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Governor's Newsletter, Winter 2001-02

Capt. Angeline A. Lazarus, MD, FACP
Governor, U.S. Navy Chapter

Wishing you a happy New Year

The beginning of a year is a great time to take a few moments to reflect and appreciate the blessings in our life. We are all affected by the tragedy of 11 September. We continue to face the challenges of man-made disasters. Yet, we know, we live in a country blessed by God and we need to be aware and be appreciative of the cost of freedom. Our Annual meeting in Norfolk, hosted by the Internal Medicine Department of the Naval Medical Center, Portsmouth from 11-13 October was a grand success. The meeting report is included in this newsletter by CAPT. Bart Gumpert. It was an outstanding program chaired and co-chaired by CAPT. Barton Gumpert and CDR. Treyce Knee respectively. Their dedication and countless off-hours commitment along with the diligent support of the members of the program committee resulted in a well-attended, well-planned scientific conference and social activities. It was a wonderful opportunity to meet the internal medicine community of Navy Medicine. The Pre-course led by LCDR. Inouye was excellent with guest speakers and workshop on medical education.

New governor for Navy chapter in Spring 2003

Let me introduce to you the incoming governor for the Navy chapter who would take over from me in April 2003. It is CAPT. Walter Coyle, Gastroenterologist at the Naval Medical center, San Diego, CA. He received his internship and residency training in internal medicine at Naval Medical Center, Portsmouth, VA. After a tour of two years as a general internist at Naval Hospital, Jacksonville, FL, he completed fellowship training in gastroenterology at Naval Hospital, Portsmouth, VA. He has been very active in the Navy chapter. He was the program chair of navy annual meeting in 1998. He is a member of the Governor's Council and the Chair of Award's Committee. He has received several "Teacher of the Year" awards at the Naval hospital, Portsmouth and the Master Teacher Award by the Navy chapter. He is a dedicated physician, teacher and academician.

Navy Chapter Annual Meeting

CAPT. Bart Gumpert, MD, Chair

We had 131 registered participants for the meeting. Great mix of staff and residents from Internal Medicine departments from the big 3. We had 8 medical students. In the future, we would like more participation from the smaller navy IM departments and more medical students. San Diego won the Medical Jeopardy contest. I received a letter last week from Dr. Clifton Cleaveland thanking us for inviting him to our meeting. He wanted to tell us that it was one of the best ACP-ASIM Chapter Meetings that he has attended!

Associates' Scientific Program Winners

Oral Research Winners: (Listed in order of winners)

  1. "Absence of a Learning Curve in the comparison of Forceps for Endoscopic Esophageal Biopsy."
    Uday Paul, NMCSD

  2. "IL-2 Infusions in Combination with Highly Active Antiretroviral Therapy (HAART) in 6 HIV Infected Patients."
    Colleen Powers, NNMC

  3. "Evaluation of an Internship Program to Prepare Graduates for GMO Tours."
    Gautam Nayak, NNMC

Oral Vignettes: (Listed in order of winners)

  1. "Selective Cox-2 Inhibitor Associated Renal Failure-A Case Series."
    Todd Sheer, NMCSD

  2. "A Novel Use of U500 Insulin via Continuous Insulin in Patients with Severe Insulin Resistance: A Case Series."
    Daniel Seidensticker, NMCP

Poster Research: (Listed in order of winners)

  1. "Does a Preprinted Reminder Aid in Documentation of Using Herbal Products?"
    Heather Ventura, NMCP

  2. "Pneumococcal Resistance at NNMC."
    James Lyons, NNMC

Poster Vignettes: (Listed in order of winners)

  1. "Use of Acetazolamide for Elevated Intracranial Pressure Associated with Chronic Meningitis: Two Case Reports."
    Sugat Patel, NMCSD

  2. "Successful Use of Theophylline in the Treatment of Hypervagatonia-Associated Sinus Node Dysfunction in an Athlete."
    Eric High, NNMC

  3. "Fatal Remote Pulmonary Metastasis of a Low Grade Fibromyoid Sarcoma Masquerading as a Large Benign Appearing Thoracic Cyst."
    Daniel Rakowski, NMCP

Laureate Award:

John Francis Eisold MD, FACP
Rear Admiral, Medical corps, U.S. Navy
Attending Physician to Congress
U.S. Capitol, Washington, DC

Rear Admiral Eisold was born in 1946 in Cleveland, Ohio. He graduated from Dartmouth College in 1968 with a bachelor's degree in Physics. He began his naval career as a Nuclear Submarine Division Officer in 1968. He received his medical degree with honors in 1976 from Dartmouth Medical School. After internship and residency in Internal Medicine at the National Naval Medical Center, Bethesda, Maryland, he served as the Chief Resident for one year. He has held many leadership positions since the completion of his residency training.

In 1980, Dr. Eisold assumed the Head, General Medicine clinic and Hypertension clinic. In 1985, he took Robert Wood Johnson Health Policy Fellowship and served in Senator Kennedy's Health Staff on Labor and Human Resources. He was appointed as the assistant Head of the Department of Internal Medicine and also assumed the role of Program Director for Transitional Residency and Intern Advisor in 1988. He served as the Attending Physician and Special Assistant to the Chief of Naval Operations from 1986-1994. He was the Medical corps advisor to the Navy Surgeon General at the Pentagon from 1986 to 1988. He was selected to be the Department of Defense's Representative on the National Advisory Council on Aging for the National Institute on Aging from 1991-1996. In 1993, he became the Chairman of Department of Medicine and the Program Director of Internal Medicine Residency. In 1995, he was promoted to the rank of Rear Admiral and was assigned to the Capitol Hill as the Attending Physician to Congress.

Admiral Eisold holds the academic rank of Adjunct Professor of Medicine, Uniformed University of Health Sciences since 1999. He is board certified in Internal Medicine and a diplomate in Geriatric Medicine. He is a member of Alpha Omega Alpha honor society. He has received the following military awards: Legion of Merit with Gold Star, Meritorious Service Medal, Navy Commendation Medal with Gold Star, Meritorious Unit Commendation with 3 Bronze stars and National Defense Medal with Bronze star.

Admiral Eisold is a fellow of the American College of Physicians-American Society of Internal Medicine for many years. He has been an active member in the Navy Chapter and provided valuable guidance and support for the First Annual Meeting hosted by the National Naval Medical Center. He has encouraged and mentored several junior staff to become Fellow of the American College of Physicians through his sponsorship. He is a well-respected clinician and a talented teacher. Despite heavy clinical responsibilities at the Capitol Hill, Admiral Eisold has shown his dedication to teaching by continuing to take the morning report at the National Naval Medical Center on a regular basis. He attends the graduation ceremonies of the residents and has been a role model and mentor for many medical students and residents.

Admiral Eisold has served in many academic and administrative committees at local and national level. He had been active in Uniformed Services School of Health Sciences serving in the medical student selection committee and also interviewing candidates for medical school. He was a member of the Executive Committee of Graduate Medical Education Committee, Executive Committee of Medical Staff, Medical Corps Professional Review Board, Hospital Medical Staff section of the American Medical Association, Clinical Competency Committee, Intern Selection Committee, and Academic Promotions Committee at USUHS.

A consummate physician, Dr. Eisold reflects commitment to clinical excellence, exemplary teaching skills, and compassion for patients that serve as role model for internists. His professional and personal life exemplifies the highest ideals, traditions and commitment of the American College of Physicians-American Society of Internal Medicine. The Navy Chapter is extremely pleased to name Admiral Eisold, MC, USN a Laureate for 1999.

Volunteerism Award: CAPT J. Kennedy from Naval Medical Center, Portsmouth received the award for volunteerism. His devotion to his community is outstanding and serves as a role model for all physicians. Most notable is his service as volunteer physician at the Chesapeake Free Clinic, a community clinic in Chesapeake, Virginia, which provides free medical care to the uninsured patients in the surrounding area. Clinics are scheduled four to five times a month. CAPT Kennedy regularly volunteers and frequently more than that if willing physicians are unavailable. Additionally, he is frequently the first to volunteer to fill in at times when a cancellation occurs and a physician is needed on extremely short notice to prevent the cancellation of the clinic The Navy Chapter is proud to recognize CAPT Joseph Kennedy for his voluntary services to his community.

Medical/Military History Quiz

Name the Generals who became Presidents

Being a Military Internist-Living Large in London: Internal Medicine in the United Kingdom
CDR Mike Hall, MC, USN, U.S. Navy Medical Clinics, U.K.

One of the most remarkable aspects of being an Internist in the Navy are the myriad of opportunities one is afforded for experiences beyond the usual "Internal Medicine Track". From operations with Special Forces Units to hyperbaric research, the choices are limited only by timing and a small bit of luck. In the latter category, when a billet in London opened up for me three years ago, I figured this chance comes around only once in a career, and I jumped. This is a short history of those three years.

As the clinic's only internist, it falls to me to help in navigating the system, and expediting emergent cases. In addition to a large (and very senior) active duty population, we have a surprisingly large retired population of WW II vintage veterans who truly are "the greatest generation", and whom I am honored to call my patients.

One of the earliest differences one encounters is that there are no Internists in the United Kingdom. All specialists fast track directly, and leave the provision of the bulk of medical care to the overworked GP (who still makes house calls!). I can recall the first several times I called a specialist who was invariably handed the phone with the introduction: "its that American GP on the phone". I tried a few times initially to explain what an Internist was but found the experience was akin to teaching the proverbial pig to dance. I do miss having admitting privileges here, and as such would not recommend the duty to an aspiring Hospitalist.

I cannot imagine how a small clinic can operate without an Internist on the staff. The combination of rigorous training and a natural disposition lends itself to the clinics most difficult cases and broadest job description. As a solo internist, I get to provide flexible sigmoidoscopy, stress tests and holter monitors, allergy and immunotherapy, pulmonary function testing and interpretation, complicated pediatrics and OB, as well as your usual "bread and butter" multi-organ system compromised patients. In addition, you are "the doctor" to attend to medical boards, med-evacs, pharmacy and therapeutics issues etc., etc.

On a more personal note, the opportunity to live in one of the world's great cities cannot be underestimated. The cities history is woven throughout the tapestry of medicine and names such as Sir Alec Fleming, the Royal College of Physicians, St. Bart's, Watson and Crick (and the Eagle pub!) and John Snow are a part of the scenery. London sits at the doorstep of Europe and travel opportunities abound. As a triathlete, I belong to local running and biking clubs, both of whom trace their history nearly to the time of the American Civil War. I've been able to be in Paris for the last 3 years to see Lance Armstrong enter that city in triumph, and this year was able to travel to L'Ape d'Huez to see this year's decisive stage of the Tour de France. And finally, in the days surrounding that awful day in September, I was able to appreciate through an outpouring of cards, and calls, and support, that there is a "special relationship" between the British and us. The sight of the front gate of our base, and that of Grosvenor Square (the US Embassy) filled with cards and flowers is one that I will never forget.

This wandering life we all lead will bring my family and myself not to Paris this July but Jacksonville Naval Hospital. And in case you were wondering if my job here was open, I'm afraid CDR Paul Savage is the next holder of the "Dr. Tom Westbrook memorial Internal Medicine chair". Best of luck in 2005! Email: (wmhall@uk.med.navy.mil).

Poem From One of Our Patients

Becky Kinder 1988

An aura of blue the trail absorbs,
Illuminating all life around me,
Branches, leaves and snowflakes
Perform a ballet of winter above
Me in sharp, voltaic electricity.

The skin is tingling, the body numb;
Confused with anticipation I become.
My experience is inexplicable and
Intangible, but nonetheless tranquil.
Paradoxically, a trance induces two
Powerful elements-fear and rationalization.

Whether I encountered another life
Existence or divine intermediation,
I will never comply to reconcile.
A new biography now follows me:
An aura of blue my trails absorb,
Illuminating all life around me

Dates to Remember

ACP-ASIM Annual Session
10-14 April, 2002
Philadelphia, PA

Chapteral Meeting of Navy Chapter
10-12 October, 2002
San Diego, CA

The Governor Needs Your Help - Newsletter Contributions Welcome!!

1. Send a write up on "Being a doctor" (200-300 words)
2. Send poems/letters from your patients if you could share them
3. Share medical/military medical historical facts

All submissions should be sent to Dr. Angeline Lazarus at: National Naval Medical Center, 8901 Wisconsin Ave., Bethesda, MD 20889-5600 or emailed to: (aalazarus@bethesda.med.navy.mil).

Thought for the Year

"The Goal of the Team is More Important than Your Role in the Team"

Chapter Contact Information

CAPT. Angeline A. Lazarus, MC, USN, FACP
Governor, Navy Chapter
National Naval Medical Center
8901 Wisconsin Avenue
Bethesda, MD 20889-5600
email: (aalazarus@bethesda.med.navy.mil)
phone: 301-319-4148
Fax: 301-295-1340

Lee Childs
Governor's Assistant
National Naval Medical Center
8901 Wisconsin Avenue
Bethesda, MD 20889-5600
email: (lkchilds@bethesda.med.navy.mil)
phone: 301-319-4377
Fax: 301-295-1340

ACP-ASIM Email Campaign

ACP-ASIM wants your email address. In an effort to ensure that you receive urgent health communications from the College, go to (http://www.acponline.org/college/aboutacp/email_change.htm) and submit your current email address. ACP-ASIM will not sell or share your e-mail address and will ensure the judicious use of your e-mail address.