Part One: The Upcoming Surgeon General’s Controversy
Dr. Casey Means, the nominee for Surgeon General, has stirred discussion following the disclosure of her financial ties to the supplement industry.
Recent financial disclosures indicate that Dr. Means has earned substantial amounts promoting various health and wellness supplements, raising potential conflict of interest concerns regarding her qualifications for the position. Known for her close relationship with Health Secretary Robert F. Kennedy Jr. and familial ties to White House adviser Calley Means, she has yet to schedule her confirmation hearing with Congress. The Office of Government Ethics revealed in a filing dated September 10 that her nomination passed initial conflict-of-interest evaluations within the federal government.
The supplement industry has connections to various members of the previous Trump administration, including Medicaid director Mehmet Oz. An AP investigation earlier this year indicated that Dr. Means has repeatedly failed to disclose her affiliations with supplement companies featured in her newsletter and social media.
Casey Means is often described as an “entrepreneurial doctor,” a title that aligns with her track record. Previously, we reviewed her book Good Energy. While it contained valuable insights on metabolism, the narrative ultimately acted as a promotion for MAHA, a lifestyle that seems geared toward affluent individuals. Her journey took a turn when she left a five-year ENT residency after four years, feeling restrained in her ability to treat underlying conditions, a sentiment she attributes to having been inadequately educated about disease causes at Stanford.
Yet, given her trajectory, skepticism arises. After departing from conventional medicine, she established a functional medicine practice to treat patients holistically, primarily those who can afford lengthy consultations. Her company Levels is part of an initiative by Health and Human Services to distribute “wearables” to the general population. Understanding the need for continuous glucose monitoring for diabetics is crucial; however, routine yearly checkups with regular blood work suffice for most people. The reality remains that many lack the resources, health insurance, or access to personal healthcare providers for such checkups. Achieving the goal of making America truly healthy (MAAHA) would require addressing these fundamental issues.
Before proceeding, it’s essential to note that while Dr. Means holds an MD from Stanford and completed portions of a residency, she currently does not possess a valid medical license in many jurisdictions, which raises significant concerns about her ability to refer to herself as a doctor. This brings us to a critical question: How many Surgeon Generals have been nominated and confirmed without a valid medical license?
Part Two: Challenges in Gene Therapy
Sarepta Therapeutics has developed a gene therapy named Elevidys for Duchenne muscular dystrophy (DMD). DMD results from the absence of dystrophin, a protein crucial for the integrity of skeletal muscle cells during contractions. This condition ultimately leads to fatal muscle degeneration. Currently, gene therapy remains the only viable hope for DMD patients.
Elevidys delivers a micro-dystrophin via infusion to the target muscles. Earlier this year, two patients died following treatment, possibly due to complications from the viral vector, although other patients experienced no adverse reactions. Elevidys has faced controversy since its inception, with critics demanding clarity on how the therapy’s efficacy is measured:
This summer sparked intense discussions regarding the safety and effectiveness of Elevidys, with key researchers questioning how much gene is actually delivered through the treatment. Although Sarepta has taken muscle biopsies and measured microdystrophin levels since the initial trial in 2017, there remain concerns about the interpretation of these measurements.
Reports claim that approximately 35% of microdystrophin is produced by patients:
This indicates that muscle cells have about one-third the amount of this miniature protein compared to healthy individuals’ levels of the full-length protein. This figure played a significant role in the drug receiving accelerated approval in 2023 for young children with DMD.
However, researchers raised caution in a recent letter to Neurology, suggesting that the reported figure might be exaggerated. Technical issues could mislead families regarding the therapy’s true impact and could hamper future research efforts. “My biggest concern is that patients and their doctors may not have the necessary information to evaluate the risks and benefits of gene therapy for Duchenne,” stated Kathryn Wagner, a professor emeritus at Johns Hopkins University.
The meaning behind the “35%” figure remains vague. Nevertheless, whether this metric constitutes a valid clinical endpoint justifying the therapy reserves uncertainty. Such uncertainty is reminiscent of whether an “immune response” serves as a reliable indicator of a vaccine’s effectiveness. The past few years have taught us that this correlation isn’t always straightforward. Gene therapy, along with stem cell therapy, has the potential to cure many severe conditions, but advancements have been slow, often overshadowed by hype that began with the mapping of the human genome and the isolation of stem cells two decades ago. Should Elevidys ultimately fail, it would exemplify BioMedicine (a fusion of Big Medicine and Big Pharma) losing sight of its goals. Moreover, consider this:
Researchers are also questioning the measurement of micro-dystrophin and calling it part of a broader debate surrounding a therapy that has polarized the medical community over the years. While Elevidys has emerged as a beacon of hope against an unrelenting disease, it failed two randomized clinical trials, faced scrutiny from the FDA, and was temporarily withdrawn from the market after the deaths of two teens, only to return for young children amid public outcry.
While it may sound harsh, false hope is ultimately less beneficial than no hope at all. If Elevidys shows effectiveness in just a few patients, that’s acceptable as society can budget for its hefty $3 million price tag for a single treatment. However, it is essential that gene therapy providers openly acknowledge the risks of failure, ensuring that patients and their families understand the potential challenges ahead.
Part Three: Global Collaborative Success
The Ozone Hole Is Gradually Repairing Thanks to Global Cooperation. Indeed, the evidence is clear:
Forty years after global policymakers began addressing the crisis posed by a significant gap in the ozone layer over Antarctica, new reports from the World Meteorological Organization indicate that recovery is underway. In the 1980s, scientists recognized a substantial hole forming in the ozone layer every southern spring and linked this phenomenon to chemicals called chlorofluorocarbons (CFCs), known to deplete ozone levels. Nations united to form the Montreal Protocol on Substances That Deplete the Ozone Layer, adopted in 1987, to eradicate these harmful substances.
Billed by environmental expert Durwood Zaelke as the “best environmental agreement we’ve ever created,” the Montreal Protocol has garnered widespread global support, numerous successful amendments, and near-complete eradication of ozone-depleting chemicals. Zaelke emphasizes, “This agreement is monumental.”
Historical opposition came from the Merchants of Doubt, who actively campaigned against recognizing the ozone hole in the 1980s, despite clear scientific evidence that culminated in a Nobel Prize in Chemistry awarded in 1995. Although initial resistance occurred, public awareness and commitment led to significant progress. This success illustrates humanity’s capacity for cooperation against threats to our environment, urging us to continue striving for positive change beyond climate conferences like COP 1-29 and beyond.
Part Four: Reevaluating Daylight Saving Time
This topic presents a personal dilemma: late afternoons during summer offer ideal golfing conditions, with magical light and active birdsong—minus the distractions of music from nearby golf carts. Recent studies, however, propose a reevaluation of our approach to timekeeping. A former farmer and lab owner I knew grew frustrated with the clock shift in March, frequently complicating his business dealings. A recent study indicates that maintaining permanent standard time may reduce obesity and stroke risks:
A new study featured in Proceedings of the National Academy of Sciences USA advocates for maintaining standard time year-round, citing potential public health benefits.
“Our research indicates that permanent standard time could lead to lower obesity and stroke rates,” states Lara Weed, a bioengineering Ph.D. candidate at Stanford University. “We hope policymakers consider disease statistics in their evaluations regarding this shift.”
Past studies have linked time changes to various health-related setbacks, including an increase in heart attacks and car accidents, resulting in disruptions to sleep, productivity, and alertness. Prominent organizations like the American Medical Association and the American Academy of Sleep Medicine have voiced opposition to time shifts, advocating for the health benefits associated with consistent exposure to morning light, though long-term effects of constant time have not been well-studied.
Though the predicted outcomes might appear trivial, a mere 0.8% decrease in obesity could equate to 2.6 million individuals in the U.S. Alleviating such health issues would undoubtedly benefit large pharmaceutical companies.
Part Five: The Overlooked Political Landscape in America
Matt McManus’ assertion that socialism is as integral to America as apple pie is fascinating and aligns with Abraham Lincoln’s perspective:
In 1861, Lincoln declared that labor is “prior to and independent of capital. Capital is merely the offspring of labor, and could never have existed without labor preceding it. Labor supersedes capital and deserves greater regard.”
Such sentiments echo through history, with figures like Eugene V. Debs, Norman Thomas, and Michael Harrington celebrated the same ideals. A prime example exists in the governance of Milwaukee in the early 20th century:
Milwaukee, famously known as “Red Milwaukee,” flourished under socialist leadership for decades. Emil Seidel, elected in 1910, promoted “municipal socialism,” vowing to provide essential services alongside living wages and community amenities. His policies resonated with the public, and he successfully launched the first public works department, later succeeding in the 1912 election despite facing an opposition coalition.
Subsequent mayors, Daniel Hoan (1916-1940) and Frank Zeidler (1948-1960), continued Seidel’s legacy, reinforcing a “sewer socialist” philosophy focused on collaboration over competition. Their success stemmed from strong support for labor movements, expansive public works initiatives, and unwavering dedication to improving living standards, especially for marginalized groups.
The humorous critique of Mark Levin provides light amidst serious discussions:
The Right’s narrative of “cultural Marxism” (Where’s Jordan Peterson these days, anyway?) attempts to frame American socialism as a foreign contagion, as asserted by Fox News’s Mark Levin. Yet, American socialism has deep roots, reflected in the views of figures like Walt Whitman, Helen Keller, and Martin Luther King Jr., who addressed genuine grievances concerning oligarchy and human rights abuses.
As our society grapples with issues from social media to surveillance capitalism, the principle that society thrives when everyone participates in prosperity holds firm. It’s a straightforward concept: addressing systemic inequities leads to societal advancement. Contrary to popular belief, wealth for a few does not come at the expense of the many; equitable opportunities create a healthier, more balanced society. However, for genuine reform to happen, we must cease the endless cycle of conflict both domestically and abroad:
“Every gun made, every warship launched, every rocket fired signifies a theft from those who are hungry, cold, or in need. This world in arms is not merely a financial burden. It represents the labor and ingenuity of workers, the dreams of children, and it diverts essential resources from schools, hospitals, and infrastructure. In essence, under the shadow of war, humanity hangs from a cross of iron.”
~President Dwight Eisenhower, April 16, 1953
See you next week!
