For the last eight years, a span that includes the attacks of 9/11, the Anthrax scares, the continuing threat of pandemic flu and a slow-motion health insurance Katrina, the office of the Surgeon General has been neglected.

Kmareka readers know that President Bush, with his weakness for bluff and swagger, liked to put John Wayne types in his administration [ Help Wanted Surgeon General– Must be a Team Player]. He should have remembered that John Wayne was just acting. Surgeon General Dr. Richard Carmona wasn’t so tough in the face of the Republican establishment.

When he was confirmed by Congress four years ago, Dr.Carmona, described by a colleague as a ‘charismatic cowboy,’ seemed like the can-do, ‘hell with the bureaucracy’ kind of guy our President likes; a tough-talking emergency room physician who jumped out of helicopters. A man who took out a gun-wielding felon in a confrontation on the highway. A man’s man. He had a reputation for a hot temper, for being difficult to work with. Which makes it all the stranger that during his tenure there was barely a peep out of him.

Compare his career with Surgeon General C. Everett Koop. You probably still remember him from the Reagan years. That’s because he took the politically risky, but admirable course of warning the public about the dangers of HIV/AIDS while advocating for effective prevention and treatment. This good doctor won respect from all points on the political spectrum because he put people ahead of politics

Carmona left the office in 2006, with the flames of the wingnuts licking at his heels because he dared to make some mild statements about the dangers of secondhand cigarette smoke.

Incredibly, there was not a line of qualified applicants begging for his vacant seat. Maybe because of this [Marginalizing the Voice of Science

Former Surgeon General Says He was Muzzled July 2007
‘Anything that doesn’t fit into the political appointee’s ideological, theological or political agenda is ignored, marginalized or simply buried,’ Dr. Richard Carmona, who served as the nation’s top doctor from 2002 until 2006, told a House of Representatives committee.

President Bush then nominated Dr. James Holsinger but the Kentucky surgeon had an anti-gay paper trail and a history of disputes with religious organizations over use of funds. The nomination failed.

Given the Democratic resistance coupled with Holsinger’s lack of response to the committee’s questions after more than ten months, in June 2008, thirteen months after his nomination, Kentucky Senator Jim Bunning, a Holsinger supporter, suggested the nomination was dead which the White House and Senate Minority Leader denied. The political scientist Norman Ornstein said, “It’s extremely unusual for somebody not to answer questions. It’s a big fat ‘dis’ of the committee and of the Senate. Even if you know or believe you are not likely to be confirmed, the idea that you wouldn’t sort of do what the committee has asked is still kind of mind-boggling.” The committee’s Republican ranking member said Holsinger’s lack of response was “not helpful” while the editorial board of Kentucky’s Courier-Journal characterized it as “disrespectful” and “baffling”.[6][5][36]Wikipedia

Presently, the chair is warmed by acting Surgeon General, Rear Admiral Steven K. Galson, who is not a household name.

Most Surgeon Generals are not stars like Dr.Koop. But they are mandated to be advocates for the American people, and educators to the public. Most have served well, traveling the country and speaking to small groups and providers, hearing citizen’s concerns first hand. Dr. David Satcher came to Providence to advocate for mental health parity, Dr. Joycelyn Elders was taken down politically for an answer to a difficult question posed at a public forum. This office is intended to serve us. Not only has it been politicized, but some on the right would like to see it eliminated, [Don’t Need No Stinkin’ Surgeon General]
because doctors have this medical ethics thing that keeps them from following orders the way the President wants them to.

Now we are going from a President who used the office as a crony prize, and couldn’t even find a taker on those terms, to a President-elect who has a strong candidate, Dr. Sanjay Gupta. Dr. Gupta has a public presence and a reputation that will not allow him to be a passive voice to any political agenda.

The telegenic Gupta seems at first an unorthodox choice for Surgeon General, a position usually occupied by a government health official. The duties of the Surgeon General include educating the public on all public-health issues, ranging from HIV prevention to obesity, as well as analyzing and advising the President and the Secretary of Health and Human Services about U.S. health policy, including insurance coverage and disease-prevention efforts.

But Gupta’s selection may hint at the Obama Administration’s seriousness about addressing the most significant health concerns facing the nation. With obesity and diabetes rates reaching record levels, especially among children, Obama’s focus has been on preventive health care –staving off disease before it arises. Having anchored specials on CNN to inspire Americans to become more active and eat healthier, Gupta, though short on traditional government experience, would seem well qualified to bring this message to the public.

Actually, Dr. Gupta has health policy experience with the Clinton administration. Let’s hope he’s paid all his parking tickets and the vetting process goes well. It’s a very good sign that the President-elect has a candidate ready and chose someone with a presence and a reputation.