Dr. C. Everett Koop, the outspoken activist and controversial surgeon general appointed by president Ronald Reagan in 1981 who served in that office until 1989 died this week at age 96. Dr. Koop had the qualities many of us would like our surgeon general to possess. First and foremost he tried to do the right thing. He recognized that tobacco was the leading cause of preventable death of American, and led the charge to warn of tobacco dangers. Although he was a political and religious conservative he was a major force in pushing the U.S. government into more aggressive and compassionate approach to the HIV/AIDS epidemic that became apparent during his tenure as surgeon general. He had a letter sent to every U.S. household with a frank discussion of HIV transmission, sexual practices that were proven to be high risk, and was unapologetic when he faced criticism about the frank and politically unpopular content of the letter. Check out this as an example of a frank public health info letter. It may look pretty straight forward now, but in 1988 it was a courageous and unpopular mailing. Gay rights activists felt it targeted them unfairly. Religious leaders felt it was too frank. Koop felt is was data driven and important. He simply put out the best information available at the time to give citizens information on how to avoid contacting HIV. He was personally against abortion but refused to allow this personal belief to bring him to use his position to influence his public position on the issues, standing up to pressure from the Reagan administration to write a statement on the psychological harm of abortion to pregnant women. Again he looked at the data and stood fast in refusing to bow to political pressure.
In short he behaved like a physician should. He looked at the data, decided on an appropriate response, and then did what he could in his position to help the problem. He did not fold to public criticism or political pressure. He just did what could to do the right thing for America and his citizen constituency. Our current surgeon general could take a lesson from his example. The office of surgeon general now seems to be little more than a political position to promote our government’s policies, not to guide our nation’s health initiatives.
I read in KevinMD a great article by Dr. Suzanne Kowen calling for a new U.S. surgeon general to move us in the direction Dr. Koop would be proud to notice. I agree that she is right on target. Say a prayer for Dr. Koop, and for future U.S. surgeon generals to learn from his example and to stay strong.