WASHINGTON – C. Everett Koop, the former surgeon general of the United States who started the government’s public discussion of AIDS during the administration of Ronald Reagan, died Monday at his home in Hanover, New Hampshire. He was 96.
A spokeswoman for the C. Everett Koop Institute at Dartmouth confirmed his death but did not disclose the cause.
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 Reagan nominated him in 1981, Koop had no formal public-health training. His chief credential was that he was a socially conservative, devout Christian physician who had written a popular treatise against abortion. His confirmation took eight months. Few people expected him to talk about homosexuality, anal intercourse, condoms and intravenous drug use when almost nobody else in the Reagan administration would even utter the word “AIDS.”
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 Fauci, director of the National Institute of Allergy and Infectious Diseases, who was 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 Koop became an unlikely hero, although some came to think that his sexually explicit talk tended to further stigmatize gay men.
“Most of us thought that a huge part of how the crisis grew exponentially was that those in power chose to ignore it for as long as they could,” recalled Peter Staley, a founding member of the AIDS Coalition to Unleash Power. “He was the only person in that administration who spoke the truth when it came to AIDS.”
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.
Michael Fiore, founder of the University of Wisconsin Center for Tobacco Research and Intervention, once said Koop’s reports on smoking “totally changed the landscape” of tobacco control.
He was among the last survivors of a small generation of U.S. doctors forced by World War II into highly responsible roles at very young ages. After the war, many became academic physicians and researchers.