WHO: Slight cancer risk after Japan nuke accident

LONDON (AP) — Two years after Japan's nuclear plant disaster, an international team of experts said Thursday that residents of areas hit by the highest doses of radiation face an increased cancer risk so small it probably won't be detectable.

In fact, experts calculated that increase at about 1 extra percentage point added to a Japanese infant's lifetime cancer risk.

"The additional risk is quite small and will probably be hidden by the noise of other (cancer) risks like people's lifestyle choices and statistical fluctuations," said Richard Wakeford of the University of Manchester, one of the authors of the report. "It's more important not to start smoking than having been in Fukushima."

The report was issued by the World Health Organization, which asked scientists to study the health effects of the disaster in Fukushima, a rural farming region.

On March 11, 2011, an earthquake and tsunami knocked out the Fukushima plant's power and cooling systems, causing meltdowns in three reactors and spewing radiation into the surrounding air, soil and water. The most exposed populations were directly under the plumes of radiation in the most affected communities in Fukushima, which is about 150 miles (240 kilometers) north of Tokyo.

In the report, the highest increases in risk are for people exposed as babies to radiation in the most heavily affected areas. Normally in Japan, the lifetime risk of developing cancer of an organ is about 41 percent for men and 29 percent for women. The new report said that for infants in the most heavily exposed areas, the radiation from Fukushima would add about 1 percentage point to those numbers.

Experts had been particularly worried about a spike in thyroid cancer, since radioactive iodine released in nuclear accidents is absorbed by the thyroid, especially in children. After the Chernobyl disaster, about 6,000 children exposed to radiation later developed thyroid cancer because many drank contaminated milk after the accident.

In Japan, dairy radiation levels were closely monitored, but children are not big milk drinkers there.

The WHO report estimated that women exposed as infants to the most radiation after the Fukushima accident would have a 70 percent higher chance of getting thyroid cancer in their lifetimes. But thyroid cancer is extremely rare and one of the most treatable cancers when caught early. A woman's normal lifetime risk of developing it is about 0.75 percent. That number would rise by 0.5 under the calculated increase for women who got the highest radiation doses as infants.

Wakeford said the increase may be so small it will probably not be observable.

For people beyond the most directly affected areas of Fukushima, Wakeford said the projected cancer risk from the radiation dropped dramatically. "The risks to everyone else were just infinitesimal."

David Brenner of Columbia University in New York, an expert on radiation-induced cancers, said that although the risk to individuals is tiny outside the most contaminated areas, some cancers might still result, at least in theory. But they'd be too rare to be detectable in overall cancer rates, he said.

Brenner said the numerical risk estimates in the WHO report were not surprising. He also said they should be considered imprecise because of the difficulty in determining risk from low doses of radiation. He was not connected with the WHO report.

Some experts said it was surprising that any increase in cancer was even predicted.

"On the basis of the radiation doses people have received, there is no reason to think there would be an increase in cancer in the next 50 years," said Wade Allison, an emeritus professor of physics at Oxford University, who also had no role in developing the new report. "The very small increase in cancers means that it's even less than the risk of crossing the road," he said.

WHO acknowledged in its report that it relied on some assumptions that may have resulted in an overestimate of the radiation dose in the general population.

Gerry Thomas, a professor of molecular pathology at Imperial College London, accused the United Nations health agency of hyping the cancer risk.

"It's understandable that WHO wants to err on the side of caution, but telling the Japanese about a barely significant personal risk may not be helpful," she said.

Thomas said the WHO report used inflated estimates of radiation doses and didn't properly take into account Japan's quick evacuation of people from Fukushima.

"This will fuel fears in Japan that could be more dangerous than the physical effects of radiation," she said, noting that people living under stress have higher rates of heart problems, suicide and mental illness.

In Japan, Norio Kanno, the chief of Iitate village, in one of the regions hardest hit by the disaster, harshly criticized the WHO report on Japanese public television channel NHK, describing it as "totally hypothetical."

Many people who remain in Fukushima still fear long-term health risks from the radiation, and some refuse to let their children play outside or eat locally grown food.

Some restrictions have been lifted on a 12-mile (20-kilometer) zone around the nuclear plant. But large sections of land in the area remain off-limits. Many residents aren't expected to be able to return to their homes for years.

Kanno accused the report's authors of exaggerating the cancer risk and stoking fear among residents.

"I'm enraged," he said.

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Mari Yamaguchi in Tokyo and AP Science Writer Malcolm Ritter in New York contributed to this report.

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Online:

WHO report: http://bit.ly/YDCXcb

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Eric Garcetti showed political savvy during busy student years

Fourth in a series of articles focusing on key periods in the lives of the mayoral hopefuls.

Ben Jealous still recalls walking into a Columbia University meeting of a new group called Black Men for Anita Hill and seeing a half-Jewish, half-Mexican kid from Los Angeles leading the discussion.

"What's he doing here?" he asked the professor who organized the meeting.

"Honestly brother," the teacher replied, "he's the only one here I'm certain will really work hard."

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It was Jealous' first exposure to Eric Garcetti, a committed young progressive known on campus for gliding between different worlds and liberal causes. As a political science major at Columbia, Garcetti patched plaster and painted walls in low-income apartments in Harlem while also serving as the president of an exclusive literary society known for its wealthy membership. He led a men's discussion group on gender and sexuality, ran successfully for student government, and wrote and performed in musicals.

His busy student years offered hints of the future political persona that would later help him win a Los Angeles City Council seat and emerge as a leading candidate for mayor. As he pursued countless progressive causes — improved race relations in New York City, democracy in Burma and human rights in Ethiopia — Garcetti also exhibited a careful stewardship of his image and a desire to get along with everyone.

Some of his critics complain that he is confrontation averse, and say his chameleon-like abilities are political. Others complain that he has lost touch with his activist roots, citing his recent advocacy for a plan to allow taller and bigger buildings in Hollywood despite strong opposition from some community members.

FULL COVERAGE: L.A.'s race for mayor

But Jealous, who went on to study with Garcetti at Oxford, where they were both Rhodes scholars, remembers his classmate as "authentically committed" to social justice and naturally at ease in different settings. That was a valuable trait in early 1990s New York City, when tensions between whites and blacks were high, said Jealous, who is now the president of the National Assn. for the Advancement of Colored People. Against a backdrop of racial violence, including the stabbing of the Rev. Al Sharpton in Brooklyn in 1991, "there was an urgent need to build bridges," he said.

On Columbia's campus, Garcetti pushed to involve more men in Take Back the Night protests against sexual violence and tracked hate crimes as president of the National Student Coalition Against Harassment. He also worked against homelessness and founded the Columbia Urban Experience, a program that exposes incoming freshmen to city life through volunteerism.

Judith Russell, a Columbia professor who taught Garcetti in a yearlong urban politics course, remembers him as a skilled organizer. "Eric was one of the best people I've ever met at getting people to agree," she said.

He was also ambitious. Russell says she wrote countless recommendation letters for Garcetti, who was always applying for some new opportunity. "For most people I have a file or two. For Eric I have a folder," she said.

Even as a student, Garcetti went to great lengths to guard his image and public reputation. In a 1991 letter to a campus newspaper, a 20-year-old Garcetti sought a retraction of a quote that he acknowledged was accurate. A reporter wrote that Garcetti called owners of a store that declined to participate in a Columbia-sponsored can recycling program "assholes." Garcetti said the comment was off the record.

"I would ask, then, if you would retract the quote, not because of the morality of my position, rather the ethics of the quoting," he wrote.

That self-awareness came partly from being raised in a politically active family. Back in Los Angeles, his father was mounting a successful campaign for county district attorney. His mother, the daughter of a wealthy clothier, ran a community foundation. Her father, who had been President Lyndon B. Johnson's tailor, made headlines in the 1960s when he took out a full-page ad in the New York Times calling on Johnson to exit the Vietnam War.

Garcetti's family wealth allowed him to carry on the legacy of political activism. While attending L.A.'s exclusive Harvard School for Boys, he traveled to Ethiopia to deliver medical supplies. In college, while other students worked at summer jobs, he traveled twice to Burma to teach democracy to leaders of the resistance movement.

In 1993, after receiving a master's degree from Columbia's School of International and Public Affairs, Garcetti departed for Oxford. There he met Cory Booker, a fellow Rhodes scholar who is now the mayor of Newark, N.J., and a likely candidate for the U.S. Senate. Garcetti, Booker said, "was one of those guys who would be in the pub at midnight talking passionately about making a better world."

In England, Garcetti worked with Amnesty International and also met his future wife, Amy Wakeland, another Rhodes scholar with activist leanings. Garcetti remembers being impressed when Wakeland missed President Clinton's visit to the Rhodes House at Oxford because she was on the streets protesting tuition hikes. Her worldview aligned with his, he told friends.

In his second year at Oxford, Garcetti persuaded student leaders to join him in a hunger strike after the passage of Proposition 187, the 1994 California ballot measure that denied immigrants access to state healthcare and schools.

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German Sees 'Clowns,' and Italian Sends Cancellation

BERLIN — The president of Italy canceled a dinner meeting Wednesday with Peer Steinbrück, Chancellor Angela Merkel’s challenger in the coming September elections, after Mr. Steinbrück referred to two prominent Italian political figures as “clowns.”

Mr. Steinbrück, the candidate for the Social Democratic Party, made the comments at an event in Potsdam on Tuesday that was part of a nationwide tour for his own campaign, said his spokesman, Michael Donnermeyer.

During the event, Mr. Steinbrück described former Prime Minister Silvio Berlusconi as “a clown with a special shot of testosterone.” At another point, he extended his remarks to include Beppe Grillo — a former comedian whose Five Star Movement won more votes than any other party in the Italian elections that ended Monday — saying that “to a certain extent, I am upset that two clowns have won.”

German leaders have not sought to hide their dislike for Mr. Berlusconi, who they say dragged Italy into the euro zone debt crisis. Before the Italian vote, several allies of Ms. Merkel made clear in public remarks that they supported Prime Minister Mario Monti and his program in Italy.

But Mr. Steinbrück’s comments appeared to hit a nerve with President Giorgio Napolitano, who is overseeing the delicate negotiations to form a new government after the Italian vote failed to produce a clear governing majority in both houses of Parliament.

“We deeply respect Germany for its successes,” Mr. Napolitano said Wednesday in a speech to the Italian community in Munich. “Germany was capable of resurrecting from its own ruins and rebuilding a new Europe together with Italy. We respect, but naturally we demand respect for our own country.”

He is scheduled to meet with Ms. Merkel in Berlin on Thursday.

Both Mr. Berlusconi and Mr. Grillo were highly critical of Ms. Merkel in their election campaigns, blaming the German government for having pushed Italy to enact painful economic austerity under Mr. Monti’s government.

Steffen Seibert, the chancellor’s spokesman, said the German government rejected the view that the outcome of the vote in Italy was a rejection of the austerity program that Ms. Merkel has championed as the best way for Europe to pull out of its financial crisis. He also said Ms. Merkel would work together with the new Italian government, “whatever it may be.”

Mr. Steinbrück spoke with Mr. Napolitano by telephone later Wednesday to “clarify” the situation, Mr. Donnermeyer said. But the remarks drew criticism from other politicians in Berlin, where comments that can be viewed as meddling in other countries’ affairs are considered undiplomatic.

Michael Meister, deputy leader of Ms. Merkel’s Christian Democratic Union in the lower house of Parliament, said via Twitter that Mr. Steinbrück “behaves like a bull in a china shop.”

It is not the first time that Mr. Steinbrück has angered one of Germany’s European partners. In 2009, while serving as finance minister in Ms. Merkel’s first government, he joked about Switzerland’s fear of the German cavalry in the midst of a disagreement with the country over tax havens.

“With such comments, Mr. Steinbrück proves he is qualified for a TV talk show, but not for the chancellery,” said Sabine Leutheusser-Schnarrenberger, the justice minister and deputy leader of the Free Democrats, Ms. Merkel’s coalition partner.

Gaia Pianigiani contributed reporting from Rome.

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Vinny Guadagnino Rescues a 'Gorgeous' Pit Bull

People Pets

By Alison Schwartz

02/27/2013 at 04:35 PM EST

Vinny Guadagnino's new dog, Bodhi

Courtesy Vinny Guadagnino; Inset: Jeff Kravitz/FilmMagic

Vinny Guadagnino may need to call former Jersey Shore castmate Snooki for some parenting tips: He's welcomed a furry new addition.

Guadagnino adopted a pit bull from the North Shore Animal League, he announced on Twitter on Saturday.

By Monday night, he'd come up with a name for his "gorgeous girl."

"Inspired by her muscles and Buddhism, meet....Bodhi," he wrote. (In Sanskrit, the word means "enlightenment.")

And it looks like the two are already clocking in plenty of quality time together, along with Guadagnino's lady friend, Melanie Iglesias.

"Long as my b----es love me," he wrote. "#cuddletime."

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Vt. lye victim gets new face at Boston hospital

BOSTON (AP) — The 2007 chemical attack left the Vermont nurse unrecognizable to anyone who knew her.

But now Carmen Blandin Tarleton's face has changed again following a facial transplant this month.

Doctors at Brigham & Women's Hospital in Boston said Wednesday that the 44-year-old's surgery included transplanting a female donor's facial skin to Tarleton's neck, nose and lips, along with facial muscles, arteries and nerves.

"I know how truly blessed I am, and will have such a nice reflection in the mirror to remind myself what selfless really is," Tarleton wrote on her blog Wednesday.

The Thetford, Vt., woman suffered burns on more than 80 percent of her body and was blinded after her estranged husband attacked her with a baseball bat and doused her with lye in 2007.

Tarleton, who once worked as a transplant nurse, has undergone more than 50 surgeries since the attack, including work to restore some of her vision.

The latest surgery took 15 hours and included a team of more than 30 medical professionals. The lead surgeon, Bohdan Pomahac, called her injuries among the worst he's seen in his career.

"Carmen is a fighter," the doctor said Wednesday. "And fight she did."

Pomahac's team has performed five facial transplants at the hospital. He said the patient is recovering very well and is in great spirits as she works to get stronger.

He said she was very pleased when she saw her face for the first time, and that her appearance will not match that of the late donor's face.

"I think she looks amazing, but I'm biased," he said with a smile.

The donor's family wants to remain anonymous, but released a statement through a regional donor bank saying that her spirit would live on through Tarleton and three other organ recipients.

The estranged husband, Herbert Rodgers, pleaded guilty in 2009 in exchange for a prison sentence of at least 30 years.

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Imperial County betting its future on renewable energy

Situated in the southeastern corner of California, bordering Arizona and Mexico, Imperial County has long depended on agriculture and cash crops that grew from the good earth.

But lately the region — which carries the dubious distinction of having the state's highest unemployment rate at 25.5% — is betting its future on a different kind of farm: green energy.

Spurred by a state mandate that requires utilities to get a third of their electricity from green sources by 2020, renewable energy companies are leasing or buying thousands of acres in Imperial County to convert to energy farms providing power for coastal cities — bringing an estimated 6,000 building jobs and billions in construction activity to the county.

Although renewable energy projects are sprouting up across the Golden State, no county needs them as much as Imperial, which has consistently ranked as the worst-performing region of California even in boom times.

The prospect of a construction boom has excited residents hungry for work. But some farmers and Native American tribes are crying foul, angry that the new projects are encroaching on land that they claim has cultural value or should be devoted to crops.

Solar, wind and geothermal projects are popping up on farms that once grew wheat, alfalfa and sugar beets. County officials say the normally hardscrabble region is benefiting from vast tracts of affordable land and lots of sunshine, the one resource the region can almost always count on.

"It's sunny 365 days of the year, damn near," boasted Mike Kelley, chairman of the county's Board of Supervisors. "Renewable energy is going to give Imperial County a shot in the arm."

Local advocates are betting that a "green rush" will lift a county that has struggled with economic upheaval. The Bureau of Labor Statistics just ranked El Centro as the second-worst metro area for job hunters, after Yuma, Ariz. Its unemployment rate fluctuated between 25% and 33% from 2010 and 2012.

Two of the county's top five employers are the Calipatria and Centinela state prisons. The agriculture sector shed jobs as farmers moved to automation and switched to less labor-intensive crops. Construction work vanished when El Centro, the county's biggest city, was hit hard by the housing crisis. Long-standing businesses such as a food processing plant moved elsewhere, taking away hundreds of jobs.

But with green energy companies scrambling to build solar installations and wind farms throughout the county, some residents are convinced that Imperial's fortunes will soon be looking up.

Tenaska Solar Ventures plans to break ground this year on its second project in the county after nearing completion on its first site, known as the Imperial Solar Energy Center South, on nearly 1,000 acres near El Centro.

The company came to the region both for its "abundant sunshine" and also proximity to the Sunrise Powerlink, a power transmission line completed last year that connects Imperial and San Diego counties, said Bob Ramaekers, Tenaska's vice president of development.

More than 500 construction workers have been hired to work on Tenaska Imperial South, with 70% coming from the local community, he said. A job fair held last year drew about 1,200 applicants. The second project will generate as many as 300 construction jobs, with priority given to local hires.

"One of the advantages of solar projects is they are not really high-tech. Anyone who has worked at all in the construction business can work in a solar facility," said Andy Horne, deputy executive officer of the county's natural resources department. "It's like a big erector set — you bolt these things together and ba-da-bing, you have a solar project."

The lure of a steady, well-paid job is what persuaded Victor Santana, 27, to start training as a journeyman electrician two years ago. He had studied film in college and hoped to make movies, but ended up working a series of odd jobs after the economic downturn — driving tractors, operating hay presses, selling vacuum cleaners. Even a video-editing gig he eventually found paid minimum wage,

"Things had dried up. There was only field work, or fast food, or working at the local mall," the El Centro resident said.

Santana finally decided to switch careers after hearing the pitch from green energy companies trickling into town. Now he earns about $21 an hour with regular raises every six months, and the prospect of steady work for another seven to 10 years just from the stream of solar and wind projects. "I feel a lot more secure than I did," he said.

Green energy may help Imperial hold onto its young people, who often try to land a government job or leave the county altogether in search of better-paying jobs elsewhere. Calipatria Unified School District is launching a vocational program this fall to prepare high school graduates for jobs in renewable energy. San Diego State is building a power plant simulator at its Brawley campus.

"With the advent of renewable energy, we are seeing a different kind of industrial base," said Mike Sabath, associate dean of academic affairs at San Diego State's Imperial Valley campus. "Hopefully that will provide opportunities to develop more job stability in the region than what we have enjoyed."

But construction has raised the hackles of some locals. There are farmers wringing their hands over fertile land snapped up by energy companies; they worry that a way of life is being edged out by corporations eager to cash in on the modern gold rush.

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Immigrants Released Ahead of Automatic Budget Cuts

Federal immigration officials have released hundreds of detainees from immigration detention centers around the country in a highly unusual effort that is intended to save money as automatic budget cuts loom in Washington, officials said Tuesday.

The government has not dropped the deportation cases against the immigrants, however. The detainees have been freed on supervised release while their cases continue in court, officials said.

But the move angered some Republicans, including Rep. Robert W. Goodlatte of Virginia, chairman of the House Judiciary Committee, who said the releases were a political gambit by the Obama administration that undermined the continuing negotiations over comprehensive immigration reform and jeopardized public safety.

“It’s abhorrent that President Obama is releasing criminals into our communities to promote his political agenda on sequestration,” said Mr. Goodlatte, who is running the House hearings on immigration reform. “By releasing criminal immigrants onto the streets, the administration is needlessly endangering American lives.”

While administration officials did not explain how they selected detainees for release, they suggested that the population did not include immigrants who were the focus of the administration’s stated enforcement priorities, including those convicted of serious crimes.

“Priority for detention remains on serious criminal offenders and other individuals who pose a significant threat to public safety,” said Gillian M. Christensen, a spokeswoman for Immigration and Customs Enforcement, or ICE, an arm of the Department of Homeland Security.

The releases, which began several days ago and continued on Tuesday, were intended “to make the best use of our limited detention resources in the current fiscal climate,” Ms. Christensen said. “As fiscal uncertainty remains over the continuing resolution and possible sequestration, ICE has reviewed its detained population to ensure detention levels stay within ICE’s current budget.”

The government-wide budget cuts, known as the sequester, are scheduled to take effect on Friday. Immigration officials declined to say whether they intended to make any further cutbacks in detention programs this week.

The agency, Ms. Christensen added, “is continuing to prosecute their cases in immigration court and, when ordered, will seek their removal from the country.”

Officials did not reveal precisely how many detainees were released or where the releases took place, but immigrants’ advocates around the country have been reporting that hundreds of detainees were freed in numerous locations, including Hudson County, N.J.; Polk County, Texas; Broward County, Fla.; and New Orleans; and from centers in Arizona, Alabama, Georgia and New York.

While immigration officials occasionally free detainees on supervised release, this mass release — so many in such a short span of time — appears to be unprecedented in recent memory, immigration advocates said.

Under supervised release, defendants in immigration cases have to adhere to a strict reporting schedule that might include attending appointments at their regional ICE office as well as electronic monitoring, immigration officials said.

Immigrants’ advocacy groups, citing the cost of detaining immigrants, have for years argued that the federal government should make greater use of practical and less expensive alternatives to detention for low-risk defendants being held on administrative charges.

The National Immigration Forum estimated last year that it cost the federal government between $122 and $164 per day to hold a detainee in its immigration system. In contrast, the organization said, alternative forms of detention could cost 30 cents to $14 per day per immigrant.

Advocacy groups applauded the releases but pressed the Obama administration to do more, including adhering more closely to its declared enforcement priorities like focusing on serious criminals and those who pose a threat to public safety, rather than immigrants accused of misdemeanors and administrative immigration violations.

“It shouldn’t take a manufactured crisis in Washington to prompt our immigration agencies to actually take steps towards using government resources wisely or keeping families together,” said Carolina Canizales, a leader of United We Dream, the nation’s largest organization of young illegal immigrants.

At a White House news briefing on Monday, Janet Napolitano, Homeland Security secretary, seemed to hint at the move. “All I can say is, look, we’re doing our very best to minimize the impacts of sequester,” she told reporters. “But there’s only so much I can do. I’m supposed to have 34,000 detention beds for immigration. How do I pay for those?”

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Kendra Wilkinson Takes Kate Gosselin's Parenting Advice After Celebrity Wife Swap

TV Watch

TV News

By Dahvi Shira

02/26/2013 at 05:00 PM EST

Kendra Wilkinson (left) and Kate Gosselin

Giulio Marcocchi/Startraks; Taylor Hill/Getty

When it comes to parenting, Kendra Wilkinson considers Kate Gosselin her mentor.

"If there's any person in this world I'm going to take motherly advice from, it's going to be Kate Gosselin," Wilkinson, 27, told PEOPLE on Friday. "She has eight kids and she knows what she's doing with them. When she told me advice, I listened. With most people, I'm just like, 'Whatever ... whatever, I'm not going to listen to you.' But she's the type I would take advice from."

The two moms connected while filming an episode of Celebrity Wife Swap, which airs Tuesday on ABC (8 p.m. ET). While Wilkinson stayed in Gosselin's Pennsylvania home with her eight kids, Gosselin, 37, ventured to L.A. to live with Wilkinson's hubby Hank Baskett and their 3-year-old son, Hank Baskett IV.

"It was very nerve-racking and I had a lot of anxiety on my end," Wilkinson said of the swap. But, she adds, "Hank's side of things was more the drama. Kate shines the light on things people don't really understand."

Gosselin, it seems, didn't appreciate the couple's more relaxed lifestyle.

"Hank stood up for me and had my back, because I don't think Kate really understands why a man like him is so domestic," the former Girls Next Door star explains. "Hank was like, 'Just chill, relax. These are our rules.' A woman gets to relax and be free. Kate freaked out because she's so used to working and structure and every minute is by the book. But that's not us, though. We're very laid back. We go with the flow."

Still, the reality stars bonded after being out of their respective comfort zones.

"We both got a taste of each other's lives," Wilkinson says of the former Kate Plus 8 star. "We got really close and really in-depth."

She even recommends the Wife Swap experience.

"People should do these swaps more often," she says. "Not just for show, but you really just find this appreciation for your neighbors through this."

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C. Everett Koop, 'rock star' surgeon general, dies

NEW YORK (AP) — Dr. C. Everett Koop has long been regarded as the nation's doctor— even though it has been nearly a quarter-century since he was surgeon general.

Koop, who died Monday at his home in Hanover, N.H., at age 96, was by far the best known and most influential person to carry that title. Koop, a 6-foot-1 evangelical Presbyterian with a biblical prophet's beard, donned a public health uniform in the early 1980s and became an enduring, science-based national spokesman on health issues.

He served for eight years during the Reagan administration and was a breed apart from his political bosses. He thundered about the evils of tobacco companies during a multiyear campaign to drive down smoking rates, and he became the government's spokesman on AIDS when it was still considered a "gay disease" by much of the public.

"He really changed the national conversation, and he showed real courage in pursuing the duties of his job," said Chris Collins, a vice president of amfAR, the Foundation for AIDS Research.

Even before that, he had been a leading figure in medicine. He was one of the first U.S. doctors to specialize in pediatric surgery at a time when children with complicated conditions were often simply written off as untreatable. In the 1950s, he drew national headlines for innovative surgeries such as separating conjoined twins.

His medical heroics are well noted, but he may be better remembered for transforming from a pariah in the eyes of the public health community into a remarkable servant who elevated the influence of the surgeon general — if only temporarily.

"He set the bar high for all who followed in his footsteps," said Dr. Richard Carmona, who served as surgeon general a decade later under President George W. Bush.

Koop's religious beliefs grew after the 1968 death of his son David in a mountain-climbing accident, and he became an outspoken opponent of abortion. His activism is what brought him to the attention of the administration of President Ronald Reagan, who decided to nominate him for surgeon general in 1981. Though once a position with real power, surgeon generals had been stripped of most of their responsibilities in the 1960s.

By the time Koop got the job, the position was kind of a glorified health educator.

But Koop ran with it. One of his early steps involved the admiral's uniform that is bestowed to the surgeon general but that Koop's predecessors had worn only on ceremonial occasions. In his first year in the post, Koop stopped wearing his trademark bowties and suit jackets and instead began wearing the uniform, seeing it as a way to raise the visual prestige of the office.

In those military suits, he surprised the officials who had appointed him by setting aside his religious beliefs and feelings about abortion and instead waging a series of science-based public health crusades.

He was arguably most effective on smoking. He issued a series of reports that detailed the dangers of tobacco smoke, and in speeches began calling for a smoke-free society by the year 2000. He didn't get his wish, but smoking rates did drop from 38 percent to 27 percent while he was in office — a huge decline.

Koop led other groundbreaking initiatives, but perhaps none is better remembered than his work on AIDS.

The disease was first identified in 1981, before Koop was officially in office, and it changed U.S. society. It destroyed the body's immune system and led to ghastly death, but initially was identified in gay men, and many people thought of it as something most heterosexuals didn't have to worry about.

U.S. scientists worked hard to identify the virus and work on ways to fight it, but the government's health education and policy efforts moved far more slowly. Reagan for years was silent on the issue. Following mounting criticism, Reagan in 1986 asked Koop to prepare a report on AIDS for the American public.

His report, released later that year, stressed that AIDS was a threat to all Americans and called for wider use of condoms and more comprehensive sex education, as early as the third grade. He went on to speak frankly about AIDS in an HBO special and engineered the mailing of an educational pamphlet on AIDS to more than 100 million U.S. households in 1988.

Koop personally opposed homosexuality and believed sex should be saved for marriage. But he insisted that Americans, especially young people, must not die because they were deprived of explicit information about how HIV was transmitted.

Koop's speeches and empathetic approach made him a hero to a wide swath of America, including public health workers, gay activists and journalists. Some called him a "scientific Bruce Springsteen." AIDS activists chanted "Koop, Koop" at his appearances and booed other officials.

"I was walking down the street with him one time" about five years ago, recalled Dr. George Wohlreich, director of the College of Physicians of Philadelphia, a medical society with which Koop had longstanding ties. "People were yelling out, 'There goes Dr. Koop!' You'd have thought he was a rock star."

Koop angered conservatives by refusing to issue a report requested by the Reagan White House, saying he could not find enough scientific evidence to determine whether abortion has harmful psychological effects on women.

He got static from some staff at the White House for his actions, but Reagan himself never tried to silence Koop. At a congressional hearing in 2007, Koop spoke about political pressure on the surgeon general post. He said Reagan was pressed to fire him every day.

After his death was reported Monday, the tributes poured forth, including a statement from New York Mayor Michael Bloomberg, who has made smoking restrictions a hallmark of his tenure.

"The nation has lost a visionary public health leader today with the passing of former Surgeon General C. Everett Koop, who was born and raised in Brooklyn," Bloomberg said. "Outspoken on the dangers of smoking, his leadership led to stronger warning labels on cigarettes and increased awareness about second-hand smoke, creating an environment that helped millions of Americans to stop smoking — and setting the stage for the dramatic changes in smoking laws that have occurred over the past decade."

Dr. Anthony Fauci of the National Institutes of Health taught Koop what was known about AIDS during quiet after-hours talks in the early 1980s and became a close friend.

"A less strong person would have bent under the pressure," Fauci said. "He was driven by what's the right thing to do."

Carmona, a surgeon general years later, said Koop was a mentor who preached the importance of staying true to the science in speeches and reports — even when it made certain politicians uncomfortable.

"We remember him for the example he set for all of us," Carmona said.

Koop's nomination originally was met with staunch opposition. Women's groups and liberal politicians complained Reagan had selected him only because of his conservative views, especially his staunch opposition to abortion.

Foes noted that Koop traveled the country in 1979 and 1980 giving speeches that predicted a progression "from liberalized abortion to infanticide to passive euthanasia to active euthanasia, indeed to the very beginnings of the political climate that led to Auschwitz, Dachau and Belsen."

But Koop, a devout Presbyterian, was confirmed as surgeon general after he told a Senate panel he would not use the post to promote his religious ideology. He kept his word and eventually won wide respect with his blend of old-fashioned values, pragmatism and empathy.

Koop was modest about his accomplishments, saying before leaving office in 1989, "My only influence was through moral suasion."

The office declined after that. Few of his successors had his speaking ability or stage presence. Fewer still were able to secure the support of key political bosses and overcome the meddling of everyone else. The office gradually lost prestige and visibility, and now has come to a point where most people can't name the current surgeon general. (It's Dr. Regina Benjamin.)

Even after leaving office, Koop continued to promote public health causes, from preventing childhood accidents to better training for doctors.

"I will use the written word, the spoken word and whatever I can in the electronic media to deliver health messages to this country as long as people will listen," he promised.

In 1996, he rapped Republican presidential hopeful Bob Dole for suggesting that tobacco was not invariably addictive, saying Dole's comments "either exposed his abysmal lack of knowledge of nicotine addiction or his blind support of the tobacco industry."

He maintained his personal opposition to abortion. After he left office, he told medical students it violated their Hippocratic oath. In 2009, he wrote to Senate Majority Leader Harry Reid, urging that health care legislation include a provision to ensure doctors and medical students would not be forced to perform abortions. The letter briefly set off a security scare because it was hand delivered.

Koop served as chairman of the National Safe Kids Campaign and as an adviser to President Bill Clinton's health care reform plan.

Worried that medicine had lost old-fashioned caring and personal relationships between doctors and patients, Koop opened an institute at Dartmouth College in New Hampshire to teach medical students basic values and ethics. He also was a part-owner of a short-lived venture, drkoop.com, to provide consumer health care information via the Internet.

Koop was the only son of a Manhattan banker and the nephew of a doctor. He said by age 5 he knew he wanted to be a surgeon and at age 13 he practiced his skills on neighborhood cats. He attended Dartmouth, where he received the nickname Chick, short for "chicken Koop." It stuck for life.

He received his medical degree at Cornell Medical College, choosing pediatric surgery because so few surgeons practiced it. In 1938, he married Elizabeth Flanagan, the daughter of a Connecticut doctor. They had four children. Koop's wife died in 2007, and he married Cora Hogue in 2010.

He was appointed surgeon-in-chief at Children's Hospital in Philadelphia and served as a professor at the University of Pennsylvania School of Medicine. He pioneered surgery on newborns and successfully separated three sets of conjoined twins. He won national acclaim by reconstructing the chest of a baby born with the heart outside the body.

Although raised as a Baptist, he was drawn to a Presbyterian church near the hospital, where he developed an abiding faith. He began praying at the bedside of his young patients — ignoring the snickers of some of his colleagues.

___

Contributing to this report were Associated Press writers Wilson Ring in Montpelier, Vt.; Jeff McMillan in Philadelphia; and AP Medical Writer Lauran Neergaard in Washington.

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Does Eric Garcetti keep his word? Accounts vary

Santiago Perez and his neighbors went straight to Councilman Eric Garcetti when they heard that a developer planned to build a 62-unit housing and retail development on their quiet street in Echo Park.

Worried that the four-story complex would tower over homes and bring excess traffic, the group emerged from their meeting at Los Angeles City Hall feeling relieved. "He told us that, yes, he's with us and he will do everything possible to reject the plan," Perez said.

But months later in front of the citywide Planning Commission, a Garcetti representative offered the lawmaker's tacit support for the project, saying it was "designed well" and would bring needed jobs and housing to the area.

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Perez and his neighbors felt blindsided. "He said one thing and then he did another," Perez said. One of his neighbors fired off an angry message via Twitter: "Eric Garcetti went back on his word."

If Garcetti succeeds in his bid to become L.A.'s next mayor, he will face new pressure to take decisive action on hotly contested issues. A number of colleagues and constituents say he has not always been a steadfast ally and decision maker.

Another mayoral front runner, Wendy Greuel, alluded to that allegation in a recent appearance before city workers, saying they need someone who will "be true to their word."

FULL COVERAGE: L.A.'s race for mayor

Garcetti insists he never wavers from a promise. In nearly 12 years in office, he has made decisions that have upset some people, he acknowledged. But the vast majority of people he has worked with have had positive experiences, he said.

He said that he never committed to fighting the Echo Park development and that he "reserves the right" to take his time forming a position on an issue. "I listen to a lot of people to make sure I'm as well-informed as possible up until the last hour," he said.

Councilman Bernard C. Parks, who has served alongside Garcetti for more than a decade, said Garcetti too often tests the political winds before taking a stand. Parks, who is backing Councilwoman Jan Perry's bid for mayor, alleges that Garcetti misled him last year by voting for a controversial redistricting plan after indicating he opposed it. Garcetti also undermined the city's efforts to hold down costs of employee union contracts, Parks said.

INTERACTIVE MAP: How Los Angeles voted

"I think he doesn't want to make an enemy of anyone," Parks said.

Garcetti said that he never told Parks he would oppose the redistricting plan and that the tough stance he took with the unions is "the reason I don't have [them] lining up behind me."

Questions of Garcetti's reliability arose for Marc Galucci, who went to the councilman for support in turning his Echo Park cafe into a restaurant serving beer and wine.

Galucci assembled neighbors to back his application for a liquor license for Fix Coffee, but parents of some children at a nearby school opposed it.

Galucci said Garcetti told him that he would remain neutral but offered suggestions on how to gain community support. Then, at 10 p.m. the night before the liquor license hearing, a Garcetti representative phoned. "Tomorrow at the hearing we're going to oppose this," she said.

"I was just flabbergasted," said Galucci. He later learned that Monica Garcia, president of the Board of the Los Angeles Unified School District, had asked Garcetti to oppose the request.

In the end, Galucci got the license, but he said the situation left him with a bad taste.

Garcetti acknowledged that the issue had been "a contentious one," but he said he had not pledged to remain neutral. He said that he initially liked the idea of a liquor permit for Fix but that community opposition "continued to grow and grow."

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