“The world is locked in a struggle between love and fear. Choose love. It is the world’s oldest medicine.”

The above quote was posted by Vivek Murthy, MD, better known as the Surgeon General soon after surprisingly being removed from the position despite having served only half of his 4-year term.

This is not a piece about politics as the Surgeon General position is one of the few that historically is not replaced when the the President who appointed them leaves office and a new administration even from the opposing party steps into power. Often that Surgeon General finishes out their term and the respect and importance of the position transcends party lines for the sake and health of Americans.  

Certainly in the few instances when there has been such a change, that Surgeon General was not suddenly removed without notice changing the current SG from one moment to the next. I’m not aware of this occurring as it did in this case without a new Surgeon General stepping in to immediately provide some sort of stable continuity. Dr. Murthy was replaced by a temp. An “acting” Surgeon General who has to fill this giant role temporarily while a new Surgeon General is appointed by the President. At this point it is unknown whether there is a candidate in mind.

For now, the temporary Surgeon General is Sylvia Trent-Adams, RN, PhD, who fills this role (temporarily) coming from her position as the Deputy Surgeon General. I hope her experience serving as Deputy to Dr. Murthy, preserves the basic and historic tenants which were at the foundation of his abbreviated time as the Surgeon General.

The news about Dr. Murthy, only 39 but accomplished way beyond his years, was released in a not-so-glowing manner, except the often obligatory throw-in sort of compliment. The Department of Health and Human Services announced on Friday that Dr. Murthy was “asked to resign and was relieved of his duties” after reportedly “assisting the new administration in its transition.” I wonder how long this aiding in the transition lasted given that Dr. Murthy was surprised to be removed and with Dr. Georges Benjamin the Executive Director of the American Public Health Association reacting with surprise, going on to say, “I knew he anticipated completing his four years. He was expecting to do that.”

Dr. Benjamin continued to state that the Trump Administration’s removal of Dr. Murthy “is another way of politicizing the job, which is in appropriate.” Benjamin continued by stating, “the reason why the Surgeon General has a term [often not coinciding with that of the President] is to depoliticize the position.”

While the HHS did not provide a reason for relieving Dr. Murthy of his position, speculation includes and is focused on both his role in helping lead a successor group, “Doctors for America” that supported passage of the Affordable Healthcare Act and because of his declaring gun violence a public health issue. The latter of which enraged the NRA and its congressional allies.

Dr. Murthy accomplished a great deal in his abbreviated time as Surgeon General injecting a realistic view of the state of health related matters in America as well as injecting a youthful energy and proactive conduct.

He went after one of his top priorities as SG, which he referred to as “tobacco and drug free living,” by sending a letter in November of last year to more than a million prescribers of controlled substances, asking them to help battle the opioid epidemic through better prescribing habits (as a start).

That same month he released the historical report, “Facing Addiction in America: The Surgeon General’s Report on Alcohol, Drugs, and Health,” which was so comprehensive and truly tailored to Americans across the board, as the historic Report explained, in clear and understandable language, the effects on the brain of alcohol and drugs and how misuse can become a disorder.

It described the considerable evidence showing that prevention, treatment, and recovery policies and programs really do work providing examples. The Report also discussed opportunities to bring substance use disorder treatment and mainstream health care systems into alignment so that they can address a person’s overall health, rather than a substance misuse or a physical health condition alone or in isolation. Additionally, it also provided further suggestions and recommendations for action that everyone—individuals, families, community leaders, law enforcement, health care professionals, policymakers, and researchers—can take to prevent substance misuse and reduce its consequences Throughout, the Report provides examples of how individuals, organizations, and communities can partner to lessen and eliminate substance misuse. The report was adamant that these efforts have to start now.

This report was considered the most important and aggressive positive report by a Surgeon General on a Health Crisis while simultaneously providing solutions through all ranks of society since the landmark report on smoking issued in 1964.

Dr. Benjamin further expressed his disappointment saying that, “I thought he [Dr. Murthy] was visible on all the right issues.”

Along with the quote at the headline of this post, Dr. Murthy shared some brief but poignant reflections on his equally brief tenure as Surgeon General.

On his Facebook page, he wrote, “”For the grandson of a poor farmer from India to be asked by the president to look out for the health of an entire nation was a humbling and uniquely American story,” he wrote. “While I had hoped to do more to help our nation tackle its biggest health challenges, I will be forever grateful for the opportunity to have served.”

He listed a number of lessons he picked up on the job.

“We will only be successful in addressing addiction — and other illnesses — when we recognize the humanity within each of us,” he wrote. “People are more than their disease. All of us are more than our worse mistakes.”

Despite being publicly removed from a position which usually leaves politics out of the way (to the extent one could hope for), he remained positive and humble, wrapping up his thoughts with his quote that bares repeating, “The world is locked in a struggle between love and fear. Choose love. It is the world’s oldest medicine.”

Dr Murthy added in closing that, “the nation will be in capable and compassionate hands” with Dr Trent-Adams taking over as acting surgeon general.

I’m optimistic she will perform the role well, and was moved by her introduction to the above mentioned report released in November.

A 24-year veteran of the USPHS Commissioned Corps, Dr Trent-Adams has served as chief nursing officer of the USPHS and the deputy associate administrator for the HIV/AIDS Bureau in HHS. Before joining the USPHS Commissioned Corps, she was a nurse in the US Army and a research nurse at the University of Maryland.

She certainly will have her hands full, especially with the knowledge that at any tine, she too will be removed as her temporary role as Surgeon General has not been given a timeline beyond stressing that it is indeed temporary.

I have faith in her and hope she’s allowed the freedom necessary to perform the duties required. My faith is increased somewhat. I mean, after all she did go to University of Maryland.

Despite my attempts at making this news a little more light hearted, as a Clinician and a Parent, I worry about the future of healthcare across all disciplines. I’ll save some of the other disturbing news for another time and take this moment to thank Dr. Murthy for a job well done. It’s just too bad he got removed as he was really beginning to enlighten the public while attempting the next phase of his plans to impact us all for the better.


Like it has been and continues to be said in many 12-Step Programs and Treatment Facilities for many years across the world, “More will be revealed.”

Medscape, Vivek Murthy, MD, Replaced as Surgeon General.

Mounteney, J., Griffiths, P., Sedefov, R., Noor, A., Vicente, J., & Simon, R. (2015). The drug situation in Europe: An overview of data available on illicit drugs and new psychoactive substances from European monitoring in 2015. Addiction, 110 (11).

U.S. Department of Health and Human Services (HHS), Office of the Surgeon General, Facing Addiction in America: The Surgeon General’s Report on Alcohol, Drugs, and Health. Washington, DC: HHS, November 2016.

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