The Present Illness

Flesh Eating Flies and Project 2025 "Efficiency" Destroys Science

• Alyssa Burgart & Arghavan Salles • Season 1 • Episode 36

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0:00 | 58:25

Flesh eating flies (disgusting!); Project 2025 budget cuts (despicable!); sterile flies; non-standard healing crystals from a crystal scientist; Hunter Biden is a natural poster


Note:

  • New data from ASCO regarding melanoma indicate those with Stage 3b to 4 melanoma had longer time to recurrence and longer time to metastasis
  • Alyssa accidentally called the screwworm fly as a “screw-tape.” Oops!


New World Screwworm Fly


Disaster OMB Budget Proposal


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Credits

  • Production by Arghavan Salles & Alyssa Burgart
  • Editing by Alyssa Burgart
  • Music by Joseph Uphoff
  • Social Media by Arghavan Salles

Don’t take medical advice from random people on a podcast. This show is for informational purposes, is meant to be fun, and is certainly not medical advice. Please, take your medical questions to a qualified professional. Nothing we say represents our employers or anyone else. 

SPEAKER_00

But this is the problem with the so-called America first policy actually supporting prevention programs in other places that is America first. That is how you protect how you protect cattle here, how you protect people here, how you protect this country, how you protect the world. That's why the phrase global health exists. Hey there, fellow nerds. Welcome to another episode of The Present Illness, the podcast where two physicians try to make sense of a world that is um really febrile on the verge of seizures and definitely underdiagnosed. I'm Arga Von Salis, a surgeon scientist in your friendly neighborhood dune scroller in residence.

SPEAKER_02

And I'm Alyssa Bergart, an anesthesiologist and bioethicist who tracks news and health law like their EKGs, full of spikes and surprises. The present illness is where we dig into public health, politics, culture, and ethics with a scalpel in one hand and a meme in the other. As a note to our listeners, we often talk about topics that can be tough and intense. Um take care while listening.

SPEAKER_00

Big thank you to everyone listening and some extra love to our subscribers and those who follow us on any of our um platforms. And a special warm welcome to anyone who just stumbled in from hearing about the death of Majon Satchapi.

SPEAKER_02

Yeah, it was really sad to hear. I um when you told me, I actually went and picked up my copy of Persepolis, which just I feel like was such an incredible work. I think it came out in 2000. It got made into a film in 2007. Um, and like just what a brilliant, brilliant woman.

SPEAKER_00

Just an incredible artist. And I don't know if people appreciate like how much that work in particular um meant to the Iranian community. So for folks who haven't watched the film or read the graphic novel, it's about her experience having left Iran at the age of, I think, nine or 10. Um, and she left in the 1980s. So she was there after the revolution. And so she recalls experiences of going to school and um the way the various aspects of the government interacted with the people at that time, and especially with girls, talking about, you know, hair coverings and all the things that people are familiar with, but her own personal experience of that, and then having left Iran at such a young age to go to Europe, and then being on her own, um, trying to make sense of the world, and it's both like a coming-of-age story, but also a lot about the culture of Iranians and what happened with the revolution in 1980, and it's just such a powerful work. Um, the animated film was nominated for an Oscar um the year that it came out, and um, she's been a really, really powerful voice um for Iranians and in particular Iranian women. She's been a huge advocate for human rights in Iran, um, has been really vocal, you know, about the woman life freedom movement and also all the massacres that we discussed back in January and all of that. So um I know that any Iranian people who saw that news today are are probably devastated. I mean, she was just so she and her work have been so impactful for us and and helping the rest of the world kind of understand a little bit more about what our experiences have been. Um and it's just a a really bright light that's lost.

SPEAKER_01

Yeah.

SPEAKER_02

Um, and I think for you know, so many people like myself were like I I knew Iranian people. I I went to school in Glendale for a little while. There's a big um Iranian population there. And um, but this uh this work and in particular the the graphic novel was just such an accessible way um into that world and to better understand, you know, kind of what had happened and um in such a humanizing way, because of course in the early 2000s it wasn't exactly a great time to be from the Middle East and be in the United States. And so I think that um, you know, the work served not only um I think it ended up serving a a lot of functions during that particular time and continues to obviously be super important. So it's really sad to hear about that. And I I hope though that um with her passing that there's a new generation of people who who learn about her work and um and then discover it themselves.

SPEAKER_00

Yeah, I hope so too. And I think um she, you know, for folks who don't know uh much about her, her husband passed away last year, and I think that loss was really hard for her. Um and you know, I don't know that there's an afterlife, but I hope that she has found some peace. Yeah, absolutely.

SPEAKER_02

Well, on a sunnier note, can I read you a nice thing that uh somebody wrote about us on the internet? Please, yes. So uh this is a listener shout out. This was a message that uh we received in our account on Instagram. Hello, I just wanted to say I really like your podcast with an exclamation point, and that's from Rochelle. It's from Rochelle on Instagram. Yeah. Um, I actually was out uh I was at an event at my kids' school yesterday, and someone that I did not know was a listener came up to me and they were like, I love the podcast. And I was like, please write us a review.

SPEAKER_00

I know that's what we need so that people can find us. It's so hard to uh get pushed out into the podcast algorithm. It's sure.

SPEAKER_02

Well, but also I think that if you love the podcast, we love you. And so we would love to hear what you have to say about the podcast and share it with others. Let us shout you out, send us these messages. We would we would love to receive them. So um anyway, thanks, Rochelle, for your delightful message. We appreciated it. Um Okay. I know we talk about a lot of tough things, okay, on this this podcast. We we do the we do the hot gossip, we give you the tough news, and we give it in a way that we hope is accessible, etc. Um, what I do want to just give an additional sort of heads up, for example, to those of you who are listening or watching. Um we're gonna get we're gonna get gross. Okay. It's gonna get real gross. Um so I woke up this morning, I thought, I'm gonna look at the news, which you know, it's generally not it's very bold. It was a bold move, but I made it. I I made, I thought, you know, we're gonna record. I should see what's happening in the news. And I will tell you, the top U.S. agriculture story today was about a little fly. A little fly. It's not the typical fly that you might see uh hanging around at your picnic or whatever. It's a um it's called a new world screw worm fly. Now that's it's as disgusting as it sounds. You're like somebody who named that was like, this is gonna be gross. And that is correct. Okay. So the reason that this fly is so important is that um, so most flies, almost all flies, they like dead things. So if you if there's like a dead animal in the woods or whatever, flies will be like, hey, that's a great meal for me and my family. Let's all go hang out there. And you know, maybe, maybe we'll lay some eggs in the meat, if you will.

unknown

Okay.

SPEAKER_02

Okay, carry on. I mean, yeah, it's it's it's gnarly. So this particular fly has an unusual feature, which is what makes it so, which is why it's the top agriculture um news piece today, is that it is a parasitic fly. And unlike those other flies, it actually relies on the living flesh of an animal to lay its eggs, and that's disgusting. Okay. And not only is it disgusting, it's very dangerous. And so this can be really problematic when these infestations happen, um, especially amongst, you know, it doesn't impact like food or whatever in terms of it's just like if an animal has a wound, it can they can lay eggs in this wound. And then that's how it ends up spreading to other animals. And it can spread to humans. So if you are a human with an open wound, this is something that can unfortunately happen to you. So the the life cycle of these little guys, um, they they lay eggs, they require, like I said, like the flesh of an animal. Each female, literally living flesh, which again, like I feel like this is it's like such a spooky topic. I feel like we could this could be, you know, this isn't timed right for a Halloween episode. But um, so they and the so the reason that this is a big deal. So this has been a problem. We we used to have these flies here in the United States until the 1960s. They were successfully eradicated through uh some, you know, strategies to to get rid of these flies. And it had mostly been pushed down to um South America, and which I guess is another place where they tend to live. And it's been moving north, and there was a big crisis at the southern border of Mexico almost a full year ago. So last July in 2025, um, a bunch of farmers and ranchers in Chiapas uh working with veterinarians and health officials had were trying to eradicate it. Well, unfortunately, the fly has continued to do what it's gonna do. We now have um the first recognized case in the United States in Texas, um, in an area just outside of Uvaldi. Um it was identified, I believe, in a town called La Prior. And so there is a quarantine now around that area. Um, but this is scary. There's a lot of ranching that happens in Texas, and so this is a real threat to um ranchers, ranchers' work and to these animals in this area, as well as to human beings in this area. So um again, so gross.

SPEAKER_00

Um I mean, the main threat it sounds like is to livestock.

SPEAKER_02

Yes, right? Yes. And because these any livestock that have, you know, it doesn't take a large wound for a small fly to be able to take advantage. And then once the eggs have been laying apparently in this area, each each female fly lays about a hundred eggs, and then all then you suddenly you have a hundred flies, and then those are gonna lay eggs. And you know, so the cycle can can happen pretty, pretty fast. And so this can get out of control very quickly without this work done. So um one of the main strategies that is typically used, and this is part of what was uh being used in Mexico, is to use it's it's called a sterile fly technique. And this is also something that's used, for example, with mosquitoes. And so you try to release a lot of um sterile uh flies, so sterile males in particular, because the males will go and uh try to fertilize the eggs of lots of these flies. And so by um creating sterile male flies, the eggs that are lain by the females are not able to reproduce. And so this is a way to um prevent the prevention of to prevent like the widespread um just mass increase in the number of flies in an area. Um, and so just to because we're leaning into the gross this week, uh, there is a image that I will share. I'll I'll share a link to uh some work that the Associated Press put out last year. And there is literally it's a 2024 photo from from Panama of literally an entire huge, like I don't know, it looks like a liter container that you could dump, and it's just they're just dumping out fly larvae onto a tray, and apparently they're all sterile. So there right now, my understanding is that there is uh one sterile fly facility. So there's these special facilities that that help make these flies. Um there's another one that's gonna be opened in the United States to try to really ramp up production of these uh sterile flies. Yeah. Now, what I saw this morning in the so the piece that I read this morning was in the Texas Tribune. And it's interesting because the, and I I'll be honest, I don't know enough about agriculture in Texas to understand what um the background of this gentleman's views. A representative from the USDA's National Veterinary Service Laboratories, um, Secretary Brooke Rollins, was the person who confirmed the case in Texas. Um, what's a little wild is that Rollins literally just the day before this out this uh case was confirmed, there was a lawmaker in Texas who said, Oh, there's a case right outside of Uvaldi. It's basically only a mile outside of Uvaldi. Now, is that exactly true? Not necessarily, but Rollins had said, like, oh, that's wrong. That's not what's happening. And so it's a little awkward now, one day later, to be like, just kidding. It's, you know, it's not that far from Uvaldi. Um but this is uh being the fact that this has made it into the US is being blamed on, you know, the this is the quote from Rollins. He said, uh, he blamed the spread of the screw tape towards the US-Mexico border on the quote, open border policies of the last administration and the resulting illicit cattle movement.

SPEAKER_01

Um sorry.

SPEAKER_00

So he's he blamed human human immigration, then bringing along with them uh uh uh I'm implicit in his suggestion there, the the humans then are bringing with them quote unquote illegal cattle, and then that's that that's the source, that's his justification of what's happened here.

SPEAKER_02

That was the that was the message that he had. Okay, yeah. Um and so it's interesting. So there was apparently another case in our um in Florida where there was a a horse that was being shipped from Argentina to Florida. I don't know, it must be a really fancy horse. And apparently that horse was identified to have this fly, but like during the regular inspection process that happens when animals are brought. Um so it's a little unclear to me why he's claiming that those things are not happening along the border. And um, anyway, I assume that we're all gonna learn a lot more about the cattle trade, I guess. Um, TBD. I mean, to be fair, we in the United States in Texas took measles and we gave that to a bunch of people in Mexico and we gave them an outbreak. So I just also think that we should probably not be so nationalistic about, I don't know, public health stuff where listen, the fly knows no borders. Okay.

SPEAKER_00

I mean, that's the thing, like, and this has come up now with the Ebola outbreak in Africa as well, as the US has been like, oh, people can't come back here, even if they're US citizens, they can't come back here, they have to go to Kenya, um, which is absurd. Um, but also people in other countries trying to close their borders, like as you said, public health does not respect political boundaries. And what's likely to happen when we close borders is that people just kind of find their way around. Um, it's not you don't stop people from traveling. You just now can't screen them um or provide support to them because they're doing it in a way that you're not aware is happening. Um, I did also just want to point out that um Doge, which is my favorite government agency.

SPEAKER_02

Can you and can you remind people what Doge stands for? Because they've probably repressed it by now.

SPEAKER_00

That would be fair. The Department of Government Efficiency run by uh Elon Musk um last year, if folks may recall. Uh, you know, he went on stage with a chainsaw because he's getting rid of so much stuff because he's gonna save so much money. Meanwhile, by the way, our our um deficit is now more than our GDP. So that worked really well. Um, anyway, Doge last year cut funding for a project dedicated to monitoring and containing the New World Screwworm in Central America. Yeah. Isn't that so cool? Um, and this is I'm just connected. You don't say. Yeah, shocking, I know. Um, but this is the problem with the so-called America First policy, in the which they aren't even doing America First, but the this idea that they've sold to voters that they're doing America first things is that actually supporting prevention programs in other places is America first. That is how you protect cattle here, how you protect people here, how you protect this country, how you protect the world. That's why the phrase global health exists. I mean, we are all related. Um, and that's why the WHO exists, and that's why the US has historically been such a um strong supporter of the World Health Organization. Um, it's not just because we're such an altruistic country here, just spending lots of money to support other people. It's because there is there are um specific benefits to the folks who live here in the United States to carry out these programs all over the world, many of those programs having been associated with USAID, which of course was um nearly completely destroyed by Elon Musk, resulting in at least hundreds of thousands of deaths. Anyway, all that to say, you know, there's this misconception that spending money elsewhere is only to help people elsewhere. And I just want to remind folks that we live in a capitalist society, nobody is doing anything just because it's the nice thing to do. I mean, I shouldn't say nobody, but governments are not doing things because it's the nice thing to do. They're doing it because of the benefit to themselves and to their people. And that's something that the folks in our current government seem not to understand. I mean, they're they're not particularly sophisticated as far as I can tell.

SPEAKER_02

Anyway, I mean, Argivon, I just think that uh this really highlights how the word efficiency has really been mangled, you know, because I think, I mean, I just hear me out, okay? I think it was pretty efficient for us to be like, you know, well, let's spend a little money, hardly anything compared to what we're spending on a dang war, I'll tell you that much. Um, like, what if we just were like, I don't know, let's try to keep things basically good here by being efficient with our investments. And it turns out that instead, if you just say, no, it's inefficient, stop spending all that money, only spend it on war, the outcomes are not great.

SPEAKER_00

Yeah, you mean um a war that no one wanted is not helping us? Turns out. Turns out I mean who could have predicted?

SPEAKER_02

Well, you know, and the other thing, I and again, I I do not know enough about uh cattle and the the transit of cattle across the US-Mexico border. And so this this person saying that that's why this happened, like I I remain open to the idea that that may be correct. Um but it also I suspect, because when I hear about what happened in Florida previously, where the case now granted, it's it's a little harder to move a horse from Argentina across an ocean. Um, but like if we had the systems in place to do inspections the way that we should, then this should be something that we can catch with an open border. It shouldn't actually, you know. I mean, having lived in Los Angeles and lived near The border. Like there's all sorts of inspections that happen. I've had my car inspected many times to make sure I'm not smuggling human beings or oranges or whatever. And, you know, it just seems like the idea that the open border itself is the fundamental problem here seems to very much simplify, simplify the explanation.

SPEAKER_00

Yeah. Well, and it and it allows for continued xenophobia and placing the blame of everything that's wrong in this country on immigrants.

SPEAKER_02

So for people in Texas who are like around the quarantine site, the advice that's being made is like for people to really inspect their animals, make sure that they're not seeing this particular fly to report anything that they may see in order to just take care and try to prevent harm to animals as well as having a massive outbreak. I did, for completeness sake, I I thought that I would let people know what the symptoms are as in a human in case you wanted to know. I hope that no humans meet up with this new world screw worm fly because it sounds gnarly. However, the CDC says symptoms can include feeling maggots, larvae, move or seeing maggots within the skin, wound, or sore or in the ears, nose, eyes, or mouth. Oh goodness, this sounds terrible. Painful skin wounds or sores that worsen within a few days. A foul smelling odor from the site of the infestation. Bleeding from open source. Bacteria can also infect wounds where the NWS magnets are present and may cause infection that can lead to symptoms like fever or chills. So folks, I mean, I don't think that you need a doctor to tell you this, but in case you do, if you notice larvae in a wound, please, and it, you know, you don't have to know what kind of larva it is. Please, I beg of you, go seek medical attention from a qualified professional because that is not okay.

SPEAKER_00

It's not okay. Well, I'm clarified that it's not normal or okay to have larvae in your wound.

SPEAKER_02

Thank you for telling our audience that. Just in case people needed permission, I just want you get that out of there.

SPEAKER_00

Yeah, that sounds terrible. I do think that the last time we had a case of this new world screw worm in this country was brought in by a human, actually, uh, like sometime last year, I think I was reading. Um anyway, and that person is fine. But uh, so it can happen. It can happen, um, but hopefully it will not. And hopefully this this one sounds like there's one case that's been identified. Hopefully they'll be able to get it under control. Um because otherwise, I I believe in the past that when there have been outbreaks of this New World screw worm, like back, you know, as you said before before the 60s, that then you lose cattle, and then so beef prices go up. And as we all know, I think the price of food, all kinds of foods, including beef, right now is already higher than um many of us can afford. So I would hate to that get even um more exacerbated by something that was being taken care of before, before we got so efficient.

SPEAKER_02

We're so efficient.

SPEAKER_00

Yeah.

SPEAKER_02

Well, anyway, I listen, I appreciate you having the bravery to let me talk about this screw worm fly.

SPEAKER_00

I honestly did not know how disgusting that was gonna be. So thank you for sharing that with us.

SPEAKER_02

Um I wouldn't say yes in the future, but here we are.

SPEAKER_00

No, I've seen some of the headlines, but I hadn't had a chance to read uh more about it. So thank you for sharing that with us. I was hoping I could talk about a topic that um is not as like physically revolting, but is also related to so-called efficiency. Um in a bad way. In a bad way, exactly. How uh uh that word has been used to destroy so much. So specifically, I want to talk about these new regulations, proposed regulations that were put out by uh the Office of Management and Budget, OMB, last week related to federal funding. Um and I want to talk specifically, it it turns out that these regulations apply to any federal funding. So grants that go to nonprofits that do work around supporting unhoused people or people who help or like who run domestic violence shelters or, you know, any kind of organization that you can think of, public health departments, like any organization that you can think of that gets money from the federal government could be affected by these proposed regulations, but I want to focus on science and research funding. Um I think it's the the impacts again are really broad, but I think this is the easiest way for me as an academic who's had federal funding to talk about these proposed changes. There are quite a few um things, it's like a 400-page document. I have not read this document, but I want to um point people to, and we'll have a link in the show notes to Dr. Elizabeth Genexie, who has an excellent summary of, she did actually read the whole thing, and she has an excellent summary, and she has multiple posts now actually about these um proposed regulations. But I want to highlight the things that I find most concerning. So the very first one is an idea that's been thrown out already by this administration, which is that political appointees would be the ones deciding what gets funded and what doesn't. So, in case folks don't know, what has happened in the past is, you know, the NIH, for example, would put out a call for grants related to a specific thing, like treatment of CLL, for example. I'm just picking a random thing. And then researchers would submit proposals that are aimed at addressing the things that are raised in that call for proposals. And then other scientists who work in that area would read these various proposals and then evaluate them. And then together they have something called the study section where they discuss the top proposals and then determine which ones they think should be funded. Now, historically, it's not the the word of the study section was not necessarily the final say, would then go to a second round, which is an advisory council, which is a group of people who then look through all of the recommendations from the study sections. Um and then, you know, usually my understanding is those get approved unless there's some major issue. But now what they're suggesting is that peer review can still happen, but it's not binding. So even the top scoring or highly most highly recommended uh proposals might not get funded just because they're going to be reviewed by a political appointee. And a political appointee, as it sounds, is not a scientist. It's not someone who understands the field in which they are reviewing applications. And in fact, they are going to be looking at whether these applications align with supposed um priorities of the administration, which also are not scientists. Like the president, I think it's pretty obvious, he's not a scientist, our head of HHS, RFK Jr., not a scientist.

SPEAKER_02

Can we take a moment, though, to imagine what it would be like if Trump did a peer review?

SPEAKER_00

I can't, I mean, I don't think he would read it. First of all, he would be like, it's boring. Did you see that he said this week that the Iran war was boring? Like he was like, I don't care if they negotiate, if they're tired of negotiating, whatever, I'm bored anyway. Um completely insulting and horrific for everyone.

SPEAKER_02

I'm just saying if he if he put the amount of effort into it that he puts into his tweets, he could be a really killer reviewer too.

SPEAKER_00

No, I think all he would say is like, this is trash. Anyway, so the point is that there's these people who are not scientists who are setting the priorities and then also deciding ultimately who gets funded. So that's extremely problematic, right? We have people who don't know what they're talking about making decisions about the direction of science in this country. In addition, um, they one have are trying to codify their right to terminate grants at any time for any reason. So obviously, this caused a lot of havoc and chaos last year when soon after the inauguration, they started just terminating research grants left and right, um, including mine. And that was really problematic for many reasons, clinical trials that had to be stopped or paused, or, you know, people who could not support the trainees in their lab anymore, or who could not support the employees in their lab anymore. Anyway, just like massive chaos. Um, and it is worth noting a lot of those grants were reinstated because there was a lawsuit that we've talked about before that said um those terminations were unlawful. But it remains the case that there were disruptions to a lot of people's work, obviously a lot of stress. And then there's people like me whose funds were never restored and research is is and whose research is being really fully threatened at this time. Anyway, so in the past, prior to this administration, terminations had been pretty rare. They would be for things like research misconduct or sexual misconduct. Um, but now what they're saying in these proposed regulations is that they can just terminate grants anytime. So even after they give you a five-year grant, they want to turn like all of all of grants into an at-will requiring. Exactly. But it doesn't make any sense because like you fund a researcher, say, for five years to do a project on diabetes, they hire staff, right? They buy machinery, reagents, whatever. It depends on the type of research, but they will invest that money in the research. And then you decide at year two that like you don't care about that type of research or that specific problem, in this case diabetes, because that's not the priority of the administration. And you're just going to stop that research. So not only does that lab lose funding, do people who were hired with that funding lose their jobs, but also however much money was invested in that research is now lost. Yep. So, I mean, that's like our grant, you know, over a million dollars had been spent on our grant before we were terminated. And we are doing the best we can with what we had at that time to try to do something productive, but it's a waste of taxpayer dollars to just then pull the rug out from under people. It's not a nobody can sustain a scientific lab this way. You have to be able to plan.

SPEAKER_02

But to be fair, Trump doesn't want to fund research with taxpayer dollars.

SPEAKER_00

He wants to fund a war and a slush fund. Well, he wants to fund himself and his family. That's what I have surmised from his actions. Anyway, okay, so so that that's the grant being terminated anytime is hugely um destabilizing to research labs. Yeah. Then the next thing I want to talk about is that new grants. So, you know, there are new granting programs, like I said, these calls for proposals that happen all the time. Um, new grants must, new grant programs must align with the administrative um policies and priorities. So again, not just existing things that are being reviewed, but anything new that's going to happen has to be in line with the priorities of people who are not scientists and don't know what would be the best use of resources. Then there's a section on scientific communication. So part of the whole reason we do research is like to learn new things, and then we share what we've learned with the rest of the scientific community. That's how we make advancements and build on other people's work. That's how we create new knowledge. Um, it's really, really important. And what they have decided is that in these proposed regulations is that any conference that someone wants to attend, they have to have pre-approval from the federal government before they can go. So that's like imagine with my grant, we submit an abstract to a conference about the research that we've done with this funding, it gets accepted. Now I have to go ask for permission from the federal government to use the funds they've already given me to go to this conference to present that work. And as we all know, having to interact with the government in the best of times is not really something anybody is keen to do. So that's a huge um block on the ability to communicate scientifically. And it's not just about conferences, they're also restricting um memberships to professional societies. They're also, um, this is also particularly concerning, that they basically said that they won't really allow these um funds to be used to pay for publication fees. So if folks don't know, previously it has been the case that if you're doing any work funded by the federal government, you're obligated to make that work accessible. And so you can do that through their own publication service, or you can do that by publishing through an open access journal. Open access journals are not paywalled, and that's what's really great about them, but they charge authors thousands of dollars to publish in these journals.

SPEAKER_02

So I recently got a paper published open access because I really wanted it to be open access. It costs over $5,000.

SPEAKER_00

And so now they're saying it's essentially unallowable to use the um federal funding for that. They say you can apply for exceptions, whatever. So basically, though, they don't want you to do that. So that's gonna make it harder for people to publish their work in a way that people can access it. The most inefficient system I've heard of, by the way.

SPEAKER_02

Yeah. We we approved you, we gave you this money, and now we're gonna make it so that it is the most inefficient possible way to use it.

SPEAKER_00

Yeah, absolutely. Um they also are restricting international collaborations, which is something that they started this year. Um, I don't have the full list of countries, but with a number of countries, they're saying you cannot collaborate with anybody in those countries. Um, it will not surprise anyone to hear that they have reiterated their ban on DEI or DEIA or so-called gender ideology or anything related to gender-affirming care. Um so there are many other points, I think, uh, in in that essay, there's probably like 16 or 17, I don't recall how many. Um, so there are other things, but those are the highlights to me that are the biggest red flags in terms of how it's going to change science and the conduct of science if these proposed regulations are adopted. They're basically their main thrust is for the government to be able to control what we do, when we do it, how we do it. And um, the best comparison, I think, that we have is lysenkoism from the USSR, where they put into a position of power someone who did not have any expertise in agriculture, and that led to famine and a lot of people needlessly dying because this person didn't believe in science and so was doing all sorts of weird things that did not work. Um, and so that's the risk that we run in having politicians determine what type of work should be funded, giving the final say on what specific projects are funded, and then restricting our ability to communicate with each other about what we found. And I I want to just put this in the context of the recent uh American Society of Clinical Oncology meeting that just happened, and folks may have seen some pretty amazing news. Like they um they published, or there was a talk about, and then also simultaneously published in the New England Journal, a new medication for pancreatic cancer that both doubles the life expectancy compared to other chemotherapy and also doubles the disease-free um survival. That's amazing. I mean, pancreatic cancer, as someone who did general surgery residency, I took care of so many patients who died from pancreatic cancer. The five-year survival is just above 10%. It's a terrible disease. It's a it's a death sentence. And so doubling the amount of time people have with their family is huge. How does that happen? It happens because we allow scientists to do their work without some politician somewhere meddling and saying, no, that's not how we should be spending our money. And the other major one that I want to point out is um melanoma, where there is an mRNA-based vaccine that's been developed that increased, I think also nearly doubled, um, but I will fact-check that in the show notes, but increased the um time to recurrence for melanoma.

SPEAKER_02

And so, just for for people who don't understand what that means, if you've had a melanoma, this treatment would make it so that your likelihood of getting another melanoma would would not happen as soon. You would have many more time before you would potentially get it again.

SPEAKER_00

Exactly. And um melanoma is another one, like depending on the subtype that a person gets, like some of them are are really terrible. And that's also a death sentence. So anything that can help people with these um cancers that have been so difficult to treat is really miraculous. So we are seeing these kinds of um breakthroughs because of the investment in science. And if we want to see continued breakthroughs like these, then we need to continue to fund scientists to do the work that they know is the most important and going to have the most benefit, not what RFK Jr. or Donald J. Trump thinks is gonna have the benefit.

SPEAKER_02

Well, and I think, you know, you mentioned, you know, some non-scientific politician who's like making these decisions. And I think it's important for people to understand that the person who is currently the director of the OMB is Russell Vott, who's a budget hawk. He's uh one of the main architects of the right-wing heritage foundation's uh Project 2025. Um, so when you're talking about Project 2025, you are talking about Russell Vott, and this is the kind of person who is now in charge of the budget. And he, it's very clear, you know, when you read Project 2025, like he wants to restructure the entire federal government. And this is just one of the um really, really problematic and terrible ways that he is choosing to do that. And the other part that I would say is there is this um, and uh Elizabeth uh Genexi had her piece that just came out today is all about the disinformation. Sorry, and and today we're we're recording this on uh June 4th. You all are listening to it on June 5th or afterwards. Um, but her most recent piece is all about the disinformation campaign around this budget. And, you know, obviously the group that coordinated Project 2025, they have deep pockets, they have a big uh, you know, we talked last week about um sort of the social structures and the disinformation structures that are really built to really spread this uh false narratives, lies about what's happening. And so, for example, um a spokesperson from the OMB said this is a quote from them, and it is not a true statement. Federal grants were already politicized to promote a far-left agenda, which I think is hilarious. Um, quote, funding went to projects like drag shows to report diversity in Ecuador and transgender experiments on mice. That ends now with this new rule the Trump administration will bring transparency to the grant-making process and ensure taxpayer dollars are spent wisely. So this is a this is an explicitly disinformation piece. So, like there was no, there were no drag shows funded in Ecuador. There was a there were claims made about transgender mice. First of all, mice cannot be transgender. There were certainly scientific studies being done on mice studying hormones. And, you know, the study of hormones is an incredibly important thing that's been going on for like a hundred years. But when they say things like this, they're just trying to make people upset and trying to use, as we've commented many times on this podcast, trying to make people feel a certain kind of way in a negative way about transgender people and you. Using science as a way to try to discredit the value of those human beings as well as to try to discredit the genuine scientific labor being done with federal funding.

SPEAKER_00

Absolutely. It's it's another part of their horrific attacks on trans people.

SPEAKER_02

So I mean, this it's just it's all ridiculous. This has all been laundered through the language of the Heritage Foundation of Project 2025. Um, and these foolish things are being repackaged as though they are truth. And of course, in opposition to actual truth-generating activities, which is science.

SPEAKER_00

Yeah. Um I I I don't I'm not surprised that they're actively operating a disinformation campaign to try to get support for what it is that they're doing. Um but this is, I mean, I don't know that we can overestimate the impact that this would have on our ability to conduct science. It it feels catastrophic to me and to a lot of other people. And um I don't, we know, with everything going on, I don't know how much people outside of science are paying attention um to this. But importantly, there is an open comment period happening right now until July 13th. And um if you go to regulations.gov and look for omb 2026 slash zero zero three four, we'll put a link. Um that will take you to the page where you can write a comment. Um, or you can go to Stand Up for Science. So if folks aren't familiar, Stand Up for Science is a nonprofit that has been doing a lot of advocacy related to all these attacks on science um for the last year and a half. So it's standupforscience.net. Um, they have on their homepage a link to where you can um enter your that same information and it'll go directly to regulations.gov. Um and there are templates that exist. If people are like, I don't know what I'm supposed to say, there are templates that exist. Um they what I've heard though from a number of people is that when for this specific purpose, when you have the same exact comment, it's not considered a unique comment. And so it is ideal if folks can actually write their own comments. It doesn't have to be long, it doesn't have to be detailed. And Elizabeth Genexi again has um a separate essay about what you might want to say um and how you might want to format a comment. Um so she has a full step-by-step thing that again will link to that. Um, and you can do as much or as little with it as you want. If you're part of an organization, um, you can encourage your organization, whether that's an academic center or it's a you know a professional organization or any group that you're affiliated with, they also can submit comments. Um, I know there have already been thousands of comments, which is fantastic, but the more the better, because not only is it possible that we could stop this, but also these comments apparently can be used for lawsuits um in the future. So really important.

SPEAKER_02

One of the things that's uh just on your comment of you know, not submitting identical things to other people and making them when you're submitting an individual comment, making it so making it personal or signing on to a larger comment from a group, is that the the government actually uses software to sort through all of these. And so if you if you have a thousand of the same comment, it's all treated as one comment. Um, and so this is where um you know, if you are if you are a patient who has benefited from you know recent scientific discoveries from NIH uh you know funded projects, which by the way, I mean, our scientific discovery process is part of what leads to private companies being able to come up with new drugs and do all sorts of things. So there's a ton of work that gets done that maybe doesn't sound like it's that important, but it's all part of the building blocks of our entire country's scientific and discovery infrastructure.

SPEAKER_00

So, yeah, I mean, this is something I talked about a while back. There are a lot of scientific discoveries that I think if you put them in front of like RFK Jr. or someone like that, they'd be like, we don't need to study the saliva of lizards or whatever, you know, because that's where GLP one came from. Um, and but like you can imagine it fit that fits right into the type of things this administration likes to put out as waste of government dollars. But GLP ones have been extraordinarily life-changing for millions of people around the world.

SPEAKER_02

And that research are you saying that a teeny tiny things piece of research that based on a headline, you can't assume that you know everything you need to know about the research?

SPEAKER_00

Correct. Or what might come. I mean, that's part of the beauty of science is that even the people doing that research don't necessarily know what's going to come of that. You know, there's so much that we just can't predict. And that's what's so very cool about science. Like you um find something really interesting, you're like, huh, what does that even mean? And then you like look into it more and you design more experiments, and then however many years down the line, you have GLP ones that are changing the world. Um, we have in the United States for the first time seen a decrease in the number of people with overweight and obesity after decades of continuously rising rates. That's amazing. And I have no doubt that if Elon Musk or RFK Jr. or someone like that had been asked, hey, should we fund this work that started at all, they would have said, no, that's a waste of taxpayer dollars.

SPEAKER_02

Well, folks, we will put links for you to leave your own comments on your own experiences. We know there's a lot of scientists and healthcare workers who listen to the show. We also know that there's a lot of you who have directly and personally benefited from the work that has come from this federal funding. And so please leave a public comment, uh, make your voice heard, and we'll send you a bunch of links to give you some, you know, little guidance.

SPEAKER_00

Absolutely. Oh, and I just wanted to, in case there's any people sensitive about lizards, uh, it was the gila monster, the saliva of a ghila monster. So I don't want to offend any people who are big reptile fans. I'm I'm not really good at the reptilian categories, but it was from the gill.

SPEAKER_02

That's where they monsters, they're like weird and cool. I believe you. I know nothing. I have a couple of uh anyway, they're they're wild.

SPEAKER_00

Okay. All right. Um, so I think are we ready for our take two and call me in the morning segment? I think, I mean, there's never been a better time. But yeah, we've talked about screw worms and we've talked about the destruction of science. So it needs something a little uplifting. Uh, what would you recommend for folks this week?

SPEAKER_02

Um, so I found I came across a video that I was very amused by, which is a gentleman who is a scientist that studies crystallography. He's a scientist of crystals. And uh I believe his he's called Nature Thought or Nature Thought. I don't know how he pronounces his handle. Um, but he did an entire video on non-standard healing crystals. He said he's fascinated by people who think crystals are for healing. And so he did a wonderful collection of really useful crystals, for ex starting with, for example, Lexapro, which is a crystal of Estalipram. Uh, he also covered stainless steel, he covered bricks. Uh, and I thought that that was really clever. I love a clever scientist, if you will. And I thought it was fun. And I like that, you know, there are some crystals that really have a lot of science-backed benefit to them.

SPEAKER_00

And I love that. Yeah, they're just not like the big purple and pink ones that people like Spencer Pratt are buying.

SPEAKER_02

Sure. Uh, I mean, those are beautiful. They're beautiful, and maybe they maybe they provide you with some some spiritual connection of some kind, and that's cool. You do you. I no shade. I think crystals are beautiful. Um, and I like that LexaPro is a crystal. I think these are both great. These are wonderful. Um, the other, the other video that I will I will put in the show notes because it gave me great joy is uh a woman whose uh handle is MelTop317, and she she introduced me not to trad wives, which we've talked about before, but trad lifting. And by that, I do mean lifting extremely heavy weights. And she is doing it in a fit and flare dress, and she looks amazing, and she makes it really funny. So I will put a link in the show notes so that you too can enjoy trad lifting.

SPEAKER_00

Women in male-dominated fields, as they say. Um, well, I wanted to share something pretty amusing that's been happening on Twitter. I know Twitter is a cesspool and no one should use it. I'm I'm I agree. And yet, that is what I'm saying. Yes. And there's still unfortunately a lot of people who are there and not elsewhere. So um the real Twitter winner of the last week or so has been very surprising. It's Hunter Biden. Um, and he created an account, and I honestly thought it was fake because I was like, what is Hunter Biden doing creating a Twitter account in this year 2026? And I just waited. And um, you know what? He has not disappointed. It has been really fascinating to watch him interact with folks. So I'm just gonna give you a few of the highlights. So he had a post about um, you know, I don't know if folks have seen some of the things that are being said about like his mom's new memoir. Joe Biden has a new book out, and Jake Tapper has once again been focused on Joe Biden's mental health as a reminder. Joe Biden is not the president of this country. And there is a man who is president who also seems to have some serious cognitive issues. I should have said that, sorry, cognitive issues, not mental health, but cognitive issues. Um, and so after Jake Tapper had posted some more attacks on Joe Biden, um Hunter had posted about many corrupt things that Jared and Ivanka and Don Jr. and Eric have been doing. Um and anyway, in response to that, um, some of these things I'm gonna tell you have been in response to that. Um, so one of them was oh, and by the way, I should say he for context, people made a big deal about him selling paintings, okay, while his father was president. And so he says, but you want to be worried about my paintings? So he said in multiple places that he made like 200, some odd thousand total over the four years. Okay. But the amounts that we're talking about with Jared and Ivanka and all the things they're doing, we're talking about hundreds of uh millions of dollars sometimes.

SPEAKER_02

Like Did I Did I ever talk about this on the podcast of the the graphs showing like the outrageous amounts of money that they've made? I don't think we it's a good question.

SPEAKER_00

I don't think we've talked about that. Um but we should I'm gonna find it.

SPEAKER_01

I'm gonna find it.

SPEAKER_00

Yeah. Okay, great. Yeah, but like he's talking about like in his post, he's talking about Eric's uh Israeli drone company that's going public for $1.5 billion and um Don Jr. getting backing to the tune of $620 million from the Pentagon for some you know company that he's a part. Anyway, so he's saying in that context, like his paintings that he made like $200,000 off, people are concerned about. Um, but so in response to his post, somebody said, You sound bitter for someone who benefited from a stolen erection. Hunter said, I've never stolen an erection in my life. That was one. Um, another one was somebody wrote to him, Hunter, I'd vote for you, but even if you're sober, which is great, I would require at least one crack joke campaign ad to pledge my loyalty. I await your response. Hunter writes back, how about let's take another crack with a Biden? Needs work, but the possibilities are endless. And uh somebody else, this is a from a separate post that he had written about being sober for seven years, which is a huge accomplishment. Congratulations to Hunter for that. Somebody wrote back, bullshit. That was your bag of coke in the White House. And Hunter wrote back, it most definitely was not. I would never have forgotten my drugs. So, you know, he's he's on a tear. It's a beautiful thing to watch. Um I I hope it continues. It's been amusing. Um, I don't know, you know, I don't know much about the guy, to be honest, but I've seen him do a couple of interviews recently where I mean, he sure has been through a lot. And it seems like he's just doing the best he can at this moment to be moving forward. Um, and yeah, I love to see him giving it to folks who are there clearly not in good faith. Um and and he's won some of them over, it seems actually, um, because he's, you know, he he's as they say a natural poster. And so I think that's it for this week's episode. If you didn't like what you heard, this has been the Plodcast podcast. Um, if you liked it, don't forget to subscribe to The Present Illness, leave us a review, and tell your friends or people on the street, you know, anyone, anyone can benefit from listening.

SPEAKER_02

You can follow us on TikTok, Instagram, and YouTube at the Present Illness to stay on top of all of our TPI-related news. We will be back next week with more headlines, hot takes, and doom scrolling, uh, hopefully wrapped in some laughs. Until then, agitate, hydrate, take a nap, and we'll see you next time on the present illness. Production by Argon Salas and Alyssa Berghart, editing by Alyssa Berghart, social media by Argon Salas, original music by Joseph Uphoff. Don't take medical advice from random people on a podcast. This shows for informational purposes. It's meant to be fun, and it's certainly not medical advice. Please take your medical questions to a qualified professional. This podcast is our hobby, doesn't represent the opinions of our employers or anyone but ourselves.

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Alyssa Burgart, MD, MA

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Arghavan Salles, MD, PhD

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