TIME: Almanac 1990/1990 Time Magazine Compact Almanac, The (1991)(Time).iso/time/042489/04248900.065

Text File | 1990-09-17 | 12KB | 213 lines

PROFILE, Page 82

A Doctor Prescribes Hard Truth

C. EVERETT KOOP, America's Surgeon General, has an opinion on

everything healthful, but he nonetheless enjoys meat and martinis

By MARGARET CARLSON


    He is, by Washington standards, a little strange. First, there
is the uniform draped with gold braid he insists on wearing. Before
he became famous, it prompted people at airports to pile him with
baggage and ask what time the flight was leaving. Then there is the
big, clunky hearing aid that he takes out and fusses with right in
the middle of a conversation, as if it were a pipe, and the canvas
tote he uses as a briefcase, and his habit of loudly cracking his
knuckles. On top of that there are the Old Testament beard and the
preacher's voice that make him seem like Moses come down again from
Mount Sinai to deliver commandments 11 through 20. Smoking? It's
an addiction that will kill you. Sex? Only in marriage. AIDS? The
best preventive device is a monogamous relationship; the second
best, a condom. Deformed newborns? Save them. Sex education? In the
earliest grade possible.

    You name it, Surgeon General C. Everett Koop has an opinion,
which he will give you with great certainty at high speed. There
has never been a Surgeon General like him, not even Luther Terry,
who slapped warnings on cigarette packs 24 years ago. It's a fair
guess that Terry was never air-kissed by Elizabeth Taylor, the butt
of jokes in Johnny Carson's monologue, was never a visitor to the
set of Golden Girls, and never lectured Hollywood producers about
showing safe sex in their programs. Antismoking is a small part of
Koop's crusade; AIDS, child abuse, domestic violence, pornography,
old people, drunk driving and Baby Doe regulations made Koop one
of the most visible officials in Washington. Now at airports people
offer to carry his bags.

    The 13th Surgeon General, whose second term runs through the
end of the year, almost never got a chance to don a uniform. When
Koop, a retired pediatric surgeon, and his wife Betty moved to
Georgetown in early 1981 to await his confirmation, they became
proof of the old saw that if you want a friend in Washington, buy
a dog. The process, expected to take a few days, turned into nine
nightmarish months of name-calling and personal attacks, as
liberals stalled his confirmation. He was called a right-wing
crank, a prolife nut, a religious zealot, inexperienced, Dr.
Unqualified (the New York Times), scary (California Congressman
Henry Waxman) and Dr. Kook. The intensity of the attacks was fueled
by prochoice advocates who feared his opposition to abortion. In
addition to being the author of several books, Koop was known for
an antiabortion film he produced in which a thousand black and
white dolls were scattered over the salt wastes of the Dead Sea to
represent millions of aborted fetuses. Koop, who became an
evangelical Presbyterian in his 30s, explains his views against
abortion and against withholding food and medical care from
congenitally deformed newborns simply: "If you had led my life, you
would understand." As a pediatric surgeon for 33 years, Koop saved
many babies no bigger than his hand. In the course of treating
100,000 patients, Koop saw many so-called difficult cases become
happy and productive children. One of these was Paul Sweeney, born
in 1965 with twisted intestines, facial deformities and a cleft
palate. Koop operated on him 37 times. For the final operation by
another surgeon in 1983, Koop returned to Philadelphia in full
dress uniform to wheel his former patient into the operating room.
Sweeney recently graduated from West Chester University in
Pennsylvania.

    Accustomed to the godlike treatment accorded surgeons, Koop
was stunned by the viciousness of Washington, which has neither
gods nor heroes. Every day he would go to his temporary office on
the seventh floor at the Department of Health and Human Services.
Every day the phone wouldn't ring. His wife, uprooted from
Philadelphia, waited in their small sublet wondering whether to
unpack. One day Koop returned to find tears rolling down her face,
a critical newspaper article on her lap. He considered leaving, but
Betty persuaded him to stay. The two had been through a lot -- long
years of medical school, Koop's fractured vertebra and stomach
surgery and, worst of all, the death of a son -- and they stuck it
out. Finally, in November 1981, he was confirmed by a
Republican-controlled Senate.

    Koop was expected to be a figurehead like most Surgeons
General, with little authority and few staff or duties, but he
quickly shook things up. He insisted that the commissioned corps
of public-health officers wear uniforms. Then the 6-ft. 1-in.,
210-lb. doctor, whose taste for red meat and martinis keeps him
from losing his paunch, pronounced the U.S. a country of fatsoes
who would have to give up cholesterol in favor of fiber. When Koop
found out that the tobacco companies had fought hardest over the
years against the Government's calling nicotine addictive, he
stated high up in his Surgeon General's report that nicotine is
addictive. "They absolutely hated it," he gloats. He said the
companies' claims that science cannot say with certainty that
tobacco causes cancer were "flat-footed lies" and that sending
cigarettes to the Third World was "the export of death, disease and
disability."

    He is not above gimmicks. Pushing his slogan "A Smoke-Free
Society by the Year 2000," he adopted a kindergarten class whose
students pledged not to start smoking ("Like Communists," he says,
"you have to get them when they're young"), and everywhere he goes
he hands out buttons saying THE SURGEON GENERAL PERSONALLY ASKED
ME TO QUIT.

    But Koop might have remained just another bureaucrat if it had
not been for AIDS. As the disease grew to near epidemic
proportions, the Administration had to do something. Conservatives
breathed a sigh of relief when in 1986 the President handed the job
to the Fundamentalist Christian Surgeon General.

    After getting assurances that he would be the sole author of
the report, Koop took to the task with an open mind, consulting
Government experts like the National Institutes of Health's Dr.
Anthony Fauci and inviting more than 25 groups, from gay activists
to the Southern Baptist Convention, to his office. He wrote 26
drafts at the stand-up desk in the basement of the brick house he
rents on the campus of the NIH. He numbered the copies he took to
a meeting at the White House and collected all of them to prevent
leaks. The next day, Oct. 22, 1986, he released the report at a
packed press conference; 16 million copies of the report and 107
million copies of an AIDS pamphlet are in print.

    Administration conservatives were stunned by the report's
candor. They were particularly outraged that he did not preach
abstinence alone and refer euphemistically to body fluids rather
than semen. "The White House doesn't like the C word. But if you
don't talk about condoms, people are going to die. So I talk."
Liberals were amazed that Koop had produced a reasoned report with
such compassion for homosexuals, whom he had once called
antifamily. Phyllis Schlafly, who said the report sounded as if it
had been edited by a gay-rights group, lashed out against Koop and
led a campaign against him. Her efforts culminated in the boycott
of a dinner in honor of Koop and persuaded two presidential
candidates, Representative Jack Kemp and Senator Robert Dole, to
pull out as sponsors of it.

    Koop says no one should be surprised, that the report is
consistent with his moral view that you can hate sin but love the
sinner. "I am the Surgeon General, not the chaplain, of all the
people, and that includes homosexuals," he says. He outraged
conservatives again in January. Although opposed to abortion
morally, Koop concluded, following an 18-month study undertaken
after President Reagan promised right-to-life leaders a report,
that the evidence just wasn't there to condemn the practice as
psychologically harmful.

    Despite his success in Washington, Koop's real calling is
medicine. By the time he was five, he knew he wanted to be a doctor
like his uncle. At 15, he would take the subway on weekends from
Brooklyn to Columbia-Presbyterian Hospital in Manhattan, pinch a
white lab coat, and take a seat in the balcony of the operating
room, transfixed for hours by amputations and appendectomies. Back
home, while his father was at the office, he would persuade his
mother to help her precocious only child round up stray cats and
dump them into a sterile trash can with an ether-soaked sponge so
that he could perform exploratory surgery. He brags that he never
lost a cat.

    Not your normal teenage pastimes, but Koop managed to avoid
being the science nerd with a slide rule in his back pocket. He was
on the wrestling, football and baseball teams, editor of the school
paper and president of the student council. He went on to Dartmouth
and Cornell University Medical College, completing his training at
the University of Pennsylvania in 1947. He surprised many people
when he decided to specialize in pediatric surgery, a decidedly
low-rent field in those days, when the real brains were going into
neurosurgery. "Children weren't getting a fair shake in surgery,
getting giant incisions like their grandfathers' and being sewn up
like a football when a tiny hole would do," he recalls. "I saw the
chance to make a difference." There were about five such surgeons
in the country at the time (there are close to 500 now), and Koop's
training consisted of going to Boston Children's Hospital and
peering over the shoulders of surgeons there, much as he did at
Columbia when an adolescent.

    Back in Philadelphia, Koop quickly became known as a tireless
and dedicated doctor. When a peptic ulcer threatened to keep him
out of surgery for months, he treated himself at night, filling an
IV bottle with milk and clamping it onto the bedpost. With the help
of his wife, then pregnant with their first child, he would thread
a tube through his nose and down his throat so the liquid could
drip into his stomach while he slept. More than once, the
jury-rigged system failed, and the Koops woke up in a soaked bed.

    Koop was named surgeon in chief at Children's Hospital of
Philadelphia in 1948. There he perfected techniques for correcting
undescended testicles and undeveloped esophaguses, skills that he
compares to threading together two wet noodles at the bottom of an
ice-cream cone with your eyes closed. His first brush with fame
came when he separated Siamese twins joined at the abdomen and
pelvis. He established the country's first neonatal unit. Noted for
his speed -- he did hernias in six minutes (he has done more than
10,000) -- he used the time saved to counsel parents and make house
calls on terminally ill patients he thought were better off at
home. Dr. Judah Folkman, a professor at Harvard Medical School who
trained under Koop, says, "I remain in awe. He was beloved at that
hospital, worrying over patients as if they were his own children."
To criticism that he tinged his medicine with religion, Koop says,
"There are no atheists at the bedside of a dying child."

    Koop learned this firsthand in 1968, when his youngest son
David, a junior at Dartmouth, fell to his death in a
mountain-climbing accident. "I thought I knew what parents went
through, but I had no idea," he says. "I felt bone-crushing grief."
For months he got such a lump in his throat talking to parents that
he had to cut his discussions short.

    Koop and his wife, the daughter of a Connecticut country doctor
for whom a punishing dawn-to-midnight schedule was normal, have
three other grown children and seven grandchildren. The Koops
recently celebrated their 50th wedding anniversary aboard the QE2.

    Whatever happens when his term is up in 1990, Koop will stay
in Washington, which has made its peace with him. His most
vociferous enemies have admitted they were wrong about him. Most
of the friends he lost in making the ethically correct -- not
politically correct -- decision on AIDS have come back. The city
that worships at the gray altar of ambiguity found there was room
for a man of black and white.