Bush Announces Nominees for Surgeon General, NIH Director
As expected, President Bush yesterday nominated an Arizona trauma surgeon who is also a sheriff's deputy to become surgeon general and a Johns Hopkins University radiologist and administrator to head the NIH, the Baltimore Sun reports. If confirmed, Dr. Richard Carmona would replace the outgoing Surgeon General David Satcher, while Dr. Elias Zerhouni would end a two-year leadership vacancy at the NIH. Presenting the nominees at a White House ceremony, Bush said both were "distinguished physicians who have worked tirelessly to save lives" (Baer, Baltimore Sun, 3/27). Carmona has a "Hollywood-grade resume" (Arizona Daily Star, 3/27). Raised in the Harlem neighborhood of New York City by Puerto Rican immigrants, he left high school to "help raise his siblings." He then joined the military and became an Army Green Beret medic serving in Vietnam. After he returned, he earned his GED and then put himself through college on the GI Bill, first earning a nursing degree, then becoming a doctor and surgeon. He later earned a masters degree in health policy (Sobieraj, AP/Philadelphia Inquirer, 3/27). He went on to found Arizona's first trauma system in 1985 and to join the Pima County sheriff's department to work on a SWAT team (Goldstein, Washington Post, 3/27). In 1992, Carmona helped save a man stranded on a cliff in a "daring helicopter rescue," an event that was later turned into a made-for-television movie. "When I first learned that Dr. Richard Carmona once dangled out of a moving helicopter, I worried that maybe he wasn't the best guy to educate Americans about reducing health risks," Bush joked, adding, "[But] that turned out to be just one of several times that Dr. Carmona risked his own life to save others" (Garvey et al., Los Angeles Times, 3/27). In 1999, Carmona stopped at a car accident in Tucson in order to help, only to get into a shootout with one of the drivers. Despite being scraped in the head with a bullet, Carmona shot and killed the man, who turned out to be a mentally ill murder suspect (Neergard, AP/Detroit News, 3/26).
The nomination of Carmona, 52, reflects the Bush administration's focus on preparing the nation's health system for possible terrorist attacks, the Wall Street Journal reports. While the surgeon general's office "sometimes seem[s] to be little more than a bully pulpit to convince people to take better care of themselves," it also "will play a critical role in helping public health workers around the country respond to terrorist attacks" (Adams, Wall Street Journal, 3/27). The surgeon general, for example, administers the Commissioned Corps, a 5,600-member organization of public health workers who respond to national emergencies; corps members served in New York and Washington, D.C., after the Sept. 11 attacks on the World Trade Center and Pentagon (Stolberg, New York Times, 3/27). Carmona,
"with a background that combines health and law enforcement, was seen as an apt fit for the emergency-preparedness aspect of the job" (Wall Street Journal, 3/27). After the Sept. 11 attacks, Carmona was in charge of implementing the bioterrorism and emergency preparedness plans for southern Arizona (Washington Post, 3/27). Some recent surgeons general have generated controversy by focusing on "hot-button issues." Satcher, for instance, "clashed" with the Bush administration last year over a report questioning the value of abstinence-only education. Bush indicated yesterday that he would like Carmona to focus on "less controversial" topics like drug and alcohol abuse and on leading a national "healthy living campaign" (Philadelphia Inquirer, 3/27). Carmona, who alternated between English and Spanish, thanked Bush for the appointment, saying, "As a high school dropout, a poor Hispanic kid, to where I am today was just nothing you could even dream about." Lawmakers from both parties said yesterday they were unfamiliar with Carmona, who has "had little exposure to the health care politics of Washington" (Washington Post, 3/27).
Finding a candidate to lead NIH has been complicated by abortion and stem cell politics; Zerhouni "met the administration's twin goals" of finding a respected scientist who could work within Bush's ethical views on research involving cloning and embryonic stem cells (AP/Detroit News, 3/27). Zerhouni helped found a cell engineering institute at Hopkins and has been a "proponent of stem-cell research in general," the Sun reports (Baltimore Sun, 3/27). In announcing the creation of the Institute for Cell Engineering, Zerhouni said that cell therapy has "enormous untapped potential to treat currently incurable diseases" (Connolly, Washington Post, 3/27). But Bush said that Zerhouni and he hold similar views about human embryo research. "Dr. Zerhouni shares my view that human life is precious and should not be exploited or destroyed for the benefits of others. And he shares my view that the promise of ethically conducted medical research is limitless," Bush said (Harris, NPR's "All Things Considered," 3/26). With respect to human cloning, some Republicans and social conservatives say the administration has assured them that Zerhouni supports a bill sponsored by Sen. Sam Brownback (R-Kansas) that would ban both reproductive and therapeutic cloning. Nevertheless, the Post reports that "even some of the scientists closest to [Zerhouni] say they cannot be sure of his views on cloning or embryonic stem cells" (Washington Post, 3/27).
Like Carmona, Zerhouni, 50, has taken somewhat of a non-traditional path to his nomination. Born in Algeria, he arrived in the United States at the age of 24 with $300 in his pocket and "little ability to speak English," the Los Angeles Times reports. If confirmed, he would take over an agency that has been without a leader since 1999 at a time when it is confronting the new challenges of stem cell research and bioterrorism. At least five of the NIH's 19 major institutes lack directors; "[a]gency insiders say prominent scientists have been hesitant to commit to those jobs until the top NIH slot is filled" (Zitner/Garvey, Los Angeles Times, 3/27) Meanwhile, the administration has proposed a $27 billion budget for NIH -- the nation's "premier biomedical research institute" -- in fiscal year 2003, up from $13.6 billion in 1998 (Baltimore Sun, 3/27). "I'll do my very best to advance the noble mission of the NIH and help improve health for all Americans," Zerhouni said. Sen. Edward Kennedy, chair of the Health, Education, Labor and Pensions Committee, said he would schedule confirmation hearings promptly. He called Zerhouni -- whose nomination was expected -- a "distinguished scientist" and said he "looked forward" to learning more about Carmona (AP/Philadelphia Inquirer, 3/27). The "All Things Considered" report is available online. Note: You will need Real Audio to hear the report.This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.