Doctors Koop and Kelsey and the Age of Great Physicians

‘Dr. Koop: The Many Lives of the Surgeon General’By Nigel M. de S. CameronUniversity of Massachusetts Press, 460 Pages‘Frances Oldham Kelsey, the FDA, and the Battle Against Thalidomide’By Cheryl Krasnick WalshOxford University Press, 424 PagesTwo prominent Democrats, Senator Kennedy and Congressman Henry Waxman, vehemently opposed Charles Everett Koop’s nomination as surgeon general, yet both men would become allies as Koop became a standout in the Reagan administration, taking on the tobacco lobby and the fight against AIDS. Anthony Fauci is just one of the important figures interviewed for Nigel Cameron’s well-researched and -considered biography.Koop also became a popular culture trope that included “Koop super-hero dolls.” “The Simpsons” scripted him, for all the latest “medical poop.” Elizabeth Taylor blew him air kisses on-air. He was the butt of jokes in Johnny Carson monologues. He played himself in “Exorcist 3.” Frank Zappa wrote a song about him. By the late 1980s, Admiral Edward D. Martin mused, “He was on everything. He was everywhere. Here was a guy with five people on his staff, who was getting more PR than the secretary … more than the president!”With a figure like Frances Oldham Kelsey, pharmacologist and physician, the biographer has to take a different tack, explaining how powerful the image of thalidomide deformed babies became. Cheryl Krasnick Walsh quotes part of a Sylvia Plath poem: “Your dark Amputations / crawl and appall.” Biography is often bashed by historians who say the genre accords too much significance to individuals, but not to Frances Oldham Kelsey, who knew how long it would have taken to curtail the drug’s distribution.Kelsey was still alive at 99 when her biographer came calling, and so like Mr. Cameron, Ms. Walsh has gone to primary sources to write a remarkable work not only about a hero of science and medicine, but an important contribution to the understanding of where Kelsey fits into the late 19th century scientific revolution in the treatment of disease. At the same time, Kelsey’s gender “isolated her from many old boys’ networks.”At a time when women and minorities were still excluded from universities and research institutions, Kelsey found her place in the FDA’s rapidly expanding role in drug research. Like Koop, she became a star, receiving the “glory, the interviews, the awards, and the public dinners.” Of course, behind the scenes Kelsey and Koop had to do the hard work not only of science but of bureaucratic management that could get in the way of executing efficient public health programs.The urge to celebrate figures like Kelsey and Koop is situated by Ms. Walsh in the postwar “zenith of the Great Physician. Magic bullets had protected a generation from meningitis, diphtheria, scarlet fever, syphilis, and polio. … The Great Physician became the arbiter of life and death, and the unquestioned dispenser of pills and potions.”Yet this postwar faith in medicine began to erode, starting in the 1960s, as the impact of nuclear radiation and toxins in the environment became apparent. Plath wrote about such pollution in her poems even as Kelsey and Koop — the latter trained as a pediatric physician, opposed to racism and antisemitism, a supporter of women surgeons, and active in the treatment of the poor — staked their careers on monitoring how government interacted with the public and the private sector. Both Kelsey and Koop understood that all the medical breakthroughs in the world could go for naught without their dogged efforts to champion as well as to expose the successes and failures of modern medicine. Writer Larry Kramer, an AIDS activist, campaigning to get the Reagan administration to launch a Manhattan Project-type effort to cure AIDS, proposed Koop as the Robert Oppenheimer figure to head the initiative.No two men could have seemed more different — the flamboyantly gay Kramer and Koop, the “dour presbyterian elder whose name had been chanted by eighteen thousand gay activists on Boston Common.” Mr. Cameron laments that Koop has been virtually erased from public memory.So also has been Frances Kelsey, whose “star” after 1962 “dimmed,” even though she kept at her job into old age and never wrote the memoirs or made the public appearances that would have extended her legacy. Now, though, Ms. Walsh’s biography restores what history has left behind.Mr. Rollyson is the author of “American Biography” and “The Making of Sylvia Plath.”

Doctors Koop and Kelsey and the Age of Great Physicians

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