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Maggie Kozel, M.D. Headshot

Warning to Surgeon Generals: Truth May Be Hazardous to Your Health

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I was 11 years old back in 1966 when the now-famous message first appeared on cigarette packages: Warning: The Surgeon General has determined that cigarette smoking may be hazardous to your health.

The unwelcome warning, delivered in tiny font under cellophane wrapping, inspired only derision and resentment among the adults in my little universe. Everyone knew someone who had smoked like a chimney and lived to be 95. Nobody had proven that smoking caused lung cancer. And who in the name of all that was holy was going to put down a pack of cigarettes because it featured that anemic little message? The whole thing was -- cough, cough -- laughable.

Of course we now know that simple message was just the beginning of what turned out to be a nationwide antismoking campaign put into play by a visionary Surgeon General, Dr. Luther Terry. It changed forever the way Americans viewed smoking, and paved the way for future Surgeon Generals and other leaders to take on issues like secondhand smoke and marketing tobacco products to children.

But what if the tobacco industry had had enough influence back then to block Dr. Terry's nomination right from the start? Or -- and this would be totally crazy -- what if the NRA, as mouthpiece for the money-soaked gun industry, had demanded to know his position on gun violence before allowing the lawmakers they financed to approve his nomination?

A decade later I was just starting my pediatric training when President Reagan tapped Dr. C. Everett Koop to be Surgeon General. Like Dr. Terry, he too had been chosen because he was knowledgeable, innovative and a strong leader. He publicly took on AIDS prevention and the importance of sex education at a time when most social conservatives still considered "condom" to be a dirty word. As a young, idealistic doctor, I witnessed firsthand the power in a physician's voice -- a power that came from speaking scientific truth in the face of fear and misinformation. We are all fortunate that Dr. Koop, like Dr. Terry, was there when the country needed him.

But what if faith-based groups had been able to send spineless lawmakers scurrying away from the nomination because they chose to look at AIDS as God's wrath towards sinners? And what if the NRA had demanded to know the nominee's position on gun violence ? Judging by Dr. Koop's 1992 article in JAMA, decrying gun violence as a "public health emergency," the gun lobby would presumably not have heard the answer they would have expected from a Reagan appointee. But that was back before the NRA had been given veto power over America's health.

Dr. Vivek Murthy is the physician that President Obama nominated to be the next Surgeon General. He is is a highly-respected Harvard-trained physician who, in addition to all his clinical responsibilities and humanitarian efforts, founded Doctors for America, a grassroots organization that has been mobilizing physicians and medical students across the country to advocate for quality, cost-effective healthcare for all our patients. He is a physician-leader for the 21st century: a seasoned clinician well-schooled in public health and economic policy, and a proven leader who urges and inspires doctors to put their patients' interests first, and to voice their opinions publicly. His clearly-stated top priority as Surgeon General? The obesity epidemic. Godspeed! He has the support of every major medical society and organization.

Unfortunately for Dr. Murthy, he does not have the support of the NRA.

That's right. The NRA -- the same group that wants to make it illegal for a pediatrician like me to talk to parents about gun safety the same way I do about pool safety and choking hazards. Deploring the fact that Dr. Murthy, and in fact the medical establishment as a whole, sees gun violence as a public health issue, the NRA has made it clear that any politician they bankroll -- and there are a lot of them -- must vote against his nomination. Senators and representatives are, as usual, taking their marching orders and refusing to approve Dr. Murthy. The White House reports that in response they are "recalibrating" their strategy, suggesting that President Obama may withdraw his support. That would be a tragic mistake, and not only because Dr. Murthy is exactly the doctor that the country needs now. Caving into such bullying sends the clear message that there is a new sheriff in town -- the gun lobby -- and that any doctor who dares speak politically uncomfortable truths to the American people will no longer qualify to be Surgeon General.

Hardly the legacy that doctors Terry and Koop -- or their presidents -- would have envisioned.

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