His nomination nearly six years ago was one of President Reagan's most bitterly contested. His opponents called him a right-wing, religious, anti-abortion zealot with no public health experience. Attacking him incessantly, they charged that he would use his public office to preach his own conservative social agenda--hardly appropriate behavior for the surgeon general of the United States. Editorial writers around the country urged the White House to "dump Koop."
His prior activism came back to haunt him: the 1978 pro-life film in which he appeared in a desert, surrounded by dolls who symbolized all the babies not born because of abortion; his description of amniocentesis, a test to detect fetal abnormalities, as "a search-and-destroy mission"; his labeling of homosexuality and single parenthood as "anti-family."
His detractors in Congress, led by Los Angeles Democrat Henry A. Waxman, chairman of the House Energy and Commerce subcommittee on health, held up his confirmation for nearly a year. During that time he would come home every night, discouraged, to the cramped apartment he and his wife had rented in Washington once it became apparent that the process was going to drag on indefinitely. He would show her that day's scathing editorials and suggest they abandon the battle.
"I can't take any more--I don't know what we're doing here," he would say. "Let's go home to Philadelphia." And she would reply: "Let me remind you--you're unemployed in Philadelphia. Let's stick it out." Betty, his wife of 48 years, says today: "I thought he could never live with himself if he gave up."
It would be out of character for Charles Everett Koop ever to abandon anything he has set out to accomplish. Koop is an imposing 6-foot-1, 206-pound figure with a booming voice, an intimidating demeanor and the same kind of neatly trimmed, square-cut beard favored by his Dutch ancestors. He is the first surgeon general in years to actively encourage the wearing of uniforms at the Public Health Service, an act he has described as "a real morale booster." And on Wednesdays, which he has dubbed "uniform day," he looks like a captain ready to put out to sea, resplendent in his gold buttons, braids and ribbons.
Today, well into his second four-year term as the nation's surgeon general, he has surprised almost everyone. A Presbyterian with strong moral convictions, he continues to speak out against abortion and in favor of protecting the rights of handicapped children. And he has made enemies as the chief defender of the Reagan Administration's controversial "Baby Doe" regulations, which brought the federal government directly into cases involving the treatment of deformed newborns.
Despite earlier concerns, however, he has not used his public platform to wage a campaign against abortion. "I don't have any authority to change the law," he says. "I haven't changed my position--I've always been hard-line on abortion--but I have extraordinary compassion for those who have to make those decisions. I'm just glad I'm not an obstetrician."
And, by launching a tireless crusade against cigarettes, Koop has become the most activist surgeon general on this issue in history and one the tobacco lobby has grown to fear and resent. He travels the country to promote his idea of a smoke-free society by the year 2000, speaking endlessly on the health dangers of cigarettes and smokeless tobacco. Declaring tobacco public-health enemy No. 1, he has become an adamant fighter for the rights of nonsmokers and an eloquent spokesman for the plight of the cigarette-addicted. "There's nothing tougher than to give up smoking," he says.
Most recently, he has taken on a new assignment. The White House has asked him to write a report to the public on AIDS, the invariably fatal disease that cripples the immune system and leaves the afflicted individual helpless against cancers, neurological disorders and ravaging infections. Reagan hopes that a report bearing the surgeon general's name will calm public fears over the disease and prove to be a watershed event in public thinking about AIDS, much as the first report on smoking by an earlier surgeon general has defined that issue since the 1960s.
Finally, even Koop's detractors have begun to recognize that his intense feelings on abortion were not lifted verbatim from a right-wing primer. Rather, Koop seems to have developed them--and his views on handicapped children--over more than three decades as a pioneer in children's surgery at Children's Hospital in Philadelphia.