Dr. Rich also conducted groundwork ballistic wound studies using high-speed photography and gelatin targets, investigating how high-speed bullets caused cavitation and wounding even some distance from the path of the bullet. He became an expert on military wounds, and the techniques he developed saved many troops from limb amputation or death. Later, he would be sure that his junior faculty and students knew the difference between “shrapnel” (last used in battle in World War I) and “fragments” produced by modern high-explosive devices.
Norm gained recognition throughout the world as a military physician who pioneered lifesaving vascular repair following traumatic injury. While in Vietnam, Norm began collecting data on all vascular injuries and later established the Vietnam Vascular Registry while stationed at Walter Reed General Hospital, Washington, DC. This registry—now housed in the National Archives, St. Louis, MO—contains thousands of entries and is still accumulating data on survivors of vascular trauma during the Vietnam War.
USU
Norm did a vascular surgery fellowship at Walter Reed General Hospital from 1966 to 1967 and became the chief of vascular surgery and head of the residency training program in 1967. At one point, Norm was both a fellow in vascular surgery and head of that training program. In the early 1970s, Dr. Rich participated on the planning committee for the new USU. President Richard Nixon signed the legislation that created the school in 1972, and its first graduating class was in 1980. Norm became the founding chairman of the department of surgery in 1977, retiring from that position in 2002. Thereafter, he served as deputy chairman and senior advisor to the two subsequent chairs, U.S. Army Colonel David Burris, MD, FACS, and U.S. Navy Captain Eric A. Elster, MD, MC, USN, FACS, coauthor of this article.
Vascular trauma and his lasting legacy
As mentioned previously, Dr. Rich became known for his work in repairing injured arteries during his time in Vietnam. Later, he worked with Frank Spencer, MD, FACS, American College of Surgeons (ACS) Past-President, to compose the most recognized book on vascular injuries. Dr. Spencer had become an expert in treating vascular wounds as a young surgeon serving in Korea. Early in the Korean War, there was a strict rule forbidding the attempted repair of war wounds involving most vessels, and anyone who attempted such a repair was subject to a possible court martial. Dr. Spencer was fully aware of this rule but nonetheless proceeded to repair an injured femoral artery with success. Eventually, the “court martial rule” was removed, and Dr. Spencer went on to do a number of limb-saving operations in Korea and elsewhere. He later stated that he told his team, before the attempt at his first repair, that if they were unsuccessful, a court martial could be expected, but if they succeeded, they would probably be given a decoration.* Dr. Spencer became the perfect mentor for Norm as they worked together to write their book, Vascular Trauma, published in 1978. Dr. Spencer’s risk-taking in Korea changed the face of vascular surgery forever.
Norm and Kenneth Mattox, MD, FACS, wrote a second edition of Vascular Trauma, and the third edition was recently edited and published by Todd Rasmussen, MD, FACS, and Nigel Tai, MD. Drs. Rasmussen and Tai are working on the fourth edition.
Dr. Rasmussen has been one of the many benefactors of Norm’s mentorship over the years. He and W. Darrin Clouse, MD, FACS, became well-known throughout the military medical system after reporting the results of their vascular operations in Balad, Iraq, carefully following up after each case and producing excellent, reliable data. Dr. Rich was, and is, very proud of their efforts, unique in the annals of warfare.†
A key example of Dr. Rich’s international leadership was the 1990 Uniformed Services University Surgical Associates Day, which featured all of the local leaders of surgery, some of whom Norm had recruited for the faculty at USU, including Charles Rob, John Hutton, Don Sturtz, Harry Shumacker, Leonel Villavicencio, Bill Drucker, Daniel Rignault, and Stan Minken (all MD, FACS) in attendance. There also was military faculty at that time, including Dr. Burris (Dr. Rich’s successor as the department chair), Bill Bolger, Peter Rhee, Gage Ochsner, Mike Marohn, and Mark Bowyer (all MD, FACS). Others who were particularly distinguished from outside our university included Michael DeBakey; Bill Blaisdell; Francis Moore; Ben Eiseman; Carleton Mathewson, Jr; and ACS Past-Presidents George F. Sheldon, Olivier Beahrs, and David Sabiston (all MD, FACS).
Norm was in his long, white coat up in front of the packed Sanford Auditorium, with guests from all over the U.S. and the world. He knew everyone, greeted old friends, and conducted a full day’s program with the confidence of a maestro leading an orchestra. From this meeting, it was obvious that Norm was an exceptional surgeon, a leader of his specialty, and a friend to all who were looking for a role model to emulate.
Lunches with Norm
Those of us lucky enough to sit with Norm around the lunch table at noon often were treated to little-known surgical history tidbits, while discussing a variety of topics. Norm has a phenomenal memory and can recite all sorts of amazing and entertaining stories. He has personally been the physician to many generals and admirals, as well as movie stars, politicians, and newsmakers. He knew President Dwight D. Eisenhower and told the story of the president’s frequent cardiac arrests at Walter Reed General Hospital, where he finally succumbed to his heart disease—despite the heroic efforts of his cardiologist, Robert Hall, MD, who spent months at his bedside, resuscitating him repeatedly. (President Eisenhower had more than 30 successful resuscitations before ultimately dying of heart failure.)
Norm also was a member of the team that provided surgical care to Sen. John C. Stennis, who had been severely injured in an attempted armed robbery and was successfully treated at Walter Reed General Hospital. The senator was among countless patients who were fortunate enough to have Walter Reed as their hospital and surgeons like Norm as their caregivers.
Norm also knows surgical history like no other. He used to tell us about the early days of Mexican military surgery, when soldiers were told to bring their girlfriends or wives with them to serve as their nurses when and if they became wounded, as absolutely no military medical care was available at the time. He was able to connect the dots between historical events, medicine, and key leaders in our field. As an example, he told us the whereabouts of the key to the Bastille, the infamous state prison in Paris, France, that was overthrown at the beginning of the French Revolution in 1789. The key still is displayed at Mount Vernon, VA.
He taught us unique history facts, such as why we call President George Washington’s home Mount Vernon. The reason is that President Washington’s half-brother, Lawrence, inherited the Little Hunting Creek Plantation from his father in 1743, and later Lawrence changed the name of the estate to Mount Vernon after Admiral Edward Vernon, his beloved former commander in the British Navy. (Before the American Revolution it was fairly common to have Americans in the British military, including Lawrence Washington.) Admiral Vernon was an ancestor of Mrs. Mary Rob, the wife of Dr. Rob mentioned previously—a wonderful teacher and surgeon and a former faculty member at USU.
The list of Norm’s accolades is almost endless. He has published more than 300 manuscripts and has been the author or coauthor of five books. He helped found a number of important organizations and has served as president of many, including international societies of high repute. He was named an ACS Icon of Surgery in 2018 and awarded the inaugural ACS Distinguished Military Lifetime Achievement Award in 2019 (see photo).
