Joycelyn Elders, M. D.: From Sharecropper's Daughter to Surgeon General of the United States of America

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The oldest of eight children, Joycelyn Elders was born Minnie Lee Jones in the tiny town of Schaal, Arkansas, in 1933. She grew up in a three-room cabin and, at age fifteen, graduated from high school as valedictorian. When she entered Philander Smith College in Little Rock, she had never seen a doctor, let alone dreamed of becoming one. Dr. Elders graduated from the University of Arkansas Medical School and then became its first black resident, its first black chief resident, and finally its first black ...
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The oldest of eight children, Joycelyn Elders was born Minnie Lee Jones in the tiny town of Schaal, Arkansas, in 1933. She grew up in a three-room cabin and, at age fifteen, graduated from high school as valedictorian. When she entered Philander Smith College in Little Rock, she had never seen a doctor, let alone dreamed of becoming one. Dr. Elders graduated from the University of Arkansas Medical School and then became its first black resident, its first black chief resident, and finally its first black professor. By the time of the Senate debate on her confirmation as surgeon general in August 1993, Dr. Elders had been a respected pediatric endocrinologist and medical scientist for a quarter of a century, as well as the director of Arkansas's health department under then-governor Clinton. But during Dr. Elders's tenure as surgeon general she came under fire for her controversial positions on such subjects as abortion, sex education, the distribution of condoms, and the legalization of drugs. Her passion and outspokenness enraged Republicans and often upset the Clinton administration. Now, Dr. Elders openly describes the top-level machinations that led the Clinton health insurance reform to self-destruct and eventually resulted in her own dismissal. She writes with equal candor about such intimate personal tragedies as her youngest son's drug addiction and arrest, and about the poisoned political climate in Arkansas, which has affected the lives of so many of the President's friends and appointees.
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Editorial Reviews

Publishers Weekly - Publisher's Weekly
Elders (b. 1933), a professor of pediatrics at the University of Arkansas, began life in the rural town of Schaal, Ark., as the oldest of eight children born to a poor sharecropper father and a mother who taught her to read by the time she was five. In candid, gripping prose, Elders describes the segregated world of her youth, then details her career through her appointment as surgeon general. Awarded a scholarship to Philander Smith College in Little Rock, Elders became a physical therapist and joined the army to study medicine. Her work attracted the attention of Governor Bill Clinton, who appointed her director of the Arkansas Health Department and, later, surgeon general of the U.S. Her outspoken advocacy of sex education for teenagers caused controversy, and she was forced to resign. Elders does not blame the president for her resignation, and believes that Clinton's political enemies may have initiated the arrest of her son for selling drugs. Writer Chanoff has collaborated on nine other autobiographies. Photos not seen by PW. Author tour. (Oct.)
Library Journal
Elders, currently a professor of pediatrics at the University of Arkansas Medical School, was for 15 months the U.S. surgeon general. In this memoir, she recounts her many accomplishments, focusing on her transformation from a poor black girl to a medical scientist. (LJ 9/15/96)
The former surgeon general shares her life story, from her childhood in Arkansas to the circumstances surrounding her forced resignation in 1994 and its backlash. She openly discusses top-level machinations that led the Clinton health insurance reform to self-destruct, her youngest son's drug addiction and arrest, and the corrupt political climate in Arkansas. Includes b&w photos. Annotation c. by Book News, Inc., Portland, Or.
Kirkus Reviews
Just what one would expect from the no-nonsense Elders: an unvarnished account that tells as much about our society as about her remarkable life.

In collaboration with writer Chanoff (a visiting scholar at Brandeis Univ.), whose labors are happily invisible, Elders tells an inspiring story of a child born to an Arkansas sharecropper in 1933 who 60 years later became the first black woman surgeon general of the US. Family and church instilled in her early a commitment to education and a high moral sense. With a college scholarship, good role models, hard work, the GI Bill, and strong mentors, she rose swiftly. When she became chief resident at the University of Arkansas Medical School in 1963, it was an unheard-of honor for a black woman, and with the help of an NIH fellowship grant in biochemistry, she was soon Arkansas's resident expert in pediatric endocrinology. Elders's story is much more than a brilliant career résumé. She shares details of her personal life—her strong marriage, her husband's deep depression, the loss of a child, and her younger son's problems with cocaine—and her introduction to public life. In 1987, Arkansas governor Bill Clinton asked her to direct the state's health department. With this appointment, Elders—a pragmatist, not a politician—battled "antichoice, antieducation, anticondom fundamentalists" outraged by her plans for distributing condoms in school clinics. Six years later, when Clinton picked the outspoken Elders as his surgeon general, he knew exactly what he was getting. Her account of her brief tenure, only 15 months, is restrained, but it's clear that relations with her boss, Donna Shalala, were rocky, and she blames Shalala and Leon Panetta, not Clinton, for her dismissal after the masturbation flap.

Now back in Arkansas teaching pediatrics, Elders says she has no regrets. She knows who she is and what she stands for. After reading this absorbing autobiography, readers will too.

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Product Details

  • ISBN-13: 9780786209583
  • Publisher: Gale Group
  • Publication date: 3/28/1997
  • Edition description: LARGEPRINT
  • Pages: 597
  • Product dimensions: 5.75 (w) x 8.76 (h) x 1.22 (d)

Read an Excerpt

I don't think anybody truly believed I wasn't qualified to be surgeon general, even though Senator John Danforth of Missouri did say I was "startlingly unqualified" and Dan Coats of Indiana seemed to have a hard time believing I was actually a doctor; at one point he asked about what nursing duties I had performed. I think those and some similar things Jesse Helms said were aberrations. On the other hand, there were issues my nomination raised that people felt very strongly about, personal issues with major policy ramifications. Sex education and teen age pregnancy, for example, abortion and AIDS and condoms in schools. Even Christian morality.

In my six years as director of Arkansas's health department, I had become a lightning rod on these issues. That was ironic in a way, because for the quarter century before that as a professor of pediatric endocrinology what I mainly saw was the inside of my laboratory, my classroom, and my clinic. In that whole time I probably hadn't ever spent more than five minutes at a stretch thinking about public health. The biggest controversy I ever got into might have been over whether we could get someday care started at the medical school. But once I moved over to the health department I landed in the middle of a national debate on values that looked more like a war than an argument.

While that debate had different components, near its heart was how people think about sex: how to teach children about it, what sexual responsibility means, and the consequences of unmarried and unprotected sexual activity for public health. Swirling around in this mix were issues like AIDS, abortion, homosexuality, and sexual abuse, which meant there was never anylack of people who were seriously disturbed about something.

The fact that I was the one at the center of these sex wars was ironic in another way too. When I was growing up in Schaal, Arkansas, sex was so secret that no adult ever mentioned it, period. Somewhere in the United States there might have been a child more ignorant about sex than I was, but you'd have been hard pressed to find her. By contrast, later on, when I be came a doctor, part of my job was to treat all the really severe problems of sexual development in Arkansas, from babies born with ambiguous genitalia to children who never went into puberty. At one time I had more experience talking to parents and children about sex than any doctor in the state and probably as much as anyone in the country. In those days there weren't more than a handful of specialists who knew much about these things.

Maybe it was because of my background that I never stopped being exasperated by all the commotion over condoms and sex education. I knew firsthand what it is like to be ignorant, and I also knew how vital it is to be informed. When I was health director, we were seeing frightening increases in AIDS cases and an epidemic of pregnancy among unmarried teenagers that was eating at the country's social fabric. But hysteria about sex was disabling our primary means of prevention, which is of course just as true today. No health professional can really tolerate that. My predecessor as surgeon general, Antonia Novello, couldn't any more than Koop or I could, although we each had our own ways of trying to contend with it.

Maybe even worse was that by focusing attention on subjects like abortion and sex education, the loud right-wing groups were distorting and politicizing health issues generally. What I hated as much as anything about my confirmation debate was that most of the other side was so preoccupied with sex issues that they didn't care in the slightest what I might have actually done for public health in Arkansas, most of which had nothing to do with sexuality.

While I was director there, we had raised our childhood immunization rate from 34 to 60 percent—96 percent for first graders. Our early-childhood health screening was twelve times what it had been. We set up sickle-cell anemia screening and a comprehensive women's health program. Our prenatal care rate went way up, as did the numbers of qualifying women getting food supplements for their children. We built a major in-home health service to care for our frail and elderly, and we made a lot of headway in attracting doctors to rural areas that didn't have any. We established home hospice care and got the churches involved in that. We built twenty-eight new public health clinics, renovated fourteen more, and opened twenty-four clinics in schools. I was proud of what we had accomplished. I thought the health department had improved the lives of a lot of Arkansans. But none of that made a whit of difference to people who were fixated on abortion and couldn't bear the thought of sex education.

Of course I have to admit I didn't make it easy for them. I had been up on the barricades a long time, and when I thought strong language was needed, I didn't shy from it. I wasn't a stealth candidate for surgeon general. A lot of what I had said was public record, and a few of my comments had really lodged in some throats. During the confirmation debate those were the ones that got repeated over and over again, most often out of context and twisted.

In one speech I had said that we've taught teenagers what to do in the front seat of cars, now we have to teach them what to do in the back, meaning that if we were instructing them on traffic safety, we surely ought to be teaching them how to protect themselves from AIDS and other sexually transmitted diseases (STDs) and pregnancy. I had said that girls going out on prom dates should carry condoms in their purses, meaning that if there was any chance they weren't going to be abstinent, they should be ready with contraception. Senators Trent Lott and Don Nickles and a couple of others believed comments like those showed I was advocating immorality. They seemed to think, like Pat Buchanan did, that I saw teenagers mainly as "rutting animals whom we expect to do a good deal of fornicating."

Worse, I had taken to calling the extremist right-to-life groups "very religious non-Christians," and more than once I had said they should "get over their love affair with the fetus." The first time Senator Coats brought those up to me, I told him that in Arkansas the groups I was talking about "fight against health education, they fight against welfare, they fight against Medicaid. They always want to have the children born, but they don't want to support them after they're here. That's an affair," I told him. "That's a short-term commitment, whereas with children that's forever. In my state," I said, "I have not seen these people out working for programs to help poor children and mothers. If we had a society where everybody was provided health care, a decent place to live, and adequate education, then, Senator, we would be taking care of people. But in my state I don't see these kinds of commitments." That was pretty much the tone of the whole debate. It was tense and confrontational.

My opponents said they were outraged by the language I used. They were offended. Even some of my supporters thought I might do well to tone it down. Senator Nancy Kassebaum of Kansas, who was a voice in my corner, said maybe I needed to work on my bedside manner, and David Pryor, one of Arkansas's two wonderful senators, mentioned that I had a number of diplomas but I didn't have one from the school of diplomacy. But others said that in their opinion, using plain, unvarnished English was a virtue, and they wished more government people would do it. My favorite was Barbara Boxer, who said she wasn't offended by my language. What she was offended by was that the infant mortality rate in the United States was higher than in nineteen other countries and that the black infant mortality rate was higher than in thirty-one other countries, including Cuba and Bulgaria. She was offended that we ranked thirty first in low-birth-weight babies and seventeenth in polio immunization and that the American preschool death rate was twentieth in the world. With that kind of record, she didn't have time to be offended by someone's language.

Copyright ) 1996 by Dr. Jocelyn Elders and David Chanoff

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