Richard Besser ’81 straddles the worlds of medicine and journalism
When new doctors take the Hippocratic Oath, they pledge to treat the sick, prevent disease, share medical knowledge with peers and serve the firm and infirm alike. In a way that few docs do, Richard Besser ’81—pediatrician, medical researcher and public health administrator—has done all of those things over the last two decades. Now, following a stint as acting director of the U.S. Centers for Disease Control and Prevention (CDC) that made him a national television figure, Besser has found still another way to serve.
As senior health and medical editor at ABC News, Besser still works to keep Americans healthy. In a sense, Besser simply stepped from one side of the microphone to the other. As the federal government’s top medical authority when H1N1 flu was first detected in the United States in 2009, he spent weeks explaining to the media what experts knew and didn’t know about the disease. Now he’s the point man at ABC for medical analysis and advice on high-impact issues, from disease outbreaks to long-term problems like obesity. He also investigates how money influences the marketing of drugs and medical procedures.
On camera, it’s easy to see why ABC executives recruited Besser: he projects calm authority and a gentleness that reflects years of treating sick children. Tall and lean, with salt-and-pepper hair that hints reassuringly of experience, he frames his advice in a low-key way that lets viewers reach their own conclusions. For example, reporting on the H1N1 vaccine in November 2009, Besser patiently explained to local anchors at ABC affiliate stations that it had undergone even more safety testing than the seasonal flu vaccine. “There’s been a big push to make it quickly, but within acceptable safety limits,” he told one station. “If you’re deciding whether to get vaccinated, don’t avoid it because you’re worried about safety.”
Besser touts simple preventive steps, especially in lieu of controversial medical treatments. Early this year the U.S. Food and Drug Administration approved prescribing statins (cholesterol-lowering drugs) for patients with normal cholesterol levels to reduce heart attack and stroke risks. Then a study released in June concluded that statins used this way did not reduce risks, asserting that drug manufacturers had played a pervasive role in studies touting expanded statin therapy. Discussing the findings for ABC, Besser argued that people with normal cholesterol counts should instead focus on eating healthy diets, getting enough exercise and quitting smoking. “Those things will prevent the risk of heart disease. It’s clear,” he told Good Morning America anchor George Stephanopoulos.
And where it’s relevant, Besser walks the walk. In his debut interview as medical editor with Diane Sawyer, while H1N1 was still generating headlines, he cheerfully pulled a bottle of hand sanitizer out of his pocket and observed, “You never know where you’re going to be, or if there’s a place to wash your hands.”
A willingness to go places, with or without hand sanitizer, sparked Besser’s interest in health and global issues, starting with a student exchange trip to Australia in high school. At Williams he majored in economics and remembers studying economic justice with former department chair Michael McPherson. “We talked about ideas like [American philosopher] John Rawls’ veil of ignorance, which asks what someone would see as just if they were blind to their own position in the world,” Besser recalls. “That’s very relevant to public health emergencies where you have to decide fairly who should get countermeasures or scarce treatments.”
After college Besser spent a year traveling around the world, mainly in Asia, where health disparities between wealthy and developing countries were glaringly obvious. He earned his medical degree at the University of Pennsylvania and did a residency in pediatrics at Johns Hopkins then went overseas again to work at the International Center for Diarrheal Disease Research in Dhaka, Bangladesh. There Besser learned to manage infections like cholera that kill nearly two million children every year—more than AIDS, tuberculosis and malaria combined.
Next came Besser’s first CDC assignment with the center’s Epidemic Intelligence Service, a post-graduate training program in epidemiology, the study of how and why certain groups in human populations get sick. On his first mission as an EIS officer in 1991, Besser determined that unpasteurized apple cider contaminated with the virulent bacterium E. coli O157:H7 had caused a Boston outbreak of hemolytic uremic syndrome, a disorder in which a digestive infection produces toxic substances that attack red blood cells, often causing anemia and kidney damage. He also met his future wife Jeanne, a food writer, during the investigation; they married in 1993 and have two sons, ages 15 and 12.
Although Besser enjoyed medical detective work, he wanted to combine clinical practice with teaching and research. In his next job, as director of the pediatric residency program at the University of California at San Diego, he researched pediatric tuberculosis (which was prevalent in the area, carried by families crossing over the border from Mexico) and treated patients for the county health department.
Five years later Besser returned to CDC to tackle public health issues at the national level, founding a program called “Get Smart” that developed guidelines for appropriate antibiotic use in adults. “Antibiotics are a precious national resource, and if we overuse them, we won’t have them when we need them,” Besser says. “Our goal was to shift people away from thinking, ‘Well, it couldn’t hurt,’ [taking an antibiotic] to ‘Will it really help?’”
“Rich brought exceptional vision and creativity to that program,” says Assistant Surgeon General Anne Schuchat, who recruited Besser back to CDC. “He built a strong research program along with steps like creating a curriculum for medical students, involving community public health agencies and designing direct outreach measures targeted at consumers. It was a beautiful combination of strong science and communication designed to motivate behavior.”
In 2001, just a month after the 9/11 terrorist attacks, Besser was sent to Boca Raton, Fla., on a CDC team investigating how a tabloid publishing office had become contaminated with anthrax, a bacterium that occurs primarily in animals, but which several nations have studied as a germ warfare agent. One editor died from inhaling anthrax; a second employee was sickened but recovered.
CDC investigators confirmed that anthrax had been mailed to the building. That made the contamination a criminal act, bringing in the FBI. For Besser, this was a new kind of cross-cultural experience. “I spent two weeks in a Winnebago camper with FBI agents who were scared to death of microorganisms and medical researchers who were scared to death of guns and terrorism,” he recalls. (Now CDC specialists train jointly with the FBI to handle terrorist attacks.) Four other people died from anthrax infections in Washington, D.C., and New York; the investigation ended inconclusively in 2008 when the chief suspect—a senior U.S. government scientist who had worked for years at a biodefense research laboratory—committed suicide just before an indictment was expected.
After that brush with terrorism, Besser took over a CDC branch that handled meningitis and “special pathogens” like anthrax and other exotic terror agents. In 2005 he became the agency’s director of terrorism preparedness and emergency response and, on his very first day, Hurricane Katrina hit the Gulf Coast. CDC sent dozens of medical personnel to the region after the storm to monitor for foodborne and waterborne diseases, provide mental health counseling and manage exposure to chemical spills. For Besser, Katrina underlined the importance of preventive steps to make communities healthier, since many people hit hard by the storm had underlying medical problems that made them especially vulnerable. It also showed the urgency of being prepared and communicating effectively during crises—useful lessons when H1N1 emerged a few years later.
When ABC called, Besser jumped at the opportunity. “Communications change perceptions and behavior,” he says. Now he’s a frequent guest on Good Morning America, where the audience averages about 4.5 million people, and World News Tonight, which draws roughly 8 million viewers every evening.
Besser told ABC that he wanted to cover what he considered important health issues, including problems with global scope like smoking and poor maternal health. “I didn’t want to do stories on diets or Botox,” he says. The network was receptive: Dr. Timothy Johnson, ABC’s senior medical editor, focused on personal health issues, so Besser’s broader interests were good complements.
His early stories covered topics like food safety and the rise of drug-resistant bacteria, but when a massive earthquake struck Haiti in January, Besser was on the scene within 36 hours. During eight days of reporting, he worked to balance his journalistic and medical missions. “It was an issue from the start, when I went to the general hospital and patients were camped out under a big tree,” he says. “I did some triage, minor first aid and small things like unkinking patients’ IV tubes, but I tried hard to make sure I was not the focus of anything I covered.”
It wasn’t always possible. On arriving at a tent city to report on how the quake was affecting pregnant women and infants, Besser found a teenage girl in labor. Besser saw that the baby was awkwardly positioned, meaning the mother might need a Caesarean section. He and the ABC team located an Israeli field hospital with an operating room, brought the girl there, and then determined that she also had preeclampsia (dangerously high blood pressure). That led to a medically-accelerated labor and successful delivery. As Besser reported, the baby was quite small—a sign that her mother had received little medical care during pregnancy.
Besser’s story for ABC described the eight-hour sequence and showed him talking to the laboring girl and consulting other doctors on his Blackberry. “What I really wanted to do was put issues like maternal health in perspective,” he says. “I want people to grasp that Haiti has pervasive health issues all the time that shouldn’t occur so close to our shores.” Other doctor/reporters, notably CNN’s Sanjay Gupta, drew critical flak for treating patients on-camera: some critics accused the journalists of grandstanding, although others called them heroes. For the most part Besser flew below the radar. “He was able to thread the needle and cover the story responsibly, always focusing on the people of Haiti,” says CDC’s Schuchat.
Not unlike a hospital, ABC is a busy workplace with many stories unfolding simultaneously—and the hours can be long. When Besser appears on Good Morning America, he leaves home in New Jersey at 5:30 a.m. to get to the studio for makeup and teleprompter practice. Afterward he may do a half-dozen radio or television interviews with ABC stations, followed by pieces for GMA’s digital edition. Around mid-day he’ll learn whether he’s scheduled to appear on World News Tonight, then discuss the topic with producers before doing phone interviews and writing his story. Besser also meets daily with colleagues to discuss health and medical trends and plan future coverage.
Nonetheless, he has also obtained his New York medical license and made plans to restart pediatrics practice part time at a center in East Harlem. Besser is comfortable with one foot in medicine and the other in journalism and doesn’t feel that joining ABC has closed any doors for him. “This job could be challenging for a long time,” he says.
Besser embraces the challenge of helping viewers wade through often-frightening health stories and sort fact from fiction. “I’ve always looked for what’s next when things got too slow or too comfortable,” he says. “I want to show solutions as well as problems and give people perspective that they can use to make smart decisions.” If Hippocrates were watching, he would surely approve.