The erstwhile nominee for Surgeon General under the Trump administration, in a recent publication, posited the potential therapeutic applications of as-yet-unsubstantiated psychedelic compounds, whilst a newsletter penned by her suggested a correlation between personal mycological experimentation and the acquisition of a romantic liaison.

Dr. Casey Means's advocacy for exploring guided psilocybin-assisted therapy warrants careful consideration, especially given the incongruity of its Schedule 1 classification under federal law—a categorization reserved for substances deemed to possess no currently accepted medical utility and a pronounced propensity for abuse—and the nascent legalisation of psychedelic therapy in Oregon and Colorado, notwithstanding subsequent municipal reversals in the former.

Tasked with disseminating the most rigorously validated scientific findings to the American populace, the Surgeon General serves as a pivotal figure in fostering proactive healthcare strategies and mitigating the incidence of morbidity and traumatic sequelae; historically, occupants of this office have leveraged their platform to spearhead national dialogues concerning exigent public health crises, encompassing, inter alia, the AIDS epidemic and the imperative of suicide prophylaxis, whilst the watershed 1964 Surgeon General's advisory on the deleterious ramifications of tobacco consumption irrevocably recalibrated the trajectory of American public health consciousness.

While luminaries such as Dr. C. Everett Koop, Surgeon General during the Reagan administration, indelibly shaped policy and entered the public consciousness, others faded into the mists of historical obscurity.

Means's ascendancy exemplifies a discernible trend, inaugurated during the Trump administration, towards prioritising candidates celebrated for their public visibility over demonstrated expertise in substantive policy domains; in Means's particular instance, the Republican chief executive explicitly attributed his selection solely to the imprimatur of Health Secretary Robert F. Kennedy Jr., averring, "Bobby thought she was fantastic," while simultaneously conceding a complete lack of prior acquaintance.

Means, a Stanford alumna with both undergraduate and medical degrees, commenced a residency in Oregon but ultimately demurred from its completion, her medical license currently listed as inactive; attempts to solicit comment were met with a declination to speak on the record.

In her 2024 opus, "Good Energy," co-authored with her brother, Calley Means—an entrepreneur currently ensconced within the Trump administration as a health advisor and avowed investor in biopharmaceutical entities specializing in psychedelic compounds—she proffered a specific recommendation regarding the therapeutic applications of psychedelics.

The book principally grapples with the intricacies of metabolic health, what Casey Means provocatively terms "good energy," advancing a panoply of strategies aimed at enabling individuals to deftly manage and ultimately ameliorate the constellation of stressors, traumas, and ingrained cognitive schemata that insidiously circumscribe their potential and actively contribute to metabolic dysfunction and diminished vitality.

One potentially efficacious avenue for exploration lies in the consideration of psilocybin-assisted therapy, alluding to the psychoactive indole alkaloid constituent of psilocybin fungi, with her rationale elucidated at length in a 750-word exegesis.

"For those feeling a profound resonance, I would further commend an exploration of intentional, therapeutically mediated psilocybin administration," she articulated, adding, "The burgeoning corpus of scientific inquiry intimates that, for certain individuals, this form of psychedelic intervention may catalyse experiences of profound existential significance, mirroring my own personal trajectory."

Despite preliminary research hinting at potential therapeutic avenues for psychedelics, a conclusive demonstration of benefits outweighing inherent risks remains elusive; while psilocybin-induced hallucinatory states, lasting several hours, may be subjectively experienced as either euphoric or profoundly disturbing, its application in conjunction with psychotherapy for conditions such as recalcitrant psychiatric disorders and alcohol dependence has garnered investigational interest, albeit with a paucity of research focused on its impact within healthy populations, and given the documented incidence of adverse physiological sequelae, including tachycardia, emesis, and cephalgia, unsupervised consumption presents considerable hazards, whereby drug-induced perceptual distortions could precipitate perilous behaviours such as exposure to vehicular traffic or other imprudent actions.

Means posited that psilocybin, among other hallucinogens, has been subject to unwarranted stigmatisation, further extolling the putative benefits of MDMA (3,4-methylenedioxymethamphetamine), colloquially known as ecstasy or molly, in the amelioration of post-traumatic stress disorder (PTSD), notwithstanding the Food and Drug Administration's recent declination to approve its therapeutic application, citing methodological flaws and attendant risks elucidated by a panel of expert advisors.

Means, deploying the appellation "plant medicine" for psychedelics in her book, recounts her inaugural psilocybin experience circa New Year's Day, 2021, catalyzed by what she characterizes as an internal prompter whispering, "it's time to prepare."

"She articulated a sensation of integration within a ceaseless, fractal concatenation of maternal and infant dyads extending back to the genesis of biological existence, postulating that, experientially, 'psilocybin may constitute a liminal portal to an alternative ontological domain, liberated from the circumscribing tenets of egocentricity, affect, and idiosyncratic biographical narrative.'"

In her October missive, Means disclosed the adjunctive use of psychedelics in cultivating the requisite psychic milieu for romantic engagement at the age of thirty-five, specifying that she had undertaken "plant medicine experiences with trusted guides" to optimise her receptivity to partnership, an assertion underscored by a mushroom emoji, whilst precluding any inference of prescriptive endorsement for similar practices.

In a recent disquisition on her desiderata for White House health policy, Means advocated for enhanced nutritional standards in scholastic food programs, proposed mandatory warning labels on heavily processed comestibles, demanded rigorous inquiries into vaccine security, and expressed a desire to eliminate conflicts of interest; while eschewing explicit mention of psychedelics, she lamented the dearth of incentives for researchers to investigate "generic, natural, and non-patentable drugs and therapies," further stipulating that a proportion of research appropriations be allocated to unconventional modalities of healthcare.

Means, a proponent of psychedelic therapeutics, has disclosed his inaugural psilocybin experience during a period of personal adversity in a 2021 blog entry, characterizing it as "the single most meaningful experience of my life — personally, professionally, and spiritually"; furthermore, in 2022, he professed to having liquidated his entire 401k portfolio to acquire equity in two firms pioneering psychedelic research and development, while remaining unresponsive to requests for elucidation on this matter.

The scheduling of Casey Means' confirmation hearing remains outstanding, her nomination having been precipitated by the withdrawal of Janette Nesheiwat, a former Fox News medical commentator, whose initial selection by the Trump administration for the surgeon generalcy was undermined by scrutiny of her credentials.