TUCSON — In his 17 years in this desert city, Richard Carmona, President Bush's choice for U.S. surgeon general, has become one of Tucson's most visible and sometimes controversial figures.
As a doctor and SWAT team member, his swashbuckling persona has made him a cult figure in law enforcement. But he also hasn't shied from controversy, which may well come up during his confirmation hearings. Carmona, for his part, is taking it one step at a time.
"I'm brand new to this," he said Thursday after his return from Washington. "I've never been through a process like this. It's a big learning curve."
And he is also demurring from opinions on health and medical subjects, saving that for his hearings.
"I'm still in the process," he said. "I can't address that."
Those who admire Carmona point to his take-charge attitude as a major plus for the new job. It was he, for instance, who assembled a task force of mental health experts in the aftermath of Sept. 11 to deal with the emotional needs of traumatized Tucson residents.
Yet Carmona's history also yields controversy. He has done battle, verbally and in court, with the medical center that hired him to revamp its trauma unit. And three years ago he resigned as the Pima County health director after being criticized by government officials about the mounting debts of a community hospital he oversaw.
His firing in 1993 also led to a career change away from trauma surgery and into the public health field.
"A lot of other opportunities opened up that I hadn't anticipated," he said. "The intensity of day-to-day trauma surgery is more than a full-time job."
Over the years, Carmona has stepped on some toes in the medical community here. That would include a wrongful termination lawsuit he filed against the Tucson Medical Center that was settled for a reported $3.9 million in 1993. In the suit, Carmona contended he was fired for complaining about violations of federal law and hospital policy. The case remains under seal.
His friend and fellow physician Terry Valenzuela said Carmona's moving away from trauma surgery coincides roughly with the date of the lawsuit settlement.
"What's tragic for the community and for injured persons is that he hasn't been able to do what he does so well," said Valenzuela, who teaches emergency medicine at the University of Arizona. "I think people have envied him and been jealous of him.
"I have many times tried to find out why he is persona non grata," Valenzuela said. "But certainly it hasn't kept him from making contributions in other ways."
Valenzuela also said Carmona has not discussed the matter in years. "He may know, but he doesn't go around telling stories," he said.
A spokesman for the medical center, Jack Jewett, declined to comment because of a confidentiality clause, but he confirmed that Carmona no longer practices trauma medicine there.
The medical center lawsuit was followed six years later by his resignation from the Pima County health director's job. Carmona quit at a time when Tucson's Kino Community Hospital was facing mounting financial difficulties. At the time, Carmona was criticized for not keeping officials apprised of the hospital's problems, while Carmona's defenders say not all the difficulties can be laid at his feet.
"I think those who look at it critically would say he did a good job," said Mike Rollins, former chairman of the hospital board. "The problems existed before he entered the system."
For his part, Carmona said he had been planning to quit the health director's post for some time and in no way felt pressured to leave.
"It got to the point where I didn't feel I could be as productive as I wanted to and it was time for someone else to give it a try," he said. "There were no hard feelings."
Sylvia Campoy, who chaired a citizens committee that oversaw the county health-care system while Carmona was in office, said the nominee can learn from the difficulties he faced in Tucson.
"If he is appointed, my wish would be that he take everything he has learned in Tucson, both good and bad, and build on those," she said.
Others, meanwhile, paint Carmona as an extremely active leader in the community, usually with a twist that combines his twin vocations of physician and part-time deputy sheriff and SWAT team member. In Tucson, his derring-do has put law enforcement squarely on his side.
"He's probably the most decorated police officer in the country," said Pima County Sheriff Clarence Dupnik, who met Carmona in 1985. One of those he has worked closely with is Tucson Fire Department Battalion Chief Les Caid, who was charged with implementing the federally funded Metropolitan Medical Response System two years ago. The system is designed to integrate city and county services in the event of a major disaster.
"The first person I thought about was Rich," Caid said. "He's worked his tail off. If we added up all the time he's put in, we probably paid him a nickel an hour over the last two years."