The Atom Bomb Speaks: Tracy Høeg on COVID, Myocarditis, and the FDA From the Inside

Episode SummaryDr. Tracy Høeg — physician, epidemiologist, and former Acting Director of the FDA's Center for Drug Evaluation and Research — joins Drs. Koka and DiGiorgio for her first interview since being fired from the agency in May 2025. She traces her unusual path from ophthalmology dropout to professional ultramarathoner to one of the most consequential and contested researchers of the COVID era, walking through her school transmission studies, the myocarditis preprint that detonated on social media, and what she actually found when she got inside the FDA: career scientists who were sharp, collegial, and largely aligned with her — not the entrenched bureaucratic resistance she expected. She also gives the most detailed account yet of how her firing went down, why she refused to resign, and what she thinks it signals about pharmaceutical industry influence over the agency.Chapter Markers00:00 Introduction and Tracy's bio02:19 Origin story: French major, med school, ophthalmology dropout07:42 Seven years in Denmark: PhD, clinical work, ultra marathon racing10:55 Back to the US: PM&R, interventional spine, and the start of COVID research13:43 Funding research outside the NIH pipeline17:18 How government funding crowds out independent science20:59 Evidence-based medicine, spine, and the N-of-one problem25:35 The Wisconsin school transmission study28:32 If masks were a drug, would they pass FDA approval?30:04 Testifying before Congress three times32:46 The myocarditis preprint: origins, backlash, and vindication38:34 Post-vaccine myocarditis: what the data actually showed43:01 Regulatory failure, COVID vaccine risk-benefit, and the pediatric question45:09 How Europe and Scandinavia got it right earlier47:58 Cancel culture in academia and the chilling effect on scientific questions51:18 Joining the FDA: how it happened and what she expected53:50 What the FDA looks like from the inside vs. the outside56:38 Where real philosophical disagreements lived within the agency58:58 Reducing animal testing and CNPV pilot: what actually got done1:01:45 Leaks to the media: where they came from and what they meant1:05:17 What the FDA's role should be1:06:23 Pharmaceutical industry influence and the Wall Street Journal editorial board1:14:48 The firing: why she refused to resign1:18:53 The chain of command and who is responsible1:21:08 What the firing signals about FDA reform1:27:42 Advice for anyone thinking about taking a leadership role in governmentCo-Host Handles@anish_koka and @drdigiorgioShow Handle@drsloungepodResource link: Anish's substack: https://open.substack.com/pub/anishkokamd/p/they-were-fixing-the-fda-then-they?r=6chj5&utm_campaign=post-expanded-share&utm_medium=webSubscribe LinksSpotify: https://open.spotify.com/show/44vw8eirsKKnjgNIrdDvrRApple Podcasts: https://podcasts.apple.com/us/podcast/the-doctors-lounge/id1832097658YouTube: https://www.youtube.com/@TheDoctorsLoungePod