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1 In 1871, the Surgeon General post was created as the top officer in the Marine Hospital Service, a quasi-military organization meant to battle diseases spread by merchant sailors.

2 The first SG was John Maynard Woodworth, who created a mobile body of physicians, the Commissioned Corps. Today it remains one of only seven uniformed services of our government. (No, the post office doesn’t count.)

3 Before 1977, all SGs served in the Commissioned Corps. Today the only requirement is that they agree with everything the president says.

4 The second SG, John B. Hamilton, really was a surgery professor. Rather than relocate to San Francisco with the Marine Hospital Service, he resigned in 1896 to run the Illinois State Insane Hospital, where he died two years later.

5 During World War I, under SG Rupert Blue, cigarettes were issued as part of each fighting man’s basic field rations kit.

6 In 1964, SG Luther Terry published a report that nailed cigarette smoking as a cause of cancer, triggering the Cigarette Labeling and Advertising Act. This sent the tobacco lobby into a frenzy of denial, bribery, and intimidation that continues to this day.

7 Antonia Novello, under George H. W. Bush, was a harsh critic of Big Tobacco. Her brother-in-law, Don Novello, played a chain-smoking priest, Father Guido Sarducci, on Saturday Night Live.

8 Surgeon General Hugh Cumming is remembered for the notorious Tuskegee Syphilis Experiment, begun under his watch in 1930, to study the effects of untreated syphilis in African American men. The program continued under six successive SGs, being declared unethical only in 1973. The study proved that it’s unhealthy to leave syphilis untreated.

9 In 1981, Reagan’s ultraconservative SG, C. Everett Koop, brought the traditional full military regalia back to the office. But he was no dandy: His famous uniform was made of polyester.

10 Koop penned a brochure (PDF) explaining the risks of AIDS—writing frankly about sexuality—and had it mailed to every household in the United States. It was the first government mass mailing of its kind. He took a lot of flak for it.

11 He also performed a cameo in The Exorcist III.

12 Today the 90-year-old Koop is a pitchman for Life Alert, the emergency medical response service with the catchphrase, “I’ve fallen and I can’t get up!”

13 Joycelyn Elders was our first black SG. Like Koop, she advocated frank sex education in schools. Unlike Koop, she did not survive the flak; she was gone within 15 months, the shortest tenure of any SG.

14 She was forced to resign because, when asked about masturbation at a U.N. conference on AIDS, she responded in a positive way. There are no existing audio or videotapes of her response; the exact words that led to her firing remain unknown.

15 Under George W. Bush, SG Richard H. Carmona said officials asked him to censor his reporting on embryonic stem cell research, contraception, and the unrealistic proposition of abstinence-only sex education. He was also instructed to mention the president three times per page in every speech he gave.

16 Separated at birth? Romanian dictator Nicolae Ceausescu also required scientists to sprinkle his name in their speeches.

17 Carmona, a high school dropout, earned his GED in the Army, was a decorated Vietnam Special Forces combat veteran, then won the “Gold-Headed Cane Award” as top graduate at the University of California Medical School. He also served as a paramedic and a nurse.

18 Resistance to Bush’s nomination of James W. Holsinger as 18th Surgeon General comes partly from his purported antigay bias. In a paper he wrote for the United Methodist Church in 1991—which some say is light on science and heavy on dogma—Holsinger declared that male homosexuality is unnatural and unhealthy.

19 On the bright side, PETA likes him: Acting SG Robert A. Whitney, who served in the interim between Novello and Elders, was a veterinarian.

20 The SG’s position has been vacant on many occasions. The longest vacancy was four years. During those times, the health infrastructure of the United States collapsed to dust. Just kidding.