The governor was testing Sister Mary Madonna Ashton, but she thought he was just being quirky. On that day in 1983, Ashton had arrived at the office of then-Gov. Rudy Perpich for an early-morning interview for a position in his cabinet.
The door flew open to the waiting area. Perpich, dressed in a dark blue suit and white shirt, held a tie in each hand. One was navy with yellow stripes, the other with red.
“Lola’s away and I don’t know which tie to wear,” he said by way of introduction, and a forthright admission that his wife normally got him dressed. Ashton looked down — thinking silently: “What do I care what tie he wears?” — and told Perpich to go with the red one.
“Years later he told me after that conversation that he didn’t need to know any more about me,” Ashton, 92, said recently. “He just wanted to know if I could make a decision.”
Ashton ended up leading the Minnesota Department of Health for eight years.
Though now out of public life and in retirement, Ashton was honored on Saturday in Washington, D.C., by the National Women’s History Project for her public policy achievements. Her deeds were highlighted along with those of 15 other women who had been leaders in civil rights, Title IX legislation, women’s suffrage, tribal affairs, science and the military. The honor puts her in the company of such female trailblazers as Abigail Adams, Susan B. Anthony, Rosa Parks and Billie Jean King.
Perpich’s decision to put Ashton in charge of one of the state’s largest agencies was roiled in controversy. The position traditionally had gone to a physician, and Ashton’s experience had come from two decades as CEO of St. Mary’s Hospital in Minneapolis.
Many feared that Perpich, a Roman Catholic whose election had been backed by abortion foes, was fanning abortion politics by naming a nun to the post.
But Ashton’s no-nonsense leadership style that blended science and human kindness won over many of her critics. During her two terms, she put Minnesota at the forefront of confronting the AIDS epidemic and took on big tobacco by pushing for laws that banned smoking in public places and using the cigarette tax as a public policy tool to discourage smoking.
“Many of us were somewhat taken aback, not knowing her, and concerned about election politics,” said Mike Osterholm, then the state epidemiologist. “She was known as a health care professional, as a hospital administrator. Beyond that, there was very little known about her. She turned out to be one of the greatest health commissioners in the history of the state.”
When Ashton took the helm, there were just four known cases of HIV/AIDS in Minnesota. Soon, the little-known illness would become a raging public health concern that sparked fear and vitriol.
It was a taboo subject and political hot potato, forcing the sister to talk frankly and publicly about sex between gay men. Under her direction, Minnesota became the first state to make HIV a reportable condition.
Osterholm, an international expert on infectious diseases, said the issue embodied Ashton’s respect for fact-based science and tenderness toward the disenfranchised, at a time when the public was afraid to even touch people with AIDS.
“Just as Nixon was the only president who could have opened the door to China, Sister was probably the only commissioner of health that could have given us that combination of caring and compassion along with outstanding public health policy,” he said.
Ashton, a St. Paul native, learned how to handle controversy at an early age. She grew up in the Episcopal Church, but attended a Catholic high school and connected deeply with the faith. She converted to Catholicism her senior year at St. Catherine University, certain that she would become a nun. After earning a master’s in social work at Saint Louis University in Missouri, Ashton joined the order of St. Joseph of Carondelet in St. Paul in 1946.
Becoming a Catholic was one thing; a nun, quite another. Her mother quit speaking to her for years, handing the phone to someone else whenever Ashton called.
“Eventually she came around, but she wouldn’t talk at all,” said Ashton, the eldest of three daughters whose father was a traveling salesman. “We had a poor relationship.”
Direct gaze, firm handshake
At the tidy apartment at Carondelet Village where she has lived since 2014, Ashton greets visitors with squared shoulders, a direct gaze and a firm handshake. She laughs deeply when reminiscing about her days in public life.
“I didn’t know a blessed thing about politics when I got into it,” she said, “and I didn’t know how broad the health department’s responsibility was, either. So I had a lot to learn when I got there. But I thoroughly enjoyed it.”
She plans her day around morning prayers, and leads a busy social life that includes lots of lunches with many of her former staffers. Sidelined recently after breaking her shoulder and hip, she’s close to ditching the walker that has curbed her mobility.
“She’s a Minnesota treasure,” said retired UCare CEO Nancy Feldman, who worked for Ashton for three years at the Health Department and considers her a role model, friend and favorite lunch companion.
“She was a tough boss,” Feldman said. “She had high standards and expected them to be met. But that produced a heck of a lot of good work.”
Minneapolis attorney Dan McInerney served as Ashton’s deputy health commissioner at a time when the department had a staff of 670 people and a budget of $140 million in today’s dollars.
“She didn’t have a lot of experience in public health, but she had a good eye for talent,” he said, and believed a manager should “get the job done through other people.”
“She gave her scientists and administrators authority,” he said. “We had to make our case to her, but there was no interference coming from any religious pressure.”
She wasn’t afraid to take a stand — once dressing down lawmakers “like your most feared Catholic nun addressing eighth-grade students,” Osterholm said, eventually receiving the funding she sought.
While in office, Ashton received death threats and the wrath of an activist known for throwing pies at officials (though she avoided that fate). The National Organization for Women slammed her for promoting abstinence as a way to reduce teen pregnancies.
After leaving public office, Ashton started a network of medical clinics run by volunteer doctors and nurses that provides free care for low-income and uninsured people not covered by government programs. The St. Mary’s Health Clinics are still fulfilling that mission.
“When I was first starting the clinics, the idea was that these won’t last more than a year or so because we’ll have national health insurance,” Ashton chuckled ruefully. She remains an advocate for any effort to improve the health care system.
“There are a lot of problems with Obamacare — everything has its flaws,” she said. “But it can be built on. It should be built on.”
While she was already dedicated to a life of service, her time on the front lines broadened her scope.
“I learned to appreciate the legislators. They have a terrible job and have to make some very hard decisions,” she said. “Most requests and proposals are good ideas. But there’s only so much money to spend.”