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Physician to two presidents avoids politics, prefers adventure. (Profile).

THE DAY THE U.S. Senate began President Clinton's impeachment trial in January 1999, Gerry Cox, MD, MHA, was sitting in an ornate conference room interviewing for a job as one of the president's physicians.

It was the height of the furor over the Monica Lewinsky scandal. Cigars, that infamous blue dress and the Senate proceedings were uppermost in the minds of many Americans. But Cox, a U.S. Navy captain who specializes in emergency medicine, was caught off guard when the question came from the interviewers.

Would you vote to convict the president?

Cox wanted to avoid that minefield. He stalled for time. He said he didn't have all the facts. He needed to hear from witnesses.

But the interviewers pressed for an answer.

Finally, Cox said yes, he would vote to remove from office the man he hoped to work for.

"I said it didn't matter though, because all my patients deserve equal treatment and respect regardless of their political affiliation, regardless of my political affiliation," Cox recalls. "I don't ask any of my other patients who they voted for."

The same day, Cox got the job.

Front-row seat to history

More than three years later, the youthful Cox, 43, sits in his small, tidy office at the National Naval Medical Center outside of Washington, D.C., where he is chief of emergency medicine.

His office bears the mementos of his time at the White House, which straddled both the Clinton and Bush presidencies. In one photo, a tuxedo-clad Cox is flanked by George W. and Laura Bush. In another, Vice President Al Gore is swearing him in for a promotion. In a third, Cox and his wife celebrate the holidays with Bill and Hillary Clinton at a White House Christmas party.

The two-year White House stint was just a small slice of a lengthy and varied career for Cox.

Nineteen years of active military duty in positions that took Cox from Saudi Arabia to Japan gave him the background the U.S. Navy was looking for to solve problems in the Naval Hospital's emergency room. His training as a flight surgeon, his skills managing the health of an entire ship's crew and his ability to work under the intense pressure of war made him the man for the job.

"He's credible and he's also got the personality to build the bridges that need to be built," says Capt. John Sentell, deputy chief of the Navy Medical Corps, who is responsible for the "care and feeding" of officers' careers. Cox has "the combination of personality and poise that was needed," Sentell says.

Some of that poise was developed at the White House, where Cox had to stick the most powerful men in America with needles.

The White House job was actually a lateral move for Cox. Though prestigious, it didn't advance his Navy career the way another position might have. "It's a sidestep because it's not in the mainstream of Navy medicine," Sentell says.

For Cox, the lure of witnessing momentous events as they happened was too much to resist. "I feel like I had a front row seat to history during that time," Cox says.

In June 1999, Cox became one of six physicians in the president's medicine cabinet. They represented the U.S. Army, Navy and Air Force, explains Barbara Idone administrator for the White House medical unit.

The medical staff works out of a three-treatment room clinic in the Old Executive Office Building on the 18-acre White House campus, she says. Physicians are on call 24 hours a day and often travel with the president and vice president.

Though their main responsibility is to ensure the health of those leaders, the medical personnel are also available for urgent care treatment of the thousands of other staffers in the complex, including Secret Service members.

Wash your hands, Mr.President

Cox traveled to Camp David with both Clinton and Bush and worked out at the gym alongside Bush.

As one of the White House physicians, Cox treated both presidents for routine health issues, like colds and sore throats, though he said most details are confidential.

Cox did have to give special thought to the job of president, making sure the leaders used proper hand-washing techniques after marathon handshaking appearances and sunscreen for outdoor events.

The staff wasn't the only ones Cox and his colleagues had to worry about. Cox kept a close eye on White House pets like Clinton cat, Socks and the now deceased Labrador, Buddy, along with Bush's canines Spot and Barney. At times, the White House doctors serve as liaisons to veterinarians, he says.

Cox started in the job by traveling with Vice President Al Gore ("You practice protecting the vice president before they let you near the big guy.") in January 2000. The Tennessee Democrat was in the throes of a national campaign for president that ultimately became one of the most controversial and peculiar presidential races in history.

For Cox, it was fascinating to watch a campaign event unfold: listening in as Gore staffers tried to spin the press and then picking up the newspaper the next morning to see how it all played out. When Cox moved on to spend more tune with Clinton, he was on the advance medical team that prepared for Clinton's G-8 summit in Okinawa and the Asia Pacific Economic Cooperation (APEC) meeting in Brunei. He also attended the United Nations Summit in New York City.

Six weeks before the events, he traveled to their locations, checking out the hospitals for emergencies, noting dangerous food to avoid and researching endemic diseases. He determined what immunizations were called for and gave the shots to the president and staff.

Though Cox moved in the highest of political circles, he usually wasn't part of them. He perfected the art of blending into the background while watching his charges.

But there were times when Cox was drawn in. Like the night Clinton, clad in jeans and a T-shirt, called Cox into the private residence for his allergy shot. It was a day after the Super Tuesday primary elections in March 2000 when Gore clinched the Democratic nomination for president.

Cox asked if Clinton was proud of Gore. Clinton talked candidly of his respect for Gore, the nuances of politics and how the two-term president missed being a candidate. "Before this job, I never was particularly interested in politics," Cox says, "but it was pretty fascinating."

After two years--the typical rotation length for White House physicians--Cox left the heady political scene and picked up where he had left off in his Navy career. "I refer to it as a sabatical from the leadership track I was on," he says.

Doctor by happenstance

Though Cox reached a prestigious milestone with his White House job, his career could have easily gone another way.

He didn't yearn to be a doctor from childhood. Nor was he someone who imagined a career in the military.

A trim man with the build of a runner, Cox wears his sandy hair cut short and a bristling mustache. He's got an even, handle-anything demeanor that must calm patients. With his shoes buffed to a high sheen, his uniform crisply pressed and gold Navy flight wings pinned to his chest above a medley of other decorations, Cox looks like he was made for the Navy.

But growing up in the small Boston suburb of Whitman, Mass., Cox's father was a journalist and his mother a radio announcer and talk show host. He knew little about a life in the military.

Cox excelled in the sciences at Dartmouth College, but also took classes in music and German and could have gone into business or the law. When it came time to make a decision on his future, he had taken pre-med classes and felt it would be a shame to waste them. "I'm committed to everything I've done, but not necessarily because I've planned years in advance to do it," he says. "I'm not a very decisive person."

Cox's parents had struggled to pay an Ivy League tuition and Cox didn't want them to foot the bill for medical school. He discovered that the U.S. Navy would pay for school and a living stipend through the Health Profession Scholarship Program in exchange for four years in the service and six weeks of active duty each year.

Cox signed up and went to the University of Massachusetts Medical School. He donned a uniform for the first time and learned the crisp salute.

The ensuing years with the Navy took him from flight surgeon school in Pensacola, Fla. (where he graduated first in his class of 30) to Japan and the Philippines as a flight surgeon to posts in North Carolina and Virginia.

During an internship at the National Naval Medical Center, where he now works, Cox met an intensive care unit nurse who was also in the Navy. Cox and his wife Catherine have been married 16 years and have two children, Alexander, 8 and Caroline, 3.

A search for adventure

When it came time to pick his specialty, Cox chose emergency medicine, though it was a new, non-traditional area then. "I really liked the idea of feeling comfortable treating all kinds of patients, taking all corners," he says. "You never know what might walk in the door next."

It also fit with the military and Cox's desire for unusual experiences--flight training and overseas travel--that weren't part of the course work for other doctors.

Very soon, he got his wish for adventure.

Just weeks after completing his residency through a cooperative program between Georgetown and George Washington universities and the University of Maryland, Cox arrived at the Portsmouth, Va., Naval Medical Center, ready to start his new career.

That was Aug. 1,1990.

On Aug. 2, Sadam Hussein invaded Kuwait. By late August, Cox was shipped to the Middle East.

He helped staff the 500-bed Fleet Hospital in Saudi Arabia, built on a vast parking lot about 100 miles from the Kuwaiti border and Iraqi soldiers.

"I remember saying to my mother, who was worried to death, that I felt like if my skills were needed in this combat environment, that's where I needed to be," he says.

Cox and his co-workers constantly worried about being overrun by Iraqi soldiers or hit by SCUD missiles. Once Cox was awakened at 3 a.m. by air raid sirens, then the crash of an explosion close by. He dove out of his cot, threw on a flack jacket, strapped a helmet under his chin and leapt into a bunker that he and colleagues had made by piling sand bags on the asphalt.

But the fear was also an undercurrent that military personnel lived with daily. When Cox jogged in the sweltering weather, a gas mask bumped along at his waist.

The meticulous Cox was known for keeping his area of the green canvas tent neat and for providing quick answers in the medical trivial pursuit games doctors devised to study for the upcoming board exams, said Peter Weimerskirch, also an emergency medicine doctor who crossed paths with Cox.

"He's a pretty dedicated and methodical person," says Weimerskirch, who has left the military and is medical director of the emergency department at the Carilion New River Valley Medical Center in Blacksburg, Va.

During his six months in Saudi Arabia, Cox treated Kuwaiti refugees, base personnel, Iraqi prisoners of war and American soldiers. He particularly remembers a young Marine officer who lost part of his arm after a U.S. cluster bomb bounced toward him during a friendly fire incident.

Cox says now that those experiences prepared him to handle just about anything in his later career. "My abilities were certainly tested, both my medical skills and my psychological stability because of the stress," he says. "It was a strengthening experience."

Steps into management

Those feelings led him to later seek a position as the senior medical officer on the U.S.S. Enterprise, docked in Norfolk, Va.

As the top doctor on the Navy's oldest nuclear--powered carrier, which was being overhauled, Cox was responsible for the health of the 3,000 crew members. Half were involved in work with the potential for radiation exposure. About 40 people worked directly under him, with three other physicians among that crew. It was Cox's first major leadership role.

He later took on others, running the Navy flight surgeon school in Florida, teaching as an adjunct assistant professor at Tulane University, where he earned his master's degree in health administration and doing policy analysis for the U.S. Surgeon General in Washington.

"Managing people taught me some humility," he said. "It was quickly apparent to me that it was not as easy as it looked. It really takes a team to get things done."

That's why he was chosen in June 2001 to take on the troubled Emergency Department at the National Naval Medical Center where he works today, says Sentell.

Though the hospital served active and retired military personnel, most of its emergency room doctors were civilians. The result was dissatisfaction by military patients who expected a Navy atmosphere and instead found bearded, pony-tailed civilian doctors, Cox says.

"When they come to a Navy hospital, by God, they expect things to be run a certain way," he adds.

Cox says he has struggled to build a team of civilian and military personnel that meshes well. Like most managers, he's had to fight for money and equipment for the E.R. that gets about 21,000 visits a year and deals with many retired military personnel. His goal, he said, is to improve efficiency and be more "customer oriented."

"I know that the medicine is good," he says. "What we needed to do is change the reputation of emergency medicine at this hospital."

He's worked to improve relationships with other hospital departments, like cardiology and obstetrics and to re-establish some teaching programs. Medical students in the same Navy scholarship program that paid for his schooling come through Cox's emergency room.

Sentell says watchers of Cox's career should expect him to land an executive officer or commanding officer post soon. With 27 major medical facilities around the world, Cox could end up anywhere. Next year Cox is eligible for retirement, though he says he expects to stay in the Navy for some time more.

While he's seen people he went to medical school with make more money or have less stressful jobs, Cox says he chose to stay in the Navy because of the unusual opportunities that opened up for him every few years.

"The Navy has given me so many chances to do so many things that my civilian colleagues could never dream about," he says. "I'm always up for an adventure."


Name: Gerard Cox, MD, MHA

Age: 43, Married with two children, lives in Arlington, Va.

Current position: Chief of Emergency Medicine Service, National Naval Medical Center, Bethesda, Md.

Military service: 19 years active duty in the U.S. Navy, Captain

Hobbies: Running, skiing, hiking, cooking

Education: AB in biology, Dartmouth College, 1979

MD University of Massachusetts Medical School, 1983

MHA, Tulane Univeristy School of Public Health and Tropical Medicine, 1997

On his career: "I don't really have a life plan. I look at opportunities as they come and I'm pretty good at creating multiple opportunities for myself."

Michelle R. Davis is a journalist working for Education Week, a national education newspaper based in Bethesda, Md.
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Title Annotation:Gerry Cox, includes related article
Author:Davis, Michelle R.
Publication:Physician Executive
Geographic Code:1U5DC
Date:Jul 1, 2002
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