Dr. Dale C. Smith, Professor of Military Medicine and History, F. Edward Hébert School of Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland, will be presenting his lecture:
“Caring for the Wounded: How the Great War Medical Experience Shaped post War American Surgery”
Can you tell us a little about yourself?
I am a career academic, that is to say I am paid to do what I love doing. I will continue to do much of it after I retire. I have a wife of 43 years and a married son. I am a season ticket baseball fan and watch ACC college basketball games when I can arrange it. My hobby is reading early church history and golden age science fiction.
What is it like to work with the medical students at the Uniformed Services University of the Health Sciences?
The Uniformed Services University is a fun place with smart and dedicated students. It is highly competitive to get in about 3,000 viable applicants for 170 seats, but the faculty has always worked very hard at team building to reduce competition among the students.
Watching the development of dual professionalism in young people dedicated to public service, even with the unlimited liability that accompanies military service, is a joy and a privilege.
What are you currently teaching?
I teach as part of the Physician in Society thread. I also have a series of small groups looking at the changes in the nature of the doctor-patient relationship from the late 19th to the early 21st century.
At the same time, I am teaching a series of small group exercises on how to be a special staff officer and give effective preventive medicine advice to the combatant commander using malarial prophylaxis in World War I, World War II and the Vietnam War.
What do you think is the leading misconception about medicine in war generally?
That war inspires or creates scientific and social progress is, in my opinion, the biggest and most dangerous historical misconception about war. War can and does, especially if the mobilization is big enough, accelerate scientific and social changes already in queue, but war is not a creative activity.
What do you think the most important advance was during the World War I?
In terms of morbidity and mortality the impact on preventive medicine was clearly the most important; the post-war work of the League of Nations medical committee is impossible to overestimate. The role of policy in making flying safe was important to aviation and all industrial health. Aviation safety policy is still transformative as we are seeing in the patient safety initiative in hospitals in the 21st century.
In terms of individual patient care, both the role of collaborative practice in specialization and laboratory support was given a huge boost by the war experience of both doctors and patients. Collaborative practice, both formal like the Mayo Clinic and informal around physicians and surgeons buildings near hospitals had begun before the war but few saw its potential. Surgical and neuropsychiatric specialization was an important beneficiary but so was clinical pathology which grew exponentially after the war.
In terms of specific therapies, blood transfusion had an expanded reputation and significant training in reconstructive surgery, occupational and physical therapy and fracture management all improved care after the war.
What were some of the ways that new discoveries during the war were disseminated to the physicians at home?
During the war, the military taught newly inducted physicians at schools to prepare them for deployment. Charles Mayo described the Military Training Center in Chickamauga Georgia as the largest medical school in the world in 1918.
Special schools were run in a variety of medical centers into 1919. By 1919, the returning physicians began to present at meetings and publish in the journals. Less well studied were the “I was there” reminiscences in local meetings and hospital rounds, which probably disseminated information and misinformation in about equal proportions.