The Perverse Incentives Eroding Patient Care, From the Opioid Crisis to the Gender Craze: Dr. Carrie Mendoza

[FULL TRANSCRIPT BELOW] “When Obamacare happened, what it did was really give more power to the insurance companies and middlemen. I saw a lot of some of the smartest doctors in my group basically retire early, leave, or go into health tech. There are people that have gone into different areas in terms of autonomy, creativity, increasing their wages, but the actual clinical practice of medicine continues to have been marginalized.”

Dr. Carrie Mendoza is an emergency medicine physician and an advocate for the depoliticization of health care and education.

“The detransitioners … There aren’t services for them … There’s not even a billing code. If you don’t have a billing code, you can’t be in the insurance stream, right? So, you’re kind of like a non-existent person in the medical world. But yet, these are young kids who’ve had surgeries, or some now need hormone replacement because they’ve had their ovaries removed,” says Dr. Mendoza.

For years, Mendoza has been tracking the transformation of clinical medicine and the doctor-patient relationship.

“It’s written into regulations that the hospital wouldn’t get paid if their scores weren’t at a certain number. And so, then the pressure rolls downhill,” she says.

In this episode, we dive into the impact of the administrative state on medicine and health care, and reflect on the opioid crisis and its similarities to the social contagion of transgenderism sweeping the youth today.

“The detransitioners are like the people that overdosed and were harmed by the opioids,” says Dr. Mendoza.

Views expressed in this video are opinions of the host and the guest, and do not necessarily reflect the views of The Epoch Times.

FULL TRANSCRIPT

Jan Jekielek:
Carrie Mendoza, such a pleasure to have you on American Thought Leaders.

Dr. Carrie Mendoza:
Thank you very much for having me.

Mr. Jekielek:
I’m going to roll a bit of tape that has troubled me immensely. For some time under Covid, there was this “othering” of the unvaccinated. In one particular instance, it was relevant to your profession as an emergency room doctor.

Speaker 3:
The number of new cases is up more than 300 percent from a year ago. Dr. Fauci said that if hospitals get any more overcrowded, they’re going to have to make some very tough choices about who gets an ICU bed. That choice doesn’t seem so tough to me. Vaccinated person having a heart attack. Yes, come right on in, we’ll take care of you. Unvaccinated guy who gobbled horse goo, rest in peace, wheezy.

Mr. Jekielek:
What is your reaction to this?

Dr. Mendoza:
It is deeply concerning that a public figure would advocate that patients should be treated differently based on whether or not they got a vaccine. It really emanates from what happened with Covid when how you were behaving to the risks around Covid became a litmus test. Of course, it diverged from what was actually going on in terms of who was really getting sick. It was the focused protection idea, looking at patients who are older that we should protect more vs. not penalizing younger kids and eliminating them from the culture.

Then once the vaccine came out, did we really look at the data as to who would benefit from the vaccine? Who needs it, and who doesn’t need it? Who might it be harming with some adverse effects? We were seeing some young men potentially having a signal related to myocarditis.

It was a complex mix of medical decision-making that happened. I was on the front lines at the beginning and still work in the ER. I was in the ER before Covid, during the roll up to it, during Covid, and now after. Much of the information that really got scaled up in the media, be it conservative media or traditional mainstream media, was really different from the experience going on in the hospital or the clinic with the patient.

To have it get to a place where a TV comedian and then other people in trusted positions like the CDC [Centers for Disease Control & Prevention] demonizing patients that were making different choices about the vaccine is unconscionable. It was a big marker as to how poorly the truth was getting out. But othering patients is not something that ethical doctors do or an ethical healthcare system does.

Mr. Jekielek:
Absolutely. You made a video for FAIR in Medicine where you talk about treating someone with a scar on their face, then realizing they’re probably a Nazi or a Nazi sympathizer, reflecting on the fact that you’re Jewish, and then of course treating them as you would any other patient, which for quite some time has been the approach.

This is the Hippocratic Oath, “Do no harm.” Treat everybody equally. This has been turned upside down, and you are asking serious questions about what has happened to the medical system.

Dr. Mendoza:
Yes, you’re absolutely right. In my work through the nonprofit, FAIR [Foundation Against Intolerance & Racism], we’re trying to depoliticize medicine and raise ethical standards by saying, “We really don’t “other” patients. We don’t demonize patients.” In my work in the emergency department here in our country, you can’t refuse care to a patient in the ER [Emergency Room] if they cannot pay.

Anyone can come through the door. In the way the healthcare system has grown in the past 50 to 60 years, there are many people that come to the ER where it’s not necessarily an emergency. Maybe they need a medication refill. There’s a variety of social ills, and we also deal with drug abuse.

I’m trained to take care of everyone. That’s my duty. What the patient is doing outside the hospital, that’s not the issue at hand. If it’s weakening their health, like alcohol and drug abuse, then I would talk about that. But someone’s political belief has nothing to do with my duty to take care of them and address the medical issue at hand.

That has been the tradition of healthcare that in part came out of the Nuremberg Trials with all the horrors from Nazi Germany and the experimentation they did. It’s concerning that now medical students and trainees are taught to “other” people, using the oppressor/oppressed context where they would not even consider treating someone who had a different political belief. That is not ethical medicine.

Mr. Jekielek:
Please tell us about your background. You’re an ER doctor, but you’ve taken some prominent stands on the issues in the area of medicine that are not common.

Dr. Mendoza:
Sure. I’m the granddaughter of a man who walked out of Russia during the Russian Revolution and escaped when he was 18, my maternal grandfather. He escaped through Poland and was able to get over to Chicago where he had some family that had escaped. But a lot of his parents and his sisters stayed behind, and I’m named after one of his sisters. He lost contact with his family during World War II. The letters stopped because they got killed, but they don’t know the exact circumstances.

I was growing up with that history and hearing the stories from my grandfather and understanding how he left everything behind. He was an engineer, but there was the persecution of Jews and the pogroms. Then he came over to Chicago and built up a life, a true immigrant story. That’s part of my background.

Plus I am named after someone who was killed in World War II, likely because they were Jewish. I feel so lucky to be in this country where things are free. But I have this innate sense when things are starting to go off track which could lead to tyranny.

That’s a big part of my motivation. I also have an older brother who was always fascinated by politics since he was young. Growing up, he was obsessed with the Watergate hearings, so I grew up hearing him talk about that. He was very into political philosophy, so I learned a lot about Marx, Hegel, and a whole host of things. With that education I feel like I have a sixth sense for when things are going towards the tyranny track, because I know where this can all go if it’s unchecked.

In terms of practicing medicine, I went through my training, which really wasn’t politicized at all 25 years ago. But as I was getting into practice and really understanding how the administrative state was affecting physician practice and ethical choices, I was thinking, “What is going on here with the opioid crisis?”

Mr. Jekielek:
You are schooled in ER medicine?

Dr. Mendoza:
Yes.

Mr. Jekielek:
You mentioned toxicology as well?

Dr. Mendoza:
Yes. I did a residency in emergency medicine in Denver. I really like acute care medicine. Someone comes in, you don’t know what they have, and there are different levels of distress in true emergencies. I love that I get to figure that out, get to manage it, get to deal with it, and hopefully save the person. I just fell in love with the critical thinking aspect.

Also in the ER, no one is telling you what to do like have a test approved or get some imaging study. It is just pure medicine. I can think about what’s going on with the patient, then order what I need. When I was in medical school at University of Chicago, I wanted to go into oncology, because they had a great program there and they did a lot of clinical trials. But I did a shift in the ER as part of my education, and I just fell in love with it.

Then I went off to Denver for my residency, but back then there weren’t fellowships for the ICU [Intensive Care Unit] like there are now. If you wanted to do critical care, you had to do internal medicine. There wasn’t a pathway to emergency medicine from critical care, and I think I would’ve done that.

The closest thing was medical toxicology. The Rocky Mountain Poison and Drug Center in Denver had a fellowship. After my residency, I did that for two years where I learned about drug overdoses, pharmacology, and how that affects everything. We took on call from five states out west including Hawaii. Every three nights I would be getting calls from ERs saying, “I have this particular situation. The patient took all these pills.”

I learned some antidotes to things you needed to know with bioterrorism. This was after 9/11, so it was antidotes for cyanide and all the classic things. The buck stopped with me in terms of deciding, “Am I going to fly this patient from rural Idaho over to a different hospital because they need dialysis because they overdosed on aspirin?” It was the critical care element that I fell in love with.

During this time I had three beautiful boys who are now almost young adults. I actually thought I would do academic medicine, but it was really hard to be a mom and do academics and work shifts. I took a job with a private group that staffed hospital ERs in the Denver area. That allowed me the flexibility to practice, but also be as home as much as I could when my kids were really little. I was really blessed to have that balance.

Mr. Jekielek:
You mentioned the administrative state intervening into the doctor-patient relationship. Typically, it’s the corporatization of medicine that has intervened into that relationship. I haven’t heard so much about the administrative state, so I’d love to talk about that. But in general, when did you notice that something was going wrong? What did you see in the system that you knew and loved?

Dr. Mendoza:
It really hit home once I got out of all my training into actual practice with this group that was basically a small business. We had contracts staffing ERs. Before that, when you’re training, at least back in that time, you’re somewhat shielded from the business side of medicine. You’re just practicing and it’s very academic. Yes, there are issues with the electronic health record and billing, which we could talk about later.

But at that time, the electronic health records were very rudimentary, so it wasn’t the main thing. When I started out, we would document on paper charts. The business of medicine, once I finished training and joined a private group, was a shocker. I was seeing the inside of the whole thing, and how much money we had to spend in order to extract the money from the insurance companies in order to get paid.

Again, people come to the ER, and you can’t refuse care. If someone came and they had a heart attack and you sent them to the cath lab, they could maybe never pay the bill, and then we would never get paid. Yet, potentially someone could still sue us. There were all these realities on the business side that were really shocking. You learn that you might get paid less this quarter because the fee for the billing company went up. That would be just one example.

The other thing was the relationship with the hospital. We were a private group and the contracts were written where certain quality metrics had to be implemented and you had to achieve them in order to have your contract be whole. Some things were in alignment with practicing medicine, like you gave an aspirin to everyone who came in with chest pain.

But some things delved into this whole world of the patient experience scores, where how the patient felt about their experience had to be at a certain level. Once I learned what that was all about, it was shocking. It’s part of the administrative state, because it’s written into regulations that the hospital wouldn’t get paid if their patient scores weren’t at a certain level.

Then the pressure rolls downhill from there. Medicine isn’t about making a patient happy, it’s about solving their medical problem. Some people come to the ER with things that I can’t make them happy about. They may have some chronic pain issues or they may have already seen 10 specialists. They are frustrated about why a certain issue can’t get resolved. The clinic would say, “Just go to the ER.”

People would be sent to us inappropriately, thinking we were somehow going to solve a problem, or told to come because we would get them an MRI [Magnetic Resonance Imaging]. But we didn’t have the guaranteed ability to get an MRI for non-emergency things. They would be upset and give you a bad score, so it was completely unfair.

When you said to the administration, “This is unfair,” they replied, “This is what we have to do. This is what the government requires.” Some of the things were inconsistent with the actual practice of medicine. It got more into the consumer aspect and what the patient felt their experience was.

Mr. Jekielek:
This is not even considering these various woke ideologies and how they started penetrating the medical system.

Dr. Mendoza:
Yes. We are clearly at the end of a cycle with a lot of things, and a lot of people are saying this. When Medicare and Medicaid started in 1965, that’s when the clock started ticking and it became political, along with having lobbyists that always needed to go to Congress, and all of a sudden they’re involved in healthcare.

There has been a slow decline in autonomy for physicians and pressure on wages. Physicians weren’t really organized to be battling against this. The AMA [American Medical Association] doesn’t really represent physicians, and their revenue comes from their billing codes. A chest pain has a certain code. They own all that and they are the gatekeepers. You can’t get a new code unless you go through the AMA.

The point is, there is really not an organized pushback for physicians. As the autonomy and wages have declined, some physicians have gone into administration as a way to keep their wages up, or to feel some sense of control and power in the equation. Then they are on the other side of the equation, where they might actually know it’s not right to say, “We need to get those patient satisfaction scores higher.”

But they’re not on the clinical side anymore. People who truly enjoy academics have stayed in. Some have risen in the ranks and are not doing as much patient care. When Obamacare happened, it gave more power to the insurance companies and all the middlemen.

I saw some of the smartest doctors in my group basically retire early or go into health tech. There are people that have gone into different areas in terms of autonomy, creativity, and increasing their wages. But the actual clinical practice of medicine continues to be marginalized. They are giving nurse practitioners and physician assistants a lot of medical decision-making, but they don’t have the same level of training. We’re seeing more of that.

The woke ideology comes in and it is really easy to pick off the medical industry, because physicians are in a weakened position. It’s also easy to infiltrate the administrative state. The woke side and corporate medicine knows that the way to get their policy prescriptions implemented is through the administrative state and regulations. They’re very knowledgeable about this and that is their business model.

Mr. Jekielek:
The medical profession has become very susceptible to these rating systems. This is one way in which companies fulfill their DEI [Diversity, Equity, & Inclusion] requirements.

If you don’t get your score up to a certain level, then you’re going to suffer. There might be people picketing outside your door, or you might lose your bonuses. There is a whole structure of disincentives that have been created to maintain this woke ideology. When did you first notice this?

Dr. Mendoza:
There is such a big administrative state blob in healthcare where policy prescriptions would come down from people who actually don’t interact with patients.

Mr. Jekielek:
Are these standards of care that you’re talking about?

Dr. Mendoza:
Some things are, or they could just be guidelines. The opioid crisis would be a good way to illustrate your question. For instance, the pain scale is when you ask, “What’s your pain level, from zero to 10?” People could say that question came from goodwill. But it was not created because there was some type of study that said, “People’s pain was not controlled.”

It was like a pain society that said, “We have this scale and we should measure the pain.” Which again, starts out as a good idea. Things went sideways when the AMA got involved along with some other parts of the government and said, “For us to measure how well the hospital is doing, we’re going to use this pain scale.”

As this bureaucracy grows, we can see this in a lot of other areas, not just in medicine, but also in education. They’re looking for ways to measure their value and it’s very seductive. They can say, “Here is the scale. We can measure this and then we can say we did better.” They think this bloated government and all this money spent on Medicare and Medicaid in the hospital is worth it, because they are measuring this and people are getting better and their pain is controlled. That’s a policy where they might say, “Okay, that’s reasonable,” or “That’s an interesting idea. Let’s try that.”

The AMA got together with Purdue Pharma. Purdue funded the quality studies that they pushed through in hospitals around the year 2000 to measure this, and then they tied it to reimbursements to the hospitals. This was because there were more people who were getting opioids that didn’t need them, and so they required a good score on the pain scale.

But these people get overdoses, complications, and all kinds of things. The harm signal was just completely ignored until it started being reported that there were overdoses. But the AMA never said, “This was a bad idea,” or, “We shouldn’t be asking the pain question to every single person,” or, “We shouldn’t be matching it to reimbursements or to physician bonuses.”

Those things have been going on in healthcare for over 20 years now. I first saw it with the opioid crisis because I’m in healthcare where I’m dealing with the results of these bad policies everyday. People come into the ER overdosed or they’re addicted and can’t go to work. They need a work note saying they fell because they were sedated, or they got into a car accident.

That person at the AMA or the Quality Healthcare Group office is not in the ER with the patient yelling at me because I refuse to prescribe them. They are not with a family whose son overdosed, because it was all iatrogenic, meaning induced by the hospital system.

These administrators weren’t facing the bad consequences of their actions. That’s the first time I really saw this giant system that doesn’t care about the results of their policy. There are people dying and they don’t care. There are people whose lives are being destroyed and they don’t care.

Mr. Jekielek:
Why did no one say, “Your policies are doing harm.” Was there no way to tell them?

Dr. Mendoza:
First of all, clearly, their salaries are not based on the results and on the fact that all these people are now addicted to these drugs. They didn’t have to face any consequences for that. Again, they’re also not practicing physicians, so they’re not faced with having to deal with that.

It’s similar to some of the things going on with the gender medicine that we’ll probably get to today. They believe that the ends justify the means. They’re so invested in that. It’s like hubris. They have a PhD and their theory is that this is the way to show value in healthcare. They’ve convinced themselves and they don’t want to hear anything to the contrary.

Mr. Jekielek:
There have been policies dealing with only one issue that entirely ignore the potential collateral damage. Stalin famously said, “If you need to make an omelet, you’ve got to break a few eggs.” The idea is that there will be collateral damage that might be human, but they believe they are doing the right thing. You’ve explained that this system gets infiltrated with woke ideology, and then it’s off to the races. Is that what you are saying?

Dr. Mendoza:
Absolutely. The opioid story really is the modern example of when healthcare gets captured by bad ideas and then bad things start happening to people, when you’re supposed to be helping them. Then somehow, the system ignores it. It was this blob of regulatory people that made up these rules that had nothing to do with actual medical practice, but they didn’t care.

The overdoses were climbing and climbing and climbing. The attorney generals were the first ones to come in and sue, basically using public nuisance laws, then there was a pathway to the pharmacies. The Trump Administration actually took out the regulation of connecting reimbursements to some of these quality metrics.

Mr. Jekielek:
In the ER, are you seeing so-called gender medicine? How did you fall into becoming an advocate around this? It doesn’t sound like an ER issue.

Dr. Mendoza:
Gender medicine is very much focused in certain pockets, specific gender centers and academic centers. I’m not talking about Planned Parenthood. One hospital I used to work at in Chicago was in a neighborhood that was also the gay community in Chicago and there were transgender people there. No big issue. One of the first issues that popped up on my radar was pre-Covid, in 2017 or 2018, when they changed the way that transgender patients registered when they came to the ER.

Historically, if a transgender person’s legal name was John Smith and he was a male, they were registered with their legal name and their biological sex. That has never been controversial. But on the patient chart there was a comment area. The person triaging would write, “Identifies as a woman, likes to be called Sue.”

When you would sign up for the patient, you would see their name, their vital signs, and you would read the comments. Comments on patients would typically be, “This person has low blood pressure.” But if they were a transgender patient, they might be about how they identify and what they prefer to be called. No problem.

Doctors had no problem, nurses had no problem, and patients had no problem. No one was offended, and no one had any issues. But medically, you need to know what their biological sex is. If you’re a biological male, you may come in with abdominal pain. To figure out what’s going on, I may need to look at your genitals. You could have an STD or a testicular mass. My job is to advocate for your health, so I need to know this. It’s just a straightforward diagnosis.

Mr. Jekielek:
If they are a biological woman, they actually might be pregnant, but you would not be allowed to do a pregnancy test.

Dr. Mendoza:
Yes, you’ve got to order the pregnancy test. You wouldn’t want to accidentally irradiate a fetus because they need a CAT scan. Back then there was no issue. But then all of a sudden it changed and the hospital said, “We’re allowing the patient to register how they want.” Immediately, I saw that as so dangerous and regressive, and going backwards on safety, because you will miss the pregnancy tests. People will stop doing exams on parts of bodies that they need to and possibly miss a cancer.

There’s a case study in the New England Journal of Medicine from 2019 of a female identifying as a man, who apparently looked like a man, and was registered as a man. She came in with abdominal pain. Of course, they never did a pregnancy test. She was hypertensive, so she basically had preeclampsia, which is a dangerous condition.

By the time they realized she was actually pregnant, I believe she miscarried. This is in the New England Journal. I left that hospital because when I expressed my concerns about how dangerous it was they said, “No, this is what we’ve been told to do by the health system.” As a practicing physician taking care of the patients, I am the one who could miss something, that’s the main thing.

But I could also be on the end of a lawsuit if something bad happened. That person up in the CEO’s office wouldn’t be accountable. It became hard to think all this through and make sure that everything was right with the patient when they’re messing up the intake data. I saw it in that way.

I’m not affiliated with a children’s hospital now, I am out in community medicine. Occasionally, we’ll see a young person that comes to the ER that says they are non-binary. They’re in the ER for mental health reasons. I’ve seen some confusion with some of the medications such as testosterone and estrogen, but not as much. What people need to know is that it’s coming, just like what happened with opioids. There’s a time lag. There is also a lot of underground use of testosterone and estrogen, because they can’t get prescriptions, which means a lot of people are going to end up in the ER.

Mr. Jekielek:
What accounts for this explosion in transgender medicine?

Dr. Mendoza:
It is very complicated. There are a lot of strands to it, but I do see a lot of similarities to what happened with the opioid epidemic. The pain scale basically created a pipeline, because with people who weren’t necessarily thinking about their pain, all of a sudden pain became a priority. I’m not saying there aren’t people who legitimately need better pain control, and certainly we have an aging population with arthritis and other different things. But it was just generalized so much that it created a pipeline.

Asking about pronouns in school is similar to the pain scale. Imagine if the school system decided that people are going to have pain and we really don’t want them to suffer. Let’s get them knowledgeable about pain. Let’s ask every kid every day what their pain score is.

Then you would have a bunch of kids saying, “My knee hurts, my ear hurts, my this or that hurts.” Then that gets attached to, “Oh, here’s a pill.” There is a flood of kids coming in that have gotten confused. You have this new cohort of mostly adolescent girls with gender dysphoria who never really had any issues before, but now all of a sudden they do.

Some of it is from school, some of it is obviously from the internet. Social media is a new element that wasn’t really around when the opioid crisis got going. Clearly, social influence is one of the things that is pulling all these people in. But they’re saying that you need the medical community to solve your problem. A pipeline is created and that’s what gets you to the medical community that wants to please.

Mr. Jekielek:
When kids are doing this, it’s clear to them that unconventional answers are the best. You don’t want to say your pronouns are just they, them, or whatever it may be. You want to say, “I am something different.” I can imagine that trend will snowball.

Dr. Mendoza:
Yes. With the pain example, obviously, some of it is subjective. I’ve had patients who say they are in extreme pain and they’re sitting there looking fine. Then I’ve had someone else who’s literally got a paper cut who’s writhing in pain. Not to say it doesn’t really hurt, but it can be a very hard thing to navigate through. Again, this became attached to strong drugs. It’s very important to figure out how you’re managing that.

Transgender medicine and the way that our current healthcare system works has really downplayed the solid clinical practice of medicine. It has somewhat of an assembly line feel. If this kid is in distress they say, “You need to go to the specialist,” which is the gender clinic. This is just the way they do things today. They do not ask, “What really could be going on here?” It’s like you only have this one problem, and here’s the catch-all solution.

Mr. Jekielek:
This is a theme that keeps coming up. They claim it’s a whole system solution. Everyone goes through a very similar process, and it’s not individualized.

Dr. Mendoza:
Exactly. We talked about opioids and the harm signals. With the detransitioners, the people on every kind of dose of testosterone and estrogen, no one is tracking them, and nobody knows the effects of these drugs.

Mr. Jekielek:
The mental health outcomes.

Dr. Mendoza:
The mental health outcomes. Are they really happier? I don’t know. Some of these people never show up again at the clinic, so how would you even know about any outcomes? The whole adverse effect side or the whole evaluation side is just not part of the conversation. That was similar to the opioid issue. As this cohort grows, because they’ve created a new cohort of patients like they did with the opioid crisis, the detransitioners, the people that cease taking the drugs, you will see more and more challenges in the healthcare system. They will come into the ER.

Mr. Jekielek:
You talked about how you’re sensitive to systems moving towards tyranny. Please explain that for us.

Dr. Mendoza:
Like we said, the ends justify the means. These associations are conflicted, like the AMA that owns the billing codes. Yet, they are saying, “This is great care.” I’ve tried to work with the CDC to get a detransitioner billing code. My whole reform policy was vetted by a committee of subject matter experts from the American Psychiatric Association. It’s been rejected multiple times. The feedback was that there was not a problem with detransitioners, so there doesn’t need to be a code.

That’s tyrannical. It’s just this bureaucracy that is detached or not caring to look and be accountable for the results of this one-size-fits-all care, to the point where the detransitioners are just like the people who overdosed and were harmed by the opioids. They just say, “We don’t want to talk about those people.”

There aren’t any services for them, and there’s not even a billing code. If you don’t have a billing code, you can’t be in the insurance stream. You’re like a non-existent person in the medical world. But yet these are young kids who have had surgeries. They have had hormone replacement because their ovaries were removed.

Now, they are thrown into early menopause and there is no infrastructure to help them, even with things like getting their sex appropriately changed back in the electronic records. We’ve heard from detransitioners that it takes forever and that people in the hospital don’t even understand. They say, “What do you need?” They’re not even aware of this group.

The tyranny comes from this top-down hubris and they are just ignoring the people that are being harmed. It’s like what Stalin did with his policies with the grain, and yet all those people were starving. Stalin’s minister Lysenko said, “This is how you do things,” but the crops weren’t growing and those people were all dying.

They said, “Don’t look over there. Those people are non-people and it’s not worth figuring out how to help them.” We started the conversation by saying that I would treat anyone in the ER because that’s my duty, whether they have a Nazi tattoo on them or whatever.

Mr. Jekielek:
You say that if you accept that breaking a few eggs is okay or you ignore the harms of a so-called benevolent policy, that that will lead to absolutely atrocious outcomes. For a lot of people, the jump from gender medicine to the Holodomor made-made famine is a big one, but you’re suggesting it’s actually a very similar way of thinking.

Dr. Mendoza:
Yes. I see it in the ER. I have seen it with the opioid issue. When seeing these detransitioners being ignored, I said, “What?” I couldn’t believe that there would be a doctor that would ever do that or a health system that would think that that was ever okay. To me, it’s the next level down in terms of debauchery from where the opioid crisis had been. Again, I was shocked. I thought, “Don’t they care that these people are dying, and that moms, dads, or a young person are having their life snuffed out? Don’t they care?”

I was shocked. Taking away these kids’ sexuality and deforming their bodies to just go along with something that’s clearly a lie is a level below in hell. If you don’t stop that kind of thinking, and if you’re not listening to physicians who are raising concerns, that’s a huge red flag.

Mr. Jekielek:
There was a Canadian woman that was denied a lifesaving kidney transplant because she chose not to get vaccinated. Which is mind-blowing too because it would not have been helpful to the transplant in the first place. As I understand it, she passed away.

Dr. Mendoza:
Yes. We didn’t get as much into Covid here. I was there on the front lines and saw the divergence from what was really going on, to what was amplified in the media in terms of patient safety. I was a lot more aware of the different choices. But yes, with that story you mention, it’s horrible to think that someone would be denied care based on a lie and ignoring the fact that there were complications with the vaccine, that it wasn’t lifesaving, and that it wasn’t stopping transmission.

Mr. Jekielek:
When this big system gets something in its mind and there’s no consequences, and there’s no way for it to feel the ramifications of those decisions in terms of human life, it will just take us down a very dark path and repeat this phenomenon again and again.

Dr. Mendoza:
Yes. The historical cultural amnesia around how medicine has been used to hurt people is part of the story. That is not taught in medical school and if you don’t have a personal background where that is part of your growing up, you might not know about that. But I think history does repeat itself. As things get more technocratic and once the gender ideology has some guardrails around it, there’s just going to be other things.

I look at it as a new form of a drug of abuse. There will be guardrails around the youth, but humans have always wanted to relieve their suffering. The question is, “How do you do that, and to what degree?” The abuse of hormones is here to stay because there will always be a market for people who want to escape from themselves.

The way our bureaucratic administrative state has developed has certainly been an accelerant for all of this. Our country is incredible and has done great things, but we’re at the tail end of the Great Society coming apart. Hopefully, some of the lessons we’ve learned is that we are a startup nation, we’re great inventors, and we are also really good at scaling back bureaucracy. You can call us entrepreneurial, and that’s been part of the story here with the Great Society.

That’s a business model for a lot of people and they don’t want to give it up. We’ve seen the whole DEI coming in as their super highway. The next thing that comes along with healthcare, you have to watch for it and see who’s going into it to enact their policy prescriptions that they can easily scale up.

Mr. Jekielek:
Carrie Mendoza, it’s such a pleasure to have you on the show.

Dr. Mendoza:
Thank you so much. I’m honored. Thank you.

Mr. Jekielek:
Thank you all for joining Carrie Mendoza and me on this episode of American Thought Leaders. I’m your host, Jan Jekielek.

This interview was edited for clarity and brevity.