REMARKS

TRUMAN AWARD

INDEPENDENCE, MI

MAY 6,199O

C.EVEREti

.


GREETINGS, ETC.


IT US TRULY AND HONOR FOR ME TO BE WITH YOU TODAY, TO


HAVE BEEN DESIGNATED AS THIS YEAR'S RECIPIENT OF THE

TRUMAN AWARD. THIS IS AN HONOR AND OCCASION THAT I

SHALL CHERISH.

I AM PARTICULARLY PLEASED THAT YOU HAVE CHOSEN TO GlvE

THE AWARD TO A MEDICAL DOCTOR, TO SOMEONE WHO HAS

DEVOTED HIS PROFESSIONAL LIFE TO THE HEALTH OF THE

AMERICAN PEOPLE.


IT IS ALSO APPROPRIATE THAT YOUR AWARD RECOGNIZE THE

CONTRIBUTIONS OF A HEALTH PROFESSIONAL, BECAUSE IT IS IN

THE FIELD OF HEALTH THAT OUR SOCIETY FACES ITS MOST


CRITICAL CHOICES IN THE YEARS AHEAD.


I APPRECIATE THIS AWARD IN A SPECIAL WAY, BECAUSE I OFTEN

THOUGHT OF HARRY TRUMAN WHEN I FIRST WENT TO

WASHINGTON. AFTER ALL, PEOPLE USED THE SAME WORDS TO


DESCRIBE TRUMAN AND ME WHEN WE FIRST ASSUMED OFFICE.

ONE OF THE PHRASES THAT COMES TO MIND IS "UNIQUELY UN-

QUALIFIED."

BUT I THINK WE BOTH PROVED OUR CRITICS WRONG. THE

PEOPLE WHO YELLED, "GIVE HIM HELL, HARRY!" SAID TO ME,

n

"SOCK IT TO `EM, DOC!"


FAR FROM BEING AN UNQUALIFIED HABERDASHER, HARRY


TRUMAN WAS MORE WELL-READ IN AMERICAN HISTORY THAN


ANY PRESIDENT IN MEMORY.                                 .


AND HE USED THAT KNOWLEDGE TO LEAD THIS NATION


THROUGH SOME OF ITS MOST TRYING YEARS.


THE EVENTS OF THE LAST YEAR IN EUROPE DO MUCH TO


CONFIRM THE THRUST OF HIS LEADERSHIP.


I WISH I HAD KNOWN HIM PERSONALLY.


IN A SIMILAR WAY, I TRUST, THIS PHILADELPHIA CHILDRENS

SURGEON PICKED UP ENOUGH SAVVY TO BE FAMILY DOCTOR TO

THE NATION AT A TIME IT NEEDED A PHYSICIAN.

HARRY TRUMAN PRESERVED AND EVEN ENHANCED THE OFFICE

HE INHERITED AND THEN WON ON HIS OWN. I TRIED TO DO THE

SAME, TO GUARD ZEALOUSLY THE INTEGRITYAND THE

OPPORTUNITY TO EXERT MORAL SUASION FROM THE OFFICE OF

SURGEON GENERAL.


TRUMAN ALSO KNEW THE VALUE OF NO-NONSENSE PLAIN TALK

AND DIRECT ACTION. I GUESS I'VE BEEN ACCUSED OF THE SAME.

I MAY HAVE HAD THE REPUTATION FOR STRAIGHT AND FRANK

TALK, BUT BELIEVE ME I NEVER SHOT FROM THE HIP.


I AM NOW IN THE FIRST FEW MONTHS OF M.-Y LIFE IN THE

PRIVATE SECTOR,.... WHERE I PLAN TO CONTINUE MY CONCERNS

AS A PUBLIC SERVANT. PUBLIC SERVICE, FOR SOME OF US, IS A


REWARD IN ITSELF.


BUT FOR ME, PUBLIC SERVICE, WITH THE APPRECIATION AND

GRATITUDE I HAVE RECEIVED FROM THE PUBLIC, IS ALSO


SOURCE OF HUMILITY AND DEEP PERSONAL SATISFACTION.


THIS AFTERNOON, THEN, I'D LIKE TO TALK A LITTLE ABOUT

CITIZEN C. EVERETT KOOP, AS HE PARTICIPATED IN ONE CORNER

OF THE AMERICAN NATIONAL GOVERNMENT OVER THE PAST 8

YEARS.

BUT LET ME WARN YOU THAT THIS WILL NOT BE AN EXERCISE IN

"KISS-AND-TELL."  I DON'T FIND THAT BEHAVIOR TO MY TASTE AT


ALL.


ALSO, AS A PRACTICING SURGEON FOR NEARLY 40 YEARS, I STILL

CARRY THE INGRAINED HABIT OF NOT VIOLATING THE

CONFIDENCES OF A PATIENT. NOT THAT EVERYONE IN

WASHINGTON REQUIRES SPECIAL CARE . . . WELL, CERTAINLY NOT

EVERYONE.

BUT LET ME BEGIN.

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FIRST, I MUST TELL YOU THAT THE PRIVILEGE OF BEING

SURGEON GENERAL HAS BEEN THE MOST DEMANDING AND MOST

EXCITING POSITION I HAVE EVER HELD. I AM STILL GRATEFUL

TO PRESIDENT REAGAN FOR HAVING NOMINATED ME IN 1981 AND

FOR HIS W-NOMINATION OF ME IN 1985.

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YOU MAY REMEMBER, I'M SURE, THAT MY NOMINATION WAS

NOT WITHOUT SOME CONTROVERSY, WHICH IS PUTTING IT AS


DELICATELY AS I CAN. IN PRIVATE LIFE I HAD BEEN AN

OUTSPOKEN PERSON WITH VERY STRONG OPINIONS ON

IMPORTANT ISSUES. AND THESE OPINIONS -- AND MY AGE, 65 --

WERE USED AS ARGUMENTS AGAINST MY BEING THE COUNTRY'S

SURGEON GENERAL.

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THE CONGRESS AND MANY PEOPLE ACROSS THE COUNTRY

DEBATED THESE MATTERS FOR ABOUT 8 MONTHS. BUTI DID,

TOO.

I ASKED MYSELF IF I SHOULD -- OR COULD -- VOW TO BE A

CHANGED PERSON IN ORDER TO GAIN THE SENATE'S APPROVAL.

SHOULD I, FOR EXAMPLE, DEPOSIT MY RELIGIOUS BELIEFS

IN A BLIND TRUST?

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SHOULD I DONATE MY MORAL VALUES TO SOME WORTHY

CHARITY?

BEFORE MOVING TO WASHINGTON, SHOULD I PACK AWAY

MY ETHICS IN AN ATTIC TRUNK?

AND I SAID, "NO . . . NONE OF THE ABOVE."

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I TRULY BELIEVED THEN -- AND I BELIEVE NOW -- THAT THE

BEST APPROACH YOU CAN MAKE TO PUBLIC SERVICE IS TO

PROMISE TO GIVE IT EVERYTHING YOU HAVE . . . OF WHATEVER IT

IS YOU m HAVE . . . TO DRAW TO THE FULLEST EXTENT FROM

YOUR OWN STOREHOUSE OF KNOWLEDGE AND PERSONAL LIFE

EXPERIENCE . . . AND TO SQUEEZE OUT EVERY OUNCE OF GOOD

JUDGMENT, OF DEEP FELLOW FEELING, AND OF LOVE OF

COUNTRY.

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AS I SAY, THAT WAS MY APPROACH AND I THINK IT WAS AND

IS THE RIGHT ONE. BUT IT DOESN'T MAKE THE ASSIGNMENT ANY

EASIER. ON THE CONTRARY, THIS APPROACH MERELY MADE ME

MORE RECEPTIVE TO THE NEW INFORMATION THAT I WOULD BE

ABSORBING IN THIS POSITION.

  LIKE MANY OTHERS WHO ARE CALLED TO WASHINGTON, I


TOO FELT GREAT PRIDE IN BEING ABLE TO SERVE MY COUNTRY

. . . AND I TOO HAYE BEEN FORCED TO DISCOVER THINGS ABOUT

MYSELF AND MY COUNTRY THAT I DID NOT FULLY UNDERSTAND

UNTIL THIS EXPERIENCE.

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AND THAT'S PROBABLY THE PREMISE OF MY REMARKS

TODAY: THAT GOVERNMENT SERVICE FORCES YOU TO KNOW

MORE THAN YOUM KNOW -- EVEN MORE THAN MAY CARE TO

KNOW -- ABOUT THE WAY OUR DEMOCRACY WORKS . . . ABOUT THE

MOTIVES, GOOD AND BAD, OF YOUR FELLOW CITIZENS --

INCLUDING COLLEAGUES AND CLOSE FRIENDS . . . AND ABOUT

YOURSELF.

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I DO NOT BELIEVE YOU CAN TRULY PREPARE YOURSELF FOR

THE EXPERIENCE, BECAUSE I DO NOT BELIEVE YOU CAN REALLY

PREDICT HOW YOU WILL ACT IN A SITUATION AFFECTING THE

LIVES OF A FEW -- OR A FEW MILLION -- TOTAL STRANGERS.

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AND IN THE HEADY EXCITEMENT OF BEING CALLED BY THE

PRESIDENT . . . OF BEING FOLLOWED AROUND BY THE PRESS . . . OF

LATE-NIGHT CONVERSATIONS WITH POWERFUL SENATORS AND

CONGRESSMEN . . . WHEN ALL THIS IS HAPPENING, YOU CANNOT --

AT THE SAME TIME -- TRULY UNDERSTAND WHAT YOUR JOB IS

GOING TO BE LIKE.

YOU SIMPLY DON'T KNOW.

AND YOU DON'T DARE ASK.

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WHEN I WAS YOUR SURGEON GENERAL, I FREQUENTLY SAID

THAT I HAD NEITHER POWER NOR BUDGET. THAT WAS

CERTAINLY TRUE, FOR I HAD ONLY A TINY STAFF AND --IN

WASHINGTON TERMS-- A TINY BUDGET, ENOUGH TO KEEP ME IN

PAPER CLIPS AND PHOTOCOPIES.

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BUT I THINK I WAS ABLE TO ACCOMPLISH A LARGE AGENDA

SOLELY THROUGH THE POWER OF MORAL SUASION.

IN THE RIGHT HANDS, MORAL SUASION CAN DO MORE THAN A

BIGGER BUREAUCRACY OR A LARGER APPROPRIATION.

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I SUPPOSE HISTORY WILL LINK MY NAME, AND THAT OF EVERY

OTHER SURGEON GENERAL WITH SMOKING...AND THAT'S FINE

WITH ME.

AFTER ALL, DURING MY TENURE, SMOKING FELL FROM 33% to

21% OF THE POPULATION.

BUT I THINK MY NAME WILL BE INEXTRICABLY BOUND WITH

ANOTHER DEADLY AFFLICTION OF THE AMERICAN PEOPLE.

I'M SPEAKING, OF COURSE, ABOUT AIDS.

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AIDS COULD BECOME THE DISEASE THAT BREAKS THE SOCIAL

COMPACT IN AMERICAN SOCIETY.

THUS FAR, THE AMERICAN PEOPLE HAVE BEEN VERY TOLERANT

OF PEOPLE WHO GET SICK BECAUSE THEY DO SOMETHING THEY

VERY LIKELY KNOW IS NOT A SMART THING TO DO. HENCE,

WE'VE RELIED UPON GENERAL TAX REVENUES TO SUPPORT V.D.

CLINICS, ALCOHOLISM AND DRUG TREATMENT CENTERS, DIET

AND NUTRITION COUNSELING, FAMILY PLANNING, EMERGENCY

MEDICAL SERVICES FOR HIGHWAY TRAUMA, AND* SO ON.

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SOME OF YOU HERE TODAY NO DOUBT WILL EXPECT MEDICAL

TREATMENT FOR CONDITIONS ATTRIBUTABLE AT LEAST IN PART

TO YOUR OWN LIFE-STYLE DECISIONS.

IT'S HARD TO EXPLAIN THIS PUBLIC SUPPORT FOR

REHABILITATIVE MEDICINE IN A FEW WORDS, BUT I SUPPOSE IT

BOILS DOWN TO THIS:

THE AMERICAN PEOPLE KNOW THAT THE FLESH IS WEAK,

BUT THEY ALSO BELIEVE IN REDEMP'I'ION AND THEY'RE

WILLING TO HELP PAY FOR IT: SYPHILITICS CAN BE CURED

. . . ALCOHOLICS CAN BE RESCUED . . . HIGHWAY DAREDEVILS

CAN BE REFORMED . . ..PEOPLE

CAN ADOPT A MORE SENSIBLE DIET.

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BUT AIDS HAS ARRIVED ON THE SCENE AND HAS BECOME THE

FIRST SERIOUS WEDGE TO BE DRIVEN INTO OUR REMARKABLE

PUBLIC HEALTH COMPACT.

THE REASON, I'M SORRY TO SAY, IS SIMPLE ENOUGH TO

UNDERSTAND.

A PERSON BECOMES INFECTED WITH H.I.V. BY DOING THINGS

THAT MOST PEOPLE DON'T DO.

IF THE INFECTION DEVELOPS INTO AIDS AND A LIFE-

THREATENING CANCER OR INFECTIOUS DISEASE, A NUMBER OF

PUBLIC PROGRAMS ARE AVAILABLE TO PROVIDE MEDICAL CARE

AND CERTAIN SOCIAL SERVICES, ALSO.

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RIGHT NOW, SUCH CARE IS RUNNING ABOUT $20,000 TO $30,000

PER YEAR PER AIDS PATIENT.

THE AVERAGE LENGTH OF TIME A PERSON WITH AIDS RECEIVES

SUCH CARE IS 12 TO 18 MONTHS.

AND THEN THE PERSON DIES.

AFTER A PRODIGIOUS INVESTMENT OF PUBLIC FUNDS, THERE IS

NO RESCUE . . . NO REFORMATION OF CHARACTER:.. NO ONE IS

SAVED OR REDEEMED AND RETURNED TO SOCIETY, AS IS THE

CASE WITH THE OTHER AFFLICTIONS I MENTIONED, SUCH AS

ALCOHOLISM, OBESITY, AND DRUG-ABUSE.

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THIS DISEASE, THEREFORE, PRESENTS THE TOUGHEST

CHALLENGE YET TO THE AMERICAN CONCEPT OF PUBLIC

HEALTH.

THE ETHICAL BURDEN OF AIDS IS COMPOUNDED BECAUSE

YOUNG BLACK AND HISPANIC AMERICANS APPEAR AMONG THE

AIDS CASE REPORTS TWICE AS OFTEN AS THEY APPEAR IN THE

POPULATION GENERALLY. THE MINORITIES WITH AIDS TEND TO

BE POOR, UNINSURED OR UNDERINSURED, AND URBAN, LIVING IN

THOSE SAME MAJOR METROPOLITAN AREAS WHERE THE HEALTH

DELIVERY SYSTEMS ARE ALREADY STRAINED TO THE LIMIT.

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`,  ALREADY IN NEW YORK CITY WELL OVER 20% OF THE BEDS IN

HOSPITALS ARE FILLED WITH AIDS PATIENTS. IT IS SAFE TO SAY

HOSPITALS IN YOUR COMMUNITIES WILL FACE THIS PROBLEM

BY THE END OF THE DECADE, IF THEY ARE NOT ALREADY

STRUGGLING WITH IT.

POVERTY IS ONE OF THE REASONS FOR A HIGHER INCIDENCE OF

AIDS IN THESE MINORITY COMMUNITIES AND IS OFTEN LINKED

TO LIVING CONDITIONS REFLECTING EXISTING RACE AND

ETHNIC DISCRIMINATION.                               -I


WE CANNOT LET A NEW DISCRIMINATION BASED ON DISEASE BE

ADDED TO OTHERS.

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I FEAR A GROWING RESENTMENT .I.G?IN~:`R AL!L AIDS PATIENTS,

BUT AGAINST BLACKS AND HISPANICS IN PARTICULAR.

WE NEED TO MAKE SURE THAT WE KEEP OUR ETHICS STRAIGHT


AS WE DEAL WITH THIS CHALLENGE. WE NEED TO MAKE SURE


THAT THE GROWING AIDS CRISIS BRINGS OUT THE BEST IN US:

FRANK TALK, COMMON SENSE, CARING AND COMPASSIONATE

ACTION. THE BEST OF AMERICAN QUALITIES, REFLECTED SO

WELL IN THE MAN FROM INDEPENDENCE.

THANK YOU.

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