America lost a true hero this week. Dr. C. Everett Koop, the former U.S. surgeon general who became known as the nation's doctor, died at his home in Hanover, N.H., at the age of 96.
Koop, who served during the administration of Ronald Reagan, was undoubtedly the most prominent surgeon general in history. Looking like a biblical prophet, with a remarkable white beard and mane of hair, with a keen scientific mind, he brought a common-sense approach to some daunting public health issues in the 1980s.
He was born in Brooklyn, N.Y., but had a deep connection with Philadelphia. After earning his medical degree from Cornell Medical College in 1941, he concentrated on pediatric surgery, then a relatively new specialty. From 1946 to 1981, he was surgeon-in-chief at the Children's Hospital in Philadelphia and became a pioneer in the field. Developing new surgical techniques for newborns, he won national recognition for reconstructing the chest of a baby born with the heart outside the body. Koop successfully separated three sets of conjoined twins. While also serving as a professor at the University of Pennsylvania School of Medicine, he established a pediatric surgery fellowship training program at CHOP that graduated 35 residents and 14 foreign fellows, many of whom went on to become pediatric surgery professors in their own right.
A devout Presbyterian, Koop was known to pray at the bedsides of his tiny patients and was an ardent abortion foe who once traveled
Those views brought him to the attention of Reagan administration officials, and led to his selection as surgeon general. His nomination was bitterly opposed by women's groups and other liberal politicians who thought he would push Reagan's conservative Republican agenda. But he promised during his confirmation hearings that he wouldn't use his post to promote his religious beliefs. During the next eight years he kept that promise, and more.
Donning the ceremonial admiral's uniform bestowed to his office, Koop became a powerful public health advocate. He campaigned against the use of tobacco and fought to drive down smoking rates; they fell from 38 to 27 percent during his tenure. He refused to issue a report requested by the White House stating that abortion had damaging psychological effects on women, saying there wasn't enough scientific evidence to support that finding.
But he may best be remembered as the nation's first AIDS educator. First identified in gay men in 1981, the disease was a source of terror and shame. At first no one knew what caused it, how it was transmitted, or how it could be stopped. As the number of deaths grew from the hundreds to the thousands, criticism of the administration's response mounted. Reagan himself was silent on the issue for years. But in 1986 the president asked Koop to prepare a report on the epidemic for the public. That report was eventually mailed to more than 100 million households in 1988. It was frank in its description of how HIV, the virus that caused AIDS, was spread. It called for the use of condoms to help prevent it and recommended widespread sex education beginning as early as the third grade. It was a dispassionate scientific evaluation of a disease that inspired much hysteria. And with it Koop was roundly condemned by his former religious supporters and became a hero to many of those who originally opposed his appointment.
“He really changed the national conversation, and he showed real courage in pursuing the duties of his job,” said Chris Collins, a vice president of amfAR, the Foundation for AIDS Research.
“A less strong person would have bent under the pressure,” said Dr. Anthony Fauci of the National Institutes of Health. “He was driven by what's the right thing to do.”
In his retirement Koop continued to speak out on public health issues, even as the surgeon general's office has lost much of its clout since his departure. It's likely that very few Americans could name the current occupant, Dr. Regina Benjamin.
Koop was a groundbreaker, in medicine and in education. He was a man who mattered. That's how he should be remembered, with gratitude.