The first time that Mehmet Oz was questioned by the Senate, in June 2014, the atmosphere was not inviting. He’d been hauled in to defend his habit of promoting unconventional supplements for weight loss, including green coffee beans, raspberry ketones, and an Asian tropical fruit called garcinia cambogia, on his daytime-television talk show. “I don’t get why you need to say this stuff,” Claire McCaskill, the Missouri senator who chaired the hearing, told him. “Because you know it’s not true.”

Last Friday, Oz was back before the Senate, this time to be questioned as President Donald Trump’s nominee to run the Centers for Medicare and Medicaid Services. In the interim, despite a turn to politics that included an unsuccessful bid to join the Senate himself, Oz has stayed the course: selling stress-relieving shrubs on social media, for instance, and leveraging his mother’s Alzheimer’s to pitch herbal remedies. Now a physician who was once described by other doctors in an open letter as demonstrating “an egregious lack of integrity by promoting quack treatments and cures in the interest of personal financial gain” may soon be tasked with regulating the health insurance of more than 150 million Americans. But the context of his return to Washington has cast the former TV star in a new, more flattering light: Next to some of the other appointees to the Department of Health and Human Services, even Dr. Oz seems safe and normal.

I’ve had a front-row seat for Oz’s unlikely transformation from maligned to mainstream. In 2013, when I was still in medical school, I launched a public effort to censure him. His exuberant pitches for unproven remedies were harming patients, I contended. I asked medical societies to do more to combat the spread of misinformation. My efforts were rebuffed at first; doctors were worried about infringing on free speech and criticizing professional colleagues. To buttress my campaign, I started collecting anecdotes from viewers of The Dr. Oz Show describing potential harm caused by his advice.

Oz did not respond to any of these efforts at the time. (He also did not respond to a request for comment on this story.) His initial dressing-down in Congress followed soon after, and then in 2015, I helped a group of medical students and residents cajole the American Medical Association into writing guidelines for ethical physician conduct in the media. Oz himself remained unchastened after this previous run of bad press, though. “We will not be silenced. We will not give in,” he told his TV viewers in 2015, while accusing one group of critics of having industry ties and denying that he ever promoted treatments for personal gain. In short, he embraced his reputation as a wellness guru and anti-establishment truth teller—the sort of person who would find a natural home in the “Make America healthy again” movement that has been popularized by Robert F. Kennedy Jr.

Oz is likely to join Kennedy’s Department of Health and Human Services—and assume control of my parents’ health insurance, among so many others’—in the weeks ahead. That prospect would have terrified me in the 2010s, when I first watched him testify before the Senate. But when I saw him do so for a second time on Friday, he no longer struck me as a major threat. Rather, he looked like an anachronism: a charming celebrity physician with a penchant for theatrical claims. In the face of the Trump administration’s chaotic razing of the nation’s biomedical infrastructure, Oz’s brand of hucksterism seems relatively mild, even quaint.

Perhaps that’s why the Senate showed so little interest in his history of hawking suspect treatments. Even Democrats went pretty easy with their questions. Senator Ron Wyden accused Oz of having engaged in “wellness grifting,” and Senator Maggie Hassan said he’d backed “unproven snake oil remedies,” but this was not a central focus of the hearing. “There are many things I said on the show,” Oz said in response. “I take great pride in the research we did at the time to identify which of these worked and which ones didn’t.”

Instead of grilling Oz on his questionable supplement endorsements, the legislators mostly used their time to lobby for niche policy fixes, and Oz in turn displayed an expertise in health-care policy that seemed worthy of his Wharton MBA. He was fluent on the topics of pharmacy benefit managers, prior authorization, insurance payment models, and the Affordable Care Act. He came out in favor of work requirements for Medicaid—a conventionally conservative approach—while also making sure to show some sympathy for health-care consumers, calling the insurance companies that profit from excessive upcoding “scoundrels who are stealing from the vulnerable.”

This all came off as rather serious and boring, in the way that such a hearing really should come off. Compare that with the nomination hearings for Kennedy: When questioned by the Senate, he botched basic facts about Medicare and Medicaid, refused to admit that vaccines don’t cause autism, and accused committee members of being shills for pharmaceutical companies. Dave Weldon, who was Trump’s pick to run the CDC, didn’t even make it to his hearing, which was also scheduled for last week. Why Weldon’s nomination was withdrawn is not exactly clear, but it’s possible he made the error of being slightly too transparent about his suspicions of standard childhood vaccines. When positioned next to Kennedy and Weldon, or to Trump’s picks to run the NIH and the FDA, Oz seems quite conventional. He clearly stated that the measles shot is both safe and effective, while doing little to attach himself to the angry COVID contrarianism expressed by Kennedy and other nominees for leadership at HHS. (HHS did not respond to a request for comment.)

So now we seem to have arrived at the strange moment when a celebrity TV doctor with no significant experience in public administration, a physician who once suggested that pineapple chunks and chia seeds were reasonable treatments for sciatica, can present himself as an unusually rational and stable candidate for leadership in the nation’s public-health establishment. Oz may even become an advocate for a more conventional approach to health-care policy in a department that is now run by someone who touts the benefits of treating measles with cod liver oil. Improbably, the “green coffee beans” guy is poised to be the grown-up in the room.

Maybe you were one of the 11.7 million people who watched when, on House M.D., the genius diagnostician Gregory House is roused in the middle of the night by a pounding at the door. A man he just gave a clean bill of health has collapsed and died. House and his colleague Eric Foreman decide to perform an autopsy themselves. Eager to see the man’s heart, House pushes Foreman to plunge a whirring saw into the patient’s sternum. They peer down: Blood seems to be trickling from the wound. “That’s odd,” says Foreman, “almost looks like he’s … bleeding?” There’s a beat. Then the man’s eyes open wide and he screams.

If you missed this particular episode, you’ve surely seen something similar. Autopsies play a starring role on CSI, Bones, and many other prime-time dramas about medicine and forensics. They may very well be the medical procedure that Americans have been most exposed to via their screens, and yet among the most misunderstood. The way these shows depict autopsies is so disastrously wrong that they not only discourage families from opting into these vital procedures; they even diminish doctors’ understanding of how autopsies work.

On television, autopsies happen in dark rooms with blue light. They involve scalpels, bone saws. Jaded techs in lab coats discuss ligature marks and defensive wounds. Doctors frown at something mysterious and disturbing. Many (but not all) of the pathologists performing autopsies are maladjusted weirdos; the nonspecialist doctors, like House, do things that would cause them to lose their medical license. In one episode of Grey’s Anatomy, Sandra Oh’s and Katherine Heigl’s characters carry out an autopsy in direct contravention of the patient and family’s orders, which is, need I say, illegal; in another, the autopsy pathologist callously chews gum and makes a dinner reservation while cutting. In just about every single episode of CSI, techs wearing no protective equipment whatsoever stand in rooms lit like dive bars, feeding slivers of human tissue into machines that whir briefly and spit out a neat list of every foreign substance in the body.

Most Americans will never see a real autopsy, so our impressions of them are formed by TV portrayals. That’s how it was for me, until I spent two weeks observing autopsies in a hospital in Pittsburgh as part of research for a novel. In real life, autopsies are performed in brightly lit rooms. (Forensic autopsies must sometimes be completed in the field if, for example, a body cannot be safely moved.) The autopsist begins with a Y-shaped incision into the sternum and works methodically through the body. Sometimes the internal organs are inspected in situ, but more typically they are removed, washed down, and dissected on a water table. The autopsist doesn’t just pick up an organ, look at it, make a diagnosis, and plop it back in; rather, they catalog as many of the body’s pathologies as possible, whether or not they’re suspected of causing death. They also take care to make sure that none of the evidence of this inspection would be visible in an open-casket funeral. It’s slow, comprehensive work that rarely involves fancy electronics.

Perhaps the most subtly ridiculous aspect of TV autopsies is the lack of personal protective equipment. In real autopsies, the people involved wear head-to-toe PPE—surgical scrubs, armguards, booties, an apron, a face mask, a splash shield, and a cap—because, when you open a human body up, all the blood, bile, and other fluids that a person had in life are still in there. Blood can still ooze from a wound, even when it’s not being pumped through the body. Did the writers of that House M.D. episode think the human body spontaneously exsanguinates when the heart stops?

Errors like these in TV depictions reduce autopsies to ghoulish spectacles, when the procedure is in fact a respectful and uniquely useful tool for understanding how a person lived and died. Families might decline an autopsy for a number of reasons: cultural taboos, simple squeamishness, a sense that the decedent has suffered enough, a desire to take possession of the body right away. But a death need not reach some threshold of suspicion or mystery to merit investigation; many teaching hospitals, where residents might observe autopsies to deepen their understanding of anatomy, will perform an autopsy for free on any patient if the family asks. Anyone can get one, and more people should.

Autopsies, even in cases where death was expected, can serve a real purpose to the living. They help present a full narrative of disease, which can help doctors treat other patients and—if communicated well—allow grieving families to move toward acceptance. Autopsies can catch hereditary illnesses that doctors tend to miss, such as signet-ring-cell carcinomas, and reveal causes of dementia that may have been misdiagnosed as Alzheimer’s. Even in suicides, where the cause of death is usually obvious, autopsies can reveal underlying problems that might have contributed to the deceased’s distress.

[Read: There are no ‘five stages’ of grief]

Despite how useful autopsies are, they have become an endangered species. In one survey conducted at Massachusetts General Hospital in the mid-2000s, residents overwhelmingly said they had never watched an autopsy, much less performed one. And doctors aren’t always comfortable discussing them with patients’ families. Autopsy rates more than halved from 1972 to 2007, plunging to a measly 8.3 percent. In many other countries, the rate is even lower.

Not all hospitals provide autopsy services; in many of those that do, asking the family of a deceased patient whether they would like an autopsy falls to residents, many of whom lack the training to properly describe and clarify the process. In that moment, there’s little to stop the grieving family from calling up all the lurid images they’ve likely seen on TV. Take, for example, a 2020 episode of The Good Doctor literally called “Autopsy.” Shaun Murphy is operating on an ER patient, an unhoused Jane Doe, when her carotid artery “blows out” and she bleeds to death in a matter of seconds. Over the next 40 minutes of screen time, the following things happen:

The hospital denies Murphy permission to do an autopsy. (Apparently, arteries explode every day.) So he tracks down the woman’s estranged son, who also denies him, inspiring Murphy to attack the man’s car, shrieking at him. Nonetheless, the head of pathology (who just broke up with Murphy) allows him to do the procedure. He conducts the autopsy himself, in a dark room and wearing no PPE beyond a cute little apron, while the pathologist stands indulgently behind him. He plucks out the woman’s liver and regards it briefly, then puts it back and exits, without sewing her up or taking a tissue sample. Finally, he shows up at the son’s house to say that his mother had Ehlers-Danlos syndrome, which is hereditary, and that the son must get treatment. All is forgiven.

This is an episode that makes a case for autopsies. The only remotely realistic thing about the episode is the son’s reluctance to consent. And after watching that gruesome exercise, would you?

[Read: Health care in the time of Grey’s Anatomy]

On these shows, the stark truth of a dead body is either milked for shock factor or smoothed over with holograms. Each chemical in a person’s body can be identified with a machine, and each story has a satisfying ending. Everyone knows life isn’t like that. We need to accept that death isn’t, either.

This article was featured in the One Story to Read Today newsletter. Sign up for it here.

When the Trump administration announced that it was canceling $400 million worth of grants to and contracts with Columbia University, ostensibly to punish the university for its handling of anti-Semitism amid pro-Palestinian campus protests, one important detail went unspecified: what type of funding, exactly, would be getting cut. In the weeks since, researchers at the university have found themselves moonlighting as detectives, trying to understand why some of them saw their life’s work upended while others were spared.

They believe they have found a pattern. As far as they can tell, nearly all of the canceled grants seem to have made some mention of diversity, equity, inclusion, or other disfavored topics, several med-school researchers told me.

Making the cuts even more maddening is the fact that, at least until a few months ago, the federal government required researchers to include plans to “enhance diversity” in many grant applications. And under a policy first implemented during the George H. W. Bush administration, the National Institutes of Health long offered supplemental funding for grants that employed someone from an underrepresented minority group. Now the same factors that helped researchers get their grants approved may have become liabilities. “You can imagine how it feels to be terminated for following the government guidelines,” Domenico Accili, an endocrinology professor, told me.

[Rose Horowitch: Colleges have no idea how to comply with Trump’s orders]

Beyond the capriciousness of punishing researchers for following the prior administration’s rules, the grant cancellations demonstrate the impossible position that Columbia’s researchers are in. If they didn’t pursue DEI objectives before, they could have lost out on grants or even violated congressional mandates. If they did, they’re at risk of ending up as collateral damage in the culture war. They’d prefer to just get back to the science.

The cuts have already had significant effects. Because medical-research funding is such a large share of federal support for higher education, Columbia’s med school has borne the brunt of the funding cuts. This makes the punishment seem even more arbitrary—the medical school is several miles away from the campus where the bulk of the pro-Palestinian protests occurred. Columbia’s cancer center has stopped work on several clinical trials for disease treatment and symptom management, Dawn Hershman, an oncologist, told me. Hershman said that, unlike many of her colleagues, she isn’t convinced that there is any DEI-specific pattern to the cuts thus far; even so, her lab has been modifying clinical research to comply with Trump’s anti-DEI directives. “This type of disruption costs money and time—time that people with cancer don’t have,” she said. Accili, who leads the Diabetes and Endocrinology Research Center, had to stop work on a clinical trial that had tracked patients since the 1990s. Because he can’t finish the study, all the data are unusable, he told me.

If the Trump administration is in fact targeting these grants because of ideological factors, it’s caught a lot of apolitical research in the crosshairs. According to an email from the director of the Columbia Stem Cell Initiative to colleagues, grants to train aspiring researchers were canceled because of their diversity component. Grants that mentioned climate, race, HIV, or COVID also appear to have been cut, as were grants that support centers to study cancer, diabetes, and Alzheimer’s.

[Read: Inside the collapse at the NIH]

Megan Sykes, the director of the Columbia Center for Translational Immunology, received supplemental funding to employ a Black graduate student on her research grant. But the grant itself studied better ways to transplant animal organs into humans. One of the grants canceled at Accili’s lab included an effort to recruit transgender patients. But the study itself looked at the progression of bone disease in humans. (Accili told me that, when it came to grants to support early-career scientists, filling out the paperwork related to the NIH’s diversity requirement was sometimes a burden. Some specialties already struggle to recruit enough young physicians; adding new demands, he said, only makes that more difficult.)

One engineering-school professor whose graduate student lost the grant that paid his stipend said that the student didn’t participate in the protests on either side. “It’s so disconnected from anything he does,” the professor, who requested anonymity for fear of more grant cuts, told me. “He’s ending up suffering consequences nominally for how Columbia’s leadership handled the protest.”

Some of the researchers feeling the biggest effects of the punishments are themselves Jewish. Columbia has an unusually high proportion of Jewish students and professors. (The Jewish campus organization Hillel estimates that Columbia’s grad-student population is 16 percent Jewish.) Many are seeing their livelihood thrown into question in the name of fighting anti-Semitism. They’re aware of the irony. Sykes, who’s Jewish, told me that she’s frightened by the rise of anti-Semitism. “But I just don’t understand the connection between that and NIH-funded biomedical research,” she said.

Last week, Trump’s anti-Semitism task force told Columbia that it would consider restoring the $400 million if the university takes a number of specific steps to crack down on pro-Palestinian protesters and address anti-Semitism, including changing its discipline policies and banning masks that protesters use to conceal their identities. But even if the money comes back, things won’t return to the way they were before. Now that Trump has set the precedent of pulling scientific funding as a punishment for unrelated offenses, scientific research will always be at risk of being caught in the middle. Prior administrations, including Joe Biden’s, have used university funding as a way to further certain priorities. But Trump’s is the first to wield the threat of lost federal funding as a political cudgel. If obeying the dictates of one administration places scientists at risk of being persecuted by the next, what are they to do?

Accili has warned faculty members not to use any terms related to diversity, equity, and inclusion in future grant proposals. He has even advised them to avoid technical phrases, such as “gain of function,” that have become associated with pandemic-related controversies. “We’re in a phase in which we have to watch what we write or what we say for fear of offending the ongoing political sensitivities,” he told me. That has never been an ideal condition for scientific progress.