Dr. Gupta, Surgeon General

Ezra Klein is pretty excited about the prospects of CNN's Dr. Sanjay Gupta as our next Surgeon General. I have no particular quibble with Ezra's theory that Gupta will be an advocate for health care reform, and that his appointment represents a reconceptualization of the position. Both of those things are probably true. But I think it's a mistake to minimize "the guy who writes warnings for cigarette labels" part of the job, or to suggest that the 1964 Surgeon General's report was just one in a line of public health PR initiatives. Rather, tobacco in particular provides an instructive lesson on how the Surgeon General can operate.

Before I explain why, I have to admit to being a bit of a Surgeon General groupie. One of my first real reporting experiences came at a terrific presentation by former Food and Drug Administration Commissioner David Kessler when I was in high school. Kessler was basically leading a master class on tobacco regulation, assigning various audience members roles to play (your loyal blogger got a minor part as a Philip Morris lobbyist). In attendance was former Surgeon General Julius Richmond, who I buttonholed after the event to ask if I could interview him for my National History Day paper. For a fifteen-year-old high school newspaper editor, it was pretty exciting to come home after school one day, and mid-snack pick up the phone to find a Surgeon General on the other end of the line. But for the project, I also read Richard Kluger's Ashes to Ashes: America's Hundred-Year Cigarette War, the Public Health, and the Unabashed Triumph of Philip Morris, which along with Kessler's A Question of Intent, provide an important lens into another one of the Surgeon General's roles: building consensus within the medical community.