Dr. Jerome Adams' rise to the office of U.S. surgeon general began in a rural town in Southern Maryland where even in high school he stood out among his peers as he racked up accolades and awards for science, math, technology and engineering.
Adams was sworn in Tuesday by Vice President Mike Pence, who appointed the anesthesiologist as Indiana's health commissioner in 2014 when he was governor of that state. Because of Adams' work there on AIDS prevention, infant mortality and other health issues, Pence advocated for President Donald Trump to nominate him as surgeon general.
Adams' journey to becoming the "nation's doctor" began on one of the many tobacco farms that once drove the economy of his hometown of Mechanicsville in a rural, impoverished part of St. Mary's County.
At Chopticon High School,from which Adams graduated in the top 5 percent of his class in 1992, he gravitated to subjects that befit a future doctor.
"He was successful in everything he pursued here," said Tony Lisanti, who taught Adams history at the high school and still teaches there. "You knew he was smart. You knew he had the potential to do great things."
Adams was involved in many school activities, including the school choir, Lisanti said. He was among a group of students who sang "It's so Hard to Say Goodbye," popularized by R&B group Boyz II Men, at his graduation ceremony, according to a commencement program.
His drive landed him a college scholarship as part of the University of Maryland, Baltimore County's Meyerhoff Scholars Program, which supports students interested in science, technology, engineering and math careers and aims to support diversity in those fields. He earned dual bachelor's degrees at UMBC — in biochemistry and in biopsychology. He also studied abroad in Zimbabwe and the Netherlands.
Freeman A. Hrabowski III, president of UMBC, remembers when a young Adams interviewed for the scholars program. He was a kid from a small town competing with students from around the world, but he held his own, Hrabowski said. He called Adams a serious student who was focused and "hungry" to achieve academic success.
While the dual degree left him too busy for campus political life, Hrabowski said Adams showed a penchant for advocacy in his academic interests, particularly in health disparities in minority communities
"He was always concerned about other people," Hrabowski said. "He always wanted to help others with the difficulties and challenges they faced."
Earnestine Baker, who was director of the Meyerhoff program when Adams was one of the participating young scholars, described him as "hard-working" and "high-achieving."
"He always had the grit to reach his goals," she said in an email.
After UMBC, Adams left Maryland to attend medical school at Indiana University and also earned a master's degree in public health from the University of California, Berkeley in 2000. In addition to a career as a practicing anesthesiologist, Adams served as an associate professor of anesthesiology at his alma mater.
Those who knew him during that time said he was serious about his medical work, and the medical profession.
"He was a dedicated physician, but also very passionate about health policy and advocating for our profession," said Dr. Robert Presson, dean of the anesthesiology department.
Adams was charismatic and networked well, which served him well in politics, said Dr. Jay Hess, dean of the medical school. He had a way of making people feel comfortable and hearing different viewpoints.
"He is not shy about reaching out and engaging with people," Hess said. "He is not afraid to take on big challenges. In this role of surgeon general, he will have to network with a wide range of constituents, and I think that is what he is born to do."
Those skills came in handy after Pence appointed Adams as Indiana health commissioner, the position he held until his nomination as surgeon general.
He is credited with convincing Pence to create needle exchange programs in Indiana after an HIV outbreak in rural Scott County was thought to be spread mostly through injection drug use. Pence was against the idea at first on moral grounds but eventually authorized a short-term emergency needle exchange and later supported legislation legalizing it throughout the state.
While in Indiana, Adams also helped reduce the state's infant mortality rate and dealt with the country's first case of the MERS virus.
Trump nominated Adams, 42, in late June. He was confirmed by the Senate in early August. His wife, Lacey, and their three children joined him at the swearing-in ceremony.
In his new position, one area of Adams' focus will be the opioid epidemic, along with untreated mental illness that may contribute to drug use. "The addictive properties of prescription opioids is a scourge in America and it must be stopped," he said in his nominating letter to lawmakers.
He brings personal experience to the issue. In testimony last year before a Senate committee about opioid use among seniors, he talked about his own brother's struggle with addiction and how it affected his elderly parents, who still live in Maryland. He said his parents had become prisoners in their own home, scared to leave because they may come home and find their son dead. Or that he might steal from the house to get money for drugs.
"My mother has severe chronic back pain, but chooses to suffer through it rather than agonize about the temptation of keeping her own pain meds around the house," he said.
"I think the is someone who has a track record of doing the right thing — and what is best for public health," Hess said.
U.S. Surgeon General Jerome Adams
Prior jobs: Indiana Health Commissioner, practicing anesthesiologist
Hometown: Mechanicsville, Md.
Education: University of Maryland, Baltimore County, biochemistry and biopsychology; Indiana University School of Medicine, medical doctorate; University of California, Berkley, masters of public health
Family: Wife Lacey and three children