Friday, January 09, 2009
BOB GARFIELD: This is On The Media. I’m Bob Garfield.
BROOKE GLADSTONE: Quick, name the Surgeon General of the United States. Actually, the position has been vacant since Richard Carmona left in 2006, but you probably never heard of him anyway. You probably have heard of the man tapped by Barack Obama to replace him, CNN’s Doctor-in-Chief Sanjay Gupta.
[MUSIC UP AND UNDER]
SANJAY GUPTA: So you've been splurging the last few weeks or you just want to get fit in 2009. Well, we've got some surefire strategies to help drop the pounds.
[OVERTALK] - saying look, I know this person’s depression is better. You know how I know? Because their frontal lobes are lighting up. This is a brave new world of neuroscience, actually being able to -
[OVERTALK] Okay, let's say you’re out in the middle of the jungle in Cameroon, as I am right now, and let's say you get really thirsty.
[SOUND OF CHOPPING] Cut down a vine with the machete. You have to have a machete.
BROOKE GLADSTONE: Gupta hosts a weekend show, writes a column for Time Magazine, authored a national bestseller and has been named one of People Magazine’s sexiest men alive. Also, he’s a neurosurgeon at a downtown Atlanta hospital. So what’s it mean when a media star becomes our nation’s family doctor? Dr. Fitzhugh Mullan is Professor of Medicine and Health Policy at George Washington University and a former Assistant Surgeon General under C. Everett Koop. He says Surgeons General have had their share of controversy. Take FDR’s S.G., Tom Parran.
DR. FITZHUGH MULLAN: Tom Parran, in the 1930s, was concerned about venereal disease. He went on national radio – I believe it was CBS – and talked candidly about syphilis. CBS said that he could not do that and they would have to take that part of the interview out because you didn't talk about venereal disease on the radio. And he said, you take that out, you take the whole interview out. I won't be interviewed if I can't talk straight. They left the interview in. And, in fact, the publicity about the effort to muzzle the discussion of venereal disease generated more controversy, more discussion and actually more candor.
BROOKE GLADSTONE: And he had the support of FDR?
DR. FITZHUGH MULLAN: He was supported. That was early in his tenure. He served for another 10 or so years. In more recent years, Joycelyn Elders, who served under President Clinton, first spoke out about needle exchange, which she favored. She was admonished for that. And subsequently she spoke about masturbation, which was just generally considered a taboo topic, and she was dismissed, effectively, following that.
BROOKE GLADSTONE: The most recent Surgeon General, Richard Carmona, he was blocked from talking about stem cell research and emergency contraception and was apparently instructed to reference the President several times on every page of his speeches. Is Carmona kind of an object lesson of how this job can go wrong?
DR. FITZHUGH MULLAN: Dr. Carmona’s tenure represents one extreme of how the President has handled the Surgeon Generalship, and that’s been essentially house arrest. He was blocked in being efficient or being useful in a lot of areas in which he thought as a public health leader he should be articulate. And the one that really, I think, rankled was that he finally spoke out on passive smoke, and the tobacco industry didn't like that, and that had to do with his being dismissed at the end of his term.
BROOKE GLADSTONE: So is the Surgeon General fundamentally the nation’s doctor or the nation’s health communicator?
DR. FITZHUGH MULLAN: Certainly the tradition of communication, of articulating issues is very important. What I think is different about the Gupta regime in the public health services - he’s also a accomplished practitioner of health policy. He’s worked in the White House before. He’s been outspoken on policy issues. And, indeed, he also has a secondary appointment in the White House Health Reform office. The Surgeon General has not always been the principal spokesman on health policy issues. That’s a new role, and it'll be interesting to see how that plays itself out.
BROOKE GLADSTONE: You know, when we went through the list of notable past surgeon general controversies, we stopped short of probably the most famous surgeon general of all, the one you worked with, C. Everett Koop.
DR. FITZHUGH MULLAN: Dr. Koop came to office in the early days of the AIDS epidemic, and he was an appointee of an administration, the Reagan Administration, that over those first years of the AIDS epidemic, in the early '80s, showed no inclination to talk about it or do much about it. And Koop, pretty much on his own, raised those issues to public attention in terms of how we dealt with the epidemic as a whole and individuals with HIV in general, and really he set a very high bar for Surgeons General stepping out from their administration and taking an important, often controversial public health stand. President Reagan tolerated him. Certainly he stayed until the end of his administration, but it was an anomalous, or unusual, situation.
BROOKE GLADSTONE: And you've suggested that great Surgeon Generals, like great presidents, are tested in times of national emergency. Do you see anything like that in the offing for Sanjay Gupta?
DR. FITZHUGH MULLAN: Well, we are in a national emergency not only in an economic sense and a military sense but in terms of health care. Obesity, in particular pediatric obesity, are huge and as yet not fully appreciated epidemics in this country. But health equity – that is, how do we give all of our citizens a similar shot at the benefits of modern medical science – is also a cause that could very much be that of the Surgeon General. I suspect that the legacy of Dr. Gupta will be the citizen forces and industry forces that he can rally to take on these health issues in American society.
BROOKE GLADSTONE: Thank you very much.
DR. FITZHUGH MULLAN: Thank you, Brooke.
BROOKE GLADSTONE: Fitzhugh Mullan is Murdock Head Professor of Medicine and Health Policy at George Washington University and a former Assistant Surgeon General.