the Department of Health and Human Wellfare, what was moved somewhere else and then to the Department of Health and Human Wellfare and then eventually to the Department of Health and Human Services where it exists today. The Surgeon General would change from a position, like I said, initially appointed by the Treasury Secretary to a position that was appointed by the President and approved by Congress, same as it is today. While who the Surgeon General reports directly to has changed a ton throughout different

presidential administrations and different government gets restructured a lot. I didn't realize this like these. That's why it works so well. I mean, they're like not like the major three branches like that stays pretty much the same, but like a lot of these other pieces get restructured. Yeah, it seems like we closed a lot of them for a little bit, just like didn't do them for a bit and now we're kind of doing Oh, yeah

There was that one guy who wanted to close a bunch of departments, but then he couldn't name any of them. Who was that? Who we're in for president? I don't know. That's what happens when you lose. Yeah, that's what happens when you lose swept into the animals The pride of the dust band. It was named Rick. Most of them are named Rick No offense to any Rick's listening. We have to have good Rick's also. Anyway, it's all right. How we fair it up the bad Rick. Currently, unless it changes again, the Surgeon General reports to the Assistant Secretary

for Health, who is like the chief advisor to the Secretary of Health and Human Services. Does that make sense? It's to where they fit into all of this. And like I said, this role evolved as the department did. And so they are now the vice admiral of the U.S. Public Health Service Commission Corps. And they oversee the U.S. Public Health Service Commission Corps as a result, which is about 6,000 uniformed officers working in all different parts throughout the federal government

and they protect, promote, and advance the health of our nation. And they're not just doctors anymore, of course. That changed over time. Initially, the idea was like they would just be doctors, but now it's people in all different areas of healthcare professionals can be part of the commission core. What their role started to evolve into,

in addition to being in charge of this, being this vice admiral, is also to sort of inform and educate the general public about health issues, right? That slowly became part of their job. That wasn't initially the goal, but over time, they thought, well, this is, I think it's when they started probably using like the nation's top, what do they say, top doctor or whatever. When they started using that sort of phrasing, which isn't like an official title, it's just what they would call it. It also gave this sort of air of like, this is the person who you can all, this is all of your family doctors, right? This is all of your primary care for the,, this is the person who you can all, this is all of your family doctors, right?

This is all of your primary care for the, and this is the person you can listen to about everything and trust what they're saying. And their health messaging is the health messaging of the United States of America. Does that make sense? Yeah. So they kind of became that person. I think much more so than like, if you think in recent years, you don't necessarily see like the secretary of health and human services as the number one person who's coming out and telling you

about stuff as much as you see the search in general being the one who's coming out and telling you about stuff, which is part of like core to that role is that they are a healthcare professional, usually a doctor, not always a doctor, but usually a doctor. So you trust that they know something about. I would argue that, I mean, this may just be a recency bias, but I would argue that even the role as sort of the public face of health in America has been greatly reduced. Like you, it just is not as much of a,

it's compared to when I was a kid, like just not as much of a public face as they used to be. You know, I think what's interesting is we, of course, have done an episode on Dr. Joyce Lynn Elders, who is a hero, as a hero champion. Easy to say, my favorite surgeon general, gone. Gone from the position, let go, demanded her resignation much too soon.

And it's very shameful. But I would say the most famous that people know, because I mean, like if you had to name a surgeon general, other than Joyce Lennelter, could you? Well, yes, because we had this conversation while I was in Chile. Well, and you proved my point because who did you name? See, I've got a coupe. That is really the only surgeon general that a lot of, I've asked this question to a lot of people. And most people can only name that surgeon general that a lot of I've asked this question to a lot of people and most people can only name that surgeon general. A lot of people don't know who the surgeon general is now who and I mean again that's kind of a kind of a tricky question because right now we have an acting surgeon general who is Susan or Sega who she is the third nurse to actually serve in

this position and she is the acting SG until the official nomination from the Biden administration is approved by Congress. So Dr. Vivek Murphy is who has been nominated. Seems like an oversight. He was also the Surgeon General under Obama. So I bet he has also the Surgeon General under Obama. So I bet he has more experience. Being Surgeon General? Well, that's cheating. Well, and then you really want somebody who has experience in public health as well. Yeah, but this is a health show for the public. Well, but I don't have a master's in public health. And I'm not saying that it is not that that is a qualification, but experience in public health is.

If you did not grow up in the 80s, you probably don't remember Sea of Rikkupe. Sea of Rikkupe was this impossibly craggie looking man who just had this very distinct just a beard. You know that was the just a beard, no mustache, mustache, if I just had the beard. No, for that. Yeah, look like a cra, like a caricature of a craggy,

which is appropriate for what we're talking about. I guess a caricature of a craggy old sea captain, and he would just get on TV and be like, listen, smoking is so bad. And he looks so old and possibly old and mean. You're like, okay, I won't smoke because see a recoup will catch you. What, do you remember the other distinctive thing about him?

Other than the just a beard, there was one other fashion choice that became very, he was known for. You don't have a pipe, did he? It's bow tie. Bow tie. No, he would not have had a pipe. That would be wild.

Why is that? He's a white antidecloak. He's a white antidecloak. Sydney and the dunce still coming on the air, still going strong. He, and you know, it's interesting because like what I would love, because I do a podcast, is from a narrative perspective, I would love it if Sea Ever Coop represented a transition to a more like popular figure for the surgeon general. And I don't necessarily think that's stuck because I was looking through the surgeon general's

surgeon general and while I might recognize some of the names here and there they really he was the only one that really sort of permeated the common public knowledge to that extent I feel like. But anyway, he was Dr. Charles Everett Cooper, C. Everett Cooper, Chick, I guess was the name a lot of people would call him, not me, because I don't know him that well. He was Reagan's surgeon general. And he was, did you know, he was a very controversial figure, like smoking, I think is the thing that most of us remember him for. We're all on the word that. Yes, I'm, and I support that entirely. I'm also anti-smoking, please don't smoke. But he was a pediatric surgeon of much renowned, performed like one of the first successful separation

of conjoined twins. I am very well-known pediatric surgeon, very famous. But what made him so controversial is that when he was chosen, he was also known to be a very devout, even gelical Christian and a figure in the anti-choice movement. Strong advocate against abortion. And so when he was appointed and approved, there were a lot of people in on the left who were very concerned about what this could mean where now we have this person in the position as the nation's top doctor so to speak and they get to

sort of tell us what they think about this. And it's interesting I was reading into it prior to his appointment he had made a helped make a film series with someone named Francis Schaeffer, who if you study, or if you're part of, if you study the evangelical movement, you know this name, who's a huge figure in the early evangelical movement, and had helped make this film series called Whatever Happened to the Human Race, which talked a lot about, like, kind of tied abortion and infanticide and euthanasia all together. And when you hear sort of these, like, echoes of the culture of death and things, this is where that came from. This is part, not the only part, but this is a part of that.

So you can see why a lot of people who were pro-choice were very concerned about C. Evercoup. But what was interesting is that he was, as far as I can tell, he was very much about the science. I will speak out about the science because that is my role. I have my private beliefs, and he was, I mean, I think very privately, he was very anti-abortion. But he would not publish reports that lied about, there was apparently a lot of pressure on him to come out with statements about how physically dangerous the procedure was to people who were pregnant and that we should ban the procedures

because they're so dangerous. And he said, well, that's not true. And so he wouldn't say it. And then he was pressured to come out with a report about how psychologically damaging it was. And he refused to do that because he didn't have the evidence to back up those claims.

So he was very much about the evidence and separated that from like what his private beliefs on the issue were, which I think it sounds like may have been a big disappointment to Reagan and the other conservatives who appointed him and kind of hoped like he'll do this for us and then we don't have to mess with it and he never really fulfilled that for them. He said later that when the HIV epidemic

you know started and became something that people began to be aware of he was prohibited from speaking out about it for quite a while by the administration and He was prohibited from speaking out about it for quite a while by the administration. And eventually he would issue a report, he was allowed to issue a report about it. And what was notable about it is how explicitly he talked about how it can be transmitted specific sexual behaviors that put you at risk and how you could prevent that transmission by using things like condoms. He advocated for sex ed, he advocated for safe sex education,

things that again, a lot of the people that he worked with would really have preferred he not say out loud. And he did advocate for those things. He actually used to have really long talks with Fauci about it. Because the two of them, I mean, if you think about it,

at the same time period, Fauci was over at the NIH, and the two of them, I mean, if you think about it, at the same time period, you know, Fauci was over at the NIH. And the two of them would have big long talks about how do we get the messaging out there. And he was very clear in saying like, we can't, this is about helping people with a disease, not about demonizing them or othering them. It's really interesting to read more about how like,

based on his background, you would have assumed he would take different positions on these issues than he did. Things used to work. I mean, things used to be able to trust that people in certain positions in government would still have some sort of integrity, right? That would not bow to political pressure. And I'm not here to like, I'm not going to throw a big C-Abrak who parade. It sounds like there's some pretty dark stuff in there. But like, at least in the, in, they took the job seriously, right? And when they're in that position, like they're taking it seriously and they're treating it with some modicum of respect. And that, I feel like

that's, I've sound like an old man, but I feel like it's really diminished. And I think it's fair to say that his, his railing against big tobacco, well, against smoking, which then, you know, harmed Big Tobacco was probably not a popular position. Effective though. I mean, I feel like he legit got the ball rolling. There was that that was the first person I can remember as someone who's born in an identity.

The first person I can remember telling me like, I mean, the science of my parents, but like one of the first really strong like this guy will come get me if I smoke. He, he, he really, it's an interesting figure. I was aware of Cievercoup, of course, the thing I knew most about him was the smoking stuff. I didn't know all this other, all these other things that he was involved in. And it's, it's interesting to read about

because he is, it's a, he's like a mixed bag. Cause I think when you start to think about the Reagan administration and everybody who was associated with it and their response to the HIV epidemic, I mean, it was abysmal. It was terrible. They did nothing. They stayed silent and a lot of people died. And there is no way to redeem that because it's irredeemable. But it does sound like eventually he was part of, along with, as we talked about with Dr. Anthony Fauci, he was part of the voices that eventually later,

later they called for, I mean, who had his own change of art, which we covered like. But called for something to be done, again, not a justification, because it was too late for so many people, but eventually was part of that voice. But it's interesting to look at Sea Everett Cooper's like,

that is a position that could wield so much power with the American public if it is used appropriately. And I don't know if that will happen, but I'm not necessarily saying. Consider it. I don't want politicians to be the ones making public health decisions because they did not go to school to do it. I want professionals who went to school to make these big decisions to be the ones making it. And certainly that could be the surgeon general, but they are also a political figure.

They are appointed by a president and approved by a Congress. They are not elected by us. You see Vivek Murphy is the one who's being able to talk about that. But I don't even know that even if they were elected by us, they shouldn't, that shouldn't be enough anyway, because who knows what we'll do, we're wild, we're the American public. But it needs to be somebody with their credentials to know what they're doing before they speak out. And so you always hope that's the surge in general,

but you can't guarantee that. So it's tough, you know, it could be a really helpful, powerful figure in making good health choices and encouraging people to make good public health decisions, or it couldn't, kind of interesting to see how that position has evolved on how, if Murphy could do. If Murphy gets confirmed,

will you do another episode about, we have it, Marthy, just to get his whole story. Just game. Yeah, I mean, do you think I, sure? That was the throw to the people. Hey, people. I don't know much about Dr. Murthy. I mean, I know he was under Obama,

also the certain general, but I don't know much about Dr. Murthy. I mean, I know he was under Obama, also the Surgeon General, but I really don't know that other than Sea Ever at Coop and because we did the episode, Joyce Lennelner's, I don't know much about the Surgeon General throughout history. I found myself googling like interesting Surgeon General

or a Surgeon General who did like famous famous who was famous or was weird or funny or anything like give me something is really hard. I think I don't know. I'm sure there are books about each of these people somewhere, but as far as like one big collection of like here's what you need to know about everybody who ever held this position. I don't know. It's also especially like once, just looking at like pictures and imagery and stuff, especially once you get to like HW Bush, like the, it's pretty diverse. Eventually it does give very diverse.

It's a very diverse, especially in like this kind of leadership position in the United States government. It's a pretty diverse list of people. I will say, despite that, I think it is worth noting, because you probably, in what I've said, if you listen to the episode on Dr. Joyce Lennelder's, you have already come to this conclusion, Dr. C. Evercoup advocated for safe sex and sex ad

in very much the same way that Dr. Joyce Lennelder's did. And I think it is notable that Clinton demanded Dr. Elders did. And I think it is notable that Clinton demanded L. Alders, Dr. Alders resignation and Reagan never demanded Dr. Coops resignation. I think that that is definitely worth noting. Just going to note it. I don't think of many differences between the two of them, but. Which is why Dr. Joyce L. Alders will forever be my favorite surgeon general and a personal hero. And I have a painting of her hanging on the wall in my office now.

Thanks so much for listening to our podcast. We want to remind you we got a paperback book out. It's called The Saul Buns Book, Illustrations by Sydney Scydling Taylor and words by us new content that deals with the pandemic and stuff. It's good and you can buy it in stores. My brother's not gonna show you a book about how to podcast, call everybody has podcasts except you. Got it chatted by Sydney and it's very good.

It's a good chapter, probably the best one in the whole book. Thanks. Let's see, what else is going on? We've got more merchandise in the store. If you want check out Got a MacroRummerch.com and that's going to do it for this week. Oh, thanks to the taxpayers for these, so there's some medicines as the intro and outro program and thanks to you for listening. That's going to do it for us this week on Saw Bones.

Be sure to join us again next time. Until then, my name is Justin McAroy. I'm Sydney McAroy. And as always, don't drill up in your head. Maximumfun.org Comedy and Culture Artist-Oant? Audience-supported

Hey, it's Jesse. What you're about to hear is real. Hey, this is Chris. Hi, Chris. It's Jesse calling for Maximum Fun. Hey, Jesse. I heard that you got into a car accident. Yeah, we'll put into thought podcasting yourself and I just laughed so hard that I slammed into a car accident. Yeah, we'll put it in the stop podcasting yourself and I just left so hard that I slammed into a construction bear.

You remember what it was? That was so funny? I will never forget. I'm sure. They started talking about Vegas and the, you know, that happens here, it stays here, and that slogan and Graham was talking about, oh, you you know wasn't there some other slogan for another commercial I was like a commercial for food and it said like whatever's in there stays in there I can't remember what it was clams or something

Clown? Just so ridiculous and man I got light, I was laughing so hard. Next thing I know, they are just really only funny. So I talked to Dave and Graham from Stop Podcasting Yourself. We would like to pay your car repair bill, is that okay? That would be super nice, Jesse. I really, thank you, I appreciate that. Thank you, I appreciate that.