ast July, Dr. Howard Zucker, 42, associate professor of clinical pediatrics and clinical anesthesiology, was selected from hundreds of applicants for one of 12 White House Fellowships. Begun in 1964, the White House Fellowship program brings Americans into government for one year to work as special assistants to Cabinet members or as presidential advisers. Dr. Zucker began his fellowship in the Department of Health and Human Services (HHS) on Sept. 5, working for HHS Secretary Tommy Thompson.
Before the fellowship, Dr. Zucker had been at Columbia since 1992 and directed the pediatric intensive care unit between 1992 and 1999. In 1993, ABCs World News Tonight named him Person of the Week for initiating pediatric ICU reunions to celebrate childrens recovery. In 2000, pediatric residents named him Teacher of the Year. Dr. Zucker spoke with In Vivo writer Susan Conova about his experience as a fellow.
Why did you apply to the White House Fellows program?
Around 1994-1995, when the Clinton administration was working on a national health care proposal, I recognized it was important for physicians to know about the legislative and regulatory process. While practicing, I attended Fordham Law School at night from 1996 to 2000 but realized the best way to understand health policy is to spend time in Washington, so I applied.
What does the program entail?
By working on special projects for a member of the Cabinet and participating in many different discussions on policy, the fellows observe firsthand how government works and watch leadership in action. The fellows meet weekly for off-the-record discussions with important figures, such as National Security Adviser Condoleezza Rice, and we occasionally meet with President Bush. The program also involves travel. Later this year, we will be going to China, Vietnam, Tibet, Ireland, and Alaska to learn about domestic and foreign policy.
What was it like working for Secretary Thompson on Sept. 11?
On Sept. 6, I told Secretary Thompson that I was interested in working on a variety of topics affecting HHS, ranging from stem cells to welfare reform. But on Sept. 11 everything changed. Secretary Thompson truly impressed me that unforgettable day. He had every agency on the phone, listened to their contributions, and led the team that responded to the disaster. The team included the Office of Emergency Preparedness, which sent emergency Push Packs and the hospital ship, Comfort, to New York. When we came to New York two days later, I witnessed true leadership as I joined Secretary Thompson when he met with Mayor Giuliani and Gov. Pataki and all the emergency agencies that had come together to address a national crisis. It was extremely well-orchestrated.
Did your experience as a physician help with the anthrax cases?
I never really thought much about anthrax before, but we quickly had to get up to speed. It helped me to talk to people from Columbia, who were kind enough to assist during the emergency situation. I spoke with Phil La Russa [professor of clinical pediatrics] for information on infectious diseases and Anne Gershon [professor of pediatrics] about vaccines.
What are you working on now?
After Sept. 11, I received many calls from doctors at Columbia and elsewhere asking what they could do to help. These conversations and other policy discussions at HHS led to one of my projects: putting together a plan for a Medical Reserve Corps that will get doctors, nurses, and retired healthcare workers throughout the country involved in assisting existing public health response teams in the event of natural or man-made disasters. Coordinating the Corps is like running an ICU and requires the expertise of people from different medical disciplines working together.
Do you have any role in the situation in Afghanistan?
After Hamid Karzai, the interim Afghan leader, visited Washington, we met with Afghan-American doctors about how HHS can help improve the health system in Afghanistan. Aid workers who had been in Afghanistan had shown us a video of the medical situation there, which was quite shocking. We saw a child obviously dying of shock and another one dying of meningitis. It was frustrating to watch as a doctor, because I knew I could have saved the Afghani children.
Better nutrition, enhanced access to clean water, and an immunization program are three ways the situation in Afghanistan could be improved. One idea to help create a medical establishment there is to apply concepts we use in America when we set up centers focused on specialized care, such as trauma centers. Not every hospital here has a trauma center. Instead, patients are funneled to tertiary care centers that have them. In Afghanistan, we need to set up hospitals that provide the urgent care and then send doctors to less-specialized peripheral clinics to deal with nutrition and dehydration. Fortunately, many federal agencies and non-profit groups are helping out.
What do you want to do after your fellowship?
The experience has expanded my horizons to life beyond medicine. Id like to use what Ive learned about policy-making and leadership, but I dont know in what venue yet. Ive thought about returning to academic medicine, going into the private sector, working at a foundation, or staying in government. Secretary Thompson has been one of the finest role models I have ever encountered. I feel Ive helped the team at HHS and made many peoples lives better, but I dont think anything can compare with taking care of children, one by one. That has been the hardest thing to walk away from.