Charity of Heart

In the dedication of her book, Joycelyn Elders, M.D.: From Sharecropper's Daughter to Surgeon General of the United States of America, Dr. Elders mentions wisdom her mother offered her: "Recognize the truth and speak out against wrongdoing." That advice is probably what got Elders into the top medical position in this country...and what caused her forced resignation after 15 months as Surgeon General.

Born in 1933, Minnie Lee Jones spent her childhood as a sharecropper’s daughter in Schaal, Arkansas. She never dreamed that one day she would be Dr. Joycelyn Elders, Surgeon General of the United States. Because of the loving support of parents, the kind attention of both church elders and school administrators and teachers, and the openness of affirmative action policies while she was growing into adulthood, Elders’ skills in science, research, and public relations were recognized. Now, in her autobiographical book, written with David Chanoff, she describes her journey from back-country Arkansas to Washington, D.C.

Most interesting in this book is her discussion of how to improve the lives of poor people in this country. Elders became well known for a couple of statements she made about illegal drugs and masturbation. However, these issues were never her focus in public office. Elders’ main focus as director of Public Health in Arkansas, as Surgeon General, and as private citizen today is "comprehensive health education, prevention of teenage pregnancy, early-childhood education, school-based clinics to make health care available for all children, a preventive approach to health care for everyone."

Elders didn’t begin her doctoring days with this agenda. Becoming state director of public health in 1987 moved her out of the university research lab and right up against the poverty and lack of education and health services she had known so well as a child. And they turned her into a committed advocate for health education.

Elders began to focus on what would bring people out of poverty into a healthy, productive life. It became clear to her that eliminating unwanted teen-age pregnancy was a major part of the solution. "In 1987 the United States had the highest rate of teenage pregnancy in the industrialized world, as it still does. We know that 80 percent of children born to unmarried teenagers would be living below the poverty line....Teenage pregnancy was the major single cause of poverty and ignorance."

For those of us who seek nonviolent lives both for ourselves and others, Elders speaks in strong words about making moral decisions for poor adolescents in our country without having lived in their conditions. Right-to-life needs to begin with the right of children to a healthy, educated childhood that will open doors for a better future.

Elders makes it very clear in her book that she is not talking about abortion. She is talking about comprehensive health-care education, self-esteem, avoiding abuse, and giving children hope and goals for the future. "Our opponents on school-based clinics had decided that I was in favor of having everybody go out and get abortions. But that had nothing to do with what I wanted. I wanted to prevent unplanned, unwanted pregnancies. I never knew a woman who wasn’t pregnant to need an abortion."

As director of public health in Arkansas, Elders proposed school-based clinics in poor rural and urban neighborhoods. She hoped that these clinics would be a health-care preventive system, teaching the children how to respect their bodies and keep them healthy.

She tells the story of her first school-based clinic at Lakeview High in Arkansas. More than 90 percent of the school population was black, and 75 percent of the senior girls were either pregnant or mothers already. Medical screenings found everything from hypertension and heart murmurs to the whole world of sexual abuse and a "widespread feeling among these young people that life was not worth living, which was connected directly with alcohol and drug use and early sexual activity." In the first year the clinic ran at Lakeview, the pregnancy rate at the school dropped to zero, and remained there for the next four years. But the vocal alarm about teaching family planning and the distribution of condoms made the clinic reduce its education program, and the rate then rose again.

Elders makes some very clear arguments about abortion and sex education. In fact, she is adamant. She clearly states she is pushing education, not abortion. "Interestingly, there was no trouble getting the drug education program into schools. I didn’t hear any of the conservatives shouting that drug education would lead to increased drug use.

"[These people] do not support the things that support children. They just want to take care of the fetus until it’s born," she says, speaking of people from the Christian Right. "These are non-Christians with a slave driver mentality."

I began to wonder if Elders knew of people like me who struggle with the balance between women’s rights to their own bodies and the issue of not killing another, which I think includes abortion. As a signer of the Seamless Garment Statement, I continue to try to oppose killing in all the ways society arranges it—war, death penalty, poverty, racism, sexism. I found the paragraph I was looking for when I read, "There are those in the antiabortion movement whose stand is part of a philosophy that includes opposition to the death penalty and a commitment to the poor. Those groups deserve respect, no matter how deeply I disagree with them about a woman’s right to choose. But there are others whose moralizing is hollow because it is not accompanied by charity of the heart."

Uninformed as a child of how to care for her own health, Elders is clear about what public policy should be for adolescent health care. I felt challenged by her willingness to speak out for the poor among us. She is offering our youth a future of promise, a way out of poverty, a chance for education and health, rather than the spiral of children bearing children, poverty begetting poverty.

I recalled the advice of Elder’s mother: "Recognize the truth and speak out against wrongdoing." If we want to take that advice ourselves, we should read this book carefully.

NANCY RICE is a free-lance writer living in Albuquerque, New Mexico. Formerly, she was a member of Jubilee Partners in Comer, Georgia, and a United Methodist pastor.

Joycelyn Elders, M.D.: From Sharecropper's Daughter to Surgeon General of the United States of America. By Joycelyn Elders and David Chanoff. William Morrow and Co., 1996.

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