I had just driven an hour and a half from Northern Virginia after staying up late finishing a story the night before. I had also just chugged my third coffee of the morning, but I was still fighting the nauseated, almost drunk sensation that’s my body’s way of telling me I should not be awake. In short, I was pooped. Wen was not.
As I sat down on the bench next to her, she flung her computer onto my lap. “Can you please look at this op-ed I wrote?” she asked.
The article was about the recent death of Freddie Gray—the 25-year-old black man who was thrashed around in a police van until he died—and the protests that shook Baltimore afterward. Wen made the argument, supported by evidence, that drug abuse, poverty, and mental illness are driving high incarceration rates in big cities—and, consequently, the citizen outrage over them. Most arrests in Baltimore are drug-related, and she thinks that if there were better programs for drug-addicted and mentally ill Baltimoreans, fewer people would be thrown in jail.
Since January, Wen has been running one of America’s oldest and most experimental health departments, in one of the poorest cities in the country. Throughout my day with her, I learned a lot about how racial disparities and poverty pry an immense gap in the health outcomes of a community. I heard about some unusual strategies—like using ex-cons to patrol neighborhoods and break up fights—that public-health experts are employing in order to address those problems.
Also, I learned that I cannot keep up with Dr. Leana Wen.
After we looked at the op-ed, it was time for the meeting. The topic of discussion was, broadly, why poor kids are so much more likely than rich kids to get asthma. In some local schools, one person said, half of kindergarteners have asthma. How could we expect kids to get better when roaches roam their bedroom walls? Or when their parents didn’t get paid before the inhaler ran out? Certain interventions—more health workers, better pillow covers—have proven to work, participants noted, but there’s not enough money to fund them.
Wen interrupted with a more inspirational note: “There is a tide of change that’s been coming in the past few years. I’m curious as to what you think the opportunities might be, not only with the [Affordable Care Act], but also with global budgeting affecting our hospitals in Maryland. Might there be opportunities there in order to use innovations that will keep people out of hospitals?” (Last year, Maryland became the talk of the health-policy world when it decided it would cap how much hospitals can spend—in effect rewarding hospitals for keeping people out of them.)
About halfway through the conversation, Wen rose abruptly, thanked everyone, and said she had to be off. Because of the recent riots, she and the city’s other agency heads had an emergency cabinet meeting.
Outside, she turned to me with a slight frown. “Unfortunately, I often don’t get to see all of any one meeting,” she said.
She phoned Shirli Tay, her assistant.
“Shirli, I need your help. Can you send Olga the call-in details? And where’s Michael, because I need him to review that op-ed, like, now. Like, urgent.” But she ended sweetly: “Cool, see you soon, bye.”
Throughout the day, I would learn that interacting with Wen is a bit like swallowing a lit firecracker. Except instead of killing you, her force makes you feel smarter and healthier.
Wen told me to call into her scheduling meeting at 8:30, but also to drive to the offices of the city public health department by 9. She rattled off the address and I started repeating it in my head so I wouldn’t forget it before I could get back to my car and punch it into Waze. I’m an atrocious driver and even worse when I’m on a conference call, but I figured I’d give it my all.
As soon as I reached my car, the call-in details arrived via a text from Tay. A few minutes later, Wen texted the details to me herself.
How is she dealing with me, calling in, getting there, and organizing her schedule all at the same time? I thought to myself as I made a wrong turn. She arrived at the health department well before I did.
* * *
Wen has a very distinctive and purposeful way of speaking, like she’s always in the process of giving a TED talk. (Which she’s done.) She’s spent much of her life overcoming a stutter. Once, in elementary school, she stabbed herself in the leg with a pencil to get out of having to speak in class.
When she was eight, her dissident family fled China for the U.S. on political asylum grounds after the Tiananmen Square massacre. Wen’s parents washed dishes and cleaned hotel rooms to survive. Growing up in Compton and East Los Angeles, she had neighbors who had asthma, who couldn’t exercise because they feared gangs, and who regularly chose between food and medicine. She figured if she became a doctor, she could work to fix all that.
She enrolled at Cal State University when she was 13 and earned a bachelor’s degree, summa cum laude, in biochemistry at 18. Upon graduation, eight medical schools offered her full scholarships.
“I worked very hard and I’m very, very driven,” she said. “The only thing I could do at that time was to work as hard as I possibly could.”
Wen chose to attend Washington University in St. Louis and later became a clinical fellow at Harvard. During med school, she took time off to serve as the president of the American Medical Student Association and to work for the World Health Organization in Geneva. She studied public health at Oxford as a Rhodes Scholar, and in 2005, she was tapped by the Department of Health and Human Services to represent medical students and residents for a congressional advisory commission. Along the way, she published in major journals like The Lancet and The Journal of the American Medical Association, as well as in popular outlets like NPR’s blogs. In 2007, the New York Times columnist Nick Kristof selected her for his “win a trip” contest, and she journeyed to East Africa on a reporting trip with him.
She ended up working as an emergency physician and professor at George Washington University, a buzzing urban hospital that treats everyone from homeless panhandlers to State Department honchos. Wen loved her job at GW—she was teaching, practicing, doing research—but she itched to make a difference in big, systemic health problems.
“In the ER, we can put tubes in people who have gunshot wounds, but we’re never addressing the core reasons of why there’s violence,” she said. “We’re not addressing cigarette smoking or obesity.”
Wen is only 32, but Baltimore has a history of seeking out youthful health commissioners. Peter Beilenson, who had the job for 13 years before he stepped down in 2005, was also 32 when he started, and Josh Sharfstein, who succeeded him, was 36 when he was appointed. “There’s a tradition of picking people who are early in their careers but interested in making a big difference for Baltimore,” said Sharfstein, who is now Johns Hopkins’ associate dean for public-health practice and helped recruit Wen.
Sharfstein said he wanted Wen for the job because it requires the creativity to come up with unorthodox solutions and the energy to overcome roadblocks. “And she has boundless energy,” he said.
Indeed, once Wen got the job, she took to it with the exuberance of an American Idol winner on the night of the finale. “This an opportunity to combine everything that I’ve ever trained to do with my passion that’s rooted in my deep personal experience,” she told me two weeks into her stint. “I feel like I’ve spent my whole life training for exactly this job.”
Sharfstein also told her something she might have taken a little too seriously: “Your only limitation as far as how much you can get done is your own capacity to stay awake at night.”
* * *
At around 11 a.m., it was time for Wen to give the first of her two speeches that day. The first, at the Johns Hopkins’ Bloomberg School of Public Health, was one of a series of talks by local leaders that was intended to make sense of Freddie Gray’s death. The event was meant to be part grievance-airing, part catharsis-providing, and part action-sparking.
Wen doesn’t have a driver, so it fell to Tay, as it often does, to pick her up from her cabinet meeting and drive her there. Tay is small, forceful, and organized like Wen, but she’s a little bit less intense. She was Wen’s super-fan back when Wen was still an ER doctor on the speech-and-op-ed circuit.
Last year, Tay was a post-baccalaureate student at the University of Maryland when she saw on Twitter one day that Wen was giving a talk at Politics and Prose, a D.C. bookstore. Tay came up afterward and introduced herself. She asked if she could shadow Wen—sort of be her mentee—at the hospital. Of course she could. READ MORE
Image: Wen as a resident at Brigham and Women's Hospital in 2012 Image Credit: Steven Senne / AP