MADIGAN ARMY MEDICAL CENTER, Joint Base Lewis-McChord, Wash. – Madigan is one of the Department of Defense’s largest medical training facilities. When it added a research year to its residency programs a while back, others recognized the value and followed suit. Now, the culmination of these research endeavors, Madigan Research Day, is a well-established highlight of the year’s calendar of events. Friday, May 7, was filled with presentations and acknowledgement of research and its benefits.
With COVID-19 blooming across the country, MRD 2020 was a fully virtual affair. Though still a significant event, the effort put into bringing the day back to the Letterman Auditorium stage for 2021 was considered important. It offers an opportunity for these young doctors to stand in front of an audience and present the findings of their year of research, and field questions on it.
Madigan Acting Commander Col. Scott Roofe was pleased to see so much support in the room for research and researchers.
“I see a lot of mentors in the room,” he noted. “We can’t do this without each other; so, thank you for that support.”
Research is generally an academic endeavor, including its reporting out. Deep understanding of most of the presentations requires a solid medical competency. But, MRD offers insight, even for the layperson, into the intense and complex work residents and staff undertake to advance medical knowledge and practice.
Still hampered by the pandemic, with restrictions on seating capacity in the auditorium and aversion to collecting people in the hallways to view the poster presentations, as has been the standard format, the Department of Clinical Investigation team negotiated the hurdles to bring an in-person event to life.
Instead of the hallway of posters, the DCI team set up monitors on the bridge in the Medical Mall and outside the auditorium that cycled through the posters. They were also available online through the DCI SharePoint page.
“The compressed, hybrid format worked well for where we are in the pandemic – hope to get to full in-person next year. There was a lot of enthusiasm and interest and that’s what MRD is all about,” said Dr. Richard Burney, the chief of DCI.
The day is not just about presentations, it is also a competition. A dozen plus awards were handed out by Roofe and Command Sgt. Maj. Albert Harris.
The structure is broken into four sections: pre-clinical, clinical, process improvement projects and poster presentations. Each had options for viewing in-person or online.
In addition, retired Army colonel and current vice president for research at Uniformed Services University of the Health Sciences Dr. Mark Kortepeter was the guest speaker.
Kortepeter was formerly the director of the Infectious Disease Clinical Research Program at USU. The IDCRP has had a central role in the DoD’s COVID-19 response. Kortepeter established the IDCRP team at Madigan when he was the leader of the program. He has also served as the deputy commander of the U.S. Army Medical Research Institute of Infectious Diseases. USAMRIID is nicknamed the “Hot Zone” for the highly infectious nature of the materials it studies. Kortepeter has written an insider’s account of the biological warfare defense lab at Fort Detrick, Md. His book, “Inside the Hot Zone,” has recently had its film and television rights optioned by a major Hollywood studio.
Kortepeter’s decades of experience gave him the ability to present this year’s Maj. Gen. Jack K. Gamble Memorial Medical Research Lecture titled, “From Ebola to COVID-19: Research During a Crisis.”
From completing his preventive medicine residency at Madigan in 1996 to the current day, Kortepeter has been at the forefront of numerous outbreaks and biological threats. He spoke specifically to how the DoD’s response to COVID was set up by other incidents. The anthrax attacks of 2001 and the Ebola outbreak of the middle of the last decade, in particular.
Kortepeter recognized the nature of COVID early on, noting the cruise ship in February 2020 with an outbreak onboard.
“Back at that time I said, the ship’s infection is pointing to an agent that is highly transmissible, at least in most environments. The virus is unforgiving and there's no room for error in the use of personal protective equipment and hand hygiene. And I have to say, over a year after I said this statement, it’s probably the smartest thing I've ever said,” Kortepeter told the lecture audience.
In moving forward with research to address the COVID pandemic, he highlighted some lessons learned from earlier experiences, especially Ebola. For that pathogen, Remdesivir, an antiviral drug, was trialed and found inferior to other therapeutic options. However, it was this early research that laid the groundwork for its completed trials and eventual approval for use as a treatment for COVID-19.
“Having this pre-existing infrastructure with the familiar containment challenges is another thing that was helpful. So these are people who trained in a containment environment with Ebola. But now, suddenly they're having to work in a containment environment with COVID. So, I think that was a worthwhile investment; we were poised and ready to work very quickly,” said Kortepeter.
He also made a strong argument for military medical research, specifically.
“If we're not studying our own populations in the DoD, no one else is going to do it and we need to know this for the impact to our beneficiaries, especially our warfighters,” he commented.
Following handing out the awards, Roofe offered a few words of praise for the researchers, facilitators and supporters.
“Readiness is the number one focus. This is enabling us to provide better care tomorrow than what’s available right now even,” Roofe said in echoing the investment aspect of research that Kortepeter noted earlier.
Closing out this year’s activities, Roofe recognized Troy Patience, a DCI team member who has been with Madigan since 1983. Patience put his tech savvy and persistent support of DCI and research to use in finding ways to surmount every challenge to make MRD happen, both in-person and as a virtual option as well.
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