The Illusion of Medical Heroism: Why Casey Means' Appointment Hits Different
The system doesn't reward the necessary voice- it rewards the safe one that sounds rebellious. Here's why that matters.
No one wants to be the person who complains about someone else's success. It feels petty. Small. Yet something about this appointment triggers a deeper truth that deserves examination.
I can’t let it go - so here we are.
Casey Means becoming Surgeon General isn't just one doctor's career win - it exposes how our culture rewards status and platitudes over earned authenticity.
When "Rules" Are Just Suggestions (For Some)
I grew up dirt poor. No safety nets. No connections. Just the relentless grind of creating opportunities from nothing while others had runway. I was building the plane mid-flight, and I’m proud of it.
Medical school in Germany became my path- sacrificing everything for my calling. Until reality hit - I was explicitly told that practicing medicine in America required completing a U.S. residency. Non-negotiable. The immutable law of medical credentialing.
So I made the gut-wrenching decision to leave everything. Rearranged my entire life. Started over. All to follow what I believed were inviolable rules.
Only to watch someone with the right connections bypass the very system I was told could not be circumvented.
The argument that the position doesn’t technically or legally require a medical residency or ‘ability to practice’ isn’t a consolation. Becoming the “Nation’s Doctor” and advising… well, everyone- on health, when anyone else doing so would be at risk of civil and criminal punishment for “practicing medicine without a license” feels like a slap in the face to everyone who has done what they were told had to be done.
This isn't about comparing resumes. I’m not vying to be the freaking Surgeon General… But it is about discovering the "rules" we structure our lives around are actually flexible - but only if you know the right people or have the right platform.
The Residency Mirage
Every year, thousands of talented doctors face the residency bottleneck. They're told it's the only legitimate path. No exceptions.
Once I’d returned to the US, I studied alongside a surgeon who had practiced for years in Europe, moved to the US when her husband scored a residency place. She had to start over, which cost YEARS of her life, because otherwise she would never practice again.
Meanwhile, those with influence skip this "essential" step and land in positions of national impact.
Two separate realities exist:
One where ordinary people follow every rule and still might not break through
Another where the well-connected treat these same "requirements" as mere suggestions
The system demanding absolute compliance from those at the bottom offers remarkable flexibility to those at the top - exactly what Republicans have accused Democrats of for the past 4+ years.
But didn’t she earn the position, by speaking out on important issues so bravely?
From what I’ve seen? Not really.
Her strategy feels familiar:
Package widely accepted health principles with aesthetic precision
Carefully avoid any truly controversial positions
Be celebrated as "brave" while risking nothing
Meanwhile, thousands of medical professionals who took actual career risks during COVID- questioning lockdowns, the arrests of lone surfers, the ridiculousness of plexiglass & seated versus standing masking protocols at restaurants, masking 2 year olds (except during naptime of course!), highlighting inconsistent data & tirelessly demanding better evidence - remain sidelined.
Their voices deliberately marginalized.
The system doesn't reward courage. It rewards the appearance of courage that never threatens power.
The Ole Landfill Virtue Signal
When someone praised as a bold voice of public health uses their platform to publicly agonize over throwing away garbage (I assume to grow her newsletter list and boost sales) while consistently remaining silent on patients rationing insulin, filing bankruptcy due to predatory medical billing practices or the erosion of medical autonomy, they've revealed their priorities.
It's health activism as performance art. The equivalent of posting inspirational quotes while the hospital burns down around you.
Real impact requires addressing uncomfortable truths, not comfortable platitudes that everyone already agrees with.
Beyond Resentment: The Path Forward
The solution isn't resenting Casey Means. She's simply playing the game as it exists.
The solution is recognizing that the game itself is broken.
One of the biggest lessons I learned during Covid is that the willingness to stand up for ‘what’s right’ no matter how controversial is one of the most important skills you can cultivate.
When medical leadership positions go to those who say what's safe rather than what's necessary, everyone suffers.
When the criteria for authority becomes popularity rather than principle, we all lose.
My frustration isn't petty. It's the natural response of someone who has to follow guidelines that apparently don't apply to everyone, and of someone who expects people in positions of power to use that power to do things that matter for those among us who are most vulnerable.
Casey has not proven herself to be a fighter with moral fortitude. Maybe she is, but given her safe approach, we really don’t know.
The world doesn't need more comfortable revolutionaries. It needs authentic voices willing to speak necessary truths- even when no one's ready to celebrate them for it.
Are you building your platform to be liked, or to matter? The difference will define your legacy.
Until next time,
Tiffany