C. Everett Koop — public health hero, activist, and the man who brought power and sway to the office of the Surgeon General — died at 96 today. Among his largest achievements were (1) speaking candidly about AIDS from a bully pulpit, from which he advocated condom use, prevention, and early sex education, despite his conservative Presbyterian beliefs; and (2) bringing the harms of smoking to the forefront nationally by comparing the habit to heroin and condemning it as “the greatest killer and producer of premature deaths” in the United States.
From the NYT:
As much as anyone, it was Dr. Koop who took the lead in trying to wean Americans off smoking, and he did so in imposing fashion. At a sturdy 6-foot-1, with his bushy gray biblical beard, Dr. Koop would appear before television cameras in the gold-braided dark-blue uniform of a vice admiral — the surgeon general’s official uniform, which he revived — and sternly warn of the terrible consequences of smoking.
“Smoking kills 300,000 Americans a year,” he said in one talk. “Smokers are 10 times more likely to develop lung cancer than nonsmokers, two times more likely to develop heart disease. Smoking a pack a day takes six years off a person’s life.”
When Dr. Koop took office, 33 percent of Americans smoked; when he left, the percentage had dropped to 26. By 1987, 40 states had restricted smoking in public places, 33 had prohibited it on public conveyances and 17 had banned it in offices and other work sites. More than 800 local antismoking ordinances had been passed, and the federal government had restricted smoking in 6,800 federal buildings. Antismoking campaigns by private groups like the American Lung Association and the American Heart Association had accelerated.
The New Yorker looked backed into their archives and pulled a nice profile written upon his retirement that highlights his work on AIDS.
In his frequent interviews with the press and in his reports to the public Dr. Koop insisted on using words that are considered taboo in much of the country—“condom,” “penis,” “rectal intercourse”—not to shock but, rather, to dispel the dark mystery that cloaked the AIDS epidemic. To Dr. Koop, there was nothing immoral about medical wisdom. By using those banned words, the Surgeon General accelerated the ongoing sexual education of America. He also alienated many of his supporters on the right: they accused him in the bitterest terms of abandoning his fundamentalist Christian convictions and promoting illicit sexual behavior. “I’m not the nation’s chaplain general—I’m the surgeon general,” Dr. Koop would counter. Meanwhile, liberals, including those on Capitol Hill who in 1981 had vehemently opposed his nomination, because of his impassioned stand against abortion and his reputation for moral fervor (Dr. Kook, they tagged him), took to hailing him as a new folk hero. But throughout this political firestorm Dr. Koop insisted that he was the same man: the same reverence for human life that had impelled him, as a distinguished surgeon at Philadelphia’s Children’s Hospital, to operate on horribly deformed infants no other doctors would go near now drove him to take bold measures against the spread of AIDS. Explicit safe-sex education for the general public, and care and protection for those stricken with the disease—these were the twin pillars of Dr. Koop’s public-health strategy.
Everyone in the US owes Koop their gratitude, especially those of us in public health. His writings and speeches are collected at NIH’s National Library of Medicine. Highly recommended.