... we don't have a Surgeon-General?
Who's this "we," anyway? I should be more precise: what happens if there no one is Surgeon-General of the United States of America?
I suppose that means that the duties of said Surgeon-General go unperformed ... whatever those duties might be. As far as I've been able to tell from my admittedly limited exposure to the work product of Surgeon-Generals (or, more likely, Surgeons-General), that consists of repetitious high-minded hectoring of we Americanos, as well as the occasional bit of low comedy, such as C. Everett Koop in his fanciful semi-naval uniform (apparently these folks acquire the spurious naval rank of "vice-admiral," albeit in the Public Health Service), or Joycelyn Elders and virtually everything she ever had to say. So, we'd have to do without that.
"Look at me! I'm a Vice-Admiral! That's even better than being a Vice Lord!"
And then, Joycelyn Elders certainly looked fetching in that naval-warrior suit herself, no?
On the other hand, that'd be one fewer bloated salary to pay.
So, whaddaya say? I say: let's give it a try.