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Think Big... Move Fast (cont.)
Beilenson’s admirers are generous with their praise. Stephen Teret, JD, MPH ’79, director of the School’s Center for Law and the Public’s Health, says, “Baltimore couldn’t be luckier than having Peter as its health commissioner. He has a towering intellect, so he’s able to immediately understand the dimensions of a problem and the complexities involved in solving it. Then he has the courage to take action.”
Beilenson has indeed been unafraid to endorse aggressive remedies for Baltimore’s health problems. Teen pregnancy? Provide long-term contraception in school-based clinics. Heroin junkies spreading HIV/AIDS and hepatitis C through dirty needles? Start the biggest city-run needle-exchange program in the country. Syphilis a major problem? Do blood testing in crack houses and bolster staffing at city clinics. Tuberculosis? Aggressively pursue all patient contacts and supervise patients so they achieve 100 percent compliance with medication regimens.
“Unless you’re trying to make a difference,” Beilenson says, “this job doesn’t interest me.”
Beilenson likes to refer to his current position as “the only real job I’ve ever had.” After graduating from Harvard and completing medical school at Emory University in 1987, he served a family-practice internship at the University of Maryland. There, he says, “I realized that almost everybody we were seeing in the emergency room were people coming back over and over again for conditions that were related to behavior: smoking, alcohol or substance abuse, and AIDS. I was very interested in politics and public health policy—my dad was a congressman [in California] for 20 years—and I was looking for a combination of the two.”
He opted for a residency in preventive medicine at the School, earning his MPH and finishing as chief resident in 1992. Teret says, “I remember him as one of the great students. He had more intellectual curiosity, and was willing to think critically and challenge a professor when appropriate. Peter didn’t shy away from controversial issues.”
During his residency, he lost two close elections for the Maryland House of Delegates and the Baltimore City Council. He may have established an undesirable electoral pattern, but he also got to know Kurt Schmoke, then running for reelection as Baltimore’s mayor. “Two months after I completed my residency,” Beilenson says, “Schmoke called me out of the blue and offered me this job.”
At 32, Beilenson was, he believes, the youngest major-city health commissioner in the country, running North America’s oldest health department. He walked right into major controversy. In his first year, the city began dispensing Norplant, an implanted, long-term contraceptive, through some of its school-based health clinics to teenage girls who requested it but could not afford it. Parental consent was not required. Some African-American community leaders denounced the program as racist, charging that it would not have been implemented had the majority of recipients been white. Strident critics even called it genocidal. The city and Beilenson stayed with the program. (Baltimore now offers Depo-Provera injections instead.)
“I would not want an extra day in this job unless I felt like we were really pushing things. We’re quite proactive,” he says, noting, “I think we’re the first place to directly observe therapy for AIDS patients.”
There are other examples: After more than 50 Baltimore city schools failed to comply with his order to shut off lead-tainted drinking fountains, Beilenson fined 15 of them, garnering much publicity and forcing compliance. (He later waived the fines when the schools finally obeyed his orders.) When three people in Baltimore showed symptoms of SARS last April, Beilenson moved swiftly to have them isolated. None had the disease, but he wanted to prevent a Toronto-style outbreak.
After 9/11, the health department created the Office of Terrorism Preparedness and Response to prepare the city for potential biological, radiological, or chemical attacks. Among other things, the new office has developed large-scale smallpox immunization plans. It also monitors the number of dead animals collected from city streets, emergency room traffic, and over-the-counter drug sales, vigilant for any indication of a bioterrorism incident. In July, the city conducted a large-scale bioterror drill.