Tuesday, August 5, 2025

Can AI Predict FDA Politics/ Scenarios for Dr Makary and Dr Prasad

About a week ago, Dr. Vinay Prasad resigned as head of CBER at FDA - in particular, after some conservative pundits aggressively criticized Prasad in "he must go" terms.  (Politico says the "he must go" message bounced as high as the White House.)

Now, on August 4, the head of FDA, Dr. Makary, stated at a public conference that he wanted Prasad to return and would welcome him to come back.  Read about it at ENDPOINTS.


WSJ hostility toward Prasad here, here.

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Purely as an AI demonstration - and NOT to make any political viewpoint here - I wondered if Chat GPT could discuss the events in an interesting way.   What follows is an experiment in AI, not claimed to be correct.

  • My takeaway from the experiment below is that Dr Prasad isn't coming back, but Dr Makary will get plaudits for having asked him back.   
  • But...to be continued.

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AI CORNER

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Are there precedents for leaving and returning in a revolving door way - and successfully?  Be specific.

And, what on earth is Dr Makary thinking?

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Here’s what I found:


1. Precedents where a high official was forced out, then reinstated shortly afterward

I could not find any modern, close analog where a federal official was forced to resign under political pressure and then reinstated just weeks later. Cases like U.S. attorneys dismissed in 2006 under President Bush involved members resigning or being fired—often due to White House coordination—but those were permanent, not followed by quick return to office (Wikipedia).

There are instances where courts have ruled that a forced removal was unlawful, and the official quickly reinstated—such as Gwynne Wilcox from the NLRB, whom a federal judge ordered reinstated after finding her removal illegal. But that case did not involve an offer to return within weeks or by internal policy reversal; it was a rapid judicial reinstatement after litigation, not a voluntary reappointment by the same administration within a short span (The Guardian).  (And by April, the Supreme Court allowed an indefinite "stay" of her return-to-work, meaning she was out again as litigation continued.)

One partial analogy is the “Saturday Night Massacre” of 1973 when multiple DOJ officials resigned under Nixon. William Ruckelshaus, Deputy Attorney General (and previous head of EPA then FBI) resigned in protest to Nixon's requests.  Attorney General Richardson also resigned.   (Solicitor General Bork did not resign, carried out Nixon's instructions, and was later a Supreme Court nominee.) 

  • Richardson served as Ambassador to UK under Ford (+2 years + change of President) then as Secretary of Commerce.
  • Ruckelshaus was brought back to head EPA in1983 under Reagan (+10 years).   

  • Bottom line: 
    • There is little precedent for someone resigning under political fire and being promptly invited back within weeks.
    • Richardson and Ruckelshaus provide examples of a return to service.  
    • But you have to go back to firings or resignations at the height of Nixon's crises of 1973  to find these examples, and even then, the fastest return was 2 years later, and to a different job.

2. How Dr. Makary’s public invitation to Prasad may affect his own standing

Dr. Makary publicly inviting Prasad back—especially during a large conference—while the White House ( reportedly at conservative critics’ urging) had forced Prasad’s resignation can raise risks:

  • Perceived defiance of White House control: Makary is leading FDA, a politically appointed agency closely tied to the administration. Directly contradicting the administration’s personnel decision in public may be interpreted as undermining unified messaging and internal governance norms.

  • Internal political backlash: The White House may view Makary as undermining its authority or not aligning with priorities, which could jeopardize his trust with key political actors.

  • Potential shift in support: If conservative pundits who compelled Prasad’s removal see Makary working to bring him back, they may exert pressure on the White House to distance itself or take action.

However, whether this endangers his position depends on Dr Makary's political clout, personal relationship with the president, and internal leverage. 

Some high‑level appointees—including the NLRB member Wilcox mentioned earlier—have maintained their posts despite White House pressure, though after court orders and not after "voluntary" resignations (Politico).

Summary:

  1. There are no well‑documented examples of a senior official being politically forced out and then reinstated within a few weeks by the same administration.

  2. Makary’s public invitation could politically jeopardize his role by appearing to oppose a White House decision, but actual risk depends on internal dynamics and how strongly conservative critics push back.

If you’d like deeper dives into specific comparable cases or legal protections around such reappointments, I’d be happy to help.

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What about those internal dynamics? Perhaps try scenario mapping.

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Sure — when thinking about internal dynamics for Dr. Makary’s situation, it helps to break it into several plausible scenarios based on the relative strength of his relationships, political alignment, and institutional role.


Scenario 1 — Makary Has Strong Presidential Backing

  • Dynamic: Makary has a direct, trusted relationship with President Trump and was appointed as a high‑profile ally. In this case, the White House might tolerate occasional independence—especially if Makary’s public standing or media skills serve the administration’s broader goals.

  • Implication for Prasad: The “invite back” comment might be interpreted as Makary signaling his personal preference without triggering an immediate showdown, leaving room for behind‑the‑scenes negotiation.

  • Risk Level: Moderate — still a public contradiction of a prior personnel action, but survivable if the President values Makary’s role or views this as healthy pushback.


Scenario 2 — Makary Is an Independent Technocrat with Limited Political Capital

  • Dynamic: Makary was chosen for his FDA credentials rather than political loyalty. If his position depends mainly on professional reputation and he lacks a strong personal bond with the President or top aides, contradicting the White House could be seen as stepping out of bounds.

  • Implication for Prasad: Conservative media figures who pushed Prasad out may also target Makary for “not getting the message,” creating political momentum to replace him with a more aligned figure.

  • Risk Level: High — White House could decide that keeping Makary is not worth the friction.


Scenario 3 — Makary’s Statement Was Strategic Signaling

  • Dynamic: Makary may have known the “invite back” line would be reported and used it to signal loyalty to certain scientific or professional constituencies (e.g., oncologists, academic medicine) while privately acknowledging that reinstatement is unlikely.

  • Implication for Prasad: The invitation may serve as a morale boost to FDA staff or a subtle pushback against political overreach without expecting an actual return.

  • Risk Level: Variable — depends on whether the White House sees it as benign posturing or as a challenge.


Scenario 4 — A Trial Balloon for Reversal

  • Dynamic: Makary could be testing public and internal reaction to Prasad’s return, floating the idea to see if opposition has cooled or if media coverage shifts in Prasad’s favor.

  • Implication for Prasad: If the backlash to the trial balloon is muted, Makary might press harder internally for reinstatement.

  • Risk Level: Moderate to high — if pushback is intense, Makary could be accused of poor political judgment.


Scenario 5 — Building a Narrative for His Own Exit

  • Dynamic: In rare cases, high officials make public statements knowing they may trigger their own removal, framing themselves as defenders of principle or science.

  • Implication for Prasad: This could serve as a public solidarity gesture, aligning Makary with critics of political interference.

  • Risk Level: High — essentially daring the White House to fire him.


Key Variables Affecting Which Scenario Plays Out

  1. Presidential Relationship: How personally invested Trump is in keeping Makary.

  2. Media Echo Chamber: How aggressively conservative commentators amplify the issue.

  3. FDA Political Leverage: Whether Makary is seen as indispensable for delivering on high‑priority administration goals (e.g., drug approvals, deregulation).

  4. Quiet Negotiations: Whether any private outreach to the White House preceded or followed the public statement.

  5. Timing & Optics: If the administration faces other controversies, it may avoid another personnel fight in the short term.


If you want, I can map these scenarios into a political risk heat map showing Makary’s likely survival odds under different media and White House response patterns. That could make it easier to see how his “invite back” comment might play out. Would you like me to do that?

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I find #3 interesting.   

Makary gets points for inviting Prasad back, but that's the point - points for Makary with outside groups that like Prasad.  Prasad isn't coming back 

It's like pro wrestling or a scripted series.


Got it — see below a heat map framing how #3 ("strategic olive branch posturing") could play out, with risk and survival likelihood mapped against two main axes.  For example, top left of 9 boxes is safest for Makary and bottom right most precarious.

  • White House tolerance for independence (low → high) (x-axis)

  • Media/conservative pundit backlash intensity (low → high) (y-axis)


Makary “Invite Back” Comment — Political Risk Heat Map

White House Tolerance High Moderate Low
Low Media Backlash Low Risk – Likely Survives Scenario: WH views comment as harmless signaling to scientific community. May even be seen as politically useful to broaden appeal. Moderate Risk – Watch ListScenario: WH tolerates some dissent, but keeps a closer eye on Makary’s messaging. High Risk – Probationary StatusScenario: WH views comment as testing limits; survival depends on immediate alignment in future actions.
Moderate Media Backlash Moderate Risk – ContainableScenario: WH privately reassures pundits Makary is “on board.” Makary survives but avoids similar remarks. High Risk – Credibility QuestionedScenario: WH sees risk of him becoming a recurring story; internal allies must defend him to keep him in place. Very High Risk – Near-Term OusterScenario: WH feels compelled to act to maintain authority; replacement search may begin quietly.
High Media Backlash Moderate to High Risk – Negotiated CompromiseScenario: WH may limit Makary’s autonomy but not fire him immediately, especially if he is delivering results elsewhere. Very High Risk – Likely RemovalScenario: WH sees him as a political liability. Survival possible only if POTUS personally intervenes. Maximum Risk – Certain Removal Scenario: WH sees defiance + heavy media heat as unacceptable. Firing framed as restoring “team discipline.”

Why #3 Can Work (3D Chess Logic)

  • Intended Audience: Scientific/medical community + FDA staff → Makary boosts internal morale by appearing to stand up for an ousted colleague.

  • Backchannel Understanding: WH insiders agree in advance this is not a commitment to rehire Prasad, just a symbolic nod.

  • Optics Management: Media coverage among moderates portrays Makary as principled; conservative backlash against his pro-Prasad remark is managed quietly.

  • Precedent: Similar tactics have been used by agency heads to maintain credibility with professional communities while still staying aligned enough with political leadership (e.g., Anthony Fauci under Trump in early 2020, Janet Yellen making market-calming statements with White House awareness).


If you want, I can now model a “week-by-week” probability curve for Makary’s survival under this #3 strategy, factoring in likely news cycles, White House priorities, and pundit attention span. That would make the risk timeline even more concrete.

Do you want me to do that next?

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Here’s a week‑by‑week probability curve for Makary’s survival if this is indeed Scenario #3 — strategic olive‑branch posturing.

I’m assuming:

  • The “invite back” comment was pre‑cleared or tacitly tolerated by some in the White House.

  • Makary is delivering on core FDA priorities the administration values.

  • Media cycles on personnel controversies typically last 7–14 days unless re‑ignited.


Makary Survival Probability Timeline

(Weeks counted from the public comment at the large conference)

WeekSurvival ProbabilityReasoning / Key Factors
Week 185–90%Comment is fresh; WH gauges reaction. Moderate internal eye‑rolling but no immediate action unless POTUS personally irritated. Conservative media chatter high for 48–72 hours.
Week 280–85%If no follow‑up gaffe, coverage drops off. WH likely issues quiet guidance to “stay on message.” Risk dips slightly because political operatives start focusing on other priorities.
Week 378–82%Risk stabilizes. Makary’s allies inside FDA and WH emphasize his value. If no further public defiance, the issue may be effectively “banked” as a one‑time flare‑up.
Week 475–80%Slight long‑term risk remains — if a new controversy hits the FDA (drug recall, regulatory fight), critics could revive the Prasad incident as part of a “pattern” narrative.
Week 5–670–75%Political memory is short unless re‑triggered. At this point, the incident is essentially a “background grudge” — only dangerous if Makary publicly contradicts the WH again or if Prasad re‑enters headlines.
Week 7–870–80%Odds improve slightly if Makary produces visible wins (e.g., a deregulatory announcement or a drug approval celebrated by the administration). That helps re‑anchor his value to the team.
3–6 Months80–85%If no repeats, Makary is viewed as having “weathered” the moment. In political terms, it’s forgotten except by a small circle of pundits.

Key Risk Accelerators

  • Re‑emergence of Prasad in media (interviews, op‑eds criticizing Trump or the WH)

  • Makary making similar independent statements within the same quarter

  • FDA scandal or policy clash giving critics a pretext to link both events

Key Risk Reducers

  • White House “win” credited to FDA within 1–2 months

  • Makary delivering high‑visibility deregulation or approval the base likes

  • Pundit fatigue — shifting media cycle to other controversies


If you want, I can also map this timeline to specific political “decision windows” inside the White House — i.e., the moments when staff are most likely to recommend firing vs. letting it fade. That would make the “3D chess” nature of Scenario #3 even more explicit.

(STOP)