The unorthodox nominee for Surgeon General, hand-picked by President Trump, recently advocated for the exploration of unvalidated psychedelic therapies in her latest publication, whilst a previous newsletter divulged that her ingestion of fungi facilitated the acquisition of a romantic liaison.

Dr. Casey Means' advocacy for exploring guided psilocybin-assisted therapy warrants circumspection, given the substance's proscription under federal statute as a Schedule 1 drug, characterized by its ostensible lack of accepted medicinal application and purported propensity for abuse, notwithstanding Oregon's and Colorado's legalization of psychedelic therapies, a legislative shift subsequently challenged by municipal ordinances in select Oregonian localities.

Entrusted with disseminating cutting-edge scientific findings to the American populace, the Surgeon General's remit encompasses the promotion of optimal health outcomes and the mitigation of morbidity and injury; historically, occupants of this office have leveraged their platform to spearhead public health initiatives addressing exigent issues ranging from the AIDS epidemic to suicide prevention, with the watershed 1964 Surgeon General's report on the deleterious effects of tobacco use exemplifying the office's capacity to effectuate a seismic shift in the nation's health trajectory.

While luminaries such as Dr. C. Everett Koop, the Reagan-era surgeon general, achieved widespread renown and exerted considerable influence on policy, others faded into the obloquy of forgotten figures.

Means's ascendancy exemplifies a discernible Trumpian penchant for prioritising prominent public figures over seasoned policy wonks, a predilection underscored in this instance by the President's avowed reliance on Health Secretary Robert F. Kennedy Jr.’s unqualified endorsement – Trump candidly admitting his own unfamiliarity with Means, stating, "Bobby thought she was fantastic."

Means, a Stanford alumna with degrees at both undergraduate and doctoral levels, embarked upon a residency in Oregon which she ultimately truncated, and her medical licensure is currently designated as non-practicing; when reached for comment, Means demurred, declining to provide any on-the-record statement.

Her 2024 treatise, "Good Energy," co-authored with her brother, Calley Means—an entrepreneur currently ensconced within the Trump administration as a health advisor, and publicly avowed investor in biopharmaceutical enterprises specializing in psychedelic compounds—contained her formal endorsement of psychedelic substances.

The book's central thesis revolves around metabolic well-being, or as Casey Means terms it, "optimal bioenergetics," advocating strategies to mitigate the panoply of stressors, traumas, and cognitive schemas that circumscribe human potential and underpin metabolic dysfunction and diminished vitality.

One potentially efficacious approach involves the exploration of psilocybin-assisted therapy, with "psilocybin" denoting the psychoactive indole alkaloid constituent of certain fungal species; her rationale is expounded upon in a 750-word disquisition.

"For those so impelled, I would further commend the exploration of intentional, clinically-supervised psilocybin therapy," she penned, adding, "Robust empirical data intimates that this form of psychedelic-assisted psychotherapy may constitute a profoundly transformative experience, even an apotheosis of sorts, for certain individuals, as it has proven for myself."

While preliminary research intimates potential therapeutic applications for psychedelics, a definitive risk-benefit analysis remains elusive; the administration of psilocybin, for instance, may precipitate protracted hallucinatory episodes, ranging from states of beatific transcendence to abject terror. Although investigated as an adjunct to psychotherapy in the treatment of recalcitrant psychiatric disorders and alcohol dependence, rigorous inquiry into its effects on the euthymic population is conspicuously scant. Furthermore, adverse reactions, encompassing tachycardia, emesis, and cephalalgia, are documented, and unsupervised ingestion poses substantial peril, given the propensity for hallucinogen-induced perceptual distortions to engender perilous behaviours, such as inadvertent exposure to vehicular traffic or other imprudent actions.

Means posited that the stigmatisation of psilocybin and kindred psychedelic compounds was unwarranted, extolling the potential of 3,4-methylenedioxymethamphetamine (MDMA), colloquially known as ecstasy or molly, in the therapeutic management of post-traumatic stress disorder (PTSD); notwithstanding, the Food and Drug Administration, subsequent to a panel of advisors' critique of methodological deficiencies and the identification of salient risk factors, declined to sanction MDMA-assisted therapy for PTSD in the preceding year.

Means, in her treatise, alludes to psychedelics as "plant medicine," chronicling her inaugural psilocybin experience circa the advent of 2021, impelled by what she characterizes as an intrinsic imperative – a hushed, internal directive to initiate preparatory measures.

"She elucidated her experience, stating, 'I perceived myself as an integral node within an unbounded, recursive fractal of maternal lineages, stretching back through aeons of primordial life,' further postulating that, in her subjective reality, 'psilocybin functions as a liminal portal, facilitating ingress into an alternative epistemological framework unconstrained by the hegemonic dictates of the ego, affective biases, and idiosyncratic historical contingencies.'"

In her October missive, Means avowed to leveraging psychedelics as a catalyst for affective receptivity in her mid-thirties, detailing carefully curated "plant medicine experiences with trusted guides" undertaken to cultivate a readiness for dyadic relating, appending the assertion with a symbolic mushroom emoji, whilst stipulating unequivocally that this disclosure should not be construed as an unqualified endorsement for analogous experimentation.

In her recent exegesis on desiderata for White House health policy, Means advocated for enhanced nutritional standards in scholastic alimentation, broached the implementation of cautionary labelling on ultra-processed comestibles, enjoined inquiries into the probity of vaccine protocols, and championed the eradication of conflicts of interest, omitting explicit reference to psychedelics but positing that the inherent lack of pecuniary enticement for research into "generic, natural, and non-patentable drugs and therapies" necessitates the allocation of a tranche of research budgets to unorthodox therapeutic modalities.

Means, a proponent of psychedelic therapeutics, has publicly avowed his transformative experience with psilocybin, characterizing it, in a 2021 dispatch, as singularly impactful across personal, professional, and spiritual domains during a period of acute adversity; furthermore, in 2022, he disclosed the liquidation of his entire 401k portfolio to acquire equity in two psychedelic-focused biotechnology ventures, and conspicuously remained unresponsive to requests for elucidation.

The procedural machinery grinds slowly concerning Casey Means' confirmation hearing, its scheduling remaining outstanding following the withdrawal of Janette Nesheiwat – a former Fox News medical contributor whose curriculum vitae engendered sufficient scrutiny to derail her initial nomination as Surgeon General by the Trump administration.