{"@context":"http://iiif.io/api/presentation/3/context.json","id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/iiif/7p8tb10c58/manifest","type":"Manifest","label":{"en":["Dr. David Satcher"]},"logo":"https://d9jk7wjtjpu5g.cloudfront.net/organizations/logo_images/000/000/246/original/CenterForHistoryFamilyMedicine_2c_RGB.png?1773344256","metadata":[{"label":{"en":["Rights Statement"]},"value":{"en":["\u003cp\u003eThis item is protected by U.S. copyright and related rights. It is being made available by the Center for the History of Family Medicine as its rights-holder for noncommercial use, including sharing and adapting the work. No permission is required for noncommercial use so long as attribution is provided. All other uses require permission from the Center for the History of Family Medicine.  Disclaimer:  The views presented in this broadcast are the speaker’s own and do not represent those of CHFM or the AAFP Foundation. The information presented is for general, educational, or entertainment purposes and should not be considered legal, health, financial, or other advice. \u003c/p\u003e"]}},{"label":{"en":["Keyword"]},"value":{"en":["family physician","U.S. Surgeon General","Black family physicians","family medicine"]}},{"label":{"en":["Subject"]},"value":{"en":["David Satcher (personal name)"]}}],"requiredStatement":{"label":{"en":["Attribution"]},"value":{"en":["\u003cp\u003eThis item is protected by U.S. copyright and related rights. It is being made available by the Center for the History of Family Medicine as its rights-holder for noncommercial use, including sharing and adapting the work. No permission is required for noncommercial use so long as attribution is provided. All other uses require permission from the Center for the History of Family Medicine. \u0026nbsp;Disclaimer: \u0026nbsp;The views presented in this broadcast are the speaker\u0026rsquo;s own and do not represent those of CHFM or the AAFP Foundation. The information presented is for general, educational, or entertainment purposes and should not be considered legal, health, financial, or other advice.\u0026nbsp;\u003c/p\u003e"]}},"provider":[{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/aboutus","type":"Agent","label":{"en":["Center for the History of Family Medicine"]},"homepage":[{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/","type":"Text","label":{"en":["Center for the History of Family Medicine"]},"format":"text/html"}],"logo":[{"id":"https://d9jk7wjtjpu5g.cloudfront.net/organizations/logo_images/000/000/246/original/CenterForHistoryFamilyMedicine_2c_RGB.png?1773344256","type":"Image"}]}],"thumbnail":[{"id":"https://d9jk7wjtjpu5g.cloudfront.net/collection_resource_files/thumbnails/000/260/245/small/SATCHERDAVID%2805-18-21%29%28EditedVersion%29.mp4_1736958066.jpg?1736958068","type":"Image","format":"image/jpeg"}],"items":[{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/3162/collection_resources/140814/file/260245","type":"Canvas","label":{"en":["Media File 1 of 1 - SATCHER_DAVID_(05-18-21)_(Edited_Version).mp4"]},"duration":5277.65333,"width":640,"height":360,"thumbnail":[{"id":"https://d9jk7wjtjpu5g.cloudfront.net/collection_resource_files/thumbnails/000/260/245/small/SATCHERDAVID%2805-18-21%29%28EditedVersion%29.mp4_1736958066.jpg?1736958068","type":"Image","format":"image/jpeg"}],"items":[{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/3162/collection_resources/140814/file/260245/content/1","type":"AnnotationPage","items":[{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/3162/collection_resources/140814/file/260245/content/1/annotation/1","type":"Annotation","motivation":"painting","body":{"id":"https://aviary-p-centerforthehistoryoffamilymedicine.s3.wasabisys.com/collection_resource_files/resource_files/000/260/245/original/SATCHER_DAVID_%2805-18-21%29_%28Edited_Version%29.mp4?1736958046","type":"Video","format":"video/mp4","duration":5277.65333,"width":640,"height":360},"target":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/3162/collection_resources/140814/file/260245","metadata":[]}]}],"annotations":[{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/3162/collection_resources/140814/file/260245/transcript/74392","type":"AnnotationPage","label":{"en":["David Satcher [Transcript]"]},"items":[{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/3162/collection_resources/140814/file/260245/transcript/74392/annotation/1","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"Dr. Daniel Ostergaard: Well, today is Monday, March 29, 2021. And this is Dr. Dan Ostergaard, formerly of the American Academy of Family Physicians staff, but currently a member of the board of curators of the Center for the History of Family Medicine, which is a function of the AAFP Foundation. And I am at the moment in Fort Myers, Florida, having fled the north as soon as we had our second shot. And even though I still live in the Kansas City area and volunteer at the Center.\n\nDr. Daniel Ostergaard: Dr. David Satcher has so graciously agreed to be with us. I will not try to go through Dr. Satcher's CV at this point, except to say he is one of, in my view, and this is obviously a little biased because I know the man, the most significant influential Surgeon General of the United States in the last 50 years. Dr. Satcher is currently in Atlanta, where he lives, and is at the Morehouse School of Medicine. And I will open the conversation by simply saying, welcome, Dr. Satcher. Having read your most recent book, with your childhood, very compelling problems there with the poverty and the origins of your search for health equity, and your near-death experience as a child, and how did that inform and direct you to become a doctor?\n\nDr. David Satcher: Well, it's great to be with you, Dan, to be with you again, we've worked together all over the world. But let me just say that, I grew up on a farm outside of Anniston, Alabama. There were nine of us, and very early I had a bout with whooping cough, which turned into pneumonia.  And so, my early years were troubled, especially those first two years. And there was one black family physician in Anniston. And he agreed to come out to see me on the farm. His name was Dr. Jackson.\n\nDr. David Satcher: And he came and spent virtually all day with us. He didn't think I was going to live, and he told my parents that I probably wouldn't make it out the week. But he also told them what to do to give me the best chance of surviving. And I will always appreciate that, of course. My mother, being a determined person that she was, was determined that if there was any chance of my survival, that we had to take advantage of it.  So, she stayed up all night, many nights, breathing for me, when she had to. But at any rate, I survived.  And I wanted to meet Dr. Jackson, but I never met him, he died that year. And I was supposed to meet him on my fifth birthday, but he died when I was four years old. And so, I then started saying that I was going to be a family physician like Dr. Jackson. \n\nDr. Daniel Ostergaard: Well, the rest is history, but pointing out the depths of the absence of the social determinants of health. Your parents education and their tenacity and your tenacity, and you going on all the way through your academic preparation.\n\nDr. David Satcher: My parents were not formally educated. My dad actually never finished the first grade. My mom went to the fifth grade and dropped out, at a time when they had to work on a new farm. So I always say that my parents were not formally educated but they were probably the smartest people in our house even as we went through high school and college. They made really good decisions, and I will always be grateful for that.\n\nDr. David Satcher: They were people of great faith. My dad learned how to read with the help of my mom. And he became superintendent for [inaudible","format":"text/plain"},"target":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/3162/collection_resources/140814/file/260245#t=0.0,306.0"},{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/3162/collection_resources/140814/file/260245/transcript/74392/annotation/2","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"] Sunday school, where he served for 25 years.  He made sure that every Sunday we had read our lesson, and that we were prepared to discuss it.  So I learned how to speak and communicate, basically, about the Sunday school lesson before I learned anything else. He was serious about learning when it came to the Bible, and things related to that, and it made a difference in our lives.\n\nDr. Daniel Ostergaard: Take it now a little bit further. And I said I wouldn't going to read your whole CV but I'm going to ask you some things which give specific CVs. Where did you go to college, and then on to med school? But when you're in the college discussion, I'm going to ask you about your activism.\n\nDr. David Satcher: Well, first, if I didn't say it I should say that I grew up in Anniston, Alabama, on a 40-acre farm that my parents had managed to save up and buy. And in addition to growing our food, it was where we learn how to take responsibility. Each one of us had a job, had a responsibility on the farm. And even during school time, we had to get up early enough to milk the cow, feed the hogs. Mostly those were the things that we learned from them, that each of us has a responsibility and we expect you to carry it out. We became like a team that had a job to do, and we did it. As you can see, I owe them a lot. They gave us all they had.\n\nDr. Daniel Ostergaard: So did you go to high school in Anniston or elsewhere?\n\nDr. David Satcher: Went to high school in Calhoun County. It was not Anniston as such. But there was a bus that came and picked us up. The bus came within about a mile of our home, so we had to walk from home to the bus route. And then the bus would take us to school. Our junior high and elementary were different schools, then high school.   The High school ride was about 25 miles, so we rode that distance. But I think the main thing is that we took school seriously. My parents took school seriously. And the teachers in Calhoun County, in Hobson City, it was called, took school seriously. And it made a difference in my life.\n\nDr. Daniel Ostergaard: Okay, take it on further to college. And where did you go to college and what was your major and that sort of thing? But where I stumbled just a little bit, is I was so intrigued by your activism for racial equality and your relationship with Dr. Martin Luther King, that I'd like you to talk about that a little bit.\n\nDr. David Satcher: Well, firstly, I want to say that my encounter with racism started very early. I remember that we were scheduled to go to town. And I saved up my money because I was determined that I was going to buy an ice cream cone. And they cost five cents. And so, we went to town, we were going to go to a movie, I was with my brothers.  And I slipped away from them to go into the store to buy the ice cream cone, it's when the lady behind the counter told me that they didn't serve my kind, and I won't use the term she used but it was very clear that I was not going to get an ice cream cone because I was Black.\n\nDr. David Satcher: And so that was the beginning. For me, it was an ice cream cone. That was how it started, and not being able to buy an ice cream cone because I was black. She didn't use the word black, but because of my race, was one of the most significant lessons that I learned very early. So that's how it started. Then it went on from there. And when I got to Morehouse College in Atlanta, I was already determined that whatever else I did, I was always going to fight for justice, I was always going to fight racism.\n\nDr. David Satcher: And that came to fruition as a student at Morehouse. And as you point out, Martin Luther King Jr. was a graduate of Morehouse. He used to come to the campus to speak to us. The president of Morehouse College was Benjamin Elijah Mays. He taught us the significance of fighting for our rights. And so, I met both Martin Luther King Jr. and Benjamin Mays while I was a student at Morehouse.\n\nDr. David Satcher: Several of us used to walk five miles to Martin Luther King Jr.'s church. He was co-pastoring it with his father. And we'd walk those five miles when we knew that Martin Luther King Jr. was going to be in town, to hear him preach. And he was the kind of person that left you in awe by his words, and the clarity of the points that he was making.\n\nDr. David Satcher: So I was very fortunate to not only attend Morehouse where Martin Luther King Jr. had graduated, but also to have a president like Benjamin Mays who influenced Martin Luther King Jr. and me, to what our own behavior. Number one, he made it clear that we were responsible, that we had to take learning seriously, and that we were expected to contribute to making the world a better place.\n\nDr. David Satcher: So, I owe a lot to Morehouse College. At the same point at Morehouse, I think it was the beginning of my sophomore year, the students called a meeting. People like Marian Wright Edelman, whose name you might know, and Otis Moss. And these were people who had decided that we the students were going to have our own movement against discrimination.  And the places where they wouldn't serve us, we were going there, to try to get served. And even if it meant going to jail, we were going to do it. So that was the beginning.\n\nDr. David Satcher: I was arrested first, I believe, in September of 1960.  I didn't stay in jail long that time, later I would end up staying longer. But I always took my schoolwork seriously. I used to get out of jail and go back to class and make one of the top grades on the exam that we would have the day after I got out. So I was fortunate. I could study while I was in jail.\n\nDr. David Satcher: This went on for all my years. I became the leader of the student movement in my senior year. I was president of the student body at Morehouse, and also became the leader of the movement.  I went to prison once, and that was not a long spell, about a week. But that's because the students had so successfully filled the jails, which that was the intent.   We're going to fill the jails so they will have no space for any more students. And we did that. And it became a part of who we were.\n\nDr. David Satcher: And I must say that working with other students and taking risk very early was important.  Somebody who was as serious about school as I was, to then participate in activities that led you to jail, was very significant. It's like making a decision, \"This is important enough that I'm willing to take a risk of my future.\"\n\nDr. Daniel Ostergaard: Wow, that's very good. That is emblematic of the commitment that you had throughout your whole career. Again, reflecting on that recent book of yours, did I recall that president Kennedy got you out of jail because you were in jail with Martin Luther King. And he made a call to the sheriff for somebody and you all got out of jail.\n\nDr. David Satcher: Your memory is so far perfect, Dan. Yeah, Mrs. King called John Kennedy, actually, just before he was elected, he was running for office.  She was worried because she had been told that they were going to kill Martin Luther King Jr. that night. They took him out of Atlanta to Athens, I believe. And also, she called John Kennedy and Robert Kennedy. They were busy running for office. And John Kennedy talked to the mayor of Atlanta, and they agreed to get Martin Luther King Jr. out of jail. And the rest of us got out of jail. That's when I was in prison. And the rest of us got out at the same time, so we were very fortunate to be associated with Martin Luther King when his life was threatened. And John Kennedy was popular and powerful enough that the mayor of Atlanta agreed to let all of us out.\n\nDr. Daniel Ostergaard: Okay, better go on to your next academic steps such as from Morehouse College on to med school, and then on to Rochester, but med school.\n\nDr. David Satcher: Well, let me say first, I did well as a student at Morehouse. I took my studies seriously. I worked in the laboratory. And as I got to be a junior and a senior, I taught other students in the laboratory in terms of laboratory studies. So when I became a senior, everybody was convinced that I was going to be admitted to the best medical school I wanted to attend. And at that time, Duke had announced that they were going to accept their first black student. No medical school in the south at the time had admitted a black student.\n\nDr. David Satcher: And so I applied to Duke. There were two black students who applied to Duke and seriously considered for admission. The other black student was somebody I never got to know, but he had gone to school at a predominately white undergraduate school. And so to make a long story short, because I tend to lengthen these stories, Duke turned me down, and they admitted the other black student.\n\nDr. David Satcher: Since everybody was expecting me to be admitted to Duke, because I had done such great a job academically and even started a research career.  I was surprised when I got turned down. It took me a while to get over that but I got over it. And it's probably one of the best things that's ever happened to me.  I was admitted to Case Western Reserve University on the MD/PhD program, because I had been involved in research with Dr. Roy Hunter, who was a mentor.\n\nDr. David Satcher: And so, I was admitted to Case Western, not just as an MD student but as a MD/PhD candidate, because I had started doing research at Morehouse.  Case Western was a perfect place for the MD/PhD program. It turns out that getting rejected by Duke may be one of the best things that happened to me, in that sense.\n\nDr. David Satcher: Duke, for many years, after they found out where I was, expressed their regrets. They were worried that they were not ready for a student who's an activist, but they apologized for that. And I used to get invited to Duke to speak just about every year, for a while. But it was an interesting situation. We were all involved in this 'movement'.\n\nDr. Daniel Ostergaard: Well, it's Duke's loss, as they told you later. To the PhD, so the MD/PhD program was A, how many years long, and B, at that point, were you planning to do research clinical medicine or what did you think your trajectory would be?\n\nDr. David Satcher: It's a good question. It was all of the above. And I want to say that, from the time that I went to college, it was very clear that I couldn't pay my way. In fact, Morehouse almost rejected me because they realized that I didn't have the money to pay tuition. And they said, \"Well, you can work your way through.\" And some of them doubted that I would be able to do that. But finally they agreed to admit me.\n\nDr. David Satcher: My first job was in the library, sending books to be prepared for binding. And then later on, the job that I got was in the biology department, where I started doing research and started teaching students. That was the beginning. Roy Hunter, who had had polio when he was a child, was a great researcher. And he just loved the fact that I was interested in research.  This made it great for me because I was able to do research with him, even published with him, and was able to get a National Science Foundation summer grant, which I used at Texas Southern University. To make a long story short, I was very fortunate. I got the right breaks when they were needed. And it all just came together.\n\nDr. David Satcher: I took my work seriously. I was actually interested in research.  And I know, a lot of people say, \"We know it's your career, we didn't know your insurance.\"  I was interested in research. Roy Hunter, in part, made me interested in research. He was a great researcher. And that interest in research benefited me tremendously. And as you know, it led to MD/PhD. Case Western, probably would not have admitted me if I had not had this background in research because they were very interested in promoting that combined degree. So things came together for me at Case Western.\n\nDr. Daniel Ostergaard: You said that all of those, when I asked you if your trajectory was likely to be research or clinical medicine, but then you went on to a clinical residency, Med-Peds residency, at the University of Rochester, so that would imply that you had a clinical interest as well.\n\nDr. David Satcher: I was interested in family medicine before there were official programs in family practice. So yeah, I was always interested. It was Dr. Jackson, somebody that I didn't necessarily remember personally, but I knew that he had saved my life, and I knew that I wanted to be as much like Dr. Jackson as I could. And so, I was interested in the practice of family medicine. I didn't fully understand it. There was no residency program in family medicine until... I think Rochester was the first if I remember correctly.\n\nDr. Daniel Ostergaard: I think you're right. It was one of the first 15, I know that.\n\nDr. David Satcher: And I ended up applying for the mixed medicine pediatric program before the family practice program was fully in place. And the rest is history. I ended up finishing family practice at UCLA after I got out to Los Angeles. I was the first residency graduate of the UCLA family practice program. But I actually started the mixed Med-Peds at Rochester, then pulled those together and finished the family practice residency at UCLA.\n\nDr. Daniel Ostergaard: That's fascinating. That almost gets us to the next section to make sure we can get all of your fantastic history stories and contributions in. Because it was after you then finished the residency at UCLA that you indeed became a Board Certified family physician. Right?\n\nDr. David Satcher: Right.\n\nDr. Daniel Ostergaard: Go ahead.\n\nDr. David Satcher: No, I was just saying I had a great experience at UCLA in family practice. I did some other things, I did the Robert Wood Johnson Clinical Scholars program, which allowed me to enrich my training for family medicine. And again, UCLA had a very good program. It was the beginning. You probably remember Bob Martin.\n\nDr. Daniel Ostergaard: Oh, absolutely.\n\nDr. David Satcher: Bob was head of the UCLA program and I was the first resident.\n\nDr. Daniel Ostergaard: Oh, I did not know that.\n\nDr. David Satcher: Yeah, I was the first resident in that program.\n\nDr. Daniel Ostergaard: Well, yeah, Bob Martin did a good thing there too. You don't remember but his first name was Lemuel.\n\nDr. David Satcher: I missed that.\n\nDr. Daniel Ostergaard: Lemuel Robert Martin. Okay, let's go on. Let's stay at UCLA. Tell us about King/Drew. And even though you were a Board Certified family physician, you became president of the university. And you created the bond, if not an official agreement it might have been, between UCLA and King/Drew. I can't remember the chronology, but let's talk about the UCLA-King/Drew part now where you are president.\n\nDr. David Satcher: Yeah, I'll do the best I can. Because I think what happened to me was, I often responded to what I considered to be things that were important and had great need. At King/Drew, of course, the first thing was sickle cell disease, which, while I was a student at Case Western, I became involved in treating sickle cell patients. Because I was working on a PhD, I still had to see patients one day a week. And one of my favorite, I guess, patients was a patient with sickle cell disease. And learn how to treat sickle cell disease much better than most people because I was working with a hematologist.\n\nDr. David Satcher: So, when I got out to King/Drew, they had patients coming into the emergency room at night in crisis, sickle cell crisis. They would call me at home to come in and see the patient when there was a serious issue. And so, I slept with the phone next to my bed.  And I had married by that time, to Callie, and I would sleep with the phone next to my bed. They would call me, and I would get up and go see the patient. Sometimes three o'clock in the morning.\n\nDr. David Satcher: I always had this mixed address. For me, family medicine was never just limited to one area, it was what it should be. We took care of several different kinds of patients. And the thing is to do practice better than anybody else, to do practice of medicine better than anybody, that's what we tried to do. And that was my experience at King/Drew, and then went on to UCLA.\n\nDr. David Satcher: I won't go into the details of UCLA unless you want me to, but King/Drew and UCLA were negotiating for a partnership. And so I was both at UCLA and King/Drew because I did finish the residency there. And so it ended up with bringing together these two institutions. Because the dean at Drew, at some point, gave up on the idea of a partnership with UCLA, so he left. And when he left, the faculty had a meeting, and I had to leave early to go to a meeting downtown.\n\nDr. David Satcher: And of course while I was away, they voted to ask me to serve as interim dean. And I was really young then. And I guess in part they thought I didn't know any better, so I said yes. And I ended up negotiating this agreement with UCLA. On May 24th 1978, we signed the agreement with UCLA that we will start a medical school. Drew, over a period of time, and these medical students would do their first two years at UCLA, and the last two years at Drew. And that happened, and that led to the medical school that now exists, which shared the students done their first two years at UCLA and last two years at King/Drew. It was a great partnership. If you know the name Sherman Mellinkof.\n\nDr. Daniel Ostergaard: Sure, he was the dean.\n\nDr. David Satcher: Yeah, the longest serving dean, I believe, at that time. And I would meet with Sherman once a month. He was amazing, brilliant guy. And he watched me as I struggled to make this thing work, and finally we did make it work. And then we had the agreement, I think, May 24th 1978. The Board of Regents at the University of California agreed to start a medical education program at King/Drew, where the students would do the first two years at UCLA and the last two years at King/Drew. Yes, that's what happened.\n\nDr. Daniel Ostergaard: Well, I can't recall the exact chronology, but from that experience did you go to Meharry or did you stay? Because you went back to King/Drew as president, right?\n\nDr. David Satcher: Yeah. Remember now, I was still in my 20s, so everything was interim. So I was the interim president at King/Drew. But during that time, I had already began to start the primary care program at King/Drew when they solicited me to be the interim president, so I ended up being in both positions. And we were able to begin the medical school program at King/Drew, with the students doing their last two years there. Then the rest of it includes some tragedy in my own life in terms of my wife's death from breast cancer.\n\nDr. David Satcher: At that time we had four children. So I decided to leave and take them back to Alabama with their grandparents, in Atlanta, where Morehouse was. Louis Sullivan wanted me to come and start the program in family medicine here at Morehouse School of Medicine. And at that time, Morehouse was actually a part of a larger school, a larger institution, Morehouse College. But I did that, and we started developing the family practice residency program.\n\nDr. David Satcher: You may know the name Dan Blumenthal. Dan started community medicine here. And together we started residency program in family medicine. And that program was three years old when the Meharry situation came up. And that's a long story which I won't tell. Meharry was on the verge of closing. And it's the kind of situation that always attracted me. I didn't think that Meharry would select me as president, but everybody was saying that I should go there for the interview. Because all the people that knew me from King/Drew.\n\nDr. David Satcher: So I finally agreed to go. And after I went there for the interview, I decided that I really had nothing more important to do than to make sure that this institution, which had already graduated over 30% of the black physicians in the country, and now it's survival was on the ropes. So to make a long story short, again, I ended up going to Meharry as president in 1982.\n\nDr. David Satcher: I've served in a lot of places, but I've served at Meharry longer than anywhere else I've served. And we went through a lot, but we survived and we had some great outcomes. Meharry has a really outstanding president now, and he's a good friend and he's a great scientist. And Morehouse has an outstanding president, and I'm trying to retire.\n\nDr. Daniel Ostergaard: I do need to know a little bit more. I think the people who will be listening and reading about this. At Meharry, during that difficult time, there was the intrigue of Vanderbilt, there was the relationship between the Meharry Hubbard Hospital and the City Hospital in Nashville. That's too long a story as you said, but I know that Bob Graham was somehow involved in that because he was a Fed at that time, and I can't remember, it was HRSA, or Health Resources Administration, but just give us a little bit about that intrigue, and then just go to the end of that.\n\nDr. David Satcher: Well, first, let me just say that Bob Graham is one of the best friends I've ever had. And because Jane Heney also... they're good people. And we were lucky that Bob was in a position that he was in with HRSA. And he used that position to help negotiate the relationship between Meharry and Vanderbilt as it related to the City Hospital.\n\nDr. David Satcher: During all this time I was interim president in way over my head. If it were not for people like Bob Graham, I'm not sure what would happen. I've been fortunate throughout my career, not to succeed because of my own knowledge and skills, but to be fortunate enough to know and to work with people like Bob Graham. And even at Vanderbilt where there was a big battle going on as to whether Meharry could share the City Hospital, and its profit, to get paid for patient care. And Vanderbilt fought against that for several years. Ike Robinson was the dean at Vanderbilt, and I used to go and eat with him just about once a week. He always said, \"No.\" That's the word that he knew best. But finally we agreed to work together.\n\nDr. David Satcher: And the ultimate outcome was that the city decided to close the City Hospital because it was about to fall down, and to buy the hospital at Meharry, which was fairly new. And so as a result of that, Meharry and Vanderbilt share the City Hospital today. And the City Hospital is on the campus of Meharry Medical College. Meharry has a long history, I could just talk about Meharry for a long time, because when I got there it had graduated, as I said, 50% of the black physicians in the country, and it was about to close. A lot of people thought it was going to close because of not having that hospital.\n\nDr. David Satcher: And we were fortunate in the sense that... It reminds me of the relationship between King/Drew and UCLA, is that even though Ike Robinson and John Mellenkoff were different kind of people, they were both people of great integrity. And they were tough. But ultimately, we agreed to share. And I think everybody was pleased with that.\n\nDr. Daniel Ostergaard: Well, and several other leaders came out of that relationship. I think of John Arredondo.\n\nDr. David Satcher: You know John too? Wow.\n\nDr. Daniel Ostergaard: Yeah. And others whom I can't remember, but John Arredondo came right to mind. So again, the legacy of Meharry and its survival, at that period, is impressive and long lasting.\n\nDr. David Satcher: Yes.\n\nDr. Daniel Ostergaard: Well, we're going to switch gears. Oh, no, you mentioned Jane Heney. Do you remember that you were the one who swore her in as the commissioner of the Food and Drug Administration?\n\nDr. David Satcher: Well, I'm very glad, but I would probably claim it even if I didn't, she is such a great person.\n\nDr. Daniel Ostergaard: Well, actually Bob Graham reminded me last night that you did the official swearing in. I assume it was when you were the Assistant Secretary of Health. Because I don't think that would be a Surgeon General job. But it was also then formally and visibly done and ceremoniously done by Al Gore, as part of Clinton/Gore.\n\nDr. David Satcher: As I said, Bob and Jane were both really good people who have made a tremendous contribution to family medicine and the practice. But also, I think to medical education and health care in this country generally.\n\nDr. Daniel Ostergaard: Let's go on now to probably the biggest chunk of our time together, which is your national and international time, which was not specific family medicine or academia, it was public service, if you will. And in that chunk of time that we're going to spend, we'd like to go over your role as the director of CDC, Surgeon General, the Assistant Secretary of Health, and I recall now that there were two people only that have been the ASH, as we say, Assistant Secretary of Health, and Surgeon General at the same time, and that was you, preceded by Julius Richmond. And both of you made major, major contributions to healthy people.\n\nDr. Daniel Ostergaard: And then the whole thing that I think has impressed me as I've given talks about primary care around the world, is your contribution as vice chair of the WHO Commission on the Social Determinants of Health, and how that has made such a difference even at my own American Academy of Family Physicians and other places. Which one do you want to start with of those public responsibilities?\n\nDr. David Satcher: Well, maybe I can tie them together in a way. I think it's interesting now to look back on the Commission on Social Determinants of Health, and the role which I was able to play on that commission. And this commission was a part of... it was appointed by WHO. So, it was a great experience. We traveled all over the world, we visited health programs all over the world, medical schools, and really got to know the different ways in which people did or did not incorporate social determinants of health into their healthcare program, into their medical education program. Was a great group.\n\nDr. David Satcher: William “Bill” Foege, by the way, want to call his name at least once.  Bill Foege and I were the US representatives, ultimately, on this Commission on Social Determinants of Health. For those who don't know the name William “Bill” Foege, Bill is given credit for having led the eradication of smallpox. Smallpox is the only disease that we've eradicated. Hopefully, polio will join that soon, but at the time, it was smallpox.  And even though Bill Foege was fairly young, most people give him credit for the strategy that was used to eradicate smallpox disease.  Bill is still around, he's at University of Washington.  He's like I am, in terms of being retired and not retired.  But he's a great guy.\n\nDr. Daniel Ostergaard: Was this, the Commission on the Social Determinants of Health, a long activity Did you meet in Geneva or in the United States, or where did you meet? I guess you said all over the world, but Geneva primarily?\n\nDr. David Satcher: Yeah. But let me just say, we started in 2005. The person at WHO who appointed us died after the first meeting, I think, it was unfortunate. We proceeded and visited countries all over the world. We visited China, we got to know their programs, countries in Pan America. We visited Africa. And the question was, how do the social determinants, social factors like where one was born, it's income, it's education, those social issues, how do they affect health outcomes? Was the question.\n\nDr. David Satcher: And we tried to define that, over that four-year period, in which we visited all of these countries. I remember a lot of these visits, especially in Pan America, in Africa, and China, where we actually looked at how are these factors? What are they and how are they affecting health outcomes, and how do we integrate them with health care? Because if you don't integrate them with health care, there's no way that you're going to take advantage of full resources of the health system.\n\nDr. David Satcher: I think family practice had and has done the best job of incorporating social determinants of health into healthcare. But I think this work of the Commission on Social Determinants, incorporated those things into medical practice for the first time, in a way that was clearly defined. And so I believe it was 2009. Started in 2005. It was in 2009 that we released our report on the social determinants of health. And a lot of these things could only be changed by changing policy. They depended upon changes in health policy, in order to be able to exchange those things. And some of those issues we help policy change were dealt with in this country, of course, in various ways.\n\nDr. Daniel Ostergaard: Well, it was about that time in, I believe, 2008, when the then secretary general of the WHO released a report called Primary Health Care: Now More Than Ever. And if I recall, she actually gave a talk at the WONCA meeting one year, I think 2013. At any rate, she built on the social determinants of health for her manifesto, almost, about the need for primary health care globally.\n\nDr. Daniel Ostergaard: Okay, let's go to the SG, the Surgeon General and Assistant Secretary of Health relationship. I would like you to, I'll just give you fair warning, to talk about maybe the top three of your Surgeon General reports in terms of their impact. I may have my own favorites but it's most important that you say yours. But when you were the Surgeon General and the Assistant Secretary of Health, that is in some ways a conundrum, in some ways an advantage. Would you describe that, and then you could do the anecdote about when you went to, I believe, you went to the White House to do something quite formal, and just before you were to make a great big pronouncement to President Bush, he informed you that \"You can't do that.\"\n\n\nDr. David Satcher: There are some things I chose to forget. Let me just introduce a couple other names. Phil Lee, you've probably been on the field, died recently. He was the first Assistant Secretary for Health. And he was the one who suggested me to serve in that role. The reason I served as both Surgeon General and Assistant Secretary for Health, was that Phil Lee decided that he couldn't continue to serve as Assistant Secretary for Health. He had recruited me from the CDC to serve as Surgeon General, and he made it known that he thought I would be the person to serve both positions. Phil is another great guy in my history. And when he died a few months ago, it was a great loss. Now, I just forgot what we were talking about.\n\nDr. Daniel Ostergaard: We were talking about SG reports.\n\nDr. David Satcher: Reports, yeah. I can deal with that.\n\nDr. Daniel Ostergaard: Before that, how the two role... I don't think the average reader or listener of your oral history, will, and maybe it's too much in the weeds, but it's very unusual for those two roles to be held by the same individual. And some challenges and some opportunities.\n\nDr. David Satcher: Yeah, they are clearly both full-time jobs. The role of the Surgeon General, which goes back to 1871, I believe. And has evolved over the years in terms of its importance to the health of the American people. I think it was not until about 1964 that the first official Surgeon General's report came out. There had been the Surgeon General in administrative head in public health.\n\nDr. David Satcher: But in 1964, the Surgeon General's report on smoking and health will always be remembered as the 'first Surgeon General's report'. And Luther Terry released that report. I have a lot of stories about Luther Terry because I knew his son Michael very well. But it was a great report, it has probably saved more lives than any single report since that time. Even though every Surgeon General says Luther Terry has released a report on smoking and health, it just goes on and on, because we go on and on without smoking. But it's been reduced significantly. It was 40-something percent of the American people were smoking when Luther Terry released this report. And today that's less than 15%. So we're still smoking too much, and yet as compared to 40% of the Americans smoking, it's about 15%. Even less, I think. The Surgeon General's report has made a big difference in terms of what can the American people look to for guidance in terms of how we conduct ourselves, including whether or not we smoke.\n\nDr. David Satcher: In my tenure as Surgeon General I released three reports on smoking and health. I did the first report on minorities and smoking, but I also did a report on women and smoking. And so I added to the smoking health report, but I also introduced some new topics. Mental health had never been the subject of the Surgeon General's report. But I don't think there's any family physician who could talk about the health of the American people and not talk about mental health. And so we decided to do a difficult report on mental health, starting with childhood. It started with the role of parents in terms of helping to support the mental health development of children. So we did that.\n\nDr. David Satcher: We also did a report on sexual health. And this related to my earlier experience at the CDC, but it also incorporated mental health and other forms of health intervention. So sexual health was a very important report that we did. Some of the things that people didn't ordinarily comfortably discuss, we tried to introduce them to the discussion of the American people. Breastfeeding, we were not the first to release that report. But breastfeeding was a very important report that we released.\n\nDr. David Satcher: Youth violence. And I'm still quite involved with how do we reduce violence in young people. But the Surgeon General's report, I believe, in about 2001, was a very important report on how do we reduce and ultimately prevent violence in our young people. That report is as relevant today as it was when it was released. It's amazing.\n\nDr. David Satcher: But I think, when I look back over the reports, I believe that mental health has received the most attention. Suicide prevention was a spinoff from mental health. But I believe that when people asked me to speak about a report, mental health is more likely to be one of the ones that they ask about.\n\nDr. Daniel Ostergaard: That's a remarkable tribute to your having used that topic for a Surgeon General's report. It may have been the one that got the most press too. A lot of them have had a lot of press. I have to mention one that's a little bit curious, and it kind of gets into your passion for leadership in all of your leadership roles, but you also released a report on oral health. And at the time you declared that you probably knew little, more or less, about oral health than any other topics in all of your SG reports.\n\nDr. Daniel Ostergaard: But it was a concept of leadership, of having a team whose expertise you trusted, and guiding the team to putting something out as part of your whole leadership challenge. I found that very, very interesting. I wouldn't have thought of oral health either but I'm glad you did it. And obviously it was recognized for something that even though that's not a huge part of any family medicine training.\n\nDr. David Satcher: It's interesting because, I don't know if you're aware, Meharry has a dental school. And so when I was president of Meharry, I was president of an institution that had both a medical school and a dental school. And not too long after I became involved there, I made it very clear to people that dentists are doctors too. And so we're going to refer to dentists as doctors. They had to get the doctoral degree. So some of that came from my Meharry experience, in terms of how we looked at people on the faculty there and what we expected of people on the faculty.\n\nDr. Daniel Ostergaard: Well, let me mention another thing you did while you were Surgeon General that was very, very special to me. And that was when you went to Durban, South Africa to give the keynote address at the 2001 triennial. It only occurred every three years. Conference from the World Organization of Family Doctors. And I remember very well, probably the preceding fall at an annual AAFP annual assembly that you were given a keynote there.\n\nDr. Daniel Ostergaard: And I trapped you in a room with one of your staff and talked about that WONCA meeting in Durban, and I said, \"If you're willing to consider it, I'll talk with the South African host organizing committee and see if they would love to have you,\" and they wanted to have you very badly. And the coolest thing about that, from my perspective, was that this was an African American Surgeon General of the United States going back to Africa, talking about equity. Comment on that.\n\nDr. David Satcher: Amazing. Let me say thank you because I know the role that you played in bringing this about, and so I appreciate that. I think that was very important. It was important to me, it was important to my colleagues in Africa, as well as currently in this country. There are things that goes on in this country that a lot of people don't know about globally. And you could argue that many of the people before that, didn't know me from a global perspective.\n\nDr. David Satcher: But it became the topic of discussion for the rest of the meeting, the presentation and the role that I was playing in this country as both Surgeon General and Assistant Secretary for Health. But I just remember the excitement at that meeting, and I remember all of the people who came up to me afterwards to introduce themselves and wanted to talk about what it was like to serve as both Surgeon General and Assistant Secretary for Health in this country. It was a great experience.\n\nDr. Daniel Ostergaard: One of them was a guy named Bruce Sparks, you wouldn't remember his name, but he became president of WONCA, World Organization of Family Doctors, at that meeting. And I went to the hospital at Witwatersrand, and his office, his family medicine staff, were the doctors in Soweto. They were the ones that covered all the ER services in Soweto. And again, your presence there just gave him such an encouragement boost. It's biblical that we should encourage each other.\n\nDr. Daniel Ostergaard: We didn't talk about CDC, talk about CDC a bit.\n\nDr. David Satcher: I could talk about CDC a long time because I always felt that, in many ways, it may have been the most important job I've held. It's hard to say that because I've had some very important positions. The CDC experience was more of a team leadership than anything else. I have been president of institutions, and as you point out, Surgeon General, but the CDC was getting to know a group of people for their expertise, calling upon that expertise when it was needed. It was a great experience. We did some very important things throughout the world at CDC.\n\nDr. David Satcher: I was able to appoint the first woman to serve as deputy director of the CDC, and that was Claire Broome. I don't know if you know that name, but Claire's the one who first described toxic shock syndrome. Then later, working with Claire, we developed the institute on AIDS at the CDC. There was no institute dealing with AIDS. And we appointed Helene Gayle, a lot of people now know, to serve as director of that institute.\n\nDr. David Satcher: I think both Helene and Claire were outstanding in their own rights, and I think they served as a source of great inspiration for other women at CDC, and there are many women in those position now. It is a lesson in what happens when you just treat people fairly and you support them. Claire's a brilliant person, and think she's in San Francisco, UCSF now. Helene Gayle has served as director of the global health program for Gates. She's had some very critical positions throughout this country and the world, and is now serving as head of The Chicago Foundation.\n\nDr. Daniel Ostergaard: I bet you could talk about CDC on and on and on, and if I would delve into the politics, which I won't, you could talk about recent CDC activities and relationships administrations, but I don't want to get either me or you in trouble.\n\nDr. David Satcher: But I hope people will not forget that the CDC is one of the world's great organizations. WHO will tell you that. They often look to the CDC for guidance, and they've been very appreciative for the role of the CDC. When I was director of the CDC, we developed several programs throughout the world, including France and Zimbabwe, and others. In other words, we took the model of the CDC in this country and replicated it in several other countries, and that has made a great difference.\n\nDr. Daniel Ostergaard: Again, back in your leadership roles and the fact that you have always learned from learning, and the necessity of teamwork and the necessity of partnerships is so clear in what you just said about WHO, the other countries and the United States CDC. I would like to now switch to... Well, I'll just do a couple of fun things.\n\nDr. Daniel Ostergaard: I have a recollection. When I was vice president of education at the American Academy of Family Physicians, that when you would give a talk or even sometimes when you weren't there in an official role, I'd see you go into the courses that you went there for your own CME. Is that a correct recollection? Even though you were in all of these public policy and academic posts, you still went and learned stuff.\n\nDr. David Satcher: Yeah. Number one, I love to learn, and number two, I need it. I always try to stay as current as possible. I didn't always succeed but I always tried to. And I think that really helped me when I became Surgeon General, in terms of being able to look at a broad field of medicine and to define the areas of greatest need for information. I think people appreciated that I realized that I didn't know everything I needed to know. But I also knew a lot about how to learn more about different areas. So we were able to... People appreciated that.\n\nDr. David Satcher: Let me say that again. It's amazing how people appreciate when you value their area of learning enough. And family practice does that better than any discipline because we have to value a lot of different disciplines in order to make the team work. And I think that helped me tremendously. I don't know if you know what this is, Dan, but this is the Surgeon General's prescription.\n\nDr. Daniel Ostergaard: Oh, I remember that.\n\nDr. David Satcher: Okay. It turns out to be very important, there are only five things on there. One deals with the need to be physically active on a regular basis. Nutrition, we focus on fruits and vegetables. Avoiding toxins like tobacco and illicit drugs. Responsible sexual behavior. And then participating on a regular basis and relaxing and stress-reducing activities. So I became known as the Surgeon General with the prescription. And I pass this on. There will be people who will come up to me at WHO, who couldn't speak English, but they found a way to ask for a prescription, so I enjoy working with them.\n\nDr. Daniel Ostergaard: Well, and indeed, again, thinking of your Surgeon General reports, it kind of covers all of those. All of those five or six things are covered in your Surgeon General reports. Mind, body, spirit. I remember that you would go in the academy CME area and go to the courses, as incognito. So even if you were there officially giving a speech with your uniform and everything, you take the uniform off and just go and do your thing, and hopefully people didn't bug you too much.\n\nDr. David Satcher: Well, they never managed to bug me too much. [crosstalk","format":"text/plain"},"target":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/3162/collection_resources/140814/file/260245#t=306.0,3747.0"},{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/3162/collection_resources/140814/file/260245/transcript/74392/annotation/3","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"] together.\n\nDr. Daniel Ostergaard: Let me mention a couple of organizations and a couple of names. You've had primary care interest percolate through all of your responsibilities, and you have been a member of the Society of Teachers of Family Medicine of the American Academy of Family Physicians, and a diplomat of the American Board of Family Medicine. So that certainly is something we cherish.\n\nDr. Daniel Ostergaard: And I'd like you to just comment on how that your primary care worldview affected your other responsibilities, because you were working usually with people who maybe didn't understand family medicine at all, maybe not even primary care. So how did this inform your ability to work with all of these disparate people and disparate organizations?\n\nDr. David Satcher: Well, the first thing I think is, it affected my attitude. I think our attitude toward multi disciplinary approach to learning and to intervening, is what's critical. And so, I think, again, in talking about the CDC and talking about Claire Broome and Helene Gayle and others, these people came from different disciplines and yet the fact that I appreciated their background and their history, I think made our relationship much more productive.\n\nDr. David Satcher: Again, that's why I say that in some ways, I think when people ask me what's the most important position you've ever had? Temptation, of course, is to say Surgeon General, and maybe that's true, but I think it's also important to point out that working in a multi disciplinary situation and valuing everybody's discipline and incorporating it the way we did at CDC, is really important.\n\nDr. Daniel Ostergaard: Next, I'd like to ask you to respond briefly to some names I've jotted down. You've already talked a little about Bob Graham and Jane Heney, I won't ask you about them again, but how about Fitzhugh Mullan, who just died not a year or so ago?\n\nDr. David Satcher: Fitzhugh was a great friend, a great human being, Fitzhugh Mullan. And I enjoyed working with him right up until, I guess you'd say, the very end. Class act, Fitzhugh Mullan, really class act. I think we were fortunate to have him with us the amount of time that we did. He died too soon, I guess you'd have to say. And yet while he was alive, he made a significant contribution.\n\nDr. Daniel Ostergaard: Second name is Ken Moritsugu.\n\nDr. David Satcher: Ken Moritsugu is interesting. He had been in the Public Health Service for over 30 years when I became Surgeon General. And I knew that the most important thing for me was going to be who do I select as deputy. Because I was going to be out traveling all over the place and giving speeches and what have you, but I needed somebody running the Surgeon General's office, especially since I was Surgeon General and Assistant Secretary for Health. And after interviewing several people, I got to know Ken Moritsugu. And Ken Moritsugu and I had met when I was out in Los Angeles. Ken played a role in the relationship between UCLA and Drew, because he was the regional director of the Public Health Service in that area, or region nine, I believe. And so Ken is a really great guy. He and his wife have made great contributions. We're very fortunate to have him participating in medicine at the highest level.\n\nDr. Daniel Ostergaard: I will tell you something about Ken Moritsugu that I bet you don't know or don't remember, but it's very germane to this conversation because Crystal Bauer, who's the Manager of the Center for the History of Family Medicine in Leawood, Kansas. The Center is a function of the AAFP Foundation. Well, I bet you don't know that Ken Moritsugu was a member of the Board of Trustees of the AAFP Foundation for several years. I enjoyed catching up with him during those times. And he was a very effective member.\n\nDr. David Satcher: Yeah, it sounds like Ken. He's just a great guy and a great leader.\n\nDr. Daniel Ostergaard: Okay, let's move on to your, I don't know how you say this, your post retirement time, because you haven't retired.\n\nDr. David Satcher: But I'm working on it.\n\nDr. Daniel Ostergaard: You're working on it. Yeah. But you've flunked. You have flunked it about four times if I remember. That David Satcher continuing contribution. And when you went back to Morehouse and you established the Satcher Health Leadership Institute.\n\nDr. Daniel Ostergaard: And I don't remember if that is an offshoot or related to the Primary Care Center which you started before that. But the whole Morehouse work, I would like you to comment on, because it's leadership training. Talk about that a little bit. And then at the end of that little bit, point out that, something I read in AMA, even today is the Medical Justice in Advocacy Fellowship of AMA and the Satcher Health Leadership Institute. As I understand what I read, it is a post doc health equity fellowship to be launched in the Fall of 2021.\n\nDr. David Satcher: Well, I'm going to say a couple of things. You probably notice that I somehow end up in leadership roles, even when I don't try to. And usually it's because somebody decided that they didn't want to do this job of leadership or they shouldn't want to. But anyway, I came back to Morehouse. You probably know the name Louis Sullivan, he was Secretary of Health and Human Services. I feel he had really done a job of selling me to the people at Stanford and UCSF. So when I left the Surgeon General's office, I had a great position already funded, and I'm not accustomed to that. But it was the funds were there, everything, all I had to do was just go and develop this Community Health Leadership Program, which is something that I really like.\n\nDr. David Satcher: And then I get to call Louis Sullivan about what they were trying to do here at Morehouse. The need was great. If I came they could get money, but it's not like they had money that they could say, \"If you come we have this money, this budget for you.\" I knew they didn't. But ultimately, I agreed to come. And together, we developed a national center for primary care. This building where I am right now, is the building of the National Center for Primary Care.\n\nDr. David Satcher: And it's the first major building on the Morehouse School of Medicine campus. So I agreed to come. I realized I was giving up a lot in coming, but also was gaining a lot coming back to Atlanta and getting involved in developing the School of Medicine at Morehouse. So, I've had a great experience here. I will say, if you read the book, of course, you are aware that I often end up in leadership roles. Not intentionally all the time, but when things don't work out for somebody... I came back with Jim Gavin, and when he decided to leave, the next call I received was the Board of Trustees asking me if I would be willing to serve, and they said, \"Well, if you can serve for three or four months, give us time to recruit.\"\n\nDr. David Satcher: Well, that's the way it usually starts. And of course, I ended up serving for over two years. And the Morehouse School of Medicine has done quite well. When I stepped down from the interim presidency, it was really big change of title to president. I was to come back to the National Center for Primary Care which I had come to develop. And so I decided that... I don't like to move into positions and move somebody else out, unless they have been a real problem or challenge. So I decided that...\n\nDr. David Satcher: George Rust had done a great job as interim director of the National Center for Primary Care. I don't know if you know George, but he did a great job. And I asked him if he wanted to stay on as director, he said yes, and we arranged for him to stay on. And I decided that since I had so often yet to develop leadership roles, to develop the Satcher Health Leadership Institute. And that's how this institute started, Satcher Health Leadership Institute.\n\nDr. David Satcher: I'm no longer the director, which is great, but we have a great director in Daniel Dawes. He's a lawyer by training, and he's really gotten into medical justice and advocacy in a way that we have not before. And so there are good people here. They step into leadership roles, and they allow me to step out, which is my next move, I guess.\n\nDr. Daniel Ostergaard: The book that you have written-\n\nDr. David Satcher: Looking Over My Shoulder?\n\nDr. Daniel Ostergaard: Yes. Looking over here and looking over your shoulder. What you did with Johns Hopkins University Press a year or two ago. The title is, My Quest for Health Equity. And that's of course been a quest of yours through all of these multiple positions. But the subheading is Notes on Learning While Leading. And another subtitle could have been, as I read it, was simply a textbook on leadership. Because there were so many anecdotes, as well as specific, even mnemonics, about leadership, such as the Crash Course in Culture Competence which stand for CRASH: Consider Culture\n\nRespect Culture\n\nAssess Culture\n\nSensitivity to Cultural Differences\n\nHumility\n\nIt's really a book about leadership as much as it is about the quest for health equity. Comment on that a little bit, please. And if it's an unabashed plug for the book, that's fine.\n\nDr. David Satcher: I'd like to plug the book because that is a great book. Not just because for me, but because the topic is so important. No, I don't think leadership is something we should take for granted. And I think often that's what we do, we take it for granted. I tried to make it very clear how my leadership interest and skills have developed. I talked about my parents and the 40-acre farm and everybody having a job.\n\nDr. David Satcher: But along the way, I would say the key thing that has defined my leadership role is that I have not been seeking leadership positions, for the most part. I've never gone out there and said, \"I want to apply for this leadership role.\" Not that some of them were not roles that were worthy of applying for, it's just that I responded to the need for leadership. And often I said, \"Well, I'll just serve in this position till they find somebody.\" And I would get started and it would be 11 and a half years later like with Meharry, that I realized we had done what we wanted to do and it was time to move on. I've been fortunate.\n\nDr. David Satcher: The reason I say learning while leading, is that I learn a lot about leadership while serving as a leader. It doesn't mean that you're going to do harm while you're in the position, it just means that you're looking for opportunities to improve yourself and to improve those you're leading.\n\nDr. David Satcher: I learned a lot about a lot of people and a lot of styles of leadership during the period that I served in leadership roles. I tell a lot of stories in the book, in part because I love stories, but in part also because I've learned a lot from stories, I've learned a lot from things that I've been through with other people. Excuse me. And I try to capture those lessons in that book.\n\nDr. David Satcher: I talked about Sherman Mellinkof, whom you knew. You may not have known Ike Robinson. These are people that I have difficult relationships with, because we were not necessarily agreeing on a lot of things and yet we became friends. I respected them. I've learned a lot from working with people who are not necessarily at first working for the same thing that I was.\n\nDr. Daniel Ostergaard: Well, the book has multiple anecdotes and stories. And I'll just lay one out as a teaser, but I won't go into it because it went on for weeks. But the-\n\nDr. David Satcher: The stories I remember.\n\nDr. Daniel Ostergaard: All right. Well, it's a teaser for anybody who buys the book. Is that story you told about the 17-year-old schizophrenic black guy, a young guy who was very, very violent. And when you were either a resident student or resident, I forgot. \n\nDr. David Satcher: I was still a student. At Case Western though. It was at Case Western.\n\nDr. Daniel Ostergaard: You went in to see him because he was thought to be... I'm about to tell the whole story. I'm not going to tell the whole story. You went in to talk to this violent kid, even wasn't much younger than you. And after the first few times he took swings at you. You were able to make really, really good contact with him. So I will let that one go right there.\n\nDr. Daniel Ostergaard: One thing when I approach the subject of the Satcher Health Leadership Institute, I said, \"What about the new project with the AMA?\" Just say a little bit about that and how one would access that, that postdoc.\n\nDr. David Satcher: Well, let me say. The new director of the Satcher Health Leadership Institute is Daniel Dawes. And Daniel wrote a book entitled 150 Years of ObamaCare. He worked in Washington, he critically analyzed Obamacare and the things that it was going through and trying to make things happen. And then, of course, recently, he wrote another book called The Political Determinants of Health. We've talked about the social determinants of health.\n\nDr. David Satcher: Daniel, who has taught political science at Johns Hopkins and other places, has been able to pull these things together, and the way they go together to make up public health. He teaches in public health at Johns Hopkins. I think people are greatly attracted to Daniel because he's critical in all of these disciplines, and students learn a lot from him. He certainly knows more about politics than I do. And he's worked in politics. He's made things happen in Washington that I'm sure I couldn't make happen. But the program, I think that you're referring to, is medical justice in advocacy. Yeah, that's the one. So this attracting a lot of interest. But I don't deserve any credit for that except getting out of the way and letting them do it.\n\nDr. Daniel Ostergaard: That's a leadership trait right there. Because I mentioned a timestamp that's going to endure, it's helpful to have a context of today. What I'd like, as a person who spent most of your life or your profession, a lot of your professional life in Georgia, Atlanta.\n\nDr. Daniel Ostergaard: And Georgia has become one of the most interesting spots in the United States in terms of pursuit of health equity, by the mechanism of voting, that I'd like you to comment on both what's happened with the legislature of Georgia, just within the last week, and stepping back into this past November and then January. The leadership shown by the Republicans who were part of the Election Commission, and I don't remember the guy's name, who I consider one of my heroes now, who went to the mic, as well as the Secretary of State. So what's happening right now with Georgia, and what's that going to do to health equity and justice, and what about leadership for those folks a while back?\n\nDr. David Satcher: Tough question. Because as you point out, there were some very impressive people who spoke out toward the election. And if they had not spoken out... They had to deal with a president who was really angry with the outcome of the election. And secretary refused to make changes in the election outcome even though the president was pushing him to do it. So that was some courageous action that took place in Georgia during that time.\n\nDr. David Satcher: And then, of course, the election runoff took place. And for the first time, Georgia elected a black senator. And that black senator, somebody might know quite well, he pastors the same church that Martin Luther King, Jr. pastor, Ebenezer Baptist Church. And he's quite a dynamic leader. But this struggle is not over.\n\nDr. David Satcher: Obviously, what's going to happen now is not clear in terms of the next election. I think he only serves two years before his tenure is up, and then there's another election. And I'm talking about pastor of Ebenezer, who had a lot to do with encouraging black people to vote. There are some people who would like to turn back that clock. They would like to do it in such a way that black people who voted in the last couple of elections wouldn't have the will to fight the system to vote again.\n\nDr. David Satcher: I don't believe that we're going to allow that to stand, I believe that the support for people to go out and vote is going to continue to be there. And I think that's going to be supported broadly by the people of Georgia. But we will see. This is Georgia, and it's a special kind of state in this country. Atlanta is even more special, when you think about what's happened here. Not just in terms of my experience as a student, but I think Martin Luther King Jr. and [DeYoung","format":"text/plain"},"target":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/3162/collection_resources/140814/file/260245#t=3747.0,5053.0"},{"id":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/3162/collection_resources/140814/file/260245/transcript/74392/annotation/4","type":"Annotation","motivation":"transcribing","body":{"type":"TextualBody","value":"], I could go on and on, were people who have lived and worked here, gone to jail here, taking great risk. And they were able to do that because there are a lot of people who live and work here who support that kind of behavior. But we will see what will happen now, as we prepare for the next election in Georgia.\n\nDr. Daniel Ostergaard: Well, you sound optimistic.\n\nDr. David Satcher: I mentioned the first black senator, but we also elected the first Jewish senator from Georgia. Same time, so they were in the same election. I know both of them very well. My son worked in the election of the other senator that I mentioned, who's the youngest senator also.\n\nDr. Daniel Ostergaard: Senator Ossoff and Reverend Warnock.\n\nDr. David Satcher: Yes.\n\nDr. Daniel Ostergaard: Okay. Lastly, loose ends. Knowing that audience for this would be likely Academy people and STFM people, anything that you would like to say that I should have asked you?\n\nDr. David Satcher: Well, you've covered a lot of ground, let me just tell you that.  And it's been challenging for me to recall a lot of things we did. We have a motto here at the Satcher Health Leadership Institute.  Basically, it says that in order to be a leader, we need people who first care enough.  We need people who care enough, but we also need people who know enough.  And we need people who have the courage to do enough, it takes courage.  And finally, in all of those areas, we need people who will persevere until the job is done.\n\nDr. David Satcher: That's what we say when we're trying to decide who to select to go into our various leadership development programs. Caring is first and foremost. Family practice, the caring, it stands out. We also need people who know enough, people who have courage to take on difficult challenges, and doing that. And then to persevere until the job is done. You always try to define who you are in a way that people can remember. So we're hoping that people can remember that leadership is about caring, it's about knowing, it's about courage to do, and it's about continuing until job is done.\n\nDr. Daniel Ostergaard: Very good motto and words to live by. And with that, I would like to thank David Satcher, MD, PhD, for all of your work for your entire career, even though you're trying to retire. And for taking the time to do this interview for us. We really appreciate it. The Center for the History of Family Medicine appreciates it. \n\nDr. Daniel Ostergaard: Thank you to Crystal Bauer for setting it totally up.","format":"text/plain"},"target":"https://centerforthehistoryoffamilymedicine.aviaryplatform.com/collections/3162/collection_resources/140814/file/260245#t=5053.0,5277.65333"}]}]}]}