Profile of a global health prankster, Bill Foege

Bill Foege in the hills near his boyhood home of Colville, Washington
Bill Foege in the hills near his boyhood home of Colville, Washington
Tom Paulson

Editor’s note: William Foege is a global health hero. Everyone from Bill Gates to Barack Obama says so. But what many may not know is that Foege is a prankster as well, and that mischief is a key to his success.

Disclosure: Bill Foege and I both graduated from Pacific Lutheran University, though separated by a few decades. Bill serves on the Humanosphere board and I consider him a good friend. That said, I’m tired of all this hero talk. I want people to know the mischievous side.

I wrote this article Prankster for Positive Disruption for PLU’s new magazine Resolute and am re-posting it here. Go take a look at the link to see more photos and info.


It may sound like a stretch, but the eradication of smallpox is directly connected to a young man slipping chewed-up rubber bands into his boss’ pipe tobacco.

That young man was Bill Foege ’57, the somewhat mischievous son of a Lutheran minister who pastored the Northeastern Washington community of Colville.

The world today knows Dr. William Foege, now 78, as the person who came up with the strategy—“ring containment,” modeled on what he learned fighting forest fires in the Pacific Northwest—that led to the eradication of smallpox in the late 1970s: the only human disease ever completely wiped off the planet. Read his book House on Fire for the full story. That episode alone makes Foege a public-health hero.

Bill Foege, pipe in hand, with colleagues helping refugees during Nigerian civil war in 1968.
Bill Foege, pipe in hand, with colleagues helping refugees during Nigerian civil war in 1968.
CDC
Some also might know him as the man who, in the late 1990s and well into the new millennium, helped the Bill & Melinda Gates Foundation launch and rapidly expand its revolutionary mission in global health—a mission that without question has transformed the global fight against many diseases of poverty. Others may recall that Foege was head of the U.S. Centers for Disease Control and Prevention during the Carter Administration and into the first part of the Reagan Administration when a strange new disease emerged on the scene – AIDS.

Foegegetsmedal
White House

In 2012, President Barack Obama awarded Foege the Presidential Medal of Freedom in recognition of all his achievements in international public health.

So yeah, he’s pretty much Mr. (or okay, Dr.) Global Health.

But what few may know about Foege is that he has always been a prankster and that this personal attribute – which he can disguise but seldom fully repress – has almost certainly been critical to his amazing list of accomplishments.

How so? Well, to begin with, psychologists tell us that practical jokers are motivated (whether they know it or not) by a desire to disrupt order, the status quo.

Foege is all about disrupting order, when he thinks it needs a little disruption. It may have started when he would sneak behind his mother at the dinner table in Colville to tie her apron strings to the chair, or when he put the rubber bands in the pipe of Jim Kohlstedt, his boss at the local pharmacy.

“I think the best one was when my brother Dick and I filled out Jim’s name and address on 300 post cards for free magazine subscriptions and sent them all at once,” Foege said.

Recalling the boyhood 'leg incident' in Colville.
Recalling the boyhood ‘leg incident’ in Colville.

Or the time he took a manikin leg from the shop and placed it in the back window of his car (to appear as if he was perhaps carting around an incapacitated woman – or worse). “I discovered that’s a good way to get stopped by the police.”

We’ve all done our share of practical jokes. But Foege, who is quite tall, never outgrew his boyish prankster ways. They just blossomed into a talent for challenging the status quo, complacency, harmful bureaucracy or worse.

In the 1960s, while working as a medical missionary on the smallpox campaign in Nigeria, he and a colleague were prevented by a local official from obtaining desperately needed vaccines. So he got his colleague to engage the official in conversation while Foege secretly loaded up their truck with the supplies. Not a prank, per se, but definitely a trickster move.

“I never told (the colleague) what I had done,” Foege recalled with a chuckle. It wasn’t that he didn’t want to tell his friend that he had done something that could have gotten them both arrested. Foege was just embarrassed he had misled the colleague because, well, he decided his friend was too honest to have pulled off the bait-and-switch.

Another time, when he was at the CDC and was getting grilled by a member of Congress who was hostile to spending American taxpayer money on foreigners, Foege asked him if he had received a flu shot that year. Yes, the Congressman replied.

“I told him about how the vaccine was manufactured using samples obtained in the Soviet Union and that he now had Soviet antibodies in his body protecting him from the flu,” Foege said. The Congressman was not amused, but others were.

Two Bills meet at the opening of the new Gates Foundation campus in Seattle
Two Bills meet at the opening of the new Gates Foundation campus in Seattle

On a more personal note, Foege once caused a ruckus at the Gates Foundation when he invited me – a journalist – to join him when the philanthropy opened its new campus in downtown Seattle. I knew the event was supposed to for select staff only, no media, and so I suggested this might cause him problems.

“Oh, I don’t think anyone will even notice,” he said. Wrong. Bill Gates looked at me like something the cat dragged in and the media affairs folks were apoplectic. I got a story out of it and some good photos (including one of Melinda Gates hugging Foege, which I’m told she has on her desk). But why did Foege even bring me along? Maybe he just liked causing a fuss.

But there’s another possible explanation. Inclusion. Breaking down walls. Anthropologists who study the sociological and cultural impacts of practical jokes say it is often done to bring someone into the fold, create social bonding and a sense of community.

All those who know Bill Foege speak of his empathy and how he so easily connects with everyone he meets. He tends to focus on others more than himself. He looks for what can bring people together as opposed to what distinguishes us from each other. In short, he has boundary issues – or issues with boundaries.

“At PLU, I used to go in people’s rooms and put limburger cheese on light bulbs,” Foege said. “It would take a while to melt before it started to smell so nobody could figure out who had put it there…. But I eventually had to do it in my own room to deflect suspicion.”

Okay, that’s hard to explain as either a positive disruption or method for creating social bonds. But that’s also classic Foege, disrupting the point of this article in order to try to deflect attention away from him and my thesis that his prankster side is based on his empathy for others and his desire to affect change.

“He also uses humor sometimes as a way to keep people at arm’s length,” said Paula Foege, his wife and a former PLU student as well. Lutherans are experts at self-deprecation, but Paula sees through it. She knows her husband is up to something when he seems to be joking around.

That’s a perspective formed from their very first meeting, when Bill was a senior but with another senior Lute snuck into a freshman orientation meeting at PLU in order to meet girls. A friend bet Bill he couldn’t get a date with the next girl to walk through the door. Paula walked through that door.

“He was a tall, skinny good-looking blonde joking around with everyone so, sure, I noticed him,” Paula recalled. But when Foege sauntered up and said he was a senior (possibly hoping to impress), Paula basically told him, nicely, to get lost. “I said I don’t like phonies.”

Foege persisted, eventually convincing a friend of Paula’s to get her to give him another chance. To make a long story short: She did, he got into medical school at the University of Washington, they got married, began their family with son David and went off to Africa to fulfill one of Bill Foege’s boyhood dreams – to work as a physician in Africa.

Many of Foege’s friends and colleagues know the story, and what motivated him from his early days. While incapacitated as a teen for months in a body cast due to a hip injury, he read about the medical missionary work of physician-philosopher Albert Schweitzer. What some may not know is that his original interest in medicine was psychiatry.

“I’d read a book about this psychiatrist who was really operating like a detective, a detective of the mind,” he said. That interest eventually lost out to his interest in going to Africa, and to becoming an infectious disease detective and a renowned leader in a field what would come to be known as global health.

Melinda Gates hugs Bill Foege
Melinda Gates hugs Bill Foege
Tom Paulson

But spend time around Foege and you can see he is still as fascinated by what makes people think what they think and do what they do as he is in fighting disease and inequity. Unlike many in the health field who approach it largely as a technical challenge – finding the best treatment for a malady, or the best methods for preventing an epidemic – he tends to see everything through the eyes of a person, a particular person.

Ask him about his battles against smallpox in Africa or India and you will hear about the people he met – the mothers with the sick children, the health workers and community leaders he came to know so well. He remembers them all by name and talks at length about their lives, their thoughts. Ask him about being director of the CDC and the difficult politics of the early days of AIDS, the deadly delays caused by stigma and apathy. Before he can answer, the very look on his face conveys no abstraction.

Public health is sometimes called population health because the point of it is to deal not with individual illnesses but with the population as a whole. For Bill Foege, public health is personal, deeply personal. Those who know him well recognize this attribute as key to what drives him, and what makes him perhaps one of the most influential people in the field of global health.

But, let the record show, being a prankster was no small part of it.

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About Author

Tom Paulson

Tom Paulson is founder and lead journalist at Humanosphere. Prior to operating this online news site, he reported on science,  medicine, health policy, aid and development for the Seattle Post-Intelligencer. Contact him at tom-at-humanosphere.org, follow him on Twitter @tompaulson and/or send a comment below.

  • a.m.kimball

    Great article. Really enjoyed it and it fits the Foege we all know and delight in…

  • Too

    I’m having a little trouble finding any Biafrans being helped in the photo that says he is doing so. Is this a prank?

    • http://humanosphere.kplu.org Tom Paulson

      Erm, I suspect you’re trying to be cute by noting that the photo does not show an actual Biafran receiving medical care or some other form of assistance. Maybe you should read up on what they actually did and the dangers they faced while working in Nigeria during the war – and then see if facile comments apply.