C. Everett Koop: Biography from Answers.com

C. Everett Koop (born 1916), one of America's most outspoken surgeons general, served two terms in the 1980s. Koop's appointment angered liberals. However, the conservative Christian doctor later alienated social conservatives by refusing to compromise his common-sense approach to health issues for the sake of politics.

Brooklyn, NY-born Koop graduated from Dartmouth College in 1937 and earned his M.D. degree from Cornell Medical College in 1941. Following an internship, he pursued postgraduate training at the University of Pennsylvania School of Medicine, Boston Children's Hospital, and the Graduate School of Medicine at the University of Pennsylvania, from which he earned a doctor of science degree in medicine in 1947.

Koop became a professor of pediatric surgery at the University of Pennsylvania's School of Medicine in 1959 and professor of pediatrics in 1971. Koop also was surgeon-in-chief of Children's Hospital of Philadelphia from 1948 until he left academia in 1981. At the hospital, Koop gained renown for success in repairing birth defects, including the separation of conjoined twins. He also was editor-in-chief of the Journal of Pediatric Surgery from 1964 to 1976.

Koop was appointed Deputy Assistant Secretary for Health of the U.S. Public Health Service under the Reagan administration in March 1981 and was sworn in as surgeon general November 17, 1981. He held the post for two terms, serving under presidents Ronald Reagan and George Bush, until resigning October 1, 1989. In that time, Koop's willingness to speak out-and speak out boldly-on public health issues earned him much media attention and the enmity of a number of former allies.

Refused to Compromise on Health Matters

Koop saw fit to wear the traditional braided uniform of the surgeon general, a decision some derided, calling him an admiral without any ships. While traveling, the uniform once caused him to be mistaken for an airline crew member. A more significant departure from the style of previous surgeons general was Koop's decision to ignore advice he had been given upon arriving in Washington. That advice was, "Keep your head down and your mouth shut, " he wrote in Koop: The Memoirs of America's Family Doctor. While the uniform confused some, the man wearing it left no doubt where he stood on numerous public health issues.

Koop took on the American tobacco industry, a bountiful source of campaign contributions for a number of congressional Republicans, when he called for a smoke-free society by 2000. Koop also pushed then-president Ronald Reagan to publicly address the AIDS crisis. In addition he weathered a storm of criticism over positions on abortion and contraception many conservatives said were in conflict with Koop's own beliefs. During the course of his tenure he was shunned by conservative former associates and embraced by liberal former detractors.

Koop became a Reagan nominee largely based on his anti-abortion activism. The devout evangelical Koop had delivered his pro-life message through a number of books, films and lectures nationwide. One film shows Koop surveying a sea of naked dolls, intended to symbolize aborted fetuses, and saying, "I am standing on the site of Sodom, the place of evil and death." Liberals challenged Koop's appointment, delaying Congressional confirmation for eight months. Once Koop took office, though, liberals and conservatives each would do a turnabout.

Shortly after becoming the nation's top doctor, Koop began speaking out against tobacco and pressed for legislation to strengthen warning labels on cigarette packs. He later called for smoke-free work environments. As a result, the ten-year period encompassing Koop's tenure is said to have seen the greatest decline in smoking by Americans ever.

Safe Sex Proponent

In an October 1986 report to the president, Koop argued sex education and condoms were the most effective way to combat the AIDS epidemic. In 1987, Koop was the lone administration dissenter from a plan calling for widespread AIDS testing. His rationale was that the prevailing stigma against people with AIDS made mandatory testing unfair and impractical. He argued that compulsory testing would force those potentially infected with AIDS or HIV, the virus that causes AIDS, further away from medical treatment and education that could prevent spread of the disease.

Conservatives found Koop's views on AIDS so unpalatable they attempted to sabotage a Washington testimonial dinner held in his honor in May 1987. Of the dinner's original sponsors, 11 boycotted the event, including then Republican presidential hopefuls Senator Robert Dole and Congressman Jack Kemp. As pickets demanding his ouster marched outside, Koop thanked those in attendance. "There has never been a time in my life when I wanted or appreciated such a show of friendship." According to a 1987 Time magazine report, Koop was discouraged by the loss of conservative supporters. "They don't listen to what I've said, but they criticize me about what somebody told them they think I've said."

One weapon in Koop's anti-AIDS arsenal was information. The surgeon general was responsible for developing an eight-page booklet on the disease and its communicability at a cost of $17 million. Understanding AIDS was mailed to 107 million households in 1988 following a year and a half of debate over what the pamphlet would and would not say. Social conservatives were angered by the pamphlet's content as it included information on condom use. The AIDS prevention effort had two sides: Prevent the spread of the disease, of course, but also prevent the spread of panic over the disease. "Trying to estimate your chances of catching the virus based on the latest magazine article or newspaper story is like playing Russian roulette, " Koop said at the time of the pamphlet's release.

Unexpected Abortion Report

Koop was routinely caught in the crossfire when medicine and politics clashed, as when President Reagan called upon the surgeon general to report on the psychological effects of abortions on women who have them. One might have guessed the outcome of a conservative president asking a conservative, staunchly anti-abortion doctor for such a document. All bets were off, however, when in early 1989 Koop wrote to the president saying data he had gathered were inconclusive; he could not determine whether women who had abortions suffered psychologically. Koop's response to President Reagan did not go unnoticed by either side of the abortion debate.

Writing in the liberal journal New Republic, John B. Judis commented at the time, "The antagonism generated by the report will only reinforce the reversal over the past eight years in Koop's constellation of friends and enemies. The New Right, which once championed him as a bearded Ahab who would slay the white whale of liberalism (and which helped him get his job), now denounces him as an instrument of immorality. Meanwhile, the liberals, feminists, and public health lobbyists who once called him 'Dr. Kook' sing his praises."

A commentator in the conservative National Review suggested that the thinking behind Koop's abortion letter was in conflict with principles underlying his stance on other public health issues. "Koop's tentative tone on [abortion] contrasts sharply with his own strong statements of yore that abortion does harm women, " according to a 1989 article in the magazine. "Nor is he averse to making stern moral, as opposed to merely medical, statements against smoking. On abortion, as on AIDS, he has learned to assume properly enlightened attitudes."

In an interview following delivery of his letter to President Reagan, Koop articulated his frustration with social conservatives and reiterated his philosophy on health policy. "What has given me so much trouble in this job from the right is that I separate ideology, religion and other things from my sworn duty as a health officer in this country."

When Koop resigned as surgeon general, he did not put the abortion debate behind him. Instead, as he did in a 1991 Good Housekeeping magazine article, he lamented the politicization of an issue that came to life as concern for the unborn and the health of women. "I wonder if they have forgotten what originally prompted the debate: the innocent unborn child, the agonized pregnant woman. Many opposed to abortion have been notoriously unhelpful to unwed pregnant women; they must be more forthcoming with their time and money to help pregnant women in hardship. And those who call themselves 'pro-choice' ought to make more of adoption as a clear choice."

Remained in Debate

Although no longer surgeon general, Koop retained a voice in the debate of public health issues during the administration of Democrat Bill Clinton. He did not keep quiet during the Clinton administration's aborted attempt to reform the health care and health insurance industries and lent his support to some Clinton initiatives.

Koop was not immune to controversy even during his early eighties. When President Clinton granted Koop a waiver in 1994 for burial at Arlington National Cemetery, congressional Republicans thought they smelled a conspiracy and suggested Koop was granted the waiver in exchange for his support of health care reform. Precedent did exist for granting a waiver to a surgeon general who had not served in the armed forces. President Reagan had approved an Arlington burial for Dr. Luther Terry, the surgeon general who first publicized the link between smoking and cancer. Koop later declined the waiver. "I do this without rancor and with an understanding of and respect for the special place that burial at Arlington has in the hearts of the American people, " a Koop statement at the time said.

In 1997, Koop co-chaired a task force on tobacco that recommended a hefty increase in the tax on cigarettes to discourage teenagers from smoking. Koop also was an opponent to granting tobacco companies immunity from further liability in conjunction with a government settlement with the industry over the cost of smoking-related illnesses. The prospect of revenue from a tobacco settlement being used to fight cancer and improve public health must have been gratifying to Koop. Indeed, a Koop remark reported by Reuters in 1998 suggested that the former surgeon general saw similarities between tobacco's reversal of fortune and his own during the 1980s. "The public is now fully aware that the tobacco industry has lied to them. This has enraged a number of Americans and has disgusted a number of people in Congress who were for years the best friends of tobacco."

Koop has written more than 200 articles and books on medicine and surgery, biomedical ethics and health policy. He is married to the former Elizabeth Flanagan and has three living children and seven grandchildren.

C. Everett Koop
Vice Admiral C. Everett Koop, USPHS Surgeon General of the United States
13th Surgeon General of the United States
In office January 21, 1981 – October 1, 1989
Preceded by	Edward N. Brandt, Jr.
Succeeded by	James O. Mason

Born	October 14, 1916 (1916-10-14) (age 93) Brooklyn, New York, U.S.
Nationality	American
Religion	Presbyterian

Early years

Dr. Koop was born in Brooklyn, New York, of immigrant German ancestry. He obtained his B.A. degree from Dartmouth College in 1937, where he was a member of Alpha Sigma Phi fraternity, and his M.D. degree from Cornell Medical College in 1941. During the 1940s and 1950s he rose in the University of Pennsylvania School of Medicine to become professor of pediatric surgery and, later, professor of pediatrics. In February 1981, President Ronald Reagan appointed Koop as Deputy Assistant Secretary for Health with the promise, fulfilled a year and 9 months later, that he would be nominated as Surgeon General.

Career

Although he was most widely known among Americans for his years being the Surgeon General, the vast bulk of Koop's career was actually spent as a practicing physician. For 35 years, from 1946 to 1981, he was the surgeon-in-chief at the Children's Hospital of Philadelphia (CHOP), and this at a time when pediatric surgery as a specialty was moving from its infancy to a full fledged profession. (When Koop established the pediatric surgical division at CHOP in 1946, it was the first such service in Philadelphia and only the second such service established in America behind Boston, where Dr. William E. Ladd and Dr. Robert E. Gross had pioneered pediatric surgical services.) Koop was able to establish the nation's first neonatal surgical intensive care unit there in 1956. He helped establish the biliary atresia program at CHOP when pioneering surgeon Dr. Morio Kasai came to work with him in the 1970s. He also established the pediatric surgery fellowship training program at CHOP. During his tenure there he graduated thirty-five residents and fourteen foreign fellows, many of whom went on to become professors of pediatric surgery, directors of divisions of pediatric surgery, and surgeons-in-chief of children's hospitals.

While a surgeon in Philadelphia Koop performed ground breaking surgical procedures on conjoined twins, invented techniques which today are commonly used for infant surgery, and saved the lives of countless children who otherwise might have been allowed to die. He invented anesthetic and surgical techniques for small bodies and metabolisms and participated in the separation of several sets of conjoined twins whose condition other physicians at the time considered hopeless. He first gained international recognition in 1957 by the separation of two female pygopagus infants (conjoined at the buttocks)^[2] and then, again, in 1974 by the separation of two ischiopagus twins (conjoined at the spine) sharing a liver, colon, and parts of the intestines with their entire trunks merged.

Koop was active in publishing articles in the medical literature. Koop later wrote that "each day of those early years in pediatric surgery I felt I was on the cutting edge. Some of the surgical problems that landed on the operating table at Children's had not even been named. Many of the operations I performed had never been done before. It was an exuberant feeling, but also a little scary. At times I was troubled by fears that I wasn't doing things the right way, that I would have regrets, or that someone else had performed a certain procedure successfully but had never bothered to write it up for the medical journals, or if they had I couldn't find it." Koop helped rectify this by publishing his own findings and results. Additionally he became the first editor of the Journal of Pediatric Surgery when it was founded in 1966.

In contrast to his years as Surgeon General, when it was his policies and speeches that had bearing on other people, his years as an operating pediatric surgeon involved a more individualized, direct, hands-on effect on others. During the course of his long career, for example, he performed some seventeen thousand inguinal hernia repairs and over seven thousand orchiopexies (surgery for correcting undescended testicle). He developed new procedures, such as the colon interposition graft for correcting esophageal atresia (congenital lack of continuity of the esophagus) or ventriculoperitoneal shunts for treatment of hydrocephalus (accumulation of excessive cerebral spinal fluid in and around the brain causing neurological problems). He also tackled many difficult cases ranging from childhood cancer to surgeries done on conjoined twins, of which he and his colleagues operated upon ten pairs during his 35 year tenure. In all he operated on many children and babies with congenital defects 'incompatible with life but amenable to surgical correction'.

Much of the opposition that Koop later faced in being confirmed as President Reagan's choice as Surgeon General came from his widely known views about right to life. In 1976, after spending an entire Saturday with his pediatric surgery fellows operating on three patients with severe congenital defects, Koop sat in the cafeteria and remarked that together they had given over two hundred years of life to three individuals who together barely weighed ten pounds. When one of the surgical fellows replied that next door at the university hospital abortions were being performed on healthy babies, Koop was stirred to write The Right to Live, The Right to Die, setting down his concerns about abortion, infanticide, and euthanasia. Koop also took some time off from his surgical practice to make a series of films with Christian apologist Francis Schaeffer entitled "Whatever Happened to the Human Race". These films, along with a book published by the same name, reflected Koop's opposition to abortion, infanticide, and euthanasia and fired much of the controversy and initial antagonism that surrounded Koop's nomination for Surgeon General.

Government Service

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Today Koop is well known for four facets of his work:

Abortion: Though Koop was philosophically opposed to abortion on personal and religious grounds, he declined to state that abortion procedures performed by qualified medical professionals posed a substantial health risk to the women whose pregnancies were being terminated, despite political pressure to endorse such a position.
Tobacco: In 1984 he wrote that nicotine has an addictiveness similar to that of heroin or cocaine. Koop's report was somewhat unexpected, especially by those who expected him to maintain the status quo in regard to his office's position on tobacco products. Koop also instituted the practice of requiring rotated health warning labels on cigarette packs and required advertising to include the labels, although some warnings had been required since 1965.
AIDS: Koop was Surgeon General when public health authorities first began to take notice of AIDS. Koop wrote the official U.S. policy on the disease and took unprecedented action in mailing AIDS information to every U.S. household. Gay activists and their supporters were unhappy with the way in which he targeted gay sex and the risk of infection through anal sexual intercourse as primary vectors of the disease, but Koop was unapologetic claiming such activities entail risks several orders of magnitude greater than other means of transmission.^[3] Koop also infuriated some former supporters by advocating sex education in schools, possibly as early as the third grade, including later instruction regarding the proper use of condoms to combat the spread of AIDS. While a straightforward telling the public about the disease was controversial, Koop was also criticized by some health activists who claimed that his office had not gone far enough in attempting to develop a cure or vaccine, reducing the role of his office to educating the public on health concerns.
Baby Doe and the Rights of Handicapped Children: In April 1982, a child born in Bloomington, Indiana was diagnosed with Down syndrome as well as esophageal atresia with tracheoesophageal fistula. Six days later, after court involvement and parental discussion involving disagreement among physicians about whether or not to treat the baby or let him die, the baby died, having been denied surgical treatment to correct his esophageal atresia and tracheoesophageal fistula. Baby Doe, as he would be known, became a symbol for children with birth defects, handicapped infants, and the debate over infanticide. Koop was not initially involved with the Baby Doe case but had a special interest in it. As a pediatric surgeon in Philadelphia, he and his colleagues had operated on 475 such babies during his 35 years there, with ever-increasing survival rates. During his last eight years in active practice, Koop never lost a full-term baby upon whom he had operated to correct esophageal atresia. It was due to this background that he became actively involved championing policies to protect the rights of newborns with defects, which led to Congress passing the Baby Doe Amendment.

Taken together, these four issues combined with Dr. Koop's personality and his willingness to make use of mass media brought to the office of Surgeon General a higher public profile than it previously had merited; he is, for instance, the first Surgeon General to have been the subject of a popular song — "Promiscuous", by Frank Zappa. Koop was a somewhat eccentric and flamboyant figure, well-known for his mustache-less beard and colorful bow ties. He wore the Surgeon General's ceremonial military uniform (a naval admiral's dress uniform, complete with medals) during much of his day-to-day work, reviving an old practice.

"Koop Report"

On July 30, 1987, President Ronald Reagan directed Koop to prepare a report on abortion's effect on women. Koop did not want to write the report, for an assortment of personal and professional reasons. He tried repeatedly to beg off, but Reagan insisted. Koop passed the task to his staff. The research and preparations for the planned report became largely the task of George Walter, who obtained a list of articles from the Centers for Disease Control and Prevention (CDC), authored mostly by CDC abortion-surveillance staff, and consulted extensively with Alan Guttmacher Institute personnel. After the meetings and the review of the articles provided by the CDC, Koop wrote and sent a letter to the President, concluding that there had been no unassailable study of the long-term effect of abortion.

Koop directed his staff to drop the project on January 10, 1989, hoping Reagan would be content with the letter. Nevertheless, George Walter proceeded to re-write the report, submitting it to Koop on January 17. Koop instructed Walter to shelve the draft and not to release any report about abortion from his office. Instead, Walter released the draft under Koop's name.

During his testimony before a Congressional committee investigating these events, Koop repeatedly tried to separate himself from the report with vague statements about not having read it.

The result of the episode was the creation of a "Koop Report", which was not researched, written, or approved by Koop, and which Koop never used to assert the safety of induced abortion.

Personal life

In the spring of 1968, Koop's son David was killed in a rock climbing accident on Cannon Mountain in New Hampshire during his junior year at Dartmouth College. While he was hammering a piton into the rock, a large section of the cliff sheared off from the mountain face, carrying him with it. The death was devastating for the family. Dr. Koop later wrote that because of his son's death he thought, "I might be better able to help parents of dying children, but for quite a while I felt less able, too emotionally involved. And from that time on, I could rarely discuss the death of a child without tears welling up into my eyes." Years later, he and his wife wrote a book to help others who had lost a child. It was called Sometimes Mountains Move and described David's story and how the Koop family members each dealt with the grieving process.

Following his career as Surgeon General, and during the so-called dot-com craze, Koop and other investors established drkoop.com in 1998. This medical information website was one of the first major online sources of health information. However, critical review of the site content revealed that many of the private care listings, medicinal recommendations and medical trial referrals were in fact paid advertisements. Dr. Koop is no longer associated with the website. The address now re-directs to healthcentral.com. Koop also continues to endorse Life Alert bracelets for the elderly. Dr. Koop is currently the holder of three professorships at Dartmouth Medical School, as well as the senior scholar at DMS's C. Everett Koop Institute. He is also a recipient of the Albert Schweitzer Prize for Humanitarianism.

He is currently sitting on The Firestorm Solutions Expert Council.^[4]

He hosted a documentary series in 1991, simply titled C. Everett Koop, M.D. It aired for six episodes on NBC.^[5]

His nickname among friends and colleagues is reportedly "Chick" (as in Chicken Koop).^[6]

In February 2007, Elizabeth Koop, his wife of nearly 60 years, died.

Currently, Dr. Koop is working on various health initiatives with his grandson, David Koop.

In Popular Culture

On the Simpsons episode entitled "Homer's Barbershop Quartet," one of the group's songs has the lyrics For all the latest medical poop / Call Surgeon General C. Everett Koop / Boop-boop-a-doop.

In the Futurama episode "Three Hundred Big Boys", Bender finds $300 cigars for sale called "Royal Kooparillo's", bearing Koop's resemblance.

On the King of the Hill episode "Hank's Unmentionable Problem", Peggy dreams of Hank dying, with Koop giving a eulogy.

In the Seinfeld episode entitled "The Boyfriend," Jerry tells Elaine, "You're like going out with C. Everett Koop!" referring to his crusade against smoking in the 1980's.

In the Defying Gravity episode "Bacon", the Koop Memorial Hospital is depicted as the main Earthbound flashback's backdrop.

In episode 105 of Da Ali G Show entitled "Science", Ali G (Sacha Baron Cohen) conducts an interview with Koop, asking him a series of bizarre and nonsensical questions including "Does all of us really 'ave bones, or is dat what da media want us to believe?", and "So, what is da chances dat me will eventually die?".

Koop was a target of some of Frank Zappa's bitterest attacks, mostly directed at his support for the P.M.R.C. but also satirizing Koop's "phony Dr. God get-up" and his warnings about the spread of AIDS through anal sex, cf "Promiscuous" on Broadway The Hard Way (1988)[1]

He also makes several appearances advocating the use of the Life Alert brand emergency devices for the elderly.

Awards and Honors

The 2nd Annual Heinz Award in Public Policy^[7]
Presidential Medal of Freedom. Awarded by President Bill Clinton.

References

^ "C. Everett Koop". Nndb.com. http://www.nndb.com/people/499/000022433/. Retrieved 2009-09-23.
^ "From 'Monsters' to Modern Medical Miracles - Separation Surgeries (20th century-present)". Nlm.nih.gov. http://www.nlm.nih.gov/hmd/conjoined/separation.html. Retrieved 2009-09-23.
^ "The C. Everett Koop Papers: AIDS, the Surgeon General, and the Politics of Public Health". Profiles.nlm.nih.gov. 1986-10-22. http://profiles.nlm.nih.gov/QQ/Views/Exhibit/narrative/aids.html. Retrieved 2009-09-23.
^ "Firestorm Solutions - Surgeon General C. Everett Koop Joins Firestorm Expert Council". Firestorm.com. http://www.firestorm.com/en/cms/?800. Retrieved 2009-09-23.
^ Goodman, Walter (1991-06-04). "Review/Television; Health Care of America's Children - New York Times". New York Times. http://query.nytimes.com/gst/fullpage.html?res=9D0CE7DB123DF937A35755C0A967958260. Retrieved 2009-09-23.
^ "[C. Everett Koop with President Ronald Reagan] [1980s]". Profiles.nlm.nih.gov. 2003-06-25. http://profiles.nlm.nih.gov/QQ/B/B/D/N/. Retrieved 2009-09-23.
^ The Heinz Awards, C. Everett Koop profile

External links

The C. Everett Koop papers at National Institutes of Health
Biography from the C. Everett Koop Institute at Dartmouth College
Why did US Surgeon General C. Everett Koop manipulate national first aid guidelines as a "buddy favor" for my father? by Peter M. Heimlich

v • d • e Surgeons General of the United States

Woodworth · Hamilton · Wyman · Blue · Cumming · Parran · Scheele · Burney · Terry · Stewart · Steinfeld · Ehrlich (acting) · Richmond · Brandt (acting) · Koop · Mason (acting) · Novello · Whitney (acting) · Elders · Manley (acting) · Satcher · Moritsugu (acting) · Carmona · Moritsugu (acting) · Galson (acting) · Weaver (acting) · Benjamin

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C. Everett Koop

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