Updated

Heart surgeon and Tennessee Sen. Bill Frist told colleagues that his intentions as the Senate's new majority leader are to "serve, not be served" so the GOP can capture the heart of the chamber and demonstrate its integrity to the nation.

"I pledge to work with members, my own caucus, the other caucus, with independents, with both houses of the United States Congress and with the administration and the president of the United States. Our purpose very simply put ... is to make each American's life more fulfilling and that means many things to many people," he said.

Frist spoke just an hour after his elevation to the top spot, which he will assume when Congress convenes Jan. 7. He immediately takes over the Republican leadership, vacated by Sen. Trent Lott of Mississippi, who was embroiled in a racially charged fight for two weeks before resigning last Friday.

"I have been given responsibility before. As a physician, the responsibility was to heal, to listen very, very closely, to diagnose, to treat and yes, to heal," Frist said. "A few moments ago, my colleagues gave me a responsibility equal to that and in some ways, an even heavier responsibility. I accepted that responsibility with a profound, profound sense of humility."

Forty-two of the 51 Republican senators present on a conference call voted by acclamation Monday afternoon. The call lasted about 45 minutes.

"Sen. Frist is a highly regarded, respected and able senator. He will be an excellent majority leader," Sen. Chuck Hagel of Nebraska said after the vote.

"Bill Frist is a unifying figure in our party," said Sen. Kay Bailey Hutchison of Texas. "The conference is united in our support for our new leader. He is the personification of the 'compassionate conservative.'"

The White House immediately congratulated Frist, a favorite of President Bush, who tried to stay out of the tumult aside from one speech in which he said segregation was a stain on U.S. history.

"I congratulate Sen. Bill Frist on his election to majority leader of the U.S. Senate. Sen. Frist has earned the trust and respect of his colleagues on both sides of the aisle. I look forward to working with him and all members of the Senate and House to advance our agenda for a safer, stronger, and better America," Bush said in a statement.

Prior to the vote, Frist arrived at his Nashville office with his wife, Karyn, mother-in-law Kathryn Mclaughlin, and two of his children, Jonathan 17, and Bryan, 15. His wife and sons joined him onstage after the vote. A third son was on his way home for the holiday.

Sen. John Warner of Virginia started the conference call with a prayer beloved by his father, who was an Army doctor caring for the wounded during World War I. Warner was among several senators who spoke on behalf of Frist, the only candidate in the race.

Frist, a 50-year-old heart-lung transplant surgeon, is considered an authority on health issues in the Senate. He still keeps his starched white lab coat in the trunk of his car, makes monthly visits to hospitals and clinics and goes on occasional overseas medical missions. When the anthrax scare surfaced on Capitol Hill last year, he worked to calm his colleagues.

Republicans hope Frist, a relative newcomer to the national political landscape, will offer a fresh face for the party — especially in efforts to attract minorities and help repair damage caused by Lott's praise of Sen. Strom Thurmond's 1948 pro-segregation presidential campaign.

At Thurmond's 100th birthday party, Lott said that if the nation had followed his home state of Mississippi in electing Thurmond president, "we wouldn't have had all these problems over all these years either.''

In his first public remarks since resigning, Lott told The Associated Press on Sunday that he had fallen into a trap set by his political enemies and had "only myself to blame."

"There are some people in Washington who have been trying to nail me for a long time," Lott said in an interview outside his home in Pascagoula, Miss. "When you're from Mississippi and you're a conservative and you're a Christian, there are a lot of people that don't like that. I fell into their trap and so I have only myself to blame."

Republicans played down the damage of Lott's words. "In the long sweep of American history, this is going to be a blip," Sen. Mitch McConnell, R-Ky., said on Fox News Sunday.

And Frist, who did not mention Lott's name in his first remarks as the new GOP leader said among his roles would be to lead the Senate to "dedicate ourselves to healing those wounds of division that have been reopened so prominently during the past few weeks."

Frist also vowed to work on health care, improving the economy and supporting the military as it battles the war on terror.

Announcing Frist's election, Sen. Rick Santorum of Pennsylvania, the No. 3 GOP leader, said the party's top priorities will be extending unemployment benefits for the jobless, and finishing the fiscal 2003 budget.

"We talked about unemployment insurance, and that has to be one of our first orders of business out of the box, which is to deal with the unemployment insurance problem that we have in the country right now," he said, adding that the conference call was not a "joyous celebration," but a solemn one in which members recommitted themselves to working on issues to better the nation.

Santorum also said that Lott participated in the discussion and thanked everyone for their prayers and support. Lott will remain in his Senate post, but currently is without portfolio.

Sen. Chuck Grassley, the incoming chairman of the Finance Committee, said he looked forward to working with Frist on creating a bipartisan health reform bill.

"Most immediately, I'm looking forward to having Sen. Frist's knowledge and experience contribute to the task of strengthening and improving Medicare, including adding a prescription drug benefit," Grassley said.

Planned Parenthood, however, said Frist's record on abortion — he opposes it — should strike fear in the hearts of all women who seek a choice.

"Sen. Frist gets a failing grade on every reproductive rights vote. His rabidly anti-choice track record indicates that he marches in lockstep with anti-choice extremists. The attacks on women's basic human rights will most certainly continue unabated under the leadership of the Bush administration's hand picked majority leader of the U.S. Senate," said Gloria Feldt, president of Planned Parenthood Federation of America.

Dumping Lott for Frist also may not lend any aid to the president as he tries to select judges for the federal bunch.

Bush nominee U.S. District Judge Charles Pickering — a friend of Lott's — was rejected by the Democratic-led Judiciary Committee in March on a 10-9 party line vote.

Pickering was opposed by civil rights groups, which accused him of racial insensitivity.

"He was very badly treated before the United States Senate," said Sen. Orrin Hatch of Utah, the incoming chairman of the committee, who suggested the president send the nomination back to the Senate.

Sen. Patrick Leahy, D-Vt., who led the committee this year, said that he would vote against Pickering if his nomination were returned to the committee.

The Associated Press contributed to this report.