Most people assume the answer is simple: greed. But the real story is far more complicated — and far more surprising.

In this episode, I sit down with Sam Kazer, PhD, a scientist who has worked across academia, global health, and the pharmaceutical industry, to break down what it actually takes to turn an idea into a real medicine. We talk about why drug development takes 10+ years, why clinical trials are so expensive, and why most drug ideas fail long before they ever reach patients.

We also explore:

1. Why “Big Pharma” isn’t a single villain
2. How academic research and industry depend on each other
3. Why biologic drugs cost more than small-molecule drugs
4. How public funding quietly enables many of the medicines we rely on
5. What people misunderstand most about drug pricing and regulation

This isn’t a defense of the pharmaceutical industry — it’s an explanation of the system we all rely on, and why simple answers don’t capture the full picture.

Is the medical system broken? And what does plastic surgery really do?

In this episode of the Unknown Variables Podcast, Dr. Anthony Rojas speaks with Dr. Kianna Jackson, MD, Chief Resident in Plastic & Reconstructive Surgery at Vanderbilt University, MIT graduate, and founder who challenged the residency application system itself.

Most people think plastic surgery is about Botox, breast implants, or celebrity aesthetics. Dr. Jackson explains why that’s wrong—how plastic surgery is about form and function, restoring faces after trauma, burns, and cancer, and helping patients reclaim their identity when their ability to speak, smile, or be recognized has been taken from them.

Dr. Jackson also shares her experience as a Black woman in surgery, confronting imposter syndrome and the “DEI hire” narrative despite graduating first in her medical school class and becoming the first Black student to win Vanderbilt’s highest academic honor. She offers a nuanced, honest discussion of affirmative action, equity vs equality, and why diversity in medicine leads to better patient outcomes.

The conversation goes deeper into the broken medical training pipeline. Dr. Jackson recounts spending thousands of dollars applying to residency, uncovering a system that extracts over $100 million annually from medical students, and building CentralApp, a platform that disrupted the residency application process nationwide—forcing ERAS to lower its fees. She also shares hard-earned lessons from founding a startup while working 80-hour weeks as a surgical resident.

This episode explores:

1. What plastic surgery really is (beyond aesthetics)
2. Facial reconstruction and restoring identity
3. Burn, cancer, and trauma reconstruction
4. Being a Black woman in surgery
5. DEI, affirmative action, and imposter syndrome
6. Why residency and medical school admissions are broken
7. The true cost of becoming a doctor
8. Lessons from building (and losing) a medical startup
9. Mentorship, medicine, and choosing the right path

Whether you’re a premed student, medical trainee, physician, healthcare professional, or simply curious about how medicine actually works, this conversation will change how you see plastic surgery—and the system behind it.

🎧 Listen to the full episode on the Unknown Variables Podcast

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What is it actually like to work at the CDC?

In this episode of the Unknown Variables Podcast, I sit down with Dr. Erin Thomas — a sociologist at the CDC — to unpack the side of public health most people never see: systems, behavior, trust, and the human factors that determine whether good science turns into real-world outcomes.

We talk about:

1. Why “CDC work” is so much more than labs and vaccines
2. How bias and structural barriers show up in lactation support and breastfeeding care
3. What the U.S. Ebola response revealed (and why COVID exposed it at scale)
4. Why changing guidance can destabilize the public — even when it’s scientifically correct
5. How CDC work shifts across roles: research → evaluation → tuberculosis (TB) programs
6. Why TB still matters in the U.S. (and who it impacts most)
7. What it takes for evidence to actually change practice in a massive organization
8. And what still gives her hope about the future of public health

If this conversation helped you see public health differently, subscribe/follow — it tells me to keep making episodes like this.

Guest: Dr. Erin Thomas (CDC)

Note: Views expressed are the guest’s own and do not necessarily represent the CDC.

Host: Anthony J. Rojas, Ph.D.