Baltimore's Leana Wen: A Doctor For The City

Mar 2, 2016
Originally published on March 3, 2016 6:48 am

It's only March, but Baltimore City Health Commissioner Leana Wen already has an embarrassingly full calendar.

She's put together the city's plan for dealing with the Zika virus, launched a campaign against soda and other sugary beverages and overseen an investigation into why so many people in the city are overdosing on fentanyl.

Trained in emergency medicine, Wen, 33, says running the health department in Baltimore is the fastest-paced job she's had.

She sees herself as the city's doctor. Each overdose death weighs on her. "It's so real for me every day," Wen says. These drug-related deaths are preventable. "And when we don't do something about it or we don't do enough, we see the consequence of somebody dying," she says. "That is really immediate."

Her work comes with grave responsibility, and she savors it.

"One of the issues I faced as an emergency physician and what led me to this job in public health, is this feeling of helplessness," she says. She recalls the time a supervisor in medical school chided her for asking too many questions about a patient's home life. "You don't want to open Pandora's box, because you don't know what's in it," he told her. "And you don't know what to do about it."

Since becoming health commissioner in January 2015, Wen has spent a lot of time in the community asking – and answering – questions.

Early in her tenure, the city was rocked by unrest after the death of Freddie Gray in police custody. She worked on the city's response to the crisis while making the case that the episode underscored the importance of public health in Baltimore.

"This lady is everywhere. She goes where the problems are," says Carlos Hardy, founder of M-ROCC, Maryland Recovery Organization Connecting Communities, an organization focused on recovery services. "She looks you in the eye, and whatever your issue is, she gives the feeling that it's important to her. And that's a gift for ... a government official."

In her first year in government, Wen has also gained fans for the clear and convincing arguments she has made on behalf of public health.

"I was just astounded by her ability to take her medical background and medical perspective and apply that to public policy," says Ben Seigel, executive director of the 21st Century Cities Initiative at Johns Hopkins University.

For 10 months, Seigel led a federal team that assisted Baltimore officials in the aftermath of the Freddie Gray unrest. He says the most challenging part of working with Wen was getting her to understand what he calls "the realpolitik" of federal funding.

"Here are what your priorities are; here's what the price tag is. Well, now we've got to fit it into existing programs out there," he recalls telling her. "For her, because she's impatient, because she wants to see results right away, that can be a challenge."

Wen acknowledges her impatience, calling it both a strength and a weakness.

"My strength is that I'm very action-oriented. I believe that you can't just have a vision. You have to get it done," she says. "I know a criticism could be and has been that I have a level of urgency to the work that may not be needed."

Some of that criticism has come from inside the health department, where there has been high turnover among her senior staff.

Her urgency is also something we've experienced, as we've chased her from community meetings and college campuses to City Hall and the halls of Congress.

She seizes any opportunity she has to give voice to her causes. But this wasn't always the case. Actually, it was quite the opposite.

Through childhood and into adulthood, Wen struggled with stuttering. For years, she hid her stutter, avoiding words she couldn't get out. Often she didn't talk at all.

"One of my earliest memories in school was that I was supposed to give this talk on the Roman Empire," she told a gathering of the National Stuttering Association last summer. "I was so terrified that I would stutter on the word 'Roman' that I actually stabbed myself with a pencil into my thigh, because I thought that would get me out of speaking in class."

Later, she wanted to study neuroscience but couldn't say the word so didn't register, she says. Midway through medical school, she was elected president of the American Medical Student Association, a position that came with a lot of public speaking responsibilities.

After suffering through a particularly trying period, she sought help. As part of therapy, Wen had to go out in public and say everything she wanted to say, without avoiding words or substituting thoughts. Her speech therapist, Vivian Sisskin, says after a shaky start Wen's impatience got the better of her.

"She didn't have patience for her own speech failures. It was unacceptable to her not to do the things she wanted to do," Sisskin says. "I think that's part of what drives her in a lot of ways. If she can do it, she's going to find a way to do it."

In government, there are moments completely outside of one's control. For Wen, one of those moments came in September 2015, when Baltimore Mayor Stephanie Rawlings-Blake announced she would not run for reelection.

The news came just eight months into Wen's time the health department. The departure of the woman who had brought Wen to Baltimore worried her. "I feel like we've finally gotten to the point where we've identified the landscape, identified the players, identified the stakeholders, gotten buy-in for the problems we have, and we're about to make significant change to really improve the health and wellbeing of our residents," she said in September.

Now, Wen takes a more sanguine view. She says she's committed to staying on until Rawlings-Blake's term ends in January 2017. Wen also says she's interested in staying on beyond then, provided the next mayor supports her vision. She's made her agenda available to all the candidates.

"All I can do is do my job, do it really well, and serve our residents in the way that they deserve," she says.

Dr. Leana Wen has been a contributor to Shots since 2013. You can read her account of why she decided to become Baltimore's health commissioner here.

Copyright 2018 NPR. To see more, visit http://www.npr.org/.

AUDIE CORNISH, HOST:

For the next few minutes, I'm going to take you behind the scenes on a series we began last summer. We've been in Baltimore examining some of the city's worst problems - drug addiction and violence. And we've been doing it through the eyes of Health Commissioner Leana Wen.

LEANA WEN: Good morning, everyone.

UNIDENTIFIED CROWD: Good morning.

WEN: Good morning.

CORNISH: Her energy and optimism caught our attention after the Freddie Gray riots when she stood up and said, look; these problems - we can do something about them.

(SOUNDBITE OF ARCHIVED BROADCAST)

WEN: We have to make the case that, actually, everything comes back to health.

CORNISH: Now, in the months since, we've reported on some of her initiatives - stopping overdoses, reducing violence, getting drug treatment on demand. Today, we're focusing on Leana Wen herself. My producer Andrea - she has been spending lots of time in Baltimore. She's here to talk more. Hey there, Andrea.

ANDREA HSU, BYLINE: Hey, Audie.

CORNISH: All right. So when he first met Leana Wen, she'd only been on the job for a few months. You know, she was this newcomer to government, and there was some skepticism about whether she could make good on all these promises. And you've seen her in all sorts of moments - right? - not just the stories we've been hearing on air. Help us understand how she's dealt with her first year.

HSU: Well, Audie, I think she's someone who wants to be a game changer, and she's throwing everything she has at this job. You know, in her previous life as an emergency room doctor, she dealt with life-or-death issues all the time, but her patients were those people who came into the ER. Now she thinks of herself as the doctor for the whole city. She talks about Baltimore's residents as patients, and that makes those life-or-death issues all the more pressing.

WEN: It's so real for me every day because if everyone that I talked to knows someone who has died of overdose, that is literally our family and our friends who are dying from this preventable issue that I have the power to try to prevent in some way. And when we don't do something about it or when we don't do enough, then we see the consequence of somebody dying. I mean, that is really immediate.

HSU: Now, that's a huge responsibility she's put on herself, but it's also one she savors because unlike in the past, she's now in a position to do something. And that's not how she felt in the ER.

WEN: One of the issues that I faced as emergency physician and what led me to this job and to public health is this feeling of helplessness that you don't want to open Pandora's box because you don't know what's in it. And you don't know what to do about it.

HSU: So you don't want to ask if someone's homeless, for instance, if you can't find them housing. Nowadays, though, she's asking lots of questions all over town.

CARLOS HARDY: This lady is, like, everywhere.

HSU: That's Carlos Hardy. He's founder of M-ROCC, an organization focused on recovery services. He towers over Leana Wen. I mean, she really is tiny. But he likens her to a field general who knows how to command her troops.

HARDY: When you talk to her, it's like you don't get the 30,000-foot level. It's like she looks you in the eye and what your issue is. She gives the feeling that it's important to her. And that's a gift. That's a gift for a - I'm not going to call her a politician but a government official.

HSU: Now, remember, this is Leana Wen's first job in government, and she only recently turned 33.

BEN SEIGEL: You know, people want to say that, oh, maybe she's naive 'cause she's younger, you know, than your typical health commissioner, but you know, I wouldn't say that she's naive. I mean, I think she's very savvy and strategic and smart.

HSU: This guy is Ben Seigel. For 10 months, he led the federal team put together by the White House to help Baltimore after Freddie Gray. He says Leana Wen really stood out for how convincing she was in laying out her priorities using science to make her arguments.

SEIGEL: She certainly has the ideas, and she certainly has the vision. But what she also has is that she's tireless, and she's not going to quit until she accomplishes her mission.

HSU: So that's outside view. Internally, it hasn't all gone smoothly. For a while, it seemed every time I showed up at the health department, someone had quite or been fired. Her pace, her style, her late-night conference calls didn't sit well with everyone. She told me as much herself.

WEN: I'm a very impatient person. This is a strength and a weakness. My strength is that I am very action-oriented. I believe that you can't just have a vision. You have to get it done. And I am an implementer and a person who executes, and I expect everyone to function at that level and speed. I know that a criticism could be and has been that I have a level of urgency to the work that may not be needed.

HSU: And that urgency is something I've actually experienced myself as I've chased her to community meetings and churches, to City Hall and the halls of Congress. She so polished every time she speaks that I was stunned to learn that not so long ago, her fear of speaking nearly silenced her. It turns out Leana Wen, who now delivers TED Talks and Senate testimony - she's a person who stutters. For years, she hid her stutter by avoiding certain words and sometimes by not talking at all. At a conference last summer, she shared a story from second grade when she was supposed to give a presentation about the Roman Empire.

(SOUNDBITE OF ARCHIVED RECORDING)

WEN: I was so terrified that I would stutter on the word Roman that I actually stabbed myself with a pencil into my thigh because I thought that that would get me out of speaking in class.

HSU: And later on, she said, she wanted to study neuroscience, but she couldn't say the word, so she never registered. Then midway through med school, she was elected president of the American Medical Student Association, and with it came a lot of public speaking. She was thrilled and, again, terrified. So for the first time, she sought help, and part of her therapy was going out and saying everything that she wanted to say - no avoiding words or substituting thoughts. She'd stutter if she had to. Her speech therapist, Vivian Sisskin, says after a shaky start, Leana Wen's impatience got the better of her.

VIVIAN SISSKIN: She didn't have patience for her own speech failures. It was unacceptable to her not to be able to do the things she wanted to do, and I think that's part of what drives her in a lot of ways - is that, if she can do it, she's going to find a way to do it.

HSU: And here's why that matters. That's the mindset Leana Wen has brought to city government. But of course, in government, there are some things that are totally out of your control, and for her, it was this.

(SOUNDBITE OF ARCHIVED RECORDING)

STEPHANIE RAWLINGS-BLAKE: I've made the decision not to seek reelection.

HSU: So that's Baltimore Mayor Stephanie Rawlings-Blake last September. And Audie, as you know, she'd taken a lot of flak for how she handled the Freddie Gray unrest.

CORNISH: Right. And this could have ramifications for Leana Wen, right? I mean, what does this mean for her, for these public health programs that she set in motion?

HSU: Well, she could be out of a job in January. You know, Stephanie Rawlings-Black has pretty much let her do everything she's wanted to do, and it's not clear whether a new mayor would do that or even keep her on. You know, in the audio diary she keeps for us, she was pretty emotional when she talked about it last fall.

(SOUNDBITE OF ARCHIVED RECORDING)

WEN: I feel like we've finally gotten to the point where we've identified the landscape, identified the players, identified the stakeholders, got buy-in for the problems that we have, and we're about to make significant changes to really improve the health and well-being of our residents.

CORNISH: You know, it's striking when you think of everything that the health department has been working on under her tenure, everything we've been reporting on - that this could go away in less than a year.

HSU: Yeah. It's definitely something looming over the health department. But people there have also told me, you know, we're under so much pressure to get things done that we don't even have time to worry.

CORNISH: Andrea Hsu, my producer and reporting partner on our series from Baltimore - Andrea, thanks so much for talking with us.

HSU: You're welcome, Audie.

CORNISH: And you can hear more about this series of stories at our website, npr.org. Transcript provided by NPR, Copyright NPR.