Many people who study medicine or Public Health know the story of Ignaz Semmelweis, the father of handwashing. Personally, I knew the story before I had read about it in my epidemiology textbook, and so I was taken aback by the absence of a key point in history that the textbook authors had left out. Ignaz Semmelweis had conducted an informal case-control study on factors that affected childbed fever, or deadly post-partum infection, by observing two different clinics: one in which medical students who also performed autopsies worked in, and another that maintained strict hygiene protocols. What the textbook had left out— and what I had already known as a woman interested in medical history—is that the people who ran the latter were mostly nuns and female nurses. While this was probably seen as a small point to the authors of the textbook, it had sparked the question in my head of how many other women have contributed to medicine and public health without any recognition. From this experience I believe it is crucial to amplify the voices and stories of ambitious women in this field, one such being Dr. Joycelyn Elders, the first black female United States Surgeon General.
Growing Up and Early Career
Dr. Elders, then Minnie Lee Jones, grew up in a rural area of Arkansas during a time where segregation was open and rampant. Her and her seven siblings worked alongside their studies to make ends meet, and eventually to pay for Joycelyn’s bus fare when she entered college at the age of 15 on a scholarship granted to her for her excellence in school. At that time, she loved studying science and decided that becoming a lab technician would suffice; being a doctor was never a thought that even crossed her mind. She had not even seen a doctor until she was 16 years old and once stated in an interview, “You can’t be what you don’t see.” She didn’t even think that she could be a salesclerk in a clothing store because she had never seen a black saleswoman and assumed that that was not an option for herself.
Her goals in life broadened at a sorority event when she met Dr. Edith Irby Jones who had been the first African American to attend the University of Arkansas Medical School. Dr. Jones became a huge inspiration for her and since meeting her she wanted to be a doctor to help children. With her newfound ambition, hard work, and natural intelligence, Elders graduated college in 3 years at the age of 19 and entered the Army.
During her service, she was trained as a physical therapist and practiced in army hospitals. She then went on to attend the University of Arkansas Medical School like Dr. Edith Irby Jones and was the only woman to graduate in her class in 1960. During her time there, despite the recent Brown v. Board case, she experienced a considerable amount of segregation and hardships. After medical school she entered a pediatric internship at the University of Minnesota, and later returned to Arkansas for her residency.
As a resident, Joycelyn Elders rose to become the chief pediatric resident that managed a team of residents and interns that was entirely comprised of white men; she later became a pediatric research fellow. She also received her master’s degree in biochemistry from University of Arkansas and went on to join the staff and eventually become a full professor.
Work and Contributions
Dr. Joycelyn Elders greatly contributed to the field of medicine and public health by using her unique clinical experiences and extensive research in pediatric
endocrinology to publish a multitude of papers. Her focus on growth complications and juvenile diabetes influenced her attitudes towards health behaviors amongst youths, so she began to advocate for youth health and study sexual behavior. For example, she noticed the health risks involved for young girls with diabetes falling pregnant which led her to advise her patients on safe family planning and sexual practices.
It was 1987 that Dr. Elders was recognized by former President Bill Clinton and appointed as the head of the Arkansas Department of Health. In this position she was able to use her ambition and knowledge to make wide scale change and advocate for clinics and sex education—especially tackling teen pregnancy— despite a large pushback from the conservative and religious groups in Arkansas. She viewed teen pregnancy as a continuation of slavery as black women were disproportionately affected by unwanted pregnancy that had lifechanging effects due to a lack of access to education and contraception. Even in the face of great opposition, she was a key player in the state passing a mandate for K-12 sex education, substance-abuse prevention, and self-esteem programs. Elders was also able to double the number of children immunized, expanded the public prenatal program in the state of Arkansas, gave attention and support to home-care options for the terminally and chronically ill, and much more.
Due to the many successes that she accomplished for public health in Arkansas, Dr. Elders was nominated by Bill Clinton for the position of U.S. Surgeon General. Before being appointed to this position, one must be confirmed by the Senate. This process was extremely unusual in Dr. Elders’ case due to pushback from senators concerned with her opinions and reputation for being vocal about sexual health. Additionally, she experienced classism, racism, and sexism from the senators and the American Medical Association; they had tried to pass a resolution to decree that only doctors could become U.S. Surgeon Generals because they did not believe that Dr. Elders was a physician. Nonetheless, she was appointed in 1993 and went on to influence President Clinton’s efforts to reorganize the healthcare system and ameliorate the nation’s public health.
She faced much criticism by bringing controversial and taboo topics to light, all while making progressive suggestions that tended to rock the political boat. In many of her positions that would be widely accepted today, she was very ahead of the curve during her political tenure. Since the topic of sex education was a political battle ground at the time, her outspoken nature was widely unappreciated. She was even dubbed “The Condom Queen” by many politicians that disagreed with her work. Similarly, she was eager to address the issue of HIV that remained a
politicized topic during the Clinton administration, as well as be open about the failures of the War on Drugs and the potential of marijuana legalization. She acquired more and more bad publicity as media outlets skewed her words and painted her as a radical, so she only remained the U.S. Surgeon General for a little over one year when President Clinton had asked her to resign as he became more affected by the Republican takeover.
She was not deterred by this setback and returned to being a researcher and professor at University of Arkansas and the Arkansas Children’s Hospital. She continued to tour and give lectures about teen pregnancy and sexual health, as well as the legalization of marijuana. She also spoke out against the military ban on transgender people, and she constantly continues to encourage more black people to become doctors in this country while openly criticizing the white-male hegemonic power in society and in medicine.
Takeaways
In an interview with New York Times, Dr. Elders was asked, “U.S. News and World Report described you this way: ‘She's intolerant, preachy, judgmental, and overbearing. She's bright, articulate, passionate and kind.’ Is that an accurate description?” To which she replied, “It's . . . pretty good. I'm only overbearing to the people I need to be overbearing with. You've got to get people's attention before you can achieve change. As Surgeon General, you have to take a stand. People are either going to love you or hate you.”
Dr. Elders serves as an inspiration for us all. She is a prime example of an ambitious woman who sticks to her morals and does what she knows is right—no matter the consequences. She faced waves of public backlash, mistreatment, and so many hardships for the sake of her passion for public health and wellness. Her story also serves to remind us of the importance of representation and networking; if she had not met her inspiration and mentor Dr. Jones, it is possible that she might not have gone on to do the amazing things that she did just because her options for herself were limited to what she saw.
I hope we can all learn a lesson from Dr. Elders and her story so that we can feel empowered to stick to our morals and strive for success without fear of naysayers, and so that we can continue to learn about and share stories of women like her, especially in the fields of medicine or other sciences, amongst our friends and with younger girls to encourage a bigger and stronger generation of ambitious women.
If you are interested in learning more about Dr. Elders, I encourage you to read her autobiography, Joycelyn Elders, M.D.: From Sharecropper's Daughter to Surgeon General of the United States of America.
Sources:
https://cfmedicine.nlm.nih.gov/physicians/biography_98.html
https://www.britannica.com/biography/Joycelyn-Elders
file:///Users/devingiordano/Downloads/the_embryo_project_encyclopedia_- _minnie_joycelyn_elders_1933-_-_2021-01-15.pdf
https://www.nytimes.com/1994/01/30/magazine/joycelyn-elders.html
https://maximumfun.org/episodes/sawbones/dr-joycelyn-elders/
https://www.statnews.com/2016/09/07/joycelyn-elders-race-medicine/
