I began to have enquiries about deanships of medical schools as early as 1967 or '68. Barry Wood, then chairman of Research Committee at Johns Hopkins, offered me the deanship there. I wasn't really ready for a deanship then and not ready at all to leave my place at Beth Israel, but other offers came. In 1970, I was offered the deanship at Columbia Presbyterian. This was while we were in England. I made several trips across the water to look at the situation at Columbia and at Presbyterian Hospital, but I had great... and I was very eager to... to take that position. It was at a time when New York was in something of an uproar. The community... members of the community were expressing their unhappiness with the way they were being treated, and it seemed to me that there was a great opportunity for Columbia and Presbyterian Hospital to, to develop and strengthen ties with members of, of the community in Harlem and in Upper Manhattan.

I presented that to the then President of Columbia University, Andrew Cordier, who had been at the UN before he, he came back to Columbia, and to the then Chairman of the Board of Presbyterian Hospital. The latter had absolutely no interest in such activities. Said to me, on one occasion, 'Doctor, our community is the world', and pointed out that on the seventh floor of the Hartness Pavilion was Madame Chiang Kai-shek and her entourage. At any rate, I finally decided that there wasn't any way that I could really achieve what I wanted to achieve in a deanship and I went to see Cordier to tell him that I was sorry, but that I was withdrawing. He said to me, 'Howard, come here'. He said, 'Come to New York, come to Columbia. You and I, together, will approach the person in charge at the Presbyterian Hospital, we'll bring him around'. He said, 'After all, I brought Ben Gurion and Nasser together, and this seems to me like a small job'. Well, it was a job that I wasn't in the mood for and I said to him, 'Andrew, nothing would please me more than working with you, and if the next team does the job that needs doing it'll be a glorious job for the dean that follows, but I don't see myself in that role'.

So, I went back to London, finished the year there, came back to the... Beth Israel, really focused largely on building community programs, and in 1972 was about to accept the position as dean of the medical school at Yale when the President of Yale, Kingman Brewster, called his friend, Derek Bok, the new President at Harvard, and a person who had been a colleague of his, Kingman's, on the faculty of the Harvard Law School, Kingman called Derek to say that he was taking a member of Derek's faculty, and Derek called me to say that he was now looking for a dean of the School of Public Health, and he would really be grateful if I would take a look at it. He said, 'I've had a committee that has looked at the school and has said to me that it's not in good condition intellectually, and if you, if you really want to change it, he said, you've, you've got... No, in fact, he, he said, 'You have three choices. You can close it, you can merge it with the medical school, or you can change it very appreciably from the outside'. He said, I... Derek said, I can't do the first, the agenda is too important, if I merge it with the medical school it'll get lost, it's just miniscule as compared with the size of the medical school, and if I... so that leaves me only one choice and would you be willing to do it with me?