By the time C. Everett Koop became a household name, he had already had a brilliant medical career spanning some 35 years at the Children’s Hospital of Philadelphia. There, he treated thousands of children, many of whom suffered from grievous defects that other surgeons would not attempt to treat. Koop’s fearlessness, compassion, keen scientific mind and sharp medical technique led to the creation of numerous anesthetic and surgical techniques used to tackle pediatric conditions that other surgeons at the time deemed hopeless. Koop gained acclaim for his work on separating conjoined twins, dealing with childhood cancer, shunting excess spinal or cranial fluid, inguinal hernia repairs, correcting esophageal atresia and other conditions.
At the same time, Koop was also known for his fundamentalist Christianity, and for strongly opposing abortion on moral grounds. After working with Christian apologist Francis Schaeffer to produce What Became of the Human Race?—a sharp criticism of abortion, infanticide and euthanasia, Koop was nominated by President Reagan in 1981 to become the next U.S. Surgeon General. Conservatives cheered the move (and liberals decried it) because of Koop’s religious convictions and overall conservatism. The hearings to confirm him were the kind of political trench warfare that have become commonplace now, but were quite rare in the early 1980s, and especially for a government position that, until then, rarely gained much notice.
Soon after his confirmation, Koop was pressured by the Reagan administration to produce a report showing that abortions caused psychological harm to the women who underwent the procedure. Koop resisted, seeing no scientific evidence to back up such a conclusion. He still opposed abortion morally (and would never waver from that), but he saw his role as Surgeon General as a scientific, not a moral one, and on those grounds he quickly became a polarizing figure for his controversial stands that were meant, above all, to keep as many Americans as healthy as possible.
Koop’s long experience with esophageal atresia led to his involvement in the “Baby Doe” case (in which a newborn with the condition was allowed to die, untreated). This, in turn, led to the Congressional passage of the Baby Doe Amendment to the 1984 child abuse law which prohibited the denial of vital health care to severely handicapped newborns.
Koop campaigned relentlessly against the use of tobacco, calling for its complete exit from American life by the year 2000 (much to the chagrin of North Carolina’s Jesse Helms, who praised Koop’s appointment). He got prominent warning labels affixed to all tobacco products, and became the tobacco industry’s most public enemy. By the time Koop’s run as Surgeon General ended in 1989, smoking in the United States among adults had dropped eleven points, from 38 percent to 27 percent.
But Koop’s most important work was on identifying the danger that AIDS posed to the public. Initially seen as a disease that only affected homosexuals and intravenous drug users, the disease was written off by many policymakers as either the problem of marginal populations, or even divine retribution against the sinful. Koop, however, saw AIDS simply as a virus that did not recognize morality. He called for compulsory sexual education in elementary school, including the widespread distribution and education in the use of condoms as a preliminary way to prevent the transmission of HIV. That Koop became so well known for his promotion of condoms annoyed him, for he would have preferred that people for a moral solution of celibacy and/or monogamy to avoid infection. But like every other policy he drove, it was all about medical necessity, the power of information, and the ability to use his position within the government as a bully pulpit to drag Americans into healthier lifestyles, no matter who it offended.
Koop stayed mostly on the sidelines since his retirement as Attorney General, and in February, after a battle with illness, he died in his New Hampshire home at 96. Those who grew up during the Koop years knew him as a stern fellow on TV with a beard like Abraham Lincoln and a manner like a distant, slightly estranged uncle. But they also learned from him that smoking kills, that AIDS does not discriminate, and that the science of health has little to do with the belief systems so often hung upon it. Koop kept his own conscience clear, upholding his strict moral convictions while carrying out his duties as Surgeon General well beyond any expectations of him, and in so doing, saved millions of lives. He did it without fanfare, and without flourish. But he changed the world, leaving it a far healthier place than it was when he entered it. If only he had lived for another 96 years.