Shedding light on his embattled years as U.S. surgeon general for the first time, Tucson physician Dr. Richard Carmona says he was severely muzzled by political operatives in the Bush administration during his entire tenure in that position.

He was forbidden to speak out on such hot-button issues as stem-cell research, abstinence, sexual health, abortion and emergency contraception when the science didn't jibe with President Bush's political views, Carmona told the House Committee on Oversight and Government Reform in a hearing Tuesday.

Even his highly praised, landmark report on the lethality of secondhand smoke was threatened by lengthy delays and unscientific editing before it was finally issued at the end of his term last year, he said.

And whenever he spoke in public, he was instructed to mention Bush by name.

"Anything that doesn't fit into the political appointees' ideological, theological or political agenda is often ignored, marginalized or simply buried," Carmona said at the hearing.

He appeared with two other former surgeons general, Dr. C. Everett Koop and Dr. David Satcher, to discuss the increasing politicization of the office, often dubbed "the nation's doctor."

"It was not just me. All of the surgeons general will tell you they have felt this kind of political pressure in recent decades," Carmona said in a subsequent interview with the Arizona Daily Star.

"But they all agreed that nobody had it as bad as Rich Carmona. No surgeon general has been as politically challenged or marginalized."

Responding, the White House said Carmona was given the authority and had the obligation to be the leading voice for the health of all Americans.

"It's disappointing to us if he failed to use his position to the fullest extent in advocating for policies he thought were in the best interests of the nation," Deputy Press Secretary Tony Fratto said. "We believe Dr. Carmona received the support necessary to carry out his mission."

Confirmation hearings are scheduled to be held Thursday for Dr. James Holsinger Jr., the Kentucky cardiologist Bush nominated as the nation's 18th surgeon general. The nomination has been criticized by gay-rights groups and Democrats due to Holsinger's past statements on homosexuality.

Plucked out of Tucson — where he was a high-profile trauma surgeon and Pima County Sheriff's Department SWAT team member — in 2002 to serve as surgeon general, Carmona quickly slipped into silent oblivion, baffling friends and former colleagues back home.

At the end of his four-year term in Washington, he was not asked to serve a second term, and he returned to Tucson, where he is now vice chairman of Canyon Ranch and president of Canyon Ranch Institute.

After his abrupt exit, Carmona declined to discuss the reasons for it or his troubles with Bush aides, until now.

"I wasn't asked to stay, largely for not being a team player. Yes, I think that contributed to their decision," he said.

"But by then, I wasn't sure I was going to stay. I was tired of the political battles day after day, of being so often at odds with the political agenda.

"We all feel the American public should be outraged that we cannot communicate with them on the merits of the science of these vital health issues."

Carmona feared he would appear as "just a disgruntled person, an unhappy camper" if he aired these concerns right after leaving office.

"I didn't want to go on the record alone. But the power of all of us speaking out on this together is the point," he said. "We are all saying essentially the same thing — that we have a dysfunctional system. This won't die now."

Carmona described himself as "quite politically naive" when he — a self-made Hispanic physician from a poor family — first arrived in Washington.

"As I witnessed the partisanship and political manipulation, I was astounded but also unsure of what I was witnessing," he told the House committee, chaired by California Democrat Henry Waxman.

For example, he wasn't allowed to make a speech at the Special Olympics because it was viewed as benefiting a political opponent. However, he was asked to speak at events designed to benefit Republican lawmakers.

Stunned, Carmona consulted his predecessors for insight and advice and was told they all had to fight political battles with the administrations they served.

"But each agreed they had never seen Washington so partisan and politically driven as it is now," he said.

The surgeon general's job is "not the doctor of a political party," he testified.

Find the online version of this story for a slide show detailing the career of Richard Carmona at www.azstarnet.com/politics

● The Associated Press contributed to this story. ● Contact reporter Carla McClain at 806-7754 or at cmcclain@azstarnet.com.

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©The Arizona Daily Star, 2006