DAVID A. KESSLER, M.D.
COMMISSIONER, FOOD AND DRUGS
EINSTEIN COLLEGE OF MEDICINE
PALM BEACH, FLORIDA
FEBRUARY 7, 1993
Good evening and thank you.
I'm delighted to be here, back with the Einstein family.
It's especially nice to be at an occasion honoring Dom and Penny Purpura--colleagues and friends.
I left Einstein a couple of years ago, but I haven't left it behind. I would like to believe that every day in my work as FDA Commissioner I call upon the values, the ethos, that make Einstein such an extraordinary place.
I'm talking about a sense of mission. About a calling. About the belief that each person can make a difference. That's what Einstein is all about.
I can do no better as a public servant than to bring those values to my work.
Last year when I spoke to the Einstein graduating class, I drew the distinction between a profession and a calling.
A profession, I said, is something you train to do. Something that you can change. Something that can get to be rather routine.
A calling is something that captures you. Something that frames your decisions and goals.
It's not something you leave behind when you pack up in New York and move to Washington. It's your compass-- your very personal compass.
The pieces come from the people you've met and the places you've been, but the craftsmanship is your very own.
It's what you return to to gauge your personal sense of success--whether you are running a hospital or a large federal agency responsible for assuring the safety of our foods, our drugs, our blood supply, our vaccines.
When I left a rewarding, challenging, and comfortable position at Einstein a couple of years ago to go to Washington, there were some eyebrows raised in New York.
Some whispering, I'm sure.
What was I getting myself into? After all, government service was not held in the highest esteem.
Wherever you turned, you heard that the American people had grown hard and cynical. That there was widespread disenchantment with our institutions, our elected representatives, and with an American dream that seemed to have failed.
Public service was part of that dream, and it was no longer perceived as a noble calling. That's what you heard. But don't you believe it.
During the past couple of years, since I became FDA Commissioner, I have had many wide-ranging conversations with my FDA colleagues. They, as much as I, are concerned with the public perception of our calling, and they, as much as I, sense the beginnings of a change in the national mood--a shift away from those negative values that have occupied American thought over the past decade.
The cynicism is still there, both inside and outside public service, but I sense a growing movement toward a practical form of idealism.
And that strikes a responsive chord with me because it
represents those values that I have tried to bring to my work as a physician, an administrator, and now as a doctor in the public service.
Our first priority when I came to the FDA was to restore the Agency's sense of pride.
Not the sort of pride that has been in fashion lately. Not the pride that your wear on your sleeve for others to admire and applaud. Not your pride in an expensive car or the school you send your kids to. Not even the justifiable pride of achievement in your chosen profession.
What we had to instill at the FDA was the private sort of pride that is always kept hidden, the pride that comes to your rescue during those dark times of the soul when doubts and disappointments go bump in the night.
It's the pride that comes with knowing that you have set your own course, and have stuck with it.
Idealistic? Yes, but practical as well.
For no worthwhile undertaking was ever translated into action without the moral support of that private sort of pride.
In the actions we have taken over the last couple of years-- getting important drugs out quicker, revising the food label or insisting that our food and drug laws are adhered to-- we gave our people at the agency something to be proud about. We gave them a cause in which to be confident.
We gave them a place where, once again, the good guys could win.
I went to Washington because I saw an opportunity to make a difference. I saw an opportunity to build on what I had done in the past and stay true to my calling.
A physician--or anyone--in the public service enjoys the most fascinating career that a person could ask for.
For a doctor, the only patient is the body politic, and the limit of responsibility is nothing less than the health of the nation. And the well-being of the nation, along with the well- being of public service, rests in the simple recognition that problems can be solved if we are willing to face our responsibilities.
Real human progress depends not so much on inventive ingenuity as on conscience. And just as a philosopher may believe in the perfectibility of man, my conscience leads me to believe in the perfectibility of public service.
But it must be the type of public service that not only draws upon the most rigorous of analytical methodology, but also articulates what we stand for and where we are going.
It must be the type of public service that seeks responsibility, not power...that seeks trust, not authority...that seeks integrity, not rank or privilege.
It must be the type of public service that equates its mission with public interest, not special interests.
The type of public service that enlists people of courage-- those who are willing to resist public and political pressure.
It must be the type of public service that enlists people of judgment--those who are willing to take risks, who are willing to admit past mistakes and are willing to correct them.
The type of public service that enlists people who are dedicated to the principles set out in the laws of the nation.
And it must be the type of public service that makes the complex decisions, as Emerson said, "on a few strong instincts and a few plain rules."
The decisions that occupy me every day at the FDA are on the surface very different from those I confronted when I was at Einstein.
Then, no one woke me in the middle of the night because a tampering had occurred that some very troubled person was putting poison in over-the counter capsules.
But scratch the surface and you will find that what we are working so hard to accomplish at the FDA is not so different from the mission that Einstein has succeeded at so well.
The very things for which I admire Einstein--and which the Purpuras embody--are the foundation of my work today.
I'm talking about the ability to scale the twin peaks of scientific excellence, and social medicine and public health. Some may think that those two are incompatible.
The scientists, manipulating test tubes and petri dishes and machines in the exquisite isolation of the laboratory. Worrying about cell counts or pieces of DNA.
Outside the laboratory, in the inner cities of this country, in the hospitals, are the human faces of this country's health care crisis.
The faces that dedicated public health workers cannot shut out. Dom and Penny have shown that both roads can be taken.
They have ensured Einstein's commitment to serving this country as a premier biomedical research institution.
Every day, it seems, I come to realize more and more how much this country's welfare depends on a solid basic science research establishment.
How much we at FDA depend on the work done at places lik Einstein. Let me give you a recent example.
Some of you may recall that a couple of months ago we approved the drug Taxol for ovarian cancer. We were able to bring that promising drug through the review process in record time: five months.
A good part of the reason was that we had the data we needed to evaluate the product.
And a big part of the reason we had the data is Dr. Susan Horowitz, a medical researcher at Einstein.
Back in the 1970s, many scientists had given up on Taxol. It seemed to have promise as a cancer therapy but it also had problems that seemed insurmountable to many scientists.
But Dr. Horowitz pushed on, discovering Taxol's unique mechanism of action. Her pioneering work got other researchers excited about Taxol again, and the result is a product that can help cancer sufferers around the world.
But beyond any single product, the Purpuras have recognized the importance of university-based research for basic science discoveries.
These discoveries generate applied technologies, which in turn create jobs, spawn new businesses, develop new therapies that cure diseases, that help people, people who pay taxes-- taxes that can be plowed back into new basic science discoveries.
Basic research is a major American resource for the 21st century. It's our collective strength, our answer to global competition, our economic lifeline.
It's the product of a creative genius that has been nurtured for decades, and has taken hold. Some people in Washington, and elsewhere, argue that more targeted research--designed with a specific purpose--should take precedence over basic research.
They risk making a terrible mistake.
Our commitment to basic research has served this country well for nearly 50 years. Extremely well.
But with people like Dom and Penny as champions of basic research and with the example they have set, I believe common sense can prevail.
They also set an example in that second peak I mentioned: social medicine, advancing the public's health.
Recently, Dom gave a speech in which he observed that two "cataclysmic events" had occurred in 1992: One, the dissolution of the Soviet Union and two, creation of a family medicine department at Einstein.
It is the first family medicine department in a New York City medical school, and it reaffirms Einstein's leadership and enduring commitment to social medicine and improving the health of all Americans.
Most of you know, the Albert Einstein School of Medicine was founded after World War II, largely in reaction to the horrors of that period.
It was the first medical school under Jewish auspices. And its founding principle was nondiscrimination.
When Albert Einstein gave permission for the medical school to be named after him, he said: "This enterprise is the greatest contribution the Jewish community has undertaken for the common weal of the American people."
He was speaking of all the American people. I see the pre- eminence of nondiscrimination being revived these days in Washington--in the name of inclusion.
That is what Einstein is about, what Dom and Penny are about and what I believe public service is all about.