Indiana Jones Goes to D.C.

Hollywood would surely approve of Richard Carmona and Elias Zerhouni, whom President Bush nominated Tuesday to be surgeon general and director of the National Institutes of Health, respectively. The two doctors seem straight out of Central Casting.

Carmona, 52, describes himself as “a high-school dropout, poor Hispanic kid,” who rose to become a Green Beret, an Arizona trauma surgeon and a SWAT team tactician/doctor. He grabbed headlines in 1992 when he rappelled from a helicopter to rescue a person stranded on a cliff and again in 1999 when, in a shootout at a Tucson intersection, he killed a murderer holding a woman hostage. However, he had a rocky time as a medical center administrator and was pushed out as chief of a debt-plagued county health department.

Zerhouni, 50, immigrated from Algeria to the United States at age 24 with, as Bush said, only “$300 and a dream,” then went on to earn respect as a radiologist and biomedical engineer. While Zerhouni’s radiology research is not as impressive as that of his predecessor, Harold Varmus, the cancer researcher and Nobel Prize winner, he is recognized as a politically savvy administrator at Johns Hopkins University. That is a key skill for anyone who attempts to run the gargantuan NIH, whose budget has grown from $2 billion in 1975 to nearly $27 billion.

If the democratic process works as it should, both Carmona and Zerhouni will soon find themselves sitting in Senate confirmation hearings far from Tinsel Town, offering up their professional lives for examination.

One objection raised so far against Carmona--that he fatally wounded a civilian--is ridiculous, considering the defensive circumstances and Carmona’s well-reported attempt to save the man’s life after he shot him. More important might be whether he has the temperament to focus on public health, for instance as Dr. C. Everett Koop did on tobacco.

Concerns raised about where Zerhouni stands on cloning and stem cell research are to the point. At Johns Hopkins, Zerhouni played a key role in developing such research, arguing that it should be “as unimpeded as possible, because it may have a huge potential for all mankind.” However, the Bush administration has suggested recently that Zerhouni would support constraints favored by the far right, specifically a bill by Sen. Sam Brownback (R-Kan.) that would criminalize even the cloning of a person’s own cells to treat illnesses such as Parkinson’s.

At the Senate hearings, Zerhouni and Carmona will have the opportunity to speak for themselves. Sen. Edward M. Kennedy (D-Mass.), who will chair the confirmation hearings, should hold them as soon as possible, consistent with the time needed to check the backgrounds of both nominees.

The posts of surgeon general and NIH chief have long been important, and the 9/11 crisis certainly added to their significance. Having a new NIH head in place, for instance, might have made the government’s response to the anthrax contaminations more assured and competent.

Carmona and Zerhouni both appear to be appealing, brave, up-from-nowhere nominees. But the pictures of their lives need to be filled in.