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EDITORIAL: Remembering Dr. Koop


WHEN PRESIDENT REAGAN nominated Dr. C. Everett Koop to be surgeon general, abortion rights proponents were horrified. The New York Times called the conservative evangelical Christian “Dr. Unqualified” and Sen. Ted Kennedy castigated him for holding a “cruel, outdated and patronizing stereotype of women.” He was confirmed anyway. By the time Dr. Koop left office in 1989, most of his critics had become supporters. He had become, said The New York Times, “the nation’s First Doctor.”

Dr. Koop won over his detractors (and annoyed some supporters) with his principled stands: AIDS should be treated as a disease, not a political football. Despite White House pressure, he could not say that abortion, which he opposed on moral and religious grounds, put most women at risk. Smoking, on the other hand, kills. And babies born with handicaps have a right to life.


With his signature moustache-less beard and his dashing official uniform, Dr. Koop often bypassed Washington politicians and took his health campaigns straight to the American people. In the early 1980s, no one understood why gay people and intravenous drug users were dying of what was then called “the gay cancer.” Dr. Koop insisted that AIDS be treated as a disease, and not a behavioral—much less political—issue. He led the fight to promulgate information about AIDS, publishing more than 20 million copies of “The Surgeon General’s Report on AIDS” and sending informational brochures to every household in the United States. He “surprised everyone,” notes Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, with his effectiveness and determination to keep AIDS in the medical, not political, realm.

After studying the effects of smoking, Dr. Koop took on Big Tobacco. He likened nicotine to heroin, and pointed out the dangers of secondhand smoke. Congressmen from the Tobacco Belt threatened to impeach him. Undaunted, in 1984 he initiated his public-education campaign, “A Smoke-Free Society by the Year 2000.” Soon after, his message caught on, and governments and businesses began restricting tobacco use on their premises. Smoking peaked at 40 percent of all adults in the 1970s; today, thanks in large part to Dr. Koop’s campaign, that number is down to 19 percent.


Before becoming America’s chief advocate for health, Dr. Koop had a groundbreaking career as a pediatric surgeon. When he began practicing in the 1940s, children being operated on were treated as little adults in regards to anesthesia and other procedures. As head of surgery at Children’s Hospital of Philadelphia, he proved that practice was inappropriate and in doing so, greatly elevated children’s survival rates. Dr. Koop created the first neonatal surgical intensive care unit in the country; he developed procedures that allowed surgeons to successfully separate conjoined twins, repair esophageal atresia, drain excess fluid from brains, and correct hernias.

Dr. Koop’s experience as a pediatric surgeon taught him the difference between survivability and “quality of life” issues. This led him to advocate for children born with non-life-threatening handicaps, children sometimes left to suffer and die despite the availability of care. Because of his advocacy, Congress passed what’s known as “the Baby Doe law,” requiring treatment unless an infant is born with a condition with which he cannot possibly survive.

Born in 1916 in Brooklyn, Dr. Koop died on Monday at the age of 96. His mission in life was to alleviate suffering. This he did in his practice and, in spectacular fashion, as surgeon general. Recipient of the Presidential Medal of Freedom, Dr. Koop’s reputation as the most influential surgeon general in U.S. history is well-earned.


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