First Woman, Latina Surgeon General Details Life of Public Service in New Book

After decades of working in the public eye, Antonia Novello says she’s not retired but in transition, and she isn’t done yet

Jennifer Ortiz,

AARP

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En español

Published April 02, 2024

Antonia Novello, M.D. was the surgeon general from 1990-1993

Antonia Novello, M.D., was the nation’s 14th surgeon general from 1990 to 1993 — the first woman and the first Hispanic person in the role.

Jack Thompson

Antonia Novello, M.D., wants you to know her name — and her full story.

A quick search will reveal her history-making role as the first woman and the first Latina to become surgeon general of the United States. In her three years as the nation’s top health official under President George H.W. Bush, she championed the health of women, children, Latinos and other underrepresented groups during major moments in public health. Novello promoted early childhood immunizations, combated underage smoking by tackling tobacco advertisements aimed at children (particularly those featuring Joe Camel), and launched initiatives during the AIDS crisis to focus on women and the prevention of neonatal transmission of HIV. She continued her role as a public servant in 1999 under New York Gov. George Pataki as commissioner for the state’s Department of Health and was responsible for the public health response in the aftermath of 9/11.

Antonia Novello is sworn in as the 14th U.S. surgeon general by Justice Sandra Day O’Connor. Left to right: Novello’s mother, Ana Delia Flores Coello; Antonia Novello; her husband, Joseph Novello; President George H.W. Bush; Justice Sandra Day O’Connor; and Louis Sullivan, secretary of the Department of Health and Human Services.

Barry Thumma/AP Photo

But reading about her accomplishments doesn’t tell us her full story. That’s Novello’s aim in her recently published memoir, Duty Calls: Lessons Learned from an Unexpected Life of Service, in which Novello, 79, recounts her challenging path to surgeon general and her crumbling marriage. Novello, with the help of coauthor Jill S. Tietjen, details the prejudices she faced as a Puerto Rican woman studying and working in the United States, as well as her story of falling in love with, divorcing and continuing to be fiercely devoted as a caregiver to her ex-husband and his family.

Fulcrum Publishing

“I’m not getting any younger, and I want this to be written while I still remember,” Novello writes in the book’s preface. She didn’t want to be left out as “one of the few US Surgeons General without a book.”

In an interview with AARP, Novello shares what grownups can gain from her memoir.

This interview has been edited for clarity and length.

What accomplishment are you most proud of, whether in your personal life or your career?

Everybody asks me, what [role] did you like more: surgeon general or commissioner of health of the state of New York? And I think they are two different jobs. It was quite a surprise for me to be health commissioner of the state of New York with such a budget and being able to do what I promised I would. From the perspective of the surgeon general, I could convince the world of doing everything, but I had no money to [do] it, just my voice and the power of the office. Both of them had lots of occasions where it was marvelous to be able to participate, but [being] commissioner of health for the state of New York, specifically on Sept. 11, made it different. All I know about public health, I practiced [during] those particular three months. And I feel very good about accomplishing some of the goals: saving lives, identifying the dead and protecting the children.

You have experienced a lot of prejudice in your life, particularly when you were going to medical school. With much of the physician workforce still white and male, what is your hope for the future of health care as it relates to having more diversity in the field?

Remember, there’s only 6 percent of doctors that are Latino and 5 percent of doctors who are African American and only 0.3 percent that are Native American. So if one sees that Native Americans are 2.9 percent of the United States population and African Americans are 13.7 and we Latinos are 19 percent, we don’t have enough to take care of ours. The most important thing that I think we have learned from all this trajectory is that language is not enough. You absolutely have to know the culture, because otherwise you will not reach the people that you were meant to save in that time.

You’ve worked to increase access to health care for underserved communities, such as Latinos, Native Americans and the LGBTQ+ community during the HIV/AIDS crisis. In your opinion, what are some of the most pressing health care issues that these underserved demographics are still facing today?

One of the things that is very important: There was a poll done, I think in 2022, asking the American public if they felt there was bias in this country, and 47 percent [said] absolutely not; 17 percent were totally unsure. I tend to believe that when you look into our culture and our ethnic groups, there [are] biases, and when you have biases, health has biases. The prejudice will take over the way that you practice, and you will become just a deliverer of a prescription but not a deliverer of health care.

In your personal life, you were a caregiver to many in your family who were experiencing health issues. What advice do you have for caregivers?

Remember that an average woman loses 11.5 years of her life being the caregiver, either as a family member or a member of the family by marriage, and by the time she wants to go back to work, it’s extremely difficult because she has lost all the ability to be on top of every knowledge that is there. And I don’t think that is recognized. And even now, caregivers that are paid, they have to do at least two to three jobs to be able to maintain themselves, surviving in the world that is getting so expensive. I have a feeling that we’re not giving the caregiver the importance and the respect they deserve. Having cared for my ex-husband for so long, almost two years, I feel that I was tremendously criticized by my peers. As I look back now, I have no remorse, no remorse whatsoever. If asked again, I will do it again.… I was there just to be able to help him until the end, and he died with me. When it’s asked, you give it; you don’t think about what it would cost and what you will lose. Caregiving is an act of love. And caregivers need more respect for what they give, not disdain for the presence of having done the job of somebody else.

What advice do you have for others who are grieving losses of family members?

The most important thing is: Get them close to their God. Make sure that friends come to see them. And in spite of telling them the end is near, give them hope. In your face show love, affection, and make sure that you spend time, quality time. Hold their hands. Pray with them. And more than anything, make them happy with your presence and promise that you’re going to come back — and do come back. False promises at the time of sickness only augment your feeling of loneliness, so don’t do that. Respect them for what they are and what they were. At the end, I think that they really appreciated it, and the happiness in [their] face when you walk into that room pays off for all the things that came after.

Antonia Novello, M.D. standing near a bust of President George H.W. Bush

Antonia Novello poses with a bust of President George H.W. Bush, who nominated her to the nation’s top public health role.

Jack Thompson

You say in your book: “I have come to realize that I have mostly lived to please society and others and in the process have forgotten about myself.” How are you focusing on yourself in retirement?

In these types of jobs I have had, there was no time to be flippant, to be noninvolved, to the point that I forgot about my own life. So I wish I would have had more time to be much more with people, bonding rather than just doing my work, giving speeches and detached from society because I believed not only would it interfere with the credibility of my job, but basically would not create a role model job for somebody who was going to follow me. Hopefully, I have learned that. And now, in those years that I have left, I’ll be more bonding, be more sensitive, less distant, hopefully.

And how are you spending your time in retirement?

I’m not retired — I’m in transition. I give so many speeches, and [there are] so many places that I go to talk to people. It’s different from before: I would give a speech and make the people weary. Now I give this speech and make the people happy with the words they hear and with options to have to change part of the world where we live. So the modus operandi has changed a little bit. I do a lot of speeches for women, not sugarcoating, but [telling them] the reality of our lives .… I impart new knowledge so that they plan ahead for things that no one tells us in some of our career paths.

What advice do you have for people entering retirement?

I always say life is becoming longer, and therefore we cannot just sit down and wait for death to come. I think we have to stay involved. More than anything, friends are crucial. You need companionship. You need friends. You need to go out to the restaurant, treat yourself like you were your best and only friend. And don’t keep your mouth shut if you have something to say. That brain of yours is still there. Keep discovering it; it’s crucial. If you are lonely, by your own choice, then when the time comes, you will not be missed. But if you are forever mixing with your friends, somebody will know that you have not called, somebody will know that you haven’t visit[ed], and they will come and trace you and they will find you. And so the other thing that I think is important: Learn to listen. I think that’s the biggest form of respect that you can give anybody.

Any final thoughts?

I believe it’s important not to believe you’re retired: You’re in transition. Don’t let anyone put you down because you’re getting old. You’re not an old person who has nothing to offer. You are the epitome of knowledge, experience and good common sense. They have no idea what they’re missing by not touching your intelligence and utilizing your Rolodex.

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Jennifer Ortiz is an associate editor at aarp.org. She previously covered personal finance, careers and other consumer topics as an editor at U.S. News & World Report and was a news writer and editor at WTOP News in Washington, D.C.