Past Surgeon General on Future Surgeon Generals

Okay, I’m back to blogging, slowly but surely.  Special thanks to Andrea, Anthony Cox, daedalus2u, and many others for your get well comments and e-mails.  Thanks also to Science Mom and TheProbe for sending me e-mails with great ideas for future posts.

Recently the DISCOVER Magazine blog, Reality Base, asked former U.S. Surgeon General (1982-9), C. Everett Koop, the question, “What are the most important things the next U.S. president needs to do for science?”

His answer #1 was: “Appoint the next surgeon general with an eye to scientific and medical prowess, rather than make it a political appointment.” 

I couldn’t agree more.  So if McCain is elected president, even if I don’t expect him to choose somebody like Jack Geiger as Surgeon General (although I think Jack would be a great Surgeon General), the message from Koop is that McCain shouldn’t choose some physician just because he/she has been long-time Republican Party kiss-ass. 

The same sort of advice goes for Obama, although it’s easier to find scientifically accomplished public health activists among liberals than among conservatives.  But you never know — Dr. Koop was appointed by Ronald Reagan.

Also: As Dr. Koop probably knows, in order for the Surgeon General to use his or her scientific or medical prowess, the Office of the Surgeon General needs to become an independent entity in which the Surgeon General reports directly to the President.  This is the way things were when Koop was Surgeon General.  Now, the Surgeon General reports to the Assistant Secretary for Health.  Indeed, the last Surgeon General, Dr. Richard Carmona (2002-6), had to have all his speeches and other public statements cleared by the office of the Assistant Secreatary of Health.  So much for independence.  (See the section entitled “Political interference” in the Wikipedia article on Dr. Carmona – it’s an accurate summary.)  

While I’m on the subject of political appointments (or rather avoiding political appointments), I should add that  Dr. Koop’s advice to the president should also be extended to the Director of NIH.  In other words: Appoint the NIH Director with an eye to scientific prowess; avoid the temptation to use any political or ideological critera in choosing the NIH Director.

Lets’s look at the major accomplishments of the Directors of NIH before their appointments, starting in 1975.  The quotes are from the official web site of the history of NIH.

Donald S. Fredrickson (1975-81): “…internationally known authority on lipid metabolism and its disorders…”

James B. Wyngaarden (1982-89): “…internationally recognized authority on the regulation of purine biosynthesis and the genetics of gout…”

Bernadine Healy (1991-93): “…chairman of the Research Institute of the Cleveland Clinic Foundation, where she directed the research programs of nine departments…” [No scientific accomplishments mentioned]

Harold E. Varmus (1993-99): “Winner of the Nobel Prize in 1989 for his work in cancer research…leader in the study of cancer-causing genes called ‘oncogenes,’ and an internationally recognized authority on retroviruses…”

Elias A. Zerhouni (2002- ): “…credited with developing imaging methods used for diagnosing cancer and cardiovascular disease. As one of the world’s premier experts in magnetic resonance imaging (MRI), he has extended the role of MRI from taking snapshots of gross anatomy to visualizing how the body works at the molecular level. He pioneered magnetic tagging, a non-invasive method of using MRI to track the motions of a heart in three dimensions. He is also renowned for refining an imaging technique called computed tomographic (CT) densitometry that helps discriminate between non-cancerous and cancerous nodules in the lung.”

President George H. W. Bush set an unfortunate precedent in 1991 when he appointed Bernadine Healy as Director of the NIH.  The appointment was purely political, based on Healy’s lifetime support of the Republican Party.  Although many feminists were overjoyed at the time, Dr. Healy was hardly a scientist.  She was a career administrator.

Let’s not forget that the National Institutes of Health have often been called the greatest scientific institution in the history of the world.  Bernadine Healy was about as qualified for the job of NIH Director as Sarah Palin is to be President of the United States.

(Recent quote from J.B. Handley: “If Dr. Healy is the Ted Williams of her field, Paul Offit is struggling to make his neighborhood T-Ball team–that’s how big she is.”  Sorry, Mr. Handley, but the perception in the scientific community would essentially reverse this analogy.  Paul Offit is undoubtedly the Ted Williams of his field.  In baseball terms Bernadine Healy is more like the mediocre player who becomes a pretty good manager, and then goes into announcing.  Baseball fan commenters are welcome to come up with someone; I can’t think of anyone offhand.)

So here’s hoping that the next president will appoint both a Surgeon General and an NIH Director with real ”scientific prowess.”  Personally, I’d like to see qualified women in both jobs.

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19 Responses to “Past Surgeon General on Future Surgeon Generals”  

  1. 1 Darjeeling

    Welcome back!

  2. 2 Ren

    Isn’t it a little naive to think that, in the current political climate (one that will surely last for a while), any politician will create a non-political entity, or appoint someone who is apolitical, especially with all the special interests and “party base” members who exert so much pressure?

    I’m talking about the ideologues on the right (who will want only pro-life, anti-stem cell, the Bible-told-me-so appointees) and on the left (who will want only pro-choice, no-stem-cell-but-that-of-an-embryo-to-hell-with-cord-blood, there-is-no-god-but-me-and-how-much-money-I-make-from-this-drug appointees) who really can’t see the forest for the trees. I’ve seen some pretty irrational people claiming to be experts on all things scientific.

    And it’s scary mostly because the silent majority in the middle is just that, silent… or silenced.

  3. 3 EpiWonk


    Naive? Maybe. Maybe not. I just learned that Rep. Henry A. Waxman has introduced legislation to protect the Surgeon General from political interference — the Surgeon General Independence Act. See

  4. 4 Ren

    Rep. Waxman is always writing letters, making inquiries, and getting involved in everything. You should have seen the scorning (yet uninformed) letter to CDC over their realignment. It’s funny that he’s trying political interference to keep the Surgeon General from political interference. The only problem is that, if a Surgeon General comes out saying something that doesn’t quite jive with one side or another, that independence will be taken away in a heartbeat.

  5. 5 andrea

    Hooray, Epiwonk yet lives! Man, that was one bitchin’ case of bronchitis you had.

    Fine, so YOU take the helm now; I’m working 60-hour weeks and have had this Whatever for four weeks now. (Either I’ve developed allergies that give me intermittent low-grade fever, or I’ve a virus that’s lasted a month. Or maybe both. I’m around students all day long, so who knows?) Plus, I just tried to step on the wrong side of my foot, again. Time to pull out the elastic wrap and cane, again. Feh.

    Oh, and YES, We Need More Scientists In Government.

  6. 6 isles

    If only we knew what floats Healy’s boat. Obviously it’s not scientific merit, or she wouldn’t be running her mouth about how vaccines are scary. What did the likes of this Handley do to groom her? Suck up to her ego? Tell her weepy stories about those meeeeean scientists (against whom she’s probably always harbored resentment) and how they are so darn picky about this thing they call evidence? Send her chocolate?

    I’d willingly buy her some Godiva if that’s all it would take.

  7. 7 Please?!


    Is this an article about how a President should select a surgeon general? Seems to me more like a weak attempt to discredit Bernadine Healy, former Director of the NIH.

    From Dr. Healy’s bio at NIH Website, “She earned a reputation as a skilled cardiovascular researcher specializing in the pathology of heart attacks.”

    A Director’s poison is an administrative role and such a high ranking position within the government should
    filled by someone with vast administrative experience. In Dr. Healy’s case, in addition to working as a researcher, she
    has filled the top position as the President of the American College of Cardiology, as well as serving as chairman of the Research Institute of the Cleveland Clinic Foundation, where she directed the research programs of nine departments, she also was deputy director
    of the White House Office of Science and Policy…all of which were positions overseeing RESEARCH.

    Why would you look for an opportunity to discredit Dr. Healy? Could it simply be because the dared question the science behind
    the claim that our vaccine program has been proven safe?

  8. 8 EpiWonk

    If I really wanted to discredit Healy, I would do whole post on her. There’s no doubt that her appointment by Bush I was almost purely a political appointment, based on loyalty to the party. The same has been true of several surgeon generals since Koop. I’m hoping that neither Obama nor McCain make the same mistake. (Do you really think the official NIH bio is going to admit that she was unqualified?)

  9. 9 Please?!

    Duh, do you think political appointments might be political? And why don’t you go ahead and do a WHOLE post on Healy. W
    What? Are you going to talk about how she was fired by the board of the American Red Cross after 9/11? There are plenty of
    articles out there about how she was a scape goat for the board. So go ahead…put your money where your mouth is and fo
    the WHOLE post.

  10. 10 EpiWonk

    I said, “If I wanted to discredit Healy…” I don’t.


  11. 11 Don Cox

    “Personally, I’d like to see qualified women in both jobs.”

    You spoiled a good post by ending it with a political statement which contradicts the rest of the post. Appointments made on the basis of gender or race are political: they are not based on the medical expertise of the individual appointed.

  12. 12 NYC Plastic Surgeon

    Good post. How long have you been running this site? I need to work on mine a bit!

  13. 13 Sindy Rushe

    Very engrossing post - Might be old news, but it was news to me.

  14. 14 Amanda Campbell

    I am enormously troubled about the next election. Considering everything that is occuring in Iraq, Afghanistan, and the Middle East (not to mention the economy) we desperately must have a superior leader. I’m far from convinced that President Obama or any of the Republican challengers so far have the experience or skills it takes to get the job done the way it has to be done. Being president of the U.S. is an exceptionally hard job. Is there someone out there with the experience, skill, and moral courage to do the job?

  15. 15 robeferre77

    I tried to publish a comment earlier, although it has not shown up. I imagine your spam filter may well be broken?

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  17. 17 Dinnie

    Without giving a rigorous treatment we briefly reflect on. We were faced with a difficult choice in deciding.

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