WASHINGTON (NYTIMES) - Dr Jerome Adams faces two difficult challenges as President Donald Trump's surgeon general: He's an African American working for a man routinely accused of racism, and he is a scientist in an administration that has shown contempt for science.

He can live with that.

"If people feel that the president needs to have a different perspective on the African American community, the one thing I would say is, he's not going to get it if there aren't any African Americans in the administration," Dr Adams said in an interview.

"People are always saying we need more black voices represented and more black perspectives represented, but they're always telling every black person in the administration you should quit.

"Those two things don't fit together," he said.

Now, as coronavirus cases surge and demands for racial justice roil the nation, Dr Adams is stepping into more of a starring role.

He will be the central figure in a public service campaign aimed at getting Americans to take the pandemic seriously and do what the president, with rare exceptions, does not do: follow public health guidance and wear a mask.

"I'm pleading with your viewers, I'm begging you: Please understand that we are not trying to take away your freedoms when we say wear a face covering," Dr Adams said on Monday morning on his boss' favorite news show Fox & Friends.

Such message must compete with relentless criticism that has come his way precisely because of his race and his stature.

Critics have called him a "token black guy" and "a clown".

California Democratic Representative Maxine Waters accused him of spewing Mr Trump's "racist dog whistles".

"His own community is not exactly a fan of this administration, and then they see Jerome up there representing the White House, and he gets a lot of blowback," said Dr Francis Collins, director of the National Institutes of Health.

"At one point, he did tell me he was having a pretty rough time."

At meetings of Mr Trump's coronavirus task force, Dr Adams is often a quiet presence, but he chimes in on his signature issue: racial disparities in health.

He said in an interview last week that he had spoken to both Mr Trump and Vice-President Mike Pence about the issue.

He was also straightforward about working for a president who has been accused of racism.

"I have a powerful opportunity to have an influence in this administration, and I feel like I need to be at the table," Dr Adams said.

"That's how I deal with it."

Politics and science have often collided in Washington, though perhaps never as much as under Mr Trump, when even face coverings have turned political.

Dr Adams has remained diplomatic on Mr Trump's near-constant refusal to wear face masks.

"It's not my place to say what image the president of the United States should be projecting," Dr Adams said.

"It's my place to say, 'Public, here's what you need to do to stay safe.'"

Dr Adams has remained circumspect.

Interviewed for the Today show on NBC before the July 4 holiday, Dr Adams hedged when asked if people should avoid large gatherings where masks were not required, saying it was not a "yes or no" question.

Musician Axl Rose branded him "a coward".

Public opinion research conducted by the Department of Health and Human Services, however, concluded that Dr Adams was a relatable figure, which is one reason he will be an anchor of new public service advertisements on radio, television, digital platforms and billboards.

The series, which will begin in urban markets, will feature him and other government scientists, including top infectious disease expert Anthony Fauci, talking with celebrities and sports figures about following public health guidance.

In separate outreach efforts, Dr Adams has recorded a video with celebrity chef Jose Andres, an outspoken Trump critic, and even asked Rose for help.

A video Dr Adams posted on Twitter this month of him dancing with his daughter and niece while wearing masks has gone viral.

The son of schoolteachers from rural south-eastern Maryland, Dr Adams said he grew up with Confederate flags and "the N word".

He first saw the Capitol while being airlifted to Children's National Hospital in Washington after an asthma attack.

Asthma kept him "stuck inside", he said, reading constantly and being branded a nerd, which helps him "empathise" with "folks who are vulnerable, who are outcasts or forgotten".

At the University of Maryland, Baltimore County, he studied biochemistry, hoped to become an engineer and met black doctors - including Dr Ben Carson, the neurosurgeon who became Mr Trump's housing secretary - for the first time.

Inspired, he went to Indiana University for medical school and trained in anaesthesiology, which he still occasionally practices at Walter Reed National Military Medical Centre.

He also received a degree in public health from the University of California, Berkeley - a "highly unusual choice" for an anaesthesiologist, said Dr Art Reingold, one of Dr Adams' professors.

His pursuit of public health was deeply personal.

Dr Adams has one brother who is developmentally disabled and another who has a history of drug-related incarceration.

In Indiana, where Dr Adams settled to practice medicine, he worked in a public hospital, shunning a more lucrative career in private practice.

Eventually, he caught the eye of Mr Pence, then the governor, who made him health commissioner.

In Indiana, Dr Adams had a pavement-pounding reputation, driving to heavily black communities all over the state for panel discussions, town hall events and fund raisers, addressing issues like obesity, infant mortality rates and opioid addiction.

"Trying to improve minority health from the bottom up made him our natural ally," said Mr Carl Ellison, the president of the Indiana Minority Health Coalition.

The surgeon general's office is what the occupant makes it.

It comes with a paltry budget and little power beyond the authority to issue reports and to speak up.

Yet, some who have served as "the nation's doctor" have made a profound difference in American life.

In the 1960s, surgeon general Luther L. Terry took on the tobacco industry and warned of the perils of smoking.

Mr C. Everett Koop almost single-handedly pushed President Ronald Reagan to recognise Aids. In the 1990s, Mr David Satcher publicly contradicted his boss, President Bill Clinton, in backing needle exchange programmes for intravenous drug users.

Mr Satcher, the only other black man to serve as surgeon general, said he had encouraged Dr Adams to "hang in there".

"I'm glad he has," he added, "even though I'm sure it's been difficult."

Like Mr Satcher, Dr Adams has made ending racial disparities in healthcare, a problem that has become glaringly apparently during the coronavirus pandemic, his signature initiative.

He said he knew from personal experience that racism - "institutionalised racism, structural racism and sometimes overt racism" - played a role.

As surgeon general, Dr Adams said, he is neither a Republican nor a Democrat.

He has a platform, and he intends to use it: "You're not always going to get along with and agree with everything your boss says or does in any job, but you stay in that job if you feel like you could have an impact."

Mr Tony Gillespie, a long-time friend and another member of the Indiana Minority Health Coalition, said that Dr Adams was "always in that place" where "if you do, you're wrong; if you don't, you're wrong".

Dr Adams is in no mood to apologise to his critics.

"Nowhere in this SG job description does it say your job is to contradict the president," he said, using the initials for his title.

He has a message for Americans: "Take my health information as health information and not as a political statement."