Tuesday, February 26, 2013


The saddest aspect of life right now is that science gathers knowledge faster than society gathers wisdom. Isaac Asimov

The recent passing of C. Everett Koop is an appropriate time to reflect on the impacts of public health policy on the welfare of the people. However, before getting into the thicket of his political life, his transformational impact as a pediatric surgery must be acknowledged. Anyone who has had the misfortune of watching their child undergo surgery owes, ultimately, a debt of gratitude to this trail blazer in surgical techniques.

It was outside of the operating room where Koop would rise to global fame. He took strong positions on AIDS, turning panic of a plague like outbreak with demands for mandatory testing and quarantine, into thoughtful discourse on behavior modifications and long term care. He infuriated both extremes of the debate on abortion by demonstrating that abortion was not a public health concern while at the same time calling it morally abominable. He challenged our basic prejudices and misunderstandings on the rights of infants with birth defects, providing the scientific basis for the Baby Doe legislation.

Koop was also an aggressive critic of the tobacco industry. Perhaps in this role he is often over credited with driving change, as by the early 1980's when he became Surgeon General, there was already a clear downward trend. That trend was started by then Surgeon General Luther Terry in 1964 who first declared definitive causality of lung cancer and the probable causality of heart disease from smoking.

Trends in Current Cigarette Smoking Among High School Students and Adults, United States, 1965–2011
CDC graph

Koop understood that through a balance of scientific thought and moral conscience, it could BE different.

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