C. Everett Koop, author of book about mountaineering, dies

A son from his first marriage, David Koop, was killed in a mountaineering accident in New Hampshire in 1968 when he was a 20-year-old student at Dartmouth. Dr. Koop and his first wife later wrote a book, “Sometimes Mountains Move,” about their experience of grieving in the hope it might help other parents who had lost children.

Over four decades of practice, he improved the technique for hernia repairs (and did 17,000 of them). He developed a correction for a congenital defect known as esophageal atresia, and a method for draining fluid from the brain into the abdomen for infants with hydrocephalus. He separated several sets of conjoined twins, including, in 1977, a pair joined at the heart in which only one baby could be saved. He trained dozens of pediatric surgeons who went on to head departments elsewhere.

In Dr. Koop’s case, the new frontier was pediatric surgery, a specialty that barely existed when he entered it. He became one of the half-dozen leading practitioners in the world.

After the war ended, the surgeon in chief at the Hospital of the University of Pennsylvania suggested that Dr. Koop take a job as the head of surgery at Children’s Hospital of Philadelphia. When he assumed the position in January 1946, he was not yet 30.

At the time, general surgeons, or specialty surgeons such as urologists, operated on infants and children without specific training in how their anatomy and physiology differed from adults. The only pediatric surgery program in the country was in Boston. Operations on newborns were rare and mortality was high.

A 64-year-old retired pediatric surgeon at the time Ronald Reagan nominated him in 1981, Dr. Koop had no formal public-health training. His chief credential was that he was a socially conservative, devout Christian physician who had written a popular treatise against abortion. His confirmation took eight months. Few people expected him to talk about homosexuality, anal intercourse, condoms and intravenous drug use when almost nobody else in the Reagan administration would even utter the word “AIDS.”

Dr. Koop, however, believed information was the most useful weapon against HIV at a time when there was little treatment for the infection and widespread fear that it might soon threaten the general population. In May 1988, he mailed a seven-page brochure, “Understanding AIDS,” to all 107 million households in the country.

Among AIDS activists Dr. Koop became an unlikely hero, although some came to think that his sexually explicit talk tended to further stigmatize gay men.

“Most of us thought that a huge part of how the crisis grew exponentially was that those in power chose to ignore it for as long as they could,” recalled Peter Staley, a founding member of the AIDS Coalition to Unleash Power. “He was the only person in that administration who spoke the truth when it came to AIDS.”

Dr. Koop was also a tireless campaigner against tobacco. As surgeon general, he released a report in 1982 that attributed 30 percent of all cancer deaths to smoking. He wrote that nicotine was as addictive as heroin, warned against the hazards of secondhand smoke and updated the warning labels on cigarette packs.