Remarks as prepared; not a transcript

Vice Admiral Richard H. Carmona, M.D., M.P.H, FACS
Acting Assistant Secretary for Health
United States Surgeon General
U.S. Department of Health and Human Services

Remarks at the National Disabled Veterans Winter Sports Clinic

Aspen, Colorado
Thursday, April 3, 2003

Thank you Tom (Tom Bowman, Acting Assistant Secretary for Public & Intergovernmental Affairs, Department of Veterans Affairs), for your kind introduction. It is truly an honor to be with you today.

For each person in this room, I know there is a story of courage, and disappointment, and endurance, and finally, overcoming.

My own story probably pales in comparison to some of yours. But like you, I’ve been tested in combat, and wounded, and have overcome some very large barriers.

All of our thoughts and prayers are with our brave men and women now in harm’s way in Iraq. Each of us must strengthen our resolve, as individuals and as part of a larger community, to meet the new challenges with courage.

America has been tested through war before, and has each time emerged stronger and more triumphant. While we do not know what the future holds, we can look ahead with confidence because we stand on the shoulders of our great countrymen – including all of you in this room - who have fought for us in past conflicts.

This is again a time of testing for America. And I have no doubt we will succeed.

As we talk this afternoon I would like to share some of my experiences as a Special Forces combat medic with you and some of the lessons I took with me that carried me through a lifetime of challenges, and still carry me today.

The first lesson is, I’ve never had to do it alone. My team worked with me, fought with me, and some even died for me. I have always stood on the shoulders of great men.

It was Thomas Merton who said, "My successes are not my own. The way to them was prepared by others. The fruit of my labors is not my own: for I am preparing the way for the achievements of another."

I can say this because I’ve lived it, and am living it today.

Many of you know my history. I have a background in public health, in the military, and law enforcement, though I did not follow a typical career pattern. I dropped out of high school.

My life turned around when I did a tour of Vietnam in 1969. I went from being a street kid to a U.S. Army Special Forces medic in a very short period of time.

I wanted to go into Special Forces and be a Special Forces medic. To do that, you had to have a high school diploma. That was my first barrier. I had to get my GED.

My experiences in the Special Forces as a teenager, basically, helped shape my life and success for the next four decades.

In the military, I learned leadership lessons such as accountability, responsibility and loyalty.

As a 19 –20 yr old I saw more first-hand than many physicians ever do in terms of tropical diseases and trauma wounds. I also delivered babies for the first time at age 19, a set of twins. I saw and lived ‘health disparities’ before it ever became a politically correct term.

Our team of 12 American advisors worked on counterinsurgency and intelligence gathering. My job as the medic was to take care of the team, and my team was always trying to keep me out of harm’s way.

I was injured several times, and as many of you know, in wartime a firefight isn’t like a movie.

I don’t have to tell anyone here that in real life the battle isn’t always won and the hero doesn’t always walk away.

In one year, I matured a decade. That year taught me more about leadership, teamwork, loyalty, and how to get a job done than anything I’ve learned before or since.

We made the difficult routine and the impossible doable.

And I’ve taken that leadership lesson with me throughout the years: I believe I can accomplish any mission. The only variables are time and resources. Once you’ve done your risk assessment, you know you can accomplish any mission . . . if you are willing to accept the risk and allocate the resources. And of course, no success is appreciated without risk.

When I got home from Vietnam, I decided I wanted to be a doctor. My family thought I was crazy. My uncle had already gotten me a slot in the electrical union.

But I wanted to go to medical school. It wasn’t easy. I went to junior college, then college and medical school — juggling my school work with different jobs to support myself. But I knew how important it was to stay focused on my education and get good grades. I had failed at that during the first half of my life.

I knew that I was lucky to have a second chance at an education. I was determined not to fail again.

After graduating from medical school, I became a trauma surgeon, a professor at the University of Arizona, and ran a health system. I also served as a police officer, paramedic, and nurse.

I’ve stayed in touch with all the communities I’ve had the privilege of serving.

As I took on new challenges, I never let go of my connections to the people and the previous jobs. There didn’t seem to be much of a correlation between these jobs as I moved up the line.

But then this job came along – ironic, because I couldn’t have planned it better if I’d tried.

Little did I know, I’ve been training for this job my whole life.

As it turns out, all my different, seemingly unrelated experiences became important following 9/11.

The nation’s health and the nation’s defense are more closely intertwined than ever. Never before in history has there been this intersection between public health and public preparedness.

The new threat we face – weapons of mass destruction causing immediate large numbers of civilian casualties – means we now need to combine the disciplines of medicine and law enforcement and the military.

Most previous Surgeons General have focused on peacetime health issues such as AIDS, chronic diseases, and teenage smoking. While these things are certainly still important and a major part of my mission, this is not the only mission I must deal with in coming years.

My mandate from our Commander-in-Chief is different. I will focus on peacetime issues such as disease prevention and health promotion but I must also key on wartime medical preparedness including homeland security and the war on terrorism.

Often those priorities overlap. For instance, the problem of obesity has a major impact on military readiness. The number of overweight adolescents has tripled since 1980. Type 2 diabetes, unheard of in young people 10 to 15 years ago, is increasing dramatically across the United States among adolescents.

One-fourth of children in America spend four hours or more watching television daily and only 27 percent of students in grades 9 through 12 get the recommended 30 minutes’ exercise a day on five or more days of the week. Obesity and overweight has been linked to increased risks of cancer, heart disease, stroke and diabetes among adults.

Often we think we’ve licked smoking, and we have come a long way. But today 3,000 people will start to smoke, many of them teenagers.

This is our pool of future recruits!

We need to focus on getting children excited about increasing the amount of physical activity in their lives.

I believe it is our patriotic duty now to be in the best shape we can possibly be, regardless of our limitations. Now, those of you who are out there on the slopes are taking it to the limit! Skiing is one of the toughest sports there is. And I congratulate you for making that effort. I wish all Americans were as physically active as you!

We couldn’t have a better role model for that message than our Runner-in- Chief, President Bush. He’s one of the busiest men in the world, but he still finds time to work out every day. He has challenged all of us to lead by example and take his challenge to "Be physically active every day."

And he expects the same of those of us who work for him.

I always have to be ready to run with him. (He will always win!) Every time I see him he asks me, "Rich, have you worked out today?" That’s why I work out at 5 am, so I can always answer "Yes, sir!"

Secretary Thompson put HHS on a diet and has led by example by losing 15 pounds. The Secretary has his entire staff wearing pedometers, and he’s always asking them how many steps they have taken.

If you are out there skiing, you are probably among the most fit of all Americans! Not everyone is an athlete, as you know.

We’re seeing a generation of kids that has been raised ON the Playstation and OFF the playground.

You may have friends or family members who think a workout is walking over to the television to switch the video or DVD. Or kids who work out by fighting over the remote.

I often tell young audiences, "If you want to see what you’re going to be like in 20 years, look at your parents." If they are fit and healthy, chances are you will be too. If they are helping themselves to another bowl of potato chips, chances are that’s what you’ll be doing, too.

Those are the kids we need to inspire. And let me tell you, your efforts here in Colorado are tremendously inspirational!

Better health for our kids will ultimately make for better soldiers, and healthier adults.

You know, one of the most boring courses – I thought so at the time anyway - we took in Special Forces was preventive medicine. We learned about hygiene and water and food sanitation, and how to do appropriate prevention and health aspects in the night areas, in remote areas, for the Montagnard people in South Vietnam.

But that wasn’t the real cool stuff. Instead, we all wanted to learn how to do cut downs and how to do surgery and take care of gunshot wounds. In retrospect, preventive medicine is probably the most important thing I learned. And it is the reason I am adamant about preventing disease and injury now.

Through the years, and even in my current role as Surgeon General, I am faced time and time again with challenges that took me back to the years I served as a medic in Vietnam.

Those years and those experiences transformed me, because I learned not only about trauma medicine, but also about a lot of other things.

I have heard it said that, "Experience is what you get when you were expecting something else."

In a combat situation, you don’t know from one day to the next what challenges you’ll face.

When I was in Vietnam, I quickly learned that not only was I responsible for the health care of my team, but for an entire village as well!

Right now, many of you may be experiencing some Post-Traumatic Stress.

You’ve lived in hell, and now you are seeing younger generations of soldiers in hell, on television. I’m sure some of you are hurting, seeing our young killed and wounded, and prisoners of war.

I hope you will take comfort in knowing that the American people are truly grateful to you for your sacrifices. Ironically I think they show this better in wartime than in peace, when they are distracted by daily issues. We are all in your debt for your tremendous sacrifices.

You can also take comfort in knowing that others can benefit from your experience.

So, as you look to the years ahead in your lives, think back to your own personal history, and the obstacles you have overcome. You can help those who follow in your path.

We need you! We need you as mentors for our young soldiers who are now fighting and being wounded and being taken prisoner of war.

We need you as mentors for some of our teenagers who face an uphill battle every morning, who’ve maybe dropped out of school, and wonder whether they can overcome their circumstances to make something of themselves.

You know that the toughest battles aren’t always on the battlefield.

Sometimes the toughest battles are right here, in the mind. Some of those men and women who come home will need a lot of rehabilitation, and a lot of hope.

As disabled veterans, you understand the interplay of mind and body.

You know that the physical battle of getting up out of bed or off the couch takes place first in the mind. If you get it right up here, in your head, your body will follow.

As actor Christopher Reeve, disabled in a riding accident, put it "If we can conquer outer space, we should be able to conquer inner space too – the frontier of the brain, the central nervous system, and all the afflictions of the body that destroy so many lives and rob our country of so much potential."

While you may have lost partial use of your body, you have kept your spirit. You get up every day and conquer inner space. Americans and particularly young Americans need to hear your message. Take it to them!

Thank you all, for who you are, and what you’ve done for America, and for what you’re going to do!

I would be pleased to answer any questions you might have.

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Last revised: January 9, 2007