Lt. Col. Charles D. Bolan, USA, MC, FACP
Governor, U.S. Army Chapter
Greetings this newsletter is devoted to Army internists, past, present and future, and to our patients, the diseases we treat, and the environment in which we work. I wish to acknowledge the award winners and support for the outstanding meeting last Fall sponsored by Brooke Army Medical Center chaired by COL Mike Berry, COL James Johnson and LTC Rick Marple, as well as the sponsors for prior meetings at Walter Reed. I especially wish to recognize the work done by the Army ACP-ASIM Awards Council, chaired previously by COL Les Reed and now by COL Dale Vincent. Finally, COL Nathan Erteschik has been appointed as Governor-elect for our Chapter, and will succeed me as Army Governor at the national ACP-ASIM spring meeting in 2001.
Internal medicine is the core specialty involving the overall health of soldiers and adults in a theatre of operations. Providing the best care for these patients raises many challenges. The setting is austere and resource-limited, and the environment hostile. The diseases and their presentation are different than what is commonly seen in peace time practice. The physician functions in a military culture, frequently as part of a line unit, which provides protection from hostile forces and yet may be the focal point of further conflict. The transition from peace-time to war-time has great consequences for patient care and physician morale. With more rapidly paced deployments and increasingly lethal biological, chemical, nuclear and other medically-based weapons, the challenges for the deploying military internist are higher than ever. Thus, the experiences of internists on prior deployments have special meaning. The World War II internist is of particular interest as this was the first conflict after the establishment of the American Board of Internal Medicine and the first where a medical officer might have an assigned doctrinal role due to expertise in Internal Medicine. Although the practice setting was highly variable in WW2, the experiences of Dr Ellis outline some of the challenges and illustrate the ideals typical of many of those who served.
After working in the Civilian Conservation Corps, Dr. Ellis started his medical studies at the Medical College of Virginia. He was encouraged to transfer to Harvard Medical College by his mentor Chester Jones. He then completed his medical training at Harvard and an internship in Internal Medicine at the Massachusetts General Hospital before starting his residency at the University of Wisconsin. After the bombing of Pearl Harbor, he was asked to join the 6th General Hospital as an internist. The 6th trained at Camp Blandon Florida, marching in sand and practicing gas mask drills from May 1942 until their deployment by ships to North Africa in January 1943. In North Africa the hospital received casualties by train from evacuation hospitals, and Dr. Ellis spent time working with Dr Theodore Woodward who was studying rickettsial disease in this theatre. When Dr Churchill, surgical consultant for North Africa, came looking for surgeons for forward units, Dr. Ellis volunteered to serve as a battalion surgeon and was assigned in this capacity to the 133rd Field Artillery Battalion of the 36th Infantry Division where he cared for allied and enemy soldiers suffering from gun shot and shrapnel wounds during the invasion of Italy. At the completion of this campaign, he was transferred to the 116th Evacuation Hospital which was the first medical unit into the Dachau concentration camp, caring for more then 40,000 survivors with typhoid, malnutrition and exhaustion. Dr. Ellis was awarded the Bronze Star Medal for his dedication to his patients with the 116th Evac.
After World War 2 Dr Ellis returned to his family and first met his three year old son, who was born while he was overseas. He joined the staff of Dr Jones in gastroenterology and served as an investigator and clinician at the Mass General and as a teacher at Harvard Medical School. He also served on multiple hospital committees, as College Governor for Massachusetts, and was made a Master in 1979. He is active as an emeritus physician at the Massachusetts General Hospital.
Dr. Ellis was part of a generation of WW2 physicians for whom the care of patients in operational settings was an integral part of their own personal experience, from which they later taught students and residents at medical schools and hospitals throughout the United States. The medical system, and Army in which they served, was slow to deploy, but their professionalism and clinical excellence helped cement the standards on which military internal medicine is built. Our present military medical system has different strengths and weakness. As heirs to these physicians we face many of the same challenges on deployment. We have their standards to guide our behavior, an immense technology to apply to increasingly diverse medical diseases, and a real challenge to shape our system to provide the best possible care for our patients.
2000 College Mastership
LTG Ronald Blanck was awarded a Mastership by the American College of Physicians-American Society of Internal Medicine at the April 2000 Annual Session in Philadelphia, Pennsylvania. LTG Blanck's military career included tours as a Battalion Surgeon in Viet Nam, Chief of Medicine at Brooke Army Medical Center, Commander of Walter Reed Army Medical Center and Surgeon General of the Army. He received many military awards commensurate with these activities including the Bronze Star and Legion of Merit. LTG
Blanck also served as the Army Chapter ACP Governor and played an instrumental role in development of the Uniformed Services University of the Health Sciences. LTG Blanck is remembered by College staff as someone who was a genuine pleasure to work with, and by his colleagues as someone who would someday be Surgeon General. He is one of a handful of military officers to receive the award of Mastership while on active duty, and joins COL (ret) Leonard Wartofsky and COL (ret) Barbara Alving as the most recent Army winners of this award. LTG Blanck retired from the Army this past summer and now serves as President of the University of North Texas Health Sciences Center, Fort Worth, Texas.
Fall 1999 Meeting
After many successful meetings in the San Francisco and Washington DC areas, Brooke Army Medical Center sponsored a spectacularly successful Fall meeting at the San Antonio Convention Center and Menger Hotel. COL James Johnson, COL Michael Berry, and LTC Richard Marple were the principal organizers for the meeting. CPT Steve Harrison played a prominent role organizing the Associates competition, which included poster and podium presentations as well as the first Army Chapter associates jeopardy competition. The Henry M. Jackson Foundation, with Dr Bryce Reddington and John Rosenquist, provided administrative and structural support, and the Jackson Foundation has continued their support for our meeting this year in Reston, and the 2001 meeting which returns to San Antonio. Award winners included the following:
Army ACP-ASIM Chapter Laureates
- COL (retired) Terry Jenkins, FACP
- COL (retired) David Peura, FACP
- COL (retired) David Haburchak, FACP
Outstanding Teacher Award
LTC William Browne—Program Director, Eisenhower Army Medical Center
Robert Moser Award
MAJ Clorinda Zawacki—Darnell Army Community Hospital Fort Hood
William Crosby Award for Superiority in Research
COL George Tsokos—Walter Reed Army Institute of Research
The Laureate Awards are presented to members of the Army Chapter, often Fellows of the College, who have made long standing and lasting contributions to Internal Medicine and the Army Chapter. COL Jenkins served for many years as Chief of Hematology Oncology at Brooke, and then as the Consultant in Internal Medicine. He was a valued mentor to many housestaff. COL Peura served as Chief of Gastroenterology at Walter Reed, and as the Consultant in this specialty. He established an international reputation in gastrointestinal diseases. COL Haburchak's military career spanned 20 years in Internal Medicine and Infectious Diseases with clinical, educational and administrative leadership assignments at Letterman, Fitzsimmons, and Eisenhower Army Medical Centers.
The Moser Award is presented in honor of Robert Moser, COL (retired) USA MC, who served as Chief of Medicine at multiple Army Medical Centers and then was editor of JAMA and later the Executive Vice President of the ACP. The award recognizes an AMEDD medical officer at the rank of Major or below for service as a general internist. Major Zawacki served for 4 years at Fort Hood, deploying during that time to the Kuwait theater of operations, and was a leader on many hospital and Internal Medicine Committees. She is now an instructor in the Physician Assistant Program at the AMEDD Academy of the Health Sciences in San Antonio Texas.
The Crosby Award recognizes superiority in research, and is presented in honor of William Crosby, COL (retired) USA MC, for his many accomplishments in Hematology and Transfusion Medicine. LTC Tsokos was recognized for his research in the field of rheumatologic disease, and for his service as Assistant Chief of the Department of Clinical Investigation at Walter Reed Army Medical Center.
The Outstanding Teacher Award was recently established to recognize members of the Army ACP-ASIM Chapter who have excelled as teachers. LTC Brown was recognized not only by the Army Internal Medicine Program at Eisenhower Medical Center, but received similar award from the Georgia Chapter of the ACP-ASIM for his work with civilian students and residents who rotated through DDEAMC.
The Excellence in Operational Medicine Award was established to recognized Army internists who have excelled in operational medicine, and who bring the highest clinical and professional leadership standards to the practice of Internal Medicine throughout the AMEDD. COL Dunn has served as a MEDDAC commander, a Division Surgeon, a Research Commander, and is presently the commander of Walter Reed Hospital and the Walter Reed Health Care System. He taught the Chemical and Biological Casualty Care Course to more than 200 physicians on site in Saudi Arabia during Desert Shield and Desert Storm.
More than 60 Associates attended the San Antonio meeting, which was coordinated by CPT Stephen Harrison, the Army Associate Council Chair. This meeting included the first Army Associates Jeopardy Competition as well as podium and poster research presentations. COL Erteschik addressed GME issues to this group at a luncheon, and Associate breakfast groups were conducted to start things off early. All winners received a small cash award and a plaque. The first place winners also received an Army Achievement Medal. The winners of the research competition are listed below:
CPT Jeremy Perkins, Walter Reed
CPT Lynn Longmore, Brooke
CPT Robert Tyler, William Beaumont
CPT David Sachar, Walter Reed
Craig Kopecky, Brooke
CPT Marten Duncan, Madigan
The Jeopardy competition was held in two heats of four teams each and included representatives from the Navy and Air Force in addition to Army Medical Centers. Each winning team received a book award, and the contest will be continued at future meetings. The winners at San Antonio are listed below.
Walter Reed Army Medical Center
Brooke Army Medical Center
Third Place (Tie)
Eisenhower Army Medical Center and
Wilford Hall Air Force Medical Center
Army Chapter Council
The Army ACP-ASIM Council is doctrinally established to include the Internal Medicine Consultant, and the Chiefs of Medicine at Army Medical Centers as well as several of the larger MEDDACS. LTC Bill Gilliland served for several years as our first Treasurer and Medical Student Advisor, while COL Les Reed served as first chair of the Awards committee. Both have retired from the council and are missed.
The new members, and additional positions on the council are listed below, along with the Awards Council members:
Treasurer LTC Michael Roy, USUHS
Informatics LTC Kevin Abbott, WRAMC
Associates Council Chair CPT Steve Harrison, BAMC
Medical Student Member 2LT Steve Donnelly, HPSP Temple
Annual Meeting Chair 2000 LTC Argyros, WRAMC
Annual Meeting Chair 2001 COL Richard Marple, BAMC
Awards Committee Chair COL Dale Vincent, TAMC
Awards Subcommittee Chairs
Laureates COL Nathan Erteschik, WAMC
Moser COL George Weightman, OTSG
Crosby COL Robert Gates, BAMC
Excellence in Operational Medicine MAJ Stephen Salerno, USUHS
Outstanding Teacher COL Dale Vincent, TAMC
Army Chapter Informatics
LTC Kevin Abbott, staff nephrologist at Walter Reed, has served as the Army Chapter Informatics Officer over the past 4 years. He designed and implemented our Web Page, set up educational sessions in computer applications at our chapteral meeting, and is committed to improving learning and communication though the use of technology throughout the AMEDD. He remains active with the WRAMC nephrology web page, which includes practice guidelines, simple algorithms for calculation of renal function, web-based reference resources, and powerpoint continuing medical education presentations.
Fellowship In ACP-ASIM
The meaning of "FACP" has been clarified in recent College discussions, directed by Sara Walker, MACP, Chair of Membership and past Chair of Credentials. Fellows in the College are successful, internist leaders who have achieved the respect of their colleagues for their academic, clinical and organizational expertise. Fellows exhibit the highest professional and ethical standards of the College. Members are eligible for advancement to FACP after a minimum of two years as a member.
Although there are several pathways for advancement to FACP, my experience as Governor has been that successful Army internists are universally well qualified for advancement, in part because of the high quality of our people, and in part because of the many demands placed on Army internists early in their career development.
Please contact me if you have any questions about advancement to FACP, and if you are eligible, please submit your application. Packets can be obtained by calling ACP-ASIM at 1-800-523-1546, ext. 2600. The completed proposal will require 2 letters from present Fellows. After the package is collected at ACP-ASIM headquarters, I will write an endorsing letter. We have never had an Army proposal not go through... so please apply now!
COL Nathan Erteschik was appointed by LTG Blanck last winter to succeed me as Governor of the Army Chapter and will assume this role at the ACP-ASIM Annual Session in April 2001. COL Erteschik has also served as a superb consultant to the Surgeon General in Internal Medicine, and as Chief of Medicine at Fort Bragg.
I will have more about COL Erteschik in future newsletters.
It has been my pleasure to serve as your Governor, I look forward to seeing as many of you as possible in the future, in particular at Army and national ACP-ASIM meetings. Please keep in touch.
Charles Bolan, LTC MC