Remarks as prepared; not a transcript

Vice Admiral Richard H. Carmona, M.D., M.P.H., F.A.C.S.
United States Surgeon General
Department of Health and Human Services

It’s great to be here with all of you. When President Bush nominated me to be Surgeon General, he asked me to speak to students about the dangers of drug and alcohol abuse, and about the importance of making healthy choices.

I am visiting schools across the nation as part of my “50 Schools in 50 States” initiative, and I’m here today to encourage you on your choice to study science.

Today is National DNA Day, and it commemorates the completion of the Human Genome Project last April and the discovery of DNA’s double helix 50 years ago. Thousands of doctors and scientists have left their offices and labs today to meet with students like you to talk about the importance of genetics and the rapid changes in health care and our society.

My sincere hope is that you will gain a better appreciation for genetics, because soon when you go to the doctor he or she may have you take a genetic test to help determine your risk for a disease or to determine how you will respond to a drug.

You may want to be the scientist who discovers treatments or the doctor who uses genetic tests. How do you get to there from here? It was not clear or easy for me.

I’m from Spanish Harlem, in New York. My family was poor. When I was your age I was running the streets. But things did get better for me, once I made up my mind that I had it in me to succeed. If you look inside yourselves, you will learn that you have it in you to accomplish anything, too.

That's the kind of confidence you can get right here at George Washington Carver High School. Why? Because you have to live it. And even if you’ve gotten off to a rough start, the experiences you have — even the tough ones — can teach you something.

You can learn a lot outside the classroom. That doesn’t mean you shouldn’t study; you should! I could have spared myself years of grief if I had just buckled down in high school.

But think about what you’re learning in your lives that is not directly related to algebra or chemistry or literature or another subject. If you’re doing your homework, and turning it on time, you are learning responsibility.

If you are watching others around you make some mistakes, and not repeating their behavior, you are learning self-discipline.

If you have made some mistakes, but have learned from them and are not repeating them, you are learning maturity.

One of the most important things I’ve learned is that I’m not alone. What I do has a big impact on everyone around me: family, friends, teachers, colleagues, and teammates.

The corollary to that is this: the good that other people do can help you be successful. A philosopher named Thomas Merton said, “My successes are not my own. The way to them was prepared by others. The fruit of my labors is not my own: for I am preparing the way for the achievements of another.”

I can say this because I’ve lived it, and am living it today. I am standing on the shoulders of some great men and women. First, my grandmother, or abuelita. My grandmother came over from Puerto Rico when she had 27 children. It was tough. She couldn’t speak English. But she saw hope and opportunity here for herself and her family.

My parents had substance abuse problems. Many of you might face the same challenge in your own families. Since my parents were dealing with their own issues, my grandmother helped raise my brothers and sisters and me. Although she was poor and uneducated, she was one of the strongest people I’ve ever known.

So, respect your elders. Be nice to your grandmother. That’s one of the best lessons you’ll ever learn!

U.S. Army
My life turned around when I did a tour of Vietnam in 1969. I went from being a street kid to a U.S. Army Special Forces medic in a very short period of time. I wanted to go into Special Forces and be an SF medic. To do that, you had to have a high school diploma. That was my first barrier. I had to get my GED.

My experiences in the Special Forces as a teenager, basically, helped shape my life and success for the next four decades. In the military, I learned leadership lessons such as accountability, responsibility and loyalty.

As a 19 - 20 year old I saw more first-hand than many ever do in terms of tropical diseases and trauma wounds. I also delivered babies for the first time at age 19, a set of twins. I saw and lived ‘health disparities’ before it ever became a politically correct term.

Our team of 12 American soldiers worked on counterinsurgency and intelligence gathering. My job as the medic was to take care of the team.

I was injured twice, and in wartime a firefight isn’t like a movie. In real life a battle isn’t always won and the hero doesn’t always walk away. In one year, I matured a decade.

You will also have years like that. You will be tested in ways you cannot now possibly foresee, whether it is through a war, a difficult job, or a traumatic family situation.

That year I spent in Vietnam taught me more about leadership, teamwork, loyalty, and how to get a job done than anything I’ve learned before or since.

And I’ve taken another leadership lesson with me throughout the years: confidence. I believe I can accomplish anything I set my mind to accomplish.

When I got home from Vietnam, I decided I wanted to be a doctor. My family thought I was crazy. My uncle had already gotten me a job as an electrician’s apprentice. But I wanted to go to medical school. It wasn’t easy. I went to junior college, then college and medical school — juggling my school work with different jobs to support myself. But I knew how important it was to stay focused on my education and get good grades. I had failed at that during the first half of my life.

Education
I knew that I was lucky to have a second chance at an education. I was determined not to fail again. I was also lucky to have the support of my wonderful wife and kids. After graduating from medical school, I became a trauma surgeon, a professor at the University of Arizona, and ran a health system. I also served as a police officer, paramedic, and nurse.

Through all this, I’ve never forgotten who I am or where I came from. I still visit my family, and the old neighborhood. And I’ve stayed in touch with all the communities I’ve had the privilege of serving. As I took on new challenges, I never let go of my connections to the people and the previous jobs. There didn’t seem to be much of a correlation between these jobs as I moved up the line.

But then this job came along — ironic, because I couldn’t have planned it better if I’d tried. As it turns out, all my different, seemingly unrelated experiences became important following 9/11. Because then the President and Health and Human Services Secretary Tommy Thompson needed a person in this position who had experience with law enforcement and the military as well as health care.

They also probably needed someone with some “street smarts.”

The fact that somebody like me could serve in this position is absolutely incredible. If Ritchie from the block can make it, there's no reason you can't do the same thing.'

Which brings me to another lesson: be prepared. My definition of luck that luck is the intersection of preparedness and opportunity. Good opportunities will come your way occasionally in life. That’s just the way life is. But you have to be prepared to take them. Be ready to say “yes” to opportunity. Say “yes” to healthy experiences.

An important part of being prepared is making the right decisions to stay healthy and stay in school.

Prevention
Prevention is so much easier than the cure! Of course, as America’s doctor I see that every day. So many of our illnesses — heart disease, cancer, diabetes — could be prevented with a good diet and moderate physical activity.

Three out of four cases I cared for as a trauma surgeon on any given night — falls, car accidents, shootings, domestic violence — were preventable by making the right decisions. The lesson is applicable to all of our behavior, all of our actions. If we do what we should do from the beginning, we will avoid costly mistakes down the road.

Make the right choices about your own health: exercise, eat right, get enough sleep!

Stay Away from Alcohol and Drugs
Don’t smoke. Don’t drink. I saw what drinking did to my parents’ lives and I said, “I don’t want this for myself.” You need to make the same decision. I know it’s tough being a kid. I had a very tough time. I am sure you are facing all kinds of temptations: to drink, or to use drugs.

I’m sure there’s peer pressure, but also because it might seem like an escape from some tough circumstances. . . if your parents are fighting, or your classes are a lot more difficult this year than ever before, or someone is bullying you, or you want to feel at ease with other students.

Drinking and driving is a huge mistake, and riding in a car with anyone who has been drinking is also a huge mistake.

Some of you might live in a household where a parent or other family member drinks too much, too often. I grew up in a household like that. Think of the terrible consequences of that addiction on the whole family: embarrassment, secrets, lies, financial problems, and the inability of that person to cope with problems or other people. Think of that, and vow to do better for yourself and your own future family.

If you’re like kids in other schools, one in four of you have smoked marijuana in the past month and one in 20 have used the narcotic cocaine. That’s not a badge of honor. Just like smoking is not a “rite of passage.”

The long-term results of drug use are addiction, which can lead to things like disease and job loss. A possible short-term consequence of illegal drug use is jail time. I don’t think any of you want that to happen. Certainly your teachers and your parents don’t. And neither do your friends.

You are becoming young adults. You have a lot of freedom to make choices. Make sure the choices you make are the right choices, for your health and for your future.

Science Education
All of you have already shown you can make the right choice and commit yourselves to it. It’s great that you have taken up the challenge to focus your studies on science.

This is often a difficult task at such an early age. Many of you may be here in hopes to go to college and have a better chance at a good job by having committed to science so early. What’s really interesting is the times you are living in right now are the greatest ever for science.

For most of the past century biology was a descriptive science — you may have learned to name the parts of a dissected frog, for example.

Genetics
But now with the completion of the Human Genome Project you will have the chance to learn how the human body works. And with that knowledge your generation may find the cures to cancer, prevent heart attacks, and be better informed on how to eat right and stay physically fit.

How do I know this? Fort Knox, Kentucky, is where our government stores billions of dollars worth of gold as collateral for our country to be able to borrow money. None of us has the key to Fort Knox. But I do have the key to another treasure and I can offer it to you for free.

This treasure also contains 3 billion letters that are written into instructions contained in almost every cell of your body. These instructions, taken all together called a genome, have been read over the past decade and now can be looked up on a computer. In fact, all of the letters of your genome will fit on a compact disk, and you can look up this “book of life” on any computer connected to the Internet. But you must learn to read the DNA, and the only way to do that is through education.

You can learn about our genome in three ways:

1. Study our DNA like a mechanic or an engineer, discovering the way we work when genes are written correctly,


2. Study our DNA like a doctor, learning how we get sick when genes are miswritten or missing,


3. Or study our DNA like a historian or anthropologist, revealing our human history and how we are related to all living things on the planet.

We need smart, talented, energetic people like you because there is so much to learn. There are many different opportunities.

You can become a scientist or a doctor. And we also need nurses and genetic counselors to explain genetic tests and interpret the risk of disease. You may find you are more interested in the political process. In Washington, D.C., my colleagues and I work on the public policy of health. We advise the President, Secretary of Health and Human Services, and members of Congress about how laws and policies can be written to help improve health.

Closing and Charge
It is more important then ever to have a strong education to get a job. By learning about genetics today, you are investing in job opportunities for your future. Most importantly, if you keep focused, keep your integrity, and stay committed, you have the chance to change the world for the better.

Character still counts. In fact, you will find in the long run, that is how your life will be measured. Your degrees, your career, and the number and kinds of cars in your garage is important for a time, but in the end not really all that important. Who you are is more important than what you do. And who you are will make a tremendous difference in what you do.

One person can make a difference. I charge each of you to be that person!

Thank you.

Last Revised: May 14, 2004

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