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http://www.nytimes.com/2002/07/23/national/23TALK.html

In Briar Patch of Advise and Consent, Safety First

By SHERYL GAY STOLBERG

ASHINGTON, July 22 — When President Bush nominated Dr. Richard H. Carmona to be the nation's next surgeon general, gay rights organizations put out the usual calls to check out his views on AIDS. The effort proved fruitless.

"There was nothing significant," said David M. Smith, spokesman for the Human Rights Campaign, a gay advocacy group.

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That, it seems, is precisely what the White House intended.

In the political briar patch that is the job of the surgeon general, Dr. Carmona, whose nomination the Senate is expected to consider on Tuesday, has a distinct advantage in winning confirmation: on such delicate public health matters as use of condoms and sex education, his record is largely a blank slate.

Dr. Carmona's selection is the latest embodiment of a Washington tradition: the nominee as tabula rasa. In an era when the Senate's mandate to "advise and consent" increasingly translates into "beat up and throw out," Democratic and Republican administrations alike pick nominees based not only on what they might do or say, but also on what they have or have not done and said.

Democrats do not blame the Bush White House for being gun-shy.

"Increasingly, we're seeing blank slates because it's safer," said Donna E. Shalala, who was health and human services secretary under President Bill Clinton. "It's a tremendous loss because it means that you don't have people who have been tested in a public arena, who have gotten mud on their face."

The trend, Dr. Shalala said, is by no means limited to Republicans. But in the case of Dr. Carmona a blank record will be especially handy when working for President Bush.

Typically, surgeons general are selected from the nation's public health experts, as was the previous one, Dr. David Satcher. But President Bush has taken strong stands against abortion and in favor of sex education that emphasizes abstinence, which made it difficult, if not impossible, for the White House to find a public health expert willing to serve as surgeon general.

"The majority of public health people disagree with the administration," said Dr. Mohammed N. Akhter, executive director of the American Public Health Association. "Public health people look at the science, and political people tend to go more toward emotion."

Dr. Carmona is a trauma surgeon whose colorful personal history has generated a buzz in Washington. A "high-school dropout and poor Hispanic kid," as he describes himself, he grew up in Harlem and is best known for his dual career as a hospital administrator and sheriff's deputy in Arizona. Though his views on medicine have not generated controversy, his career as a manager has. Critics have said he can be hard to work for.

Even so, he is expected to be confirmed, in part because the Democrats do not consider the surgeon general's job worth fighting over.

One indication of that is the gentle questioning Dr. Carmona received from the Senate health committee. Democrats on the panel did not even bother to ask for his views on abortion, the use of condoms or abstinence, but only for his views on education. As a result, one Democratic aide said, Dr. Carmona "doesn't bring a lot of baggage" to Tuesday's confirmation debate.

Baggage or not, Washington has learned to expect surprises from nominees, particularly those for surgeon general. President Ronald Reagan picked Dr. C. Everett Koop for his strong opposition to abortion. Dr. Koop later rankled conservatives by speaking bluntly about AIDS.

"I think we see something similar in Dr. Carmona," Dr. Akhter, of the public health association, said, noting that Dr. Carmona recently joined his group. "We believe that, just as Dr. Koop did, people can rise way beyond what other people expect."

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