SURGEON GENERAL, IN FAREWELL, PLEADS FOR A 'MEANINGFUL BUDGET'

WASHINGTON -- Surgeon General David Satcher, who took on President Bill
Clinton over needle exchanges for drug addicts and President Bush over sex
education, warned in a parting interview today that the "lack of a
meaningful budget" might diminish the independence of his office.

At a breakfast meeting with reporters, Dr. Satcher, whose term expires on
Wednesday, said it was essential for the nation to have a doctor who is
"independent enough to report directly to the American people on the basis
of public health and science."

But the office's $1 million budget, which would remain the same under Mr.
Bush's spending proposal for 2003, does not cover the cost of even one
surgeon general's report, the thick scientific tomes on issues like
secondhand smoke and mental health. So Dr. Satcher said he sought financing
from other agencies, as well as Congress, where politicians occasionally
tried to meddle with results.

For instance, Dr. Satcher said, he had difficulty obtaining money to
prepare his report on sexual health, which was released in June after a
lengthy delay. He also said his study of youth violence drew complaints
from Congress, which paid for it, because it did not find that the news
media caused the problem, as some lawmakers had suggested.

"There was a little friction there," Dr. Satcher said, "and some
disappointment when the results were not what people anticipated."

But, he said, the complaints were "not publicly expressed," and he would
not identify who made them.

The surgeon general has often been called "America's top doctor," but the
job, as Dr. Satcher learned in his five years in it, is hardly as benign as
the name. As a leading spokesman on public health, the surgeon general has
to confront public mores and, often, the occupant of the White House in
addressing delicate topics like contraception and sexually transmitted disease.

"I enjoy a good fight," Dr. Satcher said. "I prefer them to be fair."

He said he regretted that controversy over the sexual health report had
obscured its public health message. The study outraged conservatives with
its finding that there was insufficient science to back contentions that
teaching abstinence delayed teenagers' sexual activity.

"The full message," Dr. Satcher said, "is we ought to stress abstinence for
our young people, but we also ought to trust them with information about
how to protect yourself and others if you are sexually active."

With his distinctive military uniform -- double-breasted black coat, gold
buttons and stripes -- Dr. Satcher may be the most recognized doctor in
America. He enjoyed wearing the outfit so much that his staff, joking that
he would sleep in it if he could, gave him a copy of it in pajamas as a
going-away gift.

The son of uneducated farmers from rural Alabama, Dr. Satcher rose above
poverty and racism to become the 16th surgeon general. He entered the
position after it had been vacant for three years -- his predecessor, Dr.
Joycelyn Elders, was discharged for making impolitic comments about
masturbation -- and is widely credited with restoring dignity to an office
that some lawmakers had once considered abolishing.

After spending several months working on a book, Dr. Satcher plans to join
the Morehouse School of Medicine in Atlanta in September. He will lead a
new center to promote access to primary health care. A longtime advocate of
reducing disparities in medicine, Dr. Satcher said he intended to work on
that problem full-time and had passed up other opportunities in order to do so.

"All my life and career," he said, "I've paid attention to black people's
health. I couldn't sleep at night if I didn't."