April 12, 2016

Welcome to Army Pathology

BY Dr. Keith J. Kaplan

Following internship it was time to start my 4-year pathology residency in anatomic and clinical pathology. Through a similar process to the civilian match, I requested the opportunity to stay at Walter Reed Army Medical Center and for some reason was selected to do so. At the time, the residency program was combined with the National Naval Medical Center and the program I believe was called the National Capital Consortium or something like that. Nonetheless, there was a mix of Army and Navy pathology residents that covered both hospitals as well as doing rotations elsewhere between Baltimore and the Washington DC medical center complex including the VA hospital.

There were 5 residents total in our class, one was in my intern class at Walter Reed, while the other Army resident had worked as a general medical officer for many years, taking care of active duty troops, most recently at Eisenhower Army Medical Center in Augusta, GA. The two Navy residents were also general medical officers as well between internship and residency.

We were to have two days of orientation between the two main hospitals (which have since merged and combined into a single Walter Reed National Naval Medical Center on the Bethesda campus).

We started at what was then the Bethesda Naval Hospital for what ended up being more than a day and a half of orientation. Full tours not only of all the laboratories and meeting all the supervisors, several of the technicians and technologists but a complete tour of the facility, where all the clinics were located, credit union, places to eat and more. Some of it was helpful, a lot of it I didn’t get in my intern orientation even but was getting now. The location of the ophthalmology clinic probably could have been avoided but we went through the process for nearly 2 days.

In addition to the physical facilities, pathologists offices, resident work areas, and hours of operations of the respective laboratories we received an exhaustive series of sessions on the history of the hospital, the department, its organizational chart and perhaps at least a primer on the history of naval medicine which apparently if we did get it I don’t recall much from.

Finally, we collectively drove our vehicles through Rock Creek Park from Bethesda Naval to Walter Reed for what remained of our two days of orientation before beginning residency.

greenspanCOL Renata Greenspan, MC had joined the Army after the Vietnam War. She and her family  had escaped the Holocaust and eventually made their way to America. She worked her way up the ranks to become a full colonel, department chair of the largest pathology and laboratory medicine department in the Army if not the Armed Forces as well the pathology consultant to the Army surgeon general. She would go on to become the Director of AFIP and was its last military leader before AFIP was closed under the Base Realignment and Closings (BRAC) Act years ago. I think after AFIP closed she would go on to be the Director of the Military Cancer Institute. She was extremely easy to work for because you knew exactly where you stood with her, if you messed up, she told you, if you did a good job, occasionally she would share that too. She was quick to remind you that a pat on the back was a few feet from a kick in the a**. Before leaving for AFIP she was my department chair for about 6 years, including my time as a resident and staff pathologist.

At exactly 2:00 in the afternoon, COL Greenspan walked into the conference room where we were assembled, sat down and introduced herself. She didn’t ask us to introduce ourselves or anything else for that matter.

In her heavy Polish accent stared us down and said “I provide you staff, I provide you microscopes, I provide you cases. You show up on time in your uniform. Any questions?”

Before any of us had a chance to think of something that might even be pertinent at this point, COL Greenspan was already standing up from the table as if there would be no questions. She was right.

Our Army orientation lasted less than 1 minute after more than 12 hours of Navy orientation.

Welcome to Army Pathology.

And it was an awesome experience.

 

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Comments (10)

  1. Joe Chaffin

    Renata was the absolute best! She was my chair for four years as a staff member there. Your description of her “orientation” sounds exactly like her. By the way, Renata was also a blood banker!

    • Dr. Keith J. Kaplan

      Thank you Joe. AKA The Blood Bank Guy. I did forget to mention this about Renata! Thank you and for reference to others – Joe was the Army residency program director during these salad days of Army pathology. We had The Blood Bank Guy teach us blood bank before he was The Blood Bank Guy and he was just Joe from Detroit. Perhaps another topic for a future blog post! Thanks for the comment bbguy!

  2. George Leonard

    Remember the sound of Dr. Greenspan walking down the hall? All her personality summarized in the sound of heels on tile.

    • Dr. Keith J. Kaplan

      Yes. The pace and force at which the heels made contact with the linoleum could predict with high sensitivity and specificity if she was “calm” or “pissed” and if you were going to get a pat on the back or a kick elsewhere.

  3. Dan Cruser MD

    And that is exactly what happened. No frills, no BS. Just immediate submersion in an overwhelming sea of excellent cases and brilliant teachers. It really was great.

  4. Rick Gomez

    You all had the experience at the “mecca” of Army pathology and probably saw more material than I and my colleagues at William Beaumont (El Paso) in the late 80’s; but somehow our community hospital residency prepared us well enough to pass the Boards and humbly continue to learn after training. Wouldn’t trade the experience the DoD training in pathology provided.

    • Dr. Keith J. Kaplan

      Rick – thank you for the comment – absolutely agree with you. Fortunate to be stationed at what remained of three Army pathology training programs, down from double that not more than a few years prior. As Dr. Cruser mentioned, the value proposition was simple — great cases, great staff. Taught us how to practice to be solid general pathologists and lab directors. “I provide you staff, I provide you microscopes, I provide you cases. You show up in your uniform on time” worked out very well for all of us!

  5. David Frishberg

    Renata was definitely a no BS boss. I enjoyed our year together at WRAMC.

    That attitude is why I like to hire pathologists with military experience. You tell them to go cover a hospital and the answer is “OK. Just tell me where the scope, phone, and computer are.”

  6. Robin

    Thank you for this post.
    It gives me insight into the Army Pathology Residency. I am an HPSP medical student am looking forward to this. I am curious though as to your intern year and the other Army resident working as a GMO for several years and not going straight into the pathology residency after graduating. Was that required at the time?

    • Dr. Keith J. Kaplan

      Hi Robin,
      GMO time WAS NOT required but for some they chose to do it before choosing pathology perhaps. Many in pathology matched straight through at the time during internship for path, rads and others. One of my classmates in the Army was a GMO by choice. The 2 Navy folks were also GMOs but Army DID NOT require. It may end up that way – the reason for a clinical internship. However, now that pathology has gone to 4 years without “clinical” year or “5th year” it would seem you match right into pathology now?

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