Lecture February 7,1989 18/17 Address BY C. Everett Koop, MD, ScD Surgeon General Of the U.S. Public Health Service U.S. Department of Health and Human Services Presented to the Chapel of the Four Chaplains Philadelphia, Pennsylvania February 7,1989 The Chapel of the Four Chaplains is part of the history and the lore of the city in which I made my home for forty years before going to Washington. I might have been born in Brooklyn but my length of stay in Philadelphia, I think, qualifies me to be a Philadelphian. The Chapel is a tribute to four Navy chaplains of different faiths or denominations who willingly gave their lives that others may have their means of rescue when their ship went down in the course of the Navy's activities in World War II. I had been asked to come and be a recipient of their Legion of Honor Gold Medallion. I felt honored but also surprised and pleased to discover that I had known nine of the previous recipients, personally. They were all men and women who showed great personal courage in their lives and who dealt with their fellow human beings from a strong moral base. I was proud to be counted among them. The two that I knew that most people knew about, at least, were John Cardinal Kroll, and Bob Hope. (As I write this, the nation is mourning the death of Bob Hope. He died three days ago in the second week of his 1 OOth year of life.) I reminded the audience that I came from that city where I was a surgeon for four decades which was something that I had wanted very much to do. The memory of those years was a great source of personal satisfaction and pride. But I also was asked to be on the platform on this occasion because of things I was suddenly required to do -- whether I wanted to or not-in my role as Surgeon General. I acknowledged how much Philadelphia and it's people had changed me. Chief among them I would list the children of Philadelphia and for the past 8 years, the children of this country and of the world. Throughout my career in pediatric surgery in Philadelphia, I was taught some valuable lessons by children-lessons of hope, optimism, charity, good humor and heroism. 1 My feelings of gratitude and indebtedness to children has certainly been part of my motivation to continue to work on behalf of handicapped children, those with physical and mental deficits of one kind or another, children who are victims of abuse and neglect, youngsters who have been physically criminally assaulted, and on behalf of the newest category of child victims, those who have become the innocent victims of the plague of AIDS. I'm not only happy that I was able to do things for children but also pleased that, especially during the past 8 years when I had the privilege of being Surgeon General, I also did things that I m to do because I was where I was at the time. I briefly mentioned " Baby Doe" and " Baby Jane Doe" in passing, two children I never knew but who preoccupied my life for two full years. I'm glad I had that opportunity. And that's also the case with AIDS and with my review of the literature on abortion at the request of President Reagan. I don't think anyone enters government service hoping to be torn apart by enormously complex human experiences. One doesn't usually ask to serve where she or she knows that there is a real threat to the survival of one's moral code, much less personal and professional reputation. Then, of course, it was on my watch that the time arrived for us to go on a full offensive against the tobacco industry. I'm not a very good judge of my own performance and to be honored by the Chapel of the Four Chaplains, indicates something about Philadelphia's appraisal of my performance. Folks say that my adversarial position with the tobacco industry took a lot of courage. That may be so, but I do know it has something to do with anger. I'm speaking of my own anger at the arrogance, insolence, audacity, and the sheer brass of an industry that is abkem in our free market place, to pursue greater profits through sales of a product that is by every scientific standard, is a clear and present danger to the health of mankind. I do know if I hadn't risen to the occasion it would have been an indication of cowardice. The same is true for AIDS. I have been greatly criticized for the blunt and truthful way in which I have talked about high-risk sexual behavior and drug abuse behavior. But we are talking about those things now and we're doing so because we have to in order to save lives. In addition to things I've mentioned about learning, I also have been taught a great deal by the adversaries I've met, while serving as your Surgeon General. The main thing they taught me was that I should do everything in my power to make sure they don't win. 2