As a deeply religious Presbyterian and the author of a book opposing abortion, Koop also brought the evangelical Christian credentials Reagan wanted to
reward the religious right wing that had helped elect him.
Liberal Democrats in Congress worried Koop would use the surgeon general's bully pulpit on public health issues as a de facto church pulpit to push a
conservative religious agenda on the nation. Senate health committee chairman Ted Kennedy held up Koop's nomination in the Senate. Representative Henry Waxman, chairman of the
health subcommittee, strenuously opposed him in the House. Public health groups, women's and gay rights groups and medical associations lobbied against his
The New York Times called him "Dr. Unqualified." The Boston Globe argued that the "fanatical" Koop was a "dogmatic Christian fundamentalist with the kind
of tunnel vision that limits bureaucrats of any ideological stripe." But after eight long months, he was finally confirmed.
As the political drama played out on Capitol Hill, a far bigger and deadlier drama was just beginning, as the first cases of AIDS were reported in
the summer of 1981. Young, formerly healthy men in Los Angeles, New York, and San Francisco suddenly began to get sick and quickly die from pneumocystis
carinii pneumonia and Kaposi's sarcoma, infections that preyed on people with a weakened immune system.
For his first four years in office, religious conservative politics swayed the nation's health chief away from addressing the growing AIDS crisis. Without a cure
or vaccine, and with mounting public hysteria, Koop in 1986 was finally authorized to report on the epidemic.
When Koop set out to write his report, no one knew what, exactly, he would say. Evangelicals and gay groups alike, then the key advocates for people with
AIDS because so many of them were gay men, were nervous.
"We were desperately afraid when he took on doing the report," recalled Trust for America's Health executive director and George Washington University
health policy professor Jeffrey Levi, who was then the government relations director for the National Gay and Lesbian Task Force. "It's hard to understand
how desperate those of us who were affected by the epidemic were for the validation by a mainstream public health official."
It was, after all, in 1986 that conservative commentator William F. Buckley, Jr. called for the tattooing of every gay man and injection drug user. Other
conservative Republicans talked about quarantining HIV-positive people and "rounding up" all gay men.
But Levi and other advocates for people with AIDS were pleasantly shocked by the man who met with them. Instead of a religious zealot they expected to "go
berserk" about homosexuality and promiscuity, Levi said, "We were totally unprepared for the nature of the conversation because it was so positive and so