C. Everett Koop, who as surgeon general during the Reagan administration won the admiration of conservatives for his views on abortion, the admiration of liberals for his views on AIDS, and the admiration of the public at large for his unwillingness to put political considerations ahead of public health concerns, died Monday in Hanover, N.H. He was 96.
His death was announced by the C. Everett Koop Institute at Dartmouth College, which did not reveal a cause.
Dr. Koop was among the most influential of surgeons general in the nation’s history and assumed a high-profile from the moment he took office, in 1982. Commonly referred to as “America’s family doctor,” he was dubbed by Business Week magazine “America’s real-life Marcus Welby M.D.” Such titles indicate the degree of trust and respect he earned during his tenure as surgeon general, leaving the post in 1989.
His combination of personal candor, professional commitment, and medical competence made him something like a folk hero. At least Homer Simpson thought so. On a 1993 episode of “The Simpsons,” he sang, “For all the latest medical poop/Call Surgeon General C. Everett Koop/Poo poo pa-doop.”
Further contributing to Dr. Koop’s persona was his appearance. He resembled an Old Testament patriarch, with his booming voice and Amish-style whiskers (he grew the beard in middle age to conceal a double chin). He also made a point of wearing the uniform of the public health service (the surgeon general bears a rank equivalent to that of a navy vice admiral), further accentuating his already-commanding bearing. Dr. Koop perfectly fit the bill for an office charged by law “to promote and assure the highest level of health attainable for every individual and family in America.”
An only child, Charles Everett Koop was born on Oct. 14, 1916, in Brooklyn, N.Y. His parents were John Everett Koop, a banker, and Helen (Apel) Koop, a housewife.
“I can’t remember a time when I didn’t want to be a doctor,” he wrote in his autobiography. “I wanted to be a surgeon. The idea of using my mind, then my hands, to heal someone simply fascinated me.” Dr. Koop took this ambition so seriously he began to use scissors left handed (he was right handed) and to tie knots with one hand as preparation for the operating room.
Intellectually precocious, he entered Dartmouth at 16. While there, he picked up his lifelong nickname, “Chick.” More important, he also met a Vassar student named Elizabeth Flanagan. They wed during Dr. Koop’s first year at Cornell Medical School.
Dr. Koop did his internship at Pennsylvania Hospital, in Philadelphia, and was a surgical fellow at the Hospital of the University of Pennsylvania. At the suggestion of a superior there, he switched to the then-nascent field of pediatric surgery, doing a year’s training at Boston Children’s Hospital.
He returned to Philadelphia to become surgeon-in-chief at Children’s Hospital. Only the seventh pediatric surgeon in the country, Dr. Koop pioneered the field. He established America’s first neonatal intensive care unit and was a founder of the Journal of Pediatric Surgery. He later estimated he operated on 17,000 inguinal hernias and 7,000 undescended testicles during his 35 years as a pediatric surgeon, not to mention numerous other procedures, such as three successful separations of Siamese twins. He also taught at the University of Pennsylvania School of Medicine.
A few years after taking up pediatric surgery, Dr. Koop found the somewhat pro forma religiosity of his youth transformed into a fervent faith. “From then on,” he said in a 1982 Saturday Evening Post interview, “there was never any question: I knew I was to practice my Christianity through my surgery.”
The most-publicized form Dr. Koop’s marriage of religion and medicine took was a fierce opposition to abortion. In 1976, he published “The Right to Live, The Right to Die,” a critique of abortion, euthanasia, and infanticide. Three years later, he collaborated with the theologian Francis Schaeffer on a book and film, “Whatever Happened to the Human Race?” Dr. Koop warned against “a progression of thinking in this country from liberalized abortion to infanticide to passive euthanasia to active euthanasia, indeed to the very beginnings of the political climate that led to Auschwitz, Dachau and Belsen.”
Dr. Koop’s views on abortion drew the attention of the incoming Reagan administration. As it happened, he was about to reach retirement age, giving the idea of becoming surgeon general further appeal. “After thirty-five years at Children’s Hospital espousing the cause of the disenfranchised and fighting for a fairer deal for children,” he recalled, “I wanted to enter a larger arena and fight on behalf of a broader constituency.”
The news of Dr. Koop’s nomination created a minor political firestorm, which delayed his final confirmation for eight months. “Dr. Unqualified” a New York Times editorial called him, which a columnist preferred “Dr. Kook.” Representative Henry Waxman, Democrat of California, said, “Dr. Koop scares me. He is a man of tremendous intolerance.”
One man’s intolerance is another’s conviction — and soon enough Waxman found that on many issues Dr. Koop shared his. The “Surgeon General’s Report on Smoking and Health,” in 1982, called for a smoke-free America by 2000 and pulled no punches in criticizing tobacco use and the tobacco industry.
Dr. Koop also spoke out against excessive alcohol use and unhealthy eating habits. But it was his response to AIDS that was the watershed event in his tenure.
“If ever there was a disease made for a surgeon general,” he later recalled, “it was AIDS.” A new and growing danger to public health, the disease was also a highly charged political issue because of its prevalence among homosexual men. AIDS activists accused the Reagan administration of ignoring the disease.
In 1986, President Reagan requested that Dr. Koop prepare a report. Its frank, even-handed treatment of the disease drew criticism from the right, especially over its call for the use of condoms and educating children about the disease. When the conservative activist Phyllis Schlafly charged Dr. Koop with advocating “teaching sodomy to third graders,” he replied, “I’m not surgeon general to make Phyllis Schlafly happy. I’m surgeon general to save lives.”
Some 20 million copies of “The Surgeon General’s Report on Acquired Immune Deficiency Syndrome” were published. After its issue, David Baltimore, the Nobel Prize-winning chairman of the National Academy of Sciences task force on AIDS, called Dr. Koop “a hero, the one person in the administration who attempted to act positively and decisively.”
Although Dr. Koop unsuccessfully campaigned to be appointed secretary of Health and Human Services under George H.W. Bush, he did not surrender his high profile once his second four-year term ended. He wrote his memoirs, “Koop” (1991), and hosted a five-part NBC television series on health and a series of health-related videos for Time Inc.
He founded the C. Everett Koop Institute at Dartmouth, in 1992.
Yet Dr. Koop’s once-pristine image began showing some tarnish. There were accusations of conflict of interest when it was learned that several highly publicized stands on medical issues might be seen to benefit companies that had contributed to the Koop Institute. A website he founded, drkoop.com was labeled “drkoop.con” by one critic as its stock spiked during the dot.com fever of the late 1990s before plummeting. The website’s firm declared bankruptcy in 2001. The New York Times revealed that Dr. Koop received a commission on some products ordered through the site.
Dr. Koop, whose holdings in the company were at one point worth $56 million, dismissed all accusations of financial self-interest. He described the site as a means to further health and medical awareness. Pointing out he had once rejected $1 million to endorse a breakfast cereal, he told the Washington Post in 2000, “If I had a price [for selling out], I’d be a billionaire.”
In 1995, Dr. Koop was awarded the Presidential Medal of Freedom, the nation’s highest civilian honor.