February 25, 2013

Statement on the Passing of Former Surgeon General C. Everett Koop

It is with deep sadness that I reflect on the death and, with deep admiration, that I remember the remarkable life, of my friend, our 13th Surgeon General, C. Everett Koop.

Charles Everett Koop — “Chick,” to friends and colleagues alike — enjoyed a full and distinguished career as a pediatric surgeon before donning the now-familiar dress whites of the U.S. Public Health Service. More accurately, he helped shape the very field of pediatric surgery. When he was a young surgeon, infants with surgical needs were often treated as small adults. Dr. Koop recognized they were, in fact, unique patients with unique needs. With characteristic determination, he moved the field toward his view. And, in 1956, he established the country’s first neonatal surgical intensive care unit.

Chick was already 65 years old when President Ronald Reagan tapped him to become U.S. Surgeon General. He was a controversial candidate and proved a controversial appointment, but not for the reasons one would have anticipated back in 1981. As Surgeon General, Koop held fast to his deep respect for both the evidence of science and the value of each individual person. With limited power and an even more limited budget — he would later describe his office as being supported by “a half-dozen staff and enough money to buy paper clips and name-tags, and that’s about it” — Koop became not just “America’s Family Doctor,” but America’s greatest public health champion. He took on causes that most others lacked the courage to tackle; he saw what others failed —or neglected — to see.

Koop looked at those who did not themselves smoke, but who still breathed air thick with tobacco, and saw “involuntary smokers.” It was a radical notion at the time. Today, it is the norm. At the same time, he had compassion for smokers themselves. He saw them not as willful contributors to their own ill health, but as people suffering from a serious addiction. Most famously of all, he looked at those falling ill and dying from a terrifying new disease — a disease that was emerging, still nameless, just as he was appointed Surgeon General. He did not regard victims of this disease, which came to be known as acquired immune deficiency syndrome (AIDS), as outcasts to be shunned, but as patients to be treated. Then, through his bold educational outreach to the nation, he persuaded others to view patients with AIDS and the retrovirus that causes it, the human immunodeficiency virus (HIV), as people in need of compassion and care. His support for HIV/AIDS research helped relegate the disease to the realm of chronic diseases: still serious, to be sure; but now compatible with almost a normal lifespan.

I had the privilege of knowing Chick personally. Though he may have seemed austere to those who heard his pronouncements about public health, he was personally a warm and compassionate physician who thought deeply about science and medicine. I was privileged to serve as the first C. Everett Koop Lecture presenter at Dartmouth on Nov. 4, 2010, and I will always cherish the time I had to spend with Chick during that wonderful day.

In 1989, shortly before resigning from his position as Surgeon General, Dr. Koop gave the commencement address to a class of soon-to-be military medical practitioners. “One’s best approach to public service,” he advised them, “is to promise to give it everything you have, of whatever it is you have. You must be willing and even eager to draw heavily from your own storehouse of knowledge and life experience, from the ideas and sentiments you’ve absorbed from friends and from family — and from all that accumulated knowledge and experience, you must squeeze out every ounce of good judgment, of deep fellow feeling, and of love of country.”

C. Everett Koop followed his own sage advice. And America is healthier because he did.

Francis S. Collins, M.D., Ph.D.
Director, National Institutes of Health