When I arrived at the University of North Carolina - Chapel Hill in 1978 as a Robert Wood Johnson Clinical Scholar, I was planning to be a primary care doc in a rural community. I had chosen UNC because of its history of great health services research on rural health issues and the existence of the state’s premier rural-focused Area Health Education Center (AHEC) program. The Clinical Scholars Program (CSP) also offered me the opportunity to staff pediatric and internal medicine clinics in a couple of rural communities. It seemed like the perfect setting to move forward on the professional course I had chosen.
A perquisite of the program was the opportunity to earn an advanced degree in a health-related field. Since I knew next to nothing about public health at the time and recognized that some knowledge of epidemiology, biostatistics and health administration might be helpful, I decided to pursue a master’s degree in public health. The CSP program director suggested I meet with C. Arden Miller, Chair of the School of Public Health’s Maternal and Child Health Program. It was a recommendation that radically changed the trajectory of my career.
Dr. Miller took me under his wing and during the next two years taught me not just the principles and practices of public health but the importance, power, and potential of public health in protecting and improving the health of individuals and communities. He also led me to an understanding that epidemiology is the scientific mind of public health while maternal and child health is the social justice heart and soul of the field. He helped to dramatically change the way I looked at what is needed to create health, particularly for families and children.
During this time, Dr. Miller’s research activities were focused on assessing the impact of state and local governmental public health agencies. His findings opened my eyes to the potential and opportunities embodied in a governmental public health career. That epiphany and some direct help from Dr. Miller led to my first job in public health as the director of the Maternal and Child Health program at the Minneapolis Health Department.
Beyond the obvious impacts Dr. Miller had on my career, I have recently come to recognize some of his more subtle but profound influences. When I first met him in 1978, I wondered why a physician, who had been medical school dean and a university provost and vice chancellor, would give that up to be a just a teacher in maternal and child health. Where was the status, power, and influence in that? By his actions on many important health issues, he answered my question about power and influence. He demonstrated that physicians can influence health in so many ways other than treating individual patients. In fact, he showed that a physician working on policy, system, and environmental change could save more lives and improve the health of more people than any physician in a clinical setting.
With those same actions he also answered my ego-inspired inquiry about status. He demonstrated with great humility that no physician working on public health issues could do it alone. Public health is a team effort and physicians, as critical as they might be, are just one of the many essential team members. The credit for any advance in improving the health of communities must be shared with all of the people involved in making that happen. That’s why he never talked about his numerous accomplishments (for a partial listing see: C. Arden Miller: Advocate for Children's Health) but openly reveled in the success of all of his students - physicians and non-physicians alike.
Dr. Miller was a mentor and role model for me and for countless others. He made significant impacts on public health research and practice, effectively led organizations, and advocated tirelessly for the health of mothers and children. He did all of that with humility, dignity and class that inspired everyone who knew him.
I mention all of this because on Saturday I travelled to Chapel Hill for the memorial service of C. Arden Miller, MD. The event was attended by many former students, faculty, colleagues, family, and friends who were impacted by this remarkable individual and public health giant.
As I sat listening to the stories about Dr. Miller (some of which humorously revealed several of his not-so-perfect characteristics), I reflected on the impact he had on my career. I can honestly say that if it wasn’t for Dr. Miller, I would not be Commissioner of Health and would not be celebrating my 35th year of rewarding public health practice.
Two years ago I was able to visit Dr. Miller and thank him for all that he contributed to my personal and professional life. Many of the people at the memorial service had not had that opportunity and felt sad about that.
Knowing I’m not unique, the event made me wonder how many current public health workers have taken the opportunity to thank the people who have helped them in their careers. It also made me think about the future public health leaders among us and question whether we are effectively mentoring them to take on the public health challenges of tomorrow. As Arden Miller demonstrated, that might be the most important public health work we can do.