Famous Firsts
Hispanic Heritage Month - Sep. 15 - Oct. 15, 2007
Antonia Novello
Birth: 1944
Nationality: Puerto Rican
Occupation: physician
BIOGRAPHICAL ESSAY
When C. Everett Koop announced in late 1989 that he would retire from the post of United States Surgeon General , speculation about who his predecessor would be was particularly lively. During his eight-year tenure, Dr. Koop played an unusually prominent role in American public life, elevating the previously soft-spoken voice of the Surgeon General to a forceful, opinionated one that people paid attention to. Koop gained national prominence and respect by speaking out on controversial issues, sometimes colliding openly with the views of the administrations of presidents Ronald Reagan and George Bush on such topics as sex education and the use of condoms to prevent the spread of AIDS.
When Dr. Antonia Novello, the deputy director of the National Institute of Child Health and Human Development at the National Institutes of Health (NIH), was chosen for the Surgeon General post, many observers noted that following in the illustrious footsteps of Dr. Koop would not be easy. The first woman and the first Hispanic to hold the position, Dr. Novello brought with her a reputation for hard work and dedication, but her ability to fight for her convictions was unproven. Both Novello and administration officials admitted that questions about her views on abortion --she opposes it--had been a part of the selection process. This so-called "litmus test," allegedly applied to candidates for this and other high-level health care appointments, was a subject of widespread controversy. But Novello claimed, as reported in the Washington Post several months after she was sworn in, "I'm for the people who deserve help ... how I vote is not relevant. I think that as a woman, as a Hispanic, as a member of a minority ... I bring a lot of sensitivity to the job." Voicing a concern that echoed in other quarters, California Democratic Representative Henry Waxman told the Post, "I hope she's a fighter, because it's a bad time for infant mortality, for AIDS, for the homeless, for the uninsured, and this administration hasn't shown much interest in these problems ... she can do a lot."
Novello was born in Fajardo, Puerto Rico, on August 23, 1944. She and her brother were raised by their mother, a school teacher, after their parents' divorce. Novello suffered from a painful congenital colon condition until she was 18 years old, when it was finally corrected. She has said that one of the reasons she became a doctor was to help others who were suffering as she had. Novello received both her B.S. and M.D. degrees from the University of Puerto Rico, where she was--as described by her teacher Dr. Ivan Pelegrina in the Detroit Free Press --"one of our brightest students." Ana Flores Coello appears to have been a major motivating force in her daughter's life at this stage; Novello told Glamour: "I wasn't allowed to work until I graduated from medical school because my mother felt that once I earned money I might be sidetracked by material rewards before I got to my real work."
Develops Early Interest in Pediatric Care
Novello did get to her "real work," beginning with an internship and residency in pediatrics from 1970 through 1973 at the University of Michigan (UM) Medical Center in Ann Arbor. She served as a fellow in pediatric nephrology at UM in 1973 and 1974, and she remembered this "first job" in Glamour as germinal in her eventual decision to enter government work; she "learned how many people slip through the cracks." Monitoring the progress of patients waiting for kidney transplants, Novello was dismayed at the number who could not be helped. Those cases in which she, personally, was powerless to help were especially affecting: "You become a true caring physician when you're able to share the pain."
In 1971 Novello was the first woman to receive the UM Pediatrics Department's Intern of the Year award. Her classmate Dr. Samuel Sefton, who is now a neonatologist in Kalamazoo, Michigan, told the Detroit Free Press, "It was difficult for women to be accepted [in the medical field] then, and I always was impressed with the way she handled situations." Barbara Lanese, head nurse (then and now) of the UM perinatal unit, concurred with Sefton: "[Antonia] was a resident when female physicians weren't as readily accepted as they are today.... She was a wonderful physician, and she was warm, friendly and well-respected. She was able to break the tension just by the kind of person she is."
In 1974 Novello joined the staff of Georgetown University Hospital in Washington, D.C., as a pediatric nephrology fellow. She served as a project officer at the NIH's National Institute of Arthritis, Metabolism and Digestive Diseases in 1978 and 1979, a staff physician at NIH from 1979 through 1980, and the executive secretary in the Division of Research Grants at NIH from 1981 through 1986. She earned a master's degree in public health from Johns Hopkins University in 1982.
From 1986 until her appointment as Surgeon General, Novello served as deputy director of the National Institute of Child Health and Human Development, where she nurtured a special interest in children with AIDS. Concurrently, Novello was a clinical professor of pediatrics at Georgetown University Hospital. Her colleague there, pediatric department chairman Dr. Owen Rennert, told the New York Times that Novello "is tremendously concerned about the medical and social problems of children and she has a way of drawing others into that concern." In 1982 and 1983 Novello was a Congressional fellow on the staff of the Labor and Human Resources Committee chaired by Senator Orrin Hatch, a Republican from Utah. As reported in the Washington Post, Hatch later commented that she had "given good advice on several bills ... including legislation on organ transplants and cigarette warning labels."
Accepts Appointment to Surgeon General Post
Novello's appointment to the post of Surgeon General came at a time of controversy and hostility between some scientists involved in public health issues and the Bush administration. Several candidates for top jobs at such organizations as the NIH, the Center for Disease Control, and the Health Care Financing Administration had withdrawn their names from consideration, complaining that their interviews had included questions about their views on abortion and on the use of fetal tissue in research (another controversial practice opposed by the Bush White House). Dr. Burton Lee, the President's personal physician, might have been a contender for Surgeon General, but took himself out of the running because his views on abortion did not coincide with Bush's. In so doing, he echoed the administration's contention that it is important and appropriate that the appointee defend Bush's positions with conviction.
During Novello's two-hour interview, she was able to convince administration officials that her view on abortion was the approved one. Some observers speculated that Novello's reputation for cooperative, dedicated and essentially low-key work made her a particularly desirable choice after the outspoken reign of Dr. Koop. Yet Novello claimed at a press conference covered in the Washington Post that "as long as the data can be trusted and is not just hearsay, I'll say it like it is.... I was never told I have to keep a low profile. I really intend to be like Dr. Koop when the data is there."
As head of the 5,700 commissioned officers of the Public Health Service, Novello promised to focus her energies on AIDS-infected children, smoking (she opposes particularly the glamorous portrayal of smoking in advertisements) and such women's health issues as breast cancer and heterosexual AIDS. Other areas of concern for Novello include teenage drinking, drinking and driving, and finding ways to diminish the stigma of mental illness.
Strives for Better Health Care
The Surgeon General's is an essentially public role, and Novello--who receives several hundred invitations to speak per month--spends much of her time on the road, promoting the cause of better health. She talks with Louis Sullivan, Secretary of Health and Human Services, three or four times a week and meets with him monthly. Sullivan, with whom Novello has pledged to work closely, described her (as quoted in the Detroit Free Press) as "a very commanding woman who has a tremendous ability to reach out to communities." To what extent and to what ends she will put that ability to use is a subject of concern for some, like the Congressional official (a Democrat) quoted in the Washington Post who said, "Toni Novello is a nice, talented, hard-working woman. But she has never stood up and shouted for the programs she directs.... If she wants to play anything like the role Koop did, she is going to have to learn to speak up."
Novello's own perception of the potential power and impact of her new job became more sharply defined, she told the Washington Post, when she visited her birthplace, Puerto Rico, shortly after becoming Surgeon General: "When I got off the plane, kids from my mother's school lined both sides of the road handing me flowers.... I went to the VA hospital to speak. When the veterans saw my gold braid [she is a Vice Admiral in the Public Health Service] they all stood and saluted.... I realized that for these people, for women, I have to be good as a doctor, I have to be good as a Surgeon General, I have to be everything."
Since her appointment to the Surgeon General post in 1989, Novello has addressed and attempted to solve many of the problems which concern her, including teenage drinking. In late 1991, she met with some of the largest beer and wine companies in the United States and asked them to stop aiming their advertising at children and teenagers. "The ads have youth believing that instead of getting up early, exercising, going to school, playing a sport or learning to be a team player, all they have to do to fit is learn to drink the right alcohol," remarked Novello during a press conference covered in the New York Times. The marketers of beer and wine do not see their ads as being aimed at children and will not voluntarily back down--there may be laws in the future requiring them to include warnings in their advertisements.
In addition to her attempts to lessen teenage drinking problems, Novello has also aspired to provide better health care for children, women, and minorities. As she stated in a Hispanic interview shortly after her appointment: "I hope that being the first woman and minority Surgeon General since the post came into being--and the visibility the post confers--enables me to reach many individuals with my message of empowerment for women, children, and minorities."
Novello left her federal post in 1993, when she returned to Georgetown University School of Medicine as a visiting professor. From 1993 to 1996, she worked as the United Nations Childrens' Fund (UNICEF) Special Representative for Health and Nutrition. In June 1999, Novello was selected as the new health commissioner for the state of New York. Her appointment was greeted with some acrimony, however, due to her anti-choice stand on abortion. Novello remains in the post today.
SOURCE: Dictionary of Hispanic Biography. Gale Research, 1996.