Telling it like it is

Milestones for Dr. Joycelyn Elders span being the first African American surgeon general of the U.S. and the first person in the state of Arkansas board certified in pediatric endocrinology. President Bill Clinton appointed her surgeon general in 1993; she served for 15 months.

What childhood experiences influenced your career?Growing up in a rural area, very poor, very much impacted some of my thinking. And that was how I really got so involved in preventing teenagers from becoming pregnant. I felt if they became mothers before they became adults, they would grow up poor, ignorant, and enslaved for the rest of their lives. It just became a real mission to try and prevent that from happening. So many of our young women, especially young black women … had been abused; we’re talking about eight-and nine-year-olds becoming pregnant.

Discuss reaction to your position on preventing teenage pregnancy.Oh, I’ve been called everything. Baby killer, everything else. But I tried to convince the politicians that I never knew a woman who needed an abortion that was not already pregnant. What I was about was preventing those unplanned pregnancies.

Why did you pursue pediatric endocrinology?Well, having been mother hen forever, I enjoyed being a pediatrician. I really dedicated a lot of time to endocrinology and trying to prevent teenage pregnancies.

Who were your role models?
When I was at Philander Smith College, this young woman came and gave a talk, Edith Irby Jones . That really stood out for me. From the time I heard her, I wanted to be just like her. She knows that, and she’s 90-plus years old, and doctoring down in Houston. That influenced my life and my career and what I was to be about.

How did she inspire you? First of all, I was impressed that she was a woman and impressed that she was in medical school. That was different. She talked about the difference between taking the high road and the low. What she said just really was life-changing for me.

Other influences? When one of my brothers developed appendicitis when he was about three or four years old. We lived out in the country, 13 miles from the doctor. My dad put him on the back of a mule and went 13 miles. And at the doctor’s, there was no place to hospitalize black children. And so he had to go sit in the doctor’s office and wait all day, but at least the doctor saw him.

As U.S. surgeon general, you received a fair amount of backlash. When you have the experience of being poor like I was, when you’ve lived and seen young women’s lives being totally destroyed and ruined because of the situations that they found themselves in, when because of their lack of knowledge they were not able to get appropriate contraceptives—I saw young men and women trying to use Saran Wrap for condoms. And so, it was very hard for anybody to try and sell me on, “Well, just tell them to say no.” We’re sexual beings from the day [we’re] born to the day [we] die. And so, I’m not out there trying to convince people not to have sex, but I want them to be able to protect themselves. That’s what I’m about.

How did you affect American lives by bringing issues like teenage pregnancies to the forefront? I was out talking about it. I made America talk about it. And if you can’t communicate, if you can’t talk about it, then you aren’t going to do anything about it. And so I think the thing that I brought was, we began talking about it. We reduced adolescent pregnancies by 54 percent. And that’s a lot. And, of course, after that, you reduce the amount of welfare, poverty, improve education, and improve the lives of young women. I don’t look at myself as doing all of that; we got a lot of people involved. I think a lot of people wanted to do something about it, but I had the bully pulpit. I had the platform. And there was no way in the world that I was not going to use every inch of my bully pulpit to talk about the things I felt we needed to talk about.

How have you seen that message evolve since leaving office?Teenage pregnancy was becoming an epidemic when I was surgeon general. HIV/AIDS was becoming an epidemic. They were both sexual-related. So we could no longer walk out and say we aren’t going to talk about sex. We’re going to talk about it. So [when] I talked about it at church, the preachers said, “You don’t want us to get up there and preach about sex,” and I said, “Yes I do! Preach about it.” We want to keep young girls from having babies until they’re ready to have babies, and then if they want to have 20, I don’t care as long as they’re informed and they’re ready and this is what they want to do.

How do you think some of the health and sex-related issues you handled have progressed?Well, we’ve come a very long way. Not far enough, but now they’re going to have comprehensive health education in schools from kindergarten to 12th grade. They developed a program and have got it on the Web so teachers can go there to get the lesson plan to teach their students. Many schools are beginning to have that, and that to me is a big improvement. Besides that, we need to have more women in political power and we need to make sure we have equity in education, equity in pay, equity for women.

Bill Clinton was president during your tenure as surgeon general. You saw him and his wife, Hillary Rodham Clinton, on the campaign trail this year as she runs for president.I really had the utmost respect and admiration for Bill Clinton, and I still do. I knew him an awful lot better than I knew her because I saw him all the time.