In Memoriam

After a 10-year struggle with prostate cancer, S. Ward “Trip” Casscells III, MD, died at his home in Washington, DC, on 14 October 2012. His heroic battle with this disease demonstrated his courage, his wonderful spirit, and his desire to be present for his family and to help others with their own medical problems.

He was born in Wilmington, Delaware, in 1952. His father was an orthopedic surgeon who helped invent and develop arthroscopic surgery. Dr. Casscells graduated from Yale University and then from Harvard Medical School, magna cum laude and as the winner of the Reznik Research Prize. His internship and medical residency were at the Beth Israel Hospital in Boston, and his training in cardiovascular medicine was at the Massachusetts General Hospital. Subsequently, he was a research associate at the National Institutes of Health, where he contributed important research on the role of specific growth factors after coronary angioplasty. He then continued his research on the role of specific growth factors in “restenosis” lesions after coronary angioplasty, at the Whittier Institute in La Jolla, California.

Fig. Dr. S. Ward Casscells, Assistant Secretary of Defense for Health Affairs, listens to information regarding detainee medical operations from a Joint Medical Group health provider at Joint Task Force–Guantanamo (JTF–GTMO). Photo by Navy Petty Officer 2nd Class Michael Billings.

In 1992, Dr. Casscells was recruited to Houston to be Professor and Chief of Cardiovascular Medicine at The University of Texas Medical School and Memorial Hermann Hospital, as well as the Associate Director of Cardiovascular Research at the Texas Heart Institute. He subsequently contributed to the growth of these programs as an educator, physician, and translational clinical scientist. This included his contributions to the identification of unstable coronary artery plaques and to the discovery that such plaques had temperature heterogeneity at sites where they were inflamed. As a result of these discoveries, he and I were cofounders of Volcano Therapeutics with Mr. Olav Bergheim. Dr. Casscells also worked with Dr. Mohammad Madjid at the Texas Heart Institute. They showed both that the influenza virus causes vascular inflammation and predisposes one to the risk of myocardial infarction, and that the influenza vaccine reduces the risk of myocardial infarction in human beings.

At age 54, Dr. Casscells astonished his friends and family by joining the Army Reserves and volunteering to go to Iraq. His wife, Roxanne, told him, “This is one heck of a mid-life crisis, but to be fair, I know you cannot afford a Maserati, and you don't have the will to take a mistress.” In 2006, he became a colonel in the Army Reserves. In order to be accepted into the Army, he had to persuade Army physicians that he was physically able to participate, in consideration of his having just completed 5 years of chemotherapy and radiation treatment for prostate cancer. When he was judged able to participate, he traveled to Egypt, China, and Thailand to study avian influenza, a disease that he had researched. His charge was to protect our troops from a flu epidemic. He spent time in Iraq, where he was shelled and caught in an ambush. In 2007, President George W. Bush appointed him Assistant Secretary of Defense for Health Affairs, in which capacity he was given the responsibility of leading a $45 million health and education system, with 10 million patients in 100 countries. From his office at the Pentagon, he assumed responsibility for restructuring the Walter Reed Army Medical Center, to which he made unannounced visits to help solve problems there before participating in its closure in 2011.

Dr. Casscells received numerous recognitions for his humanitarian and patriotic leadership. These included the Department of Defense's highest civilian award, the Distinguished Public Service Medal; the Surgeon General's Medallion from the Department of Health and Human Services; the Army's Decoration for Distinguished Civilian Service; and the Order of Military Medical Merit. For his work on pandemic influenza, Dr. Casscells was awarded the Army's Meritorious Service Medal, and while serving in Iraq, he received the Joint Services Commendation Medal.

For his work in mobile telemedicine and disaster response, Dr. Casscells also earned the Department of Health and Human Services' Best Public Health Practice Award, and the Memorial Hermann Health System's Hero Award. At Boston University in 2010, he was named recipient of the 2010 Neal Pike Prize, which recognizes “individuals who have made special contributions that have improved the lives of people with disabilities.”

Dr. Casscells also wrote a book titled When It Mattered Most,¹ in which he paid tribute to medics killed in Iraq and Afghanistan; this exemplified, once again, his selfless concern for others.

Dr. Trip Casscells was unique and special: a brilliant clinical scientist, a committed educator, and a caring and compassionate physician who was loved by his patients. He loved our country, even placing himself in harm's way to help our country as a physician leader. We miss him greatly at the Texas Heart Institute and in Houston.

James T. Willerson, MD
President and Medical Director, Texas Heart Institute at St. Luke's Episcopal Hospital, Houston