Two different surgeon generals.

I'm so mad, I'm writing this with a broken wrist.

The pandemic of white mediocrity is roaring, especially in the US. The current regime comprise some of the most under qualified, incompetent, and malicious individuals, the same regime obstreperously complaining how DEI is ruining "meritocracy".

Casey Means is nomination hearing for surgeon general just happened. She is perhaps the single most undeserving surgeon general nominee, displaying none of the qualities needed to be the head of the US Public Health Commissioned Corp. To summarize:

• She did not finish residency training (which in many doctor's view means you're not a real doctor). She, as far as I can tell, barely practiced medicine after that unless you count "holistic medicine start-up" medicine.
• After dropping out of residency training, she hard pivoted to big wellness, starting a biotech company that focused on metabolic health and diet coaching. Her main occupation is now being an entrepreneur and wellness influencer, which is the farthest thing from good public health.
• She is a vaccine skeptic, and part of the weird alt-right camp of "birth control is bad for women". On various podcast appearances, she has entertained (if not endorsed) numerous unfounded and questionable health conspiracy theories.
• She is part of the MAHA movement, a movement rooted in pseudoscience and big wellness.

She is so unqualified it makes Brett Kavanaugh and Amy Coney Barrett's nominations for SCOTUS look legitimate. The vaccine skepticism alone should have disqualified her form doing anything public health related. But no. This is the timeline we're trapped in.

A few weeks ago, the main channel Everything is Public Health published an episode on Dr. Joycelyn Elders, the first black surgeon general in US history, the second woman surgeon general in US history, and the first black women surgeon general in US history. She is also, unfortunately, the shortest serving surgeon general who is not an interim. Due to her progressive views on substance abuse and sex ed, the Clinton administration forced her to resign shortly after her tenure started. Despite her excellence and qualification (seriously, look up a list of her accomplishments prior to her nomination and after), she faced mounting opposition because of the color of her skin. The republicans tried to block her nomination, interrogated her for almost a year before finally confirming her as surgeon general, and harassed her to no end.

I'm angry because we live in a world where white mediocrity is promoted over black excellence. Two surgeon general nominees, a chasm in quality but somehow being considered for the same thing. People of color, women, and other marginalized communities have to be so much better than average just to be considered, while droves of mediocre white people can fail upwards. Yes, I'm aware this is not a fair comparison because the two events are decades apart. However, people of color facing unwarranted oppositions despite their accomplishments is an evergreen phenomena in this country. We seldom see this the other way around. Means has no business in any public health leadership position, let alone the surgeon general, but she's up for confirmation. This is not just Means, but almost everyone in the current regime right now. RFK Jr., Oz, Makary, Bhattacharya, all of them have no business being anywhere near public health. None of their confirmation hearings are as fraught and hostile as Dr. Elder's. They fended off a few lukewarm questions from establishment democrats and were allowed to wreck havoc in our public health systems. Means will likely do the same. Despite having all the red flags, RFK Jr. and his cronies are given "the benefit of the doubt". Just look at all the mainstream media coverage of these confirmation hearings and the democrats who voted with the republicans. They have the sentiment of "wow isn't he a little bit weird", instead of the more accurate message of "he is dangerously incompetent and will irredeemably cripple public health in this country." The establishment media's coverage of Means is repeating the same messaging. There is no meritocracy. What we have is something closer to "mediocracy".

To be clear, I am also a mediocre person. There is nothing wrong with being average. Statistically speaking, most people are unremarkable, and I am definitely one of them. The difference is I DON'T HOLD ANY POSITIONS OF POWER. I don't have a book deal, I don't make money from doing speaking engagements, I don't run a dietary supplement company, I have never been interviewed, etc. This is a solo operation passion project that I make because I want to. In fact, if for some absurd reason I'm given a leadership position I don't deserve, I would reject said offer because the thought of messing things up for other people because I wasn't qualified enough would weigh on my conscience.

Some of your may be thinking, "she's not mediocre, she went to Stanford!" Everything is relative. If the conversation was about a middle manager position at an insurance company, sure she's not mediocre. We're talking about the surgeon general of the United States. If this is the framing we are considering, and the pool of people we are picking from are physicians with public health experience, she is woefully inadequate. Means came from a relatively well-off and privileged family, went to Stanford for undergrad and then to Stanford Medical school. This is not an aspirational tale (unlike Dr. Elder's path to public health). In terms of people who have the means and funding to go to Stanford, her outcome is not exceptional. Dozens of people graduate from Standford Medical School every year, and thousands of people graduate from medical schools every year. Most of them, unlike Means, complete residency afterwards. In the world of doctors, she is not special. In addition, claiming someone is outstanding simply by the prestige of the institution they attended leaves a bad taste in my mouth. Secondly, as someone who knows a lot of doctors, I assure you just because someone has an MD does not make them a good person or a competent one. Morons and assholes become doctors every year. We have several in this regime right now. The list of white mediocrity is extensive.

On top of all this is the staggering hypocrisy. For years (decades even), the conservatives have whined and yapped about how there's no meritocracy anymore because of affirmative action, DEI initiatives, and increasing diversity. It's the whole reverse racism nonsense, which is not a serious concept. This is hypocritical on two levels. First, when they were complaining about this the people in these leadership positions and positions of power were still majority white. Second, and this is clear now, they never cared about merit. The people they want in these positions of influence are oftentimes not the most qualified candidate available to them. Nepotism and favoritism a plenty. At their core, loyalty is more important than qualifications. This is how we end up with Casey Means being considered for surgeon general.

Was this rant essay necessary? Did it even make sense? I don't know. It's 2026, we've suffered too much to not call these absurdities out.

More podcast related updates soon. Sorry for ranting.

MJ