Dr. Louis Sullivan Oral History

Thank you, Dr. Sullivan, for being with us today. This is the George H. W. Bush Oral History interview. We're delighted that you're here. We've gone over the ground rules, so we can dispense with that. One of the things we like to do right off the bat to help our transcriber is to go around the table and have everybody identify themselves. My name is Stephen Knott.

I'm Jeff Chidester.

I'm Martha Derthick.

I'm Russell Riley.

And I'm Lou Sullivan.

I guess probably the best place to start would be to ask you if you could tell us about how you first met both George and Barbara Bush, and the circumstances surrounding that.

Surely, right. I met them, actually, in my role as then president and dean of the Morehouse School of Medicine. Our medical school is one of 46 new medical schools that opened in the last half of the 20th century in what I consider to be a remarkable period of expansion of medical education that occurred. Basically, in the mid-'50s there were a number of reports that were issued suggesting that we as a nation would be facing a doctor shortage if we didn't expand medical education. That led to a number of efforts, including health manpower legislation passed by the Congress I think in '63, which was the vehicle that provided for such programs as the National Health Service Corps, a number of scholarship programs, funds for construction, for new faculty, for residency support, et cetera.

So as a result of that, we have now today 126 medical schools, whereas we had 80 medical schools in 1950, before this started. Morehouse School of Medicine was one such school. Interestingly, [it] is the only predominantly African American medical school that was started during this time. There are three schools. Two that existed prior to that time were Howard University in Washington, which had opened in 1868, and Meharry in Nashville in 1876. The effort briefly that led to the development of the Morehouse School of Medicine was a report issued in 1969 by a special committee appointed by the Georgia Comprehensive Health Planning System. This special committee was to look at physician manpower needs in Georgia during this period of expansion. At that time President [Jimmy] Carter was Governor of Georgia and he supported the effort. So when he went to Washington as President, he continued to support our efforts and we were able to influence some legislation that was helpful to us.

Then 1980 came. Carter lost, and [Ronald] Reagan came in. We decided that it would be helpful to develop some relationships with the Reagan administration, so we invited President Reagan to speak at the dedication of the first building that we had under construction for the medical school, which was a $6.25 million building, of which $5 million was a federal grant that we had gotten. So our goal was to try and develop a relationship with the Reagan administration similar to what we had with the Carter administration.

After holding us up for a long time with the invitation that went in late January of '81, we finally heard in October of '81 that President Reagan could not come. Meanwhile--I'll just say parenthetically--it was mixed feelings we had when we got that news that the President could not come. You may recall that in March of '81 he announced his budget where he slashed education funding quite significantly, so that worried us. Then in August of '81, he then also voiced support for the policies of Bob Jones University in South Carolina, which prohibited interracial dating and other things like that. By this time, the image of President Reagan that was emerging, certainly in the black community, was not a very positive one.

So in one sense we were kind of relieved because, as you know, Atlanta is also the home of such people of Joe Lowery, head of the SCLC [Southern Christian Leadership Conference], and Andy Young, John Lewis, and a lot of other leaders in the civil rights movement, of course. I was thinking at the time that if Reagan accepted, I might have to get on the plane with him when he left, for survival. But rather than just accepting that--because we had a different view of the Bushes--we then sent a letter back that said, with courteous language, but very clearly saying, "How could you hold us up all these months, only then to tell us the President could not come? Perhaps you could help us get the Vice President." And that worked.

In July of '82, Vice President Bush came and was a speaker at the dedication of this first building we had constructed. Our construction had started in 1978 in facilities on the college campus, so the land that we had gotten and the building we'd constructed was actually across the street from Morehouse College. Parenthetically, let me mention that the medical school, while being started by Morehouse College, started as a two-year school but became a four-year school in 1981. That approval from the accrediting committee to become a four-year school triggered the separation of the medical school from Morehouse College. There are several reasons for that. The primary one, actually, is the fact that Morehouse College is a part of a consortium, the Atlanta University Center. The consortium dates from 1929. The 1929 agreement, which still is operative today, was that the colleges shall operate baccalaureate programs, and graduate and professional programs will be operated by Atlanta University.

So Morehouse College starting a medical school was really an anomaly. There's some history behind that but I won't go into that unless you want. But at any rate, we had become independent from the college at the time that Vice President Bush came down to speak at the dedication of the building. That's when I first met him. This is 9 o'clock in the morning, because he had to be in New Orleans to speak at a luncheon that day. We had been warned by his staff he could stay only about 15 minutes for the reception afterward. It turned out he stayed more than an hour. All these Democrats--Andy Young, John Lewis, then Ed McIntyre, who was Mayor of Augusta at the time, and others--were right there getting their pictures taken with the Vice President.

So the bottom line was that we had had some concerns as to how he would be received, and it was obvious to us that his staff had concerns as to how he would be received. It was our own speculation--it was never confirmed by his staff--it was our speculation that we had been given this 15-minute story so that they would have a graceful way to leave in case this didn't go well. But it went well. As he was getting ready to leave, one of his aides gave me a little box in which were vice presidential cuff links, saying, "The Vice President wants you to have these," which was fine. So anyway, it went off very well.

About two weeks later I received a call from Vice President Bush. In fact, my secretary buzzed on the intercom, "The Vice President is on the telephone." I said, "What Vice President?" She said, "How quickly you forget." I thought it was a vice president of one of the other schools or what have you, so sure enough, he was on there. What he said was, he was going to Africa in November of that year and wondered if I would go with him as a part of this delegation. So I said, "Gee, Mr. Vice President, I would be pleased to go. But not being a government official, what would be my role as part of your delegation?"

He said, "Well, Lou, to be honest with you, we don't have an Andy Young in our administration. I don't think that I, as Vice President of the United States, should go to Africa without some prominent African American as part of my delegation. You'd do me a big favor and the country a good service if you'd be willing to go, because I think you could help our delegation." So I said fine. I appreciated his honesty here. So on that trip in November of '82, which was a two-week trip, there were two other African Americans on that trip. Benjamin Payton, who was president of Tuskegee University--and parenthetically Bush had spoken in Tuskegee in the fall of '81, about nine months before he spoke at our place. The other African American was Arthur Fletcher. Fletcher had been Assistant Secretary of Labor in the [Richard] Nixon years.

So at any rate, there were three of us, although none of us were at that time government officials. So two weeks, going to eight countries in Africa. While Vice President Bush was meeting with heads of state, I would usually tag along with Barbara Bush, because she was constantly speaking to adult literacy groups in such places as Zaire, now the Congo. She spoke at the dedication of Belvedere College in Zimbabwe, built with USAID [U.S. Agency for International Development] funds, an agricultural school along the model of Tuskegee, et cetera. So that I found interesting, fascinating.

On the way back to the United States, I was talking with Barbara. We'd gotten to know each other quite well by this time. It was amazing.

How long had it been?

Two weeks on this trip. You get to know everybody traveling around on a trip like that, because visiting eight countries in two weeks is quite a marathon. So I told Barbara that I was very much interested and intrigued with her adult literacy initiative and basically that was education, which was what I was involved in. I said, "You need to be on my board." So she said, "Oh no, Lou, for me to do something like that I'd have to get clearance from the White House counsel. Let me talk with them about that. It will probably take about six weeks for me to get an answer." I said, "Fine." She called about five days later. She said, "I can do it." So she came on our board in January of '83 and served on the board of Morehouse School of Medicine until January of '89, after Bush was elected President.

When she came on our board--first of all, she was a serious trustee. She missed only one meeting during that six years she was on our board. Plus, we had our first national fundraising campaign and she was our draw. We held luncheons around the country, San Francisco, Minneapolis, New York, Miami, et cetera. So she was a real trooper. She worked very hard. Meanwhile, my wife and I were always being invited to things at the Vice President's home. So we'd gotten to know both of the Bushes very well, and really formed a great friendship and affection for them.

I also learned, which I had not known before, that the United Negro College Fund, founded in the late '40s, George Bush's mother was one of the founding directors of the UNCF. There has been a Bush on the board of the UNCF ever since that time. I guess [William] Bucky Bush out in St. Louis is now the current Bush family member there. So I became very enamored of the Bushes because of their obvious support for higher education generally, and certainly for the African American community as well. So when Bush ran for President, I offered, and my wife and I did host a reception at our home for him in early 1988, primarily to introduce him to the black community. Because within the black community, being part of the Reagan administration with a number of things, there was a little suspicion about who he was, what he stood for so far as the interests of the black community.

So we did this with the idea that this would be helpful, because as I've mentioned Atlanta, for the African American community, is a very important city. Having an endorsement from Atlanta would be helpful. As you may remember, the "peanut brigades" when Carter ran for President, came out of Atlanta, a lot of people going all over the country. So having African Americans in Georgia or Atlanta, going to Boston or other places saying, "This guy Carter, white farmer from the South, but he's fine, he's great, et cetera." I envisioned a similar--not anything that extensive--but kind of a similar principle here in having this reception.

Dr. Sullivan, can I interrupt?

Sure.

Did you have any other background in political activity before this engagement with Vice President Bush?

No, other than campus politics. No, I'd not served in any government capacity whatsoever.

Did you consider yourself a Republican at the time?

No, I considered myself an independent. In fact, the first political argument I had with my father was in 1960, during the Nixon-Kennedy election cycle, when I told my father I was going to vote for John F. Kennedy. We had our first and only argument then, because my father was a Republican, but I consider myself independent.

My father was Republican because he was of the age when a number of blacks his age identified with the Republican Party because of several factors. One, this was the party of [Abraham] Lincoln, with emancipation. Secondly, I was born in Atlanta but had grown up in a small town in southwest Georgia. My father was pretty much of an activist. He formed the first chapter of the NAACP [National Association for the Advancement of Colored People] in Blakely, Georgia, where we were. Really did a number of things, trying to repeal the poll tax and the various tests for voter education, where someone would be given something from [Immanuel] Kant or what have you and asked to interpret this, and all kinds of things like that.

Frankly, this is back in the late '30s and '40s in rural Georgia, as in other places, the Klan was still active. My father was an undertaker. Among other things, among the bodies he had, were a couple of people who had been burned, who were lynched. So my father was a real activist and the people who were on his neck were Democrats. There was no Republican Party in the South. So in 1960 when I told my father I was going to vote for a Democrat, we had a big argument. It was fine, because of course he himself later became quite enamored of Kennedy. So I had not considered myself part of any Democrat or Republican Party, but prided myself on being independent, so I would choose my votes depending upon the individual.

You mentioned President Carter earlier. Did you have any kind of ongoing relationship with President Carter?

No, no. First of all, I finished Morehouse College in 1954, then went to medical school at Boston University. So I was in Boston. Then later on I was on the faculty at Boston University. So during the Carter years, I was in Boston when the "peanut brigades" came through. Then when I went to Morehouse in '75, Carter was--I guess that was during the election cycle, because I did then go to an event in Washington to speak on Carter's behalf. This was because he had been supportive of the medical school. That as I remember was the only real relationship I had with Carter.

The people who were interested in starting the medical school--which was kind of an interesting phenomenon itself in terms of the evolution of the South--the leadership for this effort were black physicians, but hand-in-glove with them supporting this effort were white physicians in Georgia, too. We received the endorsement not only of the state chapter of the National Medical Association of Black Physicians, but also the state chapter of the AMA [American Medical Association], the white physicians. Rhodes Haverty, the white physician who was then president of the state AMA chapter, was dean of the School of Allied Health at Georgia State. So in a sense this was kind of an interesting thing that was happening, what was going on. That effort really started right after this report in 1969.

Several things happened between '69 and '75, when I came on board. A feasibility study was done. I mentioned the fact that Morehouse College started a medical school rather than Atlanta University. That's because what happened was Dr. Louis Brown, a black physician who was president of the Georgia State Medical Association, which is the state NMA [National Medical Association] chapter, was a member of this committee that recommended expansion of medical education in Georgia, because Georgia ranked 38 among the 50 states in overall physician manpower. This report further noted that in addition to being below the national average, when you looked at the fact that Georgia's population included 27 percent African Americans, but less than 2 percent of the physicians were African American, this report recommended that any expansion of medical education in the state should also address the shortage of black physicians.

So Louis Brown then brought that report to the presidents of the consortium, the Atlanta University Center, arguing that this should be the basis for a medical school to be started in the Atlanta University Center. Atlanta University was the logical institution to do this, but they turned it down. They thought this was risky, expensive, medical schools are troublesome. Universities that have them, they take half the budget or more, and all of that. So they wanted no part of it. But Hugh Gloster, the president of Morehouse College, was sitting at the trustees' meeting of Atlanta University in April of '71, when the trustees of Atlanta University accepted the recommendation from Dr. Thomas Jarrett, who was president of Atlanta University at the time, that they should not proceed. They had done a feasibility study that said this was not feasible.

But Hugh Gloster then, after that vote, said that now that the trustees of Atlanta University had voted, would there be any objection to Morehouse College looking at this idea? And there was none. The importance of that question is this agreement in the Atlanta University Center, which started the consortium in 1929, because technically it would be a violation of that agreement for a college to undertake graduate or professional education. Morehouse College did their own feasibility study in, I guess, in February of '72 they received federal dollars to do this, and a year later they concluded differently. It was feasible and was needed, et cetera. Then they got funds to do a planning study.

In 1974 I first got involved in this effort, because of what happened at Morehouse College with a small team of three people who were really managing this. They put together a committee of Morehouse College alumni who had positions in academic medicine around the country, so I was one of those people. Interestingly enough, other members of that advisory committee included Dave Satcher, who was then out at the Charles Drew Medical School in Los Angeles. I had finished in '54; Satcher I think finished in '61. A third member was Henry Foster, who was a classmate of mine, finished in '54. Foster, you may remember, was a Surgeon General's candidate who was rejected because he's an obstetrician and had performed abortions. So that was kind of an aside.

So at any rate, my involvement as a member of this committee was to advise the college on this idea of a medical school. I approached it with some skepticism because this is a college, not a university, and with all of the demands that a medical school makes. But to make a long story short, having approached this with skepticism, I became enamored of the idea that this really was something feasible after all. Then when they started the search for a dean for this, I put together a list of 11 names of people that I suggested that they consider. That was in, I guess, in September of '74. About two weeks later I got a call from Joe Gayles, who was the chairman of the small group at Morehouse College, thanking me for my list but also expressing some disappointment that it was not complete. I said, "What do you mean it's not complete?" My first reaction was All this time I spent.

Then halfway through I said, "Oh, wait a minute, no, look, I'm not a candidate. I'm perfectly happy as Professor of Medicine at Boston University and Head of Hematology at Boston City Hospital." Had NIH [National Institutes of Health] research grants plus an NIH training grant for trainees and all of that. Plus, as I was telling Steve last night, my wife is from Massachusetts, three children, all born in Massachusetts. By this time we had bought a summer place down on Martha's Vineyard. So I really had never envisioned myself going anyplace else. Joe Gayles said, "Well, we anticipated this would be your answer, but would you be willing to come down to New York in about two weeks to meet with the committee that's looking at this side of the school, as a consultant, not a candidate?" So I said, "Sure."

At the end of that meeting, which was two weeks later, it was a luncheon meeting, but it lasted until about 4:30. This committee, I should mention, included not only Joe Gayles, who was Professor of Chemistry at the college who was leading this project, looking at the medical school, but included Hugh Gloster, the president of the college; Arthur Richardson, who was dean of the Emory University School of Medicine; Pierre Galletti, who was Vice President for Medicine and Biology at Brown; and two or three other people whom I don't really remember.

But at any rate, at the end of this afternoon, Hugh Gloster said, "Well, Dr. Sullivan, I know you came here as a consultant, as one of our college alumni. You have stated that you're not really a candidate, but I hope that as you drive back to Boston this afternoon, you think about that. Because I can't speak for my fellow members on the committee, but as far as I'm concerned, you're the man we want. I'd like to see you leading this effort." So, sure enough, driving back up the Connecticut turnpike, with the fall color--by the way, I was a leaf peeper, because I love to go up into New Hampshire and Vermont with my camera in the fall and all that sort of thing--and I was thinking, Gosh, you don't have fall color like this in Atlanta.

Anyway, I asked my wife, "Do you think you could ever consider living in Atlanta?" She had visited with a friend of hers in New York, by the way, and had come back twice to pick me up and I told her, "Wait, come back in another hour, I haven't finished." She said, "I knew this was going to happen."

Forgive me, I got you off track earlier, at the point that you were beginning to host some events for the Bushes and the presidential campaign in '88. I had merely wanted to get a kind of picture about any existing partisan inclinations before then, because it's a fascinating story about your own involvement with the Republican administration. So I'll bring you back to that.

Why don't I come back to that. So my wife and I hosted this. As it turned out, Vice President Bush himself couldn't make it, but Barbara was there. Of course, as you know, Barbara is a charmer. She's probably a better campaigner than Bush himself. So it came off very well.

Meanwhile, one of my trustees on the medical school board desperately wanted to be Secretary of HHS [Health and Human Services]. He had been a finalist in 1985, remember, when Margaret Heckler went off to Ireland as ambassador. Otis Bowen came in then as Secretary. Monroe Trout, who was my trustee, was at that time senior vice president of Sterling Drug Company in New York, which later was bought by Kodak, et cetera, but Monroe had been one of three finalists in '85 for the Secretary's position. What happened with Monroe, he was interviewed by Don Regan, White House Chief of Staff, and they didn't hit it off, so that was the end of that.

That's the only time I've heard somebody crossing swords with Don Regan. [laughter]

So that was that. I mentioned that when Barbara came on our board, my wife and I were constantly going to things at the Vice President's home. But also, Barbara hosted--I mentioned our campaign. We had the final luncheon with the success of the campaign, which was a campaign at that time of $15 million, and I think we raised $17 million. We had the victory luncheon at the Vice President's home with members of the campaign committee including Monroe Trout, my trustee who desperately wanted to be Secretary.

Vice President Bush came by that luncheon while we were there. That was in 1986 that we concluded that. So with the campaign in '88, coming back to that, Monroe mentioned this to me and said, "Lou, looks as if Bush may win. You know, I was a finalist before and I still would like to have a shot at this. Would you support it?" I said, "Sure, I think you'd be a great Secretary." So I mentioned this to Vice President Bush one of the times I saw him and said, "You know, the campaign is going well. Monroe was a finalist before. He really would be a great Secretary." He said, "Oh yes, fine, sure."

I shared this with Monroe, so he knew that. In the fall of '88, I received a call from Dr. Frank Royal. Now Frank Royal is a black physician here in Richmond, who's Republican and prominent and he was close to Senator [John] Warner and others. I knew Frank from medical association meetings. Frank called me and said, "Lou, I just want you to know that I'm putting your name in to be Secretary of Health and Human Services." I said, "No, no, Frank. Look, I'm not political, I've never done this. Plus, I already have a candidate I'm supporting, one of my trustees." So we went on for about 20 minutes.

Frank said, "Look Lou, I didn't call to ask your permission. I just called to tell you this because I think you'd be the person." I said, "Okay Frank, if you want to do that, fine. But you're wasting your time." Well, interestingly enough, about a week later I received a second call from Dr. Leroy Keith, who at that time was president of Morehouse College and had a similar conversation, only this one was much shorter. I said, "Roy, look. I had a similar conversation with Frank Royal. Since you want to do this, then you go right ahead."

Sure enough, the day after the election I called then President-elect Bush down in Houston. Parenthetically he was wearing a tie on election night, when he came out to acknowledge, that I had bought and sent to him as a gift. In New York, on Fifth Avenue, you've probably passed a shop, [inaudible], I don't know if they're still there now. An interesting men's and women's clothing shop. There happened to be a nice blue tie with tiny red elephants on it, so I bought this and sent it to him and said, "Wear this on Election Day. It will bring you good luck." Sure enough, that night in Houston he was wearing the tie. So the next day, when I called to congratulate him, I said, "See, I told you. Had you not worn that tie, you'd be packing up." So we kidded.

Then I said, "Remember, we talked about Monroe before, who would be a great Secretary," because I had not taken these conversations with Royal and with Leroy Keith seriously. He then said, "That's right, Lou. I remember we talked about this, but I'm not getting kind of the reaction I think I need if I'm going to go forward with this name. So would you be willing to come up in a couple of weeks? I'd like to talk with you about this." So I said, "Sure," and I hung up. I said, "What did he mean by that? Was it talk about how do we get Monroe the position, or it sounds to me as if he wants to talk with me about becoming Secretary."

So I spoke to the chairman of my board. I told him, "I'm not sure, I may be blowing smoke or imagining things, but it may be that Bush wants to talk with me about becoming Secretary." He said, "How do you feel about it?" I said, "I'm not sure." Frankly, this really was a resetting of my compass, because I was focused completely on developing this new medical school.

But I also spoke with the Speaker of the House of the Georgia legislature. The reason for that was we had gotten state support for the school. Tom Murphy, who actually was just defeated recently, had been Speaker the whole time I'd been in Atlanta and we'd gotten his support for the medical school. One of my worries was if I pop up in Washington, even talking about going into a Republican administration, would this damage our relationship? So I went to see Tom Murphy. Interesting guy. We have a good relationship, but Tom Murphy wears cowboy boots, has a Stetson hat, is about 6? 4?, and he looks at you in a scowl. You never know whether he's pleased or not pleased. He has a little wedge of tobacco that he stuffs in his mouth, and he has a spittoon, had a spittoon right there.

By the way, I'd also learned through my colleagues--I'd go out and visit him in Bremen, his home, during the off-season. He appreciated that, so we developed a relationship. So I went to see him, said, "Mr. Speaker, I want to talk to you, because President-elect Bush has asked me to come to Washington. I think he may be asking me if I'd become a member of his administration, and I thought I'd want to talk with you and see what you thought about that." He looked at me, and he's chewing this, and he says, "Well, it's all right with me because there's not a dime bit of difference in my view between Bush and [Michael] Dukakis." [laughter] So that was my blessing, because he didn't like Dukakis.

So I went, and sure enough Bush asked if I would come into his administration. That's really the way it happened.

Then you introduced Barbara Bush at the Republican Convention that year?

Yes.

Can you tell us a little bit about that, anything that stands out from that event?

Yes, the way that happened was as I mentioned, Barbara really was a great trustee. As you know, she's a great person. One of the times I was up visiting with then Vice President Bush, he said, "You and Ginger [Sullivan] are hosting this reception, and Barbara's going to make a speech down there. Would you be willing to introduce her?" He also said at the time, "Lou, I don't know what your political affiliation is and I don't care. I don't know whether you're Republican, Democrat, Independent, or what have you. But you're our friend and if you'd be willing to do that, because Barbara thinks so much of you, it would be great of you to do that." Again, I touched my bases and they said fine.

So Ginger and I went down and we spent, I guess, several days down there and I gave the introduction. That really was purely because of our friendship with the Bushes and my appreciation to her for her tremendous role she had played as a trustee, because she really helped us quite a bit. Again, at that time, had no thoughts of myself becoming politically involved. My focus was on the school. I thought I'd play a role in helping to get my trustee at HHS because my vision was: Bush in the White House, Monroe as Secretary and me at Morehouse; that's it, I have it made. But that's not the way it happened.

Did you get the impression, for instance at this reception that you held at your home that Barbara Bush attended, was she able to convert people? Was it a hostile audience to some extent and by the end of the evening had she won them over? Did you have any sense of that at all?

Actually, no, it was really a pretty friendly audience. Interestingly, in the same way we had expected that when Bush spoke at our dedication, we'd have a hostile audience--let me back up and give you one other interesting thing when Bush spoke at our dedication. This was outside on the plaza in front of the building that was dedicated. Across the street, behind the police lines were about 15 demonstrators. So I'm uptight, thinking, Oh my goodness, what a reception for the Vice President, because I want this thing to go well.

He comes out and of course he's wearing his bulletproof vest underneath. I became very much aware of all the security and all these other things. He looked across the street and I'm feeling embarrassed and he says, "Hmm, only 15. Hell, if Reagan were here, there'd be 50." [laughter] So he was disappointed that there were not more. At any rate, that's how that happened. He was well received. Then when Barbara--this was back in, I guess in the fall of '88, or August. I have to go back and check to see exactly when this reception was, but no, she was well received. Also, it was well known by that time she was one of our trustees. Of course, she had been our main draw with this campaign, had been successful. So no, she was warmly received.

Was there anyone other than the Speaker of the House in Georgia whom you felt you had to explain yourself to?

No. Governors come and go, but Tom Murphy lives forever.

Until recently.

Yes, right. That was kind of in jest, but the reality is that Tom Murphy was a prominent--and if I had his blessing, then I knew that had there been objections elsewhere, I could say, "Look, I talked to Tom Murphy and got his blessing."

Do you remember the particulars of your conversation with the President-elect? You had indicated that you were going up to him. Could you tell us a little bit about how that conversation unfolded?

Sure, sure. He asked about my prior political involvement. I'll share this with you, my meeting with Bush was 10 o'clock, I've forgotten what the day of the week was. It was 10 o'clock in the morning. I flew up the night before; this was in December, no, late November of '88. I stayed in what was then the Carlton Hotel; I've forgotten the name. It's the hotel right on 16th Street, right down from the Hay-Adams and across the street from the Capitol Hilton Hotel.

It's the St. Regis now.

Right. That's the hotel but it was the Carlton or something like that. I came up the night before because I wanted to be sure if the weather was bad. So I had a nice leisurely breakfast and then about 9:30 I took a walk over through Lafayette Park to the White House. Just as I was crossing 16th Street and I was heading for the gate, I guess the northwest gate there, going by the circular drive of the White House, I noticed a bunch of people standing on the other side, but I didn't pay much attention. I was about halfway across the street when I heard someone say, "There he is." All of a sudden, these cameras wheeled around and these were reporters, including reporters from Atlanta. Because they, of course, get the President-elect's schedule, which I never even thought about, they knew with whom he was meeting at the time. Of course there was interest about who was he going to be appointing to various things.

As I got across the street this reporter said, "I understand you're meeting with President-elect Bush today, is that right?" I said, "Yes, this is a meeting that he requested." "Is he going to offer you the Secretary's position for HHS?" Because that had been speculation. I said, "I have no idea what the President-elect wants to talk to me about, but I certainly am pleased to respond to his question, et cetera." I'm certainly feeling, This is a mistake. These cameras are right on me. So I try to go in the gate. There were some cars parked in the circular drive and I'd forgotten, some visiting head of state was there, so that gate was sealed. They said, "I'm sorry, you can't come in here for security reasons. You have to go down, there's another gate going in through the Old Executive Office Building, you can go in that gate."

So here I am out there with these cameras and so forth, trying to walk as fast as I can without breaking into a trot to get away from them. I went in through this other gate, into the Old Executive Office Building. Of course, they couldn't come in the gate, so finally, once I got in the gate--because remember, there's a wide plaza there before you get into the building. So I went in there, and they typed in everything. Then they said, "Oh, yes, you have this meeting. We know you just came from this area, but President whoever-he-was is gone now, so we'd like to have you go back to the original gate." So I had to do this again in reverse. I finally got in. I'm trying just to not say anything, but at the same time not appear panicked or what have you.

I got in and then inside I met with Craig Fuller, who was one of his assistants, and with John Sununu. I'd met Craig before but I met Sununu for the first time. Also, one of those polling people whose name will come to me, from Michigan.

Bob Teeter.

Bob Teeter, yes. I met with then President-elect Bush and indeed he said, "Lou, I would like very much if you would be my Secretary of Health and Human Services," and so forth. He said, "You have an outstanding medical career. Now one of the things you'll find and will have to be prepared for are questions on abortion. You can talk with my staff, but in my administration what I want is teamwork. We work closely together." So having been prepared for this possibility, I said, "I'd be pleased--" In my meeting with him, he was wearing, by the way, cowboy boots with GB on them, some gift that somebody had given him before the election with the American flag implanted on them and so forth, which I thought was a little incongruous for a Connecticut Yankee who was trying to be a Texan.

At any rate, we had a good meeting, but only about 15 or maybe 20 minutes at the most. Afterward I met with Teeter and Sununu and Fuller, they kind of put me through a drill: "These are some of the things here and also stay away from the press because the President will be announcing this at some time and Congress is very jealous of their prerogatives for confirming people so you don't want to be out talking to the press," et cetera. So I said, "Fine." They also said, "Try and stay out of sight." I then said, "I've already learned my lesson," and told them what happened. They said, "What? You walked?" They were thinking, Oh my goodness, what kind of hayseed is this guy? He doesn't even know--So they said, "We'll arrange transportation out of here." And that was my last time I ever walked to the White House. I tried to stay undercover.

Meanwhile, they prepared briefing books for me and I had a little office there in the Old Executive Office Building for preparation. I stayed in Washington, went back to Atlanta I guess a day or so later, but then came back, really to go through all the briefings, about the department and everything else. At any rate, that's how things got started.

You had decided in advance that you would accept.

Yes, because when I met with my chairman, for example, basically he said that, first, for you personally this would be a great honor. Secondly, for the school, this would give us prominence and this would be very positive. You can't turn the President down if that's what--so I had really touched all the bases here. Everyone I talked to including Murphy, Speaker Murphy, was saying in essence, "Okay, fine."

My biggest personal perspective was, believe it or not, I said, "Do I really want to do this?" Because I was very excited about what I was doing, and I felt that I knew something about that. This was another world out there. But in talking with everyone, I also talked with my wife, decided that this would be not only an honor but a real opportunity and be interesting, be something different. Undergirding all of that, frankly, was our great affection for the Bushes. I felt it would be a great honor as well as fun working with them. So those are the thoughts at the time.

During this meeting with Bush, before he offered you the job, did he ask you about your political persuasion? Or did he just offer it to you based on what he knew of you?

What he knew of me. Basically, when he had asked me to introduce Barbara at the Republican Convention, he had then said, "I don't know and I don't care what your political affiliation is. You're our friend and that's the basis we would like to have you do that." So no, we didn't have any discussion there about political affiliation.

He did mention the abortion issue as something that might cause controversy, is that right?

Yes, because it had caused controversy for him, too. And as subsequently happened, it did. I made the mistake of saying the Supreme Court has ruled on this, it's the law of the land, so legally women have a right. That was a very intense lesson I then learned. These very guys, Sununu and Teeter and Craig Fuller had said, "Don't talk to the press." But what had happened, when I was back in Atlanta, this reporter wanted to talk with me and said he wanted to do a profile of me. This would be embargoed until after my confirmation and so forth, so that's fine. Well, I talk with him and the next day it's in the press. So that was an introduction to the press at that time.

I want to ask you, did this associating with Republicans cost you socially among African Americans, either within Atlanta or Martha's Vineyard or anywhere else? Were you viewed with suspicion or disdain?

In the long run, no, but early on, yes. There were questions, because this was viewed as really, the Republicans are not very interested or supportive of the issues that are important to blacks. You know, education, health care, civil rights, affirmative action, et cetera. So there were some questions like that, but not a real confrontation. There were questions as well, "Now, what's Sullivan going to do, is he going to be a turncoat and mouth the Republican line?" So there was that kind of questioning and skepticism. "Is he being an opportunist to become a Cabinet member?"

Over time I think all of that's disappeared because fundamentally I've made clear what my position is on education and on health, and frankly it's been fairly interesting. Now I'm being given great accolades for founding the medical school and the medical school itself is doing well, and we have a number of graduates there and my public positions on a number of things--and, at the same time, as you probably know, I'm currently chairman of the current President [George W.] Bush's advisory council on black colleges and universities. Basically I'm working to try and enhance federal support for these institutions, which I frankly see as consistent with the Bush family's interests.

Another interesting thing, too, that you're probably familiar with, having talked to other people in Bush's Cabinet, they don't blow their own horn. That is, most people don't know that there's been a Bush as a member of the UNCF board from the beginning. I talked with President Bush once about this saying, "People don't really--" And he said, "Well, I know, Lou, but I just don't believe in that kind of thing." This was kind of a Bush tradition, his mother and all that sort of thing. So I know that is still out there, and certainly with W. now. But again, what I'd point out is that W. has appointed more blacks to Cabinet positions and senior positions than any other President, Republican or Democrat. So there's that tension and that ambiguity and that questioning and so forth.

My position and the position I've taken is I know who I am and I know what I represent and what I try to do. I also know that in the political world, to be successful, sometimes you have to compromise. It may not be the most comfortable thing, but sometimes you have to compromise on this thing over here so you can get this thing over here. If you're an ideological purist where you're not willing to do that, then fine. You stay in your ideological purity, but I think you might be less effective in getting something done if you're not willing to compromise.

This has been and is still an ongoing issue, I think, certainly in the black community there. But that's also been an interesting thing. I think socially we've not suffered anything. Occasionally somebody will still say, "How can you be a Republican?" The way you say it when you're spitting out something very bad. But I point out to people, "Look, my father said the people who were stepping on his neck and keeping him from voting were not Republicans, because there weren't any in the South, they were Democrats." So really, you could say both parties have some blemishes here and either you work with what we have and try to improve it, or you stay above it. That's one way of addressing things, but that may not be the most effective way if you're interested in social change.

I want to ask you one related question about your own devotion to the Bushes. You've explained to us that there are people who were very open, in their personal lives, to being supportive of African Americans and being very inclusive, and really putting their time and their money where their mouths were. Some would argue that there's a difference between that and the kinds of policies that people might produce within an administration. I'm wondering, in your own case, how much the policy-related questions concerned you as you were trying to make a decision about casting your lot with these folks? Was it the case that because of your own personal relationship with them you had such a high degree of comfort that you could overlook where you felt there were shortcomings in their policy commitments? Or was it the case that their policy commitments really were very much consistent with your own, at least within the realm of Health and Human Services?

I think it's more the former rather than the latter. Let me give you an example of another area where this operated. As you know, during my time as Secretary, I was very outspoken against tobacco use. Of course the tobacco companies and the Republican Party really were hand-in-glove. I first spoke out, I guess it was in January of '90. Yes, I'd been in office just about a year. I did this, at the time, knowing that Bush had not done that. Also, that I was going beyond where the administration was. But I had decided by that time, If I get fired about this, so be it. This is one of those areas I did feel strongly about.

I knew that this was not in keeping with the position of the administration, but I decided I was going to push the limits on this and see what happens. Of course, what happened was nothing. Bush didn't come out and support me, but he also didn't come out and say, "What my Secretary said was totally wrong and not in keeping--" He was silent. Three or four months later we were at some program there in the Old Executive Office Building and he was commenting on me and says, "Of course, Lou has pointed out about the health dangers of tobacco. I know sometimes he may feel that there's a big empty echo behind him, but he's out there and he's doing a good job."

He was saying he wasn't going to get out there. Frankly, so far as I was concerned, that was fine. My feeling was that you do have to decide, where do I draw the line? Where do I say, "Okay, this is something that I have to do and if it costs me, then so be it"? That was one of those, but it didn't cost me. In fact, I later learned that someone from Philip Morris had contacted John Sununu to say, in essence, "Would you have the President call off his Secretary?" And John Sununu said to them, "I'll go to the President about this if you really want me, but you might want to think about that, because you may not get the answer that you want." So they backed off. I only learned this later; Sununu never said that to me directly.

When I learned about it, it was in an article in Time magazine that I saw it, and I just asked him and he affirmed it. So it was a situation where they knew that for their reasons, multiple, including the fact that--gosh, I've forgotten his name now, but a senior Republican who was from Richmond at the time--

There was a member of the House, Tom Bliley.

Yes, Bliley, Tom Bliley, yes. I know he was not happy with me. Of course, Philip Morris has that huge facility down there. He was cordial, but he made it very clear he didn't really agree with or appreciate those comments. Mitch McConnell over in Kentucky also spoke with the White House, saying, "At least could you get him to not talk about our international markets," et cetera. So really, there was some compromising done there, but Bush made it clear, through his inaction, and it may have been more than that--because I never frankly pushed that. I never asked--but that wasn't going to be the tipping point that it otherwise could have been.

You had mentioned earlier the interview with the Atlanta Journal-Constitution and the issue of abortion coming up. Could you just talk a little bit more about the controversy that swirled around you on that issue?

Sure. Basically, I thought I was making a very careful statement when I said, "The Supreme Court has ruled on this and this is the law of the land, so that means that women have the right to that. As Secretary, I'd be pledged to uphold the law." I thought I was crafting a very careful argument where I was hiding behind the law. Obviously, as a federal official, I would have to uphold the law.

Well, of course this came out, "Sullivan pro-choice." That caused quite a flurry there and a number of meetings. I had a fellow who now is vice chairman of my board, and who had been an assistant to Liddy [Elizabeth] Dole when she was Secretary of Transportation during the Reagan years, who came and talked and said, "This is quite a thing. Why did you open your mouth?" And of course, I'm feeling pretty stupid, the same way I felt with these damned reporters chasing me down the sidewalk before, because I'd been warned, "Don't talk to the press." But I had thought, frankly, This was a reporter from my hometown. He wants to do a profile, I want to be supportive of him and he promised to embargo this, and all that kind of thing. Of course, that didn't happen. His name is [Kevin] Sack, he's now a reporter for the New York Times, so frankly, I was part of his ticket to another position. But when this happened, I had a number of people there at HHS go through all of the history, which quite frankly, part of my problem was abortion had not been an issue I'd been involved in.

As you know, my training was in hematology, blood diseases and so forth. So really, this was new to me. Frankly, at that time I was not aware of the intense emotions on both sides of the debate here, where there are these things that are used as signals as to your position here. But obviously, the fact that I did not come out at that time and say, "I'm opposed to abortion," by default then, I'm pro-choice. So frankly I was surprised and I was concerned.

Most of all I felt I'd let Bush down. I had inflicted an unnecessary wound, both on me and on him. I was very much aware that the right wing didn't really trust him. Therefore, here's the Secretary who's closest to this issue now having gotten caught up in this. Nevertheless, of course, at any time he could have very well said, "Well, Dr. Sullivan is taking a position that I do not agree with and regretfully we are withdrawing the nomination," or something like that, but he didn't do that. He stuck with me.

Dr. Sullivan, was the statement that you crafted--you mentioned you'd been given some, marching orders is probably too strong a word, but that you'd met with three of the President's advisors and you had talked about abortion at that time.

Right.

Were you repeating in your statement what you had heard from these three advisors, or were you revising and extending what you had heard from them?

I guess, no, I can't say that. The meeting with them was not that detailed, was not that intense. They said, "The President is not for abortion except for the life of the mother." I'm not sure, but I think they probably assumed that I was more familiar with the issues here than I really was, I don't know. But I frankly thought, also, in my own naivete, because my statement was one where I thought, as any government official, that my obligation would be to operate within the bounds of the law. So I thought that by saying, "This is the law of the land as determined by the Supreme Court, and I will take an oath to uphold the law"--But as was obvious with what happened after that, that was really not the thing to say. I was trying to make my response on legalistic grounds here, not on the ideology, that sort of thing. So that's what led to that.

Their primary admonition was just, "Don't talk to the press, period." You had formulated a statement that you felt was consistent with what the President had said.

Plus, what I thought I was doing, what I had been promised was talking to this guy for an article that was going to appear later. Giving him time for a profile and all that kind of thing. I really felt pretty stupid after that, because people said, "Don't you ever take the press's word for this." So all these things I had blandly assumed would be operative were not. I really was quite chastened by that because as we mentioned before, I had not been in political life and this was something where my education was coming in various incidents that were happening.

After that that I sat down with a number of people to understand all the issues. It turns out actually, my roommate from Morehouse College, who is an obstetrician, was out in Los Angeles. He and I were good friends; he's pro-choice. He said, "Lou, I thought you were smarter than this." He sat me down, of course we're friends, and said, "Now this is the argument over here, this is the argument over here, and there's no compromise. You're trying to walk down the middle. There's no such place as the middle ground here." That was a kind of baptism by fire there. I felt that Bush could have easily been justified in jettisoning my nomination, particularly where he, as I mentioned before, had also not been received with comfort and enthusiasm by some of the people on the right.

If you had it to do over again, would you have just declined to give the interview to the reporter?

Oh sure, absolutely. I frankly felt like a chump. Here I am, how naive to believe somebody's word really stands for something, a reporter?

A pledge for an embargo is usually pretty solid, maybe we're being naive.

Well, I had accepted that as such. Of course, I'm sure there are reporters who really honor that, but some of my friends and advisors said, "Well, look, you never trust a reporter; I don't care what they tell you," because there are enough times something like this happens, where really, rather than being interested in honoring their word, they're interested in what kind of sensationalism they might get out of it.

Did you ever speak to him about it?

No, never spoke with him again. He tried to contact me to offer some apology and all of that, but I've never spoken with him again. That's one of my traits. If you give me your word on something and you go back on it, I don't have any use for you. I can deal with you if you're way over here on the right. I can argue with you and still have respect or way over there on the left or what have you. But if you give me your word about something, that's it. If you then go back on that, I'll never trust you again. I would never know when you would really do what you say you'd be doing.

Did you hear from Sununu or any of those people while this was swirling around those few days where it was headline news? Did the White House contact you at any point in the middle of this? Or were you left--?

Not directly. They did not, Sununu didn't. I don't believe Sununu called. The person whom I spoke with who is part of the pro-life community is Kay James, who ended up being my Assistant Secretary for Public Affairs. She really educated me about all of this here. And Debbie Steelman actually I had tried to recruit to be head of Social Security but she turned us down. They really put me through the paces then. At that time I'm the President's presumed nominee and they were working to do everything to salvage this. Part of this was to make sure that I really know what the issues are and I know what the line is and I know how to conduct myself and all that sort of thing.

Now, they never said this specifically and I didn't ask them, but I was pretty sure that they were doing this at the behest of the White House. Here again, I learned in the political world, sometimes it's better not to ask, just make assumptions.

Did you ever come close to thinking of withdrawing, that this has done too much damage to the President-elect?

Or that it was just not worth it, to have to deal with this kind of environment?

I wouldn't say I came close. I thought about it, but again, I decided that this would be his call and I would have accepted that had that happened. But I also, within me, said, "I'm going to fight this damn thing. I'm not a quitter and I'm not going to run away because of this." I said, "I have to learn what the issues are and really be a little smarter than I have been on this." So, I'd say there was never any serious effort, but I was prepared for that to happen, if it happened. And I was going to accept it with grace.

Among other concerns I had was, here was my friend for whom I have caused this problem. Because first of all, as you said, I was a political unknown so people would say, "Who's this guy? Why is--?" Plus there were a lot of other people, frankly, who wanted to be Secretary. Mike, Monroe Trout, Chick [C. Everett] Koop, Surgeon General, was one of the candidates, and other people who had been in the Vineyard, because Monroe Trout was head of the Republican Party up in Darien, Connecticut, and all of that. So here were other people you could say, on the basis of their involvement and on their contribution, they deserve to be out there in front of me. But I felt it was A) because of my personal relationship with the Bushes, and B) I wasn't naive either. I felt that he wanted to have an African American in his Cabinet and for those various reasons. So that's how that happened.

When you go out to Washington for the formal announcement, how did that go? Did the President say anything to you? Was there any joking about what had happened, or was it just put aside?

No, no. He said, "How you doing? You're not letting them get you down, are you?" and that sort of thing. But no specifics about, "What the hell did you say," or anything like that, nothing like that. My announcement, you may remember there were three other people there. I knew very well that having these three others was kind of cover for me, because the others were not controversial. There was Ed Derwinski to be VA [Veterans Affairs] Secretary, Manuel Lujan, and I think Bill Riley. I've forgotten who the fourth person was.

These were people there had not been any kind of controversy around. I mean, I was the poster boy at that time. So I felt he did this to diffuse it, because again, the questions afterward, really, all these other guys sitting up there, nobody had any questions for them.

You were announced with Riley, Derwinski, [Sam] Skinner, and Lujan.

Right.

A lot of people have mentioned Bush's loyalty, especially to his friends. I guess this is a good example of that. Did that change the way that you felt about Bush personally, or how you conducted your job as Secretary?

It only enhanced it. That is, I had felt before--the fact that, when I offered to host this reception--see, I knew, the question you raised about the reaction of the black community--I knew, in offering to do that, or having him come, there would be people in the black community who would raise questions. But my feeling for the Bushes was really so strong for them as individuals that I was prepared to do that. And I felt that Barbara, as one of our trustees, had gone beyond the call of duty, traveling all over the country to speak at fundraisers and so forth. So for me there was no question I was going to do that, because I wanted to do it. I wanted him to win the election for President. I did this knowing that there could be some cost, but I was prepared to pay that.

Could you tell us about how you prepared for your confirmation hearings and the kind of support you were given by the White House?

Oh sure. Quite intense preparation. There is a common term I'm sure you're familiar with, "murder boards." I had two three-ring binders that talked about all of the issues. First of all, the various programs in the department, because there are 250 programs in the department. Of course, on so many of these programs there are a lot of strong feelings. Social Security being another one, disability issues, AIDS, a lot of hot button issues, welfare. So, my preparation started right after, well actually even started before this announcement. But it was really after I met with Bush in November, for all practical purposes, I was no longer at Morehouse. I really was preparing, learning the issues and so forth.

Tom Korologos really was the manager of the murder boards. As you know, the nickname for Thomas, he's the 101st Senator. I forgot what Tom's position is now, but he has his own lobbying firm, as you know. But he really managed that. I had a bunch of people, I had public relations people and we would have mockups in the room with people questioning me and throwing out questions. Also interrupting my answers and all of the things that could happen there that could rattle me. So it was both a question of A) do I really know the issue? Did I have enough of a knowledge base? And B) how did I handle myself, being interrupted, or being asked a question that's somewhat incendiary and that sort of thing? We were focusing on both content as well as style. So I had quite intense preparations.

And they were helpful?

Oh yes, very much so. There's no question. Bush was taking a big chance on me, which I'm sure he knew. Some of these nuances, not having anything to do with abortion, but just dealing with the press in a high-profile environment like that. Also, I thought I knew how to work with the press. I'd had the press there in Atlanta at Morehouse, new school and all of that. We'd had good press. I never had any disaster like this happen. But I learned that the Washington press is very different from the press in Atlanta.

Did you make the rounds on the Senate side of Capitol Hill? Did you go visit individual Senators at all?

Yes, oh yes. That reminds me, one thing I should mention is that once this abortion thing came up, and then I made a subsequent statement--a clarification saying I am opposed to abortion except for rape, incest, and life of the mother--Arlen Specter was a little concerned, "Where does this guy really stand?" I have to remember now how this came about. I think I met with Orrin Hatch. I'd known Hatch before, because of course in my role as head of the medical school I would come to Washington to lobby for things for us, and so I knew Hatch from that.

I hope I'm not remembering something that didn't happen, but it may have been Hatch who suggested that I ought to talk with Alan Simpson, or it may even have been the White House. To make a long story short, Alan Simpson called me, said, "Lou, we need to talk." He said, "You've got yourself wrapped around the axle on probably the worst thing," et cetera, and "We've got to work through this." So Alan Simpson took me over to see Arlen Specter in his private office, just the three of us. We talked about my position on abortion and what was it. I then told Specter, "Well, it really is what I said. I'm opposed except for rape and incest." He said, "Well, that didn't sound like what you said at first. Now is that true?" I kept repeating it. I'm not going to veer off of this catechism, I don't care what he says.

After this he said, "Okay, we're going to support you." I passed out because as you know, Specter is pro-choice. Basically, what was happening there, Alan Simpson, who's highly regarded in the Senate, was really putting his blessing on me so he was bridging this gap. So that's one of the things that happened in terms of my relations with the Senate.

You said in that particular instance there were only three of you in the room. Typically you would have been traveling in the company of someone from the congressional relations office?

Oh yes, absolutely.

Do you recall who that was at the time, who you were working with?

Gosh--

Korologos would have been an outside.

No, it wouldn't have been Korologos, no, no, no. I frankly don't remember, but it was someone from the department. It may come to me, but I frankly don't remember. But this meeting, no staff. It was very clear. This is just a one-on-one thing. Obviously because Alan Simpson was who he was, I'm sure that in one sense I was still in tow, not with an HHS staffer, but with him. But they didn't want to have any staff there, which was fine.

Did you encounter any other significant opposition? I know there was only one no vote.

Not really. I did meet with some of the Senators in a Republican caucus and [Jesse] Helms was there. He said, "I'm just not comfortable with you," and he made that very clear. Of course, I tried to be as cordial as possible and said, "This is my position," et cetera. As you know, when the confirmation did come, he was the one vote. But I then told my friends, "Well, that's okay, because I would have had a hell of a lot more explaining to do back in Atlanta had Helms voted for me."

The Georgia Senators at the time were Sam Nunn and--

Herman Talmadge.

Did they get involved at all?

Oh yes, I made courtesy visits to them. Of course they were supportive of me. As a matter of fact, they were both on my board.

So you knew them before.

Oh yes, oh yes, right. They both, my appointment as dean was announced in April of '75 and I started in July '75. They were there for that announcement because the team of three people at Morehouse College really had worked to generate a lot of support for this, including support from our congressional delegation as well as people in the Georgia legislature. So when I went to Morehouse in '75, the next April, April of '76, we formed an initial board, the Board of Overseers for the medical school. Then in July of '81, when we became independent from Morehouse College, became our Board of Trustees. But Sam Nunn and Herman Talmadge were both members of that board that we appointed in 1976 and then became trustees in '81. So we knew them from that. They, of course, had been very helpful to us in Washington with legislation and appropriations there.

On the one hand you weren't much involved in politics before, but in the normal course of your functions at Morehouse, you knew a number of public officials.

Oh yes, right. But the politics then was really lobbying for things that were important to the medical school, whether it was an appropriation or whether it was some bill on student aid or things like that.

Did they speak on your behalf?

Yes, they did. They both came and spoke on my behalf.

I'm going to exercise my prerogative as the chair and call for a break.

I'm glad you did because I was about to! [laughter]

[BREAK]

I'm wondering if you might tell us how much discretion you were given in terms of selecting your sub-Cabinet positions, your staff and so forth? How did that whole process work?

I was given a fair amount, as much as I really wanted. The reality was that being new to politics, I really didn't have a bevy of people in mind to appoint for various positions. So there were a number of people who were suggested to me or who had been recommended by the White House, and I indeed accepted a number of them. This was after meeting with them, talking with them, and forming my own impression, but I felt comfortable there.

The people who were my personal choices, who I felt were very important, were my chiefs of staff. I had three chiefs of staff during my four years there. Everett Wallace, who was my first person, and he played a very key role in helping me vet various people. Now, there were some people that we did not accept for a variety of reasons, whether it was a question of their competence or the chemistry with them or what have you, and didn't have any problem with them. But frankly, most of that went through my Chief of Staff, Everett Wallace. That is, he was the bad guy; I'm the good guy. We would talk about this.

You said that you did not accept--these were just people who were applying directly to you or were you getting names from the White House?

No, including names from the White House. First of all, there were a number of people on the list, some from the White House, people who had been active in the campaign and tied to this or that Member of Congress and that sort of thing. So we had a lot of suggestions, but we also were given flexibility. That is, I don't recall anyone where we said, "No, we don't want to put that person in this position, we have another option," where I was overruled. There were a number who were suggested that we did accept.

I can give you one example: Kay James was one person I mentioned. She had been in that group of people from the White House who actually were part of my orientation team. As I mentioned, she's the one who really schooled me in what the issues and the politics are in terms of abortion and so forth. She's a very active member of the pro-life community and so forth. She became my Assistant Secretary for Public Affairs. I felt comfortable with her, because first of all we got along very well. Again, she was one of those people, if there was some issue, she would come in and talk with me privately. I had not known her before. In fact, most of the people I really had not known from before.

There was one position I filled with someone whom I had known before and I had no problem putting that person in, but not in the senior position, Dr. William Bennett. Not Bill Bennett the drug czar, but another Bennett whom I had known because I had served on various NIH review committees and advisory councils. Bennett worked out at NIH. I wanted to have someone in the office who looked over appointments to various advisory committees and councils in the department at NIH, CDC [Center for Disease Control], FDA [Food and Drug Administration], Social Security, and others.

That was a major responsibility there because first of all, I wanted to get competent people, but also people who were in agreement with my policies. So I put Bill Bennett into that office to do that vetting and I didn't have any opposition there. But, say, Kevin Moley, who was my Assistant Secretary of Management and Budget, I met him for the first time--and oh, just most of the people. I didn't have any problem, but at the same time, I think it may very well be because I didn't really have a long list of people. I wasn't saying, "These are the people I want," because I had not been in political life before.

I also felt it important to have people who were knowledgeable about the political system and who also had their connections, because I felt I would need that and could use it as a Secretary who did not have that connection. My one connection was with the President, but all these others--and of course I knew some Members of Congress like Orrin Hatch and so forth. But I was very much aware there was a whole area of interactions and personalities and organizations that I really did not have any relationship with and so it would be to an advantage to have a number of people on my staff who did have those connections.

The main question was, would they be loyal to me? Also, were they competent? Because we didn't want to put someone into a position who was not competent, for obvious reasons.

The abortion issue surfaced again with the nomination of Robert Fulton as Assistant Secretary. Any recollections from that event? He has to withdraw his nomination, I guess, at some point due to opposition from right-to-life groups.

I remember that. I remember Bob, who was a good man. Actually, this is going back quite some time so my memory may be off, but it was expressed more broadly than that. I think it was about his policies on welfare and that sort of thing. What happened, there was Fulton himself who initiated the action to withdraw. That is, I didn't suggest that to him, but I know that he--I know there was one other person--Drew Altman. Drew Altman was from New Jersey. He had been one of Governor [Thomas] Kean's state officials there, because I wanted Drew to come into the department and he came down. He was interested, but again, he withdrew when there was opposition expressed to him too. In both of those instances, it didn't end up with me going to them saying, "I think we need to do this," but they did this themselves.

Early on, I guess the whole issue of your position on needle exchanges and the President's position caused another--could you tell us a little bit about that?

Here again, that was a position that I took. Frankly, this is one of those areas of compromise, and I can tell you I honestly was not comfortable with that, because I approached this from a public health standpoint. My thinking, and my goal, was to do whatever would be helpful to diminish the transmission of the AIDS virus as well as hepatitis and a few other things. But then the ideological issues that came in were are we promoting drug abuse by making availability of needles easier, and so forth. So this is one of those areas where already now having been bitten or surprised by this abortion issue, and having this issue flare up and looking at this, I decided that this was something I needed to get rid of this as quickly as possible.

So right, I had to alter my position there. Again, this was a compromise that I really wish that I had could have avoided having to make.

The White House was pressuring you to modify your stance? Is that an accurate--?

I guess you could say so. The pressure was not any pounding of the table, but I know there were many times in the press I was painted as having a big fight with either John Sununu or Dick Darman or what have you. The reality is that we'd be sitting like this and Sununu would say, "What the hell are you talking about? What's going on," kidding like that. So it was more persuasion and jousting and that kind of thing, because we were working to try and develop a relationship and be part of a team. It was really that kind of thing. Sununu would say, "What do you really think about that," and, "See if that's where you really want to come out, because this is a big problem," and all that sort of thing. So I was persuaded that way, that this would be the preferred position to take.

The press, the media perception of John Sununu was of somebody very heavy-handed, gruff, perhaps even arrogant. I was wondering if you would give us your assessment of John Sununu, the person you knew.

I guess it's fair to say yes, he's all of those things, but that's incomplete. He's also a very approachable guy and someone who also wanted to be very helpful. He, the big political operative there, knew very well that I was a political neophyte. He could have kept his distance and said, "We'll let this guy sink or swim." But he didn't do that, he really tried to be helpful there. I formed a very good relationship with him.

I mentioned the tobacco thing where he was supporting me on my side in his own way there. And he had a great sense of humor. We'd always kid each other about--let's see if I can remember some of the specific things here. I developed a very good relationship with Sununu even though politically, ideologically we were different. He was obviously much more conservative than I, but he was respectful of my position, even when he disagreed. I also felt that a number of times he was looking at the politics, rather than the ideology. Saying, "This is a bad issue to have out there in the press, we need to resolve this. It would hurt the President or it would hurt you," or something like that. "So how do we get this off the table as quickly as possible?" As opposed to, "We don't believe in that," or that sort of thing.

He was helpful. I, even today, have a good relationship with him. As you probably know, there's an annual luncheon, Christmas luncheon, the first Friday in December of every year. He usually comes to that. I'm going to miss it this year because I'm going to be out of the country with Tommy Thompson in Africa, but we'd see him and his wife there. So I had a good relationship. Meanwhile, out in the press, it was this knock-down, drag-out thing and it was really not that way at all.

I think again, fundamentally, I approached this as I was a member of the team. I didn't see myself as coming in there to overrule the President. I mean, this is the President, this is Bush's administration. I saw my role as trying to persuade if I had a different position and to be a success if I could persuade, and then being willing to compromise when I felt that I couldn't persuade and live with that. Here again, on something I felt that I couldn't, then I said, "Well, I'll just have to take the consequences." But I did not want to get out and take a position that would be directly contradicting the President, because I was there as a part of his team. My friendship for him also was such that I would not want to do that.

President Bush came into office promising a kinder, gentler administration. Were there certain actions, steps, policies that HHS pursued in light of that that sort of distinguished the Bush administration from the Reagan administration?

Sure, we doubled Head Start funding. He made a major announcement early in his administration to expand the Head Start program. We increased AIDS funding here. In fact, this infamous San Francisco AIDS conference that I attended. Actually, I went to President Bush, I was going out for that conference, and I tried to convince him to go out with me. I said, "This would be a great thing if you were to do this, because the public perception is out there that we don't care." Quite frankly, I was pretty miffed at some of the AIDS organizations because they always had things in absolutes. That is, we had increased funding, we were doing a number of things--and again, certainly not perfect, the needle exchange issue was one--but overall, I felt that Bush was making a real effort. But he said, "Lou, I don't think I can go out to this. I'd just be a lightning rod. But you go, I'm sure you'll do a good job," and so forth. So that's what happened. So we had that kind of relationship.

You've mentioned some of the priorities. Were there other priorities of yours as well that we've not--

Oh yes, sure. Increased programs that were really helpful to the minority community. One of the things we did was establish a minority male initiative, it was a $100 million initiative to look at the whole issue of minority males, high dropout rates from school, more drug abuse, more violence, all those things. So we put together an advisory committee to initiate a number of programs to try and address that.

We also expanded the funding for the National Health Service Corps, because that had been cut quite significantly during the Reagan years. I was aware, from my own position at Morehouse as well as within the medical education community, that this was a very important program that was really helpful, because of the fact that there were so many young people who were supporting their health profession education by signing up for the National Health Service Corps. There had been reductions in student financial aid programs, the health profession student loan program, the National Defense Loan program. So we worked to increase those and we were able to do so to a fair degree, but not to the degree that I wanted.

That is, I'd have to check my math on this, but I think the National Health Service Corps program was something like a $350 million program when Reagan came in. He cut it back to I think about $130 million. I got it back up, I think, to almost $200 million. So I made some progress pushing back, but not as far as I wanted.

Also, I made a commitment to appoint more women and minorities to senior positions in the department and that I did. I feel very good about that, because that, along with the committee appointments I talked about earlier, I was aware of the fact as Secretary, that I was going to be there for a finite period of time. I didn't know how long, but my thinking was, If I could get people in place in this department, whose ideas and positions are really supportive of the kinds of things I want, this would be a life beyond my time.

For example, I mentioned my three chiefs of staff. The first one, Everett Wallace, is African American. The second, Michael Calhoun, is also African American. The third was Robin Carle, a white female, the first female chief of staff in the department and she went on after our administration to become the first female Clerk of the House up on the Hill. Social Security Commissioner, Gwen King, African American female. The HCFA [Health Care Finance Administration] administrator was Gail Wilensky, a white female. When she left to go over to the White House as health advisor, helping to work on the health plan with President Bush, I appointed Bill Toby as acting HCFA administrator; he was African American. Then the first female and first minority Surgeon General was Toni [Antonia] Novello, a Hispanic female, because up until that time the Surgeons General had always been white males.

So throughout the department there were appointments like that. I had indicated to President-elect Bush when he talked with me what were some of the things I would want to accomplish, and I said that this would be among them. He said, "Fine, that's great. I support that." So we were able to do that reasonably well. And of course, Healthy People 2000 initiative, emphasizing health promotion and disease prevention, was another. In general, more support for health professions education. So there were programs like that that we felt--and another thing that we accomplished, of course, was the food label.

The longest meeting I had in the Oval Office was a fight I had with Ed Madigan over the food labeling. Ed was Secretary of Agriculture at the time. Of course, I knew he was really beholden to the agricultural industry, including cattle farmers and dairies and all of that sort of thing. He was arguing against the food label because his argument was it would be confusing, we already had a label that worked well, and why do that? But my position was no, we need to have a label that gives people more information in a form they could use. Somebody reads the label that existed at the time saying, "This has 17 mg of sodium," what does that mean? Or it has 250 mg of fat, or what have you. We need to have a label, which we'd come up with, saying this is how much of a daily amount, so that people could do that. If we're going to be successful with our Healthy People movement, we depend upon people taking actions themselves to preserve and enhance their health. We need to give them information that they can use so that they can construct a diet that's consistent with that.

Again, President Bush's philosophy for us in the administration is, we can disagree all we want around the table here and we'll work things out. But we do it in here, not out there. If you guys, between departments, have issues you can't resolve through the normal thing, bring them to me. I think that was one of the few issues I had a disagreement with another Cabinet Secretary that we took to Bush. That turned out to be an hour and a half meeting in the Oval Office. Meetings in the Oval Office for me were usually about 15 or 20 minutes or so.

So we made our arguments there to the President. I made mine; Ed Madigan made his. I included the fact that I'd gotten a placemat from McDonald's that showed something very akin to what we were wanting to implement. So when Ed, I knew what he was going to say, so when he said, "People won't understand this," and so on, I said, "Well, gee, Ed, if that's the case why would McDonald's, who serves more people than any other company in the world, why would they have this placemat?" The President says, "Let me see that." So I knew, with that. Anyway, after the end of the hour and a half or so he said, "Okay, fellows, we had a long discussion, good discussion, everybody has aired their views and this has been very helpful. I'll think about this and I'll let you know about this. But remember, whatever we decide, we're all on the same team and we're all together and so forth, and this is all within this room."

About three days later I got the call that the President has agreed with your position on the food label. So I then called the FDA, and Carol Scheman was our associate commissioner of the Food and Drug Administration for Public Affairs, because [David] Kessler was away at the time. I said, "Okay, Carol, tell Dave that we won. We got the approval for the food label, but remember, no gloating. We're all on the same team and so forth, including Ed." The next day in the New York Times, they quoted Carol Scheman as saying, "Oh yes, we're very pleased with the President's decision and we're trying hard not to smile." [laughter] So much for really--I guess, very smooth, I couldn't say--but anyway.

Can I ask you about this hour and a half meeting? How active was the President? Was he sort of watching the two of you go back and forth, or would he intervene frequently? What was his MO [modus operandi] in that meeting?

He didn't intervene too often, but he would. He was part of the conversation, but it really was me and Ed Madigan playing out our issues before him, with him being more the judge rather than the participant. But he would ask a question. I think we felt comfortable, and I think Ed felt comfortable. He made his best--he had his chance. We weren't rushed out of the Oval Office saying, "I'm sorry guys, we're out of time," that sort of thing. We knew that one of us, one position is going to have to prevail. We didn't see where there'd be any compromise, any mixing and matching here. I think had it gone the other way I would have been disappointed, but I again would have then said, "I gave it my best shot and I can't say I wasn't heard," and so forth. Again, the Bush philosophy was, "We're part of a team and we'll have differences but the differences will be inside here."

Let me ask you about that, because one of the typical problems of a Cabinet member coming in is, sure, everybody is a member of a team, but there are different perceptions on which direction the team ought to go. Typically the view looks a bit different if you're on the White House staff than from a particular Cabinet agency. So let me ask you about this. How did you feel generally your relations with the White House staff were, and can you tell us a little bit about your routine interactions with the White House staff, any of the problems you may have experienced in dealing with them, people that you thought to be particularly helpful and maybe those you found to be particularly good infighters that gave you trouble on occasion.

There's no question that the White House staff really were around the President. At times, they were carrying out the President's message on dealing with us, but they were sophisticated. Again, there wasn't this pounding of the table. It was really saying, "Lou, let me explain to you the President's view in all of this." They'd say, "Gosh, isn't that reasonable? Can you support that?" and all that sort of thing.

The two main people at the White House I dealt with were Sununu and then later Sam Skinner, and Darman. When I would have issues about the budget or the proposals, I'd meet with Darman. At times he'd say, "Gee, let's see if we can find a way to address this," or he might say, "Lou, we just don't have any money. There's just no way I can see that." He would say, "Look, if you're not happy with that, we'll go to the President and let him decide on this." So that was the relationship. Again, Darman was a pretty tight fiscal manager. But here again, he was not unpleasant.

Now, interestingly enough, you move down the food chain, there I think the animation became a lot more active and maybe the comments more pointed. But even when Darman was saying no, he'd be saying it with grace and at least convincing me he understood and sympathized, but this is the reality, there's just not that much in the budget. Here we have these things over here, that sort of thing. So it really wasn't a decision made without my getting an opportunity to give my input and have my views listened to.

Darman's reputation is not universally as favorable--

Positive.

Or positive as you paint it. There are those who evidently felt that he had very sharp elbows. It's interesting here that you didn't feel that you were in a situation where you felt that.

Let me put it this way, try to be as accurate as possible. There were a number of times I didn't get what I wanted, but I always found Dick to be very cordial. He would listen and he didn't use sharp language, or didn't use language showing contempt for my position, that sort of thing. Now, maybe that was my interaction with him, I don't know. But among other things, it was known that I was a friend of the Bushes. I was there not on the basis of any political steam from elsewhere. For example, Sam Skinner came in--I've forgotten the political boss in Illinois, he had a lot of political steam behind him. I don't know if Sam had a personal relationship--and I don't think so--with Bush beforehand.

So it may be because of my relationship with the Bushes--I have no idea. All I can say is no, that the Dick Darman who was described in the press was not the Dick Darman I dealt with. Now, he wasn't a guy who would say, "Lou, I'm going to give you whatever you want," or that sort of thing, no. Because he did say no a number of times, but he would give me the rationale and so forth. Also, as I said, would offer, "Gee, the President's standing rule is we can always go to him." And we did that on a couple of things.

I was going to ask, could you give us some instances where you did go to the President if you can recall, where you and Darman may have differed?

I think on National Health Service Corps funding, that was one area that we went. I don't know if we got everything that we wanted, but made some progress there. I came away from those meetings feeling that part of it was giving a perspective that perhaps the President understood and resonated with. Also, I think part of it was the President wanted to be sure that I won some, that if there was something that he could manipulate so that I would win here. And Dick understood that also. It's interesting enough, he has a place up in Martha's Vineyard. I'd never run into him, but we'd go to the same hardware store and the guy says, "Dick Darman was just in here yesterday. He said if I saw you to say hello and come by for a drink," and that sort of thing.

So no, we had differences but we were cordial about them. I can't really remember anyone in the administration, say over at the White House or any other Cabinet Secretary--even Madigan, where we had the most severe differences--where we really were uncivil. That was not the case at all. Frankly, I saw that as part of the environment. I'm Secretary of Health and Human Services; I have interests here. Also I'm a minority in the Cabinet. I was very much aware of that too, that I have my own issues and I also have those perceptions out there. I think they understood that too.

Can you elaborate on that a little bit? I mean that's a subject that we haven't really probed you about much, the extent to which that occupied your thinking as a member of the Cabinet. Were you looking at a broader horizon of issues than those of just--?

Sure, sure. I would have to say that this was part of the calculus with so many decisions that I was involved in. See, from my perspective, the most important issues, the most important departments so far as the African American and perhaps other minority communities are concerned, are HHS and Education.

Other things like Commerce, yes, they're important. And State, yes, we're American citizens and we want to be sure that our position around the world is one that we feel good about. So we weren't taking leave from these other things, but the important issues for the typical black family are a job, health, the education of the children. Really, things to make sure that their life is better than my life. That was what my parents' goal was. They made a lot of sacrifices to try and achieve that. They sent me and my brother back to Atlanta to go to school when I was in fifth grade because the schools in Blakely for blacks were terrible.

That meant that during our growing up years, we were away from them a lot, but they were just that dedicated. I think it paid off. So again, my background is education and health, not business. I felt I knew something about both to a degree. I felt that I was dealing in my department with issues that are very important to the African American community and the Hispanic community, the Native American community, and to the larger community as well. The health of the population, the health of our citizens is very important, even though many people don't think about it. But you can't build a strong economy if you have a sick population. We see that in Africa right now with AIDS and other things like that.

Did the President ever call on you, either in public meetings or bring you in one-on-one, to ask you about his standing in the black community or the way that various administration policies were being perceived within the black community? Was there a kind of formal ambassadorial role that you accepted?

I wouldn't say it was formal, I'd say it was more informal, but it was very clear it was there. For example, when the Watts riots broke out, the President called me and asked if I could come over to the White House to engage in meetings with him and Sununu and others. We were there in the Oval Office watching television with the Watts riots and talking about what to do and so forth. When the President went out to California, I went with him and we spent two days or so out there, meeting with various groups.

There were a number of other instances the President would ask me to go with him to some event in New York, the Urban League convention or other things. Also, when he had nominated Clarence Thomas to be Supreme Court justice, he was up at Kennebunkport, asked if I would come up along with Constance Newman, who was then head of the Office of Personnel Management, to help try and get support from the black community for this nomination, which we worked on doing. I did get an endorsement from SCLC through Joseph Lowery, one of the civil rights organizations that gave him an endorsement. But the others I went to, Houston, met with Ben Hooks at the NAACP convention, they said no, they could just not support him.

The Urban League said, "We'll take no position. We won't oppose him, but we won't support him either." Went to a couple of Baptist church conventions there too. So while the President never said to me, "Lou, I want you to help me with the black community," in essence what he did was--and I didn't object to that at all. I saw myself as an American first, but also as a minority American who needed to help address minority issues. I didn't see myself as running away from them and saying, "I'm Secretary of everybody and I'm not going to have any special interests." Hell, that would be running away from the reality that had confronted me all of my life. So I did want to do everything I could to be a bridge and be a source of communication and to be a change agent to address these issues. So there was never any formal request or anything like that, but in fact there were a number of instances like that.

Then there were other instances when the President asked me to go with him simply as his Secretary of HHS. He went over to Johns Hopkins to speak at I think their centennial convocation and I went with him there. I had a couple of other things like that. So it wasn't always my going "as the black in the Cabinet" and so forth.

Exactly. Can I stay with this please?

Please, absolutely.

In your individual conversations with the President, did you find that he had a good ear for minority concerns? I mean, you've already testified that his heart was in the right place. My question is more one about his own political instincts and understanding about how things resonated with black Americans.

I guess, my interpretation, or my summary of the President's position on this was that this was something he was wrestling with. My own interpretation was that he did have strong feelings there, but he also was a political being where he felt that some of these policies were not popular. As you know, he vetoed the civil rights legislation although interestingly enough, some months later he signed almost an identical bill. So I think that he was responding to political tensions. He called the first bill--what did he call it?

A quota bill.

A quota bill, yes. So I think there was that tension. My own interpretation of the President's position, generally, was the fact that here he was, having been part of the Reagan administration, more conservative, generally viewed as a very successful administration overall. Reagan was one of these larger-than-life figures, although within the black community Reagan was not generally that popular. Nevertheless, the reality was understood, we understood that Reagan was very popular here. Again, my interpretation is Bush, having run against Reagan early and not getting the nomination, but then being asked to become Vice President, saw the political reality he was dealing with and decided that if he's going to become President, and also be successful in his administration as President, he's going to have to modify or attenuate some of his positions on a number of issues.

Now, again, I keep saying my interpretation, because Bush never said this to me. But as you get to know someone, you don't have to ask questions about everything. You can figure out yourself, you know how they think and you know their history and so forth. So that was my interpretation, that he really wanted to do a hell of a lot more, both for education, because of his lifelong commitment, his family's commitment to that. But again, with many people who were more conservative about funding for education, that he could take that only so far.

Let me push you in that direction. You have a unique window onto not just the President himself, but the political forces that are acting on the President from your perch in the Cabinet. I wonder if you could tell us a little bit about--I'm trying to figure out the best way to phrase this--but if Bush was attempting to deal with realities within a Republican Party that were not viewed as being friendly by African Americans, what can you tell us about those forces? I mean, did you see things within the Cabinet that concerned you in terms of their not being particularly friendly toward African Americans, either coming from the Hill or from other Cabinet agencies? Again, it's historically important for us to understand this particular period, so anything you can do to help us shed light on this would be helpful.

I cannot recall a conversation or being part of a conversation that really spoke in negative terms, say, about the African American community or aspirations, but I'm not so na?ve as to believe that some of these conversations may not have occurred elsewhere here. But I think, for me, the main expression of that was really the budget. That is, what happened in terms of where the dollars go.

Again, Bush put a lot of money into defense. For me, I felt that it would have been a better use of those dollars coming over into some of the programs in my department here. But again, I was very much aware that the President's view is a larger view than mine. He gets a lot more information from a broader array of advisors and informers than I, as well as dealing with the Congress and various constituencies out there. So I was very much aware of not only what happened in terms of the view of the black community with the Reagan years, but also Bush being viewed as "an extension of Reagan," and therefore of Reagan's policies, that there were some issues there.

But I did feel that on a number of issues that the President was responsive to the things that we wanted to do, increase funding at NIH, et cetera. At that time, if I remember correctly, I think our funding for NIH was $8.1 billion and I think we took it up to $11.6 billion, which we thought was a great increase, and that was before the NIH doubling efforts the last few years. It's now about $28 billion. Whereas there were a number of things that we were not able to do, not able to convince the President or his advisors around him, there were a number of things that we were. So I felt good about that.

And, as a symbol of how, perhaps, I was viewed in the black community, you may remember the time when Pete Stark said I was a disgrace to my race. Of course, you remember that well. Interestingly enough, about a month or six weeks after that, there was a program at a church in Oakland, there was a Reverend Alfred, I've forgotten his first name. This was Ron Dellums's district and Barbara Lee, who is now a Congresswoman, who was his chief of staff, organized this program to honor me at this huge black church, the largest black church in Oakland. And she's a Democrat. So what she and the community were saying is, "We determine who our people are, who our heroes are, and not Pete Stark." Pete Stark's district was the next one. So really, things like that were saying to me, "We're the same--you're a Republican, you're in administration, you have limitations. But we just want you to know that we support you and we want to say this publicly."

You're moving in the right direction.

Yes, right.

One follow-up question on something that you'd touched on earlier and that was Clarence Thomas's appointment. Do you recall being consulted by the President or by anybody in the White House before the nomination was made about how the vacancy was being viewed in the black community?

Let me think about that. I did have a conversation with the President. Now the question, I don't remember frankly if I talked with him about Clarence beforehand. I don't think so, but I'm just not sure. If we did, I don't remember it. But certainly after his nomination had been made, the President, as I mentioned, asked me and Connie Newman, because Connie was the highest-ranking sub-Cabinet agency head there in his administration, asked if we could really help generate some support for him, which we said we would do.

I met with Clarence after that because I frankly had not known him. But he convinced me that although he was viewed in some quarters as conservative, that his heart was in the right place. He said things such as, "I'm like you. I'm from Georgia, from Pinpoint, Georgia. Grew up poor. I haven't forgotten my roots," and all that sort of thing. So he was saying the right things. Again, I believed him. So I committed both because the President had asked me to and then meeting with him and being convinced that he had been misunderstood or misrepresented, but I would really work to try and help get his nomination.

Why do you think the SCLC was receptive to your overtures when others were not?

Well, tell you what happened there. We had a meeting up in Connie Newman's townhouse up in Capitol Hill where she lived, with Clarence Thomas and Joseph Lowery and a couple of his lieutenants, where we met for about an hour. Basically, when I went to Joe Lowery--whom I'd known of course, being there in Atlanta--he said, "Before I can make any commitment, I need to meet with this man. I need to look him in the eye. I need to determine for myself what he's made of." So we arranged a meeting.

And Clarence said the same kinds of things to Lowery that he said to me. I remember Lowery told him, "Look, Judge Thomas," or whatever he called him. He said, "I'm an old man. I don't know how many more years I have here, but I'd like to go to my grave feeling that whoever replaces Thurgood Marshall has our interests, that is, the black community, at heart. Is going to keep these issues in mind with the ruling that he or she makes," et cetera. Clarence says, "Reverend Lowery, on that score, you don't have to worry, because I'm going to be making the right decisions." So he convinced Lowery and Lowery said okay. Lowery then went to the SCLC convention, which was in Birmingham, I think, a couple of weeks later, and got an endorsement. Lowery's stature was such that if he asked the organization to endorse him, they did.

I'll tell you, while Lowery and I are still friends, he occasionally digs it in, "You got me to vote for your man." And I would have to say I'm disappointed and feel betrayed by that episode because it's clear that Thomas has not been the kind of judge he said he would be. So that is something I feel badly about. I also believe that President Bush felt he was going to be a different justice. I haven't talked to President Bush about this and I don't intend to, I wouldn't really put him on the spot that way--

If we get the chance, maybe we will.

Okay, fine. [laughter] But that's how that happened, so really Lowery came to Washington with his people and we had that meeting and so forth. I don't know, have you met with Connie Newman?

No.

You might ask her. I think you'd find her position is similar to mine, that she felt that she was used by Thomas, not by the President.

I don't want to pursue this any longer--

One thing, this is sort of a sidebar comment. When I was sworn in as Secretary, Judge Leon Higginbotham was the person who swore me in. I called Thurgood Marshall, asked him if he would swear me in and he said no. I then asked why. He said, "Congratulations, I hope you do well, but I think that my having been appointed by a Democratic administration may not serve you well, or me well, for me to swear you in." I think it's clear that he simply did not want to have anything to do with a Republican administration. But Higginbotham fortunately agreed to do that, because I did want to be sworn in by an African American judge of standing. Because again, my goal was not to run away from, or deny, or act as if I'm not African American. I'm African American and proud of it, and want that to mean something in the administration and so forth. So that's my sidebar comment.

I think it's very important and I think it's a good piece of evidence for us to have on the record, because I'm not sure that we could count on just anyone in your position taking that position. I have been interested in the subject, but was inclined to allow you to bring it up before getting it elaborated on, so I appreciate your candor.

Sure.

You mentioned you went with the President to Los Angeles after the LA riots.

Yes.

Anything that stands out from that particular trip? I mean, there was a lot of criticism at the time directed at the President for not having a domestic policy, particularly directed toward the inner cities. How did that trip go?

It was a tough trip because here we were, seeing these areas devastated by these riots here and just the carnage as a result of that. Of course, I think we in the administration were trying to determine, how do we respond to this? Because yes, the President was criticized. He was criticized, I think we went out something like three or four days later, he was criticized because we weren't out there the next day. This was one of those situations for which we were not well prepared. We were trying to figure out, What do we do, how do we respond to this?

As I mentioned, I was called and asked to come over to the White House and we were in the Oval Office. We were watching all of this. So when we were out there, we met with various groups to try and figure out what had happened and why, and what were some of the things that we could do. There was a lot of emotion, a lot of people with accusations: "You don't have a policy that is helpful to blacks or to the inner cities," and so forth. Bush's position was that "I'm here to listen, and I want to learn from this and see if there are things that we can do or things that we should change. I didn't come out here to make speeches." In fact, you may remember, I think the President made very few speeches there. You saw a lot of him walking around, viewing these different communities.

We had a lot of meetings. I think we were in the Bonaventure Hotel, if I remember correctly, a lot of meetings in the hotel of individuals and organizations that came to meet with us. But I guess the fact was that we were really flat-footed. We were stunned by this and trying to figure out what to do. In a situation like this, here's a national crisis, the President's always supposed to have an answer, always supposed to be ready with a plan or something, and we didn't have that. So we were very much aware of that.

The story at the time and I think it has persisted to this day is that the President really never did develop a domestic policy. Particularly as the '92 election approached, there was some attempt on the part of yourself and I guess Jack Kemp and others to try to push for a more assertive domestic policy and that Darman perhaps killed it, essentially. Could you give us your whole take on that?

I would say certainly within Bush's Cabinet, Jack Kemp and I were the guys who were most outspoken on the fact that we needed to have a more robust domestic policy, well articulated, et cetera. We had some meetings with other Cabinet officers, in the absence of the President, saying that too. Of course, there were a number of things going on. First of all, up until the First Gulf War, which started in January of '91, there was a buildup. In other words, a lot of the attention was focused on this situation where Iraq has invaded Kuwait, Kuwait's our friend, plus there's oil here and we clearly need to be responding to that. This is a more urgent situation, we have to deal with this, et cetera. So we felt we had that gradient we were working against there.

Then, of course, with the war occurring, which really everyone felt was a success. I mean, it was over very quickly. We had all these other nations right there with us. We freed Kuwait and all of that. As you remember, the criticism of Bush was for not going on to Baghdad. A lot of people were saying, "Why the hell didn't he do that?" Of course, he said they didn't want to get entangled in ongoing issues in the Middle East. After that, remember, we took what was really a fatal position, with Sununu saying, "We're closing up shop and we're going to coast to the election," or words to that effect. "So why do we need to diddle with these other things here?" That obviously was a real mistake because, as I remember, Bush's rating was something like 92 percent favorable at the time, so we just saw this as insurmountable there.

I know that my thinking was, Well, there's no point in shooting off our guns in this battle. I mean, we've lost this. Let's wait until after the election and then we'll mount this again. Of course, "after the election" never came, obviously. Darman's position was, "We've spent all this money, we have to pay for this. Sure, this is something that would be nice to do and urgent, but what is more urgent is the nation having a budget that's in balance or close to balance, and paying off these debts. Once we get these things out of the way, then we can look at some of these other things." Frankly, we just could not get any traction on that. I remember other members of the Cabinet saying--not in so many words, or it was never so overt--saying, "This isn't going to go anywhere so why waste time."

It's not going to go anywhere with--?

That is, developing this domestic policy. Darman's position, and also the President's huge popularity, and really saying the best thing we could do now is get ready for the election. Let's just enjoy this, coast, et cetera. So why stir up these things? The unspoken message, which we had understood from that, was that for our conservative friends, for us to do this, why stir up that? That is, we have a lock on the election, we're very popular, we've done things right. So let's not take any chances by getting into these other areas. Let's just go with that. So that was one of those areas where I think clearly Jack and I were not happy with that, but again, we felt, "Okay, we're big boys, we're political realists. We need to fold our tent and fight another day."

You had a good relationship with Jack Kemp?

Oh yes, very good relationship. I would kid Jack as being Secretary of all departments. Jack always had an opinion about everything and would tell you what you should be doing over in your department and so forth, but we had a good relationship. He would be talking about Head Start or something else. Have you interviewed Jack yet?

We have not.

What you'll find is this guy has unbounded energy, unbounded enthusiasm, has an opinion about everything, which he will share with you whether you want it or not.

So it will be an easy interview.

Just ask one question and sit back and write. [laughing]

Not everyone found that as endearing as you.

I know, I know. And of course, Jack was a guy who--you use the term "compassionate conservatism." Jack, from his own personal conviction, and he feels deeply about this, really, he wants to see more blacks in the Republican Party. Black capitalism, black businesses, and so forth. I think what Jack was saying was, "Gosh, I understand the feelings in the black community, no jobs, poverty, et cetera. I feel the same way and we need to do something about it." So Jack, yes, to his credit, can put himself in other people's shoes and feels for that. I'd be kidding him about things, making pronouncements about my department, because underneath that I knew what was really at work was his good will. But if you were someone who was very territorial, you wouldn't particularly like that about Jack. But we got along great.

You haven't mentioned Roger Porter's name today and Roger was the director of the domestic policy shop in the White House. Did you have much interaction with Roger? Was he much of a player in this administration from your perspective?

Roger was a player, but the picture I have of Roger is that he played behind the scenes. That is, he would convene the Domestic Policy Council and we'd have discussions and so forth. Whether this is a correct perception or not, my perception is that Roger was not the prime mover. Roger was the guy who got the trains running and that sort of thing, but he wasn't the guy saying, "I want this train to go to Baltimore." Somebody else would say, "I want it to go to Baltimore," and he would figure out how to get it to Baltimore. That may not be an accurate or a fair perception. Roger was, again, a nice guy. I had a number of conversations with him.

The persons who were driving things as far as I was concerned were Dick Darman on the budget and Sununu, when he was there. Sam Skinner was not as forceful after Sununu left, but Sam was the guy we looked to. Porter was there and he was helpful, but he wasn't, at least for me, he wasn't the guy I went to with an issue or for advice or help.

Is it fair to say then that ultimately the President endorsed the opinions of those who said we can just essentially coast into '92?

Yep, he did. Big mistake, but he did. I'm trying to remember now. There was an issue that I really felt very strongly about; it'll come to me later. Oh, yes. As you know, I was very active in being outspoken against tobacco use. I went to the President, I guess maybe during the third year of his administration. I'd already made all HHS facilities in Washington and around the country smoke-free. I wanted to get the President to pass an Executive order to make all federal facilities smoke-free. When I first went to him about this he said, "Lou, that's an interesting idea, but really if we're going to consider something like this, we need to put this through clearance." Meaning, put this through the other departments to get their positions. So we did that.

Initially we got support from HUD [Housing and Urban Development], from Labor, and from a bunch of departments. As I remember, the ones that said no were, first of all, the State Department. Their position was, "We do negotiations of a lot of things here and the people we negotiate with, most of them smoke. And we don't want anything interfering with that. We don't want to have some guy with a nicotine fit trying to have some international negotiation, or being ticked off," et cetera. So we made some exceptions in the whole process. We said, "Okay, State Department, except for these areas," et cetera. So we were able to get that.

The Interior Department said, "What do you mean, smoke-free facility? One of our facilities is the Washington Mall. You mean people on the Washington Mall can't smoke?" So we had to go through all of that. To make a long story short, we ended up with agreement. Oh, the VA's agreement--Of course their veteran constituency, a lot of them, are smokers. They said that we shouldn't deny veterans who have served their country if they want to smoke, so we would say that the smoking facilities in veteran's hospitals and all that sort of thing. We got a lot of conditions with this. The one department we did not get was the Agriculture Department.

So we got this, and this is about three months, I guess, before the election in '92. We sent this over to the White House: we've gotten this clearance, would the President sign off on this? It took a long time. This is one of those areas--you mentioned Roger Porter--where I had the feeling that he and maybe a couple of other people were really the responsible people. I don't have any proof of that; this is just a suspicion. So I spoke to the President about this. He says, "Okay Lou, I haven't seen it yet. Let me ask about that," and so forth. "I've asked for this thing and it hasn't come yet."

Well, the election came and he lost. I went to him and I said, "Mr. President, we've done this. You would be hailed by the health community if you were to do this. We've gotten the clearance," and so forth. He then said, "Lou, you know, I've lost this election, and I don't feel that I should encumber President [William J.] Clinton with something in the waning days of my administration. I think they should really decide what they want to do with this, because in a sense it wouldn't be fair to the incoming President." My thought was, That's a pretty damn good-sounding argument and a perfect way of ducking this, saying that, et cetera. Again, as I said, Bush never really opposed anything I wanted, but again, didn't really stick his neck out there either. So that's what happened.

And what happened? I did get Bush to take the ashtrays out of the Cabinet room in the White House.

Do you have that in your book, Martha?

No.

No, now that's a small victory, but it's very symbolic. Because the first time we had a meeting with the Senate Republican leadership, Pete Domenici came in smoking and flicking. I said to the President later, "Mr. President, we made HHS facilities smoke-free. We really represent the American people here in the Cabinet room; you ought to remove those ashtrays." Those pewter ashtrays have been there I guess since the White House was constructed. They went out, so that was a small, symbolic victory. So the next time Domenici came in he had to wait until the meeting was over before he got a smoke, or go outside.

Clinton comes in, one of the first things he does, he makes the White House smoke-free. I'm steamed. I said, damn. Again, minor thing, symbols, but as you know, symbols are important to people in terms of the symbols we send out as leaders here. At any rate, that was one of those interesting things that happened.

To what extent do you feel that Bush became fatigued? Did you have any sense of that? Was he physically exhausted by the Presidency, or do you think he was coasting because of some political calculation?

There were reports at the time that he was having some health problems and just almost literally ran out of steam.

Yes, yes, we were aware of that. Frankly, we could never really figure that out, because in one sense there was logic to the position that, "Well, we have this big lead, so why should we risk it by something here? This will take us to the election, so let's just stick with this." On the other hand, there was the issue of the economy, which we were very much worried about. Of course, people were saying, "The economy is turning around. The figures, the economists tell us this." But the problem is, the people don't feel anything. They don't see anything yet.

I didn't get the sense myself--I don't know about my other colleagues in the Cabinet--I didn't feel that Bush was physically, mentally fatigued. Maybe we all get a little tired, but nothing in terms of an overarching, brooding fatigue. We felt that this was a political calculation. We were worried about the economy; there's no question about that. Of course, Jack Kemp was another person who constantly was talking about this here. Secretary of the Treasury and Dick Darman and others were saying, "All the reports are things are turning around," et cetera. But we'd say, "Gee, nobody feels that."

You clearly had a friendship with the Bushes before his election. Did you continue to see them socially at all?

Oh sure. I was just talking with President Bush last week in fact. Frankly, what I called him about is, there is a Mr. [Michael] McCaul, a fellow who's running for, there's a new congressional district in Texas. He's running for that. I was asked by a friend of mine in North Carolina if I'd be willing to be one of the co-hosts for a reception for this fellow in Texas. This friend in North Carolina is one of those persons who has done a lot of things for me. Therefore, I would feel, Gosh, if he says this is a good guy and this is a favor, I would want to see if I could do that.

I called President Bush. I said, "There's this guy McCaul. They say that you know him and the family and all that sort of thing." He said, "Gee, Lou I don't really remember, but let me go back and look and I'll get back to you. You know, I meet a lot of people." I got a call back from him. I was out but he left a message that yes, indeed, he does know the family, good people, et cetera. He also said, "Now remember, this is before the primary," which is his way of telling me, are you sure you want to get hooked into this person here?

Then he also sent me a message--this was this past Friday and I was in Los Angeles--a message that he'd been asked by one of the educational associations of black colleges, state colleges, NAFEO [National Association for Equal Opportunity in Higher Education], I don't know if you're familiar with that. They'd like to come and meet with him to talk about strategies, get his ideas about fund raising. So he's asking me, "Lou, is this something I should do, or what do you think?" Because basically what he said to them initially was, "I'm 80 years old, and while I'm still active, I'm really trying to wind down and definitely not take on anything new." They came back saying, "Well, if you just let us talk with you, we'd like your ideas." So then he asked me, "Is this something I should do?" And I'm going to tell him no, because I happen to know these people and I don't think particularly of them.

So we have that relationship. And he and Barbara currently, for example, are honorary cochairs of an endowment campaign we have for the medical school. I was out in Houston I guess about four months ago, maybe it was six months ago, and visited with him. We were talking about the endowment campaign and I took with me one of our graduates, who is an assistant dean at Baylor. Of course, the Bushes are very active there in the Houston community. As you may know, President Bush is chairman of the board of the M.D. Anderson Board of Trustees. He and Barbara are active in the American Cancer Society's National Dialogue on Cancer. So we've talked about things like that.

I took Wayne Riley with me, one of our alumni, because I wanted him to meet President Bush. I thought this would be a big thrill for Wayne, who was one of our outstanding graduates. And I thought President Bush would enjoy meeting him, too. Here would be someone in the flesh, "Here's one of our graduates, you've helped our school, and now he's right here at Baylor, one of your favorite institutions." So that was one time. In fact, I took Wayne with me and also my vice president for development. We met at his office and we had a couple of pleasantries. Before I could make my pitch--this was to ask if he and Barbara would be willing to be on as cochairs--before I could make my pitch he said, "Okay, Lou, what is it? You didn't come all the way out here just to--" So I told him what we wanted.

During the administration, was there something about being in office that increased social distance? I mean, I'm not sure that anybody in the administration socializes a great deal with a President. I just wondered if you sensed that increasing social distance during the period of the administration.

No, no. For example, I would go over and have tea with Barbara. Interestingly enough, she always had somebody else there, who was upstairs in the White House. So I thought, That's a pretty good idea because you never know what people would say. My wife and the Bushes, we'd see each other at various things. No, there was an easy, ongoing relationship. Interestingly enough, I always call him Mr. President, I never call him George, but I always call Barbara, Barbara, not Mrs. Bush. I'm aware of that myself, because of the unevenness here. The President is the President. I say this out of respect for him and for the office. But Barbara is someone I have always known as Barbara.

When I was talking with President Bush last Friday, I said, "Please give Barbara my regards." But if I talk with her, I say, "Please give the President my regards." To me, I would be disrespectful of him and the office to presume to call him George. He's never said, "Oh, just call me George." Without that, I'm not going to take the liberty of presuming that I could do that, in spite of the fact that I feel that we have a very good, easy relationship.

Thank you, it's time for lunch.

[BREAK]

I thought we would begin this afternoon's session by talking a little more about some of the specific policy issues. We've touched on a few, quite a few actually already. Maybe at this point I would turn to Martha and see if you have any questions about the antismoking initiatives and so forth that were undertaken during Dr. Sullivan's tenure.

Thank you.

That publication--is that yours?

Yes, that's mine. I'm consulting--

Do you have any left?

The Congressional Quarterly Press does. Unfortunately, I don't.

Okay, if I can get a copy, that's interesting.

I'll get you one.

Fine.

Well, reading immodestly my own book, I found this reference to an event. I mean, this is in a chapter that describes the drive for FDA regulation. It says, "In 1989, HHS Secretary Lou Sullivan contributed to a growing campaign to combat youth smoking by instructing his department's Office of the Inspector General to investigate how well state governments were enforcing laws prohibiting the sale of cigarettes to minors. The resulting report, 'Youth Access to Cigarettes,' documented a lack of enforcement." Do you recall that particular event?

Oh, yes. Right. This was one of a number of things that we did. Basically, as I mentioned earlier, when I met with President Bush when he invited me to become his Secretary of HHS, we talked about things I wanted to do. This was among them. I had arrived at that point primarily because of my recognition of the number of people who either died or were severely impaired because of tobacco use.

So when I went to Washington, I decided I needed to do as much as I could to discourage tobacco use, but at the same time knew I was within the political crosshairs here. One way of addressing this was by saying, "Okay, how well are we enforcing the laws that exist?" And so I had the Inspector General do this report and then issue that. Basically the theme there is, we have these laws on the books, they have been passed, they should be enforced and they'll have the benefit of protecting our young people form the deleterious effects of tobacco. I knew that using the bully pulpit of the Secretary's office would have an impact there. So that was the underlying theme of doing that.

One thing I found in our briefing book, this impressive notebook that the Miller Center assembled, was an initiative that I wasn't aware of, though I thought I'd studied tobacco control pretty thoroughly. The chronology in this volume says, this is October 1991, "Sullivan announces the federal government's largest antismoking effort to date. The effort targets 17 states over seven years." Then there's a news story about this under Tab 8, "U.S. has new plan against smoking. Seven-year, $135 million program to take place in 17 states." What do you recall of that initiative?

Frankly, a lot of the details of that--I remember that issue because it was, as they say, 17 states. The idea there was, again, to draw attention of the public to this issue and to bring pressure on enforcement of the laws, as well as to increase public awareness. Particularly parents, saying to the parents that this is a dangerous product, you should be aware of this and not let your children use this. Frankly, the whole purpose of this was to elevate the profile here.

I also felt that I had credibility that some other Secretaries didn't have. Now Joe Califano is a good example, because Califano also had some antismoking efforts. But Califano is not a health professional, he's a lawyer. My immediate predecessor, Otis Bowen, was a physician, but Otis, for his own reasons, kept a very low profile. It was because his profile was so low that Chick Koop was such a prominent Surgeon General, because he was the voice out there that was being heard.

The whole theme here that we were developing was to raise public awareness that this is a bad product, causes health problems; we should really, as responsible parents or citizens, prevent our young people from starting. Because once you're hooked, it's hard to get unhooked and this also has many other benefits, reducing health care costs, reducing problems of addiction. We pushed the fact that nicotine is the most addictive substance, pound for pound, that we know.

All of these were ways we developed, or I developed, to skirt around the fact that I knew I was kind of out here on my own. But really to generate the interest and the pressure and the public support for this. One thing that happened that I thought you might ask about is the Uptown cigarette situation.

Yes, do proceed.

I just mention that because this was one of those opportunities that fit very well in that. What happened there was this. This is January of '91, no, January of '90. I was returning from the Middle East. I'd gone over to spend a week in Israel and a week in Egypt as Secretary, because we had a number of joint health programs we were supporting that were operating between Israel and Egypt. They were health programs, but the underlying theme of this was to find ways for Israel and Egypt to cooperate here. So I was going over to review these programs and inspect them. I stopped in Rome on the way back; my wife was with me.

On the plane as we left Rome, I picked up the Herald Tribune and there was a story about, "Community protests plans to test-market a cigarette." This was a short story about Philadelphia, the black community objecting to R.J. Reynolds's plans to test-market this new cigarette, Uptown, in the community. The community was saying, "This will visit more disease and death," et cetera. It so happened, a week to the day after that I was scheduled to speak at the University of Pennsylvania for the dedication of a new research building. So I turned to my wife and said, "You see this? When I go there, I'm going to knock the ball out of the park on this one." Because I saw this as a perfect opportunity, here was a community rising up.

I got back to my department the next morning. I always had a staff meeting first thing in the morning at eight o'clock, from eight until nine. As people came into my conference room, I had this story. I said, "Have any of you seen this? Look at this." They all started smiling. I said, "What's so funny?" What was funny was they had seen the story and they came into the meeting that morning to convince me that I should speak out about this. So we agreed. My speech was at the dedication of a new research building there at the University of Pennsylvania. What I did was insert into my speech, it was a 15-minute speech, so I made it 18 minutes, three minutes about how awful this was and how much tobacco causes disease and disability, and particularly among low-income and minority communities. Therefore, I supported the community. I said, "I call upon R.J. Reynolds to withdraw their plans to test-market this cigarette."

Meanwhile I sent a letter on to the president of R.J. Reynolds, a man named [Frederick Ross] Johnson. Not the CEO, but the president. We were talking earlier about the relations with the White House--as I'm sure you know, the standard for public speaking that any Secretary would do would be to have it cleared by the White House, to make sure that we're saying things consistent with the White House policy and the President and so forth. That process usually took anywhere from four or five days to a couple of weeks, depending. So I did the speech, and I was getting on the train around seven or seven-thirty that morning--I think this program was about ten-thirty that morning. My instructions to my staff were at eight o'clock that morning, send this over to the White House for clearance, which I knew was not going to happen. But I could say, "Look, I sent it over, and it's a mistake if indeed it was late."

Meanwhile, on the train, from the train I called Ed Madigan over at Agriculture, because of course the tobacco farmers there. Ed said, "Lou, you shouldn't be doing this. Have you gotten this cleared?" I said, "Well, I sent it over to the White House and they haven't given me any response," knowing very well I was twisting the truth because they hadn't had time. I called Carla Hills, our U.S. Trade Representative, because her role was to open up markets for U.S. companies for various products. I had previously talked to Carla about this, knew that this also included tobacco.

So I called Carla, said, "Carla, I just want you to know, as our Trade Representative, I'm going to give this talk." She said, "Well, Lou, that's fine by me. I don't smoke. My position as Trade Representative, if a country has a tobacco market, we want our products to have access to that market. We're not interested in developing new markets where they don't exist, but if they do exist, we want our companies to have a chance."

I called Boyden Gray, White House counsel, because of course his family was among the founders of R.J. Reynolds. So Boyden said, "Go right ahead, I sold my stock a long time ago." Sure enough, I gave my talk that morning. Eighteen minutes to be sure, but I could have saved myself and the audience 15 minutes, because nobody remembers a damn thing I said about the benefits of this new research facility, but all of it was about Uptown. It was in the newspapers all over. That's of course what led to the stories, where the tobacco companies really got after Sununu to have me called off.

But I used this opportunity. I was saying, "I'm not the first guy in here. This is the community saying, 'We don't want this,' and I support the community. After all, as Secretary of Health I should be concerned about those things that really impair the health of our citizens there." So that was one of the high profile events that we were involved in. Basically, what we tried to do was to push as far as we could, knowing that someplace the elastic might pop. I was willing to risk that, but really try and do this so that it wouldn't be easy. That is, I knew I was treading on thin ice here and I wanted to couch everything I could in as much protective coating, such as interests in the health of the public and that sort of thing, to make it difficult, if indeed someone did want to axe me in my position.

One more question which might lead us a little astray, because it's not about policy initiatives, but rather about appointments. David Kessler of course became a leading antitobacco activist and was an appointee of the administration. I just wondered to what extent you were involved in the selection of Kessler as FDA commissioner, and did anyone anticipate that he was going to become as ardent an antitobacco activist as he proved to be?

Right. Kessler's interesting. First of all, I didn't know David Kessler. But when Frank Young left the position as FDA commissioner, of course, we appointed Jim Benson as the acting commissioner until we got David Kessler. Kessler came to me, interestingly, with the recommendation from the White House, from Orrin Hatch, and from Ted Kennedy. So he really spanned--I met him and he seemed to have good credentials. I thought he was fine, but I frankly was going on the recommendations of these people. I said, "Gosh, if the White House, Orrin Hatch, and Ted Kennedy can all agree on somebody, he must be pretty good."

Dave was very good on a number of things, because we had had a generic drug scandal; some of our officials had taken gifts from people in the generic drug industry. We really had an image problem to address. So Kessler came in and did that very well. I think Dave was an effective commissioner, but he surprised everyone. Most of all he surprised Orrin Hatch, because Orrin Hatch said he rued the day that he had recommended him. As far as Hatch was concerned, he thought he was too much of an activist. But when he would talk to me, I'd say, "Look, you're the guy who recommended him, so don't complain to me."

I did not know Dave, but with those recommendations and having met him I said fine. I did not have another candidate. We'd been looking at a number of people, including the possibility of appointing Jim Benson permanently, but with Kessler's recommendation we said fine, let's go with him.

Can I ask one follow-up on this? Martha, I'm sure, probably already knows the answer to this question. But were there any significant Republican constituencies pressing for reform in the smoking industry? I'm thinking of maybe insurance companies? Did they have a stake in this at all that they were willing to--?

Not to any visible degree that I remember, but I know there were a number of companies who said they supported the concept because of health reasons, and this would have a salutary effect in terms of health care costs and their premiums. But there wasn't anyone who came and said, "I want to be on the stage with Lou Sullivan and be outspoken here." So I guess you'd say that they were supportive but not in any high profile way. This is, "I'll hold your coat for you, Lou."

Can we do Social Security?

Sure.

I wondered what recollections you had of the issues that came up, but I'm also curious about the appointment process there. I just happened to read, going through the notebook I saw some newspaper report some source that said that Dorcas Hardy wanted to be reappointed as commissioner. Instead Gwendolyn King was brought in. Is there something you can tell us about that decision?

Right. I met Dorcas when I went there because obviously there were a number of people who were holdovers from the Reagan administration. I met her and she was generally well thought of, though I think she was felt to be a pretty strong-willed person. Fundamentally, from my perspective there may have been other things here that I was not privy to, but the word from the White House was that we would like to get our own people in. In other words, Bush had a real task having been part of this Reagan administration and really kind of establishing himself. So there were a number of people like Dorcas who I think would have been happy to stay on but we decided that we wanted to get our own people, to put our own stamp on the administration, and she was one.

Again, I met Gwen King for the first time and she was among the people who were recommended on the list from the White House. During that period there in November and December and January of '89, there were a lot of people I was meeting for the first time. We were very busy sorting through and making decisions and I had a team of people looking at that. Frankly, it worked reasonably well in view of the fact that I'm new and I'm meeting most of these people for the first time, as well as being new to the government. But again, Everett Wallace, my first Chief of Staff, was perfect for that because he was a tough guy and he also knew the political establishment. I think he had also been over in the Department of Transportation when Liddy Dole was Secretary, plus his wife was a lobbyist. So he really knew the political game, the nuances, much better than I did at the time.

Quite frankly, my appointment was because of my friendship with the Bushes and my reputation in the academic community, not because of any political background or that sort of thing. So, I met Gwen King. She was one of several people we looked at and I liked her and I also had stated in my acceptance statement, when the President announced his intention to nominate me, that I'd be working to get more women and more minorities into the administration, so she fit that very well. So that's how that came about.

Do you remember any other instances of people in the department who were problematic in terms of getting them to give up the reins to the incoming administration?

Not really. Chick Koop, of course, the Surgeon General. Chick actually had been one of the candidates to be Secretary. It was a strained time when we met, after I had become Secretary, and I think it was harder on him than on me. While he never said that, I felt that he was probably thinking, Here I am, I've been in the political world all these years. I know the system and I've done very well as Surgeon General, serving Reagan and so forth. Here's this guy, comes up from nowhere and he has the job that I want. This is my own thinking of what he is--because he was really very strained.

Basically, I was trying to reassure him, because from my standpoint I didn't have any fight with him. Again, I hadn't hungered after this position. It was almost by accident that this had happened. I think his appointment was to go until around October of that year, but he resigned in August.

We've had a fair amount of testimony about this very difficult transition period from the Reagan people to the Bush people. I just didn't know if there was any more light you could cast on that for us, in terms of your own department. How the outgoing Reagan people felt or the extent to which that reached down into the department, to try to make sure that there were Bush people involved.

Right. Well, it was clear that that was the theme there, getting our own people in. Aside from Dorcas, who was very high profile and was considered very successful. Even with the fact that she really wanted to stay, that is, she didn't come in to pound the table or anything like that. She served at the pleasure of the President. "Indeed, if you'd like me to continue, I'd love to be of service," that sort of thing.

Jim Weingarden, head of NIH came in, the same thing. That for me was perhaps the most difficult and awkward because I had known Jim, because of my interaction with the NIH world. I thought he was quite good. But here again, I felt it would be good to have our own person in there, and I also got that same word from the White House, that indeed we should get our own people there. But there wasn't any confrontation that I was aware of.

Sure, I'm not suggesting there was. Quite frankly, I can't remember instances of there being anything terribly confrontational; it's more a question about the overall atmosphere in the sense of a change of regimes embedded in a change of personnel.

The one thing I'd say is that our Assistant Secretary for Personnel--Tom McFee--he'd been there for years, through all kinds of administrations. He had been, I think, appointed either by Carter or even maybe by Lyndon Johnson. He'd been there a long time. We kept him on though we knew he was a Democrat because we felt that A) we didn't have a better choice, and B) he knew the department. As you know, in the federal government the issues around personnel can be so difficult and tedious. You find somebody who loves all of that, you know, fine. Tom was quite good.

Ironically, [Donna] Shalala came in as Secretary after I left and I think about a year later Tom resigned because somehow they didn't hit it off. So the irony was that he had served under two Republican administrations here and a Democratic administration comes in and he doesn't hit it off. But he was the most prominent of the holdovers. He had been there quite a long time.

What was your impression of the professional or the career staff at HHS?

I was very impressed. I was very impressed, I was pleasantly surprised, and I stated this many times, because frankly, as someone who had not really been close to government, I had the image that one gets from Members of Congress talking about these darn bureaucrats. The way they said it, as if they were people who really don't know what they're doing except they know to say no and block, or take off early. But I was quite impressed because I found that within the department, there were a lot of dedicated people. What would impress me, for example, was sometimes I'd come into my office on a Saturday or Sunday and I'd drive in the parking lot down below and there'd be maybe a quarter or 20 percent of the cars there. People who were coming in, working on their own time, doing things, and really wanting to do a good job. Really taking very seriously what they were doing, wanting things to go well.

Now, one of the things that I did when I came in was this. I was very much aware that I was new to government and this was a whole new arena. I determined that I needed to form a good liaison with the people in the department. The typical thing, as I traveled--and I did a lot of traveling around--there were ten regional offices as well as offices in Washington and Social Security over in Baltimore. I made an effort to visit, not only each of our major facilities there in Washington, but also Social Security in Baltimore and NIH out in Bethesda, FDA in Rockville, CDC in Atlanta, but all ten regional offices and even Social Security offices in other places like Nashville, to get to know the people in the department.

I'd always have a reception wherever I was. I walk every morning; I'd invite people in the department to join me for a walk. I was doing this, frankly, because I was very much aware that they could say, "Oh gosh, who is this fellow? No political experience, doesn't know about government." I was doing this to form a linkage with them and to try and have them develop an allegiance for me. And I think it worked, because what I found was that I got a lot of support from people in the department. They always wanted to be sure that I had full information. In the same way I would go and argue my case with President Bush on occasion, they would come in and give me both sides of a debate and I would decide and we would move on from there.

So I really developed a tremendous respect and affection for the people in the department and I made them know that. I would have, for example, an open house every year around Christmas time. Not only down at the Humphrey Building, but I'd go out to Rockville, to the Parklawn Building and to NIH. So I spent a lot of time doing what you call PR [public relations] or soft things. But what I found is that employees love that, because so often I would meet somebody, I'd say, "How long have you been in the department?" "Twenty-seven years." And they'd always follow with, "And you're the first Secretary I've ever met," which I found amazing.

So, no, I really have nothing but positive things. Like in any organization, there will always be some people who don't pull their weight, or slackers. But I find that in the private sector as well. So I have very good feelings for my time in the department.

Did you attempt to consult any previous Secretaries?

Yes, I not only talked with them individually, but I set up an annual summit with all former Secretaries. I'd invite them back to spend the better part of a day, from something like 10 until 3 in the afternoon, with lunch. What I would do would be brief them on what's going on in the department, some of the salient issues, and we'd have lunch, and I'd have some of my staff doing that.

After lunch I'd dismiss all the staff and I'd say, "Look, have you had to deal with anything like this before?" What I found was almost always, "Oh yeah, back in '78," et cetera. These were both Democrat and Republican. So I was able to develop a very good support group from former Secretaries. They'd call me up on the telephone and say, "Lou, I understand that you're looking at this issue," or "There's something going on out in Kansas you need to be aware of."

What I've done since I went back to Morehouse, I've set up a summit of all former HHS Secretaries every two years, which we do in Atlanta. We've had two of those in Atlanta, where we had I think all but one of the living former Secretaries down. The last was just a year ago, when we had I guess Shalala, Califano, [Richard] Schweiker, Heckler. Let's see, who else?

Otis Bowen.

No, Bowen came to the first one. Couldn't get him back for the second. He is a very retiring guy.

We've interviewed him.

Right. But again what I found was, by doing that, by extending myself a little bit, I've developed a relationship with them that really has served me well too.

Just out of curiosity, were there documents created or records kept of these meetings?

We have a videotape. This was done in conjunction with the Southern Center for International Studies.

This is at Morehouse.

Yes.

But I'm wondering about the sessions that you have when you were--

Oh, in the department.

--in the department. That's the kind of thing that students would be fascinated to get their hands on, to know what happened.

I'm almost certain, though I'm not absolutely certain, that we do. We could easily find out, because we organized this, we prepared for it. Had people in the department come in and talk about some issue, about retirement income issues, adjusting the Social Security formula or things like that, because what we were trying to do is talk about something that's a real victory, but also talk about something that's a real problem that we hadn't yet quite figured out, to get their input on.

Did Shalala keep this up after you left?

No. She didn't have a single one.

Institutional memory is a favorite topic of political scientists, so this is quite interesting.

This is one of those things--it's interesting with Donna, because first of all, when I went into Washington, I met with Otis Bowen several times. Of course, I mentioned I had these books, because again, I'm very much aware that I'm new to this. I need to learn everything that I can, so I did that. When Shalala came in, first I found it hard to get her to come in. I called her to congratulate her with her appointment and said, "When you get a chance, I'd love to have you come in, we can sit down. I could really share with you my things." We finally got her in one day. I think she stayed maybe 30 minutes and that was it.

So it was very obvious that she decided I don't need this. Whether it was because she didn't want to be oriented by a Republican Secretary, or whether she just felt, Well, I know this. I don't know, but I found it not very satisfying. Well, that was my experience with her, but she came to the summit we had a year ago. She was out of office.

You were saying those were videotaped.

Yes, we have those. We'd be happy, if you're interested, to get you copies of those.

I think it's useful to have on the record because there will be students reading the transcripts at some future point, and this is an interesting cross-reference.

I think, from the department, because we have tremendous departmental archives, plus I have 140 boxes of my papers in storage back in Atlanta. It may even be in there. But this is one of those things I haven't gotten to, if I ever will.

If we could talk about some more issues, policy initiatives, in particular the Americans with Disabilities Act, which was passed in 1990 much to the chagrin of a lot of conservatives. I think Newt Gingrich and others were vehemently opposed to this and President Bush went ahead with it. Could you share with us any memories of that particular act and your role in it?

Well, I testified in favor of that. I remember, I can't remember the fellow's name, I'm sure you have it there, who was paraplegic himself, who was very active in supporting this. At the signing, because this was on the South Lawn of the White House, they had the signing ceremony, he was very prominent there.

It's Reagan's--I think I know who you're talking about.

Not Jim Brady?

No, not Jim Brady, but it's one of Reagan's kitchen cabinets. Either the second or the third; he passed away just a year ago.

Sorry, I'm blanking.

I can't remember, but basically, this was great fanfare. Of course, the way that President Bush framed this was that this was civil rights for the disabled, saying that we need to integrate everyone into our society and help. So I was certainly very visible and very supportive of this act. The White House primarily took the lead on this because this was something that President Bush himself had been very close to.

This is an enormous issue and I wouldn't even know where to begin, but thinking of health care. We could easily spend the rest of the afternoon dealing with health care. Is there one thing, or anything that you're particularly proud of as an accomplishment in the field of health care during your tenure? Perhaps that's the best place to start.

Yes, I would say support for the programs and agencies within the Public Health Service. I mentioned we were able to increase NIH funding significantly and funds for CDC, for childhood immunizations, as well as funds over in Health Resources and Services Administration, to support the education there. Then other things, such as launch of Healthy People 2000. I felt that there we had done reasonably well. Also, appointing the first minority and female Surgeon General, I'm talking of Toni Novello as you know, now Commissioner for the State of New York. So those things really, I felt very good about in the health realm.

Would you have preferred that President Bush be more assertive in terms of pushing some type of health care reform?

Sure. I was about to say okay, my disappointment, yes. We worked, within the department, on getting a health bill put together, because I talked with President Bush about this. At that time, we were saying 37 million Americans were without health insurance. We needed to do something to try and address this. To make a long story short, we had a team over within the department who worked and kept in touch with White House staff people like Roger Porter and others. We came up with this bill, actually in the early summer of 1990. We put this bill together and described the features and so forth. They said, "Okay, well, we're not ready yet over here at the White House. Why don't you keep it over there and let's wait until the time is right and we'll then take it from there."

Of course, we couldn't get any movement. Finally, you may remember, in the fall, I guess it was the fall of '91, Dick Thornburgh was beaten in Pennsylvania by whatever his name--

Harris Wofford?

Yes, and one of the major issues then was health insurance. So all of a sudden, after this the White House says, "Where's that bill you worked on?" So we sent it over and, of course, meanwhile we were feeling, Gosh, we should be out there, because of course we're being beaten to death by people saying, "What is this administration doing? What about the lack of health insurance?"

We sent the bill over and basically the key feature of the bill was to have a tax subsidy for purchase of health insurance. I've forgotten what the income levels were, they would phase out I think at $50,000 or $60-70,000, whatever, as well as group purchasing arrangements for small businesses to make health insurance more affordable and several other features. Our actuaries estimated that if this bill were implemented, we could reduce the number of people without health insurance from 37 million down to 5 million. Of course we said, "What do you do about 5 million?" because people would still criticize us for that. So we then said, "Five million people, the system, we could take care of that. Uncompensated care, emergency rooms, at least it would be a major improvement."

So we sent that over and then President Bush introduced that bill in a speech in Cleveland in February of '92. Now, this is well into the campaign season and the reaction at that time from the Democrats was, "Well, this is not a serious bill. Where have you been all this time and what do you do about the 5 million uninsured?" and so forth. Secondly, we could get President Bush to talk about this only occasionally after that. So it was obvious that we weren't going to get very far.

What was the reason for that, do you think? Was this Darman again, financial and budgetary concerns?

I think that was part of it. Also, I think there was, certainly among the more conservative, they were saying the federal government shouldn't be expanding its role in health care. So I think here, this was one of those areas where the political instincts of the President overrode those "compassionate" aspects. That is, there was a panic when Wofford beat Thornburgh, because Thornburgh was supposed to win that election, if you remember. So they wanted it, but even then, the bill was all ready to go, it had been ready since May of '91. So there wasn't much fine-tuning to do once it went over to the White House, but it was really February. And after that speech he spoke very little. So it was obvious that his heart or his mind was not into this, and meanwhile I'm over championing it and Jack Kemp was also anxious to see something out there.

So that was a disappointment. The other thing that happened, we could never get--the Democrats were in control, the Congress--we could never get them to schedule hearings. It was obvious they didn't want any hearings, they wanted an issue. They would say, "This is a terrible bill." So we'd say, "If the bill is so terrible, why don't you hold hearings so that the American people can really see just how terrible this is," but we could never get hearings. So we knew then we'd been overtaken by the election dynamics there.

Another controversial issue to excite people, perhaps particularly on the right, was the use of the fetal tissue research and the extension of that ban from the Reagan years.

Yes.

Do you have any recollections of that particular issue?

This is one of those issues that I took to the President and I argued with him on that. Again, my argument, my position, as a physician and researcher, was things that could enhance the health of the American public. I met with him in the Oval Office. Sununu was there. I don't remember who else, there were one or two other people, I frankly just don't remember it. But what Bush was saying was, "I hear what you're saying Lou, and it really has an advantage. This really is something, I'm afraid it goes over the line a little bit, this could encourage abortion." This is what the right wing was saying. So again, I lost that argument there.

You were the sole person in the room making the case.

Yes, yes.

One might have expected, given Bush's personal history, having lost a child, that he might have been somewhat more receptive to medical research--

My impression in that meeting was that he really was conflicted. In other words, my interpretation was that he was making a political decision in terms of how this would play with the electorate, as opposed to making a decision from his heart. You'd have to talk with him to see, but my conclusion was that he had concluded or been told by his advisors, if you support this, you're going to be in real trouble. I felt that was the dynamic that was underway in that situation.

So I felt that I made my best case, I didn't win. It's too bad and I don't feel good about that, but is this something I'm willing to say I resign? No. My feeling of allegiance for him and what he's trying to do and what he has meant to me is such that I'm not going to abandon him because of this disagreement, as strongly as I feel about it. I'm not going to go out in public and say that I disagree either.

Regarding AIDS policy, it was reported at the time that you had shifted your position on the needle exchange issue. I think we touched on this a little bit this morning, could you elaborate a little more on that? Is that an accurate portrayal?

Yes, that's accurate. See again, the general theme that I would take, because quite frankly, I didn't come into the administration with a strong political ideology. I came into the administration as a physician interested in improving the health of the American public. Just let me mention, we talked about Social Security a little bit. I didn't know a damn thing about Social Security. It's a big part of the department, half of it, and I'd say, "Fine, as long as we can get someone to run Social Security who knows how to do that, that's fine. But what I really know about and what I'd like to influence is health policy."

At the same time, I felt my responsibility is to run the best operation I can with Social Security, but the way for me to do that is not think I know how to do this but get somebody who does, and that's what I got in Gwen King. So my approach in general with the administration was to say, "What are the health issues, and what can we do about them to improve the health of the public?" That was the same thing with tobacco. A lot of people assumed I was a reformed smoker because I was so outspoken, but I'd never smoked in my life. I smoked when I was about five years old, I smoked a cigar. Got so sick!

Still here to talk about it.

I got so sick, I never had any desire for tobacco again. But automatically, many people just thought, because I made this such an issue. I felt that, Where is my expertise? Where is it that I know what I'm talking about? Where can I influence policy in a direction I think would be good? And it's really on health issues. So for each of these things, the needle exchange issue, the fetal tissue issue, AIDS research, all of these were really, How is this a health issue and what can we do to change the system, to address this, as opposed to, These are bad people because they're prostitutes or drug abusers or homosexuals or what have you. These are "bad people," so to hell with them, which some of the people on the right might say. That's not my attitude at all. My attitude and my philosophy are not judgmental, because who am I to judge someone else?

I have a knowledge base and a skill base that can hopefully improve the lives of people. If I can do that, I've made a great contribution, but I'm not out here saving souls. Saving souls is something I don't have the competence to make that judgment. But I can save lives, and then somebody else can take care of the souls. So that was the animating feature of how I approached this. I knew I was involved in administration, where there were ideologies at play. Also, as I mentioned earlier, it was my impression that Bush, having lost out to a much stronger ideologue in Reagan, in the early 80s, had determined, "Well, gosh, if I'm going to be President, if I'm going to be successful, I'm going to have to somehow change or at least change the perception here for political reasons." Therefore, if I'm going to be supportive of him and a part of his team, I shouldn't do anything that could upset that apple cart, unless I really thought that he was doing something fundamentally wrong, when I probably would have resigned rather than making a public issue of it.

I wonder if you could elaborate on how that played out on the question of AIDS? I mean, this is historically a very important period of time that people will look back on and study as a question of public health. You're coming, as you say, from a medical background in which this is being dealt with as a medical problem, but you're suddenly entering a universe in which the medical dimensions of this problem are only a small piece of it.

Sure.

What was it like to get into a room full of people whose calculus was very different from your own on this?

Well, it was interesting. The reality I faced was I had a hell of a lot more trouble with the people on the left than on the right. By that I mean this; early on, when I became Secretary, so many places I'd go there'd be a line of pickets out there. What had happened was they had already prejudged this administration and prejudged me, which I really thought was not fair and inappropriate there. The first thing that Bush did, he increased funding for AIDS by I think a couple of billion dollars, including research funding. We appointed an AIDS commission that was actually chaired by Dr. June Osborn, who was then dean of the School of Public Health at the University of Michigan. She is now president of the Macy Foundation, where I just got this grant to do a history of the school. We worked a lot with that.

Even there, all of our moves and thoughts were suspect. We got [Erwin] Magic Johnson on the commission and when he came on, he had already been told by the people on the left that these were not honorable people, or you have to watch what they say. So he came on already with an attitude; we found it difficult to work with him. They demonstrated out on the NIH campus. They had smoke bombs, went into people's laboratories, calling scientists murderers, so I just thought that was inappropriate and uncalled for. People like Tony Fauci, I'm sure you know, really dedicated researcher there. Finally, as I mentioned, I'm trying to develop a relationship or build a bridge to people in the AIDS activist community.

Remember I mentioned I tried to get President Bush to go with me to the AIDS meeting in San Francisco and I went on out. I was told that there would be a demonstration, and I knew that. By this time I'm used to this but I went there figuring, okay, they'll demonstrate and I'll let them demonstrate and then when they quiet down, I'll give my speech. It was there in the Moscone Center, have you been to the Moscone Center? It's kind of like a big quonset hut, hard walls, and the sound reverberates from everywhere. They had bullhorns and shrill whistles. It was almost painful to the ear, all of this that was going on.

I've forgotten who it was who introduced me, but the person who introduced me didn't finish the introduction when all of a sudden, these people came running down the aisles, blowing their whistles, yelling "murderer" and the bullhorns went off and so forth. So I just sat there, waiting, five minutes and then ten minutes and then finally concluded, They don't intend to stop. What they want to do is prevent me from speaking. At that point I really got very angry. We were expecting some trouble all right, because I usually traveled with one security officer. For San Francisco I had two, and the security officers were on each end of the stage to protect me.

So when I concluded they didn't intend to stop, I got up and went to the podium and I gave my entire speech. Usually in a situation like that, if I have a ten-minute speech, I cut it down to three minutes and just say some things and get out of there. But I gave the full speech, didn't miss a word because I knew that within the hall nobody could hear a thing I was saying, but I figured that at home, on television, on the radio, they could hear me because I was speaking into the microphone. My not cutting my speech short was my own personal defiance of them. They're not going to run me off one second too soon. I gave the speech and when I finished, I walked down the full length of the platform waving, as if this was a victory speech. This was my giving them the finger, so to speak, because I was pretty ticked off by then.

Then I left and we then went out to the airport and I waited in the Crown Room. In the Crown Room I got a call from, of all people, Sununu. John Sununu said, "That was fantastic, that was great." I'm sure he would have kissed me had he been able to do so. So that's really what I found, frankly, very distasteful. I was prejudged; I was not even given an opportunity. The assumption was made here. Now, whereas the people on the right would say, "I don't believe in abortion, or this about AIDS policy." I'd say, "Let's talk about this." They never picketed me, never said, "Shut up, I don't want to hear what you're saying." I might not end up moving them one iota, but at least I had dialogue. They were willing to discuss things, even if I wasn't able to convince them.

Basically the AIDS politics there, which still continues to a significant degree--and as you know, I'm co-chair of the President's AIDS Commission, one of those things I wonder why I decided to accept that appointment--but basically, where so much is influenced by stereotypes of ideology, here it's to the detriment of people. I'm seeing the same thing elsewhere around the world. I led a delegation to China back in January for the Center for Strategic and International Studies, and China has the same problems we have here only worse. Taboos about homosexuality, prostitution, drug abuse, and less than half of the Chinese people have even heard of HIV or even know that. They're a sitting duck. Their health structure or infrastructure is very weak. So a report that we gave, and Bill Frist and Kerry, Kerry from Massachusetts--

John.

They are the honorary cochairs of this task force over at the Center, but neither one went on this trip. So here again I see the same issues, the same problems getting in the way of good health care in China. I'll be going to India in January and we may find similar things there.

Did you find a level of discomfort among the political people or within the Cabinet or within the White House staff in dealing with this issue? Was this something that they were uncomfortable talking about, either from a personal situation or the politics of it?

The sense that I got was more--I'm not sure if discomfort is the right word--well, this is always an intense discussion. What I found in so many instances, people are intense in their feelings about this, in the same way about needle exchange. People say, "What you're doing is promoting drug abuse here, which is bad, and how can you do that." Really, so caught up in that, that they cannot see beyond that to say, "First of all, the evidence for that is not very good. But even if you were promoting that, is that worse than transmitting the AIDS virus here?" But I found, in my experience, that the ideologues are pure. They see things from one dimension, not from multiple dimensions.

I guess what I'm trying to get at is asking you a question about how someone like you, whose entire career has been devoted to making conclusions from evidence, how you make the transition into an environment in which so many conclusions are made, not based on evidence, but on presuppositions or ideologies. That people take evidence and try to fit it into their prevailing views.

I guess I'd summarize by saying it's difficult. There's a tension. You say, "This is pretty clear. If you analyze this, the studies have been done, they show this." So why can't they understand that? But see, that's where the compromise comes in. You have to realize that not everyone really has had that kind of orientation. There are people who distrust science or don't believe in it, or also believe that scientists are a bunch of pinkos anyway who are trying to order how we live, et cetera. So it is difficult. Frankly, there are a lot of people in science, in health, who say, "To hell with that, I'm not getting involved. That's a waste of time. I'm going to stick to the laboratory and do my research and publish. Someday, somebody will understand this and do something about it, but meanwhile, for me to do that, a waste of time. I'd get my hands dirty," and so forth.

So it really is a compromise. It comes back to what I was saying earlier. That is, you have to decide, now is this something I think is worthwhile doing? Knowing that to get something done takes repetitive testimony before the Congress, meetings with people, not only in the legislature but public interest groups, debating things. Really, to get from point A to point B is not a straight line, it's meandering all around. Rather than just taking one day, might take two years.

I think that's the compromise that we have to make, because science isn't like that. Science is evidence-based. How do we design this study to get this answer? And then whatever the answer is, that's the way we're going to go. An ideologue is going to say, "This is how I believe the world is ordered and I'm going to make sure that everything fits that, and I'm not going to be changed by anything." So that's a real conflict.

One more question on this. That is, were there any occasions during your tenure that you felt you were being politically pressured to alter your science, or to alter the science within the department, to politicize your data?

I think the needle exchange thing was really an example, because frankly, that's one of those things I don't feel good about, that troubles me. But I made the political calculation that I'll lose this battle so I can fight and win some other battles here. That I guess is the one. Coming to the abortion issue, abortion was never my issue. I hardly knew what the hell an abortion was, let alone these different positions. So I kind of stumbled into this thing and all of a sudden found myself--and my own orientation is one where I see merit on both sides.

In a very real sense, in terms of biology, abortion is taking a life. Then you get into the question when does the soul hit--who the hell knows? So that's one issue. But on the other hand, the value that a woman should be supreme over decisions about her own body. I mean, that fits with our ideal of individual freedom and choice and so forth. So it's a conflict that we haven't resolved, I haven't resolved here.

But when it comes to needle exchange, as I said, I'm not at all convinced that needle exchange leads to drug abuse. So that frankly was a political compromise I made here where I think the science was otherwise.

I appreciate your candor.

I wonder if you could talk a little bit about the Cabinet, about some of your other Cabinet colleagues, but starting with the question of, were Cabinet meetings ever fruitful? Did they matter?

Were they ever held? [laughter]

Oh yes, they were held. They were kind of erratic. On average, I guess we would have maybe two Cabinet meetings a month, but sometimes we might go two months with no Cabinet meeting and then another time might have three in one week, depending upon what's going on. That depended on a whole lot of things, whether the President is traveling or in town, what events there were. But no, they served a purpose, several purposes. One, obviously, for the President to be seen working with his Cabinet, the PR function. But also, really, to build a team. That is because by and large, unless there was a joint program I was working on, let's say with the Department of Education or the Department of Labor, I really wouldn't see, say, Lynn Martin or the other Cabinet members unless there was a social function there.

This also was where we got a lot of information about what's going on, because you're busy as you can be. I found that this was one of the most intense times of my life in terms of schedule. I'd get started in the morning with my 8 o'clock staff meeting and I'd finish up at 6 or 6:30 and then go to three or four social functions, because I found that the social functions were also work. If the American Hospital Association was in town, and I didn't go to their banquet, oh heavens, why didn't the Secretary come to our banquet? What's the message here?

Every decision would be interpreted through a political prism. So it would be a hell of a lot easier to go to these things. What you do, you go to a cocktail party one place and sit down for an appetizer somewhere else, and get a bite a third place and then go dancing. So you get home at 10, 11 o'clock at night, exhausted, only to get up the next day and repeat it all over again. Then of course, to have to travel and then come back in town after traveling and find things backed up.

So the Cabinet meetings were times we would all come together as a group. I think that was important, to feel that we were all working together as part of a team. And communications with the President--frequently you would have the press in when you've made some significant announcement there. So I think that most of us found they were useful. They were not the place to get serious business done. We had the Economic Policy Council and other working groups like that, joint task forces between two or more departments. For example, we had a task force on homelessness that included myself and Jack Kemp as cochairs. We also had the Secretary of Veterans Affairs, the Secretary of Labor. Let's see, who else? One or two other Secretaries, but then a bunch of other people here.

So the real work was done in committees and task forces. The Cabinet meetings were not where intense work was done, but I think they were still useful.

You mentioned that schedule--that day you were describing does sound very exhausting. Were there times when this was almost overwhelming? How did you deal with something like that?

Basically, yes, it was pretty exhausting. As far as the social events, the top of the heap was the formal dinners at the White House, the state dinners. Those are always elegant things, formal attire and the chamber music and the Marine color guard and all of the speeches and toasts and all that sort of thing. Each one of us in the Cabinet would be a host at our table. We would have maybe some deputy secretary or secretary of some other visiting dignitary, then usually some big political contributors there, a lot of them coming to the White House for the first time. I saw them kind of in the same position I was when I first came. That is, they were overwhelmed. We were now taking all of this for granted, this is nothing. But they were always very good things.

One time we were getting ready to go a state dinner when Benazir Bhutto from Indonesia was visiting. I was at home dressing. I told my wife, "I sure wish we didn't have to go to this damn state dinner." My wife says, "What?" She'd been waiting all day to go to this thing, because the wives or the spouses would really enjoy these things. She said, "Do you realize there will come a day when you'll look back upon this and say you wish you'd go to something like this?" So anyway, we went, because usually by the time we got started, we'd get through it.

I found, on average, maybe one night during the week I might not have to go to something. That was a fun night, being at home, just having spaghetti and meat sauce rather than Chateaubriand, et cetera. Enjoying the spaghetti and meat sauce, because just having a quiet time, my wife and me, that was fun.

A couple of other interesting things that happened. When I first got started--my wife and I walk every morning. We lived in Alexandria, a condominium called Puerto Viejo. Just south of Puerto Viejo is a walking path going toward Mount Vernon. We'd walk there every morning. We'd been there maybe six weeks when we were coming back into the condominium when we heard this voice behind us, "Dr. Sullivan?" Turn around, this fellow, "Are you Dr. Sullivan?" running toward me. My wife immediately jumped, put herself between me and this fellow, and pushed me inside through the revolving doors and my wife started beating on this guy's chest.

Just as I was going through the door, he threw these papers, "Served." It turned out I was being sued by one of the students we had dismissed from Morehouse. But what we thought was that this was somebody who was about to attack us. I made the mistake of telling the people in the department that morning about this. About an hour after the meeting, my chief of security came in and said, "I heard about your situation this morning. From now on we're going to have one of our people out there walking with you." So that happened. Some of these poor guys, because we walk pretty fast. They thought they were in good shape, but they had a rough time. Basically, what we lost, but we didn't realize it, was our privacy.

What we would occasionally do on a Saturday afternoon, we'd sneak out, drive ourselves and go to a movie. We felt like teenagers, but getting away from all of the security, all this formality and just being normal people. So that was one of the other things that we'd never thought about before. But with the schedule, worrying about everything you say, it's on the record, making sure that you're saying things correctly. My experience was one where I was obviously concerned about that.

Secondly, making sure that you represent the administration and the President and your department well. All of the demands--there's always a hell of a lot more to do than you had time. With everything that's going on, the things that we had once taken for granted assumed much greater importance because they had become rare for us.

I was wondering if I could ask you to comment on some of your Cabinet colleagues. Actually, I'd like you to start with the Vice President. I don't know if you had a lot of contact with Dan Quayle or not. Do you have any reflections or observations about him?

Dan was always very quiet in the Cabinet meetings. I had very little contact with him outside of those meetings. He did ask me and Ginger to accompany him and Marilyn on a trip to sub-Sahara Africa in August of '91. That was a one-week trip that went to Malawi, Namibia, also Nigeria, because interestingly enough in Nigeria, Jonas Savimbi from Angola came up and met with Quayle there.

We interacted with him on that trip. We went to a game preserve in Namibia and so forth. My relationship, I guess our relationship, with the Quayles was cordial and friendly, but never really of substance. I don't think I've interacted with Quayle since we left. So it was friendly, but really not a very meaningful relationship.

What about James Baker? Again, I realize you two were in very different fields, but he was such an important figure in the Bush administration.

I didn't have a hell of a lot of contact with Jim, but a reasonable amount. He was always someone who was very friendly, very helpful. My own interpretation is that because of course he and the Bushes are very close, that because we were close to the Bushes, therefore he was close to us. So we interacted to some degree, though not to a major degree. My own relations with him were friendly and easy and so forth, but I didn't interact with him that much.

In the Cabinet, who were you closest to?

I'd say, of course, Jack Kemp. We've already mentioned that because there was a lot of interaction between programs at HUD and programs at HHS. And Jack, as you already know from his personality, he bubbles over. You can't be in a room with him and not interact with him because he's going to force it. Jack also, I think more than any other member of the Cabinet, was very much concerned about reaching out to minorities and in a very substantive way. He was very vocal about that.

Another person was Lamar Alexander. Here again, because we had a lot of programs that interacted. Lamar sat right to my right because, as you know, the seating around the Cabinet table is in order of when your department was formed, and so forth. Manuel Lujan, I didn't really interact with that much as Interior Secretary, but he was to my left, so we got to know each other. Of course, he was also a minority. He lived in Alexandria also and our wives got to know each other. That's another thing, a lot of the social interactions occurred because our wives interacted. I'd get home and learn we're going over to the Bakers' next Tuesday night. She had already checked with my staff and so forth.

Let's see, Carla Hills and her husband, Rod, we interacted with socially. They were very good friends, very easy. Bob Dole and his wife, Liddy--as a matter of fact, Bob invited us out to lunch. He and Liddy, I think we'd been in Washington maybe a month, so they really extended themselves to welcome us. Lynn Martin also reasonably, because she and I did a lot of traveling together, particularly during the campaign in '92. We also had programs in the Labor Department that intersected with our programs there.

Ed Derwinski, because Ed's department, as you know, was elevated to Cabinet status with Bush. Of course, I went to that ceremony where that was done. Because the VA has this health program, the VA hospitals, the health system, we interacted there. We also engaged in, which you have in your books I noticed, an ill-fated effort to open the VA hospital system to Medicare and Medicaid patients. That came about because when we developed the Morehouse School of Medicine, we wanted to have access to the VA hospital in Atlanta. The relationship between medical schools and VA hospitals--first of all you have access to a patient base. There are faculty positions, staff positions that you develop so the staff in the hospital become faculty at the medical school, so that gives you a resource there for teaching your students and then residents. And then the VA research funds.

Well, Don Custis was chief medical officer for the VA system at the time, but the VA system, just before we got started, found that where they had two medical schools or more in one hospital, there were always difficulties dealing with the two because the two medical schools were always kind of trying to outfox each other. The Washington VA had three medical schools there; it had Georgetown, George Washington, and Howard Universities. So they found this difficult, as well as being duplicative. Rather than having one Chairman of Medicine, you had three Chiefs of Medicine and so forth. So they had made a decision that they would phase out those relationships to one medical school per hospital.

So when he came along, I went to Washington and Don Custis turned us down with our request to affiliate with the Atlanta VA, because Emory was already there. What they said was, "We have a VA hospital in Tuskegee, Alabama, that does not have any affiliation. We'd be pleased to develop this affiliation with you there." So we took it. The problem was, Tuskegee was 120 miles away from Atlanta, so it was far enough away that that relationship really never developed the way it should have. It was a real effort there for students and faculty to go back and forth. They have to go down and stay for two or three days to make it worthwhile.

The VA hospital in Tuskegee was half-empty, because the veterans' population was not that big. Now that hospital was one of the first, I think existed before the VA system started. So that hospital symbolically was very important because black veterans looked to that hospital as really important to them. Remember the Tuskegee Airmen, who escorted bomber pilots in World War II, and the Tuskegee Airmen were proud of the fact that they never lost a bomber that they escorted over bombing raids in Europe and so forth.

So to make a long story short, when I got to Washington I said, "Ed, I've got a project. Here's this hospital, half-empty. It really is not as valuable to us for teaching or research as most VA hospitals. But there are all these patients, there's no other hospital in Tuskegee." So it seemed to me it would make sense to open this hospital up to nonveterans who have a method of payment, Medicare or Medicaid. As I said, "My Medicare constituents in Tuskegee have to drive to Opelika, Alabama, if they need hospital care, in one direction about 25 miles, or to Montgomery, 30 miles in another direction. Whereas here's this hospital sitting half-empty. So if they were to come in, this becomes more valuable for teaching, increases your funding stream. These people don't have to go out of town to the hospital," et cetera. Ed said, "That's a great idea; let's do this. Why don't we see if we can find another hospital to pair with that and do a demonstration."

We found a hospital in Salem, Virginia, I believe, to pair with that. So we developed this idea. To make a long story short, when we developed this idea, the veterans' organizations went bananas. They're very protective, as you may know, about veterans' hospitals. What their theme was, Can you imagine a draft-dodger who went to Canada being right in the next bed with the guy who went to Vietnam and got both of his legs blown off? Some very emotional hypotheticals they were putting out. They went to work, to the Congress as well as to the White House, and told President Bush that if he didn't call off his two Secretaries, they were going to actively work against his election. They went to the Congress and the Senate voted 93 to 1, or 93 to 2, to instruct us to cease and desist.

I went to Sam Nunn, for example, who was one of the people. I said, "Sam, I don't understand, here's the logic." He said, "Look, don't waste your time. I understand. Logically, it makes sense, it's a good idea, but it's bad politics. End of story." So that was that. Ed and I both came away wounded. As a matter of fact, you may remember, Ed Derwinski resigned early; he did that to take the poison away from Bush because there were all these angry veterans out there. So he took the fall to say, "Okay, I made the mistake," and so forth. That was a miscalculation. We had no idea that the veterans' organizations would really react that way.

Let's take a break. We're in the stretch run here.

[BREAK]

You were going to get the name Justin Dart on the record as the person who was involved with the Americans with Disabilities Act.

I wanted to ask you about when the transition occurred between John Sununu and Samuel Skinner and Skinner becomes Chief of Staff. There were reports at the time and reports that persisted to this day that Skinner had a somewhat rocky tenure, but I was wondering if you could just give us--what did you notice? Was there any dramatic change in the way the White House ran and the way they dealt with a department like yours? Was it a smooth transition?

As I remember, I think it was fairly smooth. That is, I don't remember any major disruptions. But I do remember that there was a decided change in tone there at the White House. First of all, Sam was not the ideologue that Sununu was. Then Sam also, I think, was a more collegial leader than Sununu. Thirdly, I think that Sam having been a member of the Cabinet, there wasn't the distance between him and the Cabinet members as there was between Sununu and the Cabinet members.

I mentioned earlier that I got along very well with Sununu and we were fine even when we disagreed on things. We would kid each other. But in spite of all that, the sense of closeness that I had with Sam Skinner was much more so than with Sununu. Also, remember, this is a difficult time when Sam came in, because Sununu had been such a lightning rod. He had done something very stupid, having been grounded and taking this government car to drive him all the way to New York. I mean, it was almost like saying, "Kick me," just doing something like that. You wonder if he really thought he was going to get away with that, or was this his own way of being defiant.

Sam wasn't like that at all, but we were going into an election season and the tone had been set that we should just coast here. So I think there was less demand or expectation from Sam to be an activist. Aside from that, I think he was lower profile, less active, but I don't remember any gaffes or the ball being dropped. If there was, I've frankly forgotten about it.

If I can shift gears here and ask you about your relations with Congress, and in particular some very powerful Members of Congress, both in the opposition party. First of all, Senator Kennedy. His name pops up fairly often throughout this briefing book. Could you talk to us about your relationship with him, particularly working on issues of concern?

First of all, I had a relationship with Senator Kennedy before I went to Washington because, of course, going to Washington to visit the Congress to lobby for things that I felt were important for the medical school, he was the ranking Democratic Senator on health issues, was someone I had interacted with. He knew about the school.

Plus, when I went to Morehouse, I visited him and made known to him, "Look, I'm from Boston and Georgia." I would use every trick I knew to develop--so I had developed a good relationship with him and he was supportive of my nomination. I'm trying to remember. I think there were a few times where he might have said something where he was in disagreement, but they were always kind of sufficiently couched. They were gentle disagreements and not sharp things. So no, I had a good relationship with him.

Congressman John Dingell.

[chuckling] Dingell's another character. Dingell, of course, a very partisan Democrat. I met him for the first time, in contrast to Kennedy, and he was very formal when I went to visit with him. I also invited him over the department, too, for a visit. He was cordial, always very formal, "Now, Mr. Secretary," et cetera. When I testified before his committee for the first time, and I frankly don't remember what it was that I testified about, he swore me in. That was one of the few times I had to be sworn in, which he insisted on. I was thinking, Why is this necessary? but he insisted on that.

He was always cordial with me, correct, but cool. He was someone that I always felt I never would want to be caught in a dark alley with. Not that there was anything specific, but he was a very powerful guy and he was so correct, and cordial, and legalistic there. I mean, it was very clear he was the opposition.

Did your legislative liaison people help you at all? Sounds as though you were surprised to come up against this with Dingell. No legislative liaison officer at the department had alerted you or warned you that this was the treatment you were going to get?

No, no. Steve Kelmar was my Assistant Secretary for Legislation; he was very good. But things like being sworn in--frankly, if I was briefed on that, I have forgotten that.

I assume he did it with everyone.

Presumably. But you know, how you meet someone and the unspoken language, the body language, will give you cues. That's the way it was with him. He never said anything really incorrect or discourteous. Some of the people, like Kennedy, while we were on opposite sides of the aisle, I think there was still a collegiality that existed. That wasn't the case with Dingell at all.

Martha, you had mentioned another name--

Henry Waxman.

Waxman was another one I had known before. When I had started, Paul Rogers was Chairman of the Subcommittee on Health. You may remember that Rogers retired and then Waxman ran and he got that post. So I'd gotten to know him, not well, but I had developed a good relationship with Rogers, but I did know him before. Waxman, while not as guarded or as rigid in his approach or demeanor as Dingell was, he was still very clear that he was one of the Democratic leaders and I was a Republican Secretary.

But you know, Waxman did say words to the effect when I first met him, "I'm sure we'll have some disagreements, but I hope that we can find ways and places we can work together for the benefit of the American people and their health," and all that sort of thing. So that was my relationship with him. By and large, I got along reasonably well.

Did he applaud at all your antismoking initiative?

Oh yes, he did. And he gave me credit and so did Kennedy and a number of other people. There was enough applause or praise so that when the criticism did come, I could feel that this is not all ideological, because they disagree with this position that I'm taking, it's genuine and not done just to score political points. Because they say that.

Did you have any kind of relationship with the Congressional Black Caucus?

Oh yes.

How were they? Were they difficult for you to work with?

No, no, they were very warm. Again, because of my activities, because I'd started in '75, this is '89, so this is 14 years later. Andy Young was in Congress when I went to Morehouse. He was our Congressman, the seat that John Lewis now holds. So he took me to Washington to meet a number of people in the Congress, including members of the Black Caucus. He introduced me to Ralph Metcalfe, who was then from Illinois who sat on the Health Committee, and other people like Lou Stokes on the Appropriations Committee, and Bill Clay and so forth. So I met a number of them, Charlie Rangel, et cetera, through Andy Young.

The whole idea at that time, of course, here's this new African American-oriented medical school that we're starting in Atlanta, that we need help from and want the support of the Black Caucus. They were very helpful and very supportive, so I worked with them over the years on a number of pieces of legislation, for example, funding for the Minority Biomedical Sciences research program, which Nixon had started himself, interestingly. The national sickle cell program, something else that Nixon had started here. Remember, Nixon also started the war against cancer, saying we're going to find a cure for cancer and so forth. A lot of people forget there were some pretty good things that Nixon started. Then there were programs that we proposed that were developed into legislation. One was a program called the Research Centers at Minority Institutions program, RCMI, that we had help from people like Stokes and Waxman and other people to get that started.

Then there was another program we worked on. In 1985, I became a member of the advisory council for the National Cancer Institute, the National Advisory Cancer Council. There I advocated for the establishment of a program that's called the National Black Leadership Initiative on Cancer. That was established and still exists today. This was funded by the Congress and through efforts of the Black Caucus and others. So there were those programs, plus there were Morehouse-specific programs.

I mentioned our first building was a $6.25 million building with a $5 million federal grant. Lou Stokes had helped us with that. Also Silvio Conte, who was a ranking Republican on the Appropriations Committee. Sil Conte came from western Massachusetts and I first went to meet him and I was clear--I've forgotten who had set this up, whether it was Andy Young or somebody else--but Sil Conte was very clear. He was probably listening in one ear and it was going right out the other, as I was trying to talk about this exciting thing we're doing.

So I'm trying to think, How do I really get this guy's attention? I said, "By the way, my wife is from your district, from western Massachusetts." He said, "Oh really, what's her name?" I said, "Her maiden name was Eva Williamson." "Williamson, Williamson?" "But you may know her by, because her mother, before she married, was a Caesar." "Ah, Caesar, good family, know them well." There are thousands of Caesars over Springfield, Pittsfield, North Adams, and so forth. So he was counting votes. I got his attention and Conte really turned out to be very helpful for us. We had him down and gave him an award because he was helpful to us on our first appropriation, a second building, a $75 million appropriation for our second building.

We now have five buildings, each one of them we've gotten significant federal appropriations, because the construction authority for medical school buildings expired about the time we were getting started. These programs didn't exist, so each one of these we would go and lobby for and get language put into some bill there. The latest one, our building we just dedicated November of last year--a year ago now--was a $21 million building, our National Center for Primary Care.

So, to make a long story short, we had developed this relationship. Again, as I was saying to Ed, when Carter lost, we said, "Look, we have too much going here. We need to develop relations with this new administration," that's what led to the things there. So I knew a number of the Members of Congress because of our activities, both Morehouse-specific, but then other programs of concern to minorities more generally, or minority institutions.

We also formed, in 1977, an association of minority health professional schools, which still exists today. Its members include the four primarily black medical schools, two dental schools, five pharmacy schools and one veterinary school, that's the membership there. So there are a number of commonalities that we have. Through that organization and its foundation that we've developed too, a lot of things are going on. So we were pretty busy both at the state level and at the federal level in lobbying for things.

Because of that, that's how I knew Orrin Hatch and Arlen Specter and a bunch of other people beforehand.

When Congressman Stark made those ugly remarks about you, did he ever apologize to you personally?

What happened was he made comments on the floor of the House saying his remarks were intemperate, which he regretted, et cetera. I got a letter from him also saying, "Mr. Secretary, I apologize for my intemperate remarks. I hope we can continue to work together." Yes. What had happened was the Black Caucus reacted very negatively and of course Stark had very good relations with people like Lou Stokes and Charlie Rangel, just said, "Quiet, Pete, that's way off base. You should not have done that." As I mentioned, they had this big thing for this church out in Oakland, I'd never been out there before.

Basically, I think what had happened was that within the black community, including the Black Caucus, they'd say, "Well, this guy's Republican, but he's trying to do some of the same things that we're doing. From a political standpoint, we need to have representation in the Republican administrations," and so forth. My history in starting the medical school and my interactions with them were such that they rallied. So Stark did apologize, yes.

Were there any other members of the House or the Senate that you had a difficult relationship with?

Tom Daschle. He was an annoyance. When he was in the House, he came on the Appropriations Committee--it was either the Authorization or Appropriations, I think it was Appropriations Committee, I'm not sure. He was a junior member at the time; I guess the late 70s or early 80s. I found he asked questions that he didn't know what the hell he was talking about. He was an annoyance, but he was also very partisan. I can't remember what it was, but he asked some question and I--now wait a minute, I'm not thinking of the time when I was Secretary, but when I was there before I went to Washington. I made some quip because I just found his question impertinent. He's matured a hell of a lot since then, but I just thought he was a lightweight, didn't know what he was talking about, was trying to get some attention. That was a onetime thing; there wasn't really an ongoing thing. I can't think of anyone where I had any ongoing, long-term disagreement or problem.

We've heard reports that there was some strained relationship, to say the least, between the Bush White House and Majority Leader Mitchell, George Mitchell. Any--

I was aware of that. I think that's true, but I was never involved in that or part of that. I think that was more on the national policy level. Again, with him, he's always cordial. I would summarize that my relations with people on both sides of the aisle, certainly before going to Washington and even after getting to Washington, were pretty good.

I was a member of the administration's team and there would be times I would be right there with the administration's position. But I think they understood that. Give you an example of the other way around, Charlie Rangel is Chairman of a Select Committee on Narcotics in the House, wanted to have me come up and testify before his committee. I said, "No, it would be much better to have my Assistant Secretary from the Public Health Service come. He's closer to this." No, no, they insisted. They wanted the Secretary to come up. After this back-and-forth for about a week or so, we agreed I would go up. So I went up.

We're in the anteroom before the hearings and Charlie Rangel says, "Thanks very much for coming up. How are you doing?" and so forth. I said, "Fine." So when it's time for the hearing he'd go out and I'd go out and assume my position up front. All the committee members were there and all the television cameras were there. Charlie Rangel starts out, "Now Mr. Secretary, I want to find out, where is this administration's drug policy? I call the White House, they don't know. I call the drug czar, he doesn't know. So, Mr. Secretary of Health and Human Services, would you please tell me, what is your drug policy?" I'm thinking, What the hell is going on?

At any rate, this goes on. Then it becomes apparent to me, here are all these television cameras. What Charlie is doing, he's getting on the evening news back in New York at my expense. I'm the foil, that's why he wanted the Secretary up here, not the Assistant. The Assistant Secretary wouldn't have brought the television cameras. So for the next two hours, that was the way it went, with every member of the committee--because every member of the committee would have their own question, and once they were finished, they'd disappear. They're gone, they've gotten on the video.

At any rate, at the end of this, then it's, "Thank you very much, Mr. Secretary, for coming up." So we go back to the anteroom, I'm really burning. He says, "Lou, thanks for coming up. By the way, you're doing a great job." So that was part of the game, I understood.

After your early unhappy experience, how did your relations with the press go?

Always cautious. I really had been bitten, almost scuttled because of this press thing in the beginning. Then secondly, after that time, I always had my advisors to tell me whether I should talk with a reporter. There were some reporters I would talk with on their advice and others that I wouldn't. Also, we played the game too. We would play favorites. We would get a reporter, in essence through direct or indirect means, and we'd say, "Look, we'll give you access to the Secretary if you are good to us." So there would be some incentive there. But I always, after that fiasco with the Atlanta Constitution, I'd never talk to the press without my Assistant Secretary for Public Affairs or one of her assistants advising me. And also being in the room and recording everything, and so forth.

With that, there were some reporters you got to know and really liked. Phil Hilts with the New York Times was one. We would certainly try and favor him, give him a scoop. If we had something to announce, we would call him and give that to him. But I was always somewhat cautious with the press.

Seeing this side of the media, the Atlanta Constitution experience, was that one of the bigger shocks during your tenure, or were there others? I guess I'm trying to find out what it was that perhaps surprised you the most, being in a very high position.

It's that initial thing, that I really felt I was doing my local reporter a favor. I'd already been told, "Don't talk to the press," so I'm violating the advice I've been given because he had said he wanted to do a story that would be embargoed until after my confirmation, they want to do a profile and all of that. So I want to give the hometown boy an advantage and he's not going to do this until after I've been confirmed. My concern was not on abortion or anything, my concern is just that I'm not supposed to be talking to the press, but really set him up. So that burned me. I said, "Gosh, I've done exactly what they said I should not do." I feel stupid, because they told me you shouldn't do this. Here I go a few days later and do just that.

I'm just wondering if there were any other surprises, looking back on your four years, if there were things that stand out in your mind as, gee, it's not quite what I expected. I realize I'm asking you to--

I guess one of the things that was something of a surprise--I was aware of this before but not to the degree--really, the bully pulpit you have as Secretary. We're talking about symbols. Among the things that I did, of course, I walked every morning, I would use that to promote a healthy lifestyle. I'm walking the walk and talking the talk, so I'm not giving advice that I'm not following myself. I felt that being a physician and being an educator, I had a platform that perhaps my predecessors had not had, and so I should really use that to an advantage.

I think I mentioned that I visited our ten regional offices. I initiated a program that set up a fitness center in each of our ten regional offices and I dedicated the final one about two weeks before the end of my tenure, out in Kansas City. Also initiated the "Secretary's healthy menu" in the cafeteria of the Humphrey Building. Again, symbolic, but things like this get around the department and have a positive impact. So the degree to which you have a bully pulpit or people are watching you for cues, not only what you say but what you do, that really did surprise me. But then, that's what we do all the time with public figures, athletes as well as politicians or other prominent people.

Did your pace of speechmaking activity increase as the campaign season rolled back around in '92?

It was pretty active. I'm not sure I would say it increased; it may have. But frankly, I was pretty active throughout my four years there. As a matter of fact, at the going-away party at the department, what they presented me and my wife as a gift were two airplane seats from a plane, because I'd flown so much. I flew on average more than 300,000 miles a year because I traveled all around the country.

That's a tremendous amount of mileage.

I gave an average of more than 350 speeches, virtually one a day, within Washington or elsewhere. The only state I did not get to is Montana, I got to all other 49 states. Alaska, for example, Indian Health Service, very prominent up there. At that time, some 43 percent of the health care in Alaska was provided through the Indian Health Service. So I visited our facilities up there. Also, this was another way to ingratiate myself with Members of Congress, because Ted Stevens was very grateful when I'd be up there. I'd give him a platform, they would come and welcome me and all that sort of thing.

Remember, when I came in, I said, "I don't know this department, I don't know politics. I need to know the people in this department, I need to know all the parts," so I did that. That along with making speeches was one way I helped to establish my presence there, which I really felt I needed to do because I wasn't a Kemp who'd been around and people knew and all that sort of thing.

The other thing I guess I'd say is--we touched on this earlier--I really felt that my success or lack thereof would also be a reflection upon the African American community. I was the black Secretary and I was very conscious of that. I wanted to be successful for that as well. As I say, I looked upon my service as certainly addressing health and welfare and Social Security issues, but beyond that, a larger issue, being part of the American mainstream and in that sense kind of carrying that. In a sense, and some people look upon it as a burden, but I looked upon it as an opportunity, because from my growing up in rural southwest Georgia, I just felt that this is an opportunity I should fully exploit to try and help change people's attitudes and minds. I wanted to be successful, to demonstrate that success is not limited to one race, success can come in any number of races.

Also, I was conscious of the fact that I was only the second physician to head this department. More lawyers have headed HHS than physicians, and I was the first NIH grantee to head the department. So the scientific community and the academic community felt, Gosh, we finally got somebody in there who knows what our world is like. Of course, my worry was building up expectations beyond what I could deliver. But those were some of the things that I also had as part of my agenda too, beyond the specific programs of the department.

I realize you're not a political person, but I was wondering if you could give us your assessment of what went wrong for President Bush in '92, from your perspective.

Yes. First of all, it's the economy. That is, there's no question that people were hurting and in spite of the fact that the economists were saying, "Yes, it's coming back," and in retrospect it was, people hadn't felt that. That depression or recession, along with Bush's focus on the war, the feeling was that on international affairs, this is what animates Bush. On domestic things, he's not really interested. And I have to say, I think that was true to a degree, because I was very concerned that we had developed this health plan that I felt we needed, but they were not interested until Dick Thornburgh lost. Then even after announcing it early in '92, they didn't really push it.

So I think that is a lack of a visible, convincing, commitment to domestic issues when people were hurting, whether it was jobs or health or so forth. Also the political miscalculation that we won the war, look at the polls, let's not do anything to disrupt it. Let's just coast on reelection, then we can get back to work after that. That was obviously a miscalculation.

Was there a point where you realized that he was in trouble, do you recall that?

Oh yes. Actually, again, Kemp and I in the summer of '91 were saying, "We need to get serious. Now that the war's over, this is an opportunity for us to focus on domestic things." Bush, having been involved in the international scene, had the image of being really focused and interested only on international issues. So we felt, Okay, we've done that, now the incomplete part of the administration. Where we need to focus on and change perceptions are domestic issues. We just couldn't get traction on that. So that perspective and the economy I think were the things that turned out to be our undoing.

Did you personally feel like you made any headway in the black community in terms of helping President Bush develop more support there, or was it a draw?

I think we helped some, but rather than being able to march down field 100 yards, I think we maybe went 20 yards. I would say to the President, "Look, our approval rating in the black community is not very high. We can really move that a lot, but it's going to require some of your time and attention and you're going to have to resonate. You're going to need to meet with people like Lowery and Andy Young and so forth."

See, when Bush had come down to speak as Vice President at Morehouse, to me what was amazing, all these guys who were as partisan as any Democrat wanted to get their pictures taken with the Vice President. They did and they were very proud of that. So I said, "There's a certain status you have as President that people might vote against your policies, but they still want the association with you. You need to use that and turn that around." But didn't succeed with that and I felt that probably other advisors were drowning out what I had to say. From Bush's perspective, perhaps these were more seasoned political people whose words might be wiser than mine because of their experience, I don't know.

But there's been a sense, and I don't know exactly when this began, but a sense that Republican Presidents get a very small percentage of the black vote nationally, that if you could move that, as you suggest, from let's say 10 to 20 percent, that if you could double that in a very tight electoral environment, it really does accrue advantages. Some people have claimed it doesn't take a tremendous amount of investment to get that extra 20 percent. Let's not talk about getting 50 percent of the black vote, because that's not realistic. Did you get the sense that there were any political people that the President would listen to who were making that kind of argument?

This is the argument Jack Kemp was making, and I do think that Kemp had, within the administration and in the Republican Party, more credibility than I had. Because he'd been around, been in the Congress and all of that, and he was saying that. But even there, it was almost, "Oh, Jack, you know, wake up, be realistic." They didn't believe it. That, along with the fear of alienating some of the people on the right and so forth. But no, that was the argument I was making. Kemp and I were both making a similar argument, that within the black community there is interest and respect for business development, because that means jobs. There is certainly a very strong churchgoing community, the black church is very important in the black community. That's the other thing he was saying, he needed to meet with ministers and so forth.

And education is important. In so many ways, what is of interest to the black community is the same as in the white community. But what you have is a group of people where there are more social problems or disadvantages to overcome, and where the average black family has significantly less income. That it is going to take some time and some focused effort to help change that around. But as I said, it would be worth the effort, not only in terms of getting those votes, but also in terms of improving our country. It would be much better to have a bunch of people who are working and paying taxes, earning wages and supporting their communities, than having unemployed people who require a lot of social supports plus the breeding ground for crime and all kinds of other things.

So we're making that argument here. And of course I also pointed out to the President that my father was a lifelong Republican because he identified, like many blacks of his generation, with Lincoln. If that happened then, we could recapture it. But whatever the key was, we could never quite get it.

So it's your belief that ultimately he followed a kind of political sense that told him to go the other way, whereas his conscience probably would have told him to go--?

Sure. Because he's very proud of the fact that his mother was one of the founding directors of the United Negro College Fund and there's been a Bush there every year. I know that he and Barbara, every year, write out a personal check to the UNCF and a number of other things. I mentioned that Ben Payton went with us on this trip to Africa. Well, he spoke down at Tuskegee because of his commitment to education. So the family commitment is there and the history is there.

For whatever reason, and it's more complex than I could try and explain it, I think it was a combination of the intersection between personal conviction and compassion, and political calculation or political reality. Because again, I think of Bush's own personal history, he'd lost out to Reagan. He should have been nominated in '81 or '80, because he had been around a long time, had been in the Congress and so forth. He didn't and he lost out to this guy to the right, an actor of all things. My own feeling is that that was something that told him, "Now I need to be more calculating in how I approach this if I'm going to be elected." All this, remember, is my interpretation. He's never said anything like that to me.

Did you have any conversations, did you see him in the immediate aftermath of the election and gauge how he was handling it? Did you get any sense the impact the defeat had on him?

He was surprised and he was hurt, but, you know, he tried to be a good soldier. We had a gathering on the South Lawn of the White House, because they flew back from Houston and he tried to rally the troops and all that. We were all sad and disappointed at what had happened. Barbara in her own typical way said, "Well, we'll have some time to do that gardening we wanted to do," and so forth. But no, I think they were a little disappointed.

I had already decided that if Bush were reelected and if he asked me to continue as Secretary, I was going to do it for maybe 18 months more. The main reason for that was that was when the money was going to run out. I had some savings, but of course I was earning a hell of a lot less income as Secretary than I was out in the private sector and I was there really out of commitment and conviction. I wanted to be supportive of him and part of a winning team, but I had already quietly decided that.

But I wasn't presumptuous enough to even raise that, because if he had won the election, he might say, "Well, Lou, thanks very much, you've been a great Secretary and I'm going to let you go back to Georgia now, because I think it's time for a change," or something like that. So I felt that would be his call as to whether or not he would want me to continue serving.

I noticed you made some notes in preparation for this interview and I just want to make sure that we haven't missed anything that you consider to be of importance.

I guess the things I had written down about Bush, I knew about his strong commitment to education and to equal opportunity and I also knew that he was a very loyal person. Really, what he and Barbara had done to be helpful to us and his desire to have an impact on the nation. Also, we had the shadow of the Reagan Presidency. The Reagan Presidency was one of those larger-than-life Presidencies.

I know in my own calculus, you say there's [Franklin] Roosevelt, of course, and the New Deal, the big thing there. [Harry] Truman was fine, it was a little surprising he was as good as he was, but still, in spite of the things he accomplished, he was never Roosevelt. Then [Dwight] Eisenhower came in at the right time as a general and so forth. Then, of course, obviously Kennedy. Lyndon Johnson turned out to be a big surprise, because I remember when Kennedy was assassinated--and as you know, this weekend there were these stories on the news about this--I remember where I was, I was in the laboratory at Boston City Hospital when word got out, the President's been shot. What the hell are you talking about? And we're listening to the radio. I remember almost the exact scene there. I remember feeling, Oh my goodness, Lyndon Johnson's going to be President, this damn guy from Texas.

Well, Lyndon Johnson surprised me and a lot of other people because, as you know, he was a very active President on civil rights issues and so forth. Carter, while he was from Georgia, I think was kind of a disappointment. He was a friend of ours, but in terms of the firmament of Presidents, I think his star is really not one of the brighter ones. Then here comes Reagan. While I disagreed with a lot of things about Reagan, particularly about education, I realize that the impact of this guy and his Presidency was pretty substantial. So when I came in, I was very much aware that anyone who wants to be President wants to try and be sure that they have an impact. Bush really had a big hill to climb to emerge from the Reagan Presidency.

I wanted to be part of that and to try and help that happen, among other things. I think we talked about the tobacco cessation, et cetera. We also started a process that led to, for better or worse, regulations concerning privacy, the HIPAA [Health Insurance Portability and Accountability Act] regulations that almost every hospital administrator or physician will curse. I had a working group for electronic data interchange look at the mounting burden of paperwork that hospitals and doctors were confronting. So we said, "We'd like to develop a process initiative to move toward the use of electronic systems for storage and transfer of data," which we did back in '92. That led to HIPAA legislation in '96.

Let's see, one thing I didn't mention is, as part of my job as Secretary, I would go every year to Geneva to represent the U.S. at the annual assembly of the World Health Organization. Because it is very clear there that the U.S. really has a leadership role in influencing policies of that organization. Then the other couple of things that I was involved in and hadn't mentioned is I represented the President in a couple of instances when new heads of state came in, President [Alpha] Konare of Mali when he was inaugurated in June of '91. Also, I've forgotten the year, but when what's his name--in Haiti, who followed "Baby Doc" [Jean-Claude Duvalier]--

[Jean-Bertrand] Aristide?

Yes, Aristide was inaugurated, I was down there. I was in the middle of a mob and protection was absolutely not there, but actually not feeling any danger, interestingly enough, because it was a happy, friendly mob. But traffic couldn't go anywhere because streets were overrun with people. Then I led my own delegation to sub-Saharan Africa in January of '91 and we were there when the Gulf War broke out. We were in Zimbabwe. We were looking at AIDS/HIV and children's health issues with a 35-member delegation.

So although I was primarily a domestically oriented Secretary, there were some of these international things there. That's about it.

Was there any point at which you felt physical danger? Leaving aside the subpoena, the attempt to serve the subpoena when you were out for your morning walk--that sounds as though your wife was apprehensive at any rate. Was there any point at which you felt you were in physical danger when you were performing your official duties?

No, not danger in the sense of fearing for my life. But I guess one of the things I found trying was demonstrators. Now as I mentioned already, AIDS demonstrators were more of an annoyance. But I felt they were their own worst enemy, because they didn't know when to stop and usually the audience would turn against them, particularly at a commencement. People go to a commencement, I'm the speaker. So when I get up to speak, they stand up and start yelling or chanting or something like that. Well, after three or four minutes, the parents start saying, "Sit down, shut up." They're there to see their son or daughter graduate. So they would be self-defeating.

One group that you lost from the very beginning, are you familiar with a group called ADAPT [American Disabled for Attendant Programs Today]? Their issue was they wanted to have me as Secretary allocate one-third of the dollars we spend on nursing home care to home care, which I didn't have the authority as Secretary to do. That required congressional action, which they knew, but they always would use me as a foil. What they would do would be to come to some place where I'm speaking, whether it's a commencement or something else, they'd be in wheelchairs. I got so I could recognize them when I pulled up, I'd see these wheelchairs coming in, I'd say, "Oh-oh." They'd be very quiet, very courteous, so the ushers would push them right up front so that they could see.

They'd sit there through the program until I got up to speak, whereupon they all would throw themselves out of their wheelchairs onto the floor and start crawling toward the stage, chanting, "Why won't you meet with us?" Here I am, in the middle, or I just started a speech, and as you know, the axiom I was given by my public relations people is, "If you can't explain it in 30 seconds, you've lost it." Well, you couldn't explain to the audience, "These are people in wheelchairs, and they want me to allocate one-third of the Medicaid funds on nursing homes to home care. And I can't do this because I don't have the authority,"--I mean, really. So frankly I was trapped. I would just go right through my speech as if they were not there, and meanwhile the people in the audience would say, "Why won't he meet with those people?"

So that was the one group I really hated to see, because I knew that there was no way, I could never figure that out. But the animal rights people, they were an annoyance but we could handle them. The AIDS activists, the welfare rights people. We felt we could mount an effective counter to them. But not the ADAPT people, because the circumstances were such that we could never figure out what to do about this. But for whatever it's worth, I was the most picketed Secretary in the Cabinet, because people feel strongly about health, about things like AIDS, abortion, welfare, much more so than--they might have the conservationists on national parks or what have you, but usually those demonstrations are way out in the woods anyway, where people are not there.

Probably the most sued too.

Oh yes, oh yes, sure. Most of those were disability suits from Social Security, on disability income issues or what have you. I had the second largest legal department in the federal government, only after the Department of Justice. We had 800 lawyers at HHS, most of them on disability and other Social Security issues.

Do you have any final comments, either about your own tenure as HHS Secretary or about George Herbert Walker Bush? I think we've pretty much exhausted things, but I want to give you this chance if there are any final comments you'd like to make.

I guess I would say, in spite of the disappointments that we experienced, I think overall I feel good about the tenure. I think we accomplished some significant things here. My affection for the Bushes is as strong as it was before I went there, though I'm more politically seasoned now obviously than I was there. Secondly, I feel good about my tenure also. I frankly have been able to continue in the private sector some of things that I was involved in as Secretary.

For example, I'm currently chairing a commission on diversity in the health professions that the Kellogg Foundation is funding, trying to find ways to increase the number of minorities entering the health professions. Of course, I mentioned the AIDS Commission and the Commission on Black Colleges. Also, I'm involved in an interesting project now to try to develop a national health museum on the Mall in Washington. What has happened is, being Secretary has given me a platform that I didn't have before to do a number of things, and I'm enjoying doing them. So from that standpoint, in spite of my reservations about going to Washington--because I felt I was abandoning what I was really involved in doing, and also because of the federal ethics rules, I could not have any understanding, or any commitment at Morehouse, that when my tenure was over, I could come back. Had I decided on a two-year leave of absence I guess I could have, but I didn't do that.

So I had concluded that my Morehouse years were over when I went to Washington in '89. But then the fellow who succeeded me as President left in the middle of '92 to take a position with an HMO [Health Maintenance Organization] here in Fairfax, Virginia. The trustees approached me about coming back and I said I couldn't leave in the middle of an election year, because regardless of the merit of the reasons I'd be leaving, the press would say, "Secretary abandons President, obviously no confidence in the President's reelection prospects."

So I told the trustees no, you need to go ahead and find someone else, because if Bush wins, if he offers me a position to continue with him, I'll probably want to do that for a little time. I did want to take another real run at getting this health reform legislation. See, if Bush wins, he's no longer beholden to all those others and then I could really press him pretty damn hard and maybe get someone else and work to get this done. So that was part of what my calculus was.

Did you have to be careful that Morehouse didn't get more than its share of grants from the department or from NIH?

No, because I was recused from any decisions on that, so that helped. I also knew that Morehouse wouldn't hurt because I was Secretary, but I would let that process take care of itself and I never did anything for Morehouse, but the school did fine. At any rate, it enlarged my life and I'm doing a number of things now that I probably would not be doing had I not had that platform. I can influence some things that I'm sure I could not have otherwise. So overall I feel good about it. Talking with other people too, I don't know where I fit in the firmament of former Secretaries of that department, but in my view, probably the most outstanding people who have led this department were Elliot Richardson and Joe Califano. From comments by other people who wouldn't have any reason to be brownnosing me, they feel that my tenure was really comparable to theirs.

Also, when Bush first asked me if I would take this, he said, "Lou, I don't know if I'm doing you a favor or not, because this department has a reputation of being unmanageable. Eighteen months is the average tenure. But you would do me a great favor and the country a great service if you're willing to do it." So again, that was a challenge that I took: I'm going to prove this department can be managed.

At any rate, those were some of the things I was involved in. My circle of friends has enlarged because of this. So I don't have any serious regrets. I have regrets about things we did not accomplish, particularly on the health issue, because that issue is larger than ever now and it's more difficult than ever now. As difficult as things were then, things are much more polarized now between the two parties than was the case when we were there. At any rate, that's my final thought.

We want to thank you very much, this has been a very rewarding day, and we're very grateful that you've given us all this time. So thank you.

You're very welcome.