Dean's Roundtable James Mason, MD
James O. Mason, MD and Former Dean Cecil O. Samuelson, MD
Mar 7, 2018 12:00 AM
Dr. James O. Mason is a distinguished member of the School of Medicine’s Class of 1958. Given the Wintrobe Award—for being one of the top students in his class—Dr. Mason went to have a long and impressive career. Over the years, he was executive director of the Utah Department of Health, director of the Centers for Disease Control, assistant secretary for health and head of the US Public Health Service in the US Department of Health and Human Services, and the American delegate to the World Health Organization. Here’s what he shared in a recent Dean’s Roundtable.
Why did you pursue medicine?
Actually, my first selection was engineering, and I did two years of engineering at the University of Utah. Then after spending some time in Denmark on an LDS mission, it was that experience that led me into medicine.
The summer before I came home [from Denmark], in 1952; there was an epidemic of polio myelitis. There were so many cases with bulbar involvement [and people] couldn't breathe, and Denmark—this was not many years after World War II—didn't have iron lungs. Those were the ventilators in those days. They were as big as a silo and you could get 30 or 40 into a warehouse where you usually housed people who couldn't breathe themselves.
In Copenhagen, they didn't have any, so my experience there was not only the fear of polio, but watching people who were employed to bag these people who couldn't breathe on their own. There had to be shifts of them to keep them alive.
It was very impressive to me that you could keep people alive when they were afflicted by an epidemic disease. So, coming to medical school at the University of Utah was partially attributable to that experience in Denmark—seeing what was happening there and how important it might be to prevent those people from getting polio in the first place.
So, that led to your interest in infectious disease?
Well, there was another step in this—the Korean War. When I started medical school the United States government decided they would rather have me as a doctor than in the infantry or artillery, so I received a deferment. Although the war ended just as I graduated from medical school here, I still had a two-year draft obligation.
After my internship at Johns Hopkins in Baltimore, I was told that I could choose between the United States Navy or the United States Public Health Service. The Navy offered me a job on a cruiser where I would sail out of San Diego, and every six months I would be able to see my family.
By the time I had graduated from medical school, I not only had a wife, but I also had three children. My wife decided that I wasn't going to be seen every six months as I docked on that cruiser in San Diego. So, the other choice was United States Public Health Service. I'd always been interested in American Indians, and I thought, “I'd love to serve in the Indian health service for my two-year military obligation.” I submitted it to the Indian Health Service and nothing happened.
Here I am within weeks of having to go into the Navy and no response from the Indian Health Service. Just before I finished my induction into the Navy, I got a call from an organization I hadn't even heard of called CDC—that was Communicable Disease Center at that time—and they called and said, “How would you like to spend two years with us in the epidemic intelligence service?”
That was the most amazing experience I've ever had in my life. I was trained to be an epidemiologist. I took courses in bio statistics, and for two years I tracked epidemic disease and infectious disease in the United States. Putting that together with polio in Copenhagen and two years of military duty, I just decided, I'd like to make a career of this.
After my military obligation, the public health service said, “If you would pay us back, we'll send you to any training that'll accept you.” So, I was paid as a military captain and I completed my residency in internal medicine and then a master’s and doctorate in public health [at Harvard].
Tell us a little bit about your time at the CDC and in Washington, DC at Health and Human Services.
When I came back to the CDC as director, AIDS was just starting—1983. We rapidly recognized that we had major epidemic of disease on our hands, and yet, I could not get the budget to do what had to be done. I was told again and again, “Take it from what else you're doing.”
There wasn't anything that the CDC was doing that wasn't important, that didn't involve somebody's health somewhere along the line. I know we want small government and we want to break even and not increase the national debt, but there has to be a way, when you've got a crisis on your hands, to take care of that crisis.
Here I was under budgetary restrictions and not only do we have an executive branch and I was part of the executive branch, but we have a Congress and we have two parties in Congress and it doesn't matter what party you belong to, if you're going to succeed in Washington, or even in Atlanta, with CDC, you've got to play politics.
I was supposed to go up and tell Congress that I didn't need any money. That was the instruction coming down the executive line. It was not true. It wasn't true for FDA, it wasn't true for NIH. We all needed money. What does one do? You have a stewardship, a responsibility. You're being employed by these people, but the truth is over here. Isn't that what we're dealing with today? It's constant in government.
We were just in the first phase of investigating what's causing this disease. You can't do that by stealing money from other programs like maternal and child health or immunization or measles eradication. I had to tell Congress that I didn't have the funds to get the job done even though the message coming down was, “You tell them you've got enough.”
What are your thoughts on the current climate in public health at the CDC?
There are a lot of people who think that all of the major problems have been solved. Just take environment. One of the basic principles of public health is a safe environment. Folks before I came on the scene really cleaned up water. I've spent a lot of time in Africa. I spent a lot of time with the World Health Organization, and safe water and adequate supplies of water are absolutely vital. The thousands of lives that have been saved, it hasn't just been because of surgery and penicillin and things of that nature, but just cleaning up water. Problems are still occurring in many parts of the world. We haven't even totally solved old problems like water.
People have also reacted when the data hasn't been there. We've made mistakes—look at this researcher who says there's a link between the measles, mumps, and rubella vaccine and autism. One study and people take an opinion away, and then 20 [studies] are repeated and it doesn't hold up. There's no relationship between MMR and autism, but half the population is scared to death of MMR immunization… we've got to counter what the internet can so effectively do.
I think public health as a field of interest, is as exciting today and as challenging as it has ever been. We've got a lot of problems that have to be handled and they won't be handled by the doctor in his office, working one on one with a patient. It'll be a doctor who's responsible for not just individuals, but families and communities and defined populations.
What’s your advice to current or aspiring medical students?
Be the best doctor you possibly can. I've relied upon my medical training even as a hospital administrator or anything else I have done. Without good science, and without a good foundation, you can't do the other things. That's one of the problems with public health today. There are so many physicians that are staying away from the field and it's being led by people who don't have a medical degree. As soon as you cut environmental health and a lot of other things from its medical tether, it has no foundation.
Be a good doctor and get the best training you can get. Be the best you can be. Not the best that someone else in the medical school class can be, but the best you can be in those areas where you have talents… It doesn't matter what field you choose, but choose something that you have a passion for.
I'm 87 now, so I look back on a lot of experience and I've found that the joy is in the journey. I found so many of my medical school classmates were just looking forward to graduation and then doing this or doing that. Everything was way out there in the future. I think the joy is in the journey. I hope you appreciate being freshmen and sophomores. As I look back on it, I was thrilled just studying the marvelous human body. It's incredible. It's a miracle. I hope as you dissect that cadaver, that it means something to you. How does this thing work? It's absolutely marvelous. I'm just astounded by it. Enjoy these experiences. This should be exciting.