,. THE GREEN SHEET "Everything that was put in the papers was just a repetition of what everybody else said. I was always called an anti- abortion activist as though that were the worst thing in the world to be. A fundamentalist Christian as though that were the absolute end of the earth." r*dS,, . Times: l-4-83 Koop: Moralist with flair, P genera1 without an _-__- ating table for the last time. He dipped one finger in soap cuds and scrawled T. S. Eliot c words across the operatq ro~bn~ wmdorv. "This IS the wav the world ends this is the way the world ends not with a bang but a whimper" Ile rusaed off his SU~RCYMI`S gloves. still covered wth traces of a ttcrtt~a operanon. 1 be ronm was sltvnt of farewells on that day, March 6.1981. when Koop ;ualked out of the Ctul- dren's Hospttal in Philadelphia. lie knew he never wanted tir operate again; Koop wanted to head for Washington "There !s retlef and rclcose not havmg toconstantlpmakedccisions that have to do wth life and death People who go into surgery have a specific kind of personality that is operative in everything they do. .A good surgeon is aggressive and suspicious. Once a ma." -- a pediatric wr- aeon- cutsopenachildartddisci,\, &s the sight-of pain. he does not smileeasily. He redefines the meant ing of hurt and sotnetimes he scar. ches Par answers beyond the medi- cal books. Kooo seldom smiles. conce&ng a deadpan humor behind a stoic gaze. His words are tightly text tube babies tog:le~ rtence ,I, tutbhc health so he ,;houtd not eve',, hc thought nt for thts to0 Whv duht't uomcht,dv ask me' Who ts the guy IYIII) helped hutId a mcdt~ cat school. H ho got chddren's .Yrays for shoes removed front themarket. who .I couid g" on." That sharply clashes with the pop- ular tmnge ljf Koop, the dogmatic doctor !vho c~rmnnred legalized abor- tton wtth "the h&tnmng of the potin- cnl cttmate rhnt led to Auschwits. Ihtchau and Relscn" fle predicted ouote? "I wrote a "aoer one tune t'bat was called `The Slide to Ausch- *witz:The fact that I look at abortton. infanticide and euthanasia as SW cessive steps m the lessening of the aooreciattort of hfe IS nothma urtet Gwtth me.Many people h&talked about this for many years They JUST didn't happen to be tn a postttott where the prestdmt had uomtnated cont'd on next parJe 12 THE GREEN SHEET from previous page them for me "tflce ot a "ubhc health officml." Then what about the Rockefeller foundation quote about homosexu- als wanting test-tube babies? "There was a lesbian group that made a proposal to the Rockefeller Founda- tion for artificial insemination. I just merely quoted tt out of the news- paper. I thought it was pretty fun- ny... there is nothing that says les- bians wdl make lesbians." In Koop`s vtew. his press Image 1s a poorly drawn cardboard cutout constructed of quotes taken out of context and mlsundersrood remarks. He measures tnmself by a conser- vative's gauge, lookmg over his accompbshments from a smgular vantage point that probably nobody else but Koop could ever comnletelv understand: Depending on one's politxal vantage point, he IS either a vlllam or a hero. There is no deny- mg that the man 1s an old-fashIoned moralist with a dramatic flair. . . . `His figure is silhouetted before an office window overlooking the Capttol. His gray, pin-striped suit fills a chair and his deep voice occupies the room, a seventh-floor office in the Hubert H. Humphrey Building on Independence Avenue. Across the office, above Koop's desk is a massive black-and-white portrait of one of his four children, David, scaling the crest of a moun- tain. Koop says he feels comforted looking at David's calm determina- tion, standing beneath the clouds and above the cares of the rest of us. And only Koop knows how many times he has slid back in his office chair to look at that innocent face, unafraid of mountains that move. "David was killed six months after that picture was taken in October 1%:. HewasontouofMountAdams above the clouda with his older brother Allen. Allen took that shot and sent it to David's fiancee in Louisiana. She sent it away to one of thoseplaces thatadveniseblown-uo pictuies for 55.95. After severe1 weeks it didn't come back so she wrote away and the company said they had no record of the picture. "His fiancee assumed that it was lost forever And David was killed on the 28th of Apnl m 1968. I tele- phoned his fianceeand told her what happened She said she would take the first plane to Philadelphta. She walked out of the house to get m the car and the mallman wad commg down the drlvewav with that oic- ture rolled up m a s&011. She broight it to us: she had never seen it until she opened It m `our presence "You can Imagine. If you've lost your son in a mountarn-chmbing accident, and you suddenly see tus ptcture standing above the clouds with one foot out of heaven. It was both a terrible burden for us to look at and a great source of comfort." When Koop tells a story, he cues deep mt" the heart and operates. He lingers over the wordsand deliv- ers the last lines with the precise touch of understatement. He learned that from his maternal grandfather, Gustav Anel. a Brooklvn tmsmith who used-to load young Charles on his wagon and wander about New York. Every summer Gustav took off for Nova Scona with Charles. an onlv child, by his side and they toured by horse and wagon. They would travel from town-to-town. stoppmg on the way to hop a dory bound for the lighthouses along the coast. On a good day they would hit two light- houses, and Gustav would pull out his five-string banjo to entertain the boat crews and the lighthouse kee- pers. GustavApeLaGerman-born. self- educated man, figures as the big- gest force in Koop's childhood. Koop's father, John. a New York banker, provided the money for Koop to venture off to Dartmouth and Cornell to further his education. But Gustav probably shaped the lad more than his parents when he took young Charles about New York on a horse- drawn wagon on tinsmithmg jobs. With his grandfather's determi- nation, Koop forced his way intopre- cisely the medical spot he wanted the day after Pearl Harbor. The way Koop tells it, his life "hung on that cobweb." Young intern Charles Koop was in the hospital, suffering from a pep tic ulcer on Dec. 8. 1941. That day his wife, Elizabeth, a Umversity of Pennsylvania Hospital secretary, overheard a conversation in her office. She phoned Koop to tell him that she heard Dr. 1. S. Ravdin, ctuef of surgery, was getting ready to take off for Pearl Harbor to doctor the wounded. Bad news. Kwp had been talkmg with Ravdin about training with him and feared that Ravdm might never come back. "1 called the nurse and told her I planned to take a long sleep. I put the light out m my room, got dressed and sneaked out to catcha trolley to the university. I tried to see Dr. Ravdin.!but I was told he was busy I inquired what kind of car he drove, and I was told it was a blue Packard. "I went out and sat on the running board until he came out. I asked If I could ride downtown with him. We got on the middle of the South Street Bridge and I said. `Dr. Ravdin. I know you are gmng to Pearl Harbor tonight. I wonder what I should do about my future surgical trammg" "He had no wry of knowmg how 1 knew of his plans. He could enher thmk that I i&w somebody m the government hlrher than he did or that I had some supernarural under~ standmg In enter case. I was a force to be reckoned .wLth. lie said. `I wdl declare you esscnual 1" the urnvenrv tonrght and y"`~ may start as my resident on the 1st of July. When he came back from command of rhe 20th General Hospnal. he asked me If I would llks tea be sur@cal chief of the Chlldrell's :Iosp~tnl." Forty years after Pearl Herhor. the firat umc hoop ever ;vore ;I unl- form was the &Lay he took U.S. Surgeon C :ncrsl Kr,"p leader of rhe Comm ssiaoed Corps. 1s Reagan's spnkem,nn for hea!th care goalsandapoa :r wlthmthe Depart- mentofHeal:h md Iluma~iS~:r~:~ces. "Want to pu 5"methlr.g m your "suer that nob )dv has said? One of . the first thinc J &rgeon General Koop dtd wher: he got ,nt" uifxe. in slxte "fall rhe ihmgs that have &en said about tns ?o"r atrltude toward women. was tc appomt a woman ns his deputy" The day aftr r Dr. Faye Ahdeliah wassworn ina: thefllst femaledep- uty Surgeon G< nerol, she gave Koop two penguins. Frptty xx" there were penguins sho\`mg up all over Ihe office, all bec&usr Koop told a Joke about pengums at her swearmg-m ceremony Koop's moo6 is anmxated svhen he tells the story He adjusts his bow tie as if he were loolcina into a mirror. and tosses auay his *seT,"us s:de. Another Koo;, reDeats the lake. describing h":v he'was asked-by a zoo in Philadei Jhia to hring t~ij" pen guins down to :he Nmonal Zoo. He was pressed R r time, so it goes, nnd Kooo asked Podellah to dr!je ihr penguins dow :. That m&t -- caich this, he sayys --- Koop saw Abdellab in downtown Washington and she still had the twa pengums m the from seat. "`I thought "ou were gomg tr; uke the penguins ;o the zoo.' I told her. She smd. `I did and they liked it so much we'regc,mg back agam :"mnr- row,"' Koog s .ys. Thc!e, Koop tells a reporter, "S ze wh3 I say I brmg a sense of hum ,r to 0115 oiiice!" Stdl. it 1s di ficulr for Koop to ;hs- pel his popular ~rnage ash morahz- ing preacher If a guy, hell-bent on sending wom.en and eavs back to the 19th cent\ ry Whet:& or net his mews have bee!: exaggerated. !Cwp provokesstr" lgenlot:ons:rrliiscr;t. its and hear: few political iigurcs rallying to hi sldc Just about the t!me K;III~ thought the furor OXL'~ his ant]-aborrlon stance had d.ed down. a group of femimst psycnoioglsts circulated a pamphlet argrily "r"te?txng his appearance z.t the Anicrlcao Psy- chologxal A~sociatroii (Jonventlon last August The group. the Assoc~a- tlon of Won: n PsvchoLx!sis. con- , -. vmced some ysych&~glsts toboycott a Koop speeci because ot his i',ews on abortion. women's rights and gay rlgilrs "I was really so naive that I didn't thmk the psychologxts would de- monstrate. I took the "ccaslon to jay how sorry I was that rhey had chosen that "ccaston to dig up a lot ai rhmgs that I thought werr burled. I thought that of all people, psycholo- gists should recogmze the Sltuallon that they put themselves In." After Koop retrenched from the attack bv femimst psychoioglsts. he ws tnkcn on by vlde" game manu- facturers last month Koopcharged that the olde" games produce "aber- ratlo"s in childhood behavior" because "ever)rhmg is el,mmate. kdl, destroy." 1Vherevrr Koop goes he b&eves hc IS bemg watched with a crItIcal eye He stood m for Vice President George Bush recently toaddress the h!nmrBarr\ssociat~on Before Koop spoke. the assoczxlon's president told the assembled dmner guests, "For those of you who are uncom- fortable because you are smokmg m rhe presence of the Surgeon General. let me tell you that he Just put a large dab of sour cream and three pats of butter on tus baked potato." Everyone laughed. Now here's the U.S. Surgeon Gen- eral, the man smd, opening up the floor to Koop. Koop turned to him and smd, "Sir, I would remind you that the government pays met" give advIce. not to set an example." Maybe It was the deadpan look or :he stern tone of his words that made :Co"p sound as If he were lashmg iout at the barassoclarion'spresident. In any case, the next day, Koop's rejoinder, mmus the Introduction, was carried over the wires. "I madealittlequlp toget backat tnm and look what happened. I'm gomg to eat my potato any way I like It" E:mugh already. Beyond the pota- toes ISSW does Koop b&eve that the Surgeon General really has any power' After all, President Nixon simply abolished the Job in 1973 when he was unable to find a candi- date and never bothered to appomt anyijnc. Then Resident Carter rem- staled the job, but there are stdl thnsem thegovernment who believe that the power of the Surgeon Gen- eral peaked m 1964 when the "smok- mg LS hazardous to your health" warning came out. "The Surgeon General doesn't have power He 1s m a position of exertmg moral Persuasion." Koop say?. adjustmg his thick. wire- rlmnied glasses He looks up and pauses when he 1s asked "what kmd"' "When the Surgeon General say5 don't smoke. that IS not power, [hat 1s speakmg from a poslrlon of knowledge about an issue that 1s good for the health of incbviduals." Ten years ago Koop kxked the habIt and gave up hrs pipe. Around K0op the au'1s usually clear of clga- relte smoke. but not always because eve~`~~ne lheeds the Surgeon Gen- eral's war-n,ng Cont'd on next page from previous page `It 1s a" mrorestm~ thmg that very often people who do smoke don't smoke around me or they feel un- comfortable. I gave a talk at an unnamed place once and somebody mentlooed that practically nobody was smokmg in the room. Then somebody said, `Yes, but did you try to go to the ladies room?' I hardly ever go into the ladies room so I didn't know." There is no trace in Koop's voice of the lad who grew up in Brooklyn's Flatbush district. He once orated about morahty, the way one Imag- ines his Dutch colon~sf ancestors talked \\4len the!- settled I" ttus coun- try m 16YO. On a promue to Health and Human Services Secretary Richard Schawker, Koop agreed ro no longer stand on the pulp\t and talk about the ends of abortion. Crusader Koop's strong beliefs crystahzed one Saturday afternoon m 1976 He was trying to unwmd afteroperalmg to save three prema- ture Infants who welghed together less than 10 pounds. He has told asso- elates how he sat wth lus residents and realized "this is what we were put here for." He went home and wrote "The Right to Live; the Right to Die" m a day. Koop became an anti-abortion misslonarv of sorts. creating a multi-media crusadk called "Whatever Happened to the IIuman Race?" that he took to 20 ciues m 1979 He offered moral and me&A altrrnat~ves to aboruon. :vh:ch Koop described as carnage. Although Koopusuallyavoidsrhe wbJec1 of aborrlon today, he offers a reporter a record of "Whatever Haooened to the I iuman Race?"and telis'how it records the sound of a baby ma womu. Hu manner is that of a doctor handing out a presdrip- non to a patlent as she leaves the offxe. Thirty five years ago when Koop began pracrwmg, he was only the swh doctor," the country to devote hts surgical practu to pediatrics, compared to more than 500 pediat- TIC ~urgeo~e , is xL:q In 1 he early days there was a 95 percent mortality rate m opcrat~sns on newborns, vastly differenr than the 95 percent surv~vnl rate today. Koop success- fully oner,tcd on Siamese twins three ilmes. perhaps a medical record "I ha\? had ,m!: career and it has heen a successful one. well recog- mzed. I don't have to prove anythmg and I don't know how I wll feel then about retrrmg I`ve never felt better I absolutely t&l no different than 1 did when I was 45." And yet Koop has changed. He 1s outslde the operatmg room, a place where his expertise was unques- honed. and stdl searching for a sound level to be understood as U.S. sur- geon general.