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'Story of Hope'
New Surgeon General: 'Still a Tourist' Living the American Dream

By Carla Garnett

Photos by Ernie Branson

Young Richard Carmona was just 12 years old when he first had the sense knocked into him. His startling moment of clarity — provided inadvertently by his mother — occurred on a day when he and his three siblings were hungry. Poor and struggling, living in a tiny apartment with bare cupboards, four kids and an absentee alcoholic husband, Carmona's mother, also addicted to alcohol, had "come home not with food but with a bottle of rum."

After an argument, Carmona took it upon himself to pour the contents of her brand new bottle down the sink. Outraged, his mom swatted him across the legs with a broom. Carmona said the lash — the only time his mother ever struck him — served solely to reinforce a harsh lesson he had already begun learning: "I started to understand then how this substance can assist in destroying a family. We made up and everything was fine, but I decided then that I wasn't going to do that."

Guest speaker Dr. Richard Carmona, U.S. surgeon general tells his story.

If Carmona had squandered the rest of his life — ending up in the streets, in jail or worse — few would have been surprised. After all, not many high school dropouts from poor Latino families living in the Washington Heights part of Harlem go on to exemplary military service careers, graduate from college, ace medical school and find themselves as the nation's top doctor.

"The first time I met Dr. Carmona, I thought, 'wow, what an energetic man,'" remarked NIH director Dr. Elias Zerhouni, who introduced Carmona at the Hispanic Heritage Month observance on Sept. 19. "The second time I met him, I said, 'This guy is energizing!' The third time I saw him, I said to him, 'Can you give me some of your energy?' He has an amount of enthusiasm and commitment to his mission that is absolutely remarkable. He is a dynamic leader with a remarkable background. He has dedicated his life to serving his patients, community and country in ways that few can match."

NIH HEO president Dr. Marta Leon-Monzon welcomes Carmona.

Zerhouni and Carmona were announced as potential presidential appointees at the same time last spring and both navigated the congressional confirmation process together.

Carmona's story may sound like the American dream now, but it didn't start out that way. His father was the youngest of 27 children and his mother was the daughter of an alcoholic. The word poverty might have been used to define his neighborhood. No one in his family had ever completed higher education; in fact, finishing high school was not a priority in most of his community. The most many in his family could predict for him and his siblings was a life spent in a spare apartment doing an ordinary, but steady job.

Recalling how his uncle rapped him — physically as well as verbally, "Our people don't do that" — for turning down a job as an electrician in favor of attending college, Carmona said, "I learned another lesson: Culture is wonderful, but it also binds you."

Nevertheless, his mother — who Carmona describes as "a single mom before the term was coined" — had a dream to see one of her children graduate before she died, and she tried to instill in them an appreciation for learning. "Get an education, because an education will set you free," she would say. If she was concerned about his future, it was his grandmother who wanted him to remember his roots.

"My abuelita tried to perpetuate our culture," Carmona explained. "She came to the country in her 60s and she would always tell me, 'I'm too old to learn English, you gotta talk to me in Spanish.' I didn't understand at the time the importance of the culture and how my grandmother wanted me to maintain that culture, through the food we ate, through the traditions that would be perpetuated, through the understanding of the importance that Latinos have had in our country — she used to talk to me about the explorers and my ancestors — and the important contributions they have made."

Despite what he had told his uncle, Carmona admitted that the thought of college was more frightening to him than combat had been. "I was afraid of failure," said the former Special Forces medic who served in Viet Nam and was awarded the Bronze Star, the Purple Heart and a combat service medal. "I knew there were a lot of smart people in college. But, as you all must know, without accepting some risk there usually isn't any progress, so I said, 'Okay, I'm going to give it a shot.'"

Carmona undertook higher education with a sense of purpose, vowing to give back to the community. "It was a commitment I made to myself that if I ever made it," he said, "I wouldn't forget where I came from. I always had this idea that I would go back and stamp out disease and famine and pestilence and save the world after I got my education. The Lord didn't see it that way for me, as far as going back to Harlem, but I did get the education. I put those tools to use in other places."

These days, Carmona joked, he is often so busy in his new role that he needs handlers to point him in the direction of his next appointment and that he often sneaks away from them for restroom breaks, which they never seem to schedule for him.

"This is absolutely the most phenomenal job I could have ever envisioned," he said, "but the enormity of the job, the responsibility...I feel every day as if the weight of the world rests on my shoulders, because at times the world hangs on your every word. I don't take that responsibility lightly. To be honest with you, it scares me. I get up every day thinking, 'How can I be sure I'm doing the best job I possibly can?'"

If his words indicate the keen sense of duty he feels, Carmona insists all leaders should feel that way about their jobs, and that all meaningful work is accompanied by a measure of obligation to past, present and future generations.

Carmona and Leon-Monzon greet Dr. Nilda Peragallo of UMBC.

"I never used to talk about my story," he admitted, "but people encouraged me to, because it was a story of hope for those trying to find their way out. I recognized that it did provide a horizon for some young person to say, 'If he did it, I can do it.' Leadership is a very important quality and we need to embrace it and teach it. Mentorship is just looking over your shoulder to see who's behind you, and bringing them with you. Everybody behind you can profit from your experience and your education."

Throughout his remarks, Carmona commented on the rapport he has established with Zerhouni, HHS Secretary Tommy Thompson and the President. Recently while at the White House, the surgeon general was privately marveling at the incredible circumstances he now finds himself in, frequently mingling with people he had only read about or seen on TV. He confided the substance of his musings to President Bush. "I said, 'You know, I still feel like a tourist.' And he said, 'Well, that's good. So do I. If you ever you lose that, I probably don't want you working for me anymore. That's the kind of people we need in our administration, [people] who see the gravity and enormity, the immense responsibility you have inherited in this position.' I realize I have a finite amount of time to do the very best job I can, to leave a legacy of change that is positive, to leave this office with the President and the secretary saying, 'He was the right one for the job,' and most importantly, to have the 300 million people that I represent say, 'He cared about us, he made a difference, he did the right thing'...I'm elated, I'm overwhelmed, I'm humbled to be serving on this team with great people like Dr. Zerhouni, our President and the secretary."

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