C. Everett Koop. Part 1

Koop's biography

Dr. Charles Everett Koop, surgeon general under President Ronald Reagan, boldly led the United States on controversial health issues such as smoking, abortion, infanticide, and AIDS. Koop was a driven, dedicated public servant, committed to doing what he felt was best for the health of the U.S. people. He aggressively confronted pressing health issues while dodging Washington, D.C.'s, political machinery. During his eight-year tenure, Koop increased the influence and authority of his post with the Public Health Service. With a passion for medicine and sincere interest in promoting the public's health, Koop was affectionately regarded as "America's family doctor."

Koop was born October 14, 1916, in Brooklyn, the only surviving child of John Everett Koop and Helen Apel Koop. Koop believed from a young age that he was destined to be a doctor—specifically, a surgeon. He spent most of his free time developing the skills he would need for his medical career. As a teenager, he practiced using scissors with both hands, working to become confidently ambidextrous. He labored to improve his manual dexterity by tying tiny knots in threads he sewed through the corners of matchboxes. With the assistance of a family friend and medical student, Koop spent his Saturday mornings watching surgery in the operating room theaters of Manhattan's Columbia Presbyterian Medical Center. Eager to practice on "real" patients, Koop performed surgeries on stray animals while his mother administered anesthesia. He also volunteered and worked at hospitals and clinics across the city.

Koop had a natural tendency to tell the truth, a virtue that, wherever he went, aroused a mixture of contempt and admiration among his peers. One middle school incident of truth telling had a dramatic and positive effect on Koop's future. After he and his classmates caused a disturbance, Koop was the only one to take responsibility for his actions. The teacher responded by slapping him hard enough to raise welts. This convinced Koop's mother that he belonged elsewhere. She promptly enrolled him in the Flatbush School, an excellent college preparatory program that practically guaranteed access to an Ivy League college.

At Flatbush, Koop excelled academically and socially. He participated in football, baseball, basketball, and wrestling. Foreshadowing his future political role, he also successfully campaigned for class president.

One month before his seventeenth birthday, Koop entered Dartmouth College. The Dartmouth coaches quickly recognized Koop's talent at football and awarded him the coveted position of quarterback. However, after a severe concussion damaged his vision and threatened his surgical career, Koop quit the team. He immersed himself in premed studies, majoring in zoology. Having lost his football scholarship, Koop took a series of odd jobs to finance his way through college. To his college friends, the man with the unusual last name became known as Chick Koop.

Koop entered medical school at Cornell University in the fall of 1937. In 1938, he married Elizabeth ("Betty") Flanagan, with whom he eventually raised four children. When the United States entered World War II and many physicians were called to duty, he performed many surgeries that, under normal circumstances, would have been assigned to more senior physicians.

For his next phase of training, Koop and his family moved to Philadelphia. There, he took an internship at Pennsylvania Hospital, followed by a residency at University of Pennsylvania Hospital. After residency, in 1946, Koop became surgeon in chief of Children's Hospital of Philadelphia. He was twenty-nine years old.

During his thirty-two years at Children's Hospital, Koop helped establish pediatric surgery as a medical specialty. At the time he took the job, many surgeons were reluctant to operate on infants and small children because of the risks of sedating them. Koop devised anesthetic techniques for his young patients and worked tirelessly to perfect surgical procedures and postoperative care for children. Along with being a skilled surgeon, he was a compassionate doctor. He was sensitive to the parents of sick and dying children, and helped create support groups to meet their needs.

Koop's work with preterm and malformed babies at Children's Hospital influenced his strong position against abortion, infanticide, and euthanasia. While at Children's Hospital, Koop wrote The Right to Live, the Right to Die (1980), a best-seller outlining the relationship between those three practices. He quickly became a spokesman on these issues and committed a great deal of his time to trying to rouse the United States' conscience. Later, after he was nominated surgeon general, Koop was surprised to learn that his Republican supporters valued him more for his stance against abortion than for his impressive medical career.

In 1980, with retirement just one year away, Koop was asked if he would consider the surgeon general's post in Reagan's new administration. The surgeon general is an officer in the United States' Public Health Service Commissioned Corps, a uniformed mobile health unit. Under the leadership of the secretary of the Department of Health and Human Services, the surgeon general administers health policies and supervises personnel in the field. During his time in office, Koop broadened the surgeon general's role from low-profile administrator to high-profile leader.

Koop's surgeon general's reports and frequent testimony influenced the passage of numerous health-related mandates. He became a household name as he gently yet firmly informed the U.S. people about the most preventable threats to their health. Regardless of the political consequences, Koop believed he was obligated to provide accurate information to the public.

Koop launched an antismoking campaign with the 1982 Surgeon General's Report on Smoking and Health. In this document, he clearly stated the relationship between cancer deaths and smoking. In the years that followed, Koop produced reports linking smoking to cardiovascular disease and chronic obstructive lung disease.

In an antitobacco campaign, Koop targeted smokeless tobacco products such as chewing tobacco and snuff, citing their connection with various cancers. His actions spurred passage of the Comprehensive Smokeless Tobacco Health Education Act of 1986, 15 U.S.C.A. §4401 et seq., a mandate to educate the public about this health threat. At Koop's urging, Congress legislated warning labels for smokeless tobacco products.

Koop examined the effects of smoking on nonsmokers in his 1986 report Health Consequences of Passive Smoking. Legislators across the nation responded to his report by creating laws to restrict smoking and reduce the risk of passive smoking to nonsmokers. By 1987, smoking was banned in all federal buildings, and regulated in restaurants, hospitals, and other public places in over forty states. In 1988, Koop commissioned studies on smoke in airplanes. Congress reacted to the results of these studies by banning smoking on all flights lasting less than six hours.

Koop publicized the addictive nature of tobacco in his 1988 surgeon general's report. This report forced tobacco officials to agree to more specific surgeon general's labels on cigarettes. However, Koop lost the fight for labels identifying nicotine as an addictive substance.

Though Koop was known for his antiabortion stance, he did little on this issue during his time as surgeon general. He viewed abortion as a moral issue, not a political one, and he strongly disagreed with those who wanted to ban contraceptives and abortion. In response to Koop's position on contraception and sex education, many conservatives who at first supported him turned against him.

Koop faced a dilemma when President Reagan asked him to study the psychological effects of abortion on women. In Koop's opinion, it was a poor strategy to quibble about the effects of abortion on the mother when the effects on the fetus were conclusive. In addition, because both sides of the abortion controversy produced biased studies, the available research was useless. In the end, Koop could not gather evidence to conclusively assert or refute damaging psychological effects of abortion on the mother. He never completed the report.

In 1982, the Baby Doe case alarmed the nation. Baby Doe was born with Down's syndrome, which results in mental retardation and other physical problems, and esophageal atresia, an obstruction in the food passageway. The Down's syndrome was not correctable but was compatible with life; the esophageal atresia was incompatible with life but was correctable. On the advice of their obstetrician, the parents chose to forgo treatment, and the baby died. Koop believed that the child was denied treatment because he was retarded, not because the surgery was risky. Koop himself had performed this surgery successfully many times. Judging this to be a case of child abuse and infanticide, Koop commented publicly that it is imperative to choose life, even when the quality of that life is not perfect.

In 1983, the nation grappled with similar difficult circumstances surrounding the Baby Jane Doe case. Baby Jane was born with spina bifida (a defect in the lower back), an abnormally small head, and hydroencephaly (a condition that causes fluid to collect in the brain). At issue was Baby Jane's right to medical treatment to increase her quality of life despite her physical handicaps. Koop believed that without medical treatment, Baby Jane's spine would become infected, the infection would spread to her brain, and she would become severely retarded. He therefore advocated medical treatment for that condition.

Koop's efforts to educate Congress and the public about the medical injustices affecting handicapped children led to the Baby Doe Amendment (42 U.S.C.A. §§5101, 5102, 5103). On October 9, 1984, the amendment extended the laws defining child abuse to include the withholding of fluids, food, and medically indicated treatment from disabled children.

While in office, Koop became embroiled in the politics of educating the public about a growing health threat, AIDS. The Reagan administration prohibited Koop from speaking on the topic for nearly five years. This distressed Koop, who believed it was the surgeon general's duty to inform the public about all health issues. Despite the Reagan administration's purposeful silence on the issue, on October 22, 1986, Koop released The Surgeon General's Report on Acquired Immune Deficiency Syndrome. In it, he clearly stated the facts about the transmission of the disease and identified risk behaviors and preventive measures.

Koop was concerned that all U.S. citizens get the information they needed to stop the spread of AIDS. In May 1988, he sent the mailer Understanding AIDS: A Message from the Surgeon General to every household in the United States.

When AIDS first attracted attention, it was labeled a homosexual disease because it was transmitted predominantly through sexual contact among gay males. Koop lost the support of staunch conservatives because he refused to use his position to publicly condemn homosexual behavior. Koop's focus was to educate and save lives. Though he advocated abstinence as the best method for preventing the transmission of AIDS, he also urged the use of condoms by those who continued to engage in risky sexual behavior. Koop spoke against proposals such as mandatory testing and the detention of HIV-positive homosexuals. He challenged those who were against using tax dollars to fund AIDS research. His reasoned approach to the AIDS epidemic helped calm the hysteria of the public