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The shadow of C. Everett Koop looms large at the Children’s Hospital of Philadelphia. Much has changed since he started here in 1946, but his fundamental discoveries in our discipline inform our work daily. And Koop was not reticent. Moved that even the littlest newborns with severe congenital defects could be saved by modern surgical techniques, the evangelical Christian Dr. Koop wrote and spoke forcefully against abortion.

When Koop was nominated for surgeon general, those views tormented his months-long confirmation process in 1981. If those hearings had gone another way, Americans would have been deprived of perhaps the most successful, high-profile public health interlocutor of our times. Koop would turn the tide against tobacco-related illness and make America conversant about the AIDS epidemic.

Confirmation limbo

Thirty-three years later, Dr. Vivek Murthy, President Obama’s nominee for surgeon general, sits in another confirmation limbo, hobbled not by abortion, but over disagreements on health care and guns. And time is running out. If the nomination does not come up for a vote in this lame-duck session, it is unlikely to go anywhere in a GOP-majority Senate in January.