Dissecting the surgeon general nominee

You must have heard the news, announced two weeks ago, that CNN correspondent and board-certified neurosurgeon Sanjay Gupta was the president-elect’s top choice for surgeon general.

“You’ve got be kidding me” was my first reaction.

This was followed, over the course of two days, by puzzlement, curiosity and finally, a kind of cautious illumination.

House Judiciary Committee Chairman John Conyers, D-Mich., drafted a “Dear Colleague” letter opposing the choice. Paul Krugman of The New York Times opposes it, too.

Their refrain, with some minor variation, generally includes a discussion of his lack of relevant experience in public health, and in particular, the absence of time spent in the U.S. Public Health Service, which the surgeon general heads. Usually, surgeon generals are culled from the ranks of the PHS.

There are also the rumblings of his associations with big pharmaceutical and an interesting exchange with Michael Moore on “Larry King Live,” during which Gupta told Moore he’d “fudged the facts” in Sicko, when CNN had in fact misrepresented some of the numbers cited in Moore’s film.

A smear campaign, some called it.

I also think he’s uncomfortably polished, clearly hyperaware of his image (naturally, I guess, as a broadcast journalist), with the occasional flashes of the quiet ideologue.

Despite my dislike of him, and after a scan of the duties of the surgeon general and a consideration of past surgeon generals of consequence – C. Everett Koop during the Reagan years, most notably – and the ways in which they contrast with the unknown ones, I’m beginning to think that the choice may not have been such a bad one after all.

The office has, after all, become one in decline, without teeth and of a consistently low volume, firmly outside the awareness of the public.
This seems absurd, as the surgeon general is the official government spokesperson on matters of public health.

The president-elect has also offered him a top post in the Office of Health Reform, meaning there is a possibility that he will have input on policy. This raises important concerns about the potential connections between an ideally objective and politically insulated office responsible for giving out disease prevention and health promotion information, and another, brand-new office, with a mission burdened by plenty of entrenched interests and political baggage.

Nevertheless, Gupta, a near-constant presence on national newscasts, is good at adapting messages for a varied public. He does it already. He has an established audience too. Most importantly, Obama has shown a pretty interesting, pleasing movement away from ideologues and toward a kind of evidence-based policy. I would expect and hope that he would continue to do so, and that his administration and cabinet would follow suit.

Pending his confirmation, we should hope to see an impartial, principled, visible personality in the surgeon general’s office. It would be a good thing to actually hear from the government’s public health spokesperson.

Health promotion begins with a knowledgeable public, after all.