[Address to the] Boston Guild for the Hard of Hearing, Boston, Massachusetts
NOTE: This speech is heavily edited by Koop, and the page numbering does not correspond to the actual order of the pages.
Item is handwritten. Item is a photocopy.
Number of Image Pages:
28 (1,081,897 Bytes)
1989-11-30 (November 30, 1989)
Koop, C. Everett
This item is in the public domain. It may be used without permission.
Medical Subject Headings (MeSH):
Persons With Hearing Impairments
Congenital Birth Defects and the Medical Rights of Children: The "Baby Doe" Controversy
"[Address to the] Boston Guild for the Hard of Hearing, Boston, Massachusetts" [Reminiscence] (2003)
Box Number: 9
Folder Number: 1989 Nov 30
Boston Guild for the Hard of Hearing
C. Everett Koop
November 30, 1989
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As you know, I came to the position of Surgeon General in Washington about 8 years ago, fresh from a long career as a pediatric
surgeon. For nearly 40 years I looked at medical problems and tried to solve them with the skills in my own two hands.
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And I suspect that, subconsciously, I thought that was what health care and medical care were all about. Most physicians
have that quite natural bias, that health care is the sum total of the patching up they do for their patients.
And, to a certain extent, I guess it is.
But not altogether. And less so in the future.
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And that's one of the main lessons I learned, during my two terms as your Surgeon General.
Virtually every major health issue I had to deal with as a Surgeon General has had -- at its very heart -- the way people
behave . . . the way they behave toward themselves . . . the way they behave toward others they know and love . . . and the
way they behave toward others they don't know at all.
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Shall I list some of those issues? I'll name just a handful:
Smoking . . . The abuse of alcohol . . . unwanted pregnancies . . . child abuse and other forms of family violence . . . and
infectious diseases such as hepatitis B . . . and, course, AIDS.
I'll stop right there, although the full list is a good deal longer.
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But at the base of each of those painful, tragic, destructive, and preventable health problems is an equally tragic and destructive
This is not an easy subject discuss in a democracy, because we pride ourselves on letting the individual make the decision
as to what he or she wants out of life.
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And the rest of us have agreed -- so far, anyway -- that we will pay almost any price to keep that part of our social compact
alive and well.
Hence, we put a great deal of human material resources into vaccine research and delivery . . . into drug development . .
. into physical and mental health therapies of every kind . . . into those kinds of medical and public health responses that
are after the fact.
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And we turn to large, broad-brush kinds of public education programs to do the tough, long-term job of correcting hazardous,
high-risk human behavior. Also after the fact.
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When you think of AIDS and Hepatitis you can see
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For example, I think there's a direct, straight-line relationship between the 1960s, when many constraints disappeared,
concerning experimentation with drugs and sexuality . . . and the 1970s, when such experimentation became rather widespread
among young people in our society . . . and the 1980s, when the tragic results of much of that behavior can be more clearly
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And so we've been busy the past few years posting the weekly tallies of drug overdose deaths . . . of "children having
children" . . . of victims of a new epidemic of syphilis . . . of the escalating numbers of people with resistant strains
of gonorrhea . . . and of the expanding caseload of people who were incubating the AIDS virus until the "right" opportunistic
disease came along.
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In many areas of medicine and public health, we're making excellent progress:
Hypertension screening, organ transplantation, cancer detection and control, and so on.
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But in many other areas, we seem to be running in place, if not actually falling behind. The statistics are not good. Far
too many people in our society have fallen victim to debilitating and deadly disease. And we suspect that the worst numbers
may not be in yesterday's files. Rather, they may show up in the tally sheets of tomorrow and the day after.
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I'd like to address 3 behavioral changes in reference to hearing. A moment ago I mentioned 3 behavioral patterns that
certainly refer to hearing.
The way people behave towards themselves.
The way they behave toward others they know and love
The way they behave toward others they don't know at all.
First -- behavior toward oneself
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Many children are born with normal hearing . . . they grow and become lively adolescents . . . taking part in sports and other
recreational activities of their generation.
Unfortunately, one of those activities is contemporary popular music and one of the key means of having access to this music
is the personal recorder with headphones. We already know the terrible price of partial and total deafness paid by rock and
roll musicians, especially drummers.
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Now we're beginning to understand that the same price is being paid by those who listen to those musicians on tape, with
the volume turned up so high that the decibel level actually might exceed what it would have been, had the musician been heard
The latest sound "craze," is to put up to 8 megawatt speakers inside the closed environment of one's automobile
. . . and play rock music on such a system at top volume.
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I believe that qualifies as being a "public nuisance" and ought to be stopped on those grounds alone. I hope such
cases get into the courts and that the rest of us on public streets and highways can be protected from such assaults of high-volume
Frankly, I see no difference between the sound pollution generated by people driving cars and the air pollution generated
by people smoking cigarettes. Both kinds of pollution are harmful to human health.
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It is no easy task but we have got to change the behavior of adolescents and do it in an era when most of us have concluded
that teenagers don't change their behavior because of fear of the consequences of that behavior. How we do this remains
to be seen.
Then there's behavior toward those we love. Just think how many elderly people live together and cant [sic] communicate
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or do so poorly because one or both are hearing impaired
After I'd been in Washington for several years, I was beginning to feel more comfortable with the job
Began to like more people in the Congress, and actually enjoyed committee meetings at the White House.
Suddenly I realized why -- I was losing my hearing.
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I realized I was missing a lot and making inappropriate responses.
So I got two hearing aids. Getting a hearing aid should be just like getting eyeglasses. We have to change the behavior of
older people about wearing hearing aids -- but we have to keep hammering away at age prejudice -- a behavior toward others
we don't know at all.
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I make as many statements about my hearing aids as I can. I like to change batteries in public places.
My own hearing aids are not easy to see and, to be honest about it, I feel very comfortable with them . . . they work just
fine . . . and I'd like everyone my age - - - and the dozen or so people who are older than I - - to know that.
I'm proud of the fact, although I am hearing impaired, I am still doing exactly what I want to do. In fact, in some cases,
being hearing impaired may very well have helped.
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Another behavior toward those we dont [sic] know at all is the necessary screening and assessment of hearing and speech disorders
especially screening of newborns.
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First of all, we do not yet have the national program of screening and assessment that a country as technologically advanced
as ours ought to have. Frankly, if it were not for tremendous volunteer efforts, we'd be in terrible shape . . . we'd
have an even dimmer idea of the scope of this problem in America today. -- 24 million speech and hearing disorders --
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For example, we have the technology to do a fairly accurate assessment of hearing disorders among the newborn. But in many
hospitals and clinics -- I might even say in most hospitals and clinics -- this type of assessment just isn't done.
Babies are born with hearing and speech disorders . . . disorders which can be recognized and ought to be recognized . . .
but which are not recognized at all.
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Physicians leave the job to the parents . . . parents leave it to the schools . . . and the schools do the best they can,
but then it's already very late for many children who've had to struggle to comprehend the world around them during
those significant first years of their lives.
That's not fair. It's not fair to those children. And it's not fair to their parents and siblings.
We need to do a much better job assessing every newborn American for possible speech or hearing disorders . . . and then setting
in motion whatever is needed to correct or compensate for those disorders.
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But we've come a long way with the education of the public and the hearing impaired. So that today we can say to the
hearing impaired who have taken their place in society.
You may be deaf -- but you're not invisible
You may be heard of hearing but you will be heard
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Once again -- thank you for the honor you do me today
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And to any older Americans listening to me today -- or barely listening to me today -- I say: get tested and get a hearing
aid, if you need it. I guarantee you'll feel much younger again. I certainly do.
And now, let me close with a word of thanks for the opportunity to have been of some help in the world of hearing disorders
this year. It's been a very rewarding experience . . . one that I know I share with all of you and all of your colleagues
around the country.