Lecture Enlightens on the History of the US Surgeon General
The rise and decline of the office of the U.S. Surgeon General was the topic of a lecture by Associated Press medical writer and author Mike Stobbe, DrPH, on April 8 at the University of Arkansas for Medical Sciences Fay W. Boozman College of Public Health (UAMS COPH).
His lecture celebrated National Public Health Week and coincided with an event the previous day honoring former U.S. Surgeon General Joycelyn Elders, MD, at which efforts to establish an endowed professorship in her name were announced.
In 2005, Dr. Stobbe was a doctoral student in public health when he got the idea to write a book examining the history and merit of the office of surgeon general. He recounted how, during a class discussion in which the professor asked students to name their public health heroes, no one mentioned the surgeon general. Dr. Stobbe had grown up in the 1980s, a time when U.S. Surgeon General C. Everett Koop, MD, was constantly in the news for his straightforward talk on HIV and other controversial public health issues. He also had clear memories of working as a young reporter just a few years earlier, when Dr. Elders was in the limelight for her unhesitant stance on human sexuality, teen pregnancy, and other issues “that others were too guarded to take on.”
He wondered how, in such a short time, the office of surgeon general had so receded from the public eye and decided to make it the topic of his doctoral dissertation. Based on that work, his book, Surgeon General’s Warning: How Politics Crippled the Nation’s Doctor, was published in 2014.
His lecture highlighted the history of the office of surgeon general from its genesis in the late 19th century to today. Originating as the overseer of the country’s Marine Hospital Service, the office expanded over the years to director of the Public Health Service and as a national authority on health issues, enjoying relative autonomy from presidential or other political interference.
According to Dr. Stobbe, “the Kennedy and Johnson years were when the office really began to fall apart,” as surgeons general who did not conform to presidential agendas but were more frequently reined in. Since then, the effectiveness of the office has further declined, worsened by the fact that it has no significant resources – not even its own budget or much of a staff.
Today, Dr. Stobbe finds that few people – regular citizen and health official alike – know the name of the current US surgeon general. At his lecture, he made his point when the entire audience was stumped by his question. He contends that the office has been made completely ineffectual by the politicization of health matters and should be abolished because of “lack of political will” to reform it.
For his book, Dr. Stobbe conducted interviews with all living surgeons general and many persons who had known former surgeons general. He concluded that Dr. Joycelyn Elders, along with a handful of others including Koop, David Satcher and Jesse Steinfeld best epitomized what a surgeon general should be – someone who “helps people think about important topics … who doesn’t tell people what to think, but what to think about.”
Dr. Stobbe said he was honored to speak at UAMS, especially when Dr. Elders was honored for her significant contributions to public health.
Dr. Elders, who sat directly in front of Dr. Stobbe during his lecture, commended him for his “factual and well-written” book. She said that she does not want to see the office abolished.
“The country needs a surgeon general, but maybe it needs to be redefined,” she said. “The surgeon general needs to be out there as the educator of the nation.”