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Novello, Antonia: 1944—: Pediatrician

Antonia Novello: 1944: Pediatrician


Antonia Novello overcame childhood poverty and illness to become one of the leading doctors in America. She was trained as a pediatrician and served in the United States Public Health Service. After spending several years at the National Institute of Health, Novello was appointed United States Surgeon General by President George Bush. She was the first woman and first Hispanic to hold this position. Novello used this role to bring national attention to important health issues, such as alcohol abuse, smoking, violence, and AIDS, as well as issues that especially affected women and Hispanics.


Childhood Illness Led to Medical Career

Antonia Novello was born on August 23, 1944 in Fajardo, Puerto Rico, a town 32 miles southeast of San Juan. She was the oldest of three children. When she was eight years old, Novello's father, Antonio Coello, died. Novello and her siblings were primarily raised by her mother, Ana Delia Coello, a schoolteacher and later a junior high school and high school principal, who later remarried. At birth Novello was diagnosed with congenital megacolon, an abnormality of the large intestine. This was a painful condition that plagued Novello throughout her childhood and required frequent trips to the hospital. Novello was told that she should have surgery to correct this problem when she was eight years old; however, it was ten more years before that would happen. As Novello explained to the Saturday Evening Post, "I do believe some people fall through the cracks. I was one of those. I thought, when I grow up, no other person is going to wait 18 years for surgery."

Despite her medical problems, Novello excelled academically. She was a well-adjusted child who had a good sense of humor and who was very active in school activities. Her mother stressed the importance of an education and personally taught her math and science. "I went through a system of care that was not very keen, in a diseased state that makes you realize that there are good people and bad people in medicine, with a mother who said, 'I'm not going to let your disease be used for you not to succeed.' All those three prepared me for the job that God eventually made me have," Novello told the Hall of Public Service in an interview on June 18, 1994.

Novello graduated from high school at age 15 and then went to study at the University of Puerto Rico at Rio Pedras. When she was 18 years old she finally had surgery to correct her medical condition. However, the initial surgery was not successful and Novello continued to suffer from complications for two more years. When she was 20 years old Novello traveled to the renowned Mayo Clinic for another operation that finally corrected the problem.

At a Glance . . .

Born Antonia Coello on August 23, 1944 in Fajardo, PR; married Joseph Novello. Education: University of Puerto Rico, B.S., 1965, M.D., 1970; Johns Hopkins School of Hygiene, M.P.H., 1982. Military Service: U.S. Public Health Service, 1978.

Career: Univ. of MI Dept of Pediatrics, intern, 1970-73; Georgetown Univ. Dept of Pediatric Nephrology, fellow, 1973-76; private practice in pediatrics, 1976-78; U.S. Public Health Service, 1978; Natl Institutes of Health Inst. of Arthritis, metabolism, and digestive disease project officer, 1978-79; NIH , staff physician, 1979-1980; NIH Div. of Research Grants exe. sec, 1981-86; Labor and Human Resources Committee, Congressional fellow, 1982-83; NIH Natl. Inst. of Child Health and Human Devel., dep. director, 1986-90; U.S. Surgeon General, 1990-93; UNICEF, special rep. for health and nutrition, 1993-96; NY State Dept. of Health, commissioner, 1999-.

Memberships: AMA; Intl. Soc. of Nephrology; Amer. Soc. of Nephrology; Latin Amer. Soc. of Nephrology; Soc. for Pediatric Research; Amer. Pediatric Soc.; Assn of US Military Surgeons; Amer. Soc. of Pediatric Nephrology; Pan Amer. Medical and Dental Soc.; DC Medical Soc.; Johns Hopkins Univ Soc. of Scholars; Alpha Omega Alpha.

Awards: Public Health Service Commendation Medal, 1983; Public Health Service Citation, 1984; Certifi. of Recognition, NIH, 1985; Public Health Service Outstanding medal, 1988; Public Health Service Surgeon General's Exemplary Service Medal, 1989; Surgeon General Medallion Awd., 1990; Congressional Hispanic Caucus Medal, 1991; Order of Military Medical Merit Awd., 1992; Elizabeth Ann Seton Awd., 1993; Natl Women's Hall of Fame Inductee, 1994; Natl Council of Catholic Women Distinguished Service Awd., 1995; Miami Children's Hospital Intl Pediatric Hall of Fame, 1996; Hispanic Heritage Leadership Award, 1998; numerous other awards and honors.

Addresses: Commissioner, NY State Department of Health, 14th Floor, Corning Tower, Empire State Plaza, Albany, NY 12237.

Novello graduated from the University of Puerto Rico in 1965 with a Bachelor of Science degree. She then went on to study medicine at the same university, graduating in 1970. That same year she married Joseph Novello, a navy flight surgeon who later became a psychiatrist and a radio talk show host. The young couple moved to Ann Arbor, Michigan so that Novello could begin a pediatrics internship at the University of Michigan Medical Center. A year later Novello became the first woman to receive the University of Michigan Pediatrics Department Intern of the Year Award.


Novello stayed in Michigan until 1973 and then moved to Washington, D.C. to begin her residency at Georgetown University Hospital. Novello became interested in studying the kidneys after her favorite aunt had died from kidney failure and Novello herself was hospitalized with kidney problems. She then decided to specialize in pediatric nephrology at Georgetown. When her fellowship ended in 1976 Novello went into private practice in Springfield, Virginia. However, she soon realized that she was too emotionally involved with her patients so she left her practice. As she explained to People magazine in December of 1990, "When the pediatrician cries as much as the parents do, then you know it's time to get out."


In 1978 Novello thought about joining the United States Navy. However, a male recruiter discouraged her because of her gender. A year later she decided to join the United States Public Health Service Commissioned Corps instead. This is a branch of the United States Uniformed Services dedicated to providing highly trained health care professionals to deliver health services across the country. Her first assignment was as a project officer for the Institute of Arthritis, Metabolism, and Digestive Disease at the National Institutes of Health (NIH) in Bethesda, Maryland. A year later she was promoted to a staff physician at NIH. From 1981 to 1986 Novello worked as the executive secretary for the Division of Research Grants. During this time she continued her education, graduating in 1982 with a Master of Public Health degree from Johns Hopkins University. From 1982 to 1983 Novello also served as a Congressional Fellow for the Labor and Human Resources Committee chaired by Senator Orrin Hatch. In this position she worked on the National Transplant Act of 1984 and also helped draft the labels on cigarette packages to warn smokers of the health dangers of smoking.

In 1986 Novello was promoted again as deputy director of the National Institute of Child Health and Human Development, a position that fully utilized her pediatrics training. During her four years in this position Novello was a strong advocate for AIDS research. She was passionate about her work and felt she had reached the height of her career at NIH. However, in 1990 she was asked to fill the most prestigious position in public health, United States Surgeon General.


Became Nation's Leading Doctor

The Surgeon General of the United States is the nation's leading spokesperson on matters of public health and the head of the United States Public Health Service. The duties of this position include educating the public about health concerns, advocating disease prevention and health promotion, and providing scientifically based health policy analysis to the President and the Secretary of Health and Human Services. From 1981 to 1989 this position was held by Dr. C. Everett Koop who was appointed by President Ronald Reagan. Koop was an outspoken advocate of public health who created much controversy during his tenure since some of his views opposed those of the President. When Novello first took over for Koop, she was constantly asked, "How do you feel in Dr. Koop's shoes?" With her characteristic sense of humor, Novello told the Saturday Evening Post that she was asked that question so often that she was " going to have to learn a new specialty in podiatry."

On October 17, 1989 President George Bush nominated Novello for the position of Surgeon General. One of the key factors in his decision was the fact that Novello was publicly opposed to abortion, which was consistent with the President's views. Unlike the controversial Dr. Koop, Novello's Congressional confirmation hearings went smoothly. Antonia Novello became the fourteenth United States Surgeon General and the first woman and first Hispanic to ever hold the position. While Novello was committed to addressing the health issues of both women and Hispanics, she understood that her new role encompassed more than those particular social groups. As the Medical World News reported, at Novello's Senate confirmation hearings she stated, "I do not come before you as the surgeon general for Hispanics, or the surgeon general for women, or the surgeon general for children," but for "every citizen, regardless of race, age, sex, creed, circumstance, or political belief." Novello was sworn into her position on March 9, 1990. During the swearing-in ceremony, she announced that, "The American dream is well and alive today the West Side Story comes to the West Wing."


Fought for America's Health

During her three-year tenure Novello focused her energy on a number of health topics, including alcohol, tobacco, violence, and AIDS. She told the Saturday Evening Post that she followed the motto of "good science and good sense." Her first major public health campaign as Surgeon General attacked the problem of underage drinking. Novello publicly asked the alcohol industry to voluntarily stop creating advertisements that targeted young people. As Novello explained to the American Medical News, "I have nothing against the advertising industry. But I do have something against alcohol advertising that misleads, misinforms and unabashedly targets American youth." Novello especially criticized the distributors of Cisco, a wine with 20 percent alcohol content that was being sold as a cheap dessert wine with advertising aimed toward teenagers and the poor. In addition, Novello launched a "Spring Break '91" campaign to bring awareness to the rising number of binge drinkers among college students.

Novello used a similar strategy to continue Dr. Koop's public campaign against smoking. Most notably she joined forces with the American Medical Association to ask R.J. Reynolds Tobacco Company to voluntarily withdraw its "Old Joe Camel" cartoon advertisements for Camel cigarettes because they were too attractive to teenagers. In an article in Adweek's Marketing Week in March of 1992, Novello proclaimed, "I don't care whether their actions were intentional or unintentional. Their advertising has reached children and it is going to stop." Novello's campaign paid off several years after she left her position. In 1998 federal law prohibited such imagery in tobacco advertisements. Novello also fought to stop cigarette advertisements that targeted women, citing her concern over the fact that lung cancer had become the leading cancer death among women. She was especially critical of brands such as Virginia Slims, Satin, Ritz, and Capri that associated women's smoking with images of physical fitness and independence. As Novello explained to the American Medical News in November of 1990, "It is time that the self-serving, death-dealing tobacco industry and their soldiers of fortune, advertising agencies, stop blowing smoke in the face of America's women and children."

Novello also brought national attention to health problems that were especially prevalent to the Hispanic community, such as smoking and diabetes. As Surgeon General she convened a workshop on such issues that led to the development of a National Hispanic/Latino Health Initiative. When she left her position as Surgeon General she produced two public service announcements for the American Diabetes Association encouraging Hispanic Americans to get tested for diabetes. In 1994 she also edited a book on Hispanic/Latino health issues.


Continued Public Service after Washington

While the term of Surgeon General is four years long, Novello stepped down in June of 1993 due to the change in administration. Democratic President Bill Clinton appointed Dr. Joycelyn Elders to the job, the first African-American woman to hold the position. Novello spent the next three years working at the Georgetown University Medical School and serving as the United Nations Children's Fund (UNICEF) Special Representative for Health and Nutrition. In 1996 she was a Visiting Professor of Health Policy and Management. In June of 1999 Novello was chosen to serve as the Health Commissioner for New York. The Secretary of the United States Department of Health and Human Services at that time, Donna Shalala, told the U.S. Newswire, "Governor Pataki has made a sound choice in reaching out to Antonia Novello. She will serve New Yorkers with the same vigor and talent that she employed in serving all Americans during her tenure in Washington." In her new role Novello has continued to tackle tough issues. Her latest challenge has been to try to raise the level of accountability for hospitals and doctors in New York.

Novello has received numerous awards and honorary degrees in recognition for her public service. For example, in 1983 she received the Public Health Service Commendation Medal. In 1989 she was awarded the Surgeon General's Exemplary Service Medal and in 1998 she was recognized for her leadership at the Hispanic Heritage Awards. Novello is proud of her success and sees herself as a role model for others. In an interview for Executive Female in 1991, Novello stated, "I know that I am one example of someone who has refused to be told that she couldn't achieve her goals. As a woman, as a Hispanic, and as the first female Surgeon General, I am a testament to pushing back barriers."


Selected writings

"Condom Use for Prevention of Sexual Transmission of HIV Infection," Journal of the American Medical Association, June 9, 1993.

"Healthy Children Ready to Learn," Journal of the American Medical Association, October 7, 1992.

"Healthy Children Ready to LearnThe Challenge to the Medical Community," Journal of the American Medical Association, March 20, 1991.

"Healthy Children Ready to Learn: The Surgeon General's Initiative for Children," Journal of School Health, October 1991.

"Increasing Organ DonationA Report from the Surgeon General's Workshop," Journal of the American Medical Association, January 8, 1992.

"The Secretary's Work Group on Pediatric HIV Infection and Disease," August 1989.

"Surgeon General's Report on Health Benefits of Smoking Cessation," Public Health Reports, November/December 1990.

"Violence Is A Greater Killer of Children than Disease," Public Health Reports , May/June 1991.

"Women and HIV Infection," Journal of the American Medical Association, April 10, 1991.


Sources

Books

The Complete Marquis Who's Who. Marquis Who's Who, 2001.


Periodicals

Addiction Letter, March 1993.

Adweek Eastern Edition, November 18, 1991.

Adweek's Marketing Week, October 8, 1990; March 16, 1992.

American Medical News, April 27, 1990; June 15, 1990; October 5, 1990; October 19, 1990; June 24, 1991; November 18, 1991; March 23, 1992; April 6, 1992.

Broadcasting, December 2, 1991.

Diabetes Forecast, July 1993.

Economist, December 21, 1991.

Executive Female, March-April 1991.

Mediaweek, November 18, 1991.

Modern Healthcare, March 13, 2000; February 19, 2001; December 21, 1992; July 5, 1993.

New Republic, August 10, 1992.

People Weekly, December 17, 1990.

Public Health Reports, May-June 1991.

Saturday Evening Post, May-June 1991.

U.S. Newswire, June 4, 1999.

Vital Speeches, May 15, 1993; July 15, 1993; July 14, 1994.


On-line

Glass Ceiling Biographies, www.theglassceiling.com

Hall of Public Service, www.achievement.org

National Institutes of Health, www.nih.gov

National Women's Hall of Fame, www.greatwomen.org

New York State Department of Health, www.health.state.ny.us

Puerto Rico Herald, www.puertorico-herald.org/issues/vol4n12/ProfileANovello-en.shtml

Office of the Surgeon General, www.surgeongeneral.gov

Janet P. Stamatel

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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).

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