HHS employees' reactions to Trump administration's bizarre Saturday "What You Accomplished" email.

A "justify your existence" email from Trump's Office of Personnel Management went out on Saturday, following an Elon Musk tweet. "How is this real life?!?" one CDC employee responded.

Hi everyone,

I worked clinically overnight on Friday night and slept most of Saturday. When I woke up, my Signal was blowing up about a pretty strange tweet by Elon Musk (even by his standards) which announced an even more peculiar email that was to be sent to federal employees later that day. I spoke to a handful of HHS employees about their reactions to the situation, and what they initially planned to do. It’s worth remembering that these dedicated professionals are enduring some Kafka-esque scenarios here, and my hat is off to them for persisting through all of this nonsense. So, I’m happy to be able to amplify the voices of around half a dozen of them right here in Inside Medicine. Let’s dive in…

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A screenshot of an email sent by the Trump administration to an NIH employee. Metadata scrubbed.

Office of Personnel Management sends federal “make work” email to federal employees.

On Saturday, Elon Musk posted a rather strange tweet:

“Consistent with President @realDonaldTrump’s instructions, all federal employees will shortly receive an email requesting to understand what they got done last week.

Failure to respond will be taken as a resignation.”

Later in the day, the promised email went out, sent by the Office of Personnel Management (OPM), which essentially asked employees to justify their existence. As you can see in the screenshot of the email obtained by Inside Medicine, the email was equal parts vaguely menacing and bizarre—marked by the amateurish and unclear language (e.g., “approx. 5 bullets” and “cc your manager”) that have become hallmarks of the Trump administration.

Taking unserious things seriously.

As sophomoric and inane as this all sounded, it had to be taken seriously—or at least considered serious. Indeed, Elon Musk’s tweet made it seem like the stakes were pretty high: respond or be terminated. However, the OPM email itself (see above) contained no such direct threat, other than mentioning an ominous deadline of one Monday evening, one minute before midnight.

As usual, HHS employees reactions were a mix of confusion, annoyance, and even ironic amusement—gallows humor, to be sure.

“Every email we’ve received since January 20 could have been written by a high schooler,” said a CDC employee who was randomly terminated last week. “The first one we all got we truly thought was spam.” Unfortunately, it was not spam.

I spoke with several other current HHS employees, and asked whether they intended to reply to the OPM weekend killer. Their responses were mixed.

“Not planning on it. I’m hoping the union comes out and tells us not to,” one of my CDC sources told me. “He’s just going to feed all the responses into AI. And then what? I cannot even begin to fathom the implications of that, but they are not good.”

HHS employees weigh their options.

Some HHS employees seemed unsure about both the best strategic response and the legality of the situation. “[The] premise that we resign if we don't respond is totally illegal,” the source added.

Another HHS employee said they would probably just go ahead and reply. “Well, I certainly don't want to give anyone a stupid reason to fire me,” that person told me, saying, “I have five bullets in five minutes.” While I admire that confidence, I also don’t think this administration shares the values of many of the best minds working within HHS.

Two other CDC employees had varying responses. Asked if they would respond to the OPM email, one said, “Not sure. Going to discuss with some people on Monday. My first thought was no, unless explicitly instructed by someone at CDC.”

Another took the response in stride. “Yup!” they said, conveying a general attitude that might be characterized as whatever!

Hardly a model of efficiency.

Regardless, the OPM request was already creating "make-work" for HHS employees, and presenting them with downright wacky strategic conundrums. (So much for the “efficiency” part of the Department of Government Efficiency.) For some planning to reply to the OPM email, there’s an attempt to read the tea leaves, guessing what the priorities of the administration might be. Unfortunately, for employees who perform complicated technical work with benefits that are often not immediate, the overall request might unfairly feel more difficult. Not to mention, in many cases, there are talented employees who dutifully perform the work that they are assigned—rather than determine what that is or ought to be. Indeed, if there are in fact some HHS employees carrying out work that someone in Washington deems to be of lower priority, how would could that possibly be the fault of any given person writing a response email?

A growing sense of snark.

Meanwhile, group chats and social media posts began piling up with some superbly snarky suggestions for how HHS employees might elect to thumb their noses at OPM, President Trump, and whatever title Elon Musk has in their responses. I won’t repeat any of those delightful offerings here, but let’s just say that these folks have wonderfully subversive and clever senses of humor—and we love to see it. A little righteous indignation is certainly in order here.

As one of the CDC employee said to me: “How is this real life?!?”

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