Challenging Trump

Surgeon General, in the Hot Seat, Steps Up

WASHINGTON–Dr. Jerome Adams faces two difficult challenges as President Donald J. Trump’s surgeon general: He’s an African-American working for a man routinely accused of racism, and he is a scientist in an administration that has shown contempt for science.

He can live with that.

“If people feel that the president needs to have a different perspective on the African-American community, the one thing I would say is, he’s not going to get it if there aren’t any African-Americans in the administration,” Dr. Adams said in an interview, adding, “People are always saying we need more Black voices represented and more Black perspectives represented, but they’re always telling every Black person in the administration you should quit.”

“Those two things don’t fit together,” he said.

Now, as coronavirus cases surge and demands for racial justice roil the nation, Dr. Adams is stepping into more of a starring role.  He will be the central figure in a public service campaign aimed at getting Americans to take the pandemic seriously and do what the president, with rare exceptions, does not do: follow public health guidance and wear a mask.

“I’m pleading with your viewers, I’m begging you: Please understand that we are not trying to take away your freedoms when we say wear a face covering,” Dr. Adams said on Monday morning on his boss’s favorite news show, “Fox & Friends.”

That message must compete with relentless criticism that has come his way precisely because of his race and his stature.  Critics have called him a “token Black guy” and “a clown.” Representative Maxine Waters, Democrat of California, accused him of spewing Mr. Trump’s “racist dog whistles.”

“His own community is not exactly a fan of this administration, and then they see Jerome up there representing the White House, and he gets a lot of blowback,” said Dr. Francis Collins, the director of the National Institutes of Health.  “At one point he did tell me he was having a pretty rough time.”

At meetings of Mr. Trump’s coronavirus task force, Dr. Adams is often a quiet presence, but he chimes in on his signature issue: racial disparities in health.  He said in an interview last week that he had spoken to both Mr. Trump and Vice President Mike Pence about the matter.  He was also straightforward about working for a president who has been accused of racism.

“I have a powerful opportunity to have an influence in this administration, and I feel like I need to be at the table,” Dr. Adams said, adding, “That’s how I deal with it.”

Politics and science have often collided in Washington, though perhaps never as much as under Mr. Trump, when even face coverings have turned political.

Dr. Adams has remained diplomatic on Mr. Trump’s near-constant refusal to wear face masks.

“It’s not my place to say what image the president of the United States should be projecting,” Dr. Adams said.  “It’s my place to say, ‘Public, here’s what you need to do to stay safe.’”

Dr. Adams has brought on some of the criticism himself. In April, while urging people of color to practice social distancing and wear masks, he turned to colloquialisms, saying, “Do it for your Big Momma!” Critics including Ms. Waters, a leading member of the Congressional Black Caucus, assailed him, while Dr. Anthony S. Fauci, the government’s leading infectious disease expert–more than three decades Dr. Adams’s senior–leapt to his defense.

“He’s an African-American kid who grew up in an African-American family, so he knows exactly what he’s talking about,” Dr. Fauci said in a recent interview.  “I was almost offended by the fact that someone else was offended.”

Dr. Adams has also had difficulty living down a Feb. 29 tweet saying, “Seriously people–STOP BUYING MASKS!  They are NOT effective in preventing general public from catching #Coronavirus.”  (He was concerned at that time that masks were not available to front-line health workers.)

Dr. Adams has remained circumspect.  Interviewed for the “Today” show on NBC before the July 4 holiday, Dr. Adams hedged when asked if people should avoid large gatherings where masks were not required, saying it was not a “yes or no” question.  The musician Axl Rose branded him “a coward.”

Public opinion research conducted by the Department of Health and Human Services, however, concluded that Dr. Adams was a relatable figure, which is one reason he will be an anchor of new public service advertisements on radio, television, digital platforms and billboards.

The series, which will begin in urban markets, will feature him and other government scientists, including Dr. Fauci, talking with celebrities and sports figures about following public health guidance.  In separate outreach efforts, Dr. Adams has recorded a video with the celebrity chef Jose Andres, an outspoken Trump critic, and even asked Mr. Rose for help.

A video Dr. Adams posted on Twitter this month of him dancing with his daughter and niece while wearing masks has gone viral.

The son of schoolteachers in rural southeastern Maryland, Dr. Adams said he grew up with Confederate flags and “the N word.” He first saw the Capitol while being airlifted to Children’s National Hospital in Washington after an asthma attack.

Asthma kept him “stuck inside,” he said, reading constantly and being branded a nerd, which helps him “empathize” with “folks who are vulnerable, who are outcasts or forgotten.”

At the University of Maryland, Baltimore County, he studied biochemistry, hoped to become an engineer and met Black doctors–including Dr. Ben Carson, the neurosurgeon who became Mr. Trump’s housing secretary–for the first time. Inspired, he went to Indiana University for medical school and trained in anesthesiology, which he still occasionally practices at Walter Reed National Military Medical Center.

He also received a degree in public health from the University of California, Berkeley–a “highly unusual choice” for an anesthesiologist, said Dr. Art Reingold, one of Dr. Adams’s professors.

His pursuit of public health was deeply personal. Dr. Adams has one brother who is developmentally disabled and another who has a history of drug-related incarceration.  In Indiana, where Dr. Adams settled to practice medicine, he worked in a public hospital, shunning a more lucrative career in private practice.  Eventually, he caught the eye of Mr. Pence, then the governor, who made him health commissioner.

In Indiana, Dr. Adams had a pavement-pounding reputation, driving to heavily Black communities all over the state for panel discussions, town hall events and fund-raisers, addressing issues like obesity, infant mortality rates and opioid addiction.

“Trying to improve minority health from the bottom up made him our natural ally,” said Carl Ellison, the president of the Indiana Minority Health Coalition.

The moment that defined Dr. Adams’s Indiana career came early in 2015, in a heavily white, rural part of the state near the Kentucky border, where H.I.V. was spreading with ferocity among intravenous drug users.  Indiana law made it illegal to possess a syringe without a prescription. An evangelical Christian, Mr. Pence was morally opposed to needle exchanges, believing they encouraged drug abuse.

One of the first things Dr. Adams saw in Scott County was a Ku Klux Klan flag hanging near a Little League field.  He met with the sheriff, with clergy, with skeptical locals.  By March, the governor issued an executive order allowing syringes to be distributed in the county.

The surgeon general’s office is what the occupant makes it. In the 1960s, the surgeon general Luther L. Terry took on the tobacco industry and warned of the perils of smoking.  C. Everett Koop almost single-handedly pushed President Ronald Reagan to recognize AIDS.  In the 1990s, David Satcher publicly contradicted his boss, President Bill Clinton, in backing needle exchange programs for intravenous drug users.

Dr. Satcher, the only other Black man to serve as surgeon general, said he had encouraged Dr. Adams to “hang in there.”

“I’m glad he has,” he added, “even though I’m sure it’s been difficult.”

Like Dr. Satcher, Dr. Adams has made ending racial disparities in health care, a problem that has become glaringly apparent during the coronavirus pandemic, his signature initiative.  He said he knew from personal experience that racism–“institutionalized racism, structural racism and sometimes overt racism”–played a role.

As surgeon general, Dr. Adams said, he is neither a Republican nor a Democrat.  He has a platform, and he intends to use it: “You’re not always going to get along with and agree with everything your boss says or does in any job, but you stay in that job if you feel like you could have an impact.”

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