Norman Rich, vascular surgeon, is professor of Military Medicine and also director of the Vietnam Vascular Registry. After serving in Vietnam he started the registry based on the cases he saw during the war. He told Vascular News that developing and maintaining the registry for almost 50 years are some of this proudest achievements. He also spoke about his choice for vascular and military surgery, his mentors and his interests outside medicine including reading military history books
Why did you decide to go into medicine? In particular why did you choose vascular surgery?
My first hero/mentor was the Arizona Copper Mining Town Chief Surgeon who I wanted to emulate. Dr Utzinger had served in World War I and he told me repeatedly about the amputations that might have been prevented if vascular surgery had been developed. I learned pressure points in the Boy Scouts and I served as “medical officer” in the summers in the Copper Mine. Vascular Surgery was always at the top of my goals. Dr Utzinger insured that I met my second hero/mentor, Dr Emile Holman at Stanford University, with both of them supporting my interest.
Who were your career mentors and what advice did they impart to you?
Michael DeBakey became an early mentor thru Dr Utzinger and Dr Holman. Another mentor was Dr Carleton Mathewson at Stanford who had served in World War II like Drs Holman and DeBakey. They all helped me with a broad education while I maintained a focus on vascular surgery. I have been fortunate to have many mentors in my career including Drs Francis Moore of Harvard, Dr Frank Spencer of New York University who helped me write Vascular Trauma, Dr David Sabiston of Duke, Dr Harris Shumacker, Dr Charles Rob, both of whom worked with me, Mr Felix Eastcott of St Marys in London, Dr Jack Connolly of the University of California at Irvine, Dr F William Blaisdell at Stanford and University of California, and others.
You served as chief in the Division of Vascular Surgery and director of the Vietnam Vascular Registry, what was your proudest achievement in this time?
I graduated from Stanford University School of Medicine in 1960 and started my career as a surgeon in the army. After serving the troops in Vietnam for a year, we started the vascular registry based on the hundreds of cases we saw there. So developing and maintaining the Vietnam Vascular Registry now nearing 50 years outcomes is one of my proudest achievements. I was also very proud about having developed one of the early vascular fellowships at Walter Reed General Hospital in 1966–7.
You have worked in both South America and North America, how do they differ in terms of vascular surgery?
There are more similarities than differences. However, we in North America prevail in vascular fellowships. In South America, they were ahead of us in venous and lymphatic challenges. Juan Parodi of Argentina is just one example of the outstanding doctors in South America.
As a military surgeon, how do combat injuries compare with traumatic injuries?
Military type wounds have been more extensive except when military weapons have been used in the civilian communities. The Boston bombing in April 2013 emphasises how military type wounds are sustained by civilians.
What have been your proudest moments?
I do enjoy seeing the success of those who I have helped train. This includes the Walter Reed Vascular fellows and the medical student graduates of the Uniformed Services University of the Health Sciences.
How has vascular surgery evolved since you began your career?
Obviously, the endovascular revolution of the 21st century has changed what I knew and did dramatically. The majority of the operations that I did are not done today.
You have contributed to many journals, written books and been on 10 editorial boards— which piece of research are you most proud of?
I am most proud of the paper about understanding the pathophysiology of acute venous interruption.
What research paper has interested you recently?
The papers that have particularly caught my attention were the ones on new drugs for the prevention of deep venous thrombosis recurrence. But there are a variety of other studies that have also interested me – regenerative medicine would be included.
You are a member of an extensive number of societies, what are the benefits of being part of a medical society?
Being part of a society allows the direct exchange of ideas. The stimulation that comes from these exchanges adds to being a student for life.
In your opinion, how will vascular surgery develop in the future?
The less invasive/endovascular approach will continue.
You have won many awards throughout your career, of which are you the most proud?
I have never focused on awards; however, those that were granted by peers are most appreciated.
Tell us about one of your most memorable clinical cases.
This is another difficult question. I will always remember the extensive endarterectomies, despite the time involved in the operating room, to be satisfyingly successful. Of course, saving lives and extremities in combat casualties has always been very gratifying.
Outside of medicine, what other interests do you have?
My family with three daughters and a son with spouses and six granddaughters and three grandsons are most important to me. Reading medical and military history has always been one of my “hobbies”.
1948–1952 Ray High School, Ray, USA
1952–1954 University of Arizona, Tucson, USA
1954–1956 BA, Stanford University, Stanford, USA, BA
1956–1960 MD, Stanford University Medical School, Stanford, USA
1960–1961 Internship, Tripler General Hospital, Honolulu, Hawaii, USA
1961–1965 Residency, General Surgery, Letterman General Hospital, San Francisco, USA
1966–1967Fellowship, Peripheral Vascular Surgery, Walter Reed General Hospital, Washington, DC, USA
Current staff assignments
2012– Senior advisor to the chairman of Surgery, Department of Surgery, F Edward Hebert School of Medicine, Uniformed Services University of the Health Sciences (USUHS), Bethesda
2002–2012 Deputy chairman of Surgery, Department of Surgery, F Edward Hebert School of Medicine, USUHS, Bethesda
1977–2002 Chairman, Department of Surgery, F Edward Hebert School of Medicine, USUHS, Bethesda
1966– Director, Vietnam Vascular Registry
Previous staff assignments (selected)
1965–1966 Chief, Surgical Service, 2nd Surgical Hospital (MA), Fort Bragg, North Carolina and Republic of Vietnam – An Khe
1967–1978 Chief, Vascular Surgery Service, Walter Reed AMC
1970–1982 Consultant in Vascular Surgery to The Surgeon General of the Army
1977–1980 Chairman, Department of Surgery, Uniformed Services University of the Health Sciences, Bethesda (Active Duty Army Colonel)
1971–1983Visiting staff, Cardiovascular Branch, Armed Forces Institute of Pathology
1973–1978 Associate professor of Surgery, the George Washington University School of Medicine
1974 Faculty opponent, Goteborg University, Sweden
1976– Professor of Surgery, Uniformed Services University of the Health Sciences, Bethesda, USA
1977 Faculty Opponent, Goteborg University, Sweden
May 1981 Faculty, Visiting Professor of Vascular Surgery, Colegio Mayor de Nuestra Senora del Rosario, Bogata, Colombia
1997 Miembro Honorario, Medicina y Ciencias de la Salud, Universidad Catolica de Chile, Santiago, Chile
1983– Professor of Military Medicine (Secondary Appointment), Uniformed Services, University of the Health Sciences, Bethesda