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What caused the turnabout in C. Everett Koop's public image? The answer lies partly in the mass media's fundamental misperception of Koop, partly in Koop's skillful molding of an office to fit his strengths, and partly in what happened during the hellish nine months when he sat in a vacuous office with nothing to do.

If Koop's critics had looked more closely at his background, they would have seen he was no cardboard-cutout ideologue. His firm convictions were tempered by, and in fact formed by, human compassion. One of his closest aides explains, "What people didn't understand about Doctor Koop is that he is prolife in the purest sense of the word: not antideath, but prolife. I have seen him with thousands of people—malnourished children, Washington socialites, dying AIDS patients, abused wives, abortion-rights activists—and he treats every one of them as if he truly believes, which he does, that they are created in the image of God. He'll interrupt his busy schedule to meet with some disturbed person who insists on talking to 'the top doc.' He truly does respect the value of all human life."

Koop's strong stand on abortion had come about, after all, because of his experience with over 100,000 pediatric patients, many of them small enough to hold in one hand, many so deformed that no other surgeon would touch them. Over the years Koop had seen these babies grow into fully functioning adults with names, personalities, and individual histories: Paul, Koop's patient through 37 facial and abdominal surgeries, now a graduate of West Chester University; Chris, who required 15 operations to get his external heart in place and his lungs functioning adequately; Maria, for whom Koop fashioned an esophagus out of a section of colon and who went on to earn a Ph.D. and become a pediatric surgeon herself.

Something about the helplessness of tiny human beings had attracted Koop to the underdeveloped field of pediatric surgery. He had a soft spot for the weak and disenfranchised. And as he sat in his Washington office during the nomination hearings, for the first time he too felt weak and disenfranchised.

One by one, the various special-interest groups paid a call. Most knew little about him other than the hysterical reports they had read in the newspapers. But the prospective surgeon general who had no power and little hope had one commodity in plentiful supply: time-time to listen and to plan.

During that nine-month period, Koop heard diverse voices from all over the country. Some, such as the gay-rights advocates and the prochoicers, fiercely opposed his positions. But they too were part of the nation whose medical needs he would oversee. Koop now looks back on that period as a wonderful gift: "I had a chance to look at the health problems of the nation and wonder what I could do about them when I was finally let loose. I decided I would use the office to espouse the cause of the disenfranchised: handicapped children, the elderly, people in need of organ transplantation, women and children who were being battered and abused. During that nine months I developed a detailed agenda, something no surgeon general has ever had before. In the end, that period of acute frustration made possible every single thing I was able to accomplish in office. Now that's the sovereignty of God at work!"

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The Embattled Career of Dr. Koop