Medicine has a tendency to flatten biography.
Surgeons are often remembered in the context of a system they built, or the papers that they wrote and published. Others are remembered by the operations they popularized, or the institutions they led. This propensity for history to homogenize “stories” is particularly true for that rare breed of human: the men and women who eschew financially rewarding surgical careers in the private sector for a life of service in military uniform. Deeper motivations behind a military calling are ignored in favor of a cleaner narrative. This way, patriotism becomes uncomplicated, and sacrifice is rendered tidy. People, however, are much more complicated than their histories sometimes suggest.
Real life is rarely smooth.
Some physicians go to war young in search of the very same things any other person who joins the military might be looking for: adventure, camaraderie, or the opportunity to be a part of something much bigger than themselves. Others move toward it later, after gaining a wealth of life experiences. While those who join young perhaps don’t fully understand the stakes involved, the latter have presumably accrued sufficient life experience to know exactly what they signed up for.
Whether the decision to serve came during one’s more youthful years or closer to the twilight of a long career, honor is derived from the reasons behind that decision. All must ask that most fundamental of questions before making the decision to serve: Why?
Dr. Barbara Stimson came from a prominent American family, and lived in an era in which military service for women physicians was not only discouraged, it was prohibited. She was a cousin of Henry L. Stimson who served as the US Secretary of State, and also as Secretary of War twice, 30 years apart and including the tumultuous World War II years.
Dr. Stimson was spectacularly accomplished in her own right: part of the third class at the Columbia University College of Physicians and Surgeons to admit women, the second woman to earn a surgical internship at NewYork-Presbyterian Hospital, and the recipient of a National Research Council fellowship. She went on to become the first female member of the New York Surgical Society and the American Association for the Surgery of Trauma.
When World War II erupted, her country issued no call for her service. In fact, the record reflects that her country did not want her service. But the call to serve weighed heavily on Dr. Stimson, such that in August 1941, she set sail for England to commission in the Royal Army Medical Corps, determined to make her contribution to the war effort.
She would ultimately spend 2 years on the front lines of the British medical response to the war. When asked for her particular “why,” Dr. Stimson replied, “...because we felt that we had something to learn from the British and that, when the time came, our country could benefit from the experience of the British and avoid a number of mistakes.”¹
Could it really be that simple?
Orthopaedics in that era in no way resembled the specialty it has become in modern times. Industrialized warfare produced devastating injuries, characterized by profoundly mangled extremities, chronic infections, and prolonged disability on a scale few physicians had previously encountered. The work was dirty, exhausting, and seemingly never-ending. Surgeons learned their craft in real-time because conditions on the ground gave them no alternative.
Dr. Stimson chose this life for herself, allowing no obstacle to stand in her way in its pursuit. Her story stands as a testament to the potential power of any particular “Why?” Any reason for serving, no matter how seemingly pragmatic, can inspire generations. Where she saw an opportunity to inform the medical practice of a nation, we recognize the persistence of a determined person.
In 1968, Dr. Delos “Toby” Cosgrove, perhaps best known as the venerated Chief Executive Officer of the Cleveland Clinic from 2004 to 2017, was fresh out of his general surgery internship at the University of Rochester in New York when he volunteered for a commission in the Air Force, just 5 months after the Tet Offensive had begun in faraway Vietnam.
Three weeks later, he was in the combat hotspot of Da Nang serving as the chief of a staging flight. In almost 6 months in theater, Captain Cosgrove would oversee the evacuation of approximately 22,000 military personnel. In his free time, he also volunteered in a local clinic providing medical care to the native population.
Years later, when asked about the mindset required for such selfless actions in the face of grave personal risk, he responded, “I just saw a need and wanted to do something about it.” What emerges from Dr. Cosgrove's story is a simple commitment to usefulness. Whether caring for wounded service members or treating local civilians, he heard the cry of need and was compelled to answer it.²
Variations of this story have been repeated ad infinitum over many decades. In 2009, Colonel Hector Henry (USA), a urologist practicing in the Charlotte, North Carolina region, came out of retirement at the age of 70 to serve in the Iraq War. He cited a “strong sense of what I’m supposed to be doing” as his impetus to serve, even at an age when most surgeons have an eye toward hanging up the scalpel permanently.
In the interest of full transparency, Colonel Henry had only retired 3 years earlier, upon his return from a previous deployment to Iraq at 67. The question was no longer whether he had done enough to earn retirement, but why a man who had already given so much still felt compelled to serve.³
The “official” explanations are familiar: patriotism, contribution, service, duty. We have no reason to doubt any of these explanations, but there is a sense in which these concepts cannot entirely explain why accomplished surgeons voluntarily disrupt stable lives in order to place themselves in environments defined by uncertainty, exhaustion, bureaucracy, and human suffering.
Military medicine strips away many of the abstractions that accumulate around modern professional life. In austere environments, accomplishment matters less than usefulness. The wounded do not care about titles, academic rank, or reputation. They care whether the surgeon standing before them is competent, calm, and willing to act.
Every surgeon eventually accumulates successes, disappointments, regrets, and patients who are never entirely forgotten. Experience brings confidence, but it also brings humility. Over time, many discover that military service becomes less about proving themselves than about remaining available when their skills are needed most. The motivation gradually shifts from ambition toward stewardship. Years spent acquiring difficult skills create their own quiet obligation: to continue placing those skills in the service of others while one still can.
Military medical systems often describe readiness in logistical terms: staffing, training, equipment, sustainment, checklists. Those things matter enormously. But systems also depend on culture, and culture depends on whether experienced physicians continue to believe service remains meaningful even after they no longer need it for advancement.
Every surgeon who serves eventually develops a deeply personal answer to the “Why?” question.
For some, the answer is patriotism. For others, duty, camaraderie, gratitude, or the simple desire to be useful in moments when usefulness matters most. And for some, the answer is nearly impossible to articulate, although that makes it no less important
Military service always extracts a price. The long separations, missed time with family, exhaustion, uncertainty, lost opportunities, and physical risk are all very real. Experienced military surgeons understand this better than anyone.
Perhaps that is what makes organizations like the Excelsior Surgical Society so important. Beneath the ranks, titles, institutions, and specialties exists a quieter bond between surgeons who willingly moved toward responsibility when they could easily have moved away from it. The details of their reasons may differ. Their biographies may flatten with time. But nearly all carry some answer to the question of why they serve, no matter how private, incomplete, or trivial that answer may seem.
And yet they go anyway.
