Surgeon General Joycelyn Elders at her desk.

Joycelyn Elders, United States Surgeon General

By Elizabeth Fee

Surgeon General Joycelyn Elders in uniform.
Surgeon General Joycelyn Elders
National Library of Medicine

Joycelyn Elders was the first African-American to be appointed Surgeon-General of the United States. A brilliant, talented, and powerful woman, she had strong views and no hesitation in stating them—loudly, clearly, and honestly. She had no qualms about honing in on controversial subjects and speaking her mind, and no problem being at the center of constant media attention. Many of those on the right end of the political spectrum detested her. Rush Limbaugh vilified and ridiculed her on an almost weekly basis.

Joycelyn Elders had grown up the oldest of eight children in a sharecropper’s family in Arkansas. An astonishingly gifted child, she was awarded a scholarship to a local college, Philander Smith, in Little Rock. One day, Edith Irby, the first black medical student at the University of Arkansas, gave a speech that inspired Joycelyn to think of medicine as a possible career. After earning her bachelor’s degree in 1952, she took a job as a nurse’s aide in a Veteran Administration hospital. She soon enlisted in the Army, hearing that GI Bill benefits would allow her to extend her education. In the Army, she trained as a physical therapist, was assigned to a military hospital, and there had the distinction of treating President Dwight D. Eisenhower after his heart attack.

After the army, Elders attended the University of Arkansas Medical School, completed a residency in pediatrics, and earned a master’s degree in biochemistry. She was appointed assistant professor of pediatrics and gradually advanced to full professor. She was board certified as a pediatric endocrinologist, and was recognized as an expert on childhood sexual development.

Elders met Bill Clinton, then the state’s young attorney general. Evidently, he was impressed, and when he became governor, he appointed Elders director of the Arkansas Department of Health. As director, she was especially concerned with child health; she visited more than one hundred public health clinics, instituted school-based clinics, greatly increased childhood health screenings, and doubled child immunization rates. She was recognized for these achievements by being elected president of the influential Association of State and Territorial Health Officers. In 1992, President Clinton asked her to be his Surgeon General.

According to press reports of the time, Elders advocated the use of medical marijuana, condom advertising on television, and giving the implanted contraceptive Norplant free to drug-addicted prostitutes. She was also reported to have called pro-life anti-abortion crusaders, “religious non-Christians with slave-master mentalities,” and to have suggested that abortion opponents “get over this love affair with the fetus and start worrying about children.”

Joycelyn Elders with Antonia C. Novello, C. Everett Koop, Jesse L. Steinfeld and others.
Surgeon General Joycelyn Elders on a panel with former Surgeons General, ca 1994
National Library of Medicine

Elders was a powerful orator and hugely in demand as a public speaker. In the fifteen months she was Surgeon General, she gave more than three hundred speeches – sometimes three a day. At one trip to speak to the CDC (Centers for Disease Control and Prevention), she received three standing ovations. At another speech to Georgia state public health employees, a state epidemiologist said that people were crying and holding their hands up in the air, trying to touch her, as if she were Mick Jagger.

The History of Medicine Division of the National Library of Medicine holds a remarkable manuscript collection of Joycelyn Elders’ speeches. Many are about the need for child and teenage health information to avoid unwanted teenage pregnancies and sexually transmitted diseases. This extract from a speech represents her views and attitude rather well:

A page of transcript from the National Abortion Federation Annual Meeting 1994.None of us can afford to be complacent and to assume that we have put out enough information and provided enough education about the many risks that young people face today. I have said before, ‘It doesn’t matter if you’re on the right track, you’re bound to get run over if you just sit there.’ We need to keep moving and thinking and talking and pushing—ourselves and others—to deal with this problem.

After another speech at the National Press Club in Washington, D.C., when Elders took questions from the audience, she was asked whether she supported advertising condoms on television, and responded:

A page from a transcribed Question and Answer session at the National Press Club 1993.I do support advertising condoms on television….Not only through advertisements, but also through appropriate discussion during the hundreds of bedroom scenes aired daily during prime time can we “socially market” the most life-saving instrument readily available to Americans today.

As Surgeon General, Elders suggested that legalizing drugs might help reduce the crime rate. At a United Nations conference on AIDS, she was asked whether it would be appropriate to teach young people about masturbation as an alternative to riskier forms of sexuality. She agreed that as part of human sexuality, perhaps it should be taught. This remark—following on a number of other highly controversial pronouncements—made President Clinton feel, regretfully, that he had to ask her to resign, which she did in December 1994.

Elders returned to Arkansas as professor of pediatrics and continued her popularity on the lecture circuit. Never cowed, she voiced support for the legalization of marijuana and declared that she considered abstinence-only sex education to be child abuse.

Among her other awards, Elders received a career development award from the National Institutes of Health and served as Vice Admiral in the Commissioned Corps of the United States Public Health Service.

Elizabeth Fee is Chief Historian at the National Library of Medicine.

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