C. Everett Koop

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, 1982 – October 1, 1989
Preceded by	Edward N. Brandt, Jr.
Succeeded by	James O. Mason
Personal details
Born	(1916-10-14) October 14, 1916 Brooklyn, New York, U.S.

Charles Everett Koop (born October 14, 1916) is an American pediatric surgeon and public health administrator. He was a vice admiral in the Public Health Service Commissioned Corps, and served as thirteenth Surgeon General of the United States under President Ronald Reagan from 1982 to 1989.

Early years

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) 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

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 syndrome 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. 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.

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

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

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.

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 1980s.

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

References

Further reading

• Office of Public Health and Science (4 January 2007). "Office of the Surgeon General: William H. Stewart (1965-1969)". U.S. Department of Health and Human Services. Retrieved 2008-01-17.
• Visible and Palpable Lesions in Children by C. Everett Koop, M.D., Sc.D. Grune & Stratton 1976 ISBN 0-8089-0958-4
• The Right to Live: The Right to Die by C. Everett Koop, M.D., Tyndale 1976 ISBN 0842355936
• Sometimes Mountains Move by C. Everett and Elizabeth Koop. Tyndale 1974 ISBN 0842360646; revised edition printed by Zondervan in 1995, ISBN 0310486726
• Whatever Happened to the Human Race? by C. Everett Koop, M.D. and Francis A. Schaeffer. Crossway Books 1979/1983 revised ISBN 0891072918
• Koop: The Memoirs of America's Family Doctor by C. Everett Koop, M.D. Harper-Zondervan 1992 ISBN 0-310-59772-2
• Let's Talk: An Honest Conversation on Critical Issues: Abortion, AIDS, Euthanasia, Healthcare by C. Everett Koop, M.D. and Timothy Johnson. Zondervan 1992 ISBN 0310597811
• Soul Survivor: How Thirteen Unlikely Mentors Helped My Faith Survive the Church by Philip Yancey. WaterBrook Press (October 21, 2003) ISBN 1578568188 or 978-1578568185

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

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