Thirty years ago, Dr. Koop, then the chief of surgery at Children’s Hospital of Philadelphia and one of the most brilliant pediatric specialists in the country, was nominated by President Ronald Reagan as U.S. Surgeon General. I was a fledgling reporter, in my first year at a newspaper. Two years after Koop (who went through one of the most arduous confirmation processes in history) was officially ensconced, I was assigned to a new and unknown beat — a disease called AIDS.
Soon, Dr. Koop and I would meet and he would remain one of the scientists I would interview repeatedly during the height of the AIDS crisis.
In 1983, I was one of the only journalists in the country covering the disease and the only woman. Over that decade, it was one of my primary beats, and I traveled the country writing about the disease and its myriad victims, the possibility of cures and the seeming endlessness of the deaths for an array of oulets that included the Village Voice, the Advocate, OUT, the Philadelphia Inquirer and Philadelphia Daily News. I was an AIDS columnist for both SPIN and POZ magazines. And of course it was at PGN that my AIDS beat began, and it was for PGN that I first interviewed Dr. Koop.
Throughout that astonishing decade of death and dying, a period that decimated the gay community, I sat across from Dr. Koop a couple dozen times, talking to him about the disease that was annihilating gay men, but which would quickly spread to women and children, IV-drug users and people with hemophilia. I stood with him at CHOP where he visited babies born with the infection as he explained that everyone was a potential victim of the disease — even babies. I listened as he told me — with a deep earnestness — that AIDS had to be stopped, that as he traveled the country he visited AIDS patients in hospitals and they were all, he said, “so very young.” Koop had treated desperately ill children throughout his career, but AIDS was a disease that went right to his heart, he told me.
I didn’t like Dr. Koop the first time I met him and I didn’t think he would do anything to help us. He seemed cold and clinical and so brusque, he was almost rude. He was a big man, and an imposing figure. He had insisted on wearing the actual Surgeon General uniform; he saw it as a military-style service to the nation: He was the general in charge of the nation’s health. He wore his uniform with authority, and had a 19th-century look to him, with his Lincoln-esque beard and his pince-nez glasses.
But as time passed and more people died and he thrust himself into the forefront of the AIDS crisis, Dr. Koop was anything but anachronistic. At a time when I was covering protests in front of the White House where AIDS activists were screaming, “Say it! Say it!” because the Reagan administration refused to acknowledge AIDS, at a time when police wore big blue protective gloves to handle protestors involved in die-ins, Dr. Koop was calmly explaining the science of AIDS as it was known then. And he was explaining it whether people wanted to listen or not. He was making predictions about the spread of the disease, about the millions who would become infected, about the generations who could die.
He was insisting that children be taught safe sex in the schools, starting in third grade. He was insisting that women practice safe sex with the men they were intimate with, even though the transmission to women seemed slight at the time (now the majority of new cases in the U.S. are among women). He explained that anal sex was a serious risk factor and why, and that oral sex, not so much. He talked about sex over and over and over again because it was the primary route for transmission and he knew it. He had his office publish a pamphlet about AIDS to be distributed to the entire country because he believed it was a pandemic that might never have a cure. He asked for more voluntary testing because he believed many people were infected who didn’t know it.
I have no doubt that many men and women I knew in those activist years would have little laudatory to say about Dr. Koop, and I understand that. The position we took then — those of us on the front lines of the battle against the disease — was hard and uncompromising. People were dying. Every day we would hear of someone else we knew who had gotten the diagnosis. In 1988, I stopped going to funerals because I couldn’t bear the pain and suffering any longer.
But I knew early on that Dr. Koop was one of us: He was an activist. He was a staunch pro-life evangelical Christian and he believed every life had a God-given worth. He was horrified by all the young men who were dying, as well as the children and hemophiliacs. He said this over and over again. He led symposia, he went out campaigning for education about the disease around the country. He was a crusader against the disease. He was doing what we were doing; he was just doing it from one of the most prestigious bully pulpits in the world.
Every time I asked to speak with him, he made time because he was committed to answering my questions. He wanted to talk to his hometown gay newspaper because he wanted to get the word out, to address the community most impacted by AIDS. Dr. Koop sat across from me at Penn and said succinctly that he was committed to stanching the hemorrhage that was AIDS in our community. While everyone else was making moral judgments that designated some people innocent victims and others moral pariahs, Dr. Koop kept going back to science. No one wanted to be infected, he asserted. The virus doesn’t discriminate, why should we? We had to stop the transmission: Get condoms out there — in the schools, in the homes, in the bars and use them. He was the single loudest proponent of safe sex in the nation. He told me that every child should know how to use a condom by the third grade. This was the kind of statement that was anathema to the conservatives who had pushed for his appointment.
Still, there are those who will say that Dr. Koop didn’t get involved soon enough. But the reality is, no Surgeon General before or since created more controversy with the people who put him in office. The conservatives who had championed his nomination were immediately dismayed by his focus on AIDS and his insistence on science rather than morality. What they didn’t understand was that the man they had nominated for his unwavering pro-life stance was just doing what they had wanted him to do: saving lives. When Dr. Koop wrote his AIDS pamphlet, he refused to make changes the Reagan Administration requested: He would not take out references to condoms and he would not insert commentary on homosexuality. He had 20 million copies distributed nationwide.
The strength of Dr. Koop’s voice and his drive to educate people about the science of the disease were vitally important in the fight against AIDS. Dr. Koop fought for us, even as he was being asked to fight against us. He put science above ideology and integrity above politics. In the end, he was one of us.