One can almost hear the lusty cry echoing from the smoky trenches as a dispatch is rushed past volleys of haughty rhetoric and threats of damnation to those of us cowering at home. The document, sent from the highest medical official of the land, is titled "The Surgeon General's Call to Action to Promote Sexual Health and Responsible Sexual Behavior" -- a name so evocative of dedication, urgency and honor that it makes one's heart swell. We reflexively imagine the embattled Dr. David Satcher in a candlelit tent pitched on the banks of the Potomac, scribbling hundreds of words with obsessive diligence. Not a moment to lose.

Indeed, our bearded and bespectacled hero is at this moment locked into the crosshairs of conservative bayonets. He has rejected their sacred belief that appropriate sex education must not mention sex. And the most inflamed among them might possibly be Satcher's own commander in chief, George W. Bush, who is reported by at least one senior official to have little confidence in Satcher, whose report angers him greatly. (Bush's confidence, it seems, is in his own approach of withholding information, employed so effectively with his own children and the issue of alcohol.)

It is likely that Satcher will be ordered to fold his tent and limp home, but I pray that he does not leave before the parents of this nation have an opportunity to noisily praise his courageous acts. I read the "Call to Action" with a genuine rush of patriotic feeling, the kind of pride that comes when a government official of enormous influence takes a huge risk to make a case for "human beings," acknowledging without proviso or exception that "sexuality is a fundamental part of human life."

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He has written a document that demands we respect not just science and truth but the plight and beliefs of the "economically disadvantaged, racial and ethnic minorities, persons with different sexual identities, disabled persons and adolescents." Our crisis, reports Satcher with no apparent piety, is in the suffering of so many Americans, not in their shameful loss of morality or goodness.

"I have to deal with reality," Satcher told reporters.

And we are grateful. There are few places where the faith-based platitudes of the Bush administration are more bizarre and dreamy than in its promotion of abstinence-only "sex education" programs, which rely on the outrageous premise that if you withhold information about contraception and emotionally batter adolescents with vague threats about the importance of marriage -- an institution they have watched go up in flames -- young people will cease to be interested in sex.

As he said, he has to deal with reality. And this ain't the first time. Satcher created a work group to deal with issues of promoting responsible sexual behavior and sexual health two years ago. He planned to release his report in the fall. The nine-month delay in its publication caused scientists and health professionals familiar with its contents to panic, believing that, with the arrival of the Bush administration, the report would be indefinitely delayed or edited into pablum by abstinence-only crusaders with new access to the White House.

Satcher will only say that this was "the most controversial and sensitive" issue he has dealt with in his time in office. But he is nothing less than explicit in the first pages of the report when he articulates a litany of sadness, supported by research, that makes the necessity of the report and its honesty all too clear:

Sexually transmitted diseases affect nearly 12 million Americans each year; nearly 800,000 cases of AIDS, nearly two-thirds of which involved sexual transmission, have been reported since 1981; an estimated 900,000 Americans are living with HIV.

An estimated 1.3 million induced abortions occurred in 1996; nearly one-half of pregnancies in this country are unintended; an estimated 22 percent of women and 2 percent of men have been victims of rape; and an estimated 104,000 children are victims of sexual abuse each year.

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