>> next, kilo and a with wayne a. i. frederick. then house of commons. after that, a discussion on climate change. >> this week on q&a, our guest is dr. wayne a.i. frederick who talks to us about the challenges facing the school as well as his life and career as a cancer surgeon. >> dr. wayne a.i. frederick, why do they call howard the mecca? >> they call it the mecca for several reasons. it has been a place that has drawn people from all over the world and has been a source of

great education but also as a service. so those people who have come from all over the world to gain knowledge and get an education have then gone out around changed the world around them. so it's like going to the mecca where you can come and really know your spirit, your soul, expand your mind and the possibilities of the world around you and go out and change the world. so we feel it's akin to a mecca. >> what were the circumstances that you became interim? >> my predecessor decided that he was going to step down and i was in the position of provost, which is considered the number two position. so i was asked to fill in on an interim basis. >> where are you from originally? >> i was born in trinidad and tobago, many, many miles away from here. howard had a very great reputation in trinidad, many

physicians and so on that i interacted with while i was growing up were trained at howard university, so it was a natural fit for me to come here. >> where is howard university located? >> at the nation's capital in washington, d.c. on georgia avenue. i like to point that out because i think of georgia and florida as the center of the city. you get a little bit of everything on that very corner and i think it represents exactly the cosmopolitan of howard university right now. >> how many students are there? >> about 10,000 students, about 6500 in undergrad and the rest in our graduate programs. >> what was the original creation of howard based on? >> you know, there was a charter back on march 2, 1867 which was founded by ten men to put forward and that charter really spoke to giving opportunity to those who otherwise would not

have an opportunity. howard has a hospital on its campus which was known as freedman's hospital and that was back five years before the university. the concept was to allow freed slaves an opportunity to get medical care as they moved from the south to the north but also as the university came about it was again to give an opportunity to those who did not have an opportunity. race and ethnicity was never mentioned in our charter. we evolved into a circumstance where obviously we catered to african americans in a large way especially as we came up and through the civil rights era. we've had 16 presidents, ten of whom were caucasian and the last six have been african american. >> what's the historicically black college and university, and where does howard fit in this size of all that? >> that's a designation by the federal government that distinguishes universities that

are catering to a particular segment of the population. and again providing that opportunity in order to get that education that otherwise they would not have an opportunity elsewhere. howard university represents maybe the second or third largest of those universities. and of those universities in terms of spectrum, howard university would be the largest private university in that segment as well. when you look at the breadth of offering, probably about 105 now that have that designation of historically black college and university, looking among those i would say that we have one of the widest offerings. we have a divinity school, law school, med school, the only dental school in the district of columbia and a wide variety of undergraduate programs that we offer as well. we are the only one in that category as well. so we really represent a unique

offering in that space. >> i read that they are north of the 105 hcbu's there are 200,000 plus students nationwide. you though say you're a private school but you get a couple hundred million dollars from the federal government. why? >> that's correct. back in 19 -- well, with the funding of the school we did receive money from a governmental agency right from the founding based on the charter that was in place at the time. subsequent to that, and around 1922, there was actually an act of congress that created the federal appropriation to howard university. and then as it came through the civil rights era and had official hbcu designation by the federal government we continued to receive that appropriation. and when you look at our output in terms of what we have done to diversify america's workforce

and more importantly its leadership, brown versus the board of education was one that would not have existed if it were not for howard lawyers, and for the type of impetus that howard campus really gave to that. the thurgood marshalls of the world, of the world who are pre- imminent alumni who have gone out and really made a marked difference in the areas that would not have occurred. but that experience is still occurring today. we have a very contemporary experience today. when you look at harris from california, the attorney general. you look at mayor reed in atlanta. we are continuing to really put forward very, very prominent alum who are making significant differences in their field. so that appropriation does come to a private university is really affecting america and the globe beyond it. >> what's the total budget for the year? >> it's probably just shy of $1

billion in terms of revenues. >> here's some video back in 2010 where you got an award and you're talking about your upbringing. >> i was born in trinidad some four decades ago, my parents were informed that my life expectancy would be pretty short so i kind of grew up living for today by ultimately chose howard university. that was the only place that my mother would be comfortable sending a 16-year-old who was 5'6" and 118 pounds to go to school. so with her blessings i came here and became a physician at the age of 22 going on 23. >> let's start with that. how did you become a physician at age 22? normally it's 26, 27. >> yes. so howard gave me an incredible opportunity. back to my upbringing. one of the other reasons i came

to howard was because the first prime minister of my country eric williams was part of the political science department here. he graduated from oxford in england and then came over here because he felt howard was the black oxford and he laid the groundwork what would turn into a fight for colonialism and led the fight for trinidad. he revolutionized our country providing free health care, free education for the public. and my mom was the beneficiary of that and she was very enamored by howard university because of what she felt it represented. i became enamored of it too because of hearing stories from her about him. that led me here to washington, d.c. to attend howard university. howard has a bsmd program which i benefited from. i graduated from high school at the age of 14, i skipped a couple of grades. i think having sickle cell was a blessing in disguise.

my mother doesn't like to hear me say that but it afforded me a lot of time during hospitalizations to read and focus on my school work. and i was very enamored and intrigued by science. every time i picked up something to do with science, i would be so fascinated by it. my mom being a nurse i would go on visits with her and i became enthralled by medicine. my grandmother tells the story about me saying i would become a doctor to find a cure for sickle cell. i jumped, i graduated early from high school. on top of that i was able to matriculate in what would be an eight-year program in six years and so that led me to going to med school at the age of 19 and finishing at 22.

>> on your worst day that you remember, how bad do you feel with sickle cell anemia? >> it's been bad. i've had some very difficult days. especially as a child growing up i've had days where i've begged my mom and physicians to amputate the limb that was hurting me because the pain was so severe. i have the pain has been very intense. it can be very severe. more importantly i think just the emotions around all of it remind of the limitations on my physical body can sometimes be difficult to be especially as a young child who wants to be active. and i fell in love with soccer. so knowing that i couldn't play competitively as a result all of those things is a reminder.

i haven't been that ill that frequently in my adulthood since coming to the u.s. my health has been remarkably well. i think a lot of that has to do with the care that i received at howard university as well as the knowledge that i've gained about what my triggers are. i know when to rest and shut it down and i know how to hydrate myself. most people who know me well will tell you i would probably drink a few gallons of water a day and that has helped me significantly. so i still play soccer actively in the over 40 league so i'm trying to relive my youth through that mechanism. >> 42 years old? >> i will be 43 on june 17th. >> what is sickle cell anemia? >> sickle cell is a hemoglobin disorder in which your proteins that make up the hemoglobin because of a genetic defect are shaped differently and react

differently and deoxygenated states. so in deoxygenated states that becomes very firm and rigid and it causes the cells to take up a sickle shape instead of their usual round shape. that sickle shape also allows the cells to become stickier and so as they try to pass through and navigate the blood vessels they tend to stick to each other and kind of conglomerate as it were. that causes information locally swelling and it causes intense pain. usually at the joints or in your limbs. so usually along the long bones of those types of things. so moving and using it becomes very difficult if not impossible without causing excruciating pain. >> when do you remember first realizing that you had it? >> i think at a very young child. my mother and father stayed near -- i was the firstborn so they

stayed literally walking distance from the hospital as a result of my diagnosis in trinidad they had started screening for kids i think the year before i was born and so it became a mandatory test. so once they found out, they stayed very close. so for the first six months of my life i believe i lived across the street from the hospital. i would say as a very young child i had pains and difficulty, would get hospitalized, would really ask a lot of questions about why. so something that i've known all my life. i've always associated myself with us going to the beach and not being able to swim for long periods because i would get sick every time of flying on planes was a difficulty as well because of the pressurized cabin. i would sometimes land on a long trip from trinidad to almost be sick immediately. so it's always associated for as long as i can remember. >> do white people get sickle cell anemia and asian people?

>> it's a very interesting disorder. it says a lot about the diaspora and the world around us. people in the lower parts of the mediterranean and lower european parts, lower parts of italy and whatever, because of the african diaspora, you can meet fair-skinned people with blue eyes who get sickle cell and i've actually met a couple of people like that in my career practicing medicine. it clearly affects those of the african diaspora in larger degrees and there's in africa it became more prevalent because the host cells don't last very long the red blood cells, people don't last very long. so malaria for instance it's very difficult to contract malaria as a result so they think it proliferates it in africa as a result of that. and in between you have sickle cell, you have people with normal blood cells but you can

have people with a trait where they've inherited one gene from one parent and one normal gene from the other parent and they have the trait like my two younger brothers do. so their chance is probably a little less and they don't have the negative effects of what i have with having both defective genes. >> how do they treat sickle cell? >> most of the treatment now is comfort, care, is what we would call it. supportive care. hydration, pain medication, when you have a crisis. in terms of a cure, there are studies being done where doing bone marrow transplants and now progressively stem cell transplants are leading to cures. and i think that will be the treatment of the future. >> when was the last time you had a sickle cell crisis? >> i would say probably three, four years ago. i have not been hospitalized for a sickle cell crisis since having my tonsils taken out at the end of my fellowship in

2003 where i couldn't drink enough to hydrate myself. that's the last time. so that's over ten years ago. >> what were the circumstances of how you became interim president of howard and when did it happen? >> it happened october 1st. as i said, it was related to the president at the time stepping down announcing his resignation, his retirement i should say, and so i was asked to fill in since i was the provost and chief academic officer at the time. and it was a very humbling honor being a triple alum of the university to take on such a task. >> that's because you have an mba. >> well, that certainly does help. >> why did you do that? why did you get a master in business? >> i was associate dean for clinical affairs at the time in the medical school when i decided to pursue that. i've always been interested in business in terms of how it

works. and i felt that it was time for me to get a little more savvy about that, about spreadsheets, about strategy around acquisitions and mergers and things of that nature, and i thought the best way to do that at that time would be to pursue my mba. it also had a secondary benefit because i sat in with the students i was in charge with helping the students get an education. for the most part most didn't realize i was associate dean of the college of medicine, which is kind of down the hill on the campus. so it was a great education from both perspectives. >> how many people are there in the med school? >> in the med school we have 452 students in all four classes. we take in a class of about 115 to 120 every year. >> how many in law school? >> in law school we have i think about 380 a class. so i would say in the 300 range.

>> so when the board of directors trustees came to you and the president stepped down and said we want you to become the interim, what was your reaction? >> i was -- i would say i was surprised. i was deeply honored, very humbled by it. and i also was very motivated and determined that it would put that type of faith in me because what howard represents to me just on a personal level in terms of what it has afforded me career wise to education, i could just never pay her back enough. so it was certainly an opportunity for me to do all that i can to make sure that she thrives. and i feel very strongly about this prior to being asked, to be put in the position to steer the ship was one that i certainly had to take a deep breath and say that dreams do become reality.

>> are you a candidate for the permanent job? >> i am. >> and how long is that process going to take? >> i'm not sure. i have been participating in the process as any candidate would. >> how do you like it? >> i love it. i love it. i love everything about it. this has been a great opportunity as i move around the country and meet alum, i'm fascinated because my story i don't think is an exceptional story. my story is a true howard story. and as i move around the country i hear about so many people the first time in college, the first person in their family to graduate from college. i mean, the stories are incredible. and i want to look at what those people have gone back into their communities and do is incredible. they're not just leaders in business and in the industries, they're as received the technical knowledge for. but they've gone back in the communities and volunteered and made a difference to the communities that we're sensitive to. so it's a very humbling honor. >> here's some video from this year where you're talking about the goals of the howard medical

school. >> they understand that as sons and daughters of howard, their charge is to serve. they strive to provide excellent medical treatment especially in underserved and minority communities. fulfillment of the mission begins with howard's pipeline to prepare african americans and people of color for careers in medical sciences. >> howard university is one of the top producers of africans to medical school in this country. and when you look at minorities and african americans in particular, we lead the way in terms of sending people to medical school via application process. and then when you look, we are number two only to one of the schools. i think that says a lot about where howard is position in terms of really fulfilling the dream of that pipe line to medicine. >> talk about the trend. i mean, i read a statistic that back in the 70s that the

historicically black colleges had 85% of black students in the united states. and now it's down as low as 9%. so what's going on here? >> well clearly the opportunities have increased. when you look at historicically black colleges and universities across the board for african american students, we actually enroll only about 3% of all african american students when you take community colleges into that number as well. however, we graduate 22% of all the african americans who graduate from colleges and universities in this country. so although we only have 3% of the population, our ability to get them through and graduate them is significant. and therefore the role that we play is still a very, very important role. and it's one that we think is a sacred and moral obligation. so that trend does speak to the fact that opportunity is there. and we believe that opportunity is america's promise, we believe that education is the contract that was written.

but at howard and i think like many others we believe that we are the equal when it comes to african american education. >> what's your medical specialty? >> i'm a surgical oncologist. >> what does that mean? >> i do cancer, i do surgical -- i do basically surgery on patients with major g.i. cancers in particular, things like pancreas, stomach, colon, liver. i also do breast cancer work as well and i do a little bit of the other surgical oncology specialties. i would say the rest of that makes up about 10 to 15% of my practice which would include thyroid, skin cancers, soft tissue cancers. but my main focus is on the gastrointestinal tract cancers. >> when is the last time you did an operation? >> about two weeks ago. >> how can you be the interim president and operate at the same time? >> you have to be very organized.

i think the interim is key there. it means i will go to the results and practicing fully therefore i have to keep my skills honed because of the complex operations that i do. but i'm very organized about it. i have a great team around me that keeps me straight. and it's my passion taking care of patients, seeing them with these types of diagnoses you see things in patients that you otherwise wouldn't see. i have seen courage in patients who shouldn't have had that courage, patients with hope that shouldn't otherwise have hope. and since it's an inspiration to see those patients. >> what's been in your opinion since you've been in medicine the -- especially as applied to cancer, the biggest advance? >> i would say the biggest advance that i have seen in my career i would say is bringing the issue of quality to the forefront. medicine for a long period of time was treated as a bit of a

mystery. what physicians did, you know, had a large mystique around it. and rightly so. it does take a lot of training, it takes a lot of clear acumen around being precise to practice medicine. however, the issues around the fact that we are human and we make mistakes was one that we just never spoke about. we spoke about it in a closed setting but the interrogating why those mistakes occurred and avoiding them is not like it is in the airline industry. and i think now you're seeing that in medicine. i've seen it in my time where we're more open. and doing things in a better way to ensure that they go around. and i think ultimately that makes the patient the center of our affention that's really the right way of doing it. >> what's the toughest operation you've ever handled?

>> i do a pancreatic operation which is called a whipple. it's technical term is a pan creatic dude ect my. removing the first part of the pancreas, usually about 40% of the stomach, the bile duct, gallbladder and putting all of those back together with a loop of small intestine. it's very complicated and the average time i think nationwide for doing the operation is about six hours. at howard i think we do it an average time just under four hours. and our outcomes are very good. patients do very well but it's a very complicated operation, technically demanding. >> what's the hardest part about it? >> is identifying all of the anatomy. because sometimes there are variations of the anatomy that you don't see. that's one difficult part. another difficult part is you're operating around very major blood vessels that are critical. and that operation i've done a few times which includes taking

out the portal vein which is the main vein to the liver and replacing it with one that i've taken out of the neck, the internal jugular. so it can be technically demanding. the other thing about the operation that makes it very difficult is that you do all of the removal up front and that can take hours and then you have to go put everything back and do it in a meticulous fashion to make sure it doesn't leak and i think that also makes the operation tough when you may be tired or succombing to fatigue you're doing some of the more complex parts of the operation. >> might as well ask you this. but if you have -- somebody has pancreatic cancer what's the chance of survival? >> survival still isn't great. it's a very, very dreaded disease. it's 100 patients come to see me

with pancreatic cancer, 80% of them would not ever get an operation. it's that advanced a disease because of where the organ is located and because of the symptoms that do not become obvious until it's too late. so 80% of the patients will never have an operation, which means that they will succomb to their disease probably within six months. the other 20% would have an opportunity to be evaluated for an operation. so they may get chemo and radiation up front or we may take them directly to the operating room. if we take all 20 of those 100 patients to the operating room, another 5 to 10 would have the operation aborted because of something we found that we did not know up front. and then of the other 10, or get an operation, subsequent to that or before that, that, those are the ten patients would then develop other distant sites of disease after the operation sometimes within 10 of the following years in the order of six or seven.

so of the 100 patients, two or three may be cured by an operation or have no disease beyond five years. >> is there a cancer that you've seen in the last 20 years since you've been in this profession that is more treatable today than it was? >> i would say not necessarily my time. i would say the biggest advance that i've seen, would be in childhood cancers. but that progression had started before my time. and as a trainee, i saw what i would describe as more of the tail wind of that success story. our ability to cure childhood cancers are significant today. and it has had a major impact in terms of the cancers i treat. i would say we've become more sophisticated in identifying the ability to intersect or intervene with the right type of therapy and not necessarily

expose people to thing that is they may not need. and we've seen some of that progression i would say in breast cancer. we have seen the operation in pancreatic cancer probably become more well-defined and we train more people to do it well. esophageal cancer is another area where again i think the operation has gotten better instead of having to go into everyone's chest we've been able to do what's called a transhiatal esophagectomy where we do the operation into the neck and the chest and so the results of the operation itself, not the cancer cure but the operation itself, has better -- ability. so there's years where we've had success. the cancers that have spread to the liver, especially colon cancer has gotten better because of the drugs, not so much the operations that we've been able to do but the chemotherapy, the drugs have gotten substantially

better. >> how often have you had to tell a patient that they've got a serious cancer? >> too often. and it's one of the most humbling things that you would do. it's one of the things that i think on a daily basis in -- which enriches my life in a different way. to give people bad news is one thing. to tell people that they have cancer or that they have a relative who is dying or is dead is one of the things in life that i think puts everything in perspective for me. and i tell people often there are complex problems in the world but once you have to sit in front of an individual and have that discussion and see the hope drain away from them, and then see that person turn around and display courage and give you back that hope in humanity, you see them turn to relatives around them who otherwise would have had estrained relationships and have difficulties that, whether it's with finances or other things, other things going on in their

lives and see them put those things behind them and focus on that person, it shows you that the life that we live is a wonderful one. and it reminds you that things like love is a journey with no end. and despite the fact that we may have an end, that love goes on well beyond the people that we love being around us. >> i'm sure you've had the same experience in your life but i've had a lot of people tell me when they were first told by a doctor that they had cancer, what's your -- i don't know what you want to call it -- bedside manner and how fast do you get to the point that you're not going to survive in some cases? >> i try to be very direct. i also try to encourage patients to come with relatives because once i say that, the rest of the conversation is out the window. they do not hear anything. most patients begin to be very introspective. not just about their lives but the other thing about the human condition is that is not one

that is in isolation. the human condition requires interaction. and the first thing that patients tend to do is to think about others, think about their loved ones, their kids, graduations they may not see, weddings they may not see. it's amazing while you're speaking to them their minds are racing away about a time line of thing that is they may need to do. and so they don't hear most of your instructions that follow or even preceded that. so having an advocate in the room who can process, remind them about things, be the person to probably take notes and instructions i think is important. the other thing that i try to do is i don't do any diagnose is over the phone. i tell patients you have to come to the office. we have to sit down and have a conversation. because regardless of how big or how small you think the issue is, i think it requires a conversation, it requires my eye balls to meet yours, it requires

my attention to detail so that you can ask me any question that you want. and make sure that you get as full of an answer. and i often tell patients we have to do this again because often that first time does not cover the breadth of the concerns that a patient would have and when they go home and have a chance to really just calm down and think about it, they end up with a plethora of questions that need to be answered. >> what's the strongest reaction you've ever gotten? >> i would say as strong as it comes. i've had the unfortunate situation of telling patients that -- or telling family members that their family member has passed, you know, during an operation for trauma, for instance. and you know, i've been in the room with 50 family members of a police officer who was shot and killed and having to tell the family members. and it was one of the most awful things that i'ver experienced before i could finish staying

the words they were in hysterics. i remember that night vividly because i was a trainee at the time. i went back up to the room and called my mom, who was a nurse, it was almost midnight. i was just so traumatized and my father was a police officer and he died in what they said was a very difficult situation. while i was speaking to her my pager went off again. there was a young black male in the emergency room with a stabbing in his abdomen which says a lot about our society at the time and value of lives. i remember hanging up the phone and seeing this young man and having to take him back to the same operating room suite where this gentleman had just died and life just kept marching on despite the fact that this gentleman had lost his life and for his family time had stopped and here i was trying to extend time for this other young man.

it says a lot -- i think it was one of those moments in my career that really grounded me around the sacred nature of what i was doing and the obligation that i had to do it the best that i could do it. >> where did you learn how to do it? >> i learned -- i trained at howard university in general surgery -- >> but i mean where did you learn the technique that you use -- i don't know whether you want to call it a technique -- of dealing with people? is there anybody that taught you? >> you have. i have a mentor. he came to howard university back in 1948. he was an 18-year-old graduate from what was then known as florida a&m college. he could only apply to two medical schools at that time. how he came to be a physician is just as important. and so he could not get into -- he did not get into either medical school despite only having one b in his entire undergrad degree. the disparity at that time which unfortunately has a legacy today.

his university president petitioned howard to admit him. he graduated number one in his class and has gone on to be one of the most illustrious physician this country has produced. you name it he's been there. and he has always talked about putting the patient first. he has always talked about taking the time to make sure that patients understand. he's always talked about the hope making sure we always give patients hope. always talked about the courage that patients display that we should admire and take to heart. and so i think i've gleaned a lot of things from him. i have another mentor who is a transplant surgeon. one day i was in clinic and i was with him taking care of a caucasian woman in minnesota where he trained. she didn't have money, was getting in trouble with her transplanted organ. she had a transplanted kidney and she came to the office and

he wrote a prescription for her meds and he can tell that she couldn't be able to pay for it. when he thought no one was looking, i saw him take money out of his pocket and give it to her to get her meds. and i thought to myself, wow, he is already extending himself to her by seeing her, the insurance company probably wouldn't be happy he saw her and didn't charge her and here he was also giving her money to get her meds. i think those two men among many others really set the bar for me in terms of how i should treat patients. >> you spoke to the howard commencement back in early may. here's a brief excerpt where you're posing a question to the students. >> i pose the question to my 2014 graduates. what will you frame your degree with? will you frame it with fame and

notoriety? with wealth and recognition? or will you frame it with mentoring, with love? with service, with family? with compassion? you earn your degree not just to adorn your wall but at howard university that degree is for you to change the world around you. >> why did you want to focus on framing your degree and your life around fame and notoriety or on wealth and recognition? where does that come from? >> so my -- that question is those are the choices that you could choose. we give students the technical competence to go out and earn a living to make themselves famous, to do things that would bring them recognition. but i feel very strongly that howard university truth and service is our motto.

and our degrees really come alive if you go out and change the world around you. that's what our alum have done. and that's what thurgood marshall did with his degree, that's what vernon jordan has done with his degree. that's what lasalle le forward is doing. that's what the mayor is doing. and that class is made up of a fascinating number of individuals who are already doing that with their degrees and i think is important because the young men and women of our society today we tend to characterize them and label them because they don't do things quite the way we did -- and i'm not always sure that's fair -- we have alternative spring break on our campus and i have students who apply to do that. i had 300 students go to five cities in this country in haiti and give up their spring break instead of going to daytona beach, instead of suntanning and as they were out

in the communities mentoring, tutoring students. and these are kids that could probably even get a job during that period of time albeit for a week and required necessary funds for them to mattriculate but they think it's more important to go out and give service. so i have a renewed faith in our youth and the types of students who are coming to howard and i want them to frame the degree the way they would frame their lives. >> we found this video of a couple of howard students on you tube talking about howard university. >> so do you think it's worth coming to howard? >> i think the overall experience i've had here is definitely worth it. this goal could use a lot of renovations. major things, not minor things. buildings and floors and water. so i think it should be more work. >> it's definitely worth them

coming here. they get a bad rep about it not being like the real world or you -- if you're a black person you don't need to go to an all black school because you don't really get the true -- you don't really get the true real world experience. but two thirds of the world, if we want to talk globally, two thirds is nonwhite. so the fact that howard university you're getting the real world experience and also you get people from all types of diversity, you realize that diversity goes beyond race and ethnicity. >> i'll tell you a little secret. a long time for a long time like up until i was like 15 i wished i was white because of where i grew up. i grew up around a whole lot of white people, black and beautiful. you know, i thought i was ugly. and then coming to howard university completely eradicated all those negative feelings >> what's your reaction to any of those? >> i think it's great. i think you captured a lot of the howard story. the reality is that we have students on our campus from

around 44 countries and from just as many states. so when you look at what is happening on our campus, to speak to the young man who spoke about the diversity, it is a very, very diverse campus in that respect. the other thing i think that's important you hear in the video is that the ability to self-identify with who you are and the role that you need to play in the world is not one that can be undermined for students of that age. for that 17, 18-year-old, that period of time before you go out into the workforce is a critical period of time. and i think we afford students an opportunity to find themselves, we afford them to embark on that journey to excellence in a way that's self-fulfilling. >> what's the ratio mix at howard? >> we have about, it's 94-96% african american students. we have students from as i say all over the world and other ethnicities, students coming there from brazil, from saudi arabia, from china, et cetera.

>> the 2000 tuition was $10,000 and supposedly the latest is $22,000 plus. >> that's correct. >> what happened? >> i think higher education, the challenge are what really we are continuing to explore and try to put our arms around. and we are trying to meet that challenge. we still, however, represent of the private universities in our peer group and in the district of columbia right here we are still very cheap compared to those institutions. among the larger historicically black colleges and universities, we still charge less than spellman and moorehouse, two colleges we are a full research university and our graduate students are being exposed to a full experience. we charge less than those institutions. so i still believe that we are a great bargain in terms of from

a course point of view. the other difficulty we have is that 56% of our undergrad students are program eligible. that means their families are under the lower income part of the spectrum and i think that's the real difficulty at the howard university. we have private institution, and we are attracting a student body that you would see more at public institution. and that's another beauty about what we do is we're still able to afford those students an opportunity to get a world-class education despite their financial circumstances. and that is our mission. >> as you know there's been a lot of controversy about howard over the last, 20 years or so. mostly because of financial problems. straighten us out on that. i've read that the last couple of years, the budget has been balanced but you do get a quarter of your money from the federal taxpayer.

what's the status? and one of the young kids said ceilings are falling. >> so i would say -- let's put it in perspective. we have an aging campus. there's no doubt about that. and we certainly have a lot of what we call deferred maintenance that needs to take place. we're actively engaged in doing that. we also engage in trying to bring new facilities through the new building that we're building a $70 million facility and two new resident halls that would open this fall as well with the new dining facility to come in the spring. so we certainly are making progress on the needs. we have three major revenue streams one of which you mentioned in terms of the federal appropriation. and the reality is that we see a need to diversify those revenue streams and to expand our efforts and those are thing that is the board of trustees have been able to zero in on and to set strategies for us to go

out and do that. our endowment is the largest amount the historically black colleges and universities and it's just shy of 600 million. to put that in perspective, vanderbilt is in our peer group and they are at $6 billion. harvard, which represents the pinnicle of the nation's endowments is at 34 billion and they have a $6 billion campaign going on right now just to put it in perspective. if we're going to aspire to have that type of excellence, those types of facilities to produce that type of excellence in our campus then we have to have that type of investment. so it is my responsibility now on an interim, it would be the 17th president's responsibility when he or she is named, to go out and to ensure that we expand those revenue streams, that we modernize real estate assets that we are out raising money, that we have more corporate donations et cetera.

>> you've got a board of how many? >> around 30. >> the most controversial time was back in april of 2013 when you had a trustee by the name of renee higgenbottom brooks who wrote a letter to her fellow trustees: she even suggested, it might not be around in three years. that was a year ago. how do you deal with this? because i know you're a candidate for president. she is still on your board i assume and you do have a new chairman though. >> we have two more years to try to outlive that on one end. and on the other end the this is is a very -- this is a very dedicated truee who i think was trying to bring attention to

concerns that she had. and i think we all tend to add a little hyperably when we are trying to make a point and i think that was intended to make a private discourse and i think it was unfortunate that it got out into the public domain. nevertheless the discussion around what we need to do and all of us rallying around it so we can come together and move forward is something that has been ongoing. it was ongoing before that letter came out and i think it has even strengthened beyond that. the current chair elect stacy mobiley and the two vice chair elects, all three of them i think have really rallied the board together to ensure that we can move forward together. and as you pointed out, the vice chair, the former vice chair is still on the board and has continued to contribute to the board as we will. >> how do you get on the board?

and do you have to be an african american? >> no. a the latter question no. we have a long history of having a very diverse board as well as a very diverse board with ideology as well. senator jack kemp was on our board, one of the greatest board members i would even submit to say. getting on the board is an internal process that is conducted by one of the can hes in conjunction with the president. >> does the fed have anything to say about who son your board? >> they don't dictate who is on our board. >> you were not around but there was a time when a president nominated lee atwater. >> i was a student at the time. i started howard in 1988 that issue occurred in the fall of 88 into the spring of 89. >> did you demonstrate against it? >> i didn't because i didn't understand the issue fully and i would submit that many of us at the time probably didn't understand the issue fully in

retrospect, i can look back at the issue and i think that his nomination occurred at a time when people were also disgruntled about a lot of things at the school. >> does the president have any say, did he then, about a board member at all? >> sure. the presidents have always been involved in selecting board members and making suggestions. and as i said it's done in conjunction with the board as well and with the committee. that puts forward those nominations. and then the entire board vets that. but the president has always been involved in participating in that process. >> higgenbottom brooks also wrote in her letter, how many citizens walk in the door and can't pay? >> we -- first let me say that the district of district of columbia even before the affordable care act had a very

high insurance rate among its citizens, i would say as high as 94 to 96%. so let's start with that. so the self-pay population still represents a small percentage of the entire population. the issue is that the rest of that population, we have about 70 to 80% of the patients who come to see us have medicare or medicaid types of insurance instruments. and the reimbursement rates from those are very low. so the difficulty that we have is that we provide a very high level of care that is costly with a very low reimbursement. so making that margin is difficult. the hospital is owned obviously by the university but it is a small hospital and therefore again when you look at things like supply chain, if i order ten hips for hip replacements versus part of a bigger system where i can order 10,000 hips, you can tell again that what i

will pay versus what that other institution is going to pay is very different. so is the margins that i will make every time i do one of those procedures both automatically become very difficult. >> how many beds? >> we are licensed 452 beds and we probably occupy about 250 of those. so from a size and scale point of view, she's absolutely right. we can't survive as an independently owned hospital. so we have embarked on a process which we are still in the middle of in terms of looking for an appropriate solution for the hospital. >> back at that commencement you also invited someone to be a speaker. we're going to run a little bit of this. and i will obviously ask you if this was controversial at all. >> only this family could take one of the sons that already has three name changes. all right? and give them a fourth. dr. cohen.

i know the boards of trustees are looking at me like this is not the regular type of commencement speaker that we're used to. but it's time for us to evolve. we're changing things out here. and thanks to this board right here. >> rapper shawn combs had three names he talking about p. diddy, diddy, and puff daddy. controversial at all to have a two-year -- two years at howard and didn't get a degree but you brought him back and gave him a doctorate? >> i would say no controversy for me. let me be absolutely clear. i was never -- i can't say that it was controversial for me on that particular issue. not at all. >> why did you do it? >> i feel very strongly about that. this is a young man who attended howard university around the time i did, left howard university in good academic

standing. i think it's unfortunate that news reports describe him as a colored dropout. the reality is that african americans in this country who attend higher education, some 75 to 80% do not finish because of financial circumstances. it has nothing to do with their academic aptitude. and when we talk about colored dropouts we paint people with a scarlett letter because we're saying to them that you did not succeed despite the fact that you went beyond your high school and attempted to go to college and because you did not have the finances we must now label you in a certain way. and the reality is we don't do that for many other segments of our society. when you look at steve jobs, who never finished college, maya angelou, who didn't finish high school. >> bill gates. >> we could go on and on.

i've heard brian williams talk about his college experience, attending three universities and earning 18 credits and i get my news from him every night and i think he does an excellent job and i think the intelligence that revolves around that speaks to that. so my point is that i am a college president. i want to people to come to university and get an education. but i recognize that a lot who drop out don't drop out because of poor academic aptitude. to give a commencement address, you want someone who is going to be able to give a charge to students that will give them some type of inspiration and help them understand the journey. because that graduation is a destination that we have kind of become obsessed with. it's not the end of the journey, it's a part. it's a milestone. so you wanted a speaker who is going to speak to the greater life. and here is someone who cleaned toilets in a gas station, who is now running a company that is worth $700 million and who is evolving as he said.

i'm not crazy about some of the lyrics he used in the past but when i look at the business things he is doing now and what he is giving back in terms of philanthropy i think he is and was a good choice. >> you paid tribute to your mom earlier. is she still alive? >> she is still alive and here in d.c. right now. >> where does she live today? >> she lives in trinidad. >> if you had to go to trinidad and get on an airplane how long does it take you >> about six hours. a couple hours from miami and a couple hours to miami. >> how many people live there? >> about 1.3 million between the two countries. >> what do you remember most about your first 16 years in trinidad? >> i would say the freedom of not having things. and having to be innovative about having a good time. that really stimulates your mind when you have to go out and make a make shift ball or you

have to go out and play with friends and the social interactions that you're forced to have that my kids, that i am creating circumstances to force them to have to have play dates where they would probably rather sit and play in front of their computer screens. >> where did you meet your wife? >> at trinidad at carnival. >> how long have you been married? >> i've been married since 2004. >> and how many kids do you have? >> i have two kids. >> how old? >> one my son will be 10 and my daughter will be 8. >> both born in this country? >> both born in this country. my son would be considered an african american male. >> if you don't get the full job permanent job as president of howard, what will you do? what will be your number one love after that? >> that means i get back on the journey that i was on in terms of teaching and taking care of patients. as i do i rally around my family and decide what we do next. >> will you continue to operate on people if you become

president? >> something i will think about. the operations i do are too complex to do infrequently so i would have to strongly consider not doing them anymore. >> our guest has been for the last hour wayne frederick and i have to ask you what does a and i stand for? >> alex and ian. >> what do your closest friends call you? >> freddy. >> interim president of howard university here in washington, d.c. we thank you very much for joining us. >> thank you. >> for free transcripts or to give us your comments, visit us at q&a.org. they are also available as c-span podcasts.

>> next british prime minister david cameron takes questions from members of the house of commons. then a debate on whether campaign financing is free speech. a look at mexico and its oil and gas production. a panel of energy executives will talk about the recent decision to allow private through state-controlled energy market. that is live on c-span at 1:30 p.m. content should remain free from regulation. it is confusing the conversation. of course it want the

conversation to be free and on regulated in the sec has no place relating content online. they have always made sure that the medication pathways stay open, so today we have the vestiges of a regulated phone system. the fcc does not regulate what they say to you what i call you, but they make sure that the communication pathway is open, available, nondiscriminatory, and available for everyone to use. >> it is crucial to think about whether those platforms remain open the way they have historically. ae internet has grown up as network where anyone can communicate, anyone can get online. a teeny company can get access to the network and become in some cases, like google or facebook, a huge business. it is vital that that not change as the internet evolves. on the sec open internet policy and the flow and speed of web traffic. monday night at 8:00 eastern