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Koop: The memoirs of America's family doctor
BOOK REVIEW
KOOP: The Memoirs
of America’s
Family
By C. Everett Koop. New York, NY, Random House, 1991,342
T
autobiography of the pioHIS IS A remarkable neering pediatric surgeon-and first editor of the JoumaE of Pediatric Sueev-who became the best-known and most effective US Surgeon General in history. The 11 chapters of these “memoirs” are divided into five parts. The first four deal with his personal, pediatric surgical, political, and public experiences. In the final part-The Surgeon General Reports-Dr Koop presents his views on some of the major health issues facing the American public, such as aging, nutrition, drugs and alcohol, domestic violence, and access to health care. The pediatric surgical story of struggling for acceptance and recognition of the specialty, and its practitioners, will be familiar to older pediatric surgeons and instructive to younger ones. Dr Koop did not choose his specialty; he was appointed by Professor I.S. Ravdin at the University of Pennsylvania to become chief of pediatric surgery at the Children’s Hospital of Philadelphia; his “training” was to be a year of observing pediatric surgery at the Boston Children’s Hospital. In Boston he had the good fortune to learn “the art and philosophy of pediatric surgery” from William E. Ladd and pediatric surgical techniques from Robert E. Gross. On returning to Philadelphia, despite the initial rejection by the pediatricians and opposition by general surgeons, he developed a premier surgical service and training program at the Children’s Hospital of Philadelphia. Dr Koop established the first surgical intensive care nursery, and was innovative in utilizing colon interposition for isolated esophageal atresia, separation of conjoined twins, treating cancer in children, and counselling the parents of dying children. His reminiscences about special patients and their surgical procedures are presented concisely, with humor and compassion. In the current era of sophisticated neonatal transport, the story of how, early in his career, Dr Koop personally carried a newborn with diaphragmatic hernia to the Children’s Hospital is especially dramatic: in his arms down nine flights of
534
Doctor.
pp, $22.50.
stairs at the referring hospital, across town in front of the heater on the floor of his car, and to the operating room for immediate thoracotomy on arrival at the Children’s Hospital. In another story, there is more than a little humor and “human interest” in the diagnosis and treatment of an unusual obstructing prepyloric web in a 2%pound neonate-who happened to be an orangutan. It is also interesting the way the specialty of pediatric surgery is depicted to the book’s principally nonmedical audience. Diagnoses’and procedures are explained in a clear and understandable manner, not just clinically, but always with a human touch. The examples of the pediatric surgeon’s patient and sympathetic approach to parents should be especially enlightening to a public subjected to political and media “doctor bashing”. Dr Koop gives proper credit to the invaluable support of anesthesiologists, surgical colleagues, and nursing staff in achieving successful outcomes for infants and children. Preserving personal integrity while working for the health of the general public is the theme of Dr Koop’s tenure as Surgeon General. The Washington experience that he relates in the latter half of the book is an eye-opener for any citizen. He describes the prolonged battle over his confirmation and the fight against smoking and the transmission of the AIDS virus. The two most controversial ethical issues he faced, abortion and “Baby Doe”, find a reasoned discussion of opposing points of view, and conclusions that reflect the author’s conviction that he was the chief health officer for all thepeople-children, parents, and physicians. That he was able to accomplish as much as he did in the face of strong political pressures-many from the staff of the President who appointed him-is a tribute to a remarkable man, whom pediatric surgeons can be proud to call a colleague. Peter S. Liebert, MD
Journal of Pediatric Surgery, Vol27, No 4 (April), 1992: p 534
KOOP: The Memoirs
of America’s
Family
By C. Everett Koop. New York, NY, Random House, 1991,342
T
autobiography of the pioHIS IS A remarkable neering pediatric surgeon-and first editor of the JoumaE of Pediatric Sueev-who became the best-known and most effective US Surgeon General in history. The 11 chapters of these “memoirs” are divided into five parts. The first four deal with his personal, pediatric surgical, political, and public experiences. In the final part-The Surgeon General Reports-Dr Koop presents his views on some of the major health issues facing the American public, such as aging, nutrition, drugs and alcohol, domestic violence, and access to health care. The pediatric surgical story of struggling for acceptance and recognition of the specialty, and its practitioners, will be familiar to older pediatric surgeons and instructive to younger ones. Dr Koop did not choose his specialty; he was appointed by Professor I.S. Ravdin at the University of Pennsylvania to become chief of pediatric surgery at the Children’s Hospital of Philadelphia; his “training” was to be a year of observing pediatric surgery at the Boston Children’s Hospital. In Boston he had the good fortune to learn “the art and philosophy of pediatric surgery” from William E. Ladd and pediatric surgical techniques from Robert E. Gross. On returning to Philadelphia, despite the initial rejection by the pediatricians and opposition by general surgeons, he developed a premier surgical service and training program at the Children’s Hospital of Philadelphia. Dr Koop established the first surgical intensive care nursery, and was innovative in utilizing colon interposition for isolated esophageal atresia, separation of conjoined twins, treating cancer in children, and counselling the parents of dying children. His reminiscences about special patients and their surgical procedures are presented concisely, with humor and compassion. In the current era of sophisticated neonatal transport, the story of how, early in his career, Dr Koop personally carried a newborn with diaphragmatic hernia to the Children’s Hospital is especially dramatic: in his arms down nine flights of
534
Doctor.
pp, $22.50.
stairs at the referring hospital, across town in front of the heater on the floor of his car, and to the operating room for immediate thoracotomy on arrival at the Children’s Hospital. In another story, there is more than a little humor and “human interest” in the diagnosis and treatment of an unusual obstructing prepyloric web in a 2%pound neonate-who happened to be an orangutan. It is also interesting the way the specialty of pediatric surgery is depicted to the book’s principally nonmedical audience. Diagnoses’and procedures are explained in a clear and understandable manner, not just clinically, but always with a human touch. The examples of the pediatric surgeon’s patient and sympathetic approach to parents should be especially enlightening to a public subjected to political and media “doctor bashing”. Dr Koop gives proper credit to the invaluable support of anesthesiologists, surgical colleagues, and nursing staff in achieving successful outcomes for infants and children. Preserving personal integrity while working for the health of the general public is the theme of Dr Koop’s tenure as Surgeon General. The Washington experience that he relates in the latter half of the book is an eye-opener for any citizen. He describes the prolonged battle over his confirmation and the fight against smoking and the transmission of the AIDS virus. The two most controversial ethical issues he faced, abortion and “Baby Doe”, find a reasoned discussion of opposing points of view, and conclusions that reflect the author’s conviction that he was the chief health officer for all thepeople-children, parents, and physicians. That he was able to accomplish as much as he did in the face of strong political pressures-many from the staff of the President who appointed him-is a tribute to a remarkable man, whom pediatric surgeons can be proud to call a colleague. Peter S. Liebert, MD
Journal of Pediatric Surgery, Vol27, No 4 (April), 1992: p 534