C. Everett Koop, former surgeon general, dies


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C. Everett Koop, the former surgeon general of the United States who started the government?s public discussion of AIDS during the Reagan administration, died Feb. 25 at his home in Hanover, N.H. He was 96.

A spokeswoman for the C. Everett Koop Institute at Dartmouth confirmed his death but did not disclose the cause.

Dr. Koop was the most recognized surgeon general of the 20th century. He almost always appeared in the epauleted and ribboned blue or white uniform denoting his leadership of the commissioned corps of the U.S. Public Health Service. With his mustacheless beard, deep voice and grim expression, he looked like a Civil War admiral or, as some cartoonists suggested, a refugee from a Gilbert and Sullivan musical.

The theatrical appearance, however, masked a fierce self-confidence, an unyielding commitment to professional excellence, and a willingness to challenge the expectations of his patrons.

A 64-year-old retired pediatric surgeon at the time Ronald Reagan nominated him in 1981, Dr. Koop had no formal public-health training.

Dr. Koop, however, believed information was the most useful weapon against HIV at a time when there was little treatment for the infection and widespread fear that it might soon threaten the general population. In May 1988, he mailed a seven-page brochure, ?Understanding AIDS,? to all 107 million households in the country.

?He was a guy who surprised everybody,? said Anthony S. Fauci, director of the National Institute of Allergy and Infectious Diseases, who was Dr. Koop?s chief tutor in AIDS matters and became a close friend. ?People expected one thing and they not only got another thing, they got someone who was amazingly effective.?

Among AIDS activists Dr. Koop became an unlikely hero, although some came to think that his sexually explicit talk tended to further stigmatize gay men.

Dr. Koop was also a tireless campaigner against tobacco. As surgeon general, he released a report in 1982 that attributed 30 percent of all cancer deaths to smoking. He wrote that nicotine was as addictive as heroin, warned against the hazards of secondhand smoke and updated the warning labels on cigarette packs.

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Dr. Koop was probably one of the best Surgeon Generals we 've had for a long time, talking about HIV when many didn't want to. He only got into trouble with activists when he noted (correctly) that anal sex was a major disease vector. Not PC at the time. OTOH, he started the modern "war" on tobacco and championed pediatric health issues (he was a pediatric surgeon.)

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