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The C. Everett Koop Papers

The Avoidance of Mediocrity: On the Occasion of the Receipt of the Clarence E. Shaffrey, S.J. Award, St. Joseph's University pdf (901,512 Bytes) transcript of pdf
The Avoidance of Mediocrity: On the Occasion of the Receipt of the Clarence E. Shaffrey, S.J. Award, St. Joseph's University
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14 (901,512 Bytes)
1983-03-27 (March 27, 1983)
Koop, C. Everett
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Religion and Medicine
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Biographical Information
Metadata Record "The Avoidance of Mediocrity: On the Occasion of the Receipt of the Clarence E. Shaffrey, S.J. Award, St. Joseph's University" [Reminiscence] (2003) pdf (43,864 Bytes) transcript of pdf
Box Number: 9
Folder Number: 1983 Mar 27
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The avoidance of mediocrity
By C. Everett Koop, M.D., ScD.
On the occasion of the receipt of the Clarence D. Shaffrey, S.J., Award
St. Joseph's University
March 27, 1983
You will notice I am not wearing uniform today and that's because I'm here to speak to you as a private citizen and not the Surgeon General United States Public Health Service. It is not because I am not proud to wear that uniform; I am a very enthusiastic patriot and I came into wearing a uniform very late in life by a series of very long and complicated stories which I will not bore you with. I never saw any military service and I never wore uniform until I came into this job. I hold the rank of Vice Admiral which is as high as you can get in the Public Health Service and I can tell you to come in at the top rank instead of working your way up from the bottom has that other system beat. But wearing a uniform also provides a number of stories so that I do not even have to bother about having jokes for banquets anymore; I just wear my uniform and listen to what people say and I have enough to pass on to the next occasion. I just returned from Hawaii where I was taking part in a Pacific Base and Health Initiative and I had seat 22C on the plane leaving Honolulu, and I walked down and I put my briefcase under the seat getting out the papers I would like to read on the way and I stood there in uniform. I saw two little old ladies walking down the aisle and I thought they looked just like they were going to sit in 22A and B so I just stood back and let them come in. They both stood in front of me, took off their coats and handed them to me and I put them up where they belonged. I have learned my place.
Last summer I was out at the Marriott Hotel in Chicago with the American Medical Association House of Delegates and I was living on the 28th floor. I was going down for the early-morning meeting and I got on the elevator alone and we descended about 10 floors and on got a bellboy. He said, "What airline you fly for, Cap?" and when I said, "Braniff," he did not even laugh.
But I think the best one was when I attended the changing of the Commandant at the Navy Yard in Washington, the Coast Guard Commander was changing in a very impressive patriotic ceremony but I had to be very shortly thereafter in Hershey, Pennsylvania, to address the American Ophthalmological Association. So I picked my wife up on a street corner, we tore off to the airport, got to Harrisburg, took the limousine to the Hershey Hotel. I walked in resplendent in my dress blues, went up to the registration desk at the hotel and said, "My name is Koop." She went through the files and pulled out a prospective bill and I looked over the top of the desk to see who was going to pay it because I find if I do that in the afternoon it saves a lot of nonsense at 5 o'clock in the morning when I leave early and sure enough, it said "Charge to master account". The young lady said, "I need an identification." I said, "No, you don't. Just look there - it says 'Charge to master account'". She said, "I need an identification." So I took out my wallet and I got out my government top-secret highest possible thing that gets me into the CIA and the FBI and she looked at it for a minute, she threw it down, and said, "Don't you have a driver's license?" But those are not the reasons why I did not wear my uniform today. I am here as a private citizen.
It always gives me a great deal of pleasure to accept an award from a Roman Catholic institution -- being a Presbyterian.
I was raised in Brooklyn, New York, in an era of great religious bigotry. When I was given an honorary degree from St. Charles Barromeo several years ago, I warned the audience not to be alarmed if they felt a tremor in the earth, -- it was not an earthquake; it was just my Baptist ancestors rolling over in their graves.
I speak of this pleasure not because I am an Ecumenist, but rather because I believe that were we -- that is, you Roman Catholics and we Protestants -- to revel the similarities of our Christian faith, we would see that our differences are really as small as they are.
I feel particularly honored to receive the Shaffrey Award because although I never knew Clarence Shaffrey, I rather expect that we would have approved of and enjoyed each other.
I wanted to be a surgeon from the age of 5 and wavered only once for a year while I was a zoology major at Dartmouth and I wondered during that year whether it would be more satisfying to work one-on-one as a surgeon or to prepare young men to do the same thing (there were no women at Dartmouth in those days).
My mentor counseled me to be a surgeon. "As such," he said, "you can always do what I do, but I can never be what you plan to be."
I have tried to do both -- but where Clarence Shaffrey and I would have joined paths is in the effort to teach young men and women to combine their faith and their practice.
I thought of addressing you this afternoon on the pursuit of excellence but instead, I will accentuate the negative and spend the next few minutes discussing in brief "The Avoidance of Mediocrity".
Some achieve excellence in all that they do in life but these are rare men and women. Others achieve excellence in one field and this is a much more common attainment.
However, most people who graduate from a school such as this try to juggle so many balls in the air at the same time that it is easy to slip into mediocrity.
It is my belief that the pursuit of excellence can be very frustrating. But when we consider motivation, vocation, occupation, and ambition, -- the avoidance of mediocrity is not only possible but it leads to a satisfying and successful performance.
I would like to speak on the avoidance of mediocrity in Christian terms.
It is assumed by secular society that we who hold a religious position by faith are some sort of anomaly. It is expected -- as though it were possible -- that we remain religiously neutral in professional and public affairs.
Consciously or unconsciously we all exert an influence based upon underlying beliefs about life and "our religion" -- whatever that may be.
Neutrality is a myth.
Communism recognizes no religion. But when Nikita Khrushchev said, "We will bury you", he said that with a religious fervor that I covet for leaders of America today.
For example -- in the arguments centered around abortion -- if there is no religion-based perspective in the discussion, we are left with biologic short-term apparent, but false, solutions which when carried to a logical conclusion excuse the individual from the consequences of his action.
As Christians we understand and believe in God's forgiveness for sin. But even with forgiveness there are the natural consequences of sin. To contemplate what these consequences might be in individual lives and nationally is staggering.
Mediocrity has come into English use as a descriptive term through the French from the Latin. The Oxford dictionary defines it as "the quality of being intermediate, between two extremes; to be of the middling capacity, endowment or accomplishment". In this day, mediocrity is used chiefly in a disparaging sense in contrast with excellence or superiority.
Is there motivation which is uniquely Christian? Let me put it in terms with which I am most familiar - the practice of medicine.
If there a motivation in medicine which is uniquely Christian? We point to the development of compassion through the love of Jesus Christ as the Christian contribution to medicine. Such compassion has compelled them to practice their art in a variety of ways. The world thinks first of Christian medicine as it is expressed in the medical missionary abroad, but the great majority of Christian doctors are engaged in the domestic practice of medicine whether as teachers, or investigators, or practitioners. Some of these have express their motivation in the simple care of the sick and injured; others have found a place in their consulting rooms for personal advice and verbal witness concerning their faith in Christ; still others have entered the more competitive aspects of medicine, seeking a high place in academic or administrative medicine in order that professional excellence might in a sense authenticate or lend added credence to their Christian witness.
And yet Christian physicians are not necessarily better physicians that non-Christians. There must be an additional motivation - perhaps concerned with ambition that carries so many to the top.
I suppose that most of the questions we ask ourselves have their origin in a personal dilemma. One of them is, I know, shared by most of my professional colleagues might be summarized in two questions. First, how should a man strive to get to the top? And second, what is more effective in the cause of Christ, the Christian superbly competent professional or the doctor performing professional tasks not quite a top level, but devoting a great deal of his time to furthering the Christian cause in the use of his non-medical skills?
To state it differently, could it be that some Christians, knowing that their peace is made with God and their future settled, see little to be gained from professional advancement? How can God best be served? Is the integrity of professional competence more desirable than merely adequate professional performance by the doctor, busy in all other manner of outside Christian activities?
I am convinced that most of us confuse two words: vocation and occupation. When St. Paul wrote his letter to the young church at Ephesus he said, "We are all called to serve the living and the true God."
So you and I who are Christian have the same calling - we have exactly the same vocation - to serve the living and the true God.
The way most of us do that is usually through our occupation.
Should I, as a Christian doctor who was moved well up the ladder of professional success, continue to strive for further advancement and make his teaching, or research or clinical practice, the best possible? Or should I in a sense rest on my oars, allow momentum to carry the major part of my professional life, while I turn my attention to ancillary matters which on the surface seem more intimately concerned with Christian things?
I think the answer lies in vocation and occupation again. We work out the former by the manner in which we perform the latter.
Then there are those times when the demands of occupation are so strenuous that one can only survive through God's grace and must trust the Lord to understand.
I was asked last spring to go to a new England College to address the alumni reunion and the title that was given to me was "Health in the Year 2000". I appeared on that occasion as the Surgeon General in uniform and I gave my predictions for what I thought health would be like in this country about two decades hence. And when I finished the usual cluster of people came up to the podium, some just to say hello, some to say they liked what I said, but wild woman stayed to the end when she got up there, she said, "I cannot tell you how ashamed I am of you. To think that you would come into this atheist stronghold and have an opportunity to talk to hundreds of men and women and not once preach the gospel." And I said, "Madam, if you are Christian, you and I both have the same vocation. We are called to serve the living and the true God and for the next four years I plan to serve my God as Surgeon General of the United States."
Another thought on motivation. It is not so much what we as individuals have as Christians but in a sense it is what Christ has in us by way of an investment. It certainly would be a sin for us to make the death of Christ worthless is much as he has invested so much in us. We should work for his sake and the implications of this motivation are to be tremendous. Humility and mediocrity are of course not synonymous nor is character an excuse for lack of competence. The fact that we are doing our best to show for Christ's love does not excuse us from finding the best possible way of helping our fellow man. In fact, the latter should be the expression of the former. In other words, it is imperative that we deliver ourselves for mediocrity.
After I wrote the book and made the films entitled "Whatever Happened to the Human Race?" With Francis Schaeffer, some of you may not know that we took those films on the road to 20 cities in this country, 2 in Canada and 4 the United Kingdom. Our seminars consisted of two full days of viewing the films, giving lectures, and answering innumerable questions. When we were in Portland, Oregon, at the end of my first lecture, a middle-aged gentleman came up to see me and said, "I certainly enjoyed what you had to say, sir. I am a physician here in Portland and a Roman Catholic but I never let the two get mixed up." And I said, "How sad."
There is a tendency among all of us to compartmentalize our lives. We tend to think of our profession as the secular part of our existence and those things we do in the Christian connotation as being more in line with a Christian witness and therefore somehow or other sanctified.
Any discussion of mediocrity in medicine must eventually relate itself in some way to ambition. In our free enterprise system in the United States, medical competence is not necessarily rewarded with advancement in the profession and there is a sense in which ambition for medical advancement may not contribute to the Christian witness of the individual, but may in the long run be very effective in enhancement of the cause of Christ largely because of the influence the doctor of high status is sometimes able to wield.
On the other hand, ambitious plotting for medical advancement may paralyze an individual so that effectiveness in the cause of Christ is minimal. Some of us have been settled with responsibilities which are clinical, academic, investigative and administrative. Having achieved such a responsible position, what is the obligation of that individual? If he does not continue to push for advancement, is he flirting with mediocrity? If in each area of his professional life, he tries to achieve the best record possible, will he become so embroiled in these various activities that his opportunities for active Christian witness and may in time wither away?
Usually one speaks of only two aspects of the Christian physician's life; namely, his professional competence and those things carrying a Christian connotation which he does outside of profession. But the Lord has called most of us to be spouses and parents as well and the witness certainly lacks integrity if a misunderstanding of the Lord's calling leads to excellence in the professional field, permits dabbling in the Christian field, but produces a man or a woman who in domestic life is a mediocre spouse and a mediocre parent.
Many tensions build these days when two parents are building careers. I think we all understand that there are tensions too for the woman who loves being a wife and a mother and remember to support her by reminding her that no occupation better serve the Christian vocation.
I trust that these things I am saying or not being misunderstood. I am not suggesting that the avoidance of mediocrity is to be found in academia or medical societies or in public service. The medical missionary in a remote village in desire, the Coast guardsmen who is a physician and is engaged in search and rescue operations, or the family practitioner in media may have more opportunities for the avoidance of mediocrity than are given the Surgeon General.
Christianity does not speak in a vacuum. There is anxiety and despair all around us. The Christian physician especially has an antidote for anxiety and he has a defense against despair. Let none of us be like that physician in Portland.
Finally, let me say that we all are called to our vocation in a sometimes hostile world. I first became interested in the Christian avoidance of mediocrity when I read two articles on the same day in the British publication, the Manchester Guardian. That was 20 years ago but the hostility is worse today, I think, rather than better. This is what I read:
"In a review of William Empson's book, Milton's God, by Frank Kermode, this quotation appeared: 'Keeping Christianity in check has been an important duty of civilized people ever since the religion took hold . . . (They) worship a God so cruel that he can be persuaded to let a small proportion of the human race off eternal torture by the offered his own son for torture instead.' In the same issue, A. J. Huxley made this comment: '1960 years of Christianity and centuries more of all kinds of other religions are equal validity to their believers, seem to have brought us to a pretty pass.' This is the theater of witness in which we must operate; here is where you are on trial, here is where you cannot afford to be mediocre at anything that you do."
The Christian life with all of its liberty is like walking a tight rope. Although it is most difficult to do all things well, we must remember St. Paul's admonition, "This one thing I do."
It comes down, I think, to a matter of conscience.
There was a day when one could not quote Martin Luther in such assembly. But now that you sing his hymn, "A Mighty Fortress Is Our God", I think I might do so here. Luther said, "Conscience is where our behavior touches God." Fortunately, the conscience can learn to grow in grace.
For the Christian doctor I covet this description known to most of you, by the unknown author of the epistle to Diognetus written the second century A.D. describing the Christians of his time. "They spend their existence upon the earth but their citizenship is in heaven. They obey the established laws, but in their own lives they surpass the laws . . . in a word, what the soul is in the body, Christians are in the world . . . the soul is enclosed in the body and itself holds the body together; so too Christians are held fast in the world as a prison, yet it is they who hold the world together."
In this description there is no room for mediocrity.
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