January 6, 2009

Sanjay Gupta Teaches Me A Lesson

This appears to be real, not a joke. Dr. Gupta from CNN's "House Calls" is apparently President-Elect Obama's choice to be the Surgeon General of the United States. My immediate reaction was disappointment. "What, just because he's a pretty face with a TV gig, he gets a sub-Cabinet position? Damn, I should have signed up to be an Assistant Attorney General!" My reaction was that it had to be some kind of a joke.

Turns out, Dr. Gupta is not just good-looking (although he was named one of the 50 sexiest men alive by People Magazine, ranked between Johnny Depp and Brad Pitt). His medical qualifications are that he is an accomplished neurosurgeon with some publications under his belt; he is also a professor of neurosurgery at Emory School of Medicine in Atlanta who, while embedded as a journalist with a medical corps during the Gulf War, performed brain surgery on an Iraqi child in a combat zone. Maybe not the most academically-qualified doctor out there, but not a complete nonentity, either.

But of course he's famous for his television activities. Which is why I assumed he was something of an intellectual lightweight. After all, not all doctors are uncannily smart, like the ones who solve mysteries better than the police or provide piercing insights into the human condition like they do on television shows.

Now, in some ways, Gupta's TV experience makes him a pretty canny choice. Whatever it was historically, the SG-USA's main job has become serving as the spokesman for the government's health and medical policies. He is a figurehead for popularizing information and encouraging people to be healthier. Since Gupta's main career for the last ten years or so has been in front of a camera as a journalist (of sorts) rather than as a doctor, he's pretty well-suited for that.

And the level of generality at which broad-scale health advice is dispensed is pretty basic. Your basic internist or G.P. can put together a pretty good generalized set of guidelines that will work well for most people. You don't need a neurosurgery professor to tell you that you probably ought to eat more fruits and vegetables and to exercise regularly. So for the ceremonial and P.R. stuff, he's actually a good choice. And that's a significant part of this job.

Now, one thing you may not know about Gupta is that he was a White House Fellow in the early 1990's, working with the health care reform efforts under Hilary Clinton that ultimately came to nothing. So it's not like he's got zero public policy experience; he's got more public policy under his belt than at least 90% of his fellow M.D.s. But he hasn't succeeded in his career because of that, at least not directly. No, to succeed as he has, Gupta has needed to be bright and ambitious, get a medical degree, show up on time, smile on cue, look attractive, and read his lines clearly. How much of the writing of those lines is properly credited to him is an open question. But he also has enough background to prepare him for the role of helping fashion broad health policies.

Now, the Surgeon General is also the head of a 6,000-employee bureaucracy. This means that he needs some degree of administrative expertise and ability to manage others. He hasn't had to fight other politicians to protect his budget or make the kinds of choices and do the kinds of things necessary to keep him in his bosses' good graces. And, the Surgeon General holds the rank of Vice Admiral (that's a three-star general for you landlubbers out there). The medical corps of the various branches of the military ostensibly report to him. I suppose Dr. Gupta could delegate the military things to the careerists who do the day-to-day running of their respective medical branches of the various services and confine his involvement to ceremonial work. The career military doctors in question would probably like that just fine, come to think of it. But there is some administrative and political work -- he'll be holding a sub-Cabinet-level position, reporting to the Secretary of Health and Human Services,* the largest civilian bureaucracy in the world. So there is some reason to question whether he can be an effective head of a governmental agency in the midst of the deepest part of the bureaucratic jungle that is Washington despite his other qualifications.

I think what's really interesting here is not whether Gupta is actually a good pick or not. It was my assumption that because he's an attractive talking head on television, he must be an intellectual and political lightweight, that he's only being picked for the job to be the public policy equivalent of Vanna White. (Maybe it's a residual effect from seeing this movie.) But after looking into his background a little bit, I find that he's actually got a creditable resume with good academic and professional qualifications and some public policy experience. Considering that the job is heavily P.R. based, it's overall not a bad mix. So I pre-judged the man unfairly and I'm glad I took the time to look deeper.

Didn't it used to be that we assumed people on TV news knew what they were talking about, that they were worthy of respect? America used to take guys like Walter Cronkite and Eric Sevareid and Edward Murrow seriously? You know, guys like, um, Mike Wallace. But somewhere along the way, I got it in my head that the main reason people are "reporting" the news on broadcast media has nothing to do with their intelligence but rather with their screen or media presence. I came to think that real journalism was done behind the scenes by smart but unattractive people, whose work was given a pretty public face by well-groomed readers whose primary qualification for the job was good diction.

I've learned a valuable lesson here. Just because he's on TV doesn't necessarily mean that Dr. Gupta is some kind of an empty suit, that he doesn't have all that much intellectual firepower to bring to the table. It appears that, to the contrary, he may have been a good choice even if he hadn't been a TV personality.

UPDATE: And, anyone who pisses off Paul Krugman because he formerly dared to criticize Michael Moore can't be all bad.

* For those of you playing the home game, administration of that agency is expected to be awarded to... former Senate Majority Leader Tom Daschle.

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