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The Straight Dope


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Why does the United States Surgeon General appear in a military uniform? Have they always done so? Is it because they are leading the nation's battle against disease, smokers, and ill health in general? --Jon Komatsu, Pearl City, Hawaii

The surgeon general wears a uniform because the organization of which she is the chief, the U.S. Public Health Service, is a uniformed service. So is the postal service, you may say, but the postmaster general doesn't get to dress like Horatio Hornblower. The difference is that the PHS began as the Marine Hospital Service, which was organized along military lines in 1870 to minister to merchant sailors. The members were (and still are) given military-style commissions and naval-style ranks, the idea being that they were a mobile force ready to be thrown into the fray wherever germs raised their ugly if invisible heads. One supposes the fact that MHS doctors often served alongside regular military personnel (e.g., in military camps during wars) and sometimes had to order them around also argued for ranks and uniforms. In 1912 the Marine Hospital Service was reorganized as the Public Health Service (which is now part of the Department of Health and Human Services), but the military trappings remain.

Some PHS officers today do lead a semimilitary existence, serving tours of duty on Indian reservations or in prisons and the like. But many others are longtime medical researchers at federal labs who joined the PHS rather than the civil service mainly because of the attractive retirement benefits. (You can leave with a nice pension after just 20 years.) Uniforms had fallen into disuse until C. Everett Koop was appointed surgeon general by Ronald Reagan. Koop conceived of his post as a bully pulpit and thought the uniform (the SG is the equivalent of a three-star admiral and has a similar uniform) would get people to take him more seriously. Instead, at least at the outset, it got them to take him for an airline steward; Koop has talked in interviews about good-naturedly hoisting bags into the overhead bins for fellow passengers.

Eventually, though, Koop's considerable personal presence enabled him to put the uniform thing over, and he decided all commissioned PHS personnel should start wearing them. This rankled the troops, and the current SG, Joycelyn Elders, has not insisted that they be worn. But she puts one on herself for official appearances, and one gathers they are more commonly seen on PHS officers than they used to be. The whole thing may incline us civilian scoffers to make jokes about swords and epaulets and crossed-hypodermic insignias. But Koop and Elders have spoken out forcefully on public health issues like AIDS and smoking, and if uniforms help get the message across, what the hell.

Why does the sun darken skin but lighten hair? --Listener, Garry Meier show, WLUP-FM, Chicago

Cecil's representative, well-intentioned but feeble as always, was able to get through the first part of this answer on the air but was obliged to have the second part explained to him by another caller. Explained to him incorrectly, as it turned out, but when all you know is that you don't know you can't complain when you get shown up by someone who doesn't even know that. Sun darkens skin because it triggers the production of melanin, a brownish-black pigment that helps protect other tissue from harmful ultraviolet rays. OK, OK, actually the UV light triggers the breakdown of melanin molecules, and your skin, being live tissue, creates more of them, thus making you darker. Your hair, being dead, doesn't create more, so it just gets lighter. The exact mechanism by which all of this is accomplished is not as clear as it might be. "The ionic pathway probably begins by nucleophilic attack of the peroxide anion on the o-quinone grouping," says one medical text, clearly written by the kind of guy you wouldn't want to have season tickets next to at the ballgame. In any case, little Eddie will certainly spit out the answer quicker next time it's asked.

Art accompanying story in printed newspaper (not available in this archive): illustration/Slug Signorino.

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