The BRAC Commission voted Thursday to close the Walter Reed Army Medical Center. The hospital has treated presidents, soldiers and veterans for nearly a century.

Background

Discussion

JEFFREY BROWN: Walter Reed Army Medical Center in Washington, D.C., has long been considered the crown jewel of American military hospitals. Almost a century old, it's treated soldiers returning from war, veterans, presidents and world leaders. But while its care is considered of the highest caliber, some of its facilities have grown outdated.

OFFICIAL: All in favor.

JEFFREY BROWN: And today, the federal panel charged with reviewing military installations nationwide voted eight to zero to close it down. Anthony Principi chairs the Base Realignment and Closing Commission.

ANTHONY PRINCIPI: Kids coming back from Iraq and Afghanistan, all of them in harm's way, deserve to come back to 21st Century medical care. It needs to be modernized.

JEFFREY BROWN: Most of Walter Reed's work will be relocated seven miles away to the more modern, expanded Bethesda Naval Center in Maryland; that facility will be renamed Walter Reed in honor of the older hospital's heritage. Washington, D.C. Delegate Eleanor Holmes Norton, reacted to the news.

DEL. ELEANOR HOLMES NORTON: This is not an ordinary base closing. This is a closing of the most important hospital for the most seriously injured soldiers coming from the battlefield.

JEFFREY BROWN: Walter Reed Army General Hospital opened its doors on May 1, 1909 to ten patients. Since then, soldiers from six wars have passed through its doors. With the onset of World War I, bed capacity grew from eighty to twenty-five hundred in a matter of months. During World War II, thousands were treated there, including former Senator Bob Dole.

Today, the 73-building complex treats as many as 16,000 soldiers a year. The medical center was named for Major Walter Reed, whose late 19th Century research revealed that yellow fever was transmitted by mosquitoes, rather than direct human contact.

Walter Reed is also known as the hospital of presidents. Most notably, President Eisenhower spent time recuperating there after suffering a heart attack in 1956. He died there in 1969.

Presidents have also visited troops injured in the line of duty, most recently from the conflicts in Iraq and Afghanistan. These soldiers wounded in Afghanistan received their purple hearts in their hospital beds. Ward 57 has served as a rehab center for soldiers injured in Iraq. President Bush has been a visitor.

PRESIDENT GEORGE W. BUSH: Every time I come to Walter Reed, it confirms that which I know, which is we're providing the very best -- the best care, the best compassion. We're moving these soldiers from the battlefield to hospitals as quickly as we can, so they can begin their rehab.

JEFFREY BROWN: The president is expected to accept the federal commission's recommendations on base closings, including those for Walter Reed. The recommendations then go to Congress for a final vote.

For more on Walter Reed and its legacy, I'm joined by Dr. Howard Markel, director of the Center for the History of Medicine at the University of Michigan.

Dr. Markel, many of us know Walter Reed as the first stop at home for wounded soldiers. Tell us a little bit about the care it's provided over the years.

DR. HOWARD MARKEL: Well it's provided first-rate care for almost every disease and problem under the sun. It is as you said a general hospital so it meant it always had a first rate surgical department, pathology department, internal medicine and even had an excellent pediatrics ward so the care there was as good as the care delivered anywhere in the world during its 96-year history.

JEFFREY BROWN: What kind of advances in rehabilitation have come out of Walter Reed?

DR. HOWARD MARKEL: Well, as you noted, this is where soldiers who are wounded in the battlefield went and most seriously injured soldiers often went to Walter Reed, so rehabilitation medicine really took its birthplace at places like Walter Reed.

For example, the amputation of limbs, which is not something you want to think about unless it happens to you or unless you treat, it but it's not just a mundane removal of a limb. The surgical procedure has to be done precisely right. You need to be able to fit a prosthetic limb over that amputated leg, for example, and you also have to be able to come up with therapies and treatments to teach soldiers who are injured in the battlefield how to walk again or to use other limbs that were disabled.

And don't forget, this is translated not just for soldiers who have been wounded in the battlefield; there are a lot of people - civilians -- who have benefited from these rehab therapies that were developed at Walter Reed.

JEFFREY BROWN: And we mentioned in our setup that it is of course known as a hospital for presidents, notably President Eisenhower. Tell us a little more about that.

DR. HOWARD MARKEL: Well it was indeed President Eisenhower's hospital. Ike -- as a confirmed Army man -- it's not surprising that when he became commander in chief he chose Walter Reed as his primary care site. He did have a very serious heart attack, as you mentioned, in 1956, far more serious in retrospect than it was reported at the time; he also had a small stroke and a bowel obstruction during his presidency so Walter Reed was in the news quite a bit back then. And of course Eisenhower finally died at Walter Reed in a specially designed suite which is now still preserved in his honor.

JEFFREY BROWN: A lot of famous other folks have been there, presidents and a lot of military figures; I was reading about Gen. John Pershing, for example, spent his last years there.

DR. HOWARD MARKEL: Absolutely. Black Jack Pershing, who led the American expeditionary forces in World War I, had as it was called in those days, "a weak ticker;" he had a bad heart; he had several heart attacks and spent his last eight years of life in Walter Reed from 1941 to 1948.

Right after Pearl Harbor John Pershing wrote FDR a letter from his hospital suite begging to be re-commissioned and sent to fight the Japanese. And of course FDR sent him a very touching and kind thank you note but no thank you note.

JEFFREY BROWN: What about Walter Reed the man? We mentioned him in our setup, but he sounds like quite a remarkable figure in his own right.

DR. HOWARD MARKEL: He was indeed; he was a true medical hero. As you mentioned, in 1900, Walter Reed and his colleagues figured out the transmission of yellow fever, which was a very common, contagious, mysterious -- and I might add -- disgusting disease. It was very common in the southern United States as well as Cuba, where Walter Reed was stationed, and South America.

And the idea that a mosquito could be the intermediary between a germ or a virus in this case in a terrible disease was a hard sell to make. But Walter Reed and his colleagues proved unequivocally and scientifically that that was the case. And they revolutionized medicine because it wasn't just important in that part of the world, Cuba, but you could have never have built the Panama Canal, which was started just a few years later, if we had not figured out the importance of controlling mosquitoes from breeding and also from using mosquito netting to prevent being bitten by these diseased mosquitoes.

JEFFREY BROWN: Dr. Markel, I know you've known a lot of the doctors who have been there. Is there a culture that goes along with the name Walter Reed or these kinds of top military medical facilities?

DR. HOWARD MARKEL: Absolutely, and it's not all that dissimilar to what you used to see in many hospitals, military or civilian, twenty, thirty, forty years ago before the medical marketplace took over. But the Walter Reed culture, and I interviewed quite a few doctors and nurses and people who had worked there when I started writing about Walter Reed Hospital; and to a one they all talked of the culture of service, the traditions of how they trained their doctors and nurses, how they took care of patients, the sense of family and heritage that I think is very difficult for many of us who are civilians to understand.

JEFFREY BROWN: So, we're talking about how important this hospital has been and still is and yet we're talking on a day when they're talking about shutting it down. So you're a historian, what -- fill in that disconnect for us -- what happens to hospitals even great ones like Walter Reed?

DR. HOWARD MARKEL: Yeah it is a sad day. It's a place where, for example, Gen. Patton went to see Black Jack Perishing for his blessing before he went off to World War II, where great medical advances were made, but it also reflects one of the great paradoxes of all hospitals in the 20th and 21st Centuries.

You know, doctors like to say hospitals are obsolete about two weeks before they open, and that's true of every hospital, even if it's an iconic hospital like Walter Reed. And these buildings are old and out of date and a new hospital will replace it and I'm glad to say that it will still be called Walter Reed.

JEFFREY BROWN: Does the culture continue on, even though the building and some of the work goes on somewhere else?

DR. HOWARD MARKEL: Well, we can hope so. Hospitals are very special places; they're places where's dramas unfold daily; they're places of tragedy and triumph and where people work and given their energies to them.

The new hospital would be a combination of both the Naval Medical Corps and the Army Medical Corps, but I have faith in the tradition of the Walter Reed military hospital that it will continue to do great things in the 21st Century in its new incarnation.

JEFFREY BROWN: All right, Dr. Howard Markel, thank you very much.

DR. HOWARD MARKEL: Thank you.