Penn’s proud legacy of advancing military medicine

On October 19, 2024, Penn trauma surgeon C. William Schwab, MD, watched by the podium as two men wheeled a cart onstage.

The American College of Surgeons (ACS) had just handed out seven other awards at its Clinical Congress in San Francisco, CA. Schwab, awaiting his turn, looked at the other recipients holding their plaques and realized the item on the cart was meant for him.

Two feet high, 18 inches wide, and weighing 22 pounds, the sculpture was monumental and stunning to behold—an American eagle gripping the mace of the ACS in its talons. The eagle was mounted on a mahogany base with a bronze plaque engraved with Schwab’s name and the award he was about to receive: the Distinguished Lifetime Military Contribution Award.

As Schwab’s family and peers watched from the audience, the president of the ACS hugged Schwab and whispered in his ear, “How are you gonna get this thing home?”

A commitment to military medicine 

The ACS Distinguished Lifetime Military Contribution Award recognizes a physician’s contributions to the advancement of military surgery. Its grand physical scale befits the respect it commands.

Recalling the moment, months earlier, when he learned he’d been selected, Schwab said, “It took me a day to be able to tell my wife, because I was just blown away.”

Only four other individuals have received this honor. Schwab, a former U.S. Navy commander who separated from military service in 1980, was the first civilian.

Schwab considers his award a team win, crediting the administrative leaders and clinicians at Penn Medicine who’ve long supported his commitment to training military medics and advancing combat surgery.

As founding chief of the Penn Trauma Program and a professor of Surgery (currently emeritus), Schwab helped establish Penn’s internationally recognized Trauma and Surgical Critical Care fellowship and fostered a culture of military-civilian respect, collaboration, and bi-directional learning throughout Penn Medicine. Over the years, Penn Medicine has taught, mentored, and employed hundreds of trauma surgeons—including active and retired members of the U.S. Army, Navy, and Air Force.

In 2017, Schwab proposed a groundbreaking partnership between the Navy and Penn Medicine to address the known decline in medical proficiency among corpsmen during times of relative peace. Through this partnership, launched as a three-year pilot in the fall of 2021, Penn arranged for 11 Navy medical personnel to become fully integrated staff in the Level I Trauma Center at Penn Presbyterian Medical Center.

To maintain readiness for deployment, the Navy team received advanced training across Penn Medicine and functioned as a tightly coordinated surgical and critical care team in the high-volume trauma center. In turn, they taught their civilian colleagues vital trauma care techniques for use in remote or austere environments.

The second phase of the partnership began in late 2024. Instead of one team embedded for three consecutive years, the Navy will provide three consecutive teams arriving one year apart.

Each group will work at Penn for a year before deploying as a team for a year of military service. On the third year, they’ll return to resume their work in the Penn Presbyterian trauma center, enhancing their training with pediatric trauma medicine, burn care, or other rotations with regional Penn partners.

“It allows us to generate as many teams as we can, as quickly as we can, to get them deployed without losing the quality of the training and the education,” Schwab said.

Ensuring essential knowledge isn’t lost

The same month Schwab received his lifetime contribution award, his colleague Jeremy W. Cannon, MD, SM, FACS, a trauma surgeon and professor of Surgery at Penn Medicine, was celebrating his own notable contribution to military medicine.

Cannon is a retired U.S. Air Force colonel and assistant dean for Veteran Affairs in the Perelman School of Medicine, as well as the lead civilian contact, or Surgeon Champion, for the Penn Medicine-Navy partnership. For more than four years, he also led the effort to bring an iconic medical book back into circulation.

Originally published in 1972, “Surgeon to Soldiers” by Edward Churchill, MD, FACS, captured the author’s experience as a chief surgical consultant during World War II. The memoir became an important addition to the canon on combat trauma care. 

But with “Surgeon to Soldiers” out of print, Cannon worried valuable knowledge was being lost to newer generations.

He explained Churchill’s observation that “military surgery is truly a discontinuous specialty.” Compared to a civilian organization like Penn, where staff are often retained for decades, the military has higher turnover—continuously cycling in younger members with lots of energy and great ideas, but little experience.

“That can lead to a lack of institutional memory,” Cannon said. Without a strategy for passing on lessons learned and sharing best practices, the military faces a steep learning curve with each new group of medics, underscoring the value of books like Churchill’s.

Cannon’s passion project took him down research rabbit holes to find the current holders of publishing rights, including relatives of the deceased author. He envisioned not only reissuing the book to make the original text widely available but adding modern commentary to many of the chapters.

More than 100 military and civilian experts, including several from Penn, contributed to the updated edition published in October 2024.

Both events—Schwab’s ACS recognition and Cannon’s book reissue—embody the driving force that also powers the Penn-Navy partnership: a deep dedication to providing the highest level of trauma care, whether in communities or combat zones, and doing everything to maintain those competencies over time.

The 2024 edition of “Surgeon to Soldiers” is a powerful training tool for military surgeons. Cannon said the model for military-civilian partnerships developed at Penn takes that concept further, allowing Navy surgeons, nurses, and other allied health professionals “to apply these concepts in real-time on real patients.”

Commander Mary A. Decoteau, MD, a general surgeon, was part of the inaugural team at Penn and is remaining as department head for the Navy to provide seamless continuity for the newly arriving teams. Previously, she served at an outpatient military surgical center. At Penn Medicine, she immediately noticed the vast difference in the volume and severity of cases.

“I’m now 100 percent confident in my ability to deploy downrange (to a combat zone) and I would be absolutely prepared to deal with anything that I encountered in that situation,” Decoteau said.

The Penn-Navy partnership has “reinvigorated the patriotic spirit in our hospitals,” Schwab said. “It just makes you proud to know you’re helping the United States military. You’re training them and they’re training you.”

George Iyoob, MHA, RN, BSN, director of Trauma and Orthopedics at PPMC, who helped structure the partnership and is responsible for onboarding the teams, agrees.

“There’s a great sense of pride for the entire team to be working with our Navy colleagues and helping prepare them if they are deployed or have to go into some type of situation where these advanced skills are needed,” Iyoob said.

As for Schwab’s eagle sculpture, it was shipped to his home by the ACS in a 158-pound crate. He plans to display it in the foyer of the new office space his department will soon occupy.

“It really has to be shared with the Division of Trauma and the military,” he said.