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Richard Carmona, Your Family Doctor
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Photo: Courtesy of HHS

Richard Carmona, Your Family Doctor
By Sergio Serrichio

The Surgeon General on Obesity in the United States

“Fifty years old is wonderful to start. Sixty years old is wonderful. It’s never too late to start improving your health,” says U.S. Surgeon General Richard Henry Carmona, with the conviction of someone who knows firsthand about facing and overcoming life’s challenges.

This American of Puerto Rican descent-energetic, accomplished, and committed to community service-was chosen by President George W. Bush in August 2002 to be the lead physician of a nation on high alert.

"Rich Carmona," says the Surgeon General with a broad smile as he extends a hand to AARP Segunda Juventud. We met with him just after he had given a speech at a conference of Tricare, the health care system of the United States Armed Forces.

"Today, the nation's health and the nation's defense are more closely intertwined than ever. Never before in history has there been this intersection between public health and public preparedness," the Surgeon General told hundreds of attentive men and women in uniform.

Carmona, a combat-decorated veteran, has spent much of his career preparing for this intersection. In Vietnam, he was an Army medic. Here in the United States, he has been a public health officer, director of a regional trauma care system, and CEO of a county hospital. He has also served as an officer in a county sheriff's office, both as a surgeon and a S.W.A.T. team leader, with expertise in special operations and emergency preparedness, including weapons of mass destruction.

‘[Abuelita María] was a very important person in my life, and the matriarch of the family’

As Surgeon General, Carmona is charged with leading the nation in three areas: prevention ("what each of us can do in our own lives to make ourselves and our families healthier"), preparedness ("working with national, state and local leaders, and health care providers to ensure a strong and secure medical and public health response system"), and "closing the gap in health disparities among the nation's minorities."

For this last priority, his concern is to find a "culturally sensitive" message that will resonate with Hispanic traditions and customs, to motivate the community to improve the health of children, adolescents, adults, and the elderly.

A major challenge is to conquer the "obesity epidemic." "Today in the United States nearly two out of three people are overweight, and one in three is obese. Fifteen percent of our children and teenagers are overweight," Carmona says. And the rate at which this epidemic is growing, he warns, is "stunning." As an example, he points out that "the proportion of overweight adolescents has tripled since 1980, now accounting for nine million young people, with millions more at risk."

The situation is even worse for the Hispanic population. Among Mexican American children and adolescents, a large percentage of girls and an even larger percentage of boys are overweight.

For adults, excess weight is associated with cardiovascular diseases, type 2 diabetes, high blood pressure (hypertension), and stroke. The good news, says Carmona, is that "studies show you can stop or reverse some cardiovascular diseases and some cases of type 2 diabetes by losing weight and improving physical fitness. "

He encourages adults to lead by example. As writer James Baldwin put it: "We spend a lifetime trying to get our kids to listen to us, but they never fail to imitate us." Adds Carmona, "That is especially true in the Hispanic population, where abuelita or abuelo often have preeminent status in the family."

Abuelita María, whom Carmona talks about with devotion, was his light and inspiration. "She was a very important person in my life, the matriarch of the family, as in many Hispanic families. Though a small woman, she was very strong in her convictions and viewed this country as a land of opportunity. That's why she brought her family here; she wanted all of her children to do better in life than where they came from."

The now-Surgeon General was born in Spanish Harlem and, like his siblings, dropped out of school. One day an older neighbor, Sal, returned to the barrio. "He was in uniform, having been in the service. We struck up a conversation. He encouraged me to go back to school and get an education," remembers Carmona.

"It's not too late?" wondered young Rich. He was just 17 but had been out of school for years and was living, like most of the other kids he knew, "day-to-day, surviving." Sal sent him to a friend who was an Army recruiter.

Two years later, young Rich received his first wound in combat, saw his first buddy die in combat, and delivered his first babies, twins. "In one year, I matured a decade," says Carmona of his experience in Vietnam, where he entered the health care field as a combat medic.

"Enlisting in the Army was the best thing I ever did. It gave me my first real job. It was the first time I was held accountable and responsible," says the Surgeon General.

After returning from Vietnam, Abuelita María's advice was still ringing in his ears: "education is what will set you free." Carmona left the Army to continue his education. He attended Bronx Community College and then the University of California, San Francisco, from which he earned a medical degree in 1979. In medical school, Carmona graduated top in his class.

Then, he kept on going. At almost 50, he earned a master of public health degree from the University of Arizona (1998), where he later taught surgery, public health, and family and community medicine.

And he keeps on going. When Carmona says: "It's never too late," he does not need to explain it, he is living proof.


Now find out the Surgeon General’s thoughts on the “health catastrophe” in the United States: The Obesity Epidemic.

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