Surgeon General Unafraid of Taking a Stand on Divisive Issue

Dr. Vivek H Murthy, a Boston internist who at the age of 37 has become one of the youngest surgeons general of the United States, is a self-described dreamer and grass-roots organizer.

He has professed a deep fondness for mangoes, and his interests include studying ways to increase global happiness. But his lighthearted style should not be taken as a lack of seriousness. In fact, his stance on a divisive issue - he has been an outspoken supporter of gun control laws - put him in a professional limbo that lasted months.

Murthy's appointment was confirmed Monday night, more than a year after he was nominated - a delay that said as much about the American political cycle as it did his views. His remarks on guns, including a tweet in 2012 that "guns are a health care issue," enraged the National Rifle Association and frightened politically vulnerable Democrats ahead of the midterm election.

But Murthy, who treats acutely ill patients at Brigham and Women's Hospital and teaches at Harvard Medical School, slid through in one of the last acts of the Democratic-controlled Senate. He becomes the country's youngest surgeon general since John B. Hamilton, who left the office in 1891.

In an age when health care is a politically contentious topic and doctors often shy away from getting involved, Murthy takes positions. He is a founder of Doctors for America, a nonprofit group of 16,000 physicians and medical students whose stated mission is to improve the country's health care system and make sure everyone has access to quality health care.

The group advocated passage of the Affordable Care Act (and the election of President Barack Obama - it was originally called Doctors for Obama, a fact that rankled Republicans and even some Democrats), training members to educate people about enrollment, organizing a bus tour in Florida and holding athletic races for fundraising across the country.

Republicans have criticized Murthy, saying he is more advocate than doctor. Even some health experts said that his advocacy could hurt his ability to be taken seriously as an independent voice - something that is crucial for the position, which lacks any real power beyond its potential as a bully pulpit.

But his supporters say it is precisely his willingness to take a stand on real issues - so rare in today's political environment - that is his primary strength.

Dr. Jerry Avorn, a colleague of Murthy's at Brigham and Women's, pointed out that past surgeons general took strong and unpopular positions - on smoking in 1964 and on AIDS in the 1980s - and were remembered as courageous fighters for what was right for public health.

"One person's advocacy is another person's public health leadership," said Avorn, who is a professor of medicine at Harvard Medical School.

He called Murthy "universally respected" and said he once used one of his days off to research rehabilitation options for a hospital colleague who had been in a life-threatening car accident.

Murthy's ability to look beyond the daily duties of a doctor and think broadly about national health trends makes him well suited to the post, Avorn said.

"He understands that health and illness are intimately connected to social issues and even political decisions," he said. "He will point that out, and I predict that he will be attacked for it."

Murthy was born in Britain to immigrants from India. He grew up in Miami, and was exposed to medicine by spending time in his father's primary care clinic there. He studied at Harvard before going to medical school - and getting an MBA - at Yale.

Murthy, who was not available for an interview Tuesday, according to a Department of Health and Human Services spokesman, has said that he got the idea to create Doctors for America in 2008, when health care became a campaign issue.

"I was struck by how few physicians were organizing and gathering their ideas to actually make an impact on the candidates' platforms and, ultimately, on a health reform bill," he said in an interview published in Hospitalist News in 2012. "A few colleagues and I began Doctors for America with a simple belief that physicians should play a leadership role in designing and running our nation's health care system."

In addition to Doctors for America, Murthy created a group that carries out AIDS education and was a founder of a community health group in rural India that trains women to become health educators. He also helped found a software company whose products are meant to improve the efficiency of clinical trials, according to the Doctors for America website.

At various times in the past, the country spent years without a surgeon general, and some say the position has lost its meaning. In 1995, a certain senator from Delaware, Joe Biden, was quoted as saying: "You could eliminate the entire job and you'd have no impact on the people of America."

But the position is what the nominee makes it, and it remains to be seen what Murthy will choose. For now, he is quiet. His Twitter feed went silent in September 2013, not long before Obama nominated him.

Among his last tweets was a quote from Walt Whitman: "Charity and personal force are the only investments worth anything.