In a pandemic crisis calling out for bold leadership and sound scientific guidance, the U.S. needs to hear from a health care expert who commands the respect of the country. Our current surgeon general, Dr. Jerome Adams, a Trump appointee who continues to defend the misinformation the president is spreading, has been slow to acknowledge COVID-19’s severity. His public profile has been eclipsed by that of Dr. Anthony Fauci, the longtime director of the National Institute of Allergies and Infectious Diseases, but even Dr. Fauci’s effectiveness has been hampered when trying to share truths in news conferences while standing behind others offering lies – and now it seems he’s been marginalized even further.

Dr. Fauci, early in his career, worked closely with a true hero of American medicine: Dr. C. Everett Koop, the very visible, very courageous U.S. surgeon general in the early years of the HIV/AIDS epidemic. At that time, the sense of panic was similar to what we’re experiencing with COVID-19. It took President Reagan four years after AIDS was first identified in the U.S. in 1981 for him to even mention it in public.

Into this dangerous vacuum of leadership stepped Dr. Koop, becoming the go-to expert for guidance on the epidemic; he was effective because of his ability to articulate the scope of the problem, his refusal to downplay it and – not least of his assets – a self-dramatizing theatricality that got the press on his side. The U.S. surgeon general has little real power, but relies instead on using the bully pulpit of the office to get out their message – and this, Koop did brilliantly.

He understood the importance of sharing accurate information about AIDS with the public, yet was working under an administration that nearly fired him for having the temerity to want to save lives. They insisted that the science-based strategies for which he advocated – wearing condoms; using clean needles – would condone homosexuality and IV drug use. His bravest, most effective action, one he developed with Dr. Fauci’s help, was mailing a pamphlet to every one of the 107 million households in the U.S., outlining strategies to prevent the transmission of HIV.

Words he said then still bravely resonate.

“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. So I can tell you how to keep yourself alive, no matter who you are. That’s my job.”

I have my own connection to Dr. Koop. In 2012, at age 96, he was living in Hanover, New Hampshire, not far from where I grew up. I contacted him, not expecting to hear back, to ask for an interview in researching my undergraduate senior thesis on the role of the surgeon general in American life. Though in failing health, he generously consented, and I spent the most interesting, inspiring 30 minutes of my life sitting on the couch next to him at his home, soaking up every word.

I ended the interview by telling him how much learning about his role in the AIDS crisis had influenced me in my hopes of eventually becoming a doctor myself. He responded, “You can do it, Matt – if you have the desire, the compassion and the integrity.”

Dr. Koop passed away a year later, but as I see my first patients with COVID-19 at the hospital where I work, it’s his example that I’m drawing upon for strength. If he were surgeon general today, he would be the one we’d go to for guidance – scientific guidance, brave guidance, guidance without even the suspicion of a political bias.

“STAY HOME!” he would probably say, in that deep, sonorous voice there was no refusing, his eyes a mix of compassion and severity above that famous Lincolnesque white beard. “SAVE LIVES!”

Simple as it is, Dr. Koop’s prescription, his exhortation, his example, will indeed save lives, if we in this country are smart enough to follow his advice once again.

 


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