Warning: the Surgeon General may be good for your health.

• Author: Glastris, Paul
• Position: C. Everett Koop reports on AIDS

WARNING: THE SURGEON GENERAL MAY BE GOOD FOR YOUR HEALTH

In 199 C. Everett Koop, an anti-abortionactivist who believes so passionately in "the sanctity of life" that a colleague once said "he would ventilate an amoeba," faced an excruciating choice. A set of Siamese twins had been brought into Philadelphia's Children's Hospital, where Koop was chief of surgery. The twins were joined at the chest, sharing one-and-a-half hearts, which could support only one child. The choice was between doing nothing and having two deaths, or through surgical separation, killing one so the other might live.

Koop waited 11 days as the girls' parents, froma deeply religious Orthodox Jewish family, discussed the issue with rabbinical scholars for hours each day before making a decision. For Koop the decision was easy. "It took me about ten minutes after I knew all the facts to make up my mind about what should be done," Koop recalls. He recommended surgery. When it came time to tie off the carotid artery feeding the brain of the infant who would die, Koop, zealous defender of infants and the unborn, did the job himself.

A decade later, Koop, now surgeon general ofthe U.S. Public Health Service, made another remarkable medical decision. Last October 23, he released his now-famous report on AIDS. Some had feared that the intensely religious koop might use the occasion to moralize about the disease's wicked causes. Even the most knowledgeable outside observers had expected the kind of vague and euphemistic warnings about AIDS that Health and Human Services (HHS), under its conservative management, had been offering. Instead, Koop was compassionate and extremely frank. "It is time to put self-defeating attitudes aside," Koop announced at the news conference that day, "and recognize that we are fighting a disease, not people." Without embarrassment, he advocated the use of condoms. He denounced ideas, popular among many of his conservative friends, about quarantining AIDS victims. Most shocking of all, he called for an intensive program of sex education, beginning "at the lowest grade possible."

Conservatives were furious. They had supportedKoop for surgeon general in 1981 over the fierce opposition of liberals, believing that his strong conservative views would guarantee a politically correct public health policy. Now they felt betrayed. The Washington Times called for him to shape up or resign. Reagan administration officials in the Department of Education protested elements of Koop's call for sex education. "The very people who supported me in my tough times of '81," Koop says, "arethe people who don't seem to understand what I'm trying to say."

Today it is the liberals who appreciate whatKoop has to say. Somehow, the integrity of the man--his willingness to make the medically correct decision, not the politically correct one--had eluded them in 1981. Back then, he seemed a right-wing crank, an intolerant right-to-lifer whose reactionary views on abortion, homosexuality, and religion made him incapable of serving the larger public interest. Now, Senator Ted Kennedy, who led the Senate opposition to Koop's appointtment, applauds Koop's activities on AIDS and his vigorous campaign against both smoking and cigarette companies. And Rep. Henry Waxman, Koop's most bitter enemy on Capitol Hill in 1981, is now his biggest fan. "I just have the very highest regard for Dr. Koop," says Waxman. "He's a man of tremendous integrity. He's done everything a surgeon general should do, and more, to protect the health of the public."

House arrest

Koop came to Washington in 1981 with thereputation of being one of the finest pediatric surgeons in the world, but it was as an anti-abortion crusader that he was best known. He had sat on the boards of three national right-to-life groups and was one of the movement's major theorists. In a series of books and articles he wrote in the seventies, Koop propounded the theory that society's tolerance of abortion leads directly to tolerance of infanticide and euthanasia, first of congenitally deformed infants and the consenting terminally ill, then of babies with the wrong skin color or the elderly who have become too much of a drain on the pension fund.

In the late seventies, Koop toured the countrywith a lavish multimedia show he co-wrote, narrated, and starred in. The show's centerpiece was the film series, "What Ever Happened to the Human Race?" Shot on 50 locations in five countries at a cost of $1 million, the film is particularly famous for a scene in which a thousand black and white dolls lie scattered on the salt wastes of the Dead Sea, a gruesome representation of the six million abortions said to have been performed in the U.S. since the 1973 Supreme Court ruling legalized the practice.

To the right-to-life movement, Koop was a heroand a chip they wanted cahsed in when Ronald Reagan took office in 1981. In February of that year the administration slipped him into HHS as deputy assistant secretary of health, a job that doesn't require Senate confirmation, with the idea of bumping him up to surgeon general as soon as possible.

The surgeon general's post carries littlestatutory authority. Koop would be largely held on a leash by his superior, the cautious, conservative assistant secretary of health, Dr. Edward N. Brandt Jr. The sharp-eyed in Washington saw this as an early sign of the new administration's strategy of placating the far right while steering a more moderate course on social issues. But Democrats, already panicked over the prospect of Kesse Helms loose in a Republican-controlled Senate and an anti-abortion president...