As the Surgeon General of the United States for seven years under Ronald Reagan and George H.W. Bush, Koop — who actually was a surgeon — didn’t have a lot of power. But he considered his role to be “the health conscience of the country.” As an evangelical Christian, he promised Congress during his confirmation hearing that he wouldn’t use his position to promote religious ideology — and kept his word. A former smoker, Koop railed against smoking, and in 1984 challenged Americans to “create a smoke-free society in the United States by the year 2000.” He released eight reports on the health consequences of tobacco use, including the first on the consequences of “second hand” smoke exposure. And he listened to his conscience: he shocked his conservative supporters by suggesting condoms for “safe sex” to halt the spread of AIDS — and defied Reagan and mailed a pamphlet about AIDS to every U.S. household possible, which still holds the record for the largest public health mailing ever. Koop also advocated sex education in schools for kids as young as in the third grade.
In 1996, Koop publicly chastised Republican presidential nominee Bob Dole, who suggested that cigarette smoking wasn’t necessarily addictive. Koop said that by saying that, Dole “either exposed his abysmal lack of knowledge of nicotine addiction or his blind support of the tobacco industry,” since “even tobacco executives know” that tobacco is addictive. And while personally against abortion, he refused a White House demand to issue a report showing abortion was “psychologically harmful” to women, because there was no scientific evidence to back the politically driven claim. (An underling released the report under Koop’s name, and Koop publicly disavowed it.) After retiring from his post in 1989, Koop pledged to “use the written word, the spoken word and whatever I can in the electronic media to deliver health messages to this country as long as people will listen.” He founded the C. Everett Koop Institute at Dartmouth “to enhance our understanding of mental and physical health and the prolongation of a high quality of life.” Dr. Koop died at his New Hampshire home on February 23, apparently from kidney failure. He was 96.