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New NIH Deputy Director Kington Rooted in Science

By Carla Garnett

On the Front Page...

Stands to reason if your father is a physician, there's one question you'll be asked a lot when you're growing up: "So, are you going to be a doctor like your dad?" Newly appointed NIH deputy director Dr. Raynard S. Kington remembers hearing the query quite a bit in his youth, and given the relatively small number of black doctors at the time, perhaps he heard it more often than most. He also admits to nurturing a healthy curiosity about science as a boy. In fact, he says mischievously, he was probably only about 7 or 8 years old when he first discovered an affection for medical journals.


"Well, my father used to keep stacks of the bound copies of Medical Clinics of North America —they were the best because they were a smaller size, perfect for a child's hands — and piles of old issues of New England Journal of Medicine and Science in a closet in our attic," he explains, smiling broadly. "Long before I knew they had any other significance, my younger brother and I loved to go up there and use them to build houses, forts and mountains, and climb them. We loved them."

Dr. Raynard S. Kington
In his first full week in his new post, Kington appears relaxed and well-rested, despite the long days he assumed on Feb. 10, when NIH director Dr. Elias Zerhouni appointed him as deputy. Two years ago, when Kington first joined NIH as associate director for behavioral and social science research, the prospect that he could hold the Number Two spot at the nation's premier biomedical research enterprise was not on his radar screen. Still — similar to early predictions by neighborhood friends that he'd naturally pursue a medical career — there may have been a prescience about the extraordinary upward turn he would take when he was appointed acting head of NIAAA from January to September 2002 by then-NIH acting director Dr. Ruth Kirschstein.

"As recently as 6 months ago," he says, "it never crossed my mind that this job was a possibility. I was very happy with my other job (head of the Office of Behavioral and Social Sciences Research). In addition, the experience as acting director of NIAAA made last year a busy, but also an incredibly interesting and great year. I had an opportunity to be exposed to a large cross-section of NIH. I bring to the job a range of experiences and backgrounds, from managing fairly large units to dealing with a wide range of scientific issues. All of that prepared me for this position. I still had no idea about this. There certainly was no grand plan."

Kington recalls a childhood not unlike many other kids of his generation, growing up in a working-class neighborhood of Baltimore. His dad, now approaching his 80th birthday, had a solo general internal medical practice in one of the poorest neighborhoods in the city for more than 40 years. His mom served as a school teacher and later a community worker. Kington is one of five children — four sons and a daughter. Mathematics and other scientific and academic pursuits were a natural part of life around the house. He easily recalls how excited his dad was when Raynard came home with a 7th-grade assignment to prepare a report on venereal diseases.

"My father really got into it," Kington says. "He got out all of these medical texts and journals and spread everything out on the table. Of course I had no understanding of most of it, but I remember at least scanning Science and New England Journal of Medicine when I was 12 years old."

Kington's three brothers all worked at one time as engineers, but he was the only sibling to follow in his father's footsteps as a physician. The path to medicine was not necessarily direct, he remembers. During his adolescent days, when he and his father butted heads regularly, Kington says he swore he would never become a doctor.

"I got over that, though for many years my sister never failed to remind me of it," he says. "I thought about medicine, but I also knew there were many other things as well. My parents allowed me great room to imagine careers that in many ways would have been inconceivable for even a well-educated black person in their generation."

Kington finished high school at age 15 and medical school at 21. He spent a couple of summers in college doing internships on Capitol Hill. That's when he began to get interested in health policy. After earning his undergraduate and medical degrees at the University of Michigan, he did his residency training in internal medicine at Michael Reese Medical Center in Chicago.

Later, he completed a fellowship at the University of Pennsylvania as a Robert Wood Johnson clinical scholar, which allowed him to earn a master's degree in business administration and his doctorate in health policy and economics from the Wharton School.

"I must give my parents great credit for somehow conveying the message that I could have a different career," he says, describing the valuable detours that offered him the chance to explore many jobs. "They made it clear that I didn't have to do what they did, or what other people expected me to do. I know there were also times when they probably regretted that I was so independent, but that enabled me to have a very unusual career thus far. I've been incredibly lucky. I've had great mentors and great opportunities, many of them the result of the opportunities my parents gave me. I don't ever forget that."

Kington's new post seems ideally suited to him in a lot of ways, he says. Though all are fully packed, no 2 days are exactly alike, and he tackles myriad tasks — reading financial statements and budgets, sitting in on meetings about scientific issues and how to advance specific initiatives, brainstorming about communication strategies such as how NIH interacts with the world at large and with the department — from about 7 a.m., when his office day begins, to 6 or 7 p.m., when he usually leaves campus, many times only to stay in touch via email from his Takoma Park home.

In many senses, Kington explains, he serves as the "director" of the Office of the Director, which is a large enterprise in itself. He also is involved in a range of activities from practical operational concerns to scientific strategic planning. As deputy, he works closely with all of the senior staff — for instance, the offices that handle legislative matters and science policy issues — as well as the intramural and extramural deputy directors.

"I function in a broad role across all of those," Kington points out, "helping Dr. Zerhouni to implement his vision for what NIH can be. I've always liked jobs that use really different skills and this one allows me to use very different skills in a short period of time. You run the gamut from very practical operational issues, to complex management and financial issues, to dealing with scientific policy to frank scientific issues. Over the course of a day, I see the full range. I must admit that although I respected [former NIH deputy director] Dr. Kirschstein before, I really respect her now, seeing how hard a job it is."

Before coming to NIH, Kington got his first experience as a federal employee at the Centers for Disease Control and Prevention where he became director of the Division of Health Examination Statistics at the National Center for Health Statistics. Before the CDC, he worked for several years as a senior scientist at the RAND Corp., a non-profit think tank that seeks to improve policymaking through research analysis. Kington says he had already developed a keen appreciation for the work of NIH, having won grants from NIA and other HHS and private organizations for his studies on the use of health services by the elderly and the health status of poor people and racial minorities in the late 1980s and mid-1990s.

"NIH is an extraordinary place full of really bright people who work really hard," he says. "That goes for everyone from the administrative and support staff to legislative and policy people to communications people to bench and public health scientists doing research. It makes a big difference to work in a place like that. I've always had tremendous respect for the institution, especially when I was a grantee."

Kington, who is even now completing edits on a paper he cowrote that has been accepted into a leading journal, hopes to continue with his own investigations involving medicine, health and social factors such as age, income and race. Since his research usually involves work with large epidemiologic and social science data sets and not direct lab work, he hopes that he will be able to continue to pursue some opportunities to collaborate with other scientists, just to keep his hand in. Probably his only limitations will be time and scheduling; the main goal, though, is clear.

"I think it is important to keep active the parts of your brain that are about addressing scientific problems — asking questions and answering them in a rigorous way," he explains. "The scientist's life of the mind is an extraordinary thing. Usually, in answering one question, you will raise five more questions. At its best, it's just an incredible life and I will certainly miss that on some level.

"However," he concluded, "NIH is facing unique challenges right now. We're coming to the end of a period of rather rapid and substantial growth. We're facing a very different economic position for the country as a whole, and for the institution as well. My goal is to assist Dr. Zerhouni in managing the organization. I'm really looking forward to learning a lot about the institution. I plan to work very hard. I do take the term 'civil servant' very seriously. It is all about serving."

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