JANUARY 11, 2023 – Historical anniversaries offer us an opportunity to gain perspective on the present, see where we came from, and a chance to memorialize the trailblazers who paved the way for us all. This year the Navy Medical Department will mark several notable anniversaries that provide us ample reason to look back and celebrate.
Bicentennial (200 years):
The early years of Navy Medicine was shaped by our fight against disease. And few diseases were more deadly or impactful on our nascent service than vector-borne diseases. Medical ship logs from the Navy’s early years are full of cases of “ague,” “fever and ague,” “bilious fever,” “inflammatory fever,” “intermittent fever,” “remittent fever,” and the ever popular, “putrid, malignant ship fever”—all archaic terms for mosquito-borne illnesses that plagued the service in an era before germ theory. This year we mark the 200th anniversary of one of the first Navy-led medical investigations into the cause of vector-borne disease.
In September 1823, following an outbreak of yellow fever at the Naval Station Thompson’s Island (Key West), Florida, Secretary of the Navy Samuel Southard ordered a special mission to investigate the causes of the illness. Commodore John Rodgers oversaw a medical task force comprising three of the Navy’s most accomplished physicians—Surgeons Thomas Harris, Richard K. Hoffman, and Bailey Washington.
Rodgers and his medical task force arrived on the island on October 23, 1823, only to discover that much of the personnel assigned to the station had fled. Of the 140 Sailors and Marines remaining, 59 were sick with fever, several of whom were being treated under the care of Surgeon Thomas Williamson. Surgeons Harris, Hoffman, and Washington walked the island studying every topographical feature and collected clues with the thoroughness of forensic scientists. They noted that over half the island was covered in salt water and fresh water ponds, the latter layered with “decomposing vegetable and animal matter.” They suspected the resulting “miasma” (literally “bad air”) would have had a “powerful effect” on the health of the Sailors.
On October 29th, the surgeons drafted a report to Secretary Southard outlining six causes of the outbreak—sudden exposure to tropical climates; lack of comfortable quarters; intemperate habits; lack of fresh and wholesome provisions; “continued annoyance” by mosquitoes and sand-flies; and so-called “depressing passions,” arising from the prevailing epidemic.
Harris, Hoffman, and Washington had gone as far as medical science could (or went) without pinpointing the mosquito as the sole cause of the epidemic. Most interestingly, the surgeons noted that the disease only seemed to be present when the temperature exceeded fifty degrees. It could be argued that they were just twelve degrees away from a significant breakthrough. Mosquitoes will not bite when the temperatures drop below 62 degrees Fahrenheit.
Although the fever on the island had subsided as the weather cooled, at least 21 officers and an untold number of enlisted, died from the disease.
President James Monroe later praised the work of Commodore Rodgers and the “skilful” [sic] surgeons in his address to Congress.
Quasiquicentennial (125 years):
This year, Navy Medicine will mark the 125th anniversary of the founding of the Hospital Corps (June 17, 1898). In 1898, the Navy organized its loose conglomeration of apothecaries, medical attendants and purveyors into three enlisted rates (hospital steward, hospital apprentice first class, and hospital apprentice) and a warrant grade (pharmacist). Since then, all who have served under the banner of this corps have been known by the moniker “Hospital Corpsmen” or simply “Corpsmen.” Today, the Hospital Corps is comprised over 27,000 Sailors representing 40 Navy Enlisted Classifications (NECs).
Centennial (100 years):
On February 3, 1923, the Bureau of Medicine and Surgery (BUMED) established the Naval Dental School at the Naval Hospital Washington, D.C., for the “purpose of giving postgraduate instruction to officers of the Dental Corps and instruction to specially detailed hospital corpsmen who are trained to serve as assistants to dental officers.” In 1923, the school commenced with five dental officers and 10 hospital corpsmen (dental technicians).
Over the last hundred years, the school has operated under various names—from Naval Dental School (NDS, 1923-1971) to the Naval Graduate Dental School (NGDS, 1971-2001) to its present moniker, the Naval Postgraduate Dental School (NPDS, 2001-Present). Today, as a subordinate activity under the Naval Medical Leader and Professional Development Command (NMLPDC), NPDS conducts “advanced programs for dental officers that are designed to help the Dental Corps meet its need for officers who are fully qualified to practice, teach, and conduct research in dentistry.”
Semisesquicentennial (75 years):
Seventy-five years ago—in 1948—Navy Medicine was moving beyond the post-World War II war demobilization and adapting to a Cold War posture. As the Surgeon General reported in his Annual Report of that year, the “[Navy] Medical Department ran its course against a background of domestic inflationary trends, the ‘cold war,’ federal budgetary retrenchments, and personnel shortages.”
To address these contemporary issues, Rear Admiral Clifford Swanson, Surgeon General of the Navy, convened the first ever Navy medical leadership symposium on May 27th at the National Naval Medical Center (NNMC) in Bethesda, Md. Now known as the Surgeon General’s Leadership Symposium (SGLS), this meeting has been a tradition in Navy Medicine ever since.
The year was also marked by the largest transformation of the Hospital Corps rating in over 30 years. On April 2, 1948, the Navy changed the rating names and insignia that were a mainstay since 1916. Gone were the “pharmacist’s mate” name and the Red Geneva Cross. The new titles were hospital apprentice, hospitalman, hospital corpsman 1st, 2nd, and 3rd class. And the new insignia for the Hospital Corps was the winged caduceus.
Hospital Corpsmen who specialized in dentistry had been part of the Navy for decades. But in 1948, the Navy authorized the Dental Technician (DT) rating and badge. DTs remained part of the Hospital Corps until 1972 when they became a separate occupational specialty. In October 2005, the DT rating was merged back into the Hospital Corps. Although DTs no longer wear dental rating badges, hospital corpsmen continue to serve in an assortment of dental related NECs like dental laboratory technician, surgical technologists, maxillofacial technician, dental equipment repair, and dental hygienist.
In June 1948, as the Hospital Corps was celebrating its (then) fiftieth anniversary, President Harry S Truman signed into law the Armed Services Integration Act. This landmark legislation granted all women the chance to serve in the regular military. Prior to this only Navy nurses were allowed to serve on active duty—all others held reserve status as WAVES (Women Accepted for Volunteer Emergency Service). After June 1948, women physicians, dentists, medical administrators, scientists, clinicians and hospital corpsmen could serve in the regular Navy.
On July 12, 1948, HM1 Ruth Flora was sworn into active duty, becoming the first female corpsmen to earn this distinction. By fall of 1948, Lt. Cmdr. Frances Willoughby (Medical Corps), Lt. Mary Keener (Medical Service Corps), Lt. Paula Towle (Medical Service Corps), Lt. (j.g.) Maria Emiliana Aquino, Lt. (j.g.) Virginia J. Eager Lott (Medical Service Corps) and other Navy medical women joined the active duty.
Semicentennial (50 Years):
On May 14, 1973, Navy flight surgeon Capt. Joseph Kerwin made history as the first American physician in space. Eight years earlier, Kerwin was part of the first class of “scientist-astronauts.” Early in his NASA career, Kerwin underwent a rigorous course of “basic” training from a 10-day physical exam, learning space systems, and undergoing mission control simulation to underwater “spacewalks” in a neutral-buoyancy tank at Marshal Space Flight Center in Huntsville, Alabama.
In 1973, Kerwin and fellow crewmembers Charles Conrad and Paul Weitz spent a total of 672 hours and 49 minutes aboard the Skylab station and 3 hours and 58 minutes conducting extra-vehicular activities (EVA) to repair the damage the station suffered in orbit. As Skylab’s only physician, Kerwin was also responsible for operating what could be called the first orbiting medical clinic. Equipped with a medical kit called the In-Flight Medical Support System (IFMSS), Kerwin managed minor injuries and illnesses. He later recalled, “I had intravenous fluids, drugs, a minor surgery kit for suturing, hemostasis, and I had a fundamental lab capability. I could even do cardiopulmonary resuscitation if it were necessary.” Fortunately, other than a few headaches, a dislocated finger and one case of fluid in the middle ear due to pressure change the Skylab crew proved quite healthy.
Kerwin may have been the first Navy physician to become an astronaut but was far from the last. Eight other Navy physicians would follow Kerwin, including Lt. Cmdr. Jonny Kim.
In another aviation first, fifty years ago, Lts. Jane McWilliams and Victoria Voge became the Navy’s first female flight surgeons after graduating from the Naval Aerospace Medical Institute (NAMI) in December 1973.
Vicennial (20 Years):
On March 20, 2003, the U.S. stalemate with Saddam Hussein ended and U.S. forces invaded Iraq. Throughout the war, Navy medical personnel played pivotal roles helping to care for and stabilize critically wounded and coordinating their evacuation. These frontline medical providers continually risked their lives while caring for others. Too many would pay the ultimate sacrifice — among them was HM3 Michael Vann Johnson of Little Rock, Arkansas, was killed in Iraq on March 25, 2003 while tending to a wounded Marine. He was the first representative of Navy Medicine to lose their life in the war, but far from the last. Between 2003 and 2011, a total of 25 hospital corpsmen and a Medical Service Corps officer died in Iraq.
The Iraq War was proving ground for a new platform devised by a forward-thinking surgeon named Capt. H.R. Bohman. Known as Forward Resuscitative Surgery Systems or FRSSs, these highly mobile teams comprised of general surgeons, anesthesiologists, critical care nurses, physician assistants, Independent Duty Corpsmen (IDCs), operating room (OR) technicians, and general duty FMF Corpsmen were difference makers during the war as they provided lifesaving care for critically injured casualties.
While in Iraq, FRSS teams operated in proximity of the division maneuver elements and specialized in damage control surgical techniques to stabilize causalities and then oversee rapid evacuation to higher echelon medical facilities in the rear. In 2003, six FRSS teams (comprised of 48 individuals) were deployed to theater in the first phase of the Iraq War (OIF I).
Story by André Sobocinski
U.S. Navy Bureau of Medicine and Surgery