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A doctor in the halls of diplomacy

By Jessica Eisner MD, University of California – San Diego School of Medicine 2008-09 AAAS Fellow, State Department, Office of UNESCO Affairs

My days at the State Department were nothing like the rest of my career experiences, yet they contributed to my understanding of the world and my own profession. I am a physician with a specialty in pathology and post-doctoral research experience in molecular microbiology. When I accepted a position at the State Department, the most common question I got was “why?” 

I chose to participate in the AAAS Diplomacy Fellowship for a variety of reasons, not the least of which was to learn more about the policy behind science. The reason I focused on the State Department as opposed to a policy position at the National Institutes of Health, was because the nature of its operations was so foreign to me. I had heard of various entities at the State Department that deal with science and health-related issues, such as the Bureau of Oceans, Environment and Science; the Office of Space and Advanced Technology; and the Office of International Health, Biodefense and International Organizations, which handles activities with the World Health Organization and many others. But I had no clue what the State Department had to do with these topics, or how the United States interacted with the rest of the world on such issues. The intrigue played a large part in my decision.

I also wanted to learn more about areas of science with which I had only glancing familiarity, and to augment my knowledge of the factors that impact health worldwide. The portfolio of programs that I dealt with at the State Department included many that have bearing on the health of people across the globe, even if only tangentially. The issues ranged from climate change, ocean and freshwater policy, to AIDS education, biotechnology, and risk reduction of natural hazards. Although I didn’t use much of my medical knowledge in my activities at the State Department, the critical thinking skills I developed from years of scientific analysis were invaluable.

I had lived as a Peace Corps Volunteer (PCV) in late 1980s in the Philippines, and more recently in Ecuador with my husband and two sons. This international experience helped me to envision not only the countries and people with whom I worked at the State Department, but also what is worthwhile and what probably is not. This insight gave purpose to my efforts. It also on occasion caused frustration with the realization that something was being done that likely would not work in the setting for which it was planned; and, that this information may not have been heard at senior levels.

Previously, as a young PCV, I thought of myself as a roving U.S. Ambassador. I represented the good and giving part of America and its outreach to developing countries at the most basic level. In contrast, at the State Department (where many ex-PCVs work), there was less a feeling of ambassadorship--especially in the presence of the real ambassadors--and a more tempered sense of what can be achieved. There are so many levels through which decisions must be vetted that realism about what ultimately may be accomplished and how long it may take is a very real obstacle to optimistic thinking. Yet, experience at the State Department afforded a much deeper understanding of the workings of both national and international science policy.

A purported Chinese saying that was used more as a curse states “May you live in interesting times.” I was afflicted quite often during my fellowship as I experienced the old administration preparing to leave and the remaining non-political employees preparing for the new administration. It was an interesting time. The jockeying for positions-- figuratively and literally--sometimes changed dramatically from week to week, and so did the personnel. In just two months the number of staff in my office declined from 20 to ten. Similarly, policy positions changed dramatically for various topics in science, including a few items that I managed in my portfolio.

Given the early stage of the Obama administration and the obstacles confronting our nation, I expect that the changes will continue. That was both exciting and frustrating, but it was rarely boring.

January 2010: Jessica Eisner, MD, is now a medical director in Basel, Switzerland.

Disclaimer: The perspectives and opinions expressed in this article do not necessarily reflect the views of AAAS, the Science & Technology Policy Fellowships, the U.S. Government, or the U.S. Department of State.