The Arrow #228

Hello everyone.

This version of The Arrow is going to be a little different. I got a bit carried away with all that’s going on at HHS right now. I’m more concerned about this than just about anything else going on, because I believe RFK is the best chance we’ve had in a hundred years to really get something done about the pitiful state of American health. I don’t want anything to happen that might screw it up. Those readers from outside the US should be concerned as well since the US exports its bad health everywhere else.

I probably won’t get this carried away again, so indulge me in this one.

Well, I got savaged in the polls from last week’s Arrow because it was shorter than usual as a consequence of my cold. Maybe this will help some of you empathize better.

I can usually tolerate colds pretty well. This one, however, was accompanied with a little nausea, which dogged me throughout. And I don’t do nausea well. MD is the nausea queen in this family. She can endure nausea forever without breaking a sweat. Not me. I can do the runny nose, sneezing, watery eyes much better than she, but she totally shames me in the nausea sweepstakes. Fortunately, nausea is a rare symptom for me, but for whatever reason, it decided to strike last week.

The Casey/Calley Means Drama

There is so much going on right now in HHS with the appointment of Casey Means, M.D. as surgeon general that this subject could take up this entire edition of The Arrow. I have been reading about it extensively from a variety of sources, but have no behind the scenes knowledge myself. What I'll cobble together is drawn from what I know about the medical profession, the book business, and the contributions of others who may or may not have insider’s knowledge. Any way you look at it, it’s a fascinating situation.

Here is a synopsis of the situation as it exists in its simplest form.

Weeks ago Donald Trump nominated Dr. Janette Nesheiwat to be Surgeon General. No one much heard anything about her what with all the chaos surrounding the goings on of the Trump administration. When wars are about to break out everywhere, tariff battles are ongoing the world over, and judges are undoing presidential executive orders right and left, the confirmation of a person no one has ever heard of as Surgeon General kind of get lost in the shuffle.

Then, a week ago, out of the blue, the news comes out that Trump has thrown Dr. Nesheiwat over for Casey Means, M.D. without so much as a by your leave.

I knew of Dr. Casey Means, but I didn’t know anything about Dr. Jannete Nesheiwat, so I decided to dig in and find out what I could. It didn’t take me long to find out why Trump dropped his first choice. Online researchers had scoped her out pretty well and discovered she had misrepresented her medical training and her board certifications.

On her CV, Dr. Nesheiwat listed her medical school as the University of Arkansas for Medical Science (UAMS), which is my (and MD’s) alma mater. She did her family practice residency there, but she actually went to medical school in the American University of the Caribbean (AUC) School of Medicine in St. Maarten in the Caribbean. Apparently, she listed UAMS as her medical school, not the AUC.

Back in the 60s and 70s when medical school was practically impossible to get into for most folks, a few private medical schools opened up in the Caribbean and Mexico. The number of US medical schools were fixed, the number of doctors matriculated was fixed, and the number of doctors needed was vast. The hope was that students from these private medical schools could come to the US for residencies and end up helping with the doctor shortage.

I remember the University of Arkansas had a program whereby if you had completed your medical training at one of these schools, you could come to Arkansas and do one year of training and receive an MD degree from the University of Arkansas. This is what I thought Dr. Nesheiwat had done, but apparently not. She got her MD at the Caribbean school, then listed it as from UAMS.

Then there is the issue of her not being board certified in Emergency Medicine, as she claimed to be. Plus a couple of other indiscretions left her as fair game for removal. Which she was. And Dr. Casey Means nominated in her place.

Dr. Casey Means has the polar opposite credentials as compared to Dr. Nesheiwat.

Dr. Means was a standout student from the get go. But the funny thing is, now that she has been nominated for Surgeon General as part of the MAHA team, it’s difficult to find anything in the press on her academic achievements. The legacy media in this country is unbelievable in its hatred for anything in the least Trumpian. I’ll give you another incredible example of the New York Times canceling of Dr. Means. It’s right out of Orwell’s 1984.

Curiouser and Curiouser

If you want to see how weird this particular nomination is becoming, start out with this video from Glenn Greenwald.

I browbeat MD to transcribe the whole thing, but it’s really worth watching for a number of reasons. I’ll hit a few of the highlights with MD’s transcription.

Here is what Glenn says about Dr. Means right at the start.

I find this story so interesting because it does seem like some palace intrigue, some inter-factional drama, but I actually think it’s a lot more than that.

Casey Means is somebody who went to medical school; she went to Stanford, one of the best medical schools in the country. She apparently did well in medical school, but when she went into her residency, she apparently dropped out before becoming licensed to practice law [sic – he meant medicine]--the residency’s a requirement-- because she said she was very disillusioned with conventional science and medicine. She didn’t think the way doctors were learning, were treating patients was adequate, and so she took a different path where she recommends a sort of world view that’s based on metabolic activity and believes that certain negative mental states can cause things like cancer and the like.

I don’t want to represent all of her views, but she’s somebody who to a lot of people, especially RFK, Jr., has become a sort of icon or symbol of another way, a better way to think about health. And she’s got a lot of support. She tied herself very closely, along with her brother, Calley Means, both of them have become public spokespeople for RFK’s MAHA movement. They appear on podcasts; they’re both very articulate and well-spoken, and I was surprised actually that neither of them had been nominated for anything up until this point because I assumed both of them are going to be. I mean they are very closely aligned with RFK, Jr; they’ve become among his leading spokespeople on podcast and cable.

And yesterday Trump chose Casey Means – the one who went to medical school but didn’t finish her residency – as surgeon general.

Okay, let’s take a second to discuss the hierarchy of medical education and training.

When a person graduates from medical school, he/she is awarded a doctorate in medicine degree, an M.D. Once you’ve got an M.D. degree, no one can take it away from you. Maybe if somehow someone went back and discovered you cheated all the way through or obtained the M.D. under some sort of false pretenses (which would be pretty difficult), it might be able to be jerked. But assuming you finished medical school, you’ve got an M.D. degree. It’s a running joke in medical school: What do you call the person who graduated last in your medical school class? Answer: Doctor.

But just having an M.D. behind your name doesn’t mean you are allowed to practice medicine. It generally takes at least another year of post medical school training to be able to be fully licensed to practice medicine and three, four, five years beyond the internship to be able to practice some specialties.

Laws vary on this from state to state, presumably on how badly doctors are needed. In Arkansas, I was practicing before I even had an M.D. degree. I had finished all the courses, passed the National Boards and FLEX exams, and was qualified to graduate, but just hadn’t graduated—ie walked in my cap and gown—yet. My course work was finished in March and graduation wasn’t until June. So I began working in local emergency rooms. And let me tell you, it is a scary feeling to go into your first emergency room all alone with no one to turn to for help, and start taking care of everything that comes through the door from gunshot wounds to embedded fish hooks (this is Arkansas were talking about).

I think the powers that be kind of turn a blind eye to this kind of thing as long as the doc involved is going into a residency, which I was. Had I just gone out and started practicing with just an M.D. and no post graduate training, I’m pretty sure they would have shut me down.

I had a good friend who decided upon graduation from medical school that he did not want to be a doctor. He took off and pursued a few other careers until he met a girl and fell in love. Her father was an ENT doc, and he enticed my friend into going into practice with him. He mentored my friend and helped him learn the ENT business, but ultimately the state he was working in—I’m pretty sure it was Colorado—came calling. They said you can’t be in practice without at least one year of post grad training—an internship. It didn’t matter that he had been trained by a board certified ENT doc, he had to go do an internship. Instead, he ended up in a family practice residency.

Glen says in the transcript above that Dr. Means dropped out before becoming licensed to practice. That’s not how it works. Once you’ve got your MD and are signed into a residency program, you are licensed to practice.

You may be in a residency program where you are in training for a particular specialty, but you are still licensed to practice in whatever state(s) you’re licensed in. So, Dr. Means dropping out of her residency had no effect on her medical license.

She was in a five-year Otolaryngology (Ear, Nose, and Throat) residency, and, apparently she dropped out about half way through her fifth year. Which is really, really strange.

Residencies vary in length depending upon specialty. A neurosurgical residency is a lot longer than a family practice residency. In my day, ENT residencies were four years, now they are apparently five years.

When you make it through whatever residency program you’re in, you get the opportunity to become board certified in that specialty. You can’t become board certified in anything without a residency in that specialty.

Which is why it is so strange that Dr. Means dropped out halfway through her final year. I’ve known a number of people who became disenchanted with their chosen residency, but plodded along and finished it off, so they could become board certified. It’s really strange to get almost to the finish line, then simply give it all up. Especially since it would be almost impossible to jump back in after a year or two and finish up.

Residency are stacked. You’re a first year, second year, third year resident and so on until the final year, when you become the chief resident. There is always a train of people on track behind you. So if you drop out and try to come back a couple of years later, unless you just happen to find a place where a chief resident has bailed, as Dr. Means did, you’re out of luck. There just aren’t any spots available.

Which is why—even if they hate it—almost everyone finishes their residency when they get near the end. A lot of people jump ship in the first few years, but almost never when the end is in sight.

(Here is an article by a journalist a really respect on perhaps another reason Dr. Means quit early. I certainly don’t know the true story here, but this is another take.)

Another thing most people don’t understand about doctoring is that licensed doctors can do just about anything they’re man enough to do. For example, in my residency I happened to work with a doc who did a lot of kidney transplants. I could have conceivably gone to some small town in the middle of nowhere and done kidney transplants. I couldn’t have done them in Little Rock, because there were a lot of docs doing kidney transplants there. They would have complained to the medical board, which would have shut me down. But if I were somewhere where no one could do a kidney transplant in 500 miles, and I knew how to do one, I would be the go to kidney transplant doc. (Disclosure: I would have needed a little more training—I wasn’t close to being a kidney transplant doc. I’m just using this as an example.)

A lot of my classmates went through residency programs for all kinds of specialties. Others went through a one year internship, then went to a small town in Arkansas where the local docs took out gall bladders, appendices, and did all kinds of procedures they wouldn’t have been allowed to do in Little Rock.

Dr. Means could have gone out after she jumped ship and set herself up as an ENT doc somewhere. She just couldn’t have become board certified. Or she could have gone into practice as a GP, which is what she sort of did.

But there are some real oddities to this story than need delving into. When I first heard that she was to be nominated for Surgeon General I was delighted. Surgeon General is kind of symbolic position in which those who hold it issue reports and directives and try to change the course of the ship of national medicine. Since Dr. Means is all into diet, nutrition, exercise and avoidance of Big Pharma as much as possible, I was delighted.

Then I started reading more about it, and now I’m uncertain.

One thing that did bother me about her sudden emergence on the scene was her book deal. I know the book business. MD and I have had 14 books published by mainstream publishers, one of which (Protein Power) was on the NY Times bestseller list for 63 weeks. We have worked with multiple publishers and a few agents, so we know our way around the book biz.

When Protein Power came out, it sold okay, but it didn’t set the world on fire. It kind of languished as a hard cover book, but when the paperback came out, it finally got on the NY Times list. We had been doing a bunch of PR, which finally moved the needle.

And, as I’ll still say, it was/is a good book.

When Casey Means came out with her book Good Energy it went immediately to #1 on the NY Times list and stayed there for about 24-25 weeks. That just doesn’t happen. Sure, if you’re Tom Cruise and you write a tell all and can get on all the talk shows, your book will pop onto the list in the first week.

But what if you’re an unknown doc who bailed out of a residency in Oregon and wrote a totally pedestrian book. How can you jump on the NYTimes list the first week? It’s impossible. Eric Topol, who is a well known academic cardiologist who never met a statin or blood pressure drug he didn’t like, just wrote the same kind of book, and he hasn’t bounced to #1 on the list. A few days ago, the Wall Street Journal published an article on him and his book. He makes almost the same points that Casey Means made in Good Energy, but until she was nominated for Surgeon General, Eric Topol had vastly greater name recognition. And her book came out long before she was nominated for Surgeon General.

Now I don’t know how to write this without coming off sounding like a shit, but I’ll just say it. I read Good Energy from cover to cover and didn’t learn a single thing I didn’t already know. In fact, I might have lost some brain cells in the process. I read all the time, and I learn something from almost every book I read. Good Energy quoted a lot of stuff I’ve read from other books, but mainly it was like the WSJ article linked above. Get plenty of sleep. Eat enough protein. Get sunshine.

The question I have is how did this book rocket to the top of the NY Times bestseller list on day one? If it was a fabulous book that everyone had been waiting for, I could see it. Not for this one, though.

The NY Times has a (supposedly) tightly guarded algorithm designed to reflect the book purchases of Americans. It incorporates specific bookstores located throughout the country plus bulk sales of places such as Costco and a few other sources. People are always wanting to game the NY Times list because it is the list to be on. It isn’t the one reflecting the most books sold—that one is the USA Today list. The NY Times list is the list for the sophisticated reader. If you get on the NY Times list, then you’re books are moved to the front of the store and discounted at Barnes & Nobles and most other book stores. And your book sales balloon. Which is why when you get on the list, you usually stay for a while because being on the list keeps your sales up and that keeps you on the list.

Book houses would kill to get a book on the NY Times list. Big book houses have plenty of money and spend a lot of it promoting their big time authors, who don’t always make it onto the list.

Good Energy is a mediocre book written by an unknown author who dropped out of an ENT residency. How does a book like that jump onto the list the first week it is out?

I’m not the only one asking that question.

Naomi Wolf is wondering about the same thing.

Before I get to what Naomi says, since I’m badmouthing people right and left, let me go ahead and include her. I can then get it out of my system.

The most prestigious degree one can get from a university is a PhD. It is the ultimate degree. When I got my MD, I had to wait till the PhDs all got honored before I got to walk up and get my MD diploma. That’s just the way it is. An MD takes four years. A PhD can take ten years.

PhDs are entitled to be called doctor. They do indeed have a doctorate in whatever it is their PhD is in. But for the most part, those with PhDs don’t want to be called doctor. It’s kind of a reverse snobbery thing. It’s kind of like surgeons in the UK. They have doctorate degrees, but they want to be called Mr. In the early days of medicine, surgeons were thought of as not much more than butchers or technicians. The doctors who did all the thinking looked down their noses at surgeons. They still do to some extent.

So, the surgeons in the UK went reverse snobbery and insist on being called Mr. Which, of course, differentiates them as surgeons.

PhDs have more or less done the same. Especially the more difficult to obtain PhDs. They don’t want to be called doctor—they want to be called by their name. Or professor. It’s the ol’ reverse snobbery thing. They don’t want to have anyone think they might be a lowly physician who might go around sticking his/her finger up someone’s butt.

So, generally, those who have PhDs don’t demand to be called doctor nor do they introduce themselves as doctor.

The further from the medical sciences one gets with a PhD, the less likely the holder of such a degree insists on being called Doctor.

Which is where my gripe with Naomi Wolf comes in. She has a PhD in literature and goes around calling herself Dr. Wolf. Which is accurate, but it grates on me. Especially since she is involved in selling supplements and other health products. It lends an aura of science to something she has absolutely no training in.

Okay, go ahead and call me an anti-feminist, a traditionalist, a whatever you want. I just wanted to vent my spleen on this one. And I didn’t even mention Dr. Jill Biden. AAARRRGGGHHH.

Anyway, Dr. Wolf is extremely suspicious of Dr. Means’ instant bestsellerdom with Good Energy.

…I am puzzled, that she somehow managed to get her book, co-authored with her brother, published by a major publisher, Penguin, and given a massive PR push, though neither sibling ever wrote a book before (unheard-of).

Unheard of indeed. Naomi Wolf has more experience in the publishing business than do I, and she feels the same way. How did this book jump immediately to the NY Times list? Either the NY Times was in on it, which I seriously doubt, or the authors (it was written by both Casey Means and her brother Calley) and their agents (not literary agents, but agents involved in any kind of a gaming of the NY Times algorithm) succeeded in gaming the system.

She (and her brother) did go on the Joe Rogan podcast (which can certainly move sales) but not until October of 2024, when the book had been out 5 months. And it went to #1 in its first week of publication.

Naomi Wolf looked deeply into the finances of Levels, the health company started by Casey Means that uses continuous glucose monitor to moderate the diets of those signed up as members. If Wolf’s financial assessment of Levels is accurate—and I suspect it is, or she would be opening herself to a huge lawsuit—there would be plenty of money to fund a huge book buy all over the country at the same time to game the Times list.

I’m not saying this was done, only that there would be plenty of money to do it.

You can read Naomi Wolf’s take on the situation here, which I highly recommend. Especially given her fear of the Tech Bros, who now seem to dominate the Trump administration.

I will excerpt the part about the funding of Levels, but I would encourage you to read the whole thing. I am not an expert in VC funding, but I have tried in the past to get VC funding and came away empty handed. I had a half dozen meetings with VC folks in the Bay Area several years ago, and all came to naught. So, in my world, at least, VC funding isn’t an easy thing to obtain.

Here’s is what Naomi Wolf said about the Means siblings run at VC funding.

Casey Means’ main credentials are that she is an entrepreneur in the health space, with a highly valued startup, and that she wrote, with her brother, a bestselling book, Good Energy.

Let us start with her tech startup, Levels.com. I will argue that her business is an empty storefront, a misleadingly-packaged void into which value has been pumped artificially by some of the most entrenched, corrupt interests in Silicon Valley.

Levels.com, which Casey Means cofounded in 2019, is a company that tracks your glucose levels via a “filament” continuously inserted under the skin in your arm. Shortly after she cofounded it, Casey Means gave an interview announcing “$12M of seed funding from Andreessen Horowitz and angel investors including Marc Randolph (co-founder and first CEO of Netflix), Dick Costolo (former CEO of Twitter), Michael Arrington (founder of TechCrunch), and Matt Dellavedova (NBA player on Cleveland Cavaliers).” These big names came in for a founder who had never founded a company before, let alone a tech company.

The funding journey for Levels.com continued to be stunning: The company raised $38 million in a Series A round in April 2022. A $10 million Series A extension was raised, including $3 million in crowdfunding. Another $7 million Series A extension was secured, following the initial $38 million Series A. Levels has successfully utilized crowdfunding to raise a portion of its funding, including $5 million from its original $38 million Series A round. So to date, Levels has raised more than $55 million.

Look at who came in as founders: “Josh Clemente (SpaceX, Hyperloop), Sam Corcos (CarDash, YC), David Flinner (Google), and Andrew Conner (Google) founded Levels to solve the metabolic health crisis.”

So Casey Means’ cofounders are….Twitter and SpaceX and Google.

If a business was launched that told people, “You can stick a tiny needle in your arm and have it hooked up to the inside of your body continuously, and it will transmit your internal biometric data to your phone and thence to the Google, X and SpaceX guys for harvesting and tracking, including geolocation tracking, and then it goes up to the Cloud forever to be monetized in ways that you can’t control” — people would probably run.

But that — that — is the gold rush, the Mother Lode. They want to get inside your body.

They want that living biometric data.

So of course, Google and SpaceX and X and Andreessen Horowitz — the premier VC firm that has also heralded the mRNA vaccine and has funded startups that use AI to get lipid nanoparticles such as those in COVID vaccines around the body - came in, to boost this innocent, idealistic young surgeon’s “alternative health care” “there must be a better way” startup.

Andreessen Horowitz — this one: “WHEN are we going to have a COVID-19 vaccine, and how the heck are we going from (what’s been traditionally been up to) 12 years or so of vaccine development compressed into 12 months or so? What will and won’t be compromised here, and where do new technologies — like mRNA or messenger RNA vaccines — come in?” — came in, indeed, hard.

Casey Means’ company’s valuation shot up to $313 million.

There is plenty of money to fund the gaming of the NY Times list.

What I find interesting in this whole NY Times bestseller list situation is the lack of any info to speak of in the NY Times.

When I started out writing this piece, I thought I remembered that the book Good Energy shot to the top of the Times list, so I searched for it. I searched for Casey Means Good Energy and got no hits. I searched for Good Energy and got no hits. I searched for Casey Means and I got two hits, both of which were attack pieces on her.

Nothing about her bestsellerdom or bestselling book. It doesn’t even come up if you search the title. I thought maybe I had misremembered her book being the big bestseller it was; maybe I was all wrong about it. I certainly couldn’t get any confirmation from the Times.

So, I turned to my little AI buddy Perplexity to see if it could help. Here’s what came up.

As you can see, the book was definitely on the list. One thing I forgot to mention above that the book hit the Advice, How-To & Miscellaneous bestseller list, which is the bestseller list that is the most difficult to get on. Unlike the other fiction and non-fiction lists, which have ten spots, the Advice, How-To & Miscellaneous list only has four spaces. And the Advice, How-To & Miscellaneous list is the one which always contains the books that sell the most. Many more people buy advice books than buy fiction books (other than mega-bestseller fiction). The Advice, How-To & Miscellaneous is by far and away the most competitive list to get on, which makes it even more amazing that a so-so book by a no-name person could jump to the top of this list on week #1.

The fact that the NY Times now has nothing to find about the book and very little—other than hit pieces—on its author just shows you how biased that paper is. Once Dr. Means got nominated for a major MAGA/MAHA position, the Times was off of her like a dirty shirt. Which, of course, pushes me in her direction.

But weird as all the above is, it just basically scratches the surface.

The Arrow is a reader-supported guide to nutrition, medicine, books, critical thinking & culture. Both free and paid subscriptions are available. If you would like to support my work, the best way is by taking out a paid subscription.

Weird Science

I don’t know how many of you remember RFK’s fight to get his nomination for Secretary of HHS through the Finance Committee to get to a vote in the full Senate, which he was sure to win. The Senate Finance Committee is composed of 27 senators, 14 GOP and 13 Dems. Since RFK was a Democrat forever, you would think one of them would support him, but he knew they wouldn’t. Of the 14 in the GOP, all were basically for RFK except the GOP senator from Louisiana, Bill Cassidy. As most everyone who watched the hearings learned, Cassidy is funded in large measure by Big Pharma.

Since Big Pharma makes big money on issues Kennedy opposes—vaccines, primarily—there was a lot of worry that Cassidy might vote against Kennedy. If Kennedy didn’t get the vote, he wouldn’t get out of the committee and would not be voted on my the entire senate, which was sure to vote for him.

Cassidy extracted all kinds of promises from Kennedy, especially on vaccines, which are big, big money makers for Big Pharma. Cassidy, who should have been a little sharper than he was, extracted the promise from Kennedy that were he to subject vaccines to further testing, it was to be done using the most up-to-date science. I’m pretty sure Cassidy figured vaccines were already tested out the wazoo, so he was on safe ground extracting such a promise. I seriously doubt that Cassidy has a clue—despite being a physician—that the vast majority of vaccines on the childhood vaccine schedule have never been tested against a true placebo. Which, of course, Kennedy wants to do.

By agreeing to use the most up-to-date science should he test the vaccines, Kennedy got Cassidy’s vote. That and the fact that billionaire Kate Shanahan, who had been running as Kennedy’s VP when he was actually running for president, said she would fund primary campaigns against anyone who voted against Kennedy.

Once Kennedy got out of committee, the full senate voted him in as secretary of HHS.

But, it seems like Cassidy somehow was able to have more control over Kennedy while he was secretary than most knew about.

According to the video of Glenn Greenwald’s above, Cassidy had Kennedy on a short leash. The info comes from Kate Shanahan, his vice presidential running mate.

From MD’s transcription of Glenn Greenwald’s commentary:

she’s [Nicole Shanahan] saying that RFK, Jr. is not somebody who has the normal powers of a Health and Human Services Secretary; he doesn’t make his own decisions; he has to report to and is controlled by someone else who is not President Trump. And I think the obvious reference there is to Bill Cassidy, who is himself a physician, and was extremely skeptical of RFK, Jr’s nomination by Trump to be HHS Secretary. He was deeply offended by and stridently opposed to RFK, Jr’s questioning of or skepticism toward vaccines. He hates the anti-vax movement or anything that can be closely associated with it, which he thinks is RFK, Jr. And just other parts of … Bill Cassidy, even as a politician, is a very swampy, uni-party, establishment type of politician, very like Old School establishment GOP, not at all MAGA. And they needed his vote. If they had lost his vote, which they were very close to losing, then RFK Jr’s nomination would have failed.

And Bill Cassidy very openly said ‘if you want my vote you need to agree to a long list of limitations on what you can do, and you’ll be required to meet with me regularly and to include me in decision making, and if you don’t I’m going to call you before this committee and there will be repercussions.’ And in order to get his vote, RFK agreed to these constraints. And here is Bill Cassidy announcing his decision to vote for RFK, Jr, saying that he got huge, very extraordinary and unusual concessions from RFK about limitations on his power and the role that Bill Cassidy, particularly, would play in all HHS decision making.

“Mr. Kennedy and the Administration committed that he and I will have an unprecedentedly close collaborative working relationship if he is confirmed. We will meet or speak multiple times a month. This collaboration will allow us to work well together and therefore to be more effective. Mr. Kennedy has asked for my input into hiring decisions at HHS beyond Senate confirmed position, and he has also committed that he will work within current vaccine approval and safety monitoring systems and not establish parallel systems. If confirmed he will maintain the Centers for Disease Control and Prevention Advisory Committee on immunization practices and recommendations without changes. CDC will not remove statements on their websites pointing out that vaccines do not cause autism.

Mr. Kennedy and the Administration also committed that this administration will not use the subversive techniques used under the Biden administration like ‘sue and settle’ to change policies enacted by Congress without first going through Congress.

Mr. Kennedy and the Administration committed to a strong role for Congress aside from he and I meeting regularly he will come before the HELP committee on a quarterly basis if requested. He committed that the HELP committee chair, whether it is me or someone else may choose a representative for any board or commission formed to review vaccine safety. If he is confirmed, HHS will provide a 30-day notice to the HELP committee if the agency seeks to make changes to any of our federal vaccine safety monitoring programs and HELP committee will have the option to call a hearing for further review.

If Mr. Kennedy is confirmed, I will use my authority as Chairman of the Senate Committee with oversight of HHS to rebuff any attempt to remove the public’s access to life-saving vaccines without iron-clad, causational scientific evidence that can be accepted and defended before the mainstream scientific community and before Congress. These commitments and my expectation that we can have a great working relationship to make America healthy again is the basis of my support. He will be the Secretary, but I believe he will also be a partner in working for this end.”

Now, I find that extremely creepy and I don’t know if you noticed the graphic on the right side of the screen, which is also extremely creepy – I don’t know if this is a recognizable figure but it’s like some green person with nerdy glasses and like spiked black hair circling his face almost like he’s in the middle of a black sun hanging over a dystopian city that seems polluted or whatever. Anyway… since it was hovering on the screen for two minutes I thought I should note that too was creepy. That’s just the graphic of the Twitter user who found this video and actually did a very good job in summarizing in text form exactly what these bizarre constraints are on RFK.

Now Senator Cassidy himself said these constraints are unprecedented. And at the end he said ‘Yeah, RFK, Jr is going to be the HHS Secretary but he’s not really going to make decisions on his own. He’s going to make them in partnership with us, with me as the Chairman of this committee.

Now, as weird is this is, it gets even weirder.

Apparently, Nicole Shanahan is not a friend of the Means siblings.

According to what she told Glenn Greenwald, RFK was to not hire them for any position in the HHS, much less appoint Dr. Casey Means as Surgeon General.

From MD’s transcription:

And she said ‘Look, I’m going to support you, but I want your assurance that she sought and received from RFK, Jr. directly, that if he’s confirmed that neither of these siblings, not Casey Means nor Calley Means, would get any kind of appointment or work in HHS. She said instead people who were much more qualified would be.

And Calley Means is now a special employee to HHS, and I don’t know if Nicole Shanahan considers that to be a violation, but she certainly considers a violation of the promise that she got from RFK, Jr to have appointed Casey Means as Surgeon General. And this is what she went on to say,

“I don’t know if RFK very clearly lied to me about what is going on. I has been clear in recent conversations that he has been reporting to someone regularly who is controlling his decisions. And that person is not President Trump. With regard to the siblings, there is something very artificial and aggressive about them. Almost as though they were bred and raised as Manchurian assets.”

And the beat goes on.

A couple of days ago, I came across a Politico article claiming open war has begun between Calley Means and the Wellness Company, a supplement company involving Peter McCullough and others.

From Politico:

In a formal complaint to the Office of the Special Counsel and other agencies filed Saturday and obtained by POLITICO, Gillooly accuses Calley Means of abusing his position at HHS and violating the law prohibiting conflict of interest in government services by threatening to involve Kennedy and National Institutes of Health Director Jay Bhattacharya in the dispute.

“If one more thing happens, I’m going to go to Jay Bhattacharya and Bobby and tell him that you and your cadre of Peter McCullough and Kelly Victory are spreading lies and trying to fuck with him and hurt his administration,” Means said, naming two members of the company’s medical board, in a recording of a Saturday morning call between him and Gillooly obtained by POLITICO. (The transcript of the call is quoted in the complaint.)

During the call, Means accused The Wellness Company, a supplement vendor led by a medical board of vaccine opponents that is regularly promoted on conservative media, of leaking false information about his own company, Truemed, to Loomer. Truemed provides customers with doctors’ letters that allow them to use pre-tax dollars to purchase health and wellness products via their health insurance plans.

“I am going to sue the shit out of you and escalate this if it continues,” said Means, who is currently serving as a special government employee. In that role, Means is allowed to serve in a temporary capacity without having to step away from his personal business.

Can this get any weirder?

These people are all supposed to be on the same side, and now it’s turning into a circular firing squad.

I’m hoping RFK is as idealistic as I think he is, and he knows this will be his last true chance to bring about change in the American diet, the vaccine situation, and all the other causes he’s brought to the table. Maybe he did what he had to do to get in the position to do what he wants to do.

Like a former employer of mine used to always tell me, you’ve got to kiss a lot of ass before you can start kicking it.

I’m hopeful that RFK has done that. As long as Trump leaves him alone, which he is apparently doing, RFK is going to start kicking some ass.

Just yesterday, he was in a hearing and here is what he said about the new nutritional guidelines. You remember, no doubt, how these are put together. All kinds of “experts” put in their two cents worth over the course of multiple hearings. And, of course, all these experts have their own nests to guard. Their advice is then debated further and ultimately ends up in the nutritional guidelines that never seem to change much.

Watch the video at the bottom of the Tweet below.

I’ve blathered on about all this forever, because I find it so fascinating. My own opinion is that I think RFK will sacrifice whatever he has to sacrifice in terms of friendships or money to make his once in a lifetime opportunity make a difference. He has a max of two years, and I think he’s going for it all.

If he wants to have Dr. Casey Means appointed Surgeon General, it’s fine by me. I want to see studies on seed oils, on ultra-processed foods, and vaccines. If they are all on the same page, God bless them. Let’s do it.

I’ve just realized I’ve droned on about this forever, and I’m probably getting near my cutoff point as set by the platform. Let me try to squeeze one more bit in here before I get the axe.

The Validity of Dietary Studies

A few weeks ago David Ludwig sent me a paper he and colleagues had published on what it takes to do a legitimate study on diet along with a review of the paper. He suggested I write about it, which I intended to do, but other things got in the way.

Gary Taubes wrote the first part of a two part (or maybe three part) series on why data is thin in terms of good nutritional studies. And he lays out a more expansive explanation of Kevin Hall’s early retirement and what it means for the NIH. I suggest you give it a read.

I’ve championed Kevin Hall’s study on Ultra-Processed foods not because I thought it was a particularly good study, but because it did show those who ate UPF ended up consuming almost 500 kcal per day more than those who didn’t. There was also a Japanese study showing the same thing. Both of them were short, which, in my mind at least, made them pilot studies. You do pilot studies, which usually don’t have many subjects and don’t last a long time just to see if there may be an effect worth funding with a bigger study.

The case Dr. Ludwig and Gary make is that it takes a long time to do a decent dietary study. You can’t just do it over a week or two. It requires considerable time, especially if you are using subject as their own controls. You have to have wash out periods and you have to spend enough time on the different diets to actually adapt to them.

Let me give you an example. I don’t know how many of you have ever been on an ocean or a river cruise. MD loves to cruise—mainly because can see a lot of places without packing and unpacking every day—and I love to indulge her. So we’ve been on a number of cruises. A number of years ago, we even had several Protein Power cruises.

Anyway, when you go on a cruise you are absolutely inundated and overwhelmed with food from morning till midnight. There are the three solids, then throughout the day there is some deck somewhere serving something. And it’s all delicious.

Most cruises—at least the ones we’ve gone on—last a week. I suspect most people who go on cruises go face down in the food for the entire week. That is, after all, one of the delights for many people of cruising. I’m sure that if you counted the calories and macronutrients people ate on a one-week cruise, they would be sky high.

But what if the cruse were for eight weeks. Do you think folks would eat the same huge number of calories each week, or do you think they would slow down a bit after the first go at it?

My guess is that most people would load up the first week, or even the first few days, then gradually reduce their intake as the cruise went on and the foods weren’t so novel and enticing. As I discovered on my strict keto diet, I loved avocados until I reached the point that I almost couldn’t look at another one. You kind of get burned out irrespective of how good the food is.

Which is why short nutritional studies are hardly worth the paper they’re written on. A week on a diet doesn’t give you a lot of information. Eight weeks on a diet does. Six months even more. Which is why all these one, two, and three week nutritional studies are useless.

So my caveat to you all is that when you see a nutritional study making some outlandish claim, the first thing you should do is check to see how long it is. If it’s a week or two or even three, it probably doesn’t prove anything.

Odds and Ends

Newsletter Recommendations

Video of the Week

As I’ve mentioned numerous times, I grew up in the Missouri Ozarks. My dad got a job in St. Louis, where we lived practically on the banks of the Mississippi river. He then got transferred to Michigan (big culture shock) for a few years, then to Southern California (even bigger culture shock).

Until we made the move to California, I was terribly girl shy. I didn’t really date. I wanted to spend all my time out in the woods camping, hunting, or fishing. I had zero social life. When we moved, I was between my sophomore and junior years in high school. And I was hugely worried about going to a new school in California.

Just before we left Michigan I had fallen madly in love with my first ever girlfriend, who was a girl who lived a couple of houses down from us. I fell in love with her about two weeks before we moved. In order to keep this flame going, I, for the first time ever, started listening to pop songs on the radio. Ours was not a musical family, so we had no instruments in the house, nor did the fam ever listen to music on the radio.

When my folks bought their house in Southern California (the first home they owned—they had always rented), they bought an entertainment center to go against the wall in the living room. It was a Danish modern, sleek piece of furniture that housed a radio and a turntable. It came with a demo album.

I was totally unfamiliar with any of the songs on the demo album, except for the one by Elvis Presley. There were about eight cuts on the album, so I decided one day to play them as I lay on the floor next to the speaker.

There were three pieces out of the eight or so that I absolutely fell in love with. Now remember, I was a kid who had no real music exposure prior to this, so I came to it from a totally virginal perspective.

One of the tunes was by Elvis, of whom I was of course aware, but he was pretty much fading in those days. I can’t now remember the particular song.

The next was the Blue Danube waltz by Johann Strauss II, which I went absolutely nuts over. I thought it was the most beautiful thing I had ever heard. It started me on my pursuit of classical music.

The last cut that really affect me was a country song. It was Hank Williams (the original Hank Williams, not Hank Jr.) singing Lovesick Blues. I listened to that one over and over and over. This was right when the Beatles were kicking off, but hadn’t hit the Ed Sullivan show yet. When I started school, everyone was Beatles crazed. But I was listening to Hank Williams, which got me started listening to country music radio stations and, thanks to the Blue Danube, I was listening to classical as well.

There were no Elvis stations. As I said, at that time, he was passé and hadn’t had his resurgence, so I bought Elvis albums.

I’m sure most of you have heard Elvis and the Blue Danube, but I don’t know how many have heard Hank singing the Lovesick Blues. So that’s your VOTW this week. Hank came on the scene when he was 23, wrote song after song after song. Was a country pop crossover singer and died at 29, from basically living too hard. But what a country voice.

Time for the poll, so you can grade my performance this week.

How did I do on this week's Arrow?

Login or Subscribe to participate in polls.

That’s about it for this week. Keep in good cheer, and I’ll be back next Thursday.

Please help me out by clicking the Like button, assuming, of course, that you like it.

This newsletter is for informational and educational purposes only. It is not, nor is it intended to be, a substitute for professional medical advice, diagnosis, or treatment and should never be relied upon for specific medical advice.

Thanks for reading all the way to the end. Really, thanks. If you got something out of it, please consider becoming a paid subscriber if you aren’t yet. I would really appreciate it.

Finally, don’t forget to take a look at what our kind sponsors have to offer. Dry Farm WinesHLTH CodePrecision Health Reports, and Jaquish Biomedical.

And don’t forget my newest affiliate sponsor Lumen. Highly recommended to determine whether you’re burning fat or burning carbs.

Reply

or to participate.