For the previous yr, america has gone with out its physician. Ever since Vivek Murthy resigned as surgeon common final January, the position has remained empty regardless of President Trump’s makes an attempt to fill it. He first nominated the doctor Janette Nesheiwat however withdrew her nomination in Might after stories that she accomplished her M.D. not in Arkansas, as she had claimed, however in St. Maarten. In her place, Trump nominated Casey Means, whose background is odd, to say the least.
Means is a Stanford Drugs graduate who dropped out of her surgical residency and has since made a profession infusing religious beliefs into her wellness firm, social-media accounts, and best-selling e-book. The precise nature of her spirituality is difficult to parse: Means adopts an anti-institutionalist, salad-bar method. She may share Kabbalah or Buddhist teachings, or quote Rumi or the film Moana. She has written about talking to bushes and taking part in full-moon ceremonies, each of which drew ridicule by the conservative activist and unofficial Trump adviser Laura Loomer. Her perception in “the divine female” (which she doesn’t fairly clarify) appears to have led her to surrender hormonal birth-control capsules for halting the “cyclical life-giving nature of ladies.”
Though months have handed since her nomination, Means has nonetheless not appeared earlier than Congress—partially as a result of she went into labor together with her first baby hours earlier than her affirmation listening to was scheduled to start. (Means didn’t reply to questions for this story. A spokesperson for Invoice Cassidy, who chairs the related Senate committee, informed me that “the listening to shall be rescheduled sooner or later when Dr. Means is prepared” however didn’t provide a extra detailed timeline.) America’ yr with no surgeon common raises questions on how crucial the position actually is. However the surgeon common nonetheless serves as the federal government’s main spokesperson on public well being, and if Means is ultimately confirmed, her theology will turn into moderately consequential as a result of it’s deeply tied to her beliefs about well being. In 2024, she declared in a Senate roundtable on continual illness that “what we’re coping with right here is a lot greater than a bodily well being disaster. This can be a religious disaster.” A part of her answer to each of those crises is to reject consultants and establishments in favor of one thing way more alluring: instinct.
Means wrote in 2024 that she grew up within the Catholic religion, however left the Church in faculty. She grew fascinated by lectures on the Self-Realization Fellowship Lake Shrine, a religious heart in Pacific Palisades, California. SRF, the spiritual group behind it, was based in 1920 by Paramahansa Yogananda, the “father of yoga within the West,” whose picture graced the album cowl of Sgt. Pepper’s Lonely Hearts Membership Band. It accepts the teachings of Jesus and different religious masters and divinities, however nothing is seemingly as vital as one’s private relationship with God. Yogananda’s e-book, The Second Coming of Christ, posits that the Second Coming just isn’t essentially literal, however as a substitute entails an awakening of the divine consciousness in ourselves.
SRF’s affect is clear in Means’s recommendation that individuals observe their “coronary heart intelligence” and “divine instinct” and keep away from “blindly ‘trusting the science.’” In a publication sponsored by a probiotic-supplement firm, she wrote that “making use of the scientific methodology to well being and illness has immense utility for serving to us perceive the pure world and stay wholesome, longer lives, nevertheless it feels more and more like there’s a marketing campaign being enacted in opposition to our divine items of instinct and coronary heart intelligence.” In one other publication, she wrote in regards to the position of divine instinct in deciding whether or not to drink uncooked milk: She needs to be free to look a neighborhood farmer within the eye, “pet his cow, after which resolve if I really feel secure to drink the milk from his farm.” (One may very nicely have a stunning expertise with a farmer, Kevin Klatt, a registered dietitian and analysis scientist at UC Berkeley, informed me, “nevertheless it isn’t going to vary the truth that uncooked milk may provide you with listeria.”)
In the identical publication championing bovine contact, Means laments a religious disaster of connection to nature. She ceaselessly portrays nature as a power with humanity’s greatest pursuits at coronary heart, almost synonymous with God. In her e-book, she means that continual stress and trauma will be handled by, amongst different issues, spending time in nature and thru “plant medication”—particularly, psilocybin-assisted remedy. (Means has additionally written that psychedelics helped her be “one with the moon.”) In that sponsored publication, she warned of a prophecy she says was put forth by the Indigenous Kogi individuals of Colombia, during which humanity has solely till 2026 to show we need to proper the wrongs we now have foisted upon the Earth, or we’ll all die. “I exploit the Kogi prophecy metaphorically,” she wrote. “However I do really feel we’re on a street to catastrophe. I believe we must always take these messages severely.” Pure disasters, she implied, are a “communication from God.”
Nature worship is likely to be particularly interesting at a time when belief in consultants is declining and expertise has turn into ever extra inscrutable and overwhelming, Alan Levinovitz, a professor of faith at James Madison College and the creator of Pure: How Religion in Nature’s Goodness Results in Dangerous Fads, Unjust Legal guidelines, and Flawed Science, informed me. Means’s attraction to nature and instinct, he mentioned, is empowering as a result of it places experience again into on a regular basis Individuals’ arms.
The anomaly of Means’s religious views strengthens her attraction—they are often interpreted to suit a big selection of perception methods. Her 2024 New York Occasions greatest vendor, Good Power, makes use of phrases comparable to power and life power, together with scientific-sounding descriptions of metabolic processes, to insinuate that the vibes are off within the American eating regimen and life-style. (Means wrote Good Power together with her brother, Calley, who’s now a detailed adviser to Robert F. Kennedy Jr., the secretary of Well being and Human Companies.) In her publication, she encourages her readers to “keep away from conventionally grown meals in any respect prices,” and warns that purchasing nonorganic meals is a vote to “diminish the life power on this planet” whereas using artificial pesticides “is giving a poor sign to God (Supply!) that we would like this miracle to proceed.” (Supply insinuates a godlike or omnipotent entity.) “She’s drawing on a number of totally different concepts very freely and with out a lot rigor in ways in which really feel good,” Joseph Baker, a sociologist specializing in faith at East Tennessee State College, informed me. “That form of permits her to look like a visionary with out having to specify something.”
Emily Hilliard, a press secretary for the Division of Well being and Human Companies, wrote in an e mail that spiritual and religious beliefs shouldn’t be held in opposition to anybody who seeks a authorities job, and that Means’s “credentials, analysis background, and expertise in public life give her the suitable insights to be the surgeon common who helps make certain America by no means once more turns into the sickest nation on earth.” The surgeon common has little energy to implement coverage, however can name on Congress to place warnings on merchandise like those seen on cigarette packets, launch pointers and stories, and lend assist to varied initiatives. Means’s perception system—which Baker characterised as a “sacralization of the person”—means that she is going to use that platform to ask Individuals to grasp their very own well being. In Good Power, Means writes of continual circumstances comparable to melancholy, anxiousness, infertility, insomnia, coronary heart illness, erectile dysfunction, and most cancers, “The power to forestall and reverse these circumstances—and really feel unbelievable right this moment—is underneath your management and easier than you assume.”
That assertion is one in every of many during which Means echoes parts of manifestation: the idea that pondering good ideas and placing in effort begets good issues, which Means says is actual. She advocates “tapping into the abundance that could be a sheer legislation of our universe” and calling on a better energy—“When was the final time you merely sat quietly and requested God/spirit/ancestors/nature to assist present you the best way and information you to your highest goal?” she wrote in her publication—but additionally placing within the exhausting, exhausting work.
Means goes past instinct and coronary heart intelligence to supply concrete options for labor (and spending) that shall be divinely rewarded—basically, a reimagined prosperity gospel. The character of that work is detailed within the penultimate part of Good Power. Means recommends consuming minimally processed and largely natural meals, and taking common chilly plunges or showers. (In her publication, she additionally advises Individuals to develop nearly all of their meals; as a substitute of pets, they may “increase chickens and goats and have plentiful eggs and milk.”) She contains checklists upon checklists of habits and assessments that “allow Good Power” (and recommends getting a complete lab panel from Operate Well being, of which she was an investor). She suggests shopping for a glucose monitor by her personal firm, Ranges, and in addition recommends varied personal-care apps, water filters, and trackers for sleep, meals, and exercise. A few of these gadgets are bought by the wellness firm True Drugs, which helps prospects use their well being financial savings account for a variety of purchases, and during which Means has invested; her brother co-founded it. In keeping with monetary disclosures made public in September, Means has additionally obtained greater than $275,000 from complement corporations. (Means has pledged to divest from True Drugs and different wellness pursuits if she is confirmed.)
Apart from doubtlessly boosting her personal backside line, Means’s embrace of individualism in well being is wholly unrealistic. Individuals work longer hours than individuals in lots of different developed nations, and lots of don’t have sufficient time to cook dinner dinner, not to mention increase goats. A lot of an important vitamin victories over the previous century, such because the fortification of meals and the elimination of trans fat, had been communal and systemic, Klatt, the dietitian and UC Berkeley researcher, informed me—the kind of science-backed, population-level interventions that Means hasn’t demonstrated a lot curiosity in. A special potential surgeon common may suggest repeated visits with a dietitian and struggle for insurance coverage to cowl them, as a substitute of “advocating for this type of woo-woo stuff that has no information behind it,” Klatt mentioned. Means, although, “just isn’t a person who appears to be wedded to the scientific course of,” Timothy Caulfield, a professor and the analysis director on the Well being Regulation Institute on the College of Alberta, informed me. “That is somebody who appears to drag issues out of skinny air after which search for sciencey-sounding rhetoric” to assist them.
Maybe Means’s eventual affirmation listening to will make clear what, precisely, she intends to do because the face of American public well being. However even she will not be certain. “The way forward for medication shall be about mild,” Means wrote to her publication subscribers final yr, earlier than admitting, “I don’t precisely know the way but.”