Prognosis: Controversy

By Margaret Carlson/Washington

Joycelyn Elders, the pediatrician nominated to be Surgeon General, was the first in her sharecropper family of eight children to go to college, working her way through Philander Smith, a black institution in Arkansas, as a cleaning woman. When she was home one weekend, her younger brother Chester, now a Methodist minister in Pine Bluff, realized that she had begun to change when she took her siblings to the drive-in to see a movie. "She went to a section not marked off for coloreds," says her brother. "The attendant told her to move, and they got in a heated argument. We started to cry. We weren't into the politics of life; we just wanted to see the movie. Finally she and the attendant compromised on how far back we would go. That's when I first noticed my sister was a little different."

This week, when the Senate opens hearings on the Elders nomination, the rest of the U.S. will find out that the 59-year-old Arkansas public-health director is still a little different. While she has the bedside manner of the white- coated physician, she has also been a verbal bomb thrower, trying to wake up Arkansas citizenry to the health crises in teenage pregnancy and AIDS by promoting sex education, birth control and freedom of choice on abortion. Just after her appointment in 1987, Elders was asked if school-based clinics would dispense contraceptives. She replied, "I'm not going to put condoms on their lunch trays, but yes."

The controversy grew from there. Antiabortion activists have called her a "mass murderer" and "director of the Arkansas Holocaust." Her reputation has provoked a coalition of national right-to-life groups to challenge her nomination. "We are deadly opposed to her confirmation," says James A. Smith, a lobbyist for the Christian Life Commission. But the White House contends it is ready to fight for this nominee. Says Health and Human Services Secretary Donna Shalala: "She is colorful and plainspoken, and Americans like people who are straightforward." One Republican Senator, Don Nickles of Oklahoma, has come out against her, but no one expects it to stop there.

Elders has been in battle most of her life. It was a struggle to escape rural Schaal, Arkansas. She started school at four, walking five miles daily to catch the bus. At night, she helped her father stretch raccoon hides, which he sold to Sears. After college, she enlisted in the Army and trained as a physical therapist. Later, she was the only black woman in her class at the University of Arkansas medical school.

She made enemies traveling the state preaching that the consequences of irresponsible sex should not be a child who will more than likely grow up uncared for. She has not taken her lumps quietly. Elders attacks her religious-right critics as "non-Christians" who harbor "slave-master mentalities." Last year Elders told an abortion-rights rally that abortion foes need to get over their "love affair with the fetus." Earlier this month on a CNBC call-in show, Elders was asked what she planned to do about crack- addicted women who sell sex to buy drugs, get pregnant and have crack- addicted babies. "That's a real problem," the pragmatic Elders replied. "I would hope that we would be able to provide them with Norplant, so they could still use sex if they must to buy their drugs and not have unplanned babies."

Elders is no stranger to drug problems. In 1981 she took in a foster child, Nina, 13, a blue-eyed diabetic patient she had been treating for five years. When Nina was 25 and on her own, she was arrested on a drug charge, and Elders' husband paid the $1,000 bail to get her out. Last February the girl and her boyfriend were found murdered, possibly because of a drug deal gone bad. "It was a major loss," says her aide Carol Roddy, "like the daughter she never had."

For all Elders' empathy with families that don't work, she is at the center of one that does. Married since Valentine's Day 1960 to Oliver Elders, she cheered at almost every game during his 33 years as basketball coach of a Little Rock high school team. Her husband's 97-year-old mother, who has Alzheimer's disease, lives with them. Elders has two grown sons. My sister, says her brother Jones, is "your typical housewife. She cooks like our mother cooked -- fried chicken, turnip greens and corn bread. Yet when she gets out of the house, you wonder who this person is."

Washington will try to find out this week, but confirmation hearings are not always an accurate indicator of future performance. Who would have thought that former Surgeon General C. Everett Koop, appointed by President Reagan for his Fundamentalist beliefs and fervent pro-life position, would refuse White House pressure to label abortion "psychologically harmful," would become a crusader for condoms, or would be reviled by Phyllis Schlafly and air-kissed by Elizabeth Taylor? If Elders gets to don the gold-braided uniform of the nation's No. 1 doctor, she may end up, like Koop, infuriating her supporters and amazing her detractors.

With reporting by Ann Blackman/Washington and Richard Woodbury/Houston