A brilliant pediatric surgeon, C. Everett Koop, MD, FACS, was surgeon-in-chief at the Children’s Hospital of Philadelphia (CHOP) from 1946 to 1981. During his tenure there, Dr. Koop established the nation’s first neonatal surgical intensive care unit in 1956. He helped establish the biliary atresia program at CHOP when pioneering surgeon Morio Kasai came to work with him in the 1970s. He also established the pediatric surgery fellowship training program at CHOP. During his tenure, 35 residents and 14 foreign fellows graduated, many of whom went on to become professors of pediatric surgery, directors of divisions of pediatric surgery, and surgeons-in-chief of children’s hospitals. Dr. Koop also successfully separated several sets of conjoined twins and was the inaugural editor of the Journal of Pediatric Surgery.
Dr. Koop was nominated as Surgeon General by President Reagan and confirmed in 1981. His appointment was controversial because of his known conservative stance on many issues and his opposition to abortion.
In a 1988 report, he likened the addictive properties of nicotine to that of heroin and cocaine. This report led to a reform of the tobacco industry, and Dr. Koop challenged Americans to create a smoke-free society by the year 2000. Although this goal has yet to be achieved, smoking rates dropped from 38 to 27 percent during his tenure.
Most notably, the AIDS pandemic was recognized just after Dr. Koop’s appointment, and it put him at the front line of perhaps the greatest public health challenge in U.S. history. In 1988 he took the unprecedented step of mailing information about AIDS to every U.S. household. The literature included frank descriptions of high-risk behaviors and stressed abstinence as the best method of prevention, but it also acknowledged the need for condoms if high-risk behaviors were undertaken. He also advocated early sex education in schools. This period was tough for Dr. Koop, but he was committed to and unapologetic about the distribution of this information.
Finally, Dr. Koop was an advocate for the rights of handicapped children. The case of Baby Doe, in which parents of a child refused to allow treatment for a tracheoesophageal fistula, resonated with Dr. Koop, who was very familiar with the excellent results of this procedure. This case led to the Baby Doe Amendment, which protects the rights of handicapped infants and children.
These major issues combined with Dr. Koop’s powerful personality and his willingness to make use of mass media brought the Office of Surgeon General to a higher public profile than ever before. He became a well-known and very recognizable public figure. Dr. Koop passed away on February 25, 2013, at the age of 96.
The lessons we can all learn from Dr. Koop are straightforward. As surgeons, we must lead with conviction. This is true in the operating room, in the boardroom, the community, and in the political arena. Only when we lead with full commitment and conviction can we reach our maximum effectiveness.