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Last Updated

03 Dec 2002

Source: Washington Post, March 27, 2002

Bush Taps Carmona As Surgeon General

Fighting Bioterrorism Called a Priority

By Amy Goldstein, Washington Post Staff Writer

President Bush yesterday selected as the nation's top physician an expert in medical emergencies who has a swashbuckling past as a soldier and crime-fighter but has been relatively insulated from Washington politics and the most ethically sensitive areas of health care.

Bush announced the nomination of Richard H. Carmona, an Arizona trauma surgeon, to be surgeon general as the president moved in a single stroke to fill two of the most significant health care jobs in the federal government.

As expected for the past few weeks, Bush also named Elias A. Zerhouni, a Johns Hopkins University medical administrator, to lead the National Institutes of Health, the sprawling agency that is the nation's main engine of biomedical research and has lacked a permanent director for more than two years.

Coming 15 months into his presidency, the dual appointments come after persistent criticism from Democrats and health care advocates that Bush has allowed several prominent positions to languish unfilled at a time when the United States confronts particularly vexing biomedical issues, including cloning, stem cell research and the aftereffects of Sept. 11.

The choice of Carmona, in particular, also represents the latest example of Bush's efforts to tilt the emphasis of a variety of federal activities toward helping deter terrorism and equipping the country to withstand attacks.

The president and his aides said yesterday that the next surgeon general will have -- like those in the past -- a broad mission to educate Americans about ways they can prevent poor health.

But Carmona, 52, is the first trauma surgeon nominated to the post. After the hijackings six months ago, he was in charge of implementing the bioterrorism and emergency preparedness plans for southern Arizona. As a deputy sheriff who has worked on SWAT teams for 17 years, he also would be the first surgeon general with law enforcement experience.

During an afternoon East Room ceremony to announce the selections, Bush said Carmona would prove "an experienced voice to help educate Americans about the best precautions and response to the threat of bioterrorism."

The president called that work one of the "particularly urgent issues" the next surgeon general should address, along with two more conventional areas: improving fitness, and curbing alcohol and drug abuse. With a relatively modest size staff and little direct policymaking power, the surgeon general's main role is as a kind of megaphone that has sometimes had great influence over attitudes toward public health matters, ranging from nutrition to AIDS. At times, the position also has become a fulcrum for fierce ideological and partisan disputes, including over abortion and sex education.

If confirmed by the Senate -- Zerhouni also must be approved by the chamber -- -- Carmona would succeed David Satcher, who was appointed by President Bill Clinton and was one of the longest holdovers in a key health care job until his resignation last month.

Satcher focused mostly on comparatively noncontroversial issues, such as mental health and obesity. His predecessor, Joycelyn Elders, was forced out in a political firestorm over her views on sex education and masturbation -- and the physician Clinton chose next was rejected by GOP senators because he had performed abortions.

Yesterday, senators of both parties who are leaders on health issues said they were unfamiliar with Carmona and his record. Unlike Satcher, who previously led the federal Centers for Disease Control and Prevention, Carmona has had little exposure to the health care politics of Washington.

Officials of the American Public Health Association and the American Medical Association said Carmona was a member of both but has not been particularly active as the national level.

Still, Carmona has other attributes that could prove useful to Bush politically and substantively.

At a time when Latinos represent an important voting constituency, Carmona is a Hispanic with a dramatic up-by-the-bootstraps biography. As Bush stood beaming by his side, Carmona spoke in Spanish and English yesterday to thank the president for choosing him.

"As a high school dropout, a poor Hispanic kid, to where I am today was just nothing you could even dream about," the nominee said.

Raised in Harlem, he left school to join the military and became an Army Green Beret. He got a high school equivalency degree and eventually became a doctor, a nurse, a health policy specialist and a hospital administrator. He also founded Arizona's first emergency medical system and worked on a SWAT team.

Bush noted that Carmona in 1992 "dangled out of a moving helicopter" to rescue someone stranded on a cliff, inspiring a television movie. In 1999, he stopped at a car accident and exchanged gunshots with a man who turned out to be suspected of killing his father. The man died; Carmona ended up with a bullet grazing his scalp and a national award as a "Top Cop" by a law enforcement association.

One senior administration official said, "We were looking for someone who could really fill the role as being the nation's leading health care educator." The official added that Carmona's expertise in medical emergencies "enhanced his credentials and made him someone who could play an import role in helping the president address these issues."

His career trajectory means that Carmona has largely sidestepped matters of reproductive health, cloning and other polarizing issues. A spokeswoman for the University of Arizona College of Medicine, where he works, said that no faculty members there conduct research with human embryonic stem cells.

In announcing Zerhouni's nomination to lead NIH, Bush said he "shares my view that human life is precious and should not be exploited or destroyed for the benefits of others."

Staff writer Ceci Connolly contributed to this report.