THE EVOLUTION OF THE SURGEON GENERAL.

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One meta-point on the Gupta nomination is that this is the professionalization of the surgeon general's PR role. The job, at one point, was simply administrative. You controlled the public health corps and offered advice to the assistant secretary of HHS. But the position slowly evolved to possess a substantial public education component. The warnings on the cigarette labels were part of this, as was the accidental celebrity of the odd C. Everett Koop ("I wear one myself!) and the drug legalization controversy sparked by Joycelyn Elders. But the position was still hired for as if it called for simple expertise: Richard Carmona, Bush's surgeon general, was simply the next guy in line for the job. Choosing Sanjay Gupta is recognizing and codifying the change in the position. It is now as much about media as medicine. Gupta, whatever his other faults, is uniquely qualified at the intersection of those disciplines. It's a pick, in other words, with implications. For more on this, you can watch my Olbermann clip from last night.

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