NYC Health Commissioner Dr. Mary Bassett Still Hears the Voices of Her Patients

New York City's health commissioner talks about smoking, heroin, and an incurable malady: politics

Dr. Mary Bassett's first few years as health commissioner has been dominated by microbes.

Dr. Mary Bassett’s first few years as health commissioner has been dominated by microbes.

Dr. Mary Bassett doesn’t just talk the talk at press conferences; she walks the walk. The woman who calmed the city’s jangled nerves when Ebola was diagnosed here spent years in Africa caring for patients during the AIDS crisis. Charged now with battling an opioid epidemic, as a young doctor at Harlem Hospital she once discovered her own intern being admitted with an overdose—and she described in detail how she injected life-saving Narcan directly into his jugular. Dr. Bassett even takes her own medical advice: When the Observer met her in the Health Department’s headquarters, a Band-Aid on her shoulder covered the injection site of a flu shot she had received that morning.

Public health routinely runs into politics—most frequently, it seems, the politics of Gov. Andrew Cuomo, who had dueling press conferences and health strategies for dealing with Ebola and Legionnaires’ disease in New York City. Is that frustrating as a doctor who is more focused on science? Public health takes place at the intersection of health and society, so public health has long been mired in politics. So often, the roots of ill health have to do with the failure to address injustices in our society. So that’s why I’m really so proud to serve a mayor who’s made central to his administration the tackling such enduring problems as the gaping income inequalities, and you know the need for a more livable wage, absolutely the need to increase affordable housing, the need to give people an equal start in life by investing in early childhood. None of that answers your question about the governor. He supports a lot of the same things, and sometimes people who share the goal of supporting and advancing the health of the population disagree on how to do that. I’m very proud of the way New York City has handled its public health response on any number of issues.

‘I love taking care of patients and I actually never thought that I would stop.’

I’ve noticed is that the way we talk about heroin or opiates seems very different than the way the world talked about it in the 70s. It sure is. And that’s a good thing. It really is a good thing.

We’re viewing it as more of a public health crisis than a crime crisis. I can’t help but wonder if that’s because many of the people using opiates now happen to be white middle class Staten Islanders. I think that there’s no doubt that the fact that prescription opioids opened up a new pathway to addiction to opioids—that people who had access to prescription drugs were a whole a different population, including more middle class people, more whites, has changed the conversation. At the same time, I think that everyone agrees that this is the way the conversation needed to change and that the fact that people who are burdened with dependence on drugs need help, not incarceration, is a very important transition. So we’ve been working on many different ways to promote the idea that we need to take a public health approach to this crisis, and I don’t think that we—it’s not going to be easy. As you probably know our overdose deaths went up. And it also has to be something that we address as a whole city. While Staten Island has such high rates—as a small population you are contributing more than your share of people whose lives are tragically lost to opioids—still over half of the deaths come from the Bronx and Brooklyn, and we can’t lose sight of that.

Ebola was the first time many New Yorkers got to know who you were. What did you learn from that experience and how is it being applied now with Zika? I didn’t expect microbes to play such a prominent role in my tenure as commissioner. And one of the things that’s been a central preoccupation for me, and commitment for me, has been reducing health inequalities and addressing health inequities. I think that that has a role to play now, and it had a role to play in Ebola. One of my concerns, although the one case that was diagnosed here in New York City didn’t fit this description, was that we might have somebody who came from West Africa who was afraid to identify themselves, who was sick, alone and isolated, and it was important that we communicate with the West African community. Of course what we have now is a disease that people are mainly getting through travel. And it matters really overwhelmingly for pregnant women or women who might be pregnant. We really have wanted to make sure that we reach out to that community and make sure that people understand that this year, if you’re pregnant or you might be, you shouldn’t travel. These approaches—ensuring that we get the message out not just on the airwaves, but on the subways, through personal boots on the ground, conversations with trusted leaders, I think also reflects the fundamental strategies that will help reduce health inequities in our city more broadly.

You put yourself in an ad to urge people to stop smoking. Tell me about that decision, and your decision to smoke and to stop smoking. I started smoking when I was just 16 and I can credit a couple of reasons to it. One was I was a very well-behaved adolescent, I studied hard, I did well in school, and it was sort of a form of rebellion for me. I smoked Newports, and for me, it was sort of in a sick kind of way, or a bizarre kind of way, a form of racial identification—because that was the brand that was heavily marketing to black communities. I started smoking for the same reason a lot of young people do: because I thought it would sort of change my image. But I kept smoking because I was addicted, and that’s what I talked about in my campaign. It was not my idea to do that campaign, but I was talking to the team about the reasoning I used when I was finally able to quit. And I quit, it’s been over 30 years now, so it was a long time ago, but I had already done my medical training. It was later than it should have been. But I talked about how I would say to myself: do you want to smoke forever? No. So then answer’s no. So if you’re not going to smoke forever, you have to stop. And if you’re going to stop, well, you should stop now.

You trained at Harlem Hospital and ran AIDS clinics in Zimbabwe. in Do you ever miss working with patients? I loved the practice of medicine. There are people who go into public health who figure out when they’re doctors that they don’t really like patients—they feel that patients are complainers. I’m not of those public health doctors. I love taking care of patients and I actually never thought that I would stop. But sometimes things sort of overtake you, and in the course of my working life it became clear to me that in public health, we get to do the most good for the most people and that I could have a bigger impact on the health of a population working in public health than I could one person at a time. But I still hear the voices of my patients. I still do.

This interview was edited and condensed.