Dr. Ward Casscells

Dr. Ward Casscells, 60, a cardiologist who served with the Army in Iraq and later was assistant secretary of defense for health affairs, died October 14, 2012, in Washington, DC, of complications of prostate cancer. He was the John E. Tyson Distinguished Professor of Medicine and Public Health at the University of Texas Health Science Center–Houston and simultaneously was its vice president for external affairs and public policy. He was also a senior scholar at the Texas Heart Institute in Houston. Trip was born March 18, 1952, in Wilmington, Delaware. Named Samuel Ward Casscells III for his father and grandfather, he was familiarly known as Trip. His father, who died in 1996, was a prominent orthopedic surgeon who pioneered arthroscopic surgery. Trip graduated from Yale College in 1974 and from Harvard Medical School (magna cum laude) in 1979. He trained in medicine and cardiology at Beth Israel Hospital, Brigham and Women’s Hospital, and Massachusetts General Hospital; the Harvard School of Public Health; the National Institutes of Health; and Scripps Research Institute.

While at the University of Texas, Trip and a colleague, Dr. James (Red) Duke, initiated a series of disaster-preparedness programs focused on the Houston area. As a result of this project, Trip developed a close attachment with the US Army. In 2006, at 54, he received an age waiver to be commissioned a colonel in the Army Reserve. He then deployed to Iraq, where he was medical liaison to then commanding general George Casey and United States ambassador Zalmay Khalilzad. This service earned him the Joint Commendation Medal and honorary membership in the Iraqi Medical Regiment. In 2007, President George W. Bush appointed Trip to be assistant secretary of defense for health affairs, in which capacity he served through the start of the Obama administration in 2009. As assistant secretary, Trip led a $45 billion health and education system with 137,000 employees and 10 million patients at 900 clinics and hospitals in 100 countries. He was credited with restoring trust in the quality of care at United States military facilities. This was due to his habit of making unannounced visits to hospitals to see patients and to starting the Department of Defense’s first blog, posting his replies to all questions and criticisms, even from anonymous correspondents. Defense Department insiders tell of a famous incident in 2008 when he was told by senior defense and White House officials that rising medical costs would mean not building a new carrier group or an advanced fighter and that “health care is not the tip of the spear. If you insist on this budget, you may have to resign.” However, Dr. Casscells’s reply carried the day: “Sir, we are not the tip. Health is the muscle, brain, and heart behind the spear.”

In recognition of his work at the Pentagon, Trip received the Department of Defense’s highest civilian award, the Distinguished Public Service Medal, as well as the Army’s Distinguished Civilian Service Award, the Army’s Order of Military Medical Merit, and the General Maxwell Thurman Award. In addition, he received the Department of Veterans Affairs Commendation, the Surgeon General’s Medallion from the Department of Health and Human Services, the Department of Health and Human Services Best Public Health Practice Award, the Memorial Hermann Health System’s Hero Award, the 2010 Pike Humanitarian Prize, and the 2012 Lifetime Achievement Award in the Life Sciences from the Houston Technology Center.

What made Trip’s service at the highest rank of military medicine and his deployment to the war zone even more remarkable was a diagnosis in 2001 that he had metastasized prostate cancer. Undergoing often experimental treatment at the University of Texas MD Anderson Cancer Center in Houston, Dr. Casscells survived the disease for well over 10 years. His treatment led to advances in caring for other men stricken with prostate cancer. Trip also helped them get through their disease emotionally through his active involvement in a support group.

In addition to his academic and governmental work, Trip was the inventor of medical devices and the founder of several companies to market them. In particular, he and his colleague Dr. James Willerson developed new ways to detect vulnerable plaques as a warning of possible heart attacks and strokes, which led to their founding the Volcano Corporation. Trip, with colleagues Mohammad Madjid, MD, and Morteza Naghavi, MD, also discovered that the influenza vaccine reduces the risk for heart attack and stroke and that, in patients with heart failure, a decreasing body temperature is often a sign that death is imminent unless the therapy is adjusted.

Trip especially valued bedside judgments and common sense. An example was his learning that combat troops had not been warned to avoid aspirin, which can exacerbate bleeding in the head, chest, pelvis, and other areas that cannot be stanched by compression. Aspirin was promptly banned.

He was chairman and CEO of Casscells and Associates, which provided senior policy makers with rapid data (including the regular Zogby/Casscells surveys) and insights on health services, health care reform, health informatics, and health diplomacy. In addition, he chaired KnowMed Inc., a semantic web health information company led by his former student Parsa Mirhaji MD, PhD.

A former associate editor of Circulation and guest editor of The Lancet , Trip was widely published in the areas of prevention of heart attack and stroke, information technology, medical ethics, influenza, disaster preparedness, health diplomacy, nanotechnology, and health care management. He spoke publicly about living with cancer. His book When It Mattered Most , a tribute to medics killed in Iraq and Afghanistan, was published in 2009.

Trip served on several civic, corporate, and professional boards, including the Prostate Cancer Foundation, the American Telemedicine Association, the AMAR Foundation, Safe America, and the Critical Incident Analysis Group. He was also an elected member of several honorary societies.

He is survived by his wife, Roxanne Bell Casscells of Virginia and Washington, DC; children, Samuel W. Casscells IV, Henry Wendell Casscells, and Lillian Bell Casscells, all of Virginia and Washington; brother, Dr. Christopher D. Casscells and his wife Susan, of Wilmington; sister, R.E. Anne Casscells and her partner Susan Ketchum, of San Mateo, California; sister, Margaret Casscells-Hamby and her husband Frank Casscells-Hamby, of Orlando, Florida; and 6 nieces and nephews.