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C. Everett Koop
C. Everett Koop, 1980s.jpg
Official portrait, 1980s
13th Surgeon General of the United States
In office
January 21, 1982 – October 1, 1989
President
Preceded by Julius B. Richmond
Succeeded by Antonia Novello
Personal details
Born
Charles Everett Koop

(1916-10-14)October 14, 1916
New York City, U.S.
Died February 25, 2013(2013-02-25) (aged 96)
Hanover, New Hampshire, U.S.
Political party Republican
Spouses
Elizabeth Flanagan
(m. 1938; died 2007)
Cora Hogue
(m. 2010)
Children 4
Education
Awards Calderone Prize (1992)

Charles Everett Koop (October 14, 1916 – February 25, 2013) was an American pediatric surgeon and public health administrator. He was a vice admiral in the U.S. Public Health Service Commissioned Corps, and served as the 13th Surgeon General of the United States under President Ronald Reagan from 1982 to 1989. According to the Associated Press, "Koop was the only surgeon general to become a household name" due to his frequent public presence around the HIV/AIDS crisis of the 1980s.

Koop was known for his work on tobacco use and AIDS, and for his support of the rights of children with disabilities.

Early life and education

Koop was born in Brooklyn, New York, the only child of John Everett Koop (1883–1972), a banker and descendant of 17th-century Dutch settlers, and Helen (née Apel) Koop (1894–1970). In 1937, he earned his Bachelor of Arts in zoology degree from Dartmouth College, where he was given the nickname "Chick" (occasionally used for his first name, Charles, but here an allusion to a chicken coop). His interest in medicine followed a year in the hospital after a childhood skiing accident and brain hemorrhage. He earned his MD degree from Cornell Medical College in 1941 and Doctor of Science degree in medicine from the University of Pennsylvania in 1947.

Medical career

From 1946 to 1981, Koop was the surgeon-in-chief at the Children's Hospital of Philadelphia (CHOP). Koop was able to establish the nation's first neonatal surgical intensive care unit there in 1956. He helped establish the biliary atresia program at CHOP when Japanese 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 there he graduated 35 residents and 14 foreign fellows, 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.

Koop became a professor of pediatric surgery in 1959 and professor of pediatrics in 1971 at the University of Pennsylvania School of Medicine.

While a surgeon in Philadelphia, Koop performed groundbreaking surgical procedures on conjoined twins, invented techniques which today are commonly used for infant surgery, and saved the lives of countless children who otherwise might have been allowed to die. He invented anesthetic and surgical techniques for small bodies and metabolisms and participated in the separation of several sets of conjoined twins whose condition other physicians at the time considered hopeless. He first gained international recognition in 1957 by the separation of two female pygopagus infants (conjoined at the pelvis) and then, again, in 1974 by the separation of two ischiopagus twins (conjoined at the spine) sharing a liver, colon, and parts of the intestines with their entire trunks merged.

Koop was active in publishing articles in the medical literature. Koop helped rectify this by publishing his own findings and results. Additionally, he became the first editor of the Journal of Pediatric Surgery when it was founded in 1966.

In contrast to his years as surgeon general, when it was his policies and speeches that had bearing on other people, his years as an operating pediatric surgeon involved a more individualized, direct, hands-on effect on others. During the course of his long career, for example, he performed some seventeen thousand inguinal hernia repairs and over seven thousand orchidopexies. He developed new procedures, such as the colon interposition graft for correcting esophageal atresia (congenital lack of continuity of the esophagus) or ventriculoperitoneal shunts for treatment of hydrocephalus (accumulation of excessive cerebral spinal fluid in and around the brain causing neurological problems). He also tackled many difficult cases ranging from childhood cancer to surgeries done on conjoined twins, of which he and his colleagues operated upon ten pairs during his 35-year tenure. In all he operated on many children and babies with congenital defects 'incompatible with life but amenable to surgical correction'.

In 1976, Koop wrote The Right to Live, The Right to Die. Koop also took some time off from his surgical practice to make a series of films with Christian apologists Frank Schaeffer and his father Francis Schaeffer in 1978, entitled Whatever Happened to the Human Race? based on the book of the same title that was previously written by the elder Schaeffer. Frank Schaeffer and his associate, Jim Buchfuehrer provided a private, five hour screening to U.S. Rep. Jack Kemp and wife Joanne on their home that, according to Frank Schaeffer's account of the late evening and early morning event in his book Crazy for God, led to both the Schaeffers and Koop obtaining "...access to everyone in the Republican Party".

President Ronald Reagan, shortly after his first inauguration, appointed Koop Deputy Assistant Secretary for Health in February 1981. It was understood that Reagan would later nominate Koop to be surgeon general.

Surgeon General of the United States

C. Everett Koop on the day of his confirmation as Surgeon General (QQBBQB) noframe
Koop with his wife, Betty, Senator Orrin Hatch of Utah, and Secretary of Health and Human Services Richard Schweiker.

As expected, Koop was nominated to be Surgeon General of the United States by Reagan later in 1981. Many liberal politicians and women's groups opposed the nomination because of Koop's very conservative views. His nomination was confirmed by the U.S. Senate on November 16, 1981, by a vote of 60–24. He was sworn into office on January 21 the following year.

Tobacco

Koop's 1988 Report of the Surgeon General was somewhat unexpected, especially by those who expected him to maintain the status quo in regard to his office's position on tobacco products. During his tenure, in 1984, Congress passed legislation providing for new, rotated health warning labels on cigarette packs and required advertising to include the labels. Those labels remain unchanged today. New labels containing graphic depictions of smoking-caused illness and death have been announced by the FDA, but are on hold pending the outcome of tobacco industry legal challenges. Koop issued a challenge to Americans in 1984 to "create a smoke-free society in the United States by the year 2000." As Surgeon General, he released eight reports on the health consequences of tobacco use, including the first report on the health consequences of involuntary tobacco smoke exposure. During Koop's tenure as Surgeon General, smoking rates in the United States declined significantly from 38% to 27%.

AIDS

Koop was Surgeon General when public health authorities first began to take notice of AIDS. For his first four years in office, Koop, the nation's top health officer, was prevented from addressing this health crisis, for reasons he insisted were never fully clear to him but that were no doubt political. Koop wrote the official U.S. policy on the disease, and in 1988 he took unprecedented action in mailing AIDS information to every U.S. household. While a straightforward telling to the public about the disease was controversial, Koop was also criticized by some health activists who claimed that his office had not gone far enough in attempting to develop a cure or vaccine, reducing the role of his office to educating the public on health concerns.

Disability

In April 1982, a child born in Bloomington, Indiana, was diagnosed with Down syndrome as well as esophageal atresia with tracheoesophageal fistula. Six days later, after court involvement and parental discussion involving disagreement among physicians about whether or not to treat the baby or let him die, the baby died, having been denied surgical treatment to correct his esophageal atresia and tracheoesophageal fistula. Baby Doe, as he would be known, became a symbol for newborns with birth defects and children with disabilities. Koop was not initially involved with the Baby Doe case but had a special interest in it. As a pediatric surgeon in Philadelphia, he and his colleagues had operated on 475 such babies during his 35 years there, with ever-increasing survival rates. During his last eight years in active practice, Koop never lost a full-term baby upon whom he had operated to correct esophageal atresia. It was due to this background that he became actively involved in championing policies to protect the rights of newborns with disabilities, which led to Congress passing the Baby Doe Amendment.

Style

These four issues, combined with Koop's personality and his willingness to make use of mass media, brought to the office of Surgeon General a higher public profile than it previously had merited; he is, for instance, the first Surgeon General to have been the subject of a popular song – "Promiscuous" by Frank Zappa. He was interviewed by Ali G for comedic effect.

Koop was well known for his mustache-less beard and colorful bow ties. During much of his day-to-day work, Koop wore the Surgeon General's US Public Health Service Commissioned Corps uniform, a uniform similar to that of a U.S. Navy Vice Admiral's. During his tenure he re-instated the daily wearing of the PHS uniform by the officers of the PHS.

Later career

Following his career as Surgeon General, Koop was on The Firestorm Solutions Expert Council. Koop hosted a documentary series in 1991, simply titled C. Everett Koop, M.D. It aired for six episodes on NBC.

Koop and other investors established drkoop.com in 1997, during the dot-com bubble. This medical information website was one of the first major online sources of health information. Critical review of the site content revealed that many of the private care listings, medicinal recommendations, and medical trial referrals were paid advertisements. The company went bankrupt in 2001. Koop continued to endorse Life Alert bracelets for the elderly.

In 1999 testimony before Congress, Koop minimized concerns from health groups about the severity of allergies to latex gloves. It was later discovered that a company that manufactured latex gloves had previously paid Koop $650,000 for consulting work.

Koop held three professorships at Dartmouth Medical School, where he was also the senior scholar at the C. Everett Koop Institute.

Personal life

In early 1968, Koop's son David was killed in a rock climbing accident on Cannon Mountain during his junior year at Dartmouth College. Koop later wrote that because of his son's death he thought, "I might be better able to help parents of dying children, but for quite a while I felt less able, too emotionally involved. And from that time on, I could rarely discuss the death of a child without tears welling up into my eyes." Years later, he and his wife wrote a book called Sometimes Mountains Move to help others who had lost a child. Koop's son Rev. Norman Koop attended Eastern Baptist College (now Eastern University) and graduated in 1969. The following year the elder Koop was elected to the board of trustees, becoming the first non-Baptist member of the board.

In February 2007, Elizabeth Koop, his wife of nearly 70 years, died. On April 17, 2010, he married Cora Hogue, a former staff member of Tenth Presbyterian Church in Philadelphia.

Death and legacy

At a November 2010 news conference, Koop spoke from a wheelchair and said that he was "very, very deaf" and legally blind. Koop died on February 25, 2013, at the age of 96 at his home in Hanover, New Hampshire. According to a Koop aide, he had been ill for several months and had suffered kidney failure the previous week. No official determination of cause of death has yet been announced.

Remarking on Koop's death, American Medical Association president Jeremy Lazarus commented, "Because of what he did, and the way he did it, he had a dramatic impact on public health." The Associated Press called his impact "great", while The Philadelphia Inquirer called him "a courageous and brilliant pediatric surgeon who pioneered techniques ... and became an outspoken surgeon general". Writing for The New Yorker, Michael Specter said, "I don't think I have ever met anyone for whom I had more respect... In this era, during which progress, facts, and science are under unrelenting siege, it is thrilling to remember that even ideologues can love the truth."

Awards and honors

C. Everett Koop (26939048052)
Koop in U.S. Public Health Service uniform
  • Public Health Service Distinguished Service Medal
  • Public Health Service Meritorious Service Medal
  • Surgeon General's Medallion
  • Surgeon General's Exemplary Service Medal
  • Public Health Service Citation Medal
  • Public Health Service Outstanding Unit Citation
  • Presidential Medal of Freedom (1995)
  • Public Health Service Foreign Duty Service Award
  • Public Health Service Regular Corps Ribbon
  • Légion d'Honneur (1980)
  • Order of Merit of Duarte, Sánchez and Mella, the highest award of the Dominican Republic
  • Association of Military Surgeons of the United States with gold star
  • Denis Brown Gold Medal by the British Association of Paediatric Surgeons
  • William E. Ladd Gold Medal of the American Academy of Pediatrics
  • Fellow of the American College of Surgeons (FACS)
  • Royal College of Surgeons of England (1982)
  • Royal College of Physicians and Surgeons of Glasgow (1987)
  • Royal Society of Medicine (1997)
  • Honorary Fellowship of the Royal College of Surgeons of Edinburgh (HonFRCS) (2009)
  • U.S. Senator John Heinz Award for Greatest Public Service by an Elected or Appointed Official (1988 Jefferson Award)
  • Public Welfare Medal from the National Academy of Sciences (1990)
  • Albert Schweitzer Prize for Humanitarianism (1991)
  • Tyler Prize for Environmental Achievement (1991)
  • Emmy Award in the News and Documentary category for "C. Everett Koop, MD," a five-part series on health care reform (1991)
  • The 2nd Annual Heinz Award in Public Policy (1996)
  • Member of the American Academy of Arts and Sciences (1990)
  • Member of the American Philosophical Society (1992)

See also

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