Intros for 3 speeches at Children's Hospital of Philadelphia (1)
Philosophical statement by C. Everett Koop, MD, ScD
Surgeon-in-Chief; Children's Hospital of Philadelphia
For Presentation to the Board of Trustees and the Executive Committee of the Medical Staff
The Children's Hospital of Philadelphia, the first and oldest in America, has enjoyed a remarkable reputation, the support
of the wealthy community, the support of the community receiving care, and the admiration of colleagues throughout the world.
When I arrived there, in 1946 (much of the history of pediatric surgery will appear in this archive and elsewhere as segments
of oral history I have prepared over the years in reference to pediatric surgery and the Children's Hospital). In 1946,
when I first went to the Children's Hospital it was essentially a medical pediatric institution. Only urgent and emergency
surgery was done at Children's and there was no such term as "pediatric surgery". If someone wished to designate
what later became called, "pediatric surgery", it was called "child surgery". That meant people who practiced
it were called, "child-surgeons", which led to some confusion about who was the patient and who was the doctor. I
came to that hospital with the strong backing of the provost of the University of Pennsylvania, the Chairman of the Department
of Surgery of the University of Pennsylvania, I.S. Ravdin, of his protege and my close friend to be, as well as my mentor,
Jonathan E. Rhoads. I had the "apparent" strong backing of the Professor of Pediatrics of the
University of Pennsylvania and the Physician-in-Chief of the Children's Hospital of Philadelphia, Joseph Stokes, Jr.,
but it was a reluctant support born of necessity, and in a sense forced upon him, to avert a crisis over inadequate surgical
care in that institution.
When I went there, it was the intent of those who sponsored me that I make it the best possible teaching service for children's
surgery in the land, and it was my own personal dedication that it would be my life's work. I actually stayed there until
the age when the University of Pennsylvania forces retirement (illegally) at the age of 65, which for me was 1981, but the
expected difficult transition was avoided, because Ronald Reagan intervened early in the year of 1981 and designated me to
be the Surgeon General of the United States and I was eventually confirmed for a four-year appointment and was reappointed
for a second four-year term finishing my government career in 1989.
I am a doer and I like to think that I am innovative and creative and I fretted many times about the dilapidated state of
the old Children's Hospital in the midst of the Afro-American ghetto of South Philadelphia. I once became so upset of
the apparent lack of understanding of the Board of Trustees of their responsibility of the children in our care, that I --
with no authority -- called a meeting of the Board of Managers, held it in mid-summer, in a non-air-conditioned room, in the
basement of the old hospital and began my talk by reading the definitions of "Trustee" from several dictionaries and
then expanded upon what that meant to the Children's Hospital and what the deficiencies seemed to me to be.
I can say honestly that a new hospital was mentioned even on the day I arrived, January 4th, 1946 and continued until we eventually
moved to the Campus of the University of Pennsylvania in 1974. One of the three papers that follows this introduction was
written by me in 1971/1972 as a philosophical statement by the hospital's Surgeon-in-Chief and was delivered to the members
of the Board of Trustees, the senior members of the staff, and was discussed in both board and staff meetings from time to
time. It is an essential paper to discuss the future -- apart from buildings and location -- of the oldest children's
hospital in America -- and I covered such issues as cooperation with the underprivileged community that surrounded us, the
suburban community and beyond, the decentralization of pediatric care and the moral obligation that a children's hospital
of such reputation and such anticipated grandeur perhaps ought to serve all of the five medical schools in Philadelphia --
not to mention the osteopathic medical college -- rather than maintain its single affiliation with the University of Pennsylvania.
This paper was provocative, it was prophetic, and all of the things I raised were eventually discussed and adjudicated and
in a sense the things that I called for were done with the exception of the last, which in spite of my concern, never was
an issue raised by anyone other than I.