By Dr. Wayman Cheatham, special assistant for medical research to The Navy Surgeon General & director, Navy Medicine Research and Development Center, Navy Bureau of Medicine & Surgery.
In a June 2008 memo to the service secretaries and others, about caring for our wounded personnel and their families, Secretary of Defense Robert Gates made medical related research one of his top priorities. He said at that time, that “the Department funds billions of dollars of medical research annually for a variety of purposes. However, some of this goes for research of tenuous benefit to our military population.”
The memo went on to state that “it is not apparent that our medical research program has been adjusted to refocus priority resources on advancing the state of medical science in those areas of most pressing need and relevance to today’s battlefield experience, particularly in the area of mental health and traumatic brain injury.”
Wayman Wendell Cheatham, M.D., FACE. Photo courtesy of the U.S. Navy
He also requested the development of a tailored plan to provide research and development investments that advance state of the art solutions for world class medical care with an emphasis on PTSD, TBI, prosthetics, restoration sight eye-care, and other conditions directly relevant to the injuries our soldiers are currently receiving on the battlefield.
Reviewing this memo, I ask myself often whether we answering the Secretary’s call. Is our research focused on our warfighters’ most pressing needs? The answer is… yes and no.
We have made tremendous strides in the past few years, but our research and development must continue to focus on advancements that have the most immediate and direct impact on our warfighters, to include especially, the mental health care of our wounded warriors who may be suffering from operational combat stress, PTSD, or Tramautic Brain Injury (TBI). Numerous programs are in place, both in Iraq/Afghanistan and at Navy hospitals in the United States, to help warriors transition from the combat zone to the home front, but we can do more from the research and development arena to help these warriors. We must always strive to do better.
The United States military, and especially its Navy, has a long history of robust medical research. This began in 1853, when the U.S. Congress created the first Naval Medical Research facility in Brooklyn, New York. Since then, the Navy’s capability has grown from its humble beginnings to a large international network of laboratories and staff that work closely with our sister services and global partners to meet the medical challenges facing today’s warfighter.
Today, we have 10 Medical Research Laboratories, seven in the continental United States and three outside the continental United States, with many interesting and diverse programs which include population based medicine and epidemiology, aviation, submarine, directed energy, toxicology, emerging infectious disease evaluations, combat casualty care, diving medicine, and many more. Our overseas laboratories support American military interests around the world and have advanced U.S. diplomacy in numerous regions by studying naturally infectious diseases of military interest and public health importance for the benefit of all.
Recent successes have been many and varied, ranging from confirmatory work in the early stages of H1N1 pandemic, to the exciting progress in the development of a malaria vaccine. Our research efforts targeted at wound management, limb salvage and regenerative medicine, including enhanced wound repair and reconstruction, as well as extremity and internal hemorrhage control and phantom limb pain in amputees, directly benefit our service members in harm’s way and support our emerging expeditionary medical operations and aid in support to our Wounded Warriors.
One of the most challenging areas we have put much attention to is looking for better ways to identify and treat traumatic brain injury (TBI) and post traumatic stress disorder (PTSD). These efforts are collaborative and integrative actively partnering with DoD, the other services, the Veterans Administration and leading academic medical and research centers to make the best care available to our warriors suffering from TBI. As such, we are currently involved with and/or conducting 95 research studies in the topical area of TBI/PTSD. Sixteen are multi-center research studies with five of these conducted in collaboration with civilian research organizations. Several of these studies are in collaboration with the VA and the Army and Air Force, to include hyperbaric oxygen treatments.
While we try to move as quickly as we can to explore many potential promising treatments for PTSD/TBI to help our men and women in uniform, we will not take shortcuts. Navy Medicine’s research efforts are governed by a highly regulated process in accordance with a DoD body of ethics, providing the highest level of patient safety and patient consent.
Operational needs include those that are Navy-Marine Corps unique: expeditionary medicine, undersea medicine, and hypobaric and hyperbaric issues. We have a tremendous opportunity to fund Navy-Marine Corps specific operational needs, but we need to squelch the false impression by some that Navy R&D is redundant. It is not. Navy is always deployed and Navy Medicine can respond to injuries and illnesses that occur in environments that do not lend themselves to traditional advanced military care. For instance, a carrier cannot pull back into port in harm’s way if it has an infectious disease breakout. A submarine cannot surface without it affecting its mission. Our Navy divers and SEALs have unique issues because of the undersea environment in which they operate.
Navy Medicine is dedicated to taking care of the physical and psychological health care needs of our Sailors and Marines and their families. Whether they wear a uniform or a lab coat, our Navy research medical staff is answering the call to service. The work they are doing is of great value and service of the highest order to our Nation. Our recent research and medical advancements have made a direct impact and have saved countless lives but we still face many challenges from a research and development perspective that we will focus on for months and years to come.
