Remembering a giant
In late February, the Dartmouth community lost one of its most distinguished members with the passing of former surgeon general C. Everett Koop. Long after he left office, Koop remained the standard by which those who followed him as surgeon general are measured. In 1992, Koop returned to Dartmouth, where he had graduated from college in 1937, to found the Koop Institute. Over the past two decades, Joseph O'Donnell, an oncologist and a professor of medicine, had the chance to get to know Koop well. In this remembrance, O'Donnell recalls both Koop's intimidating persona and his warm embrace of his colleagues in the profession he loved.
Joseph O'Donnell is a professor of medicine and of psychiatry and the senior advising dean at Geisel. He is also the senior scholar at Dartmouth's Koop Institute.
I met Dr. C. Everett Koop several times before I first had a chance to sit and talk with him for an extended period of time. That chance came in 1991, when he gave the keynote address at the opening of our beautiful new medical center in Lebanon. He talked in his speech about how mothers could influence their children for the rest of their lives by getting them to do little things like brushing their teeth. He felt strongly that mothers and teachers together could use the same type of influence to get children to adopt other healthy behaviors, and that medical students could play a role as well.
After he spoke, we sat together during the dinner that followed and talked with Ann Bradley, a school nurse at a local elementary school. Using a dinner napkin, the three of us scratched out a plan for a program to develop age-appropriate K-12 health education lessons. In just a short time, many of our medical students began working with teachers in local schools. This idea, hatched on a napkin, had a profound effect on both our students and the children. It was a tangible example of Koop's creativity, vision, and love for children and medical education.
Koop came to Dartmouth to found the Koop Institute because he wanted to change medical education. He wanted to celebrate the lineage of the profession he loved by forming what he envisioned as a guild. Undergraduate premedical students would be welcomed and mentored by those further down the line, helped by medical students, housestaff, faculty, and wise "elders" such as himself. He wanted to build bridges between public health and medicine, attack some of the most vexing behavioral problems facing the nation, preserve rituals such as the physical exam, use the arts to teach the art of medicine, foster careers in service and advocacy, embrace technology without letting it detract from the doctor-patient relationship, and promote a sense of community among physicians.
I have many memories of him that show his commitment to pass on these values. One of my fondest occurred on his first day at Dartmouth. He walked across the lawn from his office with a limp. Spotting a number of students out in the fresh air on this sunny day, he approached them and said, "I want to test you. Watch me walk and tell me what is wrong with my gait." The students were petrified. Here was the former surgeon general—an intimidating presence—asking them a test question. I was nearby, and as Koop walked away the students asked me if I knew the answer. I wasn't sure myself, but I found out later that day when I had a meeting with Koop. He looked at me with a twinkle in his eye, winked, and said, "I have a blister on my big toe." It was then that I realized he had a great sense of humor. He wanted the students to like him and find him approachable. He wanted to be a part of their lives and to help them love medicine.
A later memory was of arranging for him to talk to a first-year class. I met him at the door and escorted him to the auditorium. I helped him take off his coat, only to find that it seemed to weigh about a hundred pounds. He had stuffed surgeon general's medallions into his pockets so that he could give one to each student personally. After he spoke, he took time to talk to every student and hand out his gifts.
Upon his death, tributes came in from a wide range of people whose lives he had affected—from prominent public figures to former patients. Some of these tributes reflected upon the many memorable statements Koop made over the course of his long career. He spoke the truth candidly and powerfully and was a hero for his courage to take on public health issues. A friend of his, Jack Henningfield, a professor at Johns Hopkins, recalled a speech Koop gave at his 90th birthday celebration in 2006, when he said, "My plea is that we enter this century striving for what is possible and obligatory from a humanitarian perspective, and that we view the right to health and well-being along with our most fundamental moral rights."
It was another quote that stood out for Julie Gerberding, former head of the Centers for Disease Control and Prevention, one that explained Koop's commitment to sometimes unpopular positions: "I am the Surgeon General of the heterosexuals and the homosexuals, of the young and the old, of the moral or the immoral, the married and the unmarried. I don't have the luxury of deciding which side I want to be on."
The world has lost a giant. Now it is our task to keep the legacy of C. Everett Koop alive here at Geisel in the institute that bears his name.
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