Dr. Joseph F. Boyle, president of the American Medical Association, entered his first formal debate in eighth grade in Jersey City, N.J.
"I won that debate," says the 60-year-old internist from Los Angeles. "The question was: Resolved that the colonies were justified in revolting against the king.
"By the way," he adds, "I had the negative in that debate."
Boyle, now in the middle of a one-year term as the nation's "first doctor," has been taking sides on issues from smog to boxing ever since.
Because of his oratorical skills -- "My mother always said I was vaccinated with a phonograph needle" -- his family expected him to become a lawyer or a priest. But he chose medicine.
Colleagues describe Boyle as bright and intense, a skilled parliamentarian who wields authority without ruffling feathers needlessly, a dedicated and tireless doctor. Besides his AMA duties -- he'll average nearly a speech a day this year -- Boyle maintains a private practice in Los Angeles and is on the faculty of the UCLA School of Medicine.
"He seems to require remarkably little sleep," says Dr. Cash Rose, a California colleague.
He's also a father of eight , a voracious reader (James Michener is a favorite), an amateur photographer and a self-described "enthusiastic but horrible golfer. If I hit a dozen good shots in the course of a round, I've had a great afternoon."
As a specialist in diseases of the lung, Boyle has been an outspoken advocate of tough air pollution laws since the 1960s.
In 1967, he was appointed by then-governor Ronald Reagan to the California Air Resources Board, which was responsible for setting health-based air quality standards for the state, including automobile exhaust controls. After the board adopted stringent measures requiring smog-control devices on older cars, Reagan replaced its members, including Boyle, with a whole new board more to his liking.
It is hardly surprising that Boyle, a lung specialist from smog-ridden Los Angeles, should get involved in the fight against air pollution. What is surprising is that he's a smoker.
A lung doctor, author of numerous scientific papers on respiratory disease, former member of the California Air Resources Board, former board president of the Los Angeles County chapter of the American Lung Association, and now the nominal head of organized medicine, Boyle cannot kick the tobacco habit.
"Everybody's on his case about it all the time," says Rose Schlichter, a longtime friend and a lung association staff member in Los Angeles. "He takes it very philosophically. He says, 'Hell, I know what's going on, but I can't stop.' "
"Everybody has to have one defect," says another colleague, "and I guess that's his."
"I'll stop again," Boyle says. "I quit for five years, up till about three years ago. It is something I must do again. I'll just have to.
"It's something I don't do in public, and certainly never when I'm with patients." But at other times, "particularly if I'm alone and tired," he succumbs.
If Boyle speaks with quiet matter-of-factness about his own smoking, he rises to almost evangelical tones when discussing the doctor-patient relationship and the ethical responsibility of a physician to "see patients as people first and clinical problems second."
At the close of his Georgetown speech last week, Boyle's voice quavered as he affirmed that "our code of ethics is a bible by which we shall live" and invited medical students to "join me in helping to change the world, because we can."
No one doubts that he believes it. Earlier in that speech, he took pains to rebut what he acknowledged is a common comment by older doctors to medical students these days: that medicine "used to be fun."
"Nothing grates on me more," Boyle said. "Plain balderdash. There is no more satisfying life that one could possibly entertain."
While he is generally regarded as a conservative, Boyle also went on record last week opposing further federal cuts in funding for Medicaid and Medicare by the Reagan administration.
"I can assure you that as far as the AMA is concerned, during the next four years, we will make it quite clear that we have had enough," he said in his Georgetown speech. "We can no longer watch while more and more people are pushed to the back of the bus and possibly out into the street."
He also reiterated previous calls for mandatory courses in medical ethics at all medical schools, since "70 percent of graduates tell us that their training has been less than adequate in helping them deal openly with their patients, identifying conflicts in medical ethical issues and providing awareness of social responsibility."
Under Boyle's leadership, the AMA touched off a heated debate last month by calling for "the elimination of both amateur and professional boxing." Boyle himself once called boxing "an exhibition designed to titillate people who find it glamorous watching macho men punch each other in the face."
The AMA statement on boxing drew heavy publicity, even though it was only one of dozens of positions on major health issues -- from smokeless tobacco to sexual abuse -- adopted by the AMA at its Honolulu convention.
Boyle says he wasn't surprised by the furor over the proposed boxing ban, for he expected even more public opposition. One recent national poll found public opinion almost evenly divided, with 46 percent favoring the AMA position.
Not that Boyle and the AMA didn't take some uppercuts from boxing's defenders. A former editor of Ring magazine, Bert Randolph Sugar, referred to Boyle as a "spokesman for the chapter of the Flat-Earth Society known as the AMA." In a New York Times commentary that invoked Nobel Peace Prize winners Martin Luther King and Desmond Tutu, as well as former heavyweight champions from Jess Willard to Floyd Patterson, Sugar concluded:
"The AMA has once again proved it can make headlines -- too many papers using their space to holler 'gesundheit' every time they sneeze -- and has political muscle and can misdirect our attention away from the many problems that beset the medical fraternity. But until the AMA meets in Watts or Harlem, or finds a cure for the common cold, it cannot presume to speak with a social awareness or pass moral judgments. Until then, it should simply take two aspirins and call us in the morning."
Other critics charge that by focusing on boxing, the AMA abdicated its responsibility to zero in on a much more devastating epidemic -- smoking -- which kills an estimated 1,000 Americans, or the equivalent of three fatal jumbo jetliner crashes, every day.
Despite repeated surgeon generals' warnings, a ban on televised cigarette advertising and a library's worth of evidence on the lethal effects of smoking, more than 50 million Americans still are unwilling or unable to quit.
What else should be done to wean smokers from their health-destructive habit? "Just keep on with the kinds of educational activities we've been engaged in," Boyle said. "There's a been a steady decline in the number of smokers in this country. I wouldn't say that this has been in any way a losing campaign, but we need to keep putting across the message.
"We need to keep reminding patients that if they engage in unhealthy activities, there's a price they're going to have to pay."
Meanwhile, Boyle is still wrestling with his own habit. It's a little like arguing the American Revolution from the Tory side -- only harder.
He offers no excuse, declining to blame his smoking on addiction or the pressures of his job. What made him resume smoking after a five-year abstinence?
"Stupidity," he says. "Just plain stupidity. I was seeing a patient at the hospital around 3 a.m. I was tired. I stepped outside the room, and the patient's brother-in-law offered me a cigarette. It seemed like a good idea.