The Present Illness

White House's Fever Dream Photoshoot

• Alyssa Burgart & Arghavan Salles

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In their final episode of 2025, Drs. Salles & Burgart perform a brief examination of the Vanity Fair exclusive featuring Trump's new White House staff. Our physician hosts dissect the viral photoshoot that's causing more raised eyebrows than a Botox convention, with special attention to the inflammatory rhetoric surrounding Susie Wiles and her supporting cast of characters.

The physicians perform a thorough examination of HHS cutting AAP funding while also funding an extremely unethical study of the Hepatitis B vaccine, news of HHS abandoning Hepatitis B vaccine recommendations for newborns, and Idaho’s anti-scientific tossing of school vaccine mandates (and Florida showing symptoms of the same). The doctors discuss ethical complexity in mitochondrial risk assessment for anesthesia in the setting of bombing of boats off the coast of Venezuelan.

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Credits

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

Arghavan Salles (00:00)
And there is no

ethical justification for withholding that treatment from some of these newborns in this country. And why are they doing it in that country? Because they know they could never do a study like that in the United States or Europe because IRB would not approve it.

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's increasingly febrile and definitely underdiagnosed. ⁓ I'm Arghavan Salles a surgeon scientist in your friendly neighborhood doom scroller in residence.

Alyssa Burgart (00:32)
And I'm Alyssa Burgart an anesthesiologist and bioethicist who tracks news and health law like they're 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.

Arghavan Salles (00:46)
Huge thanks to everyone who's listening today and a special thank you, extra love to our subscribers and followers. And a welcome to anyone who just stumbled in from that Vanity Fair article about the band of characters making up the White House staff.

Alyssa Burgart (01:01)
Wait, I didn't... What's in Vanity Fair? I haven't read this.

Arghavan Salles (01:05)
So ⁓ briefly, this is an article that came out a couple of days ago in which a writer for Vanity Fair, man named Chris Whipple, who has interviewed many many chiefs of staff for the White House, interviewed the White House chief of staff Susan Wiles

11 times over the past year and has summarized basically what he learned from her but also he has some little tidbits from Stephen Miller, Marco Rubio, JD Vance, Caroline Lovett, etc. What has gotten people's attention the most I would say is the portraits, the photos that are part of the piece that were taken by a man named Christopher Anderson, a photographer named Christopher Anderson. The one that I would guess

if anybody listening has seen is the Caroline Lovett photo. It's very close up. It's very close up. Like uncomfortably close. You've seen this?

Alyssa Burgart (01:54)
⁓

Okay,

okay, okay. So this is funny. So I had no idea where these photos were from because like I've, you know, I've been in the OR. I'm like basically I'm a basement dweller. I'm not online as much as, quite as much as you are. But a friend of mine sent me, I think her name's, you know the woman who's like always got the whiteboard and she's always telling you like the way it is. Do you know who I'm talking about? Rashanda, freaking love her. Love her.

Arghavan Salles (02:02)
You

Rashanda, Rashanda who says it's really very simple, I love her too.

Alyssa Burgart (02:24)
⁓ she's so funny. So anyway, girlfriend sent me that and she was talking about like, this is why your photos look so terrible is like what happened to this skin? You're a terrible person. Like this photographer doesn't like you, this makeup artist doesn't like you because everyone knows you're a terrible person. So I had no idea that that's what this was from. So you're giving it a lot of context. I just sort of thought she'd like found these photos, but they're together.

Arghavan Salles (02:51)
No, no, they're in this photo spread from this article that was actually published in two parts. There's a part one and a part two, but they came out as far as know the same day. And so there's a really close up photo of Caroline Levitt where, mean, I'm not trying to be cruel, but she's only 27 and she could easily from that photo be like our age, 20 years older. And she's got these, I think people have been very,

Alyssa Burgart (03:14)
I know what you're talking, okay, okay.

Arghavan Salles (03:20)
fixated or mesmerized in some way by her lips. She's got these, it looks like injection marks, like she's had fresh injections into her lips right before a major photo shoot. It's all very odd. And then she's got like this orange contouring on her nose, you know? ⁓ Anyway, so that's Caroline Love it. And there's another really close up one of JD Vance where he just looks like,

Alyssa Burgart (03:28)
Hmm

⁓ I'm looking at. I'm looking at this right now. Yeah.

Mmm.

Arghavan Salles (03:50)
that creepy

Alyssa Burgart (03:50)
Angry.

Arghavan Salles (03:50)
uncle that you never want to come to any of your family events. he's, you know, it's just like super ick. That's the JD Vance one. There's ⁓ another close up of Marco Rubio that for some reason is in black and white. The other ones are in color. And the Marco Rubio one has like stray hairs and lots of skin discoloration and things that you can see. Doesn't look good. You know what I mean? And so, so I mean, you know.

as they say, hate AGEist people. anyway, so he, all these photos people are spending a lot of time talking about because many of them are quite unflattering. And, ⁓ you know, they've asked the reporter, or sorry, the photojournalist why he didn't touch up these photos. And his response was, why would I? photography is about capturing reality. And ⁓ he says something like, you know,

Alyssa Burgart (04:40)
Mmm.

Arghavan Salles (04:47)
People keep asking me about this and we're just so used to seeing touched up photos and glossy images, but these are not celebrities. These are politicians. This is a photo essay. It's not a glamour shot. And what he was kind of pointing to is how accustomed we have become to not seeing any flaws on anybody. Because people are reading a lot into the photos, which I don't know if that's.

Alyssa Burgart (04:51)
Mm-hmm.

I see.

Mm-hmm. Mm-hmm.

Arghavan Salles (05:12)
how they're intended, but like about how he must not like these people, because they're so unflattering. ⁓ But anyway, that may be part of it. And he's saying, this is what these people look like. I'm just sharing with you what these people actually look like. There's lots of, if people are interested, there's lots of people writing about and talking about, for example, the specific paintings that are behind some people in some of these photos. What do they mean? Like there's one behind Caroline Lovett that is a poppy.

Copies have a very short bloom time. Is there some suggestion that Caroline Leavitt is not going to be in the public eye for long or not going to be in this role for long? You know, there's all sorts of speculation about what is the intention. Yes, exactly behind the framing of these. But the last thing I'll say about this, because we have a lot to talk about today, but the last thing I'll say about it is Christopher Anderson, the photojournalist, did an interview with Washington Post about these photos and they asked him about

Alyssa Burgart (05:54)
That's so funny.

Mm-hmm.

Arghavan Salles (06:11)
the experience and he said that Stephen Miller seemed to be really concerned about how these photos were gonna turn out and asked like, should I smile or should I not smile? And he said, well, it's up to you. How do you want people to see you? And then Stephen Miller said something to him like along the lines of, you have a lot of power here. I hope you'll choose to be kind or something like that. And the photographer says,

Alyssa Burgart (06:35)
Oh my gosh, wait, wait, wait, wait, wait, wait, wait, wait,

wait, wait,

Arghavan Salles (06:40)
Correct. And then the photographer said, you too.

Alyssa Burgart (06:44)
No, no. Stephen Miller said that. That's such a fascinating... Wow. Wow. I don't even know what to do with that. This is not a kind man.

Arghavan Salles (06:47)
Yeah.

Right? Yeah.

You have a lot of power, you could choose to be kind.

Alyssa Burgart (07:04)
Do unto others as you would have done unto yourself, sir.

Arghavan Salles (07:09)
Right? I mean, the photographer's response was just perfect for that moment. ⁓ you know, anyway, it's been a very, I would recommend if folks have interest to read the article because there's a lot more here than we're gonna talk about around what does Susan Wiles actually say about Trump and JD Vance and Elon Musk and Marco Rubio. And what does she think about the way this past year-ish, almost a year, has gone for them? And there's a lot of speculation.

Alyssa Burgart (07:15)
Huh.

Mm.

Arghavan Salles (07:39)
because she says, for example, that Trump has an alcoholics personality, which is not a particularly complimentary thing to say. There's a lot of speculation that she doesn't like him or she's looking to rehab her own image or whatever. That is just for the record, not my personal take. I think she's very happy with how things are going and she doesn't really think of that as particularly insulting. She thinks of it as just like a true statement of kind of the eccentricities of Donald Trump. That's my read, but I'd be curious ⁓ if our

listeners read the article, what they think about it.

Alyssa Burgart (08:14)
Well, okay then. Well, I'm really glad that you put that in context for me. Now I'm going to look for that article and I will re-watch Roshanda's video with more context.

Arghavan Salles (08:28)
Yes, yes, I mean.

Alyssa Burgart (08:29)
We'll make sure to put

a link. Go ahead.

Arghavan Salles (08:31)
We should definitely put a link and I would just say like always always watch Roshanda's videos. She's pretty much always on point

Alyssa Burgart (08:37)
⁓ we love her. She's

always she's she always delivers. We will make sure to put a link to her video in the show notes. ⁓ Well, listen, we're we're glad everyone's here. Love that you're here.

Arghavan Salles (08:45)
Perfect.

Alyssa Burgart (08:49)
know, Argavan, I wanted to share another really nice review that we got. You ready to hear it? It's gonna make your day. All right, from friend of the pod, Dr. Morgan Levy, a sharp perspective. The present illness brings together two physicians with diverse perspectives to talk about healthcare in our society in a way that is equally intelligent while also feeling like you're gossiping with your healthcare best friend.

Arghavan Salles (08:54)
I am.

Alyssa Burgart (09:16)
It's both informative and refreshing. Highly recommend listening. Morgan, you're a delight. Thank you.

Arghavan Salles (09:23)
Yes, Morgan's amazing. Dr. Levy, we should call her. I met Morgan when she was a medical student, so I always called her Morgan. But to be fair, she also calls me Arguevan, so we're on equal footing. But she's now in residency and thriving. Thank you so much for your comment, ⁓ Morgan.

Alyssa Burgart (09:27)
Yes. Me too.

Well,

one of the things I think we have to talk about is the AAP funding cuts, the American Academy of Pediatrics.

Arghavan Salles (09:50)
Yeah, so the American Academy of Pediatrics represents about 67,000 pediatricians and they... Correct, correct. And I meant that as the most inclusive term for pediatricians. And they have actually been in existence for 95 years this year, protecting children's health and advocating for children's health. And ⁓ they also have been very active in the last

Alyssa Burgart (09:58)
and pediatric subspecialists like me.

Arghavan Salles (10:20)
I mean, they're always fighting disinformation, but we've had so much more of it coming out this year, especially as relates to children's health because of our leadership, if you want to call it that, at the Department of Health and Human Services. And so you can think back to that horrible Tylenol press conference. You can think about what's happening with hepatitis B, all sorts of misinformation, disinformation related to autism. Anyway, they are very active at

Alyssa Burgart (10:25)
Mm-hmm.

Mm-hmm.

Arghavan Salles (10:49)
giving people actual evidence-based data and conclusions to help folks understand what's going on. And they have been very critical of these harmful decisions and comments being made by our federal government. And so yesterday, was, ⁓ we're recording here on the 18th, so it was on the 17th of December, there was a headline that the Department of Health and Human Services has revoked seven grants.

Alyssa Burgart (10:57)
Mm-hmm.

Arghavan Salles (11:17)
from the AAP. We don't know exactly how much they total, but we know they're millions of dollars. Just one of the grants I read had paid out 18 million in the last two years to the organization. And these grants, again, we don't have a lot of detail as of yet, but these grants ⁓ study things like decreasing sudden infant death and improving adolescent health and ⁓ identifying autism.

early and preventing fetal alcohol syndrome. So these are obviously super important issues that are really, really relevant to children's health in this country. So for people who are saying that they want to make America healthy again, and then to revoke huge amounts of funding from one of the major organizations that looks out for children's health in this country on these specific topics ⁓ is certainly at odds with their stated mission of making us healthy.

And the reason they gave in the letter that they sent to the AAP was that the AAP used language they didn't appreciate. For example, they referred to pregnant people and postpartum people. ⁓ And last site check.

Alyssa Burgart (12:26)
It's so gross

when you think women are people. That's really...

Arghavan Salles (12:29)
Exactly.

How dare you? How dare you think of us as people? Right? It's weird. And then they also didn't appreciate apparently some language in one of the proposals about ⁓ how racial health disparities can be exacerbated by emergencies, which is a true statement. And they also did not think there was adequate or they didn't appreciate the language around diversity in clinical

which I can pull up the exact wording because that one's even the weirdest to me because they say constantly, right, you and I have talked about higher ed before and we both obviously work in higher ed and you know, one of the main things that the folks on the right have been saying for a long time is that there's not enough diversity of thought in higher education, right? They're the ones actually pushing for diversity and we can talk about why that's not exactly what they're saying, but like that's what they say they're saying. But what the language was,

Alyssa Burgart (13:09)
Mm-hmm.

Arghavan Salles (13:28)
that they took issue with was that AAP was incorporating diverse perspectives into clinical care and public health materials. So they're going to sit there and say, we need more diversity of thought in higher education, but how dare the AAP talk about diverse perspectives in clinical care and public health materials.

Alyssa Burgart (13:48)
But, Argevan, I only want the diversity to be white.

Arghavan Salles (13:53)
Don't forget the men. It's the white men. That's who we really need.

Alyssa Burgart (13:57)
I mean,

it's so embarrassing, you know, these arguments from the right that it's like, ⁓ higher ed is just all thought police and you're making, you're brainwashing our adolescents by educating them. And it's just, it's so embarrassing because of course we should be engaging in a diversity of perspectives so that we can find truth through scientific inquiry.

And so, but it doesn't mean that like just any old perspective should be given the same amount of value if it doesn't have, I don't know, any evidence to support it.

Arghavan Salles (14:33)
Right, we don't have an obligation to both sides something where all the science and evidence is clearly on one side. We don't have to platform ⁓ views that are anti-scientific and actually harmful. The executive director of the AAP, or sorry, the chief executive of the AAP, Mark Del Monte said, the sudden withdrawal of these funds will directly impact and potentially harm infants, children, youth, and their families and communities across the United States.

It's worth noting that on the same day that they announced they were terminating all these grants, they also announced that they're giving $1.6 million to some Danish researchers to study the hepatitis B dosing, which has been studied ad nauseum, ad nauseum. And what they are, I mean, there's so many issues here. Like one, that there was no call for applications.

Right? Which is normally what happens when the federal government gives out grants that there is a call for applications, people submit their proposals, there's a review process by scientists who review these applications and then award those that have the most merit. But instead this was just, guess, I don't know, R.F.K. Jr. or one of his pals decided that they wanted to give these specific researchers $1.6 million, but it gets worse because

the study that's being proposed, we don't have a ton of information about it, but they are planning to go to Guinea-Bissau, which is a country in Africa where about 20 % of the population has hepatitis B and they want to have a randomized trial. So some newborns will get the vaccine and some will not is what we can surmise from what's known and that is

extraordinarily, I mean don't have to tell you you're a bioethicist so it's extraordinarily unethical to expose newborns to a condition that we have no cure for, that we know 90 % of newborns who get hepatitis B will go on to develop chronic hepatitis B. We also know that 25 % of those with chronic hepatitis B will die from complications of hepatitis B.

And there is no

ethical justification for withholding that treatment from some of these newborns in this country. And why are they doing it in that country? Because they know they could never do a study like that in the United States or Europe because IRB would not approve it.

And that is exactly why IRB exists. Sorry, I'm just gonna say real quick, Institutional Review Board is what IRB stands for.

Alyssa Burgart (17:01)
No, they're just.

Yeah, and I mean the...

to, this makes me so angry. ⁓ To unethically, I mean, this is a study that is inherently unethical for all the reasons that you've just described. And it's also because, you, this is not something where these two treatment versus non-treatment or, you know, vaccination versus non-vaccination. This is not something where there is equipoise. These are not things where there is some sort of even handedness of risk. And that's why you're going to,

⁓ you know, compare them head to head, that it's taking, is explicitly exposing children in a specific population that is already very high risk to develop life threatening complications and purposefully exposing them to the disease. And that's just terrible.

Arghavan Salles (18:03)
Exactly. I from what we know,

like I said, we don't have a lot of details, but they have said it's a randomized trial and they're trying to understand when, like how the vaccine should be given. We have been studying this for decades. The newborn dose was implemented in the United States in 1991. Okay. That is over 30 years ago. So we have tons of data.

Alyssa Burgart (18:24)
Well,

and like so for, and so since the institution of hepatitis V vaccination, I mean, there's been a 77 % decline in chronic hepatitis B infection in kids under five since 1990. So like it was, there was a huge study that was done between 1990 and 2019.

And I mean, the massive amount of reduction is so important. And there's been a 99 % reduction in acute hepatitis amongst people who are under 19 in the United States. So in the United States, it's a 99 % reduction and we're just gonna get, we just wanna give that up. I mean, this makes me very, very angry. And there's been also like, there's been long-term studies in multiple places around the world that have.

a high incidence of hepatitis B. And we know that, for example, if you look at like there was a study in China that was like almost 40 years long that showed that they could actually, they had a 72 % reduction in the liver cancer incidence in their population of vaccinated people And then they had a ⁓ 70 % protection against liver cancer mortality.

So by preventing liver cancer, you prevent a lot of people from dying of liver cancer. And so you don't vaccinate a kid when they're a baby. They may not develop cancer until they're into their adult years. And then they're going to die as a young adult, or they're going to die significantly younger than they would otherwise. And so the idea of withholding a vaccine that should be promoted. And I'm not saying that you should

mandate vaccines, we want families to have informed consent, we want families to understand what the risks and benefits are, but the reality is the risks are so microscopic compared to the benefits.

Arghavan Salles (20:10)
Yeah, I mean, I might say we should mandate vaccines. I mean, the thing about vaccines is that they are for the community. They're not just for the individual. I mean, I hear you, like that we have, everyone should have autonomy over their body, obviously.

Alyssa Burgart (20:25)
Well, so for example, when we talk about vaccine mandates, it is not a mandate that you must be vaccinated. It is a mandate that you must be vaccinated in order to utilize public schools, work in a hospital, you know, whatever. So those mandates are very, very reasonable. I also understand that like you want clinicians, there are some kids where they do have a risk from being vaccinated at a certain time. have kids who have...

Arghavan Salles (20:37)
Right.

Alyssa Burgart (20:52)
you know, cancer, they have certain conditions where they can't be vaccinated at a particular time and you want clinicians to be able to help families make informed choices. ⁓ But the idea, what we're seeing RFK and his MAHA goons do is try to dissuade people from doing something that is extremely high benefit and extremely low risk.

Arghavan Salles (20:54)
Mm-hmm.

Yeah, absolutely. I 100 % agree. The reason I wanted to talk like one second pit stop on the mandate question is because as you know, states like Florida and Idaho are trying to take away the school. Right, that's right. But to take away the school vaccine mandates. And I don't know that it's clear to folks when we say a mandate what we're talking about. So I think what we're saying, which makes perfect sense is

Alyssa Burgart (21:21)
Mm-hmm. Sure.

Idaho already did it.

Mm-hmm.

Yeah. Yeah, good.

Arghavan Salles (21:43)
there should be leeway for when folks get the vaccines ⁓ and there should be informed consent, of course, for the families. And if folks choose not to get vaccinated, that doesn't mean that they should have access to all the spaces where they could expose other people, other children, especially the folks who are immunocompromised to vaccine preventable illnesses. Because we know, for example, that to your point about cancer patients, they may have been vaccinated, but still be vulnerable.

Alyssa Burgart (21:56)
Mm-hmm. Mm-hmm.

Arghavan Salles (22:13)
to these diseases. And so some folks can't protect themselves. They need the community protection that high rates of vaccination afford us. And this is what we're seeing now, by the way, with pertussis or whooping cough, where we're starting to have more and more cases of that, yet another vaccine preventable illness. And of course, we've talked before that we have the largest

Alyssa Burgart (22:19)
Mm-hmm.

Arghavan Salles (22:36)
outbreak of measles this year in the United States that we've had in over 25 years since we had our measles elimination status ⁓ in the year 2000. So what happens when a particular individual chooses not to vaccinate their children doesn't just affect them and their children. Unfortunately, it affects our entire community and our entire country and then people travel. So it affects people around the world as well.

Alyssa Burgart (23:02)
And this is part of also what's so problematic about the political ideologies that have emerged within the within conservative spaces that are really hyper focused on individual rights. So same if you think about individual gun rights, like I should be able to own a gun, I should be able to do whatever I want. This whole concept that like I have, I should have the ability to do whatever I want and what's best for me is incredibly harmful to

everyone else in the community. And this kind of ideology is exactly what's fueling the anti, one of the many things that's fueling this anti-vaccine movement is because this idea, and you'll see, you see a lot of the anti-vaccine organizations really using language that calls out, you know, medical freedom and like informed consent action network. And it's all to really drive up this idea that your doctor is trying to hurt you and your children.

Arghavan Salles (23:54)
Mm-hmm.

Alyssa Burgart (24:01)
because they're trying to take away your freedom. Freedom to die of cancer.

Arghavan Salles (24:06)
Not only that, but freedom to infect people around you and have them die. That's not

Alyssa Burgart (24:10)
Absolutely,

But this is what I'm saying is like this entire ideology is like not even thinking about anybody outside of your own home. I mean, it's just, it's so isolationist and it's so incorrect and it's depressing. So when you were talking about the AAP, I went to the national meeting ⁓ back in late September and the meeting was actually, the meeting opened the day after that bananas Tylenol thing that you were talking about where

Arghavan Salles (24:17)
Mm-hmm.

Mm-hmm.

Mm-hmm.

Alyssa Burgart (24:39)
Trump said, don't take Thailand all a bazillion times.

And there was the opening to the meeting. The president of the organization actually led the entire group in a collective scream because it was because poor pediatricians are just getting hammered. And the American Academy of Pediatrics is such an incredible organization. They center children in everything that they do, which is quite different from many other professional organizations that

Yes, they care about patient safety. Yes, they care about patients doing well, but oftentimes are also highly motivated by, ⁓ you know, what are the needs of the of the clinicians? And I don't think that that's in any way bad. But the American Academy of Pediatricians, pediatrics will always put patients first and foremost in all of their public health messaging. And I've just been so proud to be a member of that organization and to ⁓ have access to.

Arghavan Salles (25:23)
Mm-hmm. Mm-hmm. Mm-hmm.

Alyssa Burgart (25:41)
to the guidance that they create for the public as well as for clinicians like us because we desperately need rational, reasoned, well-supported data in order to be able to have these conversations because we are not getting that from the government anymore.

Arghavan Salles (25:58)
No, absolutely not. mean, it's become clearer and clearer. And to get back to this point about the hepatitis B vaccine, a couple of weeks ago, the ⁓ new advisory committee on immunization practices, which is basically a sham largely of ⁓ people who are, a lot of them not physicians and a lot of them not knowing anything about immunizations, vaccines, vaccinology, immunology, ⁓ who

Alyssa Burgart (26:21)
Well, they literally

put ⁓ whatever RFK is like private attorney on there.

Arghavan Salles (26:27)
Yeah, I don't know if he's actually one of the ASIP members, he did, yeah, he presented at the, yeah, yeah. But that's exactly right. He's a lawyer who sues people who make vaccines.

Alyssa Burgart (26:32)
he presented to them with all his stupid nonsense. Ugh. Ugh.

Yeah,

that's how they make all their money. That's how RFK has made so much money.

Arghavan Salles (26:44)
Correct.

then he sits there and tries to pretend like pediatricians are making money off of vaccinations, which they don't. I think we've talked about this before, but a lot of pediatricians, we talked to them, they actually lose money on vaccines because of how much it costs to store them properly, to obtain them, like everything that goes with giving. Yeah, and the reimbursement that comes from insurance companies for those vaccines is so low that they're often losing money.

Alyssa Burgart (26:58)
Yes.

You gotta pay people to administer them, like all of that.

Boom.

Arghavan Salles (27:13)
⁓ In the meantime, RFK Jr. sits there and talks about these so-called perverse incentives, but he's the one who has made so much money in his career out of demonizing vaccines and pediatricians.

Alyssa Burgart (27:27)
What's so crazy, and I can't, I think we've talked about this before, I can't remember, but it's like, the wellness industry is like multipliers larger than the pharmaceutical industry. It's like, it's just like, it doesn't make any sense.

Arghavan Salles (27:36)
Correct.

No, and that's thing. It doesn't make any sense, but the messages sound compelling, right? Like we've talked about the wellness industry in general, like they make it seem scary to get a vaccine when in reality we know quite clearly that not getting a vaccine, these vaccines that we're talking about like for measles and ⁓ pertussis and hepatitis B, et cetera, that's actually a much scarier thing because you're exposing yourself or your children to unnecessary risks for conditions that we do not have.

Alyssa Burgart (27:46)
yeah.

Mm-hmm.

Arghavan Salles (28:11)
And for. And so the the ACIP when they met their recommendation was to revoke the long-standing recommendation of newborn vaccination for hepatitis B. And that recommendation then went to the head of the CDC and that person just this week has officially endorsed the recommendation that came from ACIP to change the timing of that dose to two months of life. And that is

egregious and exposing people to unnecessary risk. We know that, and to be fair, I should point out they continue the recommendation that if the pregnant person is positive for hepatitis B, the newborn should get vaccinated within 24 hours. So they didn't go completely off the rails. But the problem is we tried that strategy of only vaccinating the babies where the ⁓ pregnant person was known to have a positive ⁓ status for hepatitis B.

And when we did that, we were only able to decrease the number of cases of newborn hepatitis B by about 50%. And that's because...

Alyssa Burgart (29:17)
Yeah,

because like we are not the same as these other freaking countries. Like they're always like, make it like Denmark. And I'm like, y'all, do you look around? Do we have the social structure for healthcare that they have in Denmark? No, we do not. We do not.

Arghavan Salles (29:30)
Right,

well what I was going to say, that is also true and about half of the cases in newborns don't come from the pregnant person. They come from exposure in the house or in child care settings or wherever else the baby might go.

Alyssa Burgart (29:38)
No!

because

freaking hepatitis lives on surfaces for like aweek I mean, this is the thing that's so bananas. We have so many kids, we don't know how they got it. We don't know where it came from. But then you try to talk about these things with folks who are not aware of these facts and they're like, hepatitis is a sexually transmitted disease. Are these kids having sex or are they injecting drugs? Because we got a bigger problem then.

No people, it's freaking living on your kitchen table. It is on your doorknobs. It is at your grocery store. Like this is something, it's just out and about and it's easily transmitted through.

Arghavan Salles (30:21)
Well, and a lot ⁓

of people, I've seen studies up to 70 % of people who have hepatitis B don't even know they have it. So that's why it could be grandma, it could be aunt, uncle, cousin, anyone who is coming into contact with that newborn could unknowingly expose that newborn. And so this recommendation of changing from newborn vaccination where they're protected, ⁓ at least somewhat, it's a three dose series, but where they start to get that protection from the first day of life.

Alyssa Burgart (30:35)
Mm-hmm.

Mm-hmm

Arghavan Salles (30:51)
and then changing it to two months means that for two months newborns could get infected literally anywhere in any time with something that again is that we have no cure for and has a high risk of leading to liver cancer or cirrhosis and then ultimately death. There is absolutely no reason to expose these newborns to that.

Alyssa Burgart (31:06)
Mm-hmm.

Arghavan Salles (31:10)
it also can be transmitted sexually, as you said, but that is not the only way that it can be transmitted. And I have little understanding for or compassion for people who are pretending otherwise, because that's just not evidence-based. So.

Alyssa Burgart (31:13)
Absolutely.

Well, and you the other thing too is it's it's transmitted through you can have just micro cuts. like just, you know, your skin is dry and there's a micro cut that is that can be a way that that gets absorbed and that you become infected. And the other thing that, you know, folks haven't, you know, we've been we've been talking about like the risk, the long term risk of hepatitis and the long term risk of, you know, developing hepatos cellular carcinoma, for example. But the other thing that can happen is.

Arghavan Salles (31:33)
Okay.

Alyssa Burgart (31:54)
You know, in my practice, taking care of kids with liver disease, like you'll see kids were like they develop an infection, like a separate infection that causes them to have some acute liver reaction that can be quite severe. And so if you have something like that on top of an existing amount of liver damage because you've had this chronic inflammation because of chronic hepatitis B infection, like we're going to see worse outcomes from things that we see now, but are not quite as bad.

Arghavan Salles (32:25)
Yeah, that's absolutely right. mean, it's hard for me to fathom a decision that says we are going to expose more children, more vulnerable newborns to preventable illnesses that have significant long-term consequences that will hurt them in numerous ways. mean, measles, like we've talked about before, measles famously wipes out your immune system's memory, basically.

Alyssa Burgart (32:52)
Mm-hmm. Mm-hmm.

Arghavan Salles (32:54)
Even if a child were vaccinated for everything, let's say with the exception of measles ⁓ or they were vaccinated, but for whatever reason they got sick with measles anyway, their immune system loses all that memory for everything else, not only that they were vaccinated for, but had exposure to themselves just naturally in the course of their life. And so they have to restart. So they're now vulnerable again to illnesses that were preventable, but also not curable.

Alyssa Burgart (33:13)
Mm-hmm.

Arghavan Salles (33:24)
It's really, we cannot overstate the harm that is being done by these decisions and also the rhetoric and also the confusion that this is all causing for in particular parents of young ones.

Alyssa Burgart (33:30)
Mm-hmm.

Totally, it's really adding, I imagine, a lot of stress to parents who are trying to make sense of what's happening. It's a lot of stress for pediatricians who are trying to, now it's all this dance, I think, with lot of families of like, help me understand where you're at. There's a lot of things going on right now, how can I help you? How do I build trust with this family? I know that...

Arghavan Salles (33:59)
I'm out.

Alyssa Burgart (34:04)
Folks who are working in OB are working really hard to also promote vaccination, both for pregnant people as well as for ⁓ their infants when their infants are born. So I think there's a lot of opportunities to try to strategize. But as you and I know, it is really hard to overcome these sort of viral, for lack of better word, viral disinformation. And this is disinformation. Like this stuff is wrong. They know it's wrong. They don't care.

Arghavan Salles (34:32)
Yeah, because they're trying to make money off it. Yeah, it's vile. It's so hard to be someone who cares about truth and who cares about science and who cares about evidence and who cares about people in this moment because it's just constant assaults on decency and science and people, like on our humanity every single day.

Alyssa Burgart (34:39)
Yeah.

Mm-hmm.

Arghavan Salles (35:00)
I just want to honor that for folks who are listening to that, you know, we're all struggling. Like if you're struggling, you're not alone because this is terrible. Terrible, terrible. mean, like a slightly off topic, but Rob Reiner passed away this weekend and his wife, Michelle Stinger Reiner, she was a photographer they met on the set of When Harry Met Sally. He was so enamored by her that he changed the ending of When Harry Met Sally. Anyway, I'm bringing this up because

Alyssa Burgart (35:07)
You are not alone.

Mm. Yeah.

Arghavan Salles (35:29)
They were found dead in their home on Sunday. ⁓ People believe, authorities believe that it was their son ⁓ who killed them. And on Monday morning, our president posted a message insulting Rob Reiner and suggesting that

Alyssa Burgart (35:48)
who was

a prominent democratic advocate.

Arghavan Salles (35:52)
Yeah, and I would say he was a prominent advocate for humanity and decency and also children. People may not know he did a lot of advocacy and his wife did a lot of advocacy work for children. They were both ⁓ instrumental in getting marriage equality passed. So really from, mean, I don't know them, didn't know them obviously did not have that honor, ⁓ but they really seem like very decent people who fought till the very end for our country's democracy and believed in humanity and shared values.

Alyssa Burgart (36:01)
Mm-hmm. Mm-hmm.

Arghavan Salles (36:22)
And our president posted a commentary on his true social accounts, insulting Rob Reiner, and then saying essentially that he deserved it because he was opposed to Trump and Trump's policies and making it about him when this is really a family tragedy that no one would wish on anyone. And to have it be so public, it was their daughter who found them. I mean, it is horrific.

Alyssa Burgart (36:50)
I didn't know that part.

Arghavan Salles (36:53)
And we have a guy in the highest office of the land who is role modeling, centering everything on himself, making everything about hate, and then victim blaming people who have died a tragic death. ⁓

Alyssa Burgart (37:10)
I've said

it before and I'll say it again. It's an embarrassing time to be an American.

Arghavan Salles (37:15)
is the most embarrassing time I can think of in my lifetime. And that's saying a lot, because there's been a lot of embarrassing things that we've done. ⁓ But I do want to add on to that and say one of the things that we're doing is that's not just embarrassing and shameful, but actually criminal, ⁓ is the bombing of boats in the Caribbean. ⁓ We're bombing fishermen. by the way, this does come up.

Alyssa Burgart (37:22)
Yes. Yes. Yes.

Arghavan Salles (37:41)
tie it back into our Vanity Fair article point. This does come up in the article and Suzy Wiles ⁓ at one point she says that this is about, she almost explicitly says that it's about regime change because she says we're gonna keep doing it until Madura gives up. And that's important.

Alyssa Burgart (37:57)
There's nothing America

loves more than a regime change.

Arghavan Salles (38:01)
in another country.

Alyssa Burgart (38:02)
Yeah, yeah,

To impose regime change, especially, you know, throughout the world.

Arghavan Salles (38:06)
Correct. And the reason I'm bringing

up that point is that is not what the narrative is that we've been sold. We've been told this is about drugs. Anyone with two eyes ⁓ or ears or the ability to read Braille, anybody who is taking in information can tell that that's not what's happening, right? Because they have simultaneously pardoned multiple people who have trafficked drugs into the United States and sold drugs to American citizens.

Alyssa Burgart (38:34)
Mm-hmm.

Arghavan Salles (38:35)
So it's

obviously not about drugs, but she actually says it essentially that that's what is happening. And so that's another, I mean, it's criminal. People say, well, it's not really a war crime because we're not at war, but it's still a crime.

Alyssa Burgart (38:51)
Well, and you know, what I want to bring this to as well is, you know, I'm sure there's a lot of our listeners who are like, yeah, well, that's terrible that we're like bombing boats in Venezuela. It's a health problem too, and it's a health problem in the United States. And I'm going to explain why. You know, I'm a pediatric anesthesiologist and like just, we're just starting to get more and more reports of a presumed mitochondrial

finding, is mitochondrial DNA. mean, you know, they're like the powerhouse of the cell. That's usually what people remember about them. And despite terrible RFK saying that you can just look at a kid and tell them they have a mitochondrial problem, which you can't. There are a bunch of mitochondrial conditions that actually are profoundly impacted by the anesthesia medications that I use. so medications that are extremely safe for almost everyone in the population for us to use, we use them every single day.

Arghavan Salles (39:21)
Yeah.

Alyssa Burgart (39:47)
If you have certain mitochondrial conditions, they can actually be lethal and lethal in relatively small doses. And so what we've ⁓ there are these reports that are coming out from around the world that over the past few years, there's this base pair mutation that's been identified in people of Venezuelan descent. Now, we don't know how prevalent this is. We don't know, you know, how much how often is this found in people who are of other

country's descent, but there's definitely a signal in the 25 people who are healthy were exposed to a simple anesthetic and many of them have suffered severe, severe neurologic disease from this, not woken up from anesthesia, had profoundly, have been profoundly neurologically injured and quite a few of them have died. And so when we're trying to think about

And this is an emerging issue that's being talked about right now. The American Society of Anesthesiologists and the Society of Pediatric Anesthesia put out ⁓ really a sort of put up a flag to be like, this is something that we're seeing. We're gathering this information. We have to figure out how do we screen families knowing that there may be this risk in people who are specifically of maternal Venezuelan families? How do we screen for that?

While we've got ice running around and terrorizing our families and preventing people from wanting to come in for healthcare to begin with, you have somebody who actually presents to potentially have a surgery anesthesia that we routinely tell people like, hey, there are some really specific risks, but overall this is safe. You're a healthy child having a low risk surgery. Like we have ways to keep you safe. And then to have a child who is otherwise healthy be exposed to a single routine anesthetic and potentially

Arghavan Salles (41:26)
Mm-hmm, mm-hmm, mm-hmm, mm-hmm, mm-hmm.

Alyssa Burgart (41:39)
die? mean, that is a, that's terrifying to me. And I'm worried about how is it that we ethically screen folks who are coming in for anesthesia to prevent this injury from happening to them so that we can use medications that we don't think are as likely to cause a problem? How do we screen for people while our freaking government is bombing people from that very same country for like being fishermen and our country is trying to change the regime there?

Arghavan Salles (42:02)
huh.

Mm-hmm.

Alyssa Burgart (42:08)
And we've got ICE running around harassing people for like not being white enough, whether they're citizens or not. And so ⁓ there's a lot of work coming out of Miami, which has a very high Venezuelan population here in California where we live. There's quite a few people from Venezuela who live here as well. ⁓ And so these are just some of the ways where things that seem so disconnected from our health, like political things, things the government are doing.

Arghavan Salles (42:34)
Hmm.

Alyssa Burgart (42:37)
They seem like they're so disconnected and yet they are deeply impacting our ability to provide care in this country for children. I mean, in this particular case for children, but also for adults who like don't know that they may have this mitochondrial disease. Insurance doesn't pay for you to just randomly get a bunch of genetic testing. So it's extremely expensive if you wanted to try to screen somebody. So it's just all sorts of ethical issues that are coming up around screening in general.

Arghavan Salles (42:54)
Mm-hmm.

Alyssa Burgart (43:04)
and how do we provide a safe anesthetic that are profoundly complicated by the political situation that's being perpetuated by our like incredibly ⁓ violent and careless administration.

Arghavan Salles (43:16)
I mean, that sounds so scary if you can imagine being a parent, ⁓ you know, who has a child with that ancestry and they need medical care. I mean, first of all, as you said, in this context for anyone who doesn't look like a white person to be getting medical care is scary because it's an interaction with, you know, what people think of as the system, ⁓ even though, like, we're not obviously connected to the federal government. ⁓ But it's already scary and people are already avoiding

Alyssa Burgart (43:19)
I'm so scared.

Arghavan Salles (43:46)
healthcare because of what's happening with ICE and the unlawful detentions and deportations, ⁓ which by the way are harming also US citizens. Also the White House, I'll have to double check, was it the White House or the DHS? I think it was the DHS account actually just posted what all we want for Christmas is remigration. Remigration is ethnic cleansing.

Alyssa Burgart (43:47)
Mm-hmm.

Mm-hmm.

Arghavan Salles (44:07)
So that's all happening that prevents people from seeking healthcare or any, doing anything really where they have to interact with other people and go out in the world. And there's a renewed...

focus from our government now to denaturalized citizens. I am a naturalized citizen. And they're doing so much investigating around people's social media. I personally was, I I think about this, I walk my dog, like, should I be leaving my house? Like, I don't know. Obviously, like I'm relatively safe and privileged, but really anything could happen to me, my mom, our family members. And that's, this is a... ⁓

state-sponsored fear that has been induced among everyone. I wanted to add that when we're talking about Venezuela, this week we have increased our military activity in the waters surrounding ⁓ Venezuela. And they're saying that our government is basically threatening a land war.

Alyssa Burgart (45:04)
It's really scary.

Mm-hmm.

Arghavan Salles (45:13)
So the Venezuela defense minister today said, the people of the US must understand that their government is an instrument of war. And once again, they intend to send young Americans back to their homes in black body bags and coffins. And I do think we need to understand that. I think that everyone needs to understand that that is the intention of this government in order to get, let's just be clear about where they're going with that. And you know what would help?

us to like not need oil so much is if we invested in clean energy. But they've taken away all the funding as much as they could for anything related to climate change. ⁓ And they just defunded a major climate research center this week. Anyway, we could go on forever about all the harms that are being caused by this government, but these are the main ones that are, I would say they're at top of mind for me this week.

Alyssa Burgart (46:06)
yeah, it's rough stuff. I'll put a link in the show notes if people want. There's a really lovely ⁓ webinar that an anesthesiologist did ⁓ in Miami talking about this. is of Venezuelan descent. has Venezuelan children. He's a pediatric anesthesiologist in the United States. Really interesting stuff. for anybody who wants to get in the weeds with me, you can watch it. I'm going to put together ⁓

a summary also on my substack that I'm putting together. ⁓ I'll tell you what, I think that we should shift gears and talk about Take Two and Call Me in the Morning, because we gotta have something that's more fun than the war machine and kids dying under anesthesia.

Arghavan Salles (46:34)
great.

Yeah, yeah. Well,

so this is someone I've been thinking about mentioning for the last few weeks. Her name is Taylor Ann Gallo, and she does makeup. And I'm not like a, you know, I'm not hugely into makeup. I only wear it so I don't look like a ghoul. But ⁓ she does incredible looks. ⁓ she talks about, she even calls herself a shape shifter because it's so dramatic, the difference between, yes.

Alyssa Burgart (46:56)
Okay.

Okay.

Really?

Arghavan Salles (47:19)
between how she looks before and after her makeup. And ⁓ here's some things I love about her. One, she's super snarky. Like she'll yell at you and call you names. And I guess I like that when it's safe and they're not in my home. And then she ⁓ also really loves makeup. Like she just thinks it's fun and interesting and she does a lot of color. So it's not, this is not, we're gonna try to look like we're not wearing makeup makeup. It's like we are clearly wearing makeup and it's fantastic.

And so she talks about, she's all sorts of different colors, red, blue, purple, green, whatever. And she has some very strong feelings about how you should apply things like contour. I'm too lazy to do contour, but it's fun to watch her talk about it. And she, you know, she just has such great personality. So I love her. You know, for people who care, she does swear a lot. I think it's endearing, but I guess somebody might feel otherwise.

Alyssa Burgart (48:13)
Me too.

Arghavan Salles (48:14)
Yeah, exactly. Me too. So I'll put a link to one of her videos in the show notes. ⁓ whether you're looking for makeup advice or just entertainment, I think she provides both.

Alyssa Burgart (48:27)
Fabulous. Well, you know, this makes me think of, I don't, I'm not as good remembering the names of all these creators, so I apologize, but I just stumbled on a creator who is, he like comes up with some silly story. He's got a mustache, he's wearing like a, ⁓ have you seen that guy? Yeah, and he's got ⁓ like a hat, he looks like he's, I don't know, gonna go work on a farm.

Arghavan Salles (48:41)
yeah, I know that guy. Yeah.

He's a cowboy.

Yeah, yeah, he's a cowboy. I think he calls it cowboy drag, I'm not sure.

Alyssa Burgart (48:53)
But he does like, he has these funny stories and then you get to watch him turn into a completely different character by becoming like, know, drag Cindy Lou Who and it's just, I find great joy in it. I find it very funny. And I learned so much about the makeup. I don't do any of those things. Like this is as complicated. This eyeshadow is as complicated as I get. I joke at work that I put glitter on my eyes so I look less dead on the outside than I feel on the inside.

Arghavan Salles (49:20)
Yeah, I have I have a similar

strategy that person's name is Glenn DeVar by the way, we'll put a link in the show notes ⁓ But also one note about him is I've started seeing his videos first when he didn't even know anything about makeup So if you've only seen him recently, he's very good at it. He did not use to be very good at it So that's how it started was he was like learning Yeah, he was learning how to do makeup and I was kind of like I'm a masculine like he's a masculine guy, you know, he's ⁓ different from who you were

Alyssa Burgart (49:25)
we will, we will.

Mmm. Yeah. Yeah. this is fun. Ooh.

Yeah.

Arghavan Salles (49:50)
maybe people might think of as doing drag, but he did it to be like, I can do drag. And so he's been on this incredible learning journey and he's much more knowledgeable about makeup than I am. But anyway, that's Glenn. ⁓

Alyssa Burgart (50:04)
well then

I'm gonna make my assignment to find one of his old videos. And we'll put that, because I love a learning journey. I love seeing people evolve over time. I personally, I'm looking forward to you and I looking back on like our first episode and being like, wow, we know so much more now than we did then. That sounds super fun.

Arghavan Salles (50:08)
yeah, you should.

Yeah, so what's the thing that you'd like to recommend for folks this week?

Alyssa Burgart (50:29)
⁓ well, okay. So what's given me joy is that this Monday, I mean, I'm going to like totally humble brag. got a viewpoint in the Journal of the American Medical Association, JAMA, which I joke is the New York Times of academic publishing. ⁓ I know the New York Times kind of sucks a little bit now.

Arghavan Salles (50:45)
I don't even know if we can say that anymore, because New York Times is so terrible. It's the Vanity Fair. ⁓

I'm academic publishing. Anyway, go on.

Alyssa Burgart (50:55)
Anyway, I was very, very proud to get this piece in. It's on unconsented pregnancy testing in the emergency department, something that given ⁓ the risks that people are facing with their healthcare data not being as private as they think it is, the government taking so many actions in relation to ⁓ just reproductive rights in general.

Pregnancy tests are really important information. They're really important information for people in the emergency department to collect because we don't want people to die of things like ectopic pregnancies. ⁓ But I do think there are these unique risks to this information that we shouldn't be just doing these tests on everybody. And that's really how this gets done, sort of practically speaking, is they're treated more like it's a mandatory test. A lot of patients don't understand that they...

that they can say no. And frankly, I actually put out a video online asking people like, hey, what's happened? Like, have you ever been asked to just pee in a cup and you really didn't know what was going to happen? And of course, a lot of people are like, yeah, and they did a pregnancy test and they did a drug screen. And I had no idea that those things were going to not only be done, but put in my medical record, which is a legal document. ⁓ So I'm hoping I know that it's it's already upsetting some people in the emergency department who

Arghavan Salles (51:56)
Thank you.

Mm-hmm.

Alyssa Burgart (52:11)
are working very hard and are nervous about how are they gonna do more, more conversations with patients. I really hope that this is gonna be an inspiration to come up with efficient ways that do not involve usurping the rights of our patients to make sure that they have information in their chart that is not gonna be harmful to them. ⁓ So I'm very proud that that paper's out. I'll put a link in the show notes because it's kind of fun.

to get a big paper out in the world. And I'm very vain. I like to see my name in print. That's, know.

Arghavan Salles (52:42)
I mean, I think it's a huge accomplishment.

So kudos to you for publishing that. And I'm just wondering if you can tell us, like, what is the recommendation that you all make in your article?

Alyssa Burgart (52:51)
I mean, we say, listen, we should get consent for this kind of test. We get consent for things like HIV because that also has unique risks for being in your chart, et cetera. So we really feel like there's a lot of ways to do that efficiently. think that we should get, I'm personally a fan of opt-in consent and I can put a link to a colleague of mine's paper, feminist midwife, Stephanie Tillman, who's brilliant, has a great paper on ⁓ opt-in consent for pregnancy testing.

opt out consent would be reasonable. That's something that I think people in the ED think they have. But if you don't tell people what you're testing, they don't actually have an opportunity to opt out if they have reasons to. And there's a lot of people where they don't have any reproductive organs anymore, or they are completely abstinent. They're LGBTQ. They're not having sex with a sperm producing partner. There's all these reasons why. ⁓ And there's data to show that when you ask people if they're

likely to be pregnant or if there's a risk of that and you screen appropriately, it's actually very high fidelity. And so I just think there's opportunities to really narrow who's getting tested. On top of this, of course, we need better protections for this data in general. And we can have emergency waivers of consent that can be very appropriate, again, in a genuine emergency. But we know that there's a lot of things that happen in the emergency room that are, you know, they're not immediate emergency, like they're a

Arghavan Salles (54:08)
Mm-hmm.

The person's not

in extremis when they're presenting. They have an urgent medical problem, but it's not ⁓ taking their life within the next couple of minutes. So there's time to talk.

Alyssa Burgart (54:18)
Yeah. Yeah. Absolutely.

Yeah,

so, yeah, so I'm really, hoping that folks can let this be a way to reconsider the way that testing is being conducted now in the light of, listen, these risks are important and they are not, I don't think that it's right for us in healthcare to be like, well, it happens outside of the hospital, not my problem. Like, that's not how I wanna take care of my patients and.

Arghavan Salles (54:45)
Mm-hmm.

Alyssa Burgart (54:49)
I think it's a good time for us to lean into that discomfort and say like, how can we really enhance our patient's ⁓ agency rather than to diminish it?

Arghavan Salles (55:00)
Yeah, I mean, it's such an important topic and I really am grateful to you and your colleagues for writing it. I want to articulate something very clearly for our listeners that, you know, we see not only pregnancy, but miscarriages being criminalized in this country. And so that's part of the concern of having a documentation of a positive pregnancy test is what happens if someone has a miscarriage, which is legal, right? You can't make it illegal for people to have a miscarriage, but then there's

Alyssa Burgart (55:13)
Mm-hmm. Mm-hmm.

Well,

Arghavan Salles (55:28)
If there's not that documentation, have less exposure to risk. But if there's that documentation there, that causes potentially some new problems. And if someone has an abortion in a state where that's not allowed legally, because we don't believe in this country that everyone should have access to healthcare, that's...

Alyssa Burgart (55:38)
Mm-hmm.

Mm-hmm.

Arghavan Salles (55:51)
creates new problems for a person who is already in a very difficult situation. So I can see how people might think it's harmless, but actually there's a lot of harm that can come from doing pregnancy tests.

Alyssa Burgart (55:59)
Yeah. Well,

and to your point, it's not just those positive pregnancy tests, right? Like it's a negative pregnancy test. If you're being hurt, you get a positive pregnancy test in Texas and then you suddenly have a negative pregnancy test, maybe some vigilante is going to say, well, you had an abortion and I'm going go after you to make $10,000. So I'll throw in, I'll throw in, because you made the very great point about pregnancy criminalization, which we talk about the paper.

Arghavan Salles (56:07)
Mm-hmm. Mm-hmm.

Mm-hmm. Mm-hmm.

Exactly right.

Alyssa Burgart (56:28)
I will put in a report to Pregnancy Justice, which is a phenomenal organization that I highly recommend folks check out. And then there's a great op-ed in The Nation on this topic from the CEO of Pregnancy Justice and the CEO of Physicians for Reproductive Health. Amazing, really well written, dovetails great with this piece. ⁓ And then just so that we're not ending on another intense topic. ⁓ The other thing, the other ⁓

that's been giving me joy lately, came across this really fun video of a woman who was like, well, when you apply for grants, as you know, you can no longer use words like woman because those are the naughty words that you're not allowed to use when you apply for grant funding. And so she has come up with a suite of alternative words. So for example, if you're not going to be able to write women, you can write wenches or baby motels. And it's very funny.

Arghavan Salles (57:08)
Mm-hmm.

Okay.

Alyssa Burgart (57:24)
And I was very amused and it's very tongue in cheek. So we'll put that in the show notes and I hope it gives all of you a laugh.

Arghavan Salles (57:31)
Yeah, perfect. And if folks wanna, I mean, the Vanity Fair article is not funny on its own, but if you want us to commentary on the Vanity Fair article, I think that also has potential to bring folks joy.

So on that note, that's it for this week's episode. If you didn't like what you heard, this has been the Tucker Carlson Show. If you liked it, don't forget to subscribe and follow The Present Illness. Please leave us a review or rating and tell everyone you know to tune in.

Alyssa Burgart (57:58)
You can follow us on all the places, TikTok and Instagram. are at the present illness and you can stay on top of all of our TPI related news.

Arghavan Salles (58:05)
We are going to take a short break for the holidays and we hope you will too. ⁓ We will be back in January of 2026 already with more headlines, hot takes and doom scrolling, hopefully wrapped in some laughs. Please take care of yourselves in the interim.

Alyssa Burgart (58:08)
Mm-hmm.

Happy holidays, happy new year, and until then, agitate, hydrate, take a nap. Ooh, I hope you have some PTO folks. Take those naps, they're delicious. And we will see you next time on The Present Illness. And for our credits, production by Arghavan Salles and Alyssa Burgart editing by Alyssa Burgart, social media by the great Arghavan Salles, 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. So please take your medical questions to a qualified professional.

Arghavan Salles (58:53)
I


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Alyssa Burgart, MD, MA

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Arghavan Salles, MD, PhD

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