Portrait: Dr. C. Everett Koop

Warning: The Surgeon General Is a Man of Strong Convictions

 

 

 
 

 

 

r. Koop is here... Dr.
Koop is here .. . Dr.
Koop is in O.R." No
Orwellian monotone
this. The voice an-
nouncing the arrival
is alive with excite-
ment. It belongs to a
young nurse, the first
person to spot the bearded pediatric
surgeon as he steps off the elevator.

As Koop approaches, smiling
broadly at the booming P.A. greeting,
she runs the length of the small re-
ception area to throw her arms
around the big doctor, hugging and
kissing him like a long-lost daddy. In
an instant, she is joined by a half
dozen other young nurses who also
greet Koop with squeals and kisses.

It has been Just about a year since
Koop left this place to join the Rea-
gan administration as U.S, Surgeon
General, but at Children’s Hospital
in Philadelphia—and especially here
in the C. Everett Koop Surgical Cen-
ter—he is still as close.to being a god
as anyone ever comes.

After Koop finally frees himself
from his hero’s welcome, he takes a
companion ona tour of the hospital's
neonatal intensive care unit. Years
before, in the old Children's Hospital
on the other side of Philadelphia,
Koop had envisioned just such a to-
tal care facility for sick infants. The
futuristic medical complex that he
now surveys-—all green blips, hyp-
ersensitive monitors, . miniaturized
computer terminals and gleaming
stainless steel incubators—is his liv-
ing monument to that dream.

Koop peers through a thick glass
wall at a roomful of tiny premature
patients. “These little ones demand
constant care,” he says. “We set this
up so there would be one nurse for
every one and a half patients. You
can't leave them alone for a minute.
That's total life support in there. ...
See that little guy over there? I bet he
doesn’t even weigh three pounds. I've
had to open the chests of smaller ba-
bies than him.” .

On the way out Koop stops in
front of a large, empty operating
Toom. “This,” he says almost in a
whisper, “is the room where we sepa-
rated the Siamese twins." Koop, in
fact, has successfully separated Sia-
mese twins three times, believed to
be a medical record. In addition, he
has perfected scores of new surgical
and diagnostic techniques, many of
which are SOP (Standard Operating
Procedure) today.

When Koop began practicing 35

   

 

By Mike Mallowe Photographs by Leroy Woodson Jr.

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 4the U.S. to devote his entire surgi-
cal practice to pediatrics. (Today the
field numbers about 500.) At that
time many operations on newborns
carried with them a 95 percent mor-
tality rate. By the time he left Chil-
dren's Hospital, Koop was among
those who had helped reverse that to
a 95 percent survival rate.

“The founders of pediatric sur-
gery preceded his era,” says Dr. John
Templeton of Children’s Hospital,
“but Dr. Koop was that rare combi-
nation of everything you look for ina
surgeon—gifted technician, skilled
researcher, excellent clinician and
able administrator.”

Is this, then, the “monster” whose
nomination as Surgeon General was
so bitterly assailed by assorted femi-
nista, freedom-of-choicers, liberal
legislators and editorial writers?
Indeed it is. But if Koop is a pussy-
cat around preemies and adoring
nurses, don’t be misled: Charles Everett Koop Is a tough old pro, a
broad-shouldered oak of a man with a stevedore's grip and an un-
bending will. He has been called stuffy, pompous, egotistical (even

for a surgeon)—and worse. His black rages in the face of medical in-
competence are legendary. “I think I must scare people,” he says

gently. “I don’t think people quite know what to do with me.”

As far back as the presidential campaign of 1980, the Reagan
team knew exactly what it wanted to do with Koop. As one of the na-
tion’s most outspoken antiabortion crusaders, Koop had just con-
cluded a speech to a right-to-life group in Washington when Richard
Schweiker--soon to be Reagan's Secretary of Health and Human
Services—called him aside and asked if he would consider accepting

.the Surgeon General post.

Schweiker’s offer couldn't have come at a better time, for soon
Koop would be retiring as surgeon-in-chief of Children’s Hospital.

Sttll, he was hesitant.

“All I could think," Koop says, “was that if I took it, it would mean

going to work for somebody else for the first time in my life.” But he

says that on election night, watching Reagan’s lead grow on televi-

sion, “] suddenly knew that I wanted to be a part of all that. I picked
up the phone and made one call. Change my status, I told them, from
‘available’ to ‘enthusiastically seeking.’ ”

Officially, the Surgeon General 1s the chief of the 7,000-strong

Commissioned Corps of the U.S. Public Health Service, as well as a
power inside the very political Department of Health and Human
Services. However, his (there has never been a female Surgeon Gen-
eral) real importance traditionally has been as the President's
spokesman—ideally his conscience—articulating the nation’s
health care goals. No man who ever held the office brought to it the
contentiousness, or the background, of Everett Koop.

Koop grew up in Brooklyn’s Flatbush district, the descendant of ear-
ly Dutch colonists. In his youth, a skiing accident that badly frac-
tured a cervical vertebra and a brain hemorrhage suffered during a
football scrimmage kept him laid up for more than a year and forced
him “to get to know what it feels like to be a patient.” He entered Dart-
mouth in 1933 at 16 and upon graduation enrolled at Cornell Medi-
cal College, where he met his wife, Elizabeth, then a Vassar student.
Koop began his residency at the University of Pennsylvania Hospital
early in World War II, never to abandon the love of pediatrics that he
developed there,

But ever since his nomination as Surgeon General was first
leaked to the press, Koop has been viewed more as symbol than phy-
sician. His position on abortion was the flash point: Koop viscerally,
and passionately, opposes it. “One Saturday in 1976,” he recalls, “I
had operated on three newborns. Around five that afternoon, I was
sitting with my residents trying to unwind. We'd just taken three
premature babies, all of whom had something incompatible with
life, corrected it and given them a seventy-year life expectancy. We

weren'tsmug, but we felt—we knew—
that this is what we were put here
for. Then all of a sudden I realized
that those three babies together
didn’t weigh ten pounds. Yet infants
like them, with nothing wrong with
them physically, were being aborted

all aver the city that same day.
“I went home and wrote The Right
To Live; The Right To Die in a day.
After that, I could never tum back.
When we have one and a half million
abortions a year, there's a cheapen-
ing of life. That makes it easy to
move on to the next classification of
citizens who might not be seen as
having a life worth living, and that’s
the elderly. That's three groups who
have no advocate—the unborn, the
newborn and the aged. But believe
me, as Surgeon General, I intend to

give them an advocate.”

As an antiabortion missionary,
Koop created a chilling multimedia
crusade called Whatever Happened
% to the Human Race? The program,
which he took to 20 cities in 1979, offered moral and medical alter-
natives to abortion, which was depicted as carnage. Koop called the
widely used amniocentesis test, for detecting abnormal fetuses, a
“search and destroy mission.” He also made pronouncements like
this: “I can see prophetically a progression of thinking in this coun-
try from liberalized abortion to infanticide to passive euthanasia to
active euthanasia, indeed to the very beginnings of the political cli-

‘mate that led to Auschwitz, Dachau and Belsen.”

Not surprisingly, once tapped for the Surgeon General job, he be-
came a prime target of freedom-of-choice leaders. He was de-
nounced as an intolerant, sanctimonious medical Calvinist who
would brand homosexuals and even ERA proponents with the same
white-hot poker he applied to women seeking abortions. Edward
Kennedy charged that Koop had “cruel, outdated and patronizing
stereotypes” of women. “Dr. Koop scares me,” said California Repre-
sentative Henry A. Waxman, who helped stall Koop's congressional
confirmation until last November. “All those with whom he dis-
agrees he characterizes as antifamily.”

“When you've got absolutes that you feel are God-given,”
counters Koop, a steadfast Christian fundamentalist, “you don't
have much room for compromise on right or wrong. That's one of the
reasons I irritate people.”

At 65, it was said that he was too old for the job (indeed, the Rea-
gan administration had to push through a law enabling Koop, at that
age, to assume the post). He was also accused of lacking the neces-
sary background in public health administration. “When you do in-
novative procedures that make anesthesia safe for babies," thun-
ders Koop in reply, “it’s a contribution to public health. When you
make surgical procedures safe for children, and operations that you
do are copied all over the country, I think that’s public health.”

Officially confirmed as Surgeon General by a 68-24 Senate vote
last November, and sworn in this January, the administration's
most visible antiabortion symbol is ready to move on to other mat-
ters. “I've said all that I have to say and written all that I have to write
on that issue,” he explains. “There are other, bigger things that I
should turn my attention to as Surgeon General: where this country
is and where it’s going in health care.”

Sometimes, though, Koop talks earmestly about resuming sur-
gery. It is obvious how much he misses those early days in the oper-
ating room. “It was almost like we were beginning to invent the
wheel,” he says wistfully. “Everything you did then was brand-new;
it was such an exciting time....

“The challenge,” he says, “is to do a routine operation that you've
done over and over again, without a single wasted motion. To go in
with an experienced nurse who knows me; to put out my hand, get
the right instrument without ever looking up; do this; do that; finish
the operation. Nothing wasted—that's pleasure. That's total plea-
sure.” And it's the kind of pleasure that Dr. Koop has yet to find with-
in the bureaucratic confines of Washington, D.C. #