Stories

Reflecting on Dr. Houry’s talk, highlighting crisis leadership, ethical decision-making, and the realities of navigating public health systems.

By Setayesh Assadzadeh-Nahvi, Class of 2028 (Public Health Science Major)

On April 1, Dr. Debra Houry lost 2,500 staff in a single day and had only hours to decide what to save. That moment became the foundation of her April 15th talk at Santa Clara University for the Markkula Center for Applied Ethics 2026 Regan Lecture, where she described navigating her role at the CDC as Chief Medical Officer and Deputy Director in what she called “ER mode.” Sitting there, it felt less like a lecture and more like listening to someone walk through real-time crisis decisions. Faced with rapid staffing cuts, she and her team met every few hours to reassess priorities, deciding which programs could continue and which had to be let go. These decisions had immediate consequences, from scaling back responses to lead poisoning to shutting down screening programs. She framed public health leadership as a form of system-level triage, requiring constant, high-stakes decision-making under pressure.

Alongside this, Dr. Houry emphasized a “sleep at night” principle, making decisions that remain ethically defensible even under political pressure. She spoke about the challenges of protecting scientific integrity, including moments where she took sole responsibility to shield her team, highlighting leadership grounded in accountability and care.

As a student, the talk left me with a sense of hope. It didn’t shy away from the difficulty of public health, but it showed that integrity still matters and that it’s possible to stand by your values while making a meaningful impact.