To Heal a Nation : As head of CDC, Dr. David Satcher takes a holistic view. Although healthy minds in fit bodies are important, he knows firsthand that we must also cure social ills--including violence.

Two memories, like freeze-frames in time, re main with David Satcher from the twilight of his near-death half a century ago and have defined much of his life:

He is 2 years old and suffering from a severe case of whooping cough. His parents are told that he will not survive the week.

Even at such a young age, he remembers a desperate, searing struggle for air. “You never forget that,” he says today, very softly.

The neighbors come, dozens of them, to gather on the front porch of the Satcher home in rural Anniston, Ala. They are there to comfort the family of a dying child.

“They came to be supportive,” he recalls. “They didn’t have any medical expertise. They were there because a family was about to lose a child.”

His was an extraordinary recovery, due to the efforts of a local doctor--the only black physician in the area and the only physician willing to travel to the Satcher home--and to those of his mother, Anna, who struggled mightily to keep her young son alive. In the years that followed, she recounted the story for him again and again: How he refused to die, despite the doctor’s dire prediction. How, in the segregated Alabama of the 1940s, one physician responded when no one else would.

The experience inspired Satcher’s decision, at age 8, to make medicine his calling. Like the doctor who helped save him, Satcher would help others without adequate medical care. Moreover, his near-death from a disease that today is preventable by immunization only heightened that commitment.

“It’s been my whole life--what I’ve experienced personally,” Satcher says. “It makes me what I am.”

It is hardly surprising, then, that Satcher intends to apply many of those same ideals in his new role as director of the Centers for Disease Control and Prevention.

There are numerous examples from Satcher’s past to demonstrate his commitment--delivering care to the poor in Watts and migrants in Upstate New York or, as president of Nashville’s Meharry Medical College, bucking Establishment academia to ensure that black students had the same academic opportunities as their white counterparts.

During the 1970s, he served as interim dean at Charles R. Drew Postgraduate Medical School and chairman of its family medicine department.

While at Drew, he created a program with UCLA in which medical students would study for two years at UCLA and two at Drew, where they would then provide medical care to Watts residents. And by 1974, he established a free clinic in the basement of the Second Baptist Church, where he was a member, and became its medical director.

During his time in Los Angeles, he also worked in the Martin Luther King Jr. General Hospital and directed the King-Drew Sickle Cell Center. In addition, he taught and worked at UCLA School of Medicine.

“One of the most impressive things about Dave is that he always keeps his sights on the needs of the most vulnerable members of our society, particularly minorities, the poor, women and children,” says Dr. Marc Rivo, a friend who has worked with Satcher on health reform and professional medical issues during the last five years.

“Every policy decision he makes factors that into it--it’s not just a rhetorical position for him,” says Rivo, who directs the division of medicine in the bureau of health professions in the Health Resources and Services Administration.

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Satcher, 52, a tall man with salt-and-pepper hair and a matching beard, is thoughtful, deliberate and soft-spoken. But he is also an imposing figure who emanates a kind of presence.

He was one of nine children born to self-taught farmers whose formal education did not extend beyond elementary school. All were delivered at home by a midwife--an old-fashioned midwife, he is quick to point out, “not a nurse midwife.” Two of the children who came before him died--one at birth, the second within the first week. His parents also adopted a 10th--the child of a relative who had gotten into trouble.

“I may have come from a poor family economically, but they were not poor in spirit,” Satcher says. “We had a rich environment from the spirit of my parents, both of whom had a vision for their children. They didn’t keep us out of school working in the fields. They made it clear that school came first, and that teachers were heroes.”

His parents had no money to send him to college. Satcher received scholarships and worked lots of jobs and graduated Phi Beta Kappa from Morehouse College, where Satcher’s son, Daraka, 19, is a student. (Satcher and his wife, Nola, a poet, have three other children: Gretchen, 25, a graduate student at USC; David, 23, a student at the University of Texas, El Paso, and Daryl, 17, a high school junior.)

Satcher received both his medical degree and doctorate degree in cytogenetics at Case Western Reserve University in Cleveland, where he was elected to Alpha Omega Alpha honor medical society.

As president of Meharry--the post he held just before coming to CDC--he came up with a plan to save both his school and a failing municipal hospital in Nashville. The two would be merged, in effect making the city hospital the teaching center for Meharry students. The proposal was controversial because black doctors would be caring for mostly white patients. But the plan--which Satcher says evoked a “community debate that spanned several years and resulted in a coalition of support which cut across all racial, ethnic and economic levels”--worked, saving both the hospital and the school.

He was no stranger to such conflict.

“As a medical student in Cleveland, during my first rotation as a student in the ward, one of my first patients was a white man from Mississippi. When his family found out I was black, they got him out of the hospital.” He pauses, and smiles. “I wasn’t fazed. There were some advantages to having grown up in Alabama.”

Also at Meharry, he pushed to move the educational setting from the hospital into the community. “He received funding from us to relocate their family medicine training program into a public housing project, directly into a community health center that was on site,” Rivo recalls. “We gave him the seed money and he arranged the linkage with the United Neighborhood Health Center--and family medicine residents are now providing regular care in that community.”

Rivo pauses. “One thing is real clear: he is in his element when he’s out in the community,” Rivo says. “He’s one of those people who has the ability to carry himself in a way that brings respect and admiration--whether he’s at a meeting of medical school deans or hospital execs, or out in public housing. He connects with people.”

Satcher also decided that Meharry would admit students who scored lower on admission tests than their white counterparts--and, in 1982, the school was in danger of losing accreditation because of this. Again, his instincts proved correct.

“At any level, most black students score lower on all standardized tests,” Satcher says. “Meharry tried to work with that knowledge. We took students no other medical schools would take, students that others had given up on. We said: No student will be allowed to graduate without passing both parts of the national boards. Will you let us take who we want? That meant we had to get them ready. By 1991, 94% of those who entered, graduated.”

The school did not lose its accreditation.

“Meharry took them, believing there was nothing more important we could do than develop people,” he says. “Many of those students are now full professors at those medical schools where they were turned down.”

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In taking charge at CDC, Satcher faces a formidable task--that of revitalizing a demoralized agency that has become politicized and fragmented in recent years over how best to deal with some of the more controversial public health issues: AIDS, abortion and violence, for example. Satcher also has the job of steering CDC back to its original mission: preserving the public health through global surveillance by identifying and tracking diseases before they get out of hand, as well as prevention and education.

“Dr. Satcher has a tremendous challenge in convincing the American public of the appropriateness of linking public health and social problems--and in revitalizing an agency that has not seen inspiring leadership for some time,” says Jeff Levi of the AIDS Action Council Foundation.

“There are good people there who have become demoralized. And there is also a generation of people who entered the system without being exposed to the positive philosophy of CDC’s mission.”

Satcher’s bosses clearly think he’s up to it. Health and Human Services Secretary Donna Shalala interrupted a recent a meeting with several members of her staff to rave to a reporter about the man she describes as “one of the great catches of the Clinton Administration.”

“We consider CDC one of the jewels in our crown, and he’s the right person at the right time,” she says. “We were very anxious to get him. He’s got first-class credentials. He is a physician and a leader in health, and he has particular concerns about prevention and minority health, which is of great concern to this department.”

For his part, Satcher’s direction seems resolute. He wants to return the agency--with its 6,800 employees and $2 billion budget--to its original mission, keeping politics out of it, and broaden CDC’s scope in the way it defines public health.

First and foremost, “we are going to follow the science,” he says, citing the agency’s recently released AIDS education campaign promoting condom use as an example. “There are people in this country who disagree with this, saying the best way to keep from getting AIDS is to refrain from having sex. But the science told us that people between the ages of 18 and 25 are very active sexually. What does that tell us? We’ve got to prevent the spread of AIDS. So we’ll follow the science.”

In terms of widening the agency’s reach, he regards violence as a pressing public health issue because it is killing people as swiftly as any deadly virus or bacterium. The subject is not a new one for CDC--the agency has been working on violence for some years--but it has been overshadowed by other issues. Having Satcher embrace it so publicly--and place it so high on CDC’s agenda--will undoubtedly give a needed boost and more attention.

“Violence is a global issue and we are a Third World country when it comes to violence,” he says. “We at CDC believe violence is a public health problem, and that we can prevent a lot of it by educating people about firearms,” he adds.

“People are scared, and they think the way to protect themselves is to get a gun. That’s ridiculous. Our easy access to guns is what distinguishes this country from other countries, especially for children. (When) we grew up, we fought--but nobody got killed.”

It is at this point that Satcher evokes the vision of his childhood neighbors who came to support his parents as he lay near death. It is this strong sense of community embodied in the vision of the townsfolk who rallied around his parents that Satcher thinks is missing from much of America today--a loss, he believes, that lies at the root of some of the country’s most disturbing social ills, including its public health failures.

“What has happened to us?” he asks. “We’ve lost that community. That’s why kids join gangs--to try to have a family, a community.”