Nominee Fends Off Tough Senate Questions

Richard Carmona, President Bush’s candidate for surgeon general, described himself Tuesday as a “people’s doctor” who ably managed a trauma center, a hospital and a public health system in Tucson and still had time to moonlight on the sheriff’s SWAT team.

Carmona, 52, testifying at his confirmation hearing before a Senate committee, said his nomination as one of the nation’s top doctors was the culmination of “my apparently disjointed career paths.”

“As I related to my young and very inquisitive daughter, it is as if the fairy godmother reached out and touched me and cast me in the best Disney movie ever made,” Carmona said.

Though the 90-minute hearing was cordial, Carmona faced questions about his management skills, style and struggles to become board certified as a surgeon. Several people told The Times that segments of his testimony were misleading.

Carmona, a high school dropout who went on to become a decorated Vietnam War veteran and trauma surgeon, called the job he was nominated for “the ultimate opportunity for public service.”

“Of necessity, ... the role of the United States surgeon general has broadened significantly from that of traditional public health responsibilities to now include the expanded leadership role of addressing homeland defense and domestic preparedness,” said Carmona, who added that he would focus on prevention, both of disease and of terrorism.

If confirmed as surgeon general, Carmona would wear a uniform and be granted the rank of a three-star admiral in the commissioned public health corps. The position has been highly visible over the years, with occupants of the office such as C. Everett Koop becoming household names and tackling controversial health issues.

But it is a job done largely from the bully pulpit. Although the surgeon general has the 5,600 commissioned officer corps, whose duties range from control of contagious diseases to disaster relief, the office itself has only a small staff and relies almost entirely on the generosity of Congress to fund studies and outreach projects.

Several members of the Senate Health, Education, Labor and Pension Committee asked Carmona to explain rocky episodes while a medical administrator and the struggles he had getting board certification. Those were reported in The Times on Monday.

Carmona said he was “disappointed” in the story and attributed the complaints to people from his past who had been unable to put disagreements behind them.

Committee Chairman Edward M. Kennedy (D-Mass.) asked Carmona about the accuracy of the report that he had twice failed his surgery boards. Carmona would only say he had passed the exam “in the time allotted.”

“I don’t think anybody has ever questioned my competency or my ability as a surgeon,” he said.

Kennedy asked Carmona about his departure in 1999 from his job as head of the Pima County Health System, a move that the Tucson press reported as being the outcome of a showdown between Carmona and the county health commissioners.

Carmona said he started the job with the intention of staying one year, grew tired of it after three years and by the fourth year “had been trying to leave.”

“I had put a very definite time to leave at the end of that contract year, and I did so,” he said. “Some people, for their own benefit, chose to characterize this as being forced out, but it was not so.”

Sylvia Campoy, then the county health commission chairwoman, said Tuesday that Carmona never had an agreement to stay for one year only. She said Carmona still had 18 months left on his contract when he negotiated his resignation so the county had to buy it out for $70,000. Just prior to his resignation, Carmona told the Tucson Weekly that he still had “unfinished business” but would be willing to go if he had become a source of divisiveness.

Kennedy seemed satisfied with Carmona’s answers, telling him at hearing’s end, “I’m confident you’ll be confirmed.”

Carmona was asked by Sen. Jack Reed (D-R.I.) about a reported incident in which Carmona, then head of the Tucson Medical Center’s trauma unit, had a dispute with Angie Calvino, a nurse who had complained to her supervisor about Carmona’s decision in a case involving a child. Carmona had demanded her resignation, saying she had breached protocol.

Calvino accepted a demotion after Carmona agreed not to report her to the state nursing board. Later he reported her anyway, according to a former hospital official.

Reed questioned whether the incident represented a double standard, in light of Carmona’s reputation as a “swashbuckling” doctor who didn’t mind taking risks to protect his patients.

Carmona told Reed he was required by law to report the nurse, that she had problems and had only come to work with his unit because “she couldn’t carry her own weight” in the emergency department.

Emergency room doctors and more than half a dozen nurses reached Tuesday said Calvino had no problem doing her job. In fact, after Calvino was demoted, all but one of the nurses she worked with wrote a joint letter to the Tucson Medical Center board in her support, saying they no longer had faith in Carmona.

A former hospital official, who requested not to be named on the advice of legal counsel, said Calvino was a staff member in good standing at the time of the dispute and that Carmona had been under no legal obligation, as he contended, to report her to the board.

Calvino, reached overseas where she is living with her husband, called Carmona’s comments “totally untrue” but “predictable.”

“We never had any competency issues [with Calvino] as far as I’m concerned,” said Nancy Mattingly, who was the nursing director of emergency services and Calvino’s supervisor.

“She was a very compassionate person,” Mattingly said. “She was a patient advocate and sometimes she did get into hot water because she thought she was sticking up for the patients.”

Times special correspondent Maureen O’Connell in Tucson contributed to this report.