Surgeon general says she's just one of us Top U.S health official targets alcohol, AIDS.


WASHINGTON -- Truth is, Surgeon General Antonia C. Novello could do without that uniform.

The navy blue Public Health Service duds she wears are coolly formal, not the image that the engaging Novello wants to convey. She seeks to be a "voice of the people," their "ombudsman," as she puts it.

She is wearing her uniform when a photographer comes to take her picture for this story. Wait a minute, she says, launching into a comic commentary about her hair not looking right. She tries to interest the photographer in a photo from her files, but he disapproves.

"What do you mean?" she says in mock anger.

Novello is very sensitive to how the public sees her. The surgeon general's job is a soapbox for health issues, which makes her keen to establish a warm relationship with her audience.

"I am just a normal human being and I think that is probably one of the things that will make the public much more comfortable with me," she says.

She decorates with that in mind. The waiting room to her office is lined with Cabbage Patch dolls and pictures of her with children, underscoring that at heart she remains what she first trained to be, a pediatrician.

There's another message in the decor -- that the surgeon general is no longer Dr. C. Everett Koop, her predecessor, whose outspoken views on condom use, smoking and other subjects made the Reagan administration squirm.

Some people suspected that the Bush administration wanted a low-key successor. But after 15 months in office, Novello is finding the spotlight, stepping out of Koop's shadow in her own way.

Last month, continuing her widely publicized assault on the alcohol industry, she criticized the G. Heileman Brewing Co. for targeting blacks with a new high-alcohol malt liquor, PowerMaster.

In January, she attacked a fortified wine called Cisco, which is 20 percent alcohol but resembled a low-alcohol wine cooler and may have led some people to drink too much. Some drinkers lost consciousness, hallucinated or experienced other problems, she charged.

As a result, Cisco's packaging was changed to reflect its potency. Novello keeps a bottle on her desk as a trophy.

Her research into Cisco led her to investigate teen-age drinking. Last month, she announced the results of a study that found teen-agers lack essential knowledge of alcohol and can easily buy it despite laws prohibiting sales to minors.

"One of the things it showed is kids do not drink just because of peer pressure," she says. "That the kids drank because they were depressed, they were bored, they wanted to get high. . . . Are we looking into the generation of alcoholics of the future right now, here today?"

Novello believes that 1930s laws prohibiting disclosure of alcohol content on beer containers should be repealed so that consumers know how much alcohol they're drinking. She also wants more comprehensive health warning labels on containers.

She riles the alcohol industry by criticizing advertising aimed at minorities, whom she says suffer disproportionately from diseases related to alcohol.

Referring to billboard ads in minority neighborhoods, she says, "I believe if you are poor, if you have very little in life but to look at the sky and see something that looks positive, and that positiveness is tied to something like alcohol or tobacco, and you have no other way of thinking that there's harm, chances are you might end up believing drinking and smoking is tolerable. . . ."

Beer Institute president James Sanders begs to differ. "I believe that anyone who feels that we are unfairly advertising to any segment of the American population is not really well informed," he says. "The fact that markets drive advertising rather than the other way around is not understood. . . .

"I think she seems more inclined to listen to public advocates, so-called public advocates. . . . Sometimes the surgeon general has used quotes from those people in her own press releases. So I don't question her motivation at all. I simply feel that some of the things she has referred to are really not based on science or fact," Sanders says.

One of the advocacy groups he criticizes, the Center for Science in the Public Interest, is as enthusiastic about Novello as Sanders is dismayed.

"Her willingness to speak out on alcohol issues is unprecedented," says Patricia Taylor, head of CSPI's alcohol policies project.

Novello's concerns about minority health issues are deeply felt. She was born 46 years ago in Fajardo, Puerto Rico, and speaks Spanish-flavored English. She graduated from the University of Puerto Rico School of Medicine and continued her education in the United States, receiving a master's degree in public health from Johns Hopkins University.

She is acutely conscious -- and proud -- of her status as the first Hispanic and first woman named surgeon general. On her wall is a photo of her swearing-in ceremony last year, inscribed by Supreme Court Justice Sandra Day O'Connor: "To another woman pioneer, with admiration and respect."

While she is becoming increasingly known for her views on alcohol issues, Novello also stresses AIDS prevention and treatment. She is an expert on pediatric AIDS and a visible supporter of the Whitman Walker AIDS Clinic in Washington. "We would say she's been quite involved with us," says clinic administrator Jim Graham.

But Daniel Bross, executive director of the AIDS Action Council, a national advocacy group, says he's disappointed.

"I know she has done some things locally in Washington, like with the Whitman Walker clinic," Bross says. "But leadership is more than showing up for an event. . . . It's leadership dealing with issues such as prevention, care, the whole issue of funding, increased funding for AIDS, the issue of infected health workers."

Novello has been careful not to get too far ahead of the Bush administration on issues like AIDS. Before naming her, the administration made sure she agreed with its anti-abortion position.

"I consider myself a voice of the people," she says. "And I am an administration official and, as such, I also represent the interests of the administration."

She also says, "I am very outspoken, but I also believe being a woman and being a minority you always learn when to speak. And it's very important I speak in a way by which the counsel I will give is heeded, not just speaking for itself."

Sen. Barbara A. Mikulski, D-Md., who like Novello is a strong advocate of women's health issues, says she is "doing a commendable job," but should "do even more to bring women and minority health issues to the forefront of the American health agenda."

Novello doesn't yield in defending her record. "I know that some people would believe that perhaps Dr. Koop was much more vociferous and much more active, but they must remember that was seven years," she says, referring to his long tenure. "I only have 15 months and there is not one day in those 15 that I cannot be proud of our accomplishments."

She has certainly shed her anonymity. Back when she was named surgeon general, the public knew more about her brother-in-law -- comedian Don Novello, or Father Guido Sarducci to "Saturday Night Live" fans -- than about her. That despite a distinguished career which included being deputy director of the National Institute of Child Health and Human Development in Bethesda, Md.

Novello, called Toni by those who know her, doesn't live a high-profile life with her husband, psychiatrist Joseph Novello. Indeed, she sounds positively ordinary as she talks about how she relaxes with music (preferably classical) and films.

" . . . When I really want to block everything, I go rent about 10 movies," she says. "My husband goes in the room and there I have my Diet Coke and my popcorn with caramel, and cashews, and I'm there for 12 hours."

Told she sounds like a typical American, she says firmly, "I am."

"The most important thing, I think, in this job, is I cannot become so separated from what the people believe that I am . . . that then they cannot relate to me. I am not an icon. I am a normal human being doing the job given to me, doing it the best I can."

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