"Before I started, I visited my father in his nursing home. He was a cardiologist. Quiet, kind, and a man of few words. Parkinson's disease had silenced him almost completely. I sat at his bedside, holding his hand, and told him about my new role. "Dad," I said, "I want to be the best health commissioner." He looked at me and softly spoke last words he would ever speak to me: "How would you know?""
"It was a devastatingly simple question. How do you know if you're doing a good job in public health? Being the best doesn't mean giving the best speech, pushing through the boldest policy, or even working the longest hours. It means saving the most lives. But how could we measure that? At the time, tobacco was killing more New Yorkers than anything else. Yet we didn't even know how many people smoked. No one was counting."
"That changed when my colleague Dr. Farzad Mostashari launched a simple but powerful survey. We started calling 10,000 New Yorkers every year, asking if they smoked cigarettes. The results were sobering: 22% of adults smoked, with no progress in a decade. If nothing changed, tobacco would kill 400,000 New Yorkers and disable a million more with heart attacks, strokes, lung disease, and cancer. Now we could see the crisis clearly. The next step was to act."
On September 11, 2001, presence in rural India prompted immediate return to New York after witnessing the World Trade Center attack. Three months later Mayor-elect Mike Bloomberg appointed the narrator as health commissioner. A visit to a father with Parkinson's produced the question "How would you know?" prompting a focus on measuring public-health impact by lives saved. Annual telephone surveillance of 10,000 New Yorkers found 22% of adults smoked and no progress in a decade, projecting 400,000 deaths and a million disabilities if unchanged. Raising the tobacco tax became the central policy pursued despite fierce political opposition.
Read at Fortune
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