The Missionary Doctor

After a career of nearly 30 years as one of the nation's leading pediatric surgeons, Dr. C. Everett Koop was nearing retirement age in the mid-1970s when he decided that the fight against abortion was as important as the effort to save lives on the operating table. A devout evangelical Christian, Koop poured out his prolife passions in two books, five educational films and a nationwide lecture tour. His style of argument was anything but dispassionate: in one film segment, Koop looked over a sea of naked dolls symbolizing aborted fetuses, and proclaimed, "I am standing on the site of Sodom, the place of evil and death."

This prolife pedigree prompted Ronald Reagan to nominate Koop as Surgeon General in 1981. For eight months the appointment was held up in Congress as liberals challenged Koop's views, his zealotry and his public-health credentials. When Koop finally won Senate confirmation, few expected him to limit his public advocacy to health warnings on cigarette packs.

Today Koop, 70, is as controversial as ever, but the same proud passion and idealistic intensity that once endeared him to conservatives now enrage right- wing activists. This sea change stems from a single cause: the politics of AIDS. The Surgeon General is the Administration's leading advocate of the view that sex education is the most effective way to limit the AIDS epidemic. Beginning with a controversial report to the President last October, Koop has insistently argued that candor and condoms are more effective public-health tools than sermons on chastity. Last week Koop was the lone Administration dissenter from a plan for widespread AIDS testing. His argument: "I don't think anyone should be forced to have a test, in view of the stigma that goes along with AIDS these days."

, A tall (6 ft. 1 in.) bulky man with a Captain Ahab beard and a stentorian voice, Koop recognizes that his largely symbolic job as the nation's top public-health official provides little more than a bully pulpit. "Anything I've done in the five years I've been Surgeon General," he explains, "has been with moral suasion and borrowed money." His crusades have ranged from a call for a "smoke-free society by the year 2000" to militant advocacy of the rights of deformed infants. Koop, who delights in the gold braid of the traditional Surgeon General's uniform, has also promoted some idiosyncratic causes: he recently tried, with only partial success, to revive moribund regulations requiring most members of the Public Health Service to wear their military-style uniforms on duty.

Nothing Koop has attempted in office has been nearly so divisive as the current AIDS debate. Former liberal critics, like California Democratic Congressman Henry Waxman, now say they were wrong in their initial assessments of Koop. But erstwhile conservative allies, such as Paul Weyrich and Phyllis Schlafly, have mounted protests charging that "Koop's proposals for stopping AIDS represent the homosexuals' views, not those of the profamily movement."

Right-wing opposition marred a Washington testimonial dinner for the Surgeon General last month: eleven original sponsors boycotted the Koop dinner, including G.O.P. presidential contenders Senator Robert Dole and Congressman Jack Kemp. With pickets marching outside the dinner and demanding his ouster, Koop took pains to thank those who risked the wrath of the right by attending. "There has never been a time in my life," he said, "when I wanted or appreciated such a show of friendship." Of his former allies, Koop complains, "They don't listen to what I've said, but they criticize me about what somebody told them they think I've said. I find that discouraging."

As surgeon in chief at Children's Hospital of Philadelphia, Koop won renown for his record in repairing birth defects, including dramatic work separating Siamese twins. Ever since he and his wife Elizabeth embraced evangelical Christianity in the 1940s, Koop has seen a clear connection between medicine and morality. It is a vision that animates his mission as Surgeon General. "I don't think you can ever separate your religious, ethical or moral values from the way you do your job," says Koop. "There are social opportunities and obligations that go with sharing one's religion, such as the compassionate care of the sick."

In the weeks ahead, Koop may have to weigh his own ethical imperatives against the political demands of Administration policy on AIDS. Koop does not promise silence, but suggests he will bow to the will of the President: "I'm a health officer, and I have to support the law of the land. That's my job." It is a job that will only become more arduous as America struggles to contain the AIDS epidemic.