Sometimes people are not as they seem. That truth was confirmed after President Ronald Reagan made Dr. C. Everett Koop his surgeon general in 1981. A pioneering pediatric surgeon, he nevertheless appeared to have been picked mostly because of his conservative views and his strong, religiously inspired opposition to abortion.
At the time, liberals opposed his nomination and conservatives applauded it. Both groups ended up being surprised. Although he never wavered in his pro-life sentiments, Dr. Koop, who died at his home in Hanover, N.H., on Monday at 96, was both principled and pragmatic. He was not there to advance his own religious views; he did what scientific evidence demanded and public policy needed.
In the process, he became perhaps the best, certainly the best-known, surgeon general the country has seen. He saw a bully pulpit where others had seen only an obscure government post.
In making Americans listen, he relishing wearing the vice admiral's uniform that traditionally came with the job but that predecessors had shunned. His beard and striking presence made him seem like a cross between an Old Testament prophet and an avuncular family doctor.
He was to need an authority anchored in strong beliefs. His public health enemies were formidable. On his watch, he faced down the tobacco industry and the fear and denial accompanying the AIDS epidemic.
Offending political interests or prevailing social prejudices was not his concern. He was not afraid to warn of the disastrous public health consequences of smoking and when he left office the number of smokers was significantly down. He did not pull punches on AIDS either, scandalizing his critics by endorsing condoms and sex education as a means to fight the epidemic.
It is not an exaggeration to say that the lives of millions of people, some not yet born, have been and will be saved because of Dr. Koop's recommendations and influence. That is the greatest legacy any advocate for public health could have.