More harm and chaos within the US federal research system

I work inside the US federal research system and The BMJ allowed me to publish an anonymous account of how science and certain populations are under attack from our own government.1 Last week continued to be bad. We were overwhelmed with distractions and threats to productivity.

First, our residents, fellows, interns, and post-docs were fired for being new government employees on their probationary period. The preparation to sit with them was heartbreaking. We had to discuss the details of how to prepare to be fired at a random time and consider what would happen to them. In addition to being unemployed, they will lose their health insurance that is linked to their employment. This fills them with fear. Someone I know is on an expensive medication for a chronic condition, and without insurance cannot get the medication.

These fired colleagues have been betrayed. They came to us to learn, and they trust us to help prepare them for the future. We look to them to run laboratories, coordinate studies, and write manuscripts, but more so to expand our science and eventually replace us. They leave a gap that will be hard to fill, and we have already lost education and training because of the pandemic. If only our leaders would realise that this “firing of the children” or of “probationary employees” is no way to cure cancer or any other disease.

Next, we had to spend time reviewing our webpages for forbidden words and concepts. We had to review not just outward facing internet pages, but also internal files. We were policing our internal selves. We then had to review the internal pages of another group while they inspected ours. Did we use the word “gender” or “equity” or did we imply that one group is better or worse because of the actions of another group? We now have only two sexes in the US and zero genders, and the word “transgender” is strictly forbidden. I find it odd that the word is so offensive that it can no longer be said or written. Last week I wrote about digital genocide that comes from deleting the transgender population from our datasets. It is worth noting again here.1

For programmes that require accreditation or engage in public health this review of webpages and internal files is particularly challenging. One of the newest institutes in the National Institutes of Health is the National Institute of Minority Health and Disparities. I continue to check that they exist amid the chaos. I feel bad pointing them out in case they have been under the radar with our “thought police” not noticing them. Studies of disparities and inequities are especially important in the US because we lack universal health coverage. The differences in outcomes and access became widely recognised when one of our most beloved television celebrities, Oprah, ran a two-hour special dedicated to health inequities focused on the experience of the pandemic. Black History Month, which is February, is not spoken of this year: it is as if it never existed and we are in an alternate universe. Oddly, even those outside of the federal government do not mention it. Was it so easy to erase this or is everyone frightened of the consequences? It is impossible to tell.

Then at 5pm on Saturday every single federal employee received a wild email telling us we must report our five activities from last week to a central authority. Also, we were told via X [formerly Twitter] that if we did not complete this by 11.59pm on Monday it would signal our resignation. Some tell us that “This is normal business practice in the private sector.” But it is not normal business practice in any sector. If you are required to do a time accounting, you are trained how to do it; and it would not be sent to you on a random Saturday evening with a “you quit” deadline a little more than 48 hours later. Afterall, we cannot use our federal accounts on our private phones and computers—and what if someone were in the hospital or on vacation? Many of the agencies have pushed back as there is a national security risk: imagine if the FBI and CIA employees were to complete that assignment.

Project 2025, the plan prepared over years for what would happen when Trump was elected, told us that they want federal employees to be traumatized. It is true, we do not have the right to work and should not feel smug in the relative stability of a government job. In this new environment, we must resist and survive. How does a responsible public servant and scientist survive when colleagues are being fired and budgets slashed? Here are my suggestions. You might like to share others.

1. Recognise that fear and trauma are the goals. Knowing that is a form of comfort as it establishes a baseline. They want us to go to sleep and wake up afraid: “The head of the military has been fired” and “There is an email that if you don’t respond to will get you fired.”

2. Stand together. While it is impossible to know who thinks destroying science is a great idea, find those you can trust and communicate safely and outside of work. Meet for coffee. Go for a walk together.

3. Never quit. Remember your training and your responsibilities to the Constitution and to your profession. If you quit, they will not replace you. Do not go quietly.

4. Prepare to be fired so that the shock and awe do not surprise you. Download tax documents, retirement documents. Save your contacts and your performance appraisals on your personal computer. Also, save your manuscripts in progress. Expect to be cut off in the middle of the night with no return.

5. Practice selfcare and cling to your wellness. Put down the phone and be religious about sleep hygiene. Go for walks or lift weights or dance. Preserve your physicality, you will need it for the long haul. Love your family and spend time with your friends.

None of us deserve this. If we wanted to shrink the federal government and remove waste and fraud, we would have designed a systematic approach to review portfolios and do away with priorities that were no longer relevant to the needs of the nation. But they did not ask experienced managers and leaders. They wanted shock and awe, to drain the swamp. Oddly, some Americans are cheering, and that might be the hardest part to understand—not because as researchers and healthcare professionals we are privileged, but because the lack of data and lack of research progress in health conditions will hurt their families, neighbourhoods, and communities—the very same communities that we belong to and are serving. It is complex. Do not be discouraged. We must stay strong.