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Can A 32-Year-Old Doctor Cure Baltimore's Ills?

Aug 6, 2015
Originally published on October 28, 2015 11:00 am

Neighborhoods in Baltimore are still struggling to recover from the riots that broke out following the funeral of Freddie Gray, who suffered a fatal injury to his spine while in police custody. In the aftermath of the unrest, we here at NPR spent many hours trying to understand the raw anger on display. We looked at police brutality, economic disparities and housing segregation in Baltimore.

Our conversations eventually led us to Leana Wen.

Wen, a 32-year old emergency physician, had become Baltimore's health commissioner just a few months earlier. With Baltimore leading the news day after day, she seized the moment to get her message out, including on this blog, where she has been an essayist.

She wrote about the health department's immediate response to the unrest, making sure hospitals were protected and that staff and patients could get to them, and that ensuring seniors could still get prescriptions when their pharmacies were looted and burned.

After calm was restored, she turned her focus to the city's more chronic issues. For years, she argued, Baltimore has been traumatized by poverty, violence and drug abuse, problems that can be treated through public health.

"We have to make the case that actually, everything comes back to health," she told us in May. "My hope is that we can really make Baltimore into a model for the rest of the country to follow when it comes to treating the core roots of our problems."

That left us wondering, does everything actually come back to health? If so, what can you accomplish in city government? And can a health commissioner really make a difference?

Starting today, we're going to try to answer those questions. We're following Leana Wen over the coming months as she takes on some of Baltimore's thorniest problems. One thing already clear is that she's in a hurry.

Deputy Commissioner Olivia Farrow, a veteran at the health department, laughs remembering how Wen was holding meetings before she'd even officially started the job.

"Someone was telling me a joke," she says. "It's not 'Wen,' it's 'Went.' I mean, she's already ahead of you and gone, trying to make the fix."

New to Baltimore, Wen is relying heavily on Farrow and other senior staff to help her navigate the often murky politics of the city. Farrow believes Wen's lack of political experience is a plus.

"There's something about people who come from the outside," she says. "Just their ability to kind of say, 'Hey, let's think about things differently.' A lot of times that can rub people the wrong way. Some people survive that and some people don't."

Leana Wen was born in Shanghai and came to the United States at the age of 8. Her parents were Chinese dissidents who sought political asylum here, first landing in Logan, Utah, and a couple of years later moving on to Los Angeles. They lived in Compton and East Los Angeles, neighborhoods Wen describes as not so different from the poorer parts of Baltimore.

As a child, she dreamed of becoming a doctor. She entered college at the age of 13 and majored in biochemistry. After medical school, however, she was confronted by a sad reality. In the emergency room you can resuscitate victims of gun violence and overdose, she found, but you can't prevent them from returning over and over again.

"It is not a satisfying cycle for us to be in, when we're treating problems at the very end of those problems, rather than preventing them from happening in the first place," she recently told her staff.

This summer, homicides in Baltimore have soared to levels not seen in four decades. The heroin epidemic is showing no sign of abating, and throughout the city there is a sense of frustration that no matter what happens, and no matter how many leaders speak out, nothing changes.

So Wen is asking her team to think big, to come up with innovative approaches to these festering problems. She believes that given all the focus on Baltimore since the death of Freddie Gray, this is a rare opportunity to act.

"I don't want that window of opportunity to close for us," she says. "I don't want to be the person who isn't leading us toward this vision at a time that's so critical in Baltimore's history."

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AUDIE CORNISH, HOST:

Today and tomorrow, we're spending some time in Baltimore, where some neighborhoods are still struggling to recover from the riots that broke out following the death of Freddie Gray at the hands of police.

In the aftermath, we spent many hours trying to understand the raw anger on display. We talked about police brutality, economic disparities and housing segregation in Baltimore, and we interviewed many people. One of those people was Leana Wen.

(SOUND BITE OF ARCHIVED BROADCAST)

CORNISH: Dr. Wen, welcome to the program.

LEANA WEN: Thank you.

CORNISH: When I spoke with her in May, she was only about four months into the job as Baltimore's health commissioner. During the riots, Wen stepped up. The Health Department was pressed into round-the-clock service making sure hospitals were protected and staffed and that patients got their prescriptions. But after things settled down, Dr. Wen seized the moment. She told me and many others that there's an even bigger role for public health to play - treating the poverty, violence and drug addiction that have traumatized the city for years.

(SOUNDBITE OF ARCHIVED BROADCAST)

WEN: We have to make the case that actually, everything comes back to health. My hope is that we can really make Baltimore into a model for the rest of the country to follow when it comes to treating the core roots of our problems.

CORNISH: But is that true? Does everything actually come back to health? If so, can a health commissioner really make a difference? How do you even get something going in city government? Well, starting today, we're going to try to answer some of those questions. We're following Leana Wen and her team over the coming months as they try to do just that - make a difference. But first, she's had to win over hearts and minds in the health department, and that means spicing up the annual staff meeting. And her supervisors play along.

PATRICK CHAULK: Good morning. I'm Patrick Chaulk, the assistant commissioner for HIV/STD Services.

(APPLAUSE)

CHAULK: We're also known as the bureau of bugs, drugs and sex.

(LAUGHTER)

CORNISH: A little humor, a little Zumba - two staffers, fitness instructors in their workout gear are helping the new boss with her moves, not that she needs the help. Commissioner Wen used to be a competitive ballroom dancer.

UNIDENTIFIED WOMAN: You rock, Dr. Wen. You rock.

CORNISH: Leana Wen is 32 and an emergency physician. In her formal green shift dress and elegant jewelry, you can tell she feels a little silly.

WEN: Was it ridiculous, or was it OK?

CORNISH: Since January, she's been on a campaign to connect with this staff and with the city of Baltimore, her new home. She was born in Shanghai and came to the U.S. at the age of 8. Her parents, Chinese dissidents, sought political asylum and first landed in Logan, Utah. But a couple years later, they moved to a place a bit more like Baltimore. And that's the story she shared at this staff meeting.

WEN: Now, you may not know from looking at me now, but I grew up in the inner-city in Los Angeles. I grew up in Compton and in East LA.

CORNISH: Heads turn in the room - a silent huh.

WEN: I saw what happens when my classmates - for example, my friends were the victims of gun violence, but many of them were also the perpetrators of violence as well.

CORNISH: Wen tells her staff she dreamed of becoming a doctor. But when that dream came true, she was confronted by a sad reality. In the ER, you can resuscitate victims of gun violence and overdose, but you can't prevent them from returning over and over. You don't get to the root of the problem.

WEN: It is not a satisfying cycle for us to be in when we're treating problems at the very end of those problems rather than preventing them from happening in the first place.

OLIVIA FARROW: She wants to get out there and make things happen.

CORNISH: That's Olivia Farrow, deputy commissioner. Farrow was one of the movers and shakers Dr. Wen brought back from previous administrations to help her navigate the city's rough-and-tumble politics. Farrow laughs, remembering how before Dr. Wen even started the job, she was already holding meetings.

FARROW: Somebody was telling me a joke. It's not Wen; it's Went. (Laughter). I mean, it's - she's already ahead of you and gone, you know, trying to make the fix.

CORNISH: Dawn O'Neill, another deputy chimes in. She remembers her first meeting with Leana Wen to discuss the job. It was all of 30 minutes on a Friday night.

O'NEILL: She called me the next day and said, I've got a spot for you. Please come on my team and that you have till tomorrow because the press release - I'm working on the press release right now. I said, tomorrow (laughter), like, seriously?

FARROW: She doesn't play around. I mean, she makes decisions and, you know, wants to see things happen.

CORNISH: Dr. Wen leans heavily on these two, trusting they'll stop her from making rookie mistakes. But Farrow thinks Wen's lack of political experience might be a plus.

FARROW: You know, there's something about people who come from the outside, haven't been in government, just their ability to kind of say, hey, let's think about things differently. A lot of times, that can rub people the wrong way. And some people survive that, and some people don't. And she pushes, and it's good.

CORNISH: As hard as their push, the person Leana Wen pushes the most is probably Leana Wen. She's spent the last few months on a crash course in all things Baltimore.

WEN: Woah. Is that Gregory?

CORNISH: On any given day, you might find her celebrating a maternal infant health program...

WEN: He looks like a very happy camper.

CORNISH: ...Participating in a panel discussion on health disparities or stopping by yet another health fair.

UNIDENTIFIED MAN: I'm glad you could make it.

WEN: Thank you for having me here.

CORNISH: Like this one thrown by a black fraternity.

UNIDENTIFIED MAN: Omega Psi Phi, Pi Omega chapter.

WEN: All right.

UNIDENTIFIED MAN: The dignitaries that are here thus far...

CORNISH: There are endless hands to shake, hugs to give and names to learn.

UNIDENTIFIED MAN: And then we have our grand basileus.

WEN: Basileus...

UNIDENTIFIED MAN: Basileus.

WEN: Basileus, basileus.

UNIDENTIFIED MAN: Yeah - same as president. And...

WEN: Man, that is definitely not something that I would've necessarily known.

(LAUGHTER)

WEN: Grand basileus.

UNIDENTIFIED MAN: The grand basileus.

CORNISH: Stop by stop, meeting by meeting, Leana Wen is taking on the unknowns, learning the ropes, trying to figure out what's in her purview. She's already made curbing the heroin epidemic and adding mental health services top priority. But she's asking her staff to think bigger.

WEN: Is there anything else in public health law that you guys think that are, like, interesting, relevant?

CORNISH: She turns to Gabe Auteri, her special assistant. He's just out of grad school.

WEN: You just took a class in it, Gabe. What was interesting?

GABE AUTERI: Like, what do you want, like, a list of ideas?

WEN: Well, just what did you encounter in that class that you're like, oh, if only we could do that in Baltimore, that would be pretty cool.

AUTERI: Mandated mental health screening for all students entering X grade...

WEN: Oh.

AUTERI: ...Like immunizations. That's what I wrote my paper on - got an A.

CORNISH: Can they even do that?

WEN: Is that state, or is that - that's got to be state.

AUTERI: Local - no.

WEN: We can't do it, though. We don't legislate schools, right? Or do we?

CORNISH: She tells him to send around his paper and look into it.

WEN: I love these big ideas. Let's do it, right? Why not? This is our chance now. You know, who knows how much time we have here. We just don't know, and so I don't want to say, like, oh, let's wait until next year, the next year, the next year. Who knows? This is our chance, so this is our year. All right.

CORNISH: For all of her optimism, Leana Wen is not blind to the realities just outside her door. This summer, Baltimore has seen its worst homicide rate in four decades. And brewing just under the surface is frustration. And no matter what happens, no matter how many cameras turn their lenses on Baltimore, no matter how many leaders speak out, nothing seems to change. This is her challenge, and this is what we're going to explore over the coming months.

(SOUNDBITE OF MUSIC)

CORNISH: Tomorrow, what happens when a flagship violence-prevention program hits a bump?

WEN: Now, this was disappointing and certainly not the news that we were hoping for.

CORNISH: Leana Wen faces a crisis. That story tomorrow. Transcript provided by NPR, Copyright NPR.