Thursday, February 28, 2013

The Julia Child of Public Health

My favorite C. Everett Koop story might be a fantasy of my own but that doesn't matter; there's a point to it anyway.

It's about Koop in a movie.  I can't identify it in his Imdb database (yes he has one) so it might have been a lookalike or I might have just made it up.  But still: it's some kind of blaxsploitation thingy from the 90s.  The gent is about to make his moves on the lady when the bearded gent with the bow tie and the gold braid  interrupts to remind him that (I quote from memory) "when you have sex with her, you are having sex with anybody she ever had sex with--and just to drive home the point, I've brought them with me here tonight."  Whereupon we get a parade that would do justice to a Shrine hospital fundraiser.  ("My brother?  You're my brother!--Hey man, you were away for the weekend...)  

And that's all I remember which may mean "that's when I woke up," though rarely are my dreams quite so funny.  Still, even if I did spin this thread out of my own gizzard (very unlikely) or was befuddled by a standin (more possible)--even it wasn't the man himself still, isn't that just the way we think of our late distinguished surgeon general--able make an emotional connection up there with the best of politicians. able to be funny without losing his dignity, able to deliver a health message with with a sense of urgency, yet without making himself a nuisance or a bore? 

Some would say I exaggerate; some will remember the notorious pamphlet he sent to every household in America warning against the risk of AIDS (here's the pamphlet).  Indeed he did ruffle some feathers.   In the pamphlet he talked about condoms and anal sex, and he said that homosexual males were more at risk than the general population.  But can you name any other politician so willing to touch so many third rails on public health--or even more, any who could have gotten away with it?   Koop was one of those rare individuals who could, in effect, say "I'm not a politician but..." and make you believe he really was just trying to speak the truth--and, bye the bye, that he had some warrant, by way of background or knowledge, for speaking as firmly as he did.

The corollary was the emotional connection: we came to see him as a person who really cared about  nothing so much as saving lives, or of removing the impediments against living life well. The attitude imbued his campaigns against AIDS, against tobacco (the other great hot-button issue), against abortion.

Abortion: for anyone who lived through the Reagan years, the story of Koop and abortion scarcely needs retelling.   He came into office as an avowed foe of abortion, yet used almost none of his political capital to pursue that issue.  Called to account, he seemed to try to finesse the issue.  He said he'd concluded that abortion was not essentially unsafe.  Having so concluded (he told the New York Times) "he had declined to speak out on abortion because he thought his job was to deal with factual health issues like the hazards of smoking, not to express opinions on moral issues."

I can believe there is a core of truth in that statement, but I suspect it needs context.  Koop does seem to have had a knack for dialing hot issues down.  And while I don't doubt that he maintained his personal aversion to abortion (he was, after all, a master at saving infant's lives), I wouldn't be at all surprised to find that he came to have compassion for women thrust into the awful choice, and unwilling to intrude himself into a private decision.

I said he was  the Julia Child of public health. Actually, that's too simplistic.  So far as we know, Julia Child had no enemies, none.  Koop had plenty of enemies--on abortion, on tobacco, on homosexual sex and whatnot.  But even the loudest opponents seem oddly blunted, considering the general nature of the debate on issues of this sort.  Maybe it was just political prudence--they felt the heat, even if they didn't see the light.  Whatever: in any event, it cleared the way for Koop to make his connection with America, and to deliver his message.  Maybe Julia Child is not the right comparison: maybe I should have said Oprah.

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