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Maintenance Phase

Why Don't We Have a Surgeon General?

July 27, 2026

AI Summary

5 min read

Why Don't We Have a Surgeon General?

A year and a half into Donald Trump's second term, the United States still doesn't have a Surgeon General. The position—often called "America's top doctor"—leads over six thousand uniformed officers in the U.S. Public Health Service and translates scientific findings into public guidance. It's a role that requires a seasoned healthcare provider and a strong communicator. But the Trump administration has now nominated three different people for the job, and none of them have made it through.

The First Nominee: A Résumé Problem

In November 2024, Trump nominated Dr. Jeanette Neshwat. She was serving as medical director for CityMD, a chain of urgent care clinics in New York. Her sister Julia was a homeland security advisor under the first Trump administration, and her brother-in-law is Mike Waltz—the former congressman who accidentally added a journalist to a Signal chat about war plans. Another sister, Jacqueline, is a former pageant winner married to Scott Stapp, the lead singer of Creed.

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What you'll learn

  • 1 (00:44) **The Mystery: No Surgeon General After 18 Months** - Michael and Aubrey set up the central question: why, a year and a half into Trump's second term, is there no confirmed Surgeon General?
  • 2 (03:27) **Nominee #1: Janette Neshewat - The Resume Fraud** - Trump's first pick, a Fox News doctor, is nominated in November 2024 but withdrawn six months later.
  • 3 (11:07) **Why Neshewat Also Failed on the Right** - The MAHA faction, led by Laura Loomer, attacked her for being insufficiently anti-vaccine.
  • 4 (15:55) **Nominee #2: Casey Means - The Functional Medicine Grifter** - The second nominee is a Stanford-trained doctor who quit her surgical residency six months shy of completion.
  • 5 (28:21) **The Means Family: A Conservative Pedigree** - Casey's brother, Calley Means, is a key figure in the MAHA world and co-author of her book.
  • 6 (38:31) **Casey Means' Confirmation Hearing: A Grilling** - Casey Means' basic CV checks out (Stanford, OHSU residency), but her confirmation hearing in February 2026 is a disaster.
  • 7 (46:14) **The MAHA Coalition Fractures** - The fight over Means reveals the deep rift within the MAHA/Trump alliance.

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Show Notes

We’re nearly halfway through Trump's second term and we still don’t have a Surgeon General. What gives?

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