Antonia Novello

Antonia Novello

In 1990 Antonia Novello (born 1944) became the first female United States Surgeon General; she was also the first Hispanic in history to win the appointment to this nationally prominent government office. During her three-year term, Novello won praise for her campaigns targeting America's youth, especially her crusade against underage tobacco use. The former pediatrician used her post to voice criticism of tobacco companies and their marketing strategies; a few years after Novello's tenure, strict legislation was enacted to drastically curb teenagers' access to cigarettes.

Novello's own youth was marked by hardship and medical trauma. She was born Antonia Coello in Fajardo, Puerto Rico, the first of Antonio and Ana Delia Coello's three children. Shortly after the birth of their daughter in 1944, the Coellos were informed that Antonia suffered from congenital megacolon, an abnormality of the large intestine. This required periodic visits to the hospital for treatment, because of her body's inability to rid itself of waste; one side effect was a periodically swollen abdomen.

Compounding Novello's burden was the death of her father when she was eight. Her mother-a teacher who later became a high school principal-was told that her daughter could have an operation to correct the procedure. Yet it never happened. "The university hospital was in the north, I was 32 miles away, my mother could only take me on Saturday, so the surgery was never done, " Novello explained in an interview with Saturday Evening Post writer Carol Krucoff. "I do believe some people fall through the cracks, " Novello continued. "I was one of those. I thought, when I grow up, no other person is going to wait 18 years for surgery."

A Standout Student

Still, Novello is grateful to her mother for not allowing her to feel sorry for herself because of her condition. Instead of pampering her, Ana Flores-who had remarried-pushed her child to succeed academically, and Novello graduated from high school at the age of 15. She then enrolled at the University of Puerto Rico at Rio Pedras, and it was there that she finally grew weary of her long-term condition. The hospital treatments remedied her occasionally distended stomach-but as she explained to the Saturday Evening Post, "By the time I was 18, it was not good to have those big bellies one month that are, in the next month, flat."

Novello's first surgery, however, was not a complete success, and she suffered from complications for another two years. Finally, at the age of 20 she traveled to the renowned Mayo Clinic for a final operation, which was successful. By this time Novello's exposure to the medical establishment had strengthened her own ambitions-she had dreamed of becoming a pediatrician since her childhood, and her academic achievements brought the realization that such a goal was indeed possible. After earning her undergraduate degree from the University of Puerto Rico in 1965, she applied to its school of medicine-but was afraid to tell her mother, since female doctors were still such a rarity. Once informed, however, her mother vowed to provide the financial support toward her daughter's aspiration, and Novello received her medical degree in 1970. That same year she wed Joseph R. Novello, a Navy flight surgeon who later became a psychiatrist.

Too Compassionate

Soon after their marriage, the newlyweds won residencies at the University of Michigan Medical Center in Ann Arbor, Michigan. Novello's was in pediatrics, and she completed further training in her specialty, pediatric nephrology, at Georgetown University Hospital in 1975. Her childhood illness had made her an unusually compassionate physician, but would also be her undoing. For a time in the mid-1970s, she had a pediatric practice specializing in kidney health, but took her job to heart. "When the pediatrician cries as much as the parents do, then you know it's time to get out, " Novello recalled in an interview with People in 1990.

In 1978, Novello considered joining the U.S. Navy, but was discouraged by a male recruiter. Instead she signed on with the U.S. Public Health Service in 1979. The PHS is a quasi-military corps of doctors, nurses, and other medical personnel who conduct research, serve in areas where there are shortages of doctors (such as on Native American reservations), and assist in national disaster relief. Novello joined the PHS's National Institutes of Health, and began as project officer in the Institute for Arthritis, Metabolism, and Digestive Disease. By the early 1980s, she was a serving as a Congressional fellow, lending her expertise to the staff of Capitol Hill legislators drafting health-related legislation.

Nominated as Surgeon General

In 1982, Novello earned a degree in public health from Johns Hopkins University in Baltimore. Four years later she was promoted to deputy director of the National Institute of Child Health and Human Development in 1986, which effectively combined her pediatrics training with a desire to assist and act for those who could not. In her new job, she became a prominent activist for pediatric AIDS research, and executed her duties with zeal and zest for the job, certain that her post was the apex of her ambitions. Yet when Novello's name was mentioned to fill the vacant Surgeon General slot during the presidency of George Bush, she realized she could do even more.

Traditionally, the sitting U.S. president nominates the Surgeon General from among a list of accomplished physicians to serve as director of the U. S. Public Health Service. That honoree is also charged with raising public awareness on health issues and serving as the administration's spokes-person for such matters. On March 9, 1990, Novello was sworn in as U. S. Surgeon General, after a Senate confirmation hearing that was markedly dissimilar to that of her controversial predecessor, Dr. C. Everett Koop. She was the fourteenth physician to hold the job, but its first female and its first minority. "Today West Side Story comes to the West Wing, " Novello joked in her swearing-in speech at the White House, referring to the Broadway musical about Puerto Rican immigrants and the section of the American president's mansion used for public ceremonies.

Not surprisingly, in her new role Novello initiated campaigns designed to raise awareness for America's children and their health-care needs. She was an advocate of the necessity for preschool immunization programs to reduce infant mortality rates, and espoused increased research and funding into providing better health care services for America's minorities, women, and children-all traditionally underserved by a medical establishment skewed to provide the best care only to fully employed Americans with job-provided health insurance. Novello and her Surgeon General's office also launched a "Spring Break '91" campaign that targeted the rising number of binge drinkers among American college students; she undertook a speaking tour of college campuses herself to make her point. Her office also implemented AIDS awareness programs.

Novello and Joe Camel

But perhaps Novello's greatest impact during her three-year tenure as Surgeon General came as a result of her vehement opposition to teen smoking. She was the most prominent government official to target the "Joe Camel" advertising campaign by tobacco giant R.J. Reynolds, whose cartoon "spokescamel, " Novello bluntly declared in 1992, was a clear ploy aimed at luring new underage smokers. Backing her up were statistics showing that though the number of adult smokers had declined, three thousand teens were picking up the habit on a daily basis.

By 1998 such imagery was prohibited by federal law, vending machines were banned, and stores that sold tobacco products were responsible for checking the identification of any potential purchasee who appeared to be less than 28 years old. The rising rates of lung disease among American women-attributable to a much higher rate of smokers over the last two decades-focused Novello's attention on the tobacco companies and their marketing strategies as well; in the "women's lib" era, cigarette smoking was positioned as a "liberated" act, since it had been looked upon with such censure for so many decades. "Call it a case of the Virginia Slims woman catching up with the Marlboro Man, " People reported her as saying.

Novello's stint as Surgeon General also found fault with alcohol advertising aimed at teenagers. One particular target of her wrath was a high-alcohol sweet wine called Cisco; Novello spoke publicly against it and its maker, alleging it was aimed at teenagers since it resembled Kool-Aid. She excoriated other beverage companies and their advertising agencies that tied in their product with sports in the context of their marketing campaigns, which she asserted gave teens a confusing message that alcohol use was somehow both adventureous and healthy.

Such deeds helped make Novello one of the most popular Surgeon Generals in history. She was also far less controversial than her successor, Dr. Jocelyn Elders, who was forced to step down during the Clinton Administration for her frank pronouncements. She continues to play an active role in public-health issues, especially pediatric-related topics, and works for UNICEF (United Nations International Children's Emergency Fund) as a special representative for health and nutrition. A professor of medicine at Georgetown University since 1986, Novello resides in the Washington area still with her husband, a prominent psychiatrist whose brother is comedian Don Novello, most famous for his occasional appearances on the long-running NBC program Saturday Night Live as Father Guido Sarducci. The sense of humor, presumably, is a shared one: "I survived many times in my life by learning to laugh at myself, " Novello told the Saturday Evening Post' s Krucoff. "That's the best medicine. But I also became very self-assured and capable of saying that if I could do that, I can do anything."

Further Reading

Detroit Free Press, October 30, 1990.

Newsweek, October 30, 1990.

People, December 17, 1990.

Saturday Evening Post, May/June 1991.

USA Today, April 30, 1991.

Washington Post, October 18, 1989; October 24, 1989; May 8, 1990.

"Dr. Antonia Novello -The Hall of Public Service, " Academy of Achievement, http://www.achievement.org/autodoc/halls/ser (May 4, 1998).