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

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Episode Summary

Dr. 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 Markers

00:00 Introduction and Tracy's bio

02:19 Origin story: French major, med school, ophthalmology dropout

07:42 Seven years in Denmark: PhD, clinical work, ultra marathon racing

10:55 Back to the US: PM&R, interventional spine, and the start of COVID research

13:43 Funding research outside the NIH pipeline

17:18 How government funding crowds out independent science

20:59 Evidence-based medicine, spine, and the N-of-one problem

25:35 The Wisconsin school transmission study

28:32 If masks were a drug, would they pass FDA approval?

30:04 Testifying before Congress three times

32:46 The myocarditis preprint: origins, backlash, and vindication

38:34 Post-vaccine myocarditis: what the data actually showed

43:01 Regulatory failure, COVID vaccine risk-benefit, and the pediatric question

45:09 How Europe and Scandinavia got it right earlier

47:58 Cancel culture in academia and the chilling effect on scientific questions

51:18 Joining the FDA: how it happened and what she expected

53:50 What the FDA looks like from the inside vs. the outside

56:38 Where real philosophical disagreements lived within the agency

58:58 Reducing animal testing and CNPV pilot: what actually got done

1:01:45 Leaks to the media: where they came from and what they meant

1:05:17 What the FDA's role should be

1:06:23 Pharmaceutical industry influence and the Wall Street Journal editorial board

1:14:48 The firing: why she refused to resign

1:18:53 The chain of command and who is responsible

1:21:08 What the firing signals about FDA reform

1:27:42 Advice for anyone thinking about taking a leadership role in government

Co-Host Handles

@anish_koka and @drdigiorgio

Show Handle

@drsloungepod

Resource 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=web

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