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The Betty H. Carter Women Veterans Historical Project

Oral history interview with Irene Rich, 2006

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Object ID: WV0361.5.001

Description: Primarily documents Irene Meyers Rich’s childhood in Anchorage, Alaska; her education at the University of North Carolina at Greensboro (UNCG) in the late 1960s and early 1970s; her service with the Army Nurse Corps from 1972 to 1999, including her tenure as director of breast cancer research for the Department of Defense from 1994 to 1998; and her personal life after her military career.

Summary:

Rich speaks briefly about her background, including her family’s move to Anchorage, Alaska, and her studies UNCG. Topics related to UNCG include transitions in the late 1960s and early 1970s in student clothing; panty raids; Margaret Moore; nursing training and courses; and nursing clinical sites.

Rich discusses why she joined the Army Nurse Corps in 1971, noting the influence of an army recruiter at UNCG and the Vietnam War on her decision. Specifically, Rich recalls the impact of seeing soldiers, wounded men, and coffins coming off of planes at Elmendorf Air Force Base in Alaska. She also describes her father’s reaction to her plans and having to fly in a cargo plane with coffins from Elmendorf on her way to basic training.

Rich provides an overview of her military career. She talks about basic training at Fort Sam Houston, including training for field work and using goats to prepare for medical field work in Vietnam; working in obstetrics and becoming head nurse in the newborn nursery at Fort Benning, Georgia; and setting up an orphanage for Vietnamese orphans arriving at Fort Benning.

Rich provides more information about her tour in Nuremberg, Germany, in the early 1980s. She explains her supervisory position overseeing health clinics outside of Nuremberg and her efforts to raise standards of care. She describes working in obstetrics during bomb threats at the Nuremberg Hospital; evacuating delivery patients; and interactions with German civilians and cultural differences. Rich also remembers being part of a European Contingency Hospital in the mid-1980s and supporting a NATO exercise in Turkey using an old MASH (Mobile Army Surgical Hospital) unit from the Korean War.

Rich also comments on earning PhD in women’s health nursing from Catholic University in Washington, D.C., and her growing interest in medical research. She talks about her dissertation studying early pregnancy and the psychology of pregnancy in the early 1990s; and her continued involvement with research. Topics related to her 1994 to 1998 tenure at Fort Detrick, Maryland, as director of the Department of Defense Breast Cancer Research Program include the appropriation of funds for breast cancer research; managing breast cancer research programs and bringing together people in the field; being involved with Congress; continuing the program after the initial appropriation; the debate over including cancer survivors on scientific review panels; the breast cancer program being closed; and having to transition to similar work for prostate cancer.

Rich discusses the challenges of being a military couple when this was new in the military. She speaks about having to fulfill traditional military wife duties; her husband’s military career; deciding to make the military a career; and other issues of being a dual service couple. Other personal topics include taking care of her in-laws after her retirement and the contract and part-time work she has done since leaving the Army Nurse Corps.

Creator: Irene Aurelia Meyers Rich

Biographical Info: Irene Meyers Rich (b. 1950) of Anchorage, Alaska, served in the Army Nurse Corps from 1972 to 1999. From 1994 to 1998, Rich was the director of the Department of Defense Breast Cancer Research Program at Fort Detrick, Maryland.

Collection: Irene M. Rich Papers

Rights: It is responsibility of the user to follow the copyright law of the United States (Title 17, U.S. Code). Materials are not to be reproduced in published works without written consent, and any use should credit Jackson Library, The University of North Carolina at Greensboro.

Full Text:

Beth Carmichael:

[Today is August 9,] 2006. My name is Beth Carmichael, and I'm with Colonel Irene Rich at the offices of the Women in Military Service for America Memorial [WIMSA] in Arlington, Virginia. We're here to conduct an oral history interview for the Women Veterans Historical Project at the University of North Carolina at Greensboro.

Thank you so much for talking with me today. If you could give me your full name, we'll use that as a test of our recorder.

Irene Rich:

Okay. Irene, and my middle name is Aurelia, my maiden name is Meyers, and Rich, R-i-c-h.

BC:

And you could spell your middle name for me?

IR:

A-u-r-e-l-i-a.

BC:

Thank you.

[Recording paused]

BC:

I'd like to start by talking a little bit about your background. Can you tell me when and where you were born and a little bit about your family and childhood?

IR:

I was born in 1950 in Los Angeles, California. My father was studying at UCLA [University of California at Los Angeles] after the war. I was born October 20, 1950. When I was three, my father finished his studies, and we moved to Tempe, Arizona, which is where my mother had been raised. My father was raised in a silver-mining town of Globe, Arizona, up in the hills. I have two brothers and we lived in Arizona until I was nine. My father had always wanted to be a pilot, and he joined the army in World War II in the glider corps, and it disbanded. So he always wanted to be a pilot, saved his money and took flying lessons and worked for the FAA [Federal Aviation Administration]. The year that Alaska became a state, the Federal Aviation Administration was expanding services, and I remember he came home and told my mother that we were going on a two-year hunting and fishing vacation to Alaska. She was taking a pot roast out of the oven and dropped it. [laughing]

BC:

I'll bet that was a big surprise.

IR:

But they never left, stayed in Alaska permanently. So when I was nine, we moved to Anchorage, Alaska, and my brother is on faculty at the university there and my other brother is in Seattle [Washington] now, but that's home. Except in the army, you know, we never were assigned in Alaska.

BC:

That must have been quite a change, going from Arizona to Alaska.

IR:

To Alaska, yes, yes, it was.

BC:

What did you think of Alaska?

IR:

Oh, we loved it. You know kids. Dark all winter, cold, and we skied. It was just a wonderful place to grow up—which is kind of how I got led to join the army.

BC:

Before we get to your military service, I'd like to talk more about your childhood. Did you finish high school in Alaska?

IR:

Yes, Anchorage High School.

BC:

What did you do after graduation?

IR:

I went to Arizona State University for one year and transferred to the University of North Carolina at Greensboro [UNCG] my sophomore year and graduated in the first class of UNCG after the school was accredited.

BC:

How did you make that transition and what led you to UNCG?

IR:

Well, I am married to my best friend, and we were high school sweethearts. I said right away, “I want to go to college in North Carolina.” Well, my parents knew nobody in North Carolina, and said, “We went to Arizona State.” My mother did. “That's where you'll go.” So I went. Nowadays, kids have a lot more choices. My husband and I, and we were not married then, ran a teenage recreation center every summer during vacation and really started seriously dating, and I transferred after that freshman year.

BC:

Was he in North Carolina?

IR:

Yes, NC State [North Carolina State University].

BC:

Can you tell me about your time at UNCG?

IR:

Well, I was there for my sophomore year till I graduated. I was in Grogan Hall. It had a creek going through the middle of it. I don't know if it's still there. I haven't been back. Spent a lot of time at the library. UNCG—A lot of my classmates dated people at UNC [University of North Carolina at Chapel Hill] or at State, and so you were off and about a lot. I loved the school, and it was the last of kind of an old collegiate atmosphere, because in the time I was there, things changed. The first year I was there, you had kind of wear a dress for breakfast, unless you were in your PE [physical education] uniform, which was pretty awful, this little dress with pantaloons. You had a class blazer and little beanie that you wore all the time. Then it was the end of the sixties, '69 to '72, that all changed, and by the time I graduated, everybody was in jeans and peace signs on their t-shirts, and so it was a real transition period, I think.

BC:

What was campus life like then? Was there a lot of activism on campus, any protests?

IR:

Not so much at UNCG, but there were at like Chapel Hill. I hate to say it. What there were were panty raids all the time [laughing] and it was really kind of—I remember I was at the library and I came home one night, and a bunch of—a fraternity or two from Chapel Hill had a panty raid, and my roommates threw all my underwear out and my drawer was empty, that kind of stuff. So it was before activism on campuses, or if it ever got that way at UNCG, I wasn't there then.

BC:

Were there any professors or people on campus that stood out to you?

IR:

Margaret Moore and Dean Eloise Lewis were the two that were most memorable. Margaret Moore was my clinical instructor and was retired military, and nobody wanted to be in her clinical group when we went the first year into the hospital. When the roster came out, and I was in her group, everybody else was—she really was like a military drill sergeant, and she lined up her clinical group of eight or nine of us almost at attention, and since I'm military now, I understand, but at the time—inspected our shoes, made sure we were starched and pressed and whatever, and when we got to the hospital, our group lined up and sort of marched in. The rest of them were, you know, “I'm going to the hospital, no big deal.” So she conducted it with great rigor and she demanded an awful lot of her students, and to get through her clinical group, you knew you had accomplished something. So we stayed more, worked harder, had a higher bar, more expectations. And Dean Lewis was wonderful.

BC:

What was your training and coursework like?

IR:

Traditional nursing, you know, anatomy, physiology, every clinical practice, your med/surg, psychiatric nursing, and we had to drive off. I know that we, my clinical group drove to Butner Hospital, which was south of Durham [North Carolina], I think, for psychiatric rotation, and then spent part of the time at the VA [Veterans Administration] Hospital, which I think was north of High Point [North Carolina]. So we did a lot of driving off-site to clinical sites, and that was fun and interesting. At the VA Hospital, and I'm not sure even where it was, it became very apparent that there was a war going on and that young men were coming back devastated, you know, head injuries and stuff like that.

BC:

How did you feel about the Vietnam War? Was that something that you were thinking about while on campus and studying?

IR:

I think it was on the news and it was the beginning of an anti-war movement. Now, my husband, you know, he was my boyfriend back then, was in ROTC [Reserve Officers Training Corps] and so we kind of fell into the support side of it. My decision to join the army—I actually was going to skip class because my roommate and I liked this soap opera. I can't even remember what it was. I don't even watch soap operas now. We were going down the back staircase as Dean Eloise Lewis was coming up to go to—I forget what the class was, but the army recruiter was presenting. She said, “Oh, I'll walk you all up there,” so we got hooked. So I heard this presentation from the recruiter and really started thinking about it. I want to say it was May, and it was May of my junior year, I think.

I went home to Alaska, and my father worked at Elmendorf Air Force Base, at the tower there. In those days, you had a family car and if I wanted it, then I had to—the days I wanted to have a car, I had to drive him to work early in the morning, be there to pick him up promptly, and if you were late, you didn't have car privileges. So I would get there always at least a half hour early to pick him up.

Every, I want to say between three and seven minutes, planes were coming in and out of Elmendorf to Vietnam, and there'd be—I'd sit up on the hill by the tower and watch, and a plane would come and these perky soldiers—and it was the last spot before Vietnam. So these perky soldiers would pop out to go take a break and stretch their legs, and I'd think, “Ah, they're going.” And a plane would land and these other soldiers who were far more somber would get out, and I'd think, “Oh, they're coming back,” and a real distinct difference.

Then a lot of the planes were cargo planes and it took me a couple days to realize that they were—these ambulances would come and they were loading coffins on these cargo planes. Maybe every seventh or eighth plane was a Nightingale hospital ship, and it would land and a whole fleet of ambulances would line up and they would offload the people that weren't going to tolerate, you know, didn't tolerate the flight, and I'd count the number of people going in ambulances one day and the next day that number of coffins would come back.

BC:

Oh, my goodness.

IR:

Why am I teary eyed? And I thought, “Wow, there's this whole war and everybody is so angry at the war, they hate soldiers.” It's drafted. I mean it's our generation and they're drafted, and they're offloading and going to the hospital at Elmendorf and coming back in coffins.

BC:

Did that have an impact on your decision to join?

IR:

Oh, it was, because it made me think about none of them wanted to be in a war, the war was unpopular, nobody would consider military service. I mean it was like not something anyone would opt to do. My brother, who was a year older than I, had a real high draft number, so my father was greatly relieved that he would never have to go to Vietnam. And I went and said, “You know, I think I'm going to join.” At the time, you had to be twenty-one or of a certain age or your father had to sign the paperwork, and he wouldn't sign.

BC:

What was his reaction?

IR:

He was horrified. He said, “No daughter of mine is going to be in the military,” end of story. And you know, he dodged a bullet of having his son go, and to have me do that, he was just—

BC:

Was he concerned primarily about Vietnam and safety? Or was it the idea of his daughter being in the military?

IR:

Safety. He also—his daughter and reputation and, yes, yes, all those things, horrified. But it kept weighing on my heart, and I waited till I was old enough, signed up, told him and went, I joined, and I joined the Student Nurse Program so that I was on active duty from December before I graduated to June, about six months.

BC:

So you joined in the end of 1971?

IR:

Oh, no, actually I joined—I'm sorry, I joined in June of '71 and got promoted to lieutenant while I was still in college in December of '71, graduated in June of '72, and went on active duty in September.

BC:

How did your mother respond?

IR:

She wasn't as vocally opposed, and she fretted that I'd go to Vietnam and, yes—because what you saw on TV back then, of course, you're not old enough to know that, but they had flag-draped coffins coming off the plane every day on the news.

BC:

Were you ever concerned about being sent to Vietnam?

IR:

Not particularly. In fact, I would have gone and it's youth, you know, invincible, nothing bad would happen to me.

BC:

What happened after you graduated then in June of '72? Were you sent to basic training?

IR:

Well, I went home. There was a backlog of basic training slots, so I got assigned to a September or late August basic training, went home to Alaska, and there was an airline strike. Now, when you're in Alaska and—before my report date, and so I called the recruiting station and said, “I have these orders to report, but of course my ticket is no longer valid out here. The airline's not flying. I guess I just can't go. Sorry.” [laughing] Doesn't work that way. So I got sent out to Elmendorf Air Force Base with military orders, and I hadn't been to basic, didn't have a uniform, so I got orders to fly in civilian clothing and got on one of those planes that was landing all the time. So they put me on a cargo plane where little net seats come down, and I got in there, sat down, and I was back with the cargo by myself and there stacked were three thick coffins. I was with yesterday's coffined soldiers.

BC:

What did you think?

IR:

“Well, what have I done?” [laughing] So here are the coffins, and they don't drape them with flags until they land them at their destinations, so they were just in metal things. There was this fishnet pallet back here, and it was full of people's stuff coming back from Vietnam, and there were these ceramic elephant end tables that were just the fashion in the Orient. All I could look at, other than the coffins, were those ceramic elephant end tables, and I've never liked them since and I wouldn't have one in my home. But those coffins, you know, they moaned and creaked because there was the air pressure as the plane went up and down. It wasn't a jet, it was an old propeller plane, and it went to Andrews Air Force Base [Maryland], and so it was a long flight from Alaska.

BC:

Dangerous.

IR:

Oh, yes, on a propeller plane with those coffins, and it was sobering.

BC:

By yourself?

IR:

Yes.

BC:

What happened when you arrived at Andrews?

IR:

Then I got a civilian ticket and flew to basic training, but it made it seem ever so real.

BC:

Where did you attend basic?

IR:

San Antonio [Texas], Fort Sam [Houston, Texas].

BC:

What was training like, can you describe it?

IR:

Yes. It was wonderful fun. In our class, we sort of had four roommates and instantly got immersed in it and made good friendships. We had two, I think, platoons of nurses and some medical service corps, a platoon of physicians, and helicopter pilots all in our basic. There was this old quadrangle at Fort Sam and we all were learning to march together and getting our uniforms and going to classes and going to Camp Bullis, [Bexar County, Texas], which you learned field nursing and how to set up a tent and all that stuff. At the time, they had a goat lab, and you went in and they anesthetized goats, but they shot them and you had to learn to debride gunshot wounds, and you had a lot of lectures on that because a lot of our class was on orders to Vietnam right out of basic. In '72, it started to wind down, so most of those orders got cancelled.

BC:

So they used the goats for practice?

IR:

Yes, and the animal activists went after them, and they quit it after Vietnam. But it was, they were teaching you that battlefield precious hour kind of stuff, but with animals, and that was also sobering.

BC:

Were you primarily with women or was there a lot of interaction with the men, too?

IR:

Oh, oh, there was a lot of interaction, oh, yes. There was all dentists, physicians, helicopter pilots, medical service corps, officers and enlisteds at the basic. So it was probably 60 percent men, 40 percent women.

BC:

How were you treated by the men? Did you notice any discrimination?

IR:

Fine. Well, it was medical crap, so it was fine.

BC:

How long did basic last?

IR:

I should know that. August to November, maybe three months, yes, three months.

BC:

What was your first assignment after basic?

IR:

Fort Benning, Georgia, and so I reported to Fort Benning, Georgia, and it was an interesting time. One of the nurses in my basic class, we reported and signed in together at the hospital. I think it was that, pretty much. She—her husband had worked and supported her through nursing school, and he then quit and went to her first assignment. The deal was she would support him to get his master's degree. What struck me as we were in processing, now here's the discrimination piece, as we got into personnel and they were giving us an ID card, and she said, “Well, I need one for my husband.” They said, “Well, he's not a dependent.” So they had dependent ID cards for wives.

BC:

But not for husbands.

IR:

Well, the chief of personnel came out and said, “Is your husband 100 percent disabled?” Well, no. And they were very reluctant. I think at the time there was almost a class action lawsuit in progress, and it was a real battle for her to get him an ID card. Rather than call them family members, it was dependents, and men were not dependent on their wives back then.

BC:

Was she able to get the card?

IR:

Ultimately, and I can't tell her story. I don't remember it. But I remember being appalled.

Fort Benning, Georgia, back in 1972 was still old army, infantry center, Airborne School, Ranger School, and all that. My husband and I were engaged to be married. I reported in in November the following August. So I reported in and my supervisor liked me and I was getting good assignments and I was being groomed to do well in the Army Nurse Corps. At that time, if you were pregnant, you were processed out immediately upon getting a positive pregnancy test. You weren't allowed to be pregnant in the Army Nurse Corps. So a lot of the nurses that came in that were married got pregnant right away to get out, because they had gotten scholarship money, et cetera. So career nurse corps officers were pretty generally not parents and not married, and there was a real bias against married officers. The other thing that was very interesting, so when I got married, my supervisor, I noticed a distinct difference in relationship, from being groomed and have a promising career to, “Oh, are you pregnant yet,” kind of thing.

BC:

Waiting for you to leave.

IR:

Right, right. More night shift, which helped because back then, couples like a young lieutenant male, the wife was part of the package, and so I think my husband's first three officer evaluation reports had a paragraph about my suitability.

BC:

Really?

IR:

Oh, yes. I'll see if I can find those when I sort through stuff in the basement.

But a little paragraph saying, “Although this young lieutenant is married to an Army Nurse Corps officer, they are a suitable military couple, yada, yada, yada.” Now, what do you need to do to be a suitable military couple? Put yourself on the night shift, go to the battalion commander's officers' wives teas, wear your white gloves, and sign up to work your assigned day at the thrift shop or do whatever your duty was as a military wife, which was a full-time job.

BC:

So you were both serving in the military and then serving as a military wife?

IR:

Yes, right, two full-time jobs.

BC:

Where was your husband stationed? Was he at Fort Benning as well?

IR:

Yes, he was at Fort Benning, and he went to basic training at Fort Benning, Airborne School and Ranger School, graduated Ranger School and was the first new Airborne School graduate to be selected to be on their cadre, so he taught skydiving.

BC:

What did you do at Fort Benning?

IR:

I worked at Martin Army Hospital. When I went in—here's the downside of being an army nurse. The army gets to order you, and you don't necessarily get to choose what you do. So I interviewed with the director, chief nurse, and she said, “Well, what would you like to do?” when I signed in.

I said, “Well, I'll do anything, but I don't like OB [obstetrics].” I was down on OB in ten minutes.

She said, “I'm sorry, but that's where we need you, and that's where you're going.” I found that I loved it, so I was in women's health my entire career until I went into research.

BC:

Were you doing general hospital nursing in the OB ward?

IR:

Yes. I started out working on postpartum, and in three months they said, “You're now the head nurse in newborn nursery.” I said, “But I've never worked newborn nursery, never been a head nurse. Don't know what I'm doing.” Didn't matter. I went to a newborn nursery that had one lieutenant, and by then I was a first lieutenant. They had a second lieutenant, myself, and a whole fleet of civilian nurses that had been there twenty-three years.

BC:

That you were now in charge of.

IR:

Yes. Lessons in humility. [laughing] Yes. So everything I learned about leadership, I learned the hard way and from the school of hard knocks. So I don't think I was very good at it at first but I developed those skills.

BC:

Did you enjoy the work?

IR:

Oh, yes. I would say every assignment, and the nice thing about the military—you know, one of the downsides is you don't always get your choice. One of the good things is you get a new job every so often, eighteen months to three years. And I found things to passionately enjoy in every one of those positions.

BC:

Did you know at this point that you would be making a career out of it?

IR:

Oh, no, I wasn't going to make it a career, no.

BC:

It was just—

IR:

I was going to get out. So at Fort Benning, I put in to get out and had a job at the local community college school of nursing. We talked about it, and my husband and I decided that if he was going to stay in the military and you moved every three years, you'd forever have no seniority. So then I pulled that resignation back and stayed, and I swore, “I'll stay one tour at a time,” but pretty soon it was pretty clear that it worked well for us. At about the ten-year point, I also toyed with getting out, both of us did.

BC:

How did it work with you and your husband being in the service? Did they assign one of you first and then bring along the other?

IR:

Well, what we had to do—and dual service couples were a new entity. My husband and I were the first generation of couples in the military, so it was a conundrum, a bit. So we always made it a point, the Hoffman Building over off the Beltway is where personnel still is, and we would go see our career monitors well in advance of an anticipated assignment and say—well, the first time we went, we were at Fort Benning, and we knew we'd be due for orders, so we went—came to Washington, reviewed our records. By the way, that was probably '74, and they said, “Don't wear a uniform, don't do anything to indicate you're military. We've had three incidents of people having tomatoes and apples thrown at them.” So it was very unpopular. I mean there was a lot of protesting around here.

So we came up, reviewed our records, and said, “Well, our priority is to stay together, so we volunteer to go to Korea together.”

They said, “Oh, we couldn't possibly send you to Korea. We'll send you to Hawaii.” So we went to Hawaii for three years. That was very nice.

BC:

Did they tell you why they couldn't send you to Korea?

IR:

No positions for both of us.

BC:

Just no positions?

IR:

Yes. So we went back and there was this other couple, army nurse and he was military, and we said, “We really recommend you go to Washington and tell them—We volunteered for Korea and they said, 'There's just no openings,'” sent us to Hawaii. They were going the next week and they went and they said, “Oh, we just want to stay together. We'll go to Korea,” and they went to Korea. [laughing]

BC:

Good timing for you.

IR:

Yes.

BC:

How was Hawaii?

IR:

Wonderful. I spent three years there, worked at Tripler [Army Medical Center, Honolulu], before they renovated it. Tripler was this old hospital that looks over Pearl Harbor, and we were on the seventh floor and overlooked with a fresh air balcony Pearl Harbor. You know, on the night shift a lot, go out and have your lunch, and very nice. We loved Hawaii.

BC:

What years were you there? Mid-seventies?

IR:

[looking through papers] Yes. I was there from '75 to '78.

BC:

Was this also OB nursing?

IR:

Yes. I worked labor and delivery, antepartum, and that's it. Labor and delivery in the antepartum ward.

BC:

Was it all women?

IR:

All women?

BC:

In the hospital? Were you working with all women?

IR:

With labor and delivery? Yes, I would think so. Yes, pretty much. [both laughing] One of the things we did for the first time, though, was have male nurses work labor and delivery, and that was a big whoop-ti-do.

It worked very—let me go back to Fort Benning. One of the interesting things I did there—when we pulled out of Vietnam and they airevac[uat]ed all the orphans, planeloads of orphans out of Vietnam, the last two planes out of Vietnam came out to Fort Benning, and I was tasked with about five other people to set up an orphanage and take this old school down in the swamps and had, I want to say, a hundred and ten, a hundred and fifteen orphans. One of the last planes out of Vietnam crashed, and they took the surviving babies and stuff, put them in cardboard boxes, and threw them on this plane. We got them in after this flight from Vietnam, and that was very interesting because those kids are now grown and highly productive.

But we had all these babies and the pediatricians that I worked with, we went to deworm them. The things you learn the hard way. And the orphans didn't have a long life expectancy. They were fed rice bottles, and you'd put them on regular formula, so they all diarrhea, and they were put on regular formula actually on the plane. So we got them and they were just soaked in diarrhea, so we had a lot of really sick kids. Yes, the standard of care was way different for what we could for them instantly than what you would do with a child when they're in that shape here. But that was okay, because they were pretty resilient.

We were trying to judge how old kids were. I mean to ask, this one's four months old. Then I put this cardboard box down and turn around, and the kid would be sitting up with teeth. So very emaciated and whatnot. We got Red Cross volunteers in and had a twenty-four hour-a-day shift for each baby to stimulate them. It was wonderful.

BC:

It's probably fascinating work, and at the same time very sad.

IR:

Yes. But they all went to good homes.

BC:

Did they?

IR:

I think. They had a lot of political stuff about getting them adopted. There was a Dr. Tisdale and his wife [Colonel Patrick and Betty Tisdale] spearheaded the Fort Benning orphanage experience.

BC:

How did you feel about the end of the war? Did it have much of an impact on your work other than that?

IR:

What stopped—although I was in OB, the hospital was full of amputees and really injured patients, kind of like Walter Reed [Army Medical Center] today, and that stopped. I think there was a real morale problem in the seventies after Vietnam, and we really noticed it in Hawaii.

Now in a hospital setting, it wasn't so bad for me. But my husband was at Scofield Barracks, and morale—there were drug problems from soldiers out of Vietnam, all of the antiwar, antimilitary was at its height, and it wasn't a very pleasant experience for him. When we left Hawaii in '78, he got out of the military, got his master's degree and stayed out. At the end of our assignment at Fort Benning, Georgia, which was '78 to '82, we were going to get out. Or actually in 1980, I think we were going to get out. The hospital commander came down and said, “Why are you getting out?”

I said, “Well, my husband's not active duty, and we're going to go home to Alaska, dah, dah, dah, dah.”

He said, “What can I do to talk him back into the military?” He called my husband.

My husband said, “Well, I was infantry, but I now have an economic degree and in accounting and I want to be in the Finance Corps.” The hospital commander called around and got the Finance Corps commanding general to bring him back on active duty. And he came back and we stayed. Yes.

BC:

What happened next?

IR:

I went for a master's degree at Vanderbilt [University in Nashville, Tennessee], and that's where I got hooked on research. I got a really good advanced education there, got my master's in parent/infant nursing, but I minored in education and management as well. I did a double focus in that. I loved what I did. I loved research. I loved my thesis project.

My husband was picked to be on a State Department team and went to Liberia after the [Samuel K.] Doe regime took over in a real bloody coup, and the State Department wanted to establish good relationships with the Liberian government. So he went over to help the Doe new army set up a payroll. So he was in Liberia, I was in graduate school, he came back, and I graduated, and we got assigned to Germany.

BC:

Germany?

IR:

Yes.

BC:

Were you hoping to go overseas?

IR:

We assumed we'd go overseas, so we were assigned in Nuremberg, and that was a good four years as well. I love Germany. Now, the first assignment I had there, for half of my tour, I supervised outlying health clinics, and it was back during there was a Cold War and a Berlin Wall. President [Ronald W.] Reagan went into office or was in office. He was from [pause]—

BC:

[Nineteen] eighty to eighty-eight.

IR:

Yes, so he was president, and we had the highest troop strength in Germany that we had since World War II, but Nuremberg Hospital was responsible for fourteen thousand square miles of all these little outposts with border patrol missions and training missions.

BC:

A very different setup.

IR:

Yes. So each of those little outposts had families and their own little health clinic, and when I got to Germany, they said, “These health clinics have no standards and no supervision.” For the first time, they were trying to move to get them to Joint Commission standards of care, so I was given the job of supervising nursing care in ten outlying health facilities. So I was in a military car going to outlying clinics five days a week.

BC:

And these clinics served the German people, the locals or the—

IR:

American families. So it was the only health care for American families out in these communities several hours from Nuremberg, and they had to have an emergency room and fly people in if they were really ill or run clinics all night, and they were staffed usually with a new graduate nurse and a new person out of their internship in like family practice and a bunch new medics and whatnot.

So my job was to go in and establish standards and scope of practice and training and mainly monitor health care in those clinics, and so that was a wonderful job that I passionately cared about. Two months after I arrived, they were all inspected by the inspector general and flunked unanimously. But it was real easy, because I would go in and speak to some young medic and say, “Oh, hi.” At the time I was a major—do I need to talk faster?

BC:

No, I just wanted to check the tape.

IR:

Okay. I'd say, “What was the most fun you had this month since I was here last?”

“Oh, I aspirated a knee. I started twelve IVs. I diagnosed this. I removed these moles with the dot.” So you had twenty-year-old medics with no medical background doing anything they wanted, and doctors that wanted to be at home that were letting them practice like they were way advanced, and we reigned all that it and brought it under control.

BC:

How did they respond to you being there?

IR:

I had a nurse in every clinic and we had a team. We had a physician supervisor in Nuremberg, very senior colonel, myself as a major, I had two senior sergeants, one that were LPNs [Licensed Practical Nurse], and amongst the four of us, we went out and worked with our respective counterparts in every health clinic and said, “This is where you have to be, and this is where you are.”

For example, Grafenwoehr Base is a major training facility in Germany where they do live fire and all this stuff, so they had, at the time, probably as high a trauma load of injury—as in gunshot injuries and explosion injuries—as any hospital even in the States. And they had an inpatient capability. The first time I went in the clinic, I talked to this medic, I said, “Oh, tell me what you do.”

“Oh, I've been put in charge of CMS [Central Material Supply], but you know, major, I took over and I didn't get to overlap with the person that did it before.”

I said, “Oh, well, how's it going?”

“I figured it out.” I opened a cabinet and there were these huge bundles. What is this? Oh, whatever, some sort of forceps or something. What she was doing was taking things as they outdated and putting another layer of wrapping over them and autoclaving again and again and again, so there were like twelve layers of wrap.

I went to the commander and I said, “Are you aware that none of your instruments are sterile? And I'm shutting you down.” I called the hospital commander, I said, “Get the CMS team out here right now, provide this youngster training, and for the next twenty-four to forty-eight hours you're shut down and everything has to be—” So that's the kind of thing.

BC:

What does CMS stand for?

IR:

Central Material Supply, it's where you sterilized everything. What this kid was doing was she didn't know how to do the sterilizer. She put another wrap on and ran things through a sterilizer, sort of, but she didn't know how to do that either. So I just assumed it was all not okay.

BC:

Did you do this the whole time that you were in Germany?

IR:

No, for two years. Then I went back into OB and was the supervisor, head nurse of labor and delivery and then supervisor of obstetrics, the labor and delivery, pediatrics, and OB.

BC:

Was that back at Nuremberg Hospital?

IR:

Yes, that was the main Nuremberg Hospital. That was at a time when there was a lot of terrorism going on in Germany, a lot of bombing of American posts and such. So we had bombing threats all the time when I was head nurse of labor and delivery there. I also was chosen to be the consultant to the 7th Medical Commander, which is the overall general in charge of health care across all of Europe, and at that time I think there were three hundred thousand soldiers. So I traveled to all the hospitals and looked at standards.

But in our own labor and delivery, we had to be able to evacuate every time we had a bomb threat real quickly, so we had emergency delivery kits and all this stuff. We got used to going out to the parking lot and going back in. Now one day, we were in the middle of an emergency C-section and my NCO [non-commissioned officer] came in and said, “Major, we've got to evacuate.”

I said, “Well, gather everybody else. We can't go.” I stayed and the pediatric nurse stayed and physician and first assistant. They got the baby and took the baby out. The NCO came back with combat helmets and flak jackets and said, “They have found the bomb. Can you go?”

I said, “We can't go for at least twenty minutes.” So we put our stuff on, surgeon started singing Nearer, My God, to Thee [laughing] and they evacuated way out beyond the hospital perimeter wall, and a bomb squad diffused the bomb so we didn't blow up.

BC:

Did you ever feel afraid while you were there? Were the threats that constant?

IR:

I don't have a sense of being afraid. No more than if you walked by the Capitol, are you worried that there's going to be a terrorist attack? I mean that's kind of the reality. There was probably more a sense of that because there were bombings at bases and PXs [Post Exchange] and stuff. So if you had your briefcase and you happened to leave it laying somewhere and lose it, it would likely be disposed of by the bomb squad by blowing it up. In fact, that happened to somebody I knew. And people watched for suspicious behavior.

[End Tape 1, Side A—Begin Tape 1, Side B]

IR:

The command would issue an alert forbidding you to go out into the community, and in Nuremberg it was the center of Nazi Party activities. So there would be Nazi stuff. And if you flew out and about on helicopters during air evacs, you would sometimes see swastikas in cornfields or in the crop fields.

BC:

There was still that much of a presence?

IR:

Yes.

BC:

Did you have much interaction with the German civilians?

IR:

Yes. We lived for three, or two and a half years we lived out on the German economy before we moved onto our post housing, and we only moved on post because the dollar was not doing well against the [Deutsche] Mark, and it was getting more and more and more expensive every month. So we went ahead on the base housing. But yes, we lived out on the economy and had met some good German folks. We noticed the cultural difference. We were up at 5:00, out the door at 5:30, not in until 6:30 in the evening, working long hard hours. The German people thought we were crazy because they had a much more—they had a thirty-six-hour workweek that they stuck to. We lived in a little row house, and the neighbors on either side complained because we were taking showers at five in the morning instead of showering in the evening and so culturally really different.

Now, we really fretted over whether to send my daughter to a German school, and I wish I had. But we didn't speak German well, and I felt like, man, kindergarten, first grade, you want to be able to reinforce, and I probably could have done that in any case. But she was very fluent. We'd go to the market on Saturday, and she would negotiate price for me.

BC:

Children pick up new languages so much more quickly.

IR:

Yes. Anyway, so yes, I enjoyed Germany very much.

Applied for a doctoral education and left there for here and went to Catholic University [in Washington, D.C.].

BC:

This is all still while serving?

IR:

Yes.

BC:

What was your doctorate in?

IR:

Women's health nursing, but I really—my goal was to be a nurse researcher and work at Walter Reed in the Nursing Research Service. But in the interim, for as long as I was on active duty, to be a research expert wherever I was, and they didn't have—like I really wanted to publish and stuff when I was in Germany, but it was before the Internet and I didn't have access to a medical library of any kind. So it was really prohibitive, and so I wanted to be able to go to somewhere like Germany and mentor nurses along and help them with research projects or whatever.

So when I went to Catholic University, I said—you know, there's a core. You have to have a dissertation topic. But a lot of the rest of the coursework is the same. I took every available statistics course and research methods course that I could while I was there, and I was a school nurse and I took all the education courses and really did a dissertation that was heavy duty in terms of—I did instrument development, had a dissertation sample of six hundred and sixty subjects, did quantitative and qualitative methods, and had a wonderful time with it.

BC:

What were you doing with it?

IR:

Well, I'm studying early pregnancy and psychology of pregnancy.

BC:

It must have been very interesting.

IR:

It was very interesting. It was very interesting.

BC:

Is this how you really became involved in the research side of things?

IR:

Yes, it was.

BC:

Can you tell me a little bit about your work in research?

IR:

Okay. I finished my disser—well, Murphy's Law is that if it can go wrong, it will go wrong. And the army funded me for three years to get a dissertation. At Catholic, the average student takes four to five years. I had it all mapped out where I could study early pregnancy and I was going to get people into my sample to validate my instrument that I developed, and I needed an equal number in all three trimesters and I had gone to major military medical centers and gotten permission to go there. [Operation] Desert Storm I happened, and honest to goodness, there was no new pregnant women because their husbands were all gone.

BC:

What instrument was this that you—

IR:

I developed a questionnaire that measured attitudes towards pregnancy.

BC:

What did you do when your sample group disappeared?

IR:

Well, I then had to figure out, and here I am active duty, and it was Desert Storm I. I had to figure out where men hadn't deployed, there had to be a reserve force somewhere, and get permission to go to those facilities. So imagine calling at a time of war saying, “Hi, are your soldiers deployed?” [laughing] It didn't go over well. So I had to do a lot of whatever.

I finally figured that the reserve force that wouldn't go to Desert Storm I would be if Korea acted up. So I found that Madigan [Army Medical Center in Tacoma, Washington] hadn't deployed its soldiers and I already had permission and I went to Fort Riley, Kansas, right as they were deploying. So there were pregnant women, I did my sample, and the husbands were all leaving within the week, and it was a great validation for my [unclear]. They were way up there already. I was looking at psychological symptoms of stress, which they had, and overall attitudes toward pregnancy. Then I was much delayed getting to Madigan where they hadn't deployed, and I used Walter Reed, but I had very slow data collection because I had to wait for that war to be over, for the soldiers to come home and impregnate their wives, which is a forced delay.

BC:

What did your study reveal?

IR:

That my instrument had—I had subscales and labeled them for different components of attitude towards pregnancy, and my findings were basically related to pregnancy intendedness a lot. If you had a real unwanted pregnancy, your psychological symptom distress was higher and your pregnancy attitude was less positive, and you know, common sense kind of stuff, but it validated the scale. And really desired pregnancies, of course, had less symptoms of stress and higher attitude towards pregnancy scale scores.

BC:

Where did all this research lead you in your dissertation?

IR:

Well, here's one of the pitfalls of the military again. My thesis work was on early pregnancy and it was very interesting and I had interesting findings, got sent to Germany, couldn't publish them. I finished my three years' time and had data collected but I hadn't run my analyses, so I went to work at Walter Reed and completed it over the next two years on the side, or actually eighteen months, and defended my dissertation one day. By then, by the way, I was working at Nursing Research Service and I had a whole bunch of potential grantees submitting grants, and I was submitting a grant the next day myself.

So I defended my dissertation, submitted my grant application, and got my grant up and running, and got tapped on the shoulder to go to Fort Detrick [Frederick, Maryland], and so I never—I had to stop and never was able to complete my work on my grant. My grant was to do a detailed analysis of women as their husbands deployed, prewar through—and never got, never did that. It went by the wayside. I got tapped on the shoulder and had three or four days' notice to go to Fort Detrick.

Congress had appropriated $225 or $235 million for breast cancer research, and Fort Detrick is the army's research center, and they have what they call Research Area Directorates, and those are the equivalent in the army system of institutes at NIH [National Institutes of Health]. They each have a program of research, so combat casualty care, you know, has a whole portfolio of projects that benefit soldiers on the battlefield, and chemical and biological defense, and they have USMR that does all the work on emerging diseases in the biological fore, laboratory, that kind of stuff. So they had five established Research Area Directorates and they started a new one, which I got sent to as the first director for congressionally directed research initiatives. So I had $225 million of money for breast cancer research and a blank canvas, and that's a lot of research money.

BC:

Had you done work with breast cancer patients and research before?

IR:

No. I told them that, too. [laughing] I had actually worked a little less than a year, maybe a year, on the Ward 67, which was gyn-oncology at Walter Reed, but we didn't—and we did breast reconstruction for breast cancer patients. We did plastic surgery, gyn-oncology. But oncology had not been my focus.

So I brought you this [leafing through papers]. I didn't know if you'd want it or not, but this is—we went to the Institute of Medicine, and the army—the command had gone to the Institute of Medicine and requested strategies for managing the breast cancer research program. So that came to me as I went to the command, and we followed that to the letter. But we had to use that money as if we were NIH. It was money to augment and meet unique niches in breast cancer that were unmet. The eyes of the world, every—it was taking a group of scientists that were educated back during Vietnam when I was on the university and giving money to the army to the post that did chemical and biological warfare research in the old days, and nobody, and I mean nobody, believed that the army could do this.

BC:

How did the army get involved in this?

IR:

Well, Congress appropriated the money in the defense budget, and it was—the Berlin Wall had just come down, and if you went through the newspapers, you'd see all this stuff about Congress was dickering over the peace dividend. So they were trying to carve up the defense budget to go to other peaceful initiatives, and it passed some firewall legislation that would expire after a period of time that precluded any defense dollar going anywhere but defense so that that defense budget pie wouldn't be used up. Well, that's public policy and how it works in this country.

So the money was appropriated. The National Breast Cancer Coalition, the [Susan B.] Komen Foundation, all the breast cancer advocates, it was their advocacy heyday where it built up to a major crescendo, as it were, and they were insisting this money be appropriated to augment breast cancer, probably with the notion that it would get transferred to NIH, but it couldn't be. So the army had the ability to send it back to the president and say, “We don't want this. Send it back to Congress,” and they did. They said, “We don't do breast cancer research.” And with that firewall legislation, Congress said, “Do it.”

In the meantime, the money had to be expended on breast cancer grants in a two-year period, and they dickered away six months of that, so you had eighteen months to take and start a whole new institute, do peer review, come up with a vision for the program. Thank God, my boss had had the foresight to order this report.

BC:

Were you running research programs and labs or was this simply providing funds to—

IR:

This was a worldwide, not just the U.S., grant program. So we had to do an announcement and call for proposals. In the army, they call them Broad Agency Announcements, and the terminology in the army is different than NIH. So here I am. I've been at the bedside forever, finally got my dream job in nursing research and was acting director defending my dissertation and mentoring these people with their grant writing initiatives. There was congressional money for TriService Nursing research, which is what that was all about, and I was very happy where I was as a nurse researcher, and literally got air-dropped into this.

BC:

How did you feel about it?

IR:

I had a stack of ten borrowed people, scientists from other military labs up there, and this job to do, and the eyes of Congress on me, and the eyes of the world, because Science magazine had an investigative reporter tracking everything we did, and they had, I want to say, a six-page spread in Science magazine laid out for—we couldn't talk to them until we finished the grant process, so we contracted out peer review to a company and had peer review, and then we selected, based on the strategy they had here, the second tier, the programmatic review panel, and we got some of the best minds in the country. We put breast cancer survivors in at every stage of the game and selected grants and awarded the awards. The Science magazine editor called and said, “I hate to disappoint you, but you're down to half a page in our magazine, because I couldn't find anybody that was unhappy with what you're doing.” It was a heck of an eighteen months.

BC:

I bet.

IR:

Yes. What a learning—because it was just intense, and what I learned is, your far better—I had this money that was a big national investment, so I called the director of NCI [National Cancer Institute] and I said, “Here's what I had to do, and I have to do it. What's your advice to me? I'm real interested in what you can do to help me in my initiative,” so I got some of his key staff to sit my senior panel. When I had a shortfall in the peer review, NCI directed their grants officials to help us get fill-in grant reviewers and stuff. I got a crash course at every level of NIH.

BC:

What is NCI?

IR:

National Cancer Institute. Right away, I had to start going up to the [Capitol] Hill and responding to senators and congressmen and answering their questions about the program. When it's Congressionally directed and mandated in Congressional language, it has a good bit of Congressional ownership, and the whole time, if you talk about politics, the army didn't so much want that program. So even from the army officials, it was a pull and a tug with Congress, and NCI would much have preferred to have the money.

BC:

Than have it go through you?

IR:

Yes. So I got initiated into public policy and political process and interacting with the, three surgeon generals, trial by fire, very interesting.

BC:

This is the early 1990s?

IR:

Yes. I have like the L.A. Times featured our program in a Sunday supplement one year. I have that somewhere in what I've got packed up.

BC:

What happened after that final eighteen months? You awarded the money and then was that the end of your responsibility?

IR:

No. Well, it was supposed to be. They said, “We're just sending you up to do this.”

So my husband, by the way, had been assigned to Korea. And you asked how it worked, it worked real well being dual service when we lieutenants in junior ranking, but the more senior we got, the more difficult it became to get an appropriate position for him and for me and to balance that. So he went to Africa without us. He went to Korea. He was in Korea, and I was home with our daughter in Springfield, and they said, “Oh, there's this short-term bunch of money, and go run this, and then we'll bring you back and you can do whatever you want, but we'll move you up there for what.”

I thought, “my husband's in Korea, damn, I drive sixty-five miles one-way, roundtrip, as a single parent, to do my job,” and I had two secretaries, but I'd be on the phone with my secretary. It was the early cell phones when they were gigantic. She'd read my mail as I drove the Beltway, and I'd dictate correspondence, and had appointments every ten minutes all day every day. I'd come home and do stuff with my daughter and then work another three or four hours, get up and do it again. Nobody should work that hard forever but everybody should do it for a short time. [laughing]

BC:

A once-in-a-lifetime opportunity.

IR:

Yes. So the one-time only program, we got such rave reviews with the first cycle that Congress has continued to appropriate, and the program is still at Fort Detrick and they do research at the direction of Congress. Like they've done some Mad Cow [Disease], you know, protein prion work. They do breast cancer. Well, Congress continued to appropriate, and that's, by the way—I, in 1997, had the Institute of Medicine review how well we were doing, and that's this book.

BC:

So you continued in that role beyond the initial—

IR:

Oh, yes, I was in the role until 1999, yes. So I did it about five years. Actually, [leafing through papers] these are good summaries of this, too, of kind of what I did and how I did it.

BC:

Where did you turn when you finished with that?

IR:

Well, I actually retired.

BC:

In 1999?

IR:

In—June 1, the last day of May actually was my retirement in '99, and I was twenty-eight years in the military by then, hard to figure. My family is teasing me because an archivist is talking to me. [laughing] But I retired from the army. My husband's parents—how did I survive all that, is a question you could ask.

BC:

Right.

IR:

My parents had passed away already, but my husband's parents were dear friends. His father landed at the beach in Normandy [France] and lost a brother there and was a senior sergeant in his reserve unit in World War II, and was battlefield commissioned to lieutenant and led his unit during the rest of World War II, through the Battle of the Bulge and all that. So he was like a proud father that his son was in the military. But Nana, as a military wife, could not believe, because you understand she worked for the battalion commander's wife, how hard life would be for us. So every step of our way in the military, they would call and say, “Well, how's the next couple months look?” I'd say, “Oh, I have to go on a field duty dah, dah, dah,” and they would show up, whether we were in Germany or wherever, and kept our household in order.

BC:

How wonderful.

IR:

His aunts all took part in that, too, so we had family support, you know, my husband in Korea, that got us through all that.

BC:

Brings about a lot of changes when you have children and couples in the military who are traveling and sent to two different places, especially overseas.

IR:

Well, now, it's the same issues are there for the people, families going to Iraq, and kids left at home with the grandparents, and it takes a level of social support that is unbelievable. It's an issue.

But back to Fort Detrick. Even at Fort Detrick they thought it would be a one-time only thing. We got 2,700 proposals, and they didn't do things electronically then, by hand, twenty copies delivered, and it was several miles of shelving in an old warehouse. We had to triage all those to make sure they got to the right peer review panels and do peer review guidelines, and all that was just an enormous undertaking. But there's nothing like a good challenge to take folks and get them into an operational team. In my tenure there, Congress kept appropriating money, and there was—Next year, the Assistant Secretary of Defense decided we weren't going to do breast cancer research in the military, end of story. So all my borrowed people vanished. You know the army, if they don't want you—

BC:

Was there any explanation for that?

IR: “It's not—there was a pay as you go, and so they felt like the breast cancer money was out of their pocket for military stuff and that it was not relevant to the mission of the military. So they'd gotten into it with President [Bill] Clinton.”

In the meantime, I've got $25 million appropriated that is tied up and I can't spend it and my clock's ticking, and there was a big blowout. It was, this letter was published in the Washington Post, but I actually have a copy of it, where—I can't think of the undersecretary's name, said, “We're closing down the breast cancer program.” He got a letter of reprimand, written and signed by President Clinton from [former White House Chief of Staff] Leon Panetta, and I've got a copy of it. Well, when the Secretary of Defense gets a letter of reprimand over your program, and you're in the army, people stand a little far back from you. So that was an interesting process.

In the meantime, Congress kept liking what we did, and one of the big scientific issues at the time was consumers wanted results, and they didn't want general funding of interesting science. They wanted targeted scientific programs, and the National Institutes of Health, the National Cancer Institute, didn't want—targeting is a problem because a lot of science benefits all cancer, and then when is it appropriate to take the dollars and funnel it in, and they felt like insisting that this amount of dollars goes to this one specific disease was counterproductive.

One of the things by interacting with every director of NCI when I was in my role is that, like I said, you know what, have your key staff work with me and we always need to have our advisory panels make sure that we are doing things that are uniquely different and that you can't do. Your budget is wrapped differently, and there's constraints on how rapidly you can make a change. We can do and test, and so we coexisted quite nicely.

Then my undoing, they appropriate—here I've been, my entire career in women's health, they appropriated the DOD [Department of Defense] prostate cancer research program. I went, “Ah. That's one system called male that I haven't dealt with.” And it begged the question, since we expanded beyond breast cancer, we did osteoporosis, neurofibromatosis, Congress decided that we could do orphan diseases and things where there was a lot of political pressure to get answers. Advocates were marching up there insisting, and those funds got sent to DOD so that we could manage them and do this process.

But what we did for the first process, we had to then say, okay, I sat in my office and I thought, “Oh, prostate cancer.” I had a really solid team that I had put in place, and I had to do everything with my little—I didn't have a staff yet. I had a process in place where the army would authorize you slots, took two and a half years. So I had every six months to borrow all but four people, so I'd have to orient people as they came in, but I could write contract specifications and hire people to do stuff. So I hired really senior scientists that had retired from the NIH peer review system to help me write guidelines and do stuff, so I had all these brain trust folks on contract.

I would give them a challenge and say, “Okay,” I said, “I have to be really smart about everything to do with prostate cancer and prostate cancer research in the U.S. and abroad and a history of it,” and I wrote specifications for what I needed to know, and I had a book delivered to me and I read it every night and then had them searching for who the best players in the field were. Andrew von Eschenbach, who's the outgoing National Cancer Institute director and now the FDA [Food and Drug Administration] guy that's being grilled by Congress to be approved as commissioner, was my chairperson of my senior panel for prostate cancer, my programmatic review panel.

But I brought to the table—and this was one of the exciting things. In breast cancer, in every single—I developed—what I developed was a process where you could rapidly take money, get smart about that money, and bring—here I had—I had—

BC:

The top people.

IR:

Well, I had this, guidelines for breast cancer, so that was somewhat easy, but all of a sudden—and I had very little time, and I didn't have time to do this for prostate cancer, to come up with a system to a process that would work for prostate cancer. It was right as all my trained staff was leaving and move on to the—

BC:

Yes.

IR:

I brought in every group that had any say in prostate cancer, every professional association, every university that was heavily endowed, and I funded a meeting. I had said we have this amount of prostate cancer money and we're going to come up with a strategy for how to expend it and you're invited to play. So of course, everybody came. And you have to answer these questions. If resources were unlimited, what's needed to move prostate cancer research forward? Then we'll finally get to among all these good ideas what recommendations do you have for the DOD, et cetera?

What was very interesting, we got money for ovarian cancer and prostate cancer at the same time, and we had these meetings and I was—one of the most profound things I realized, because in breast cancer I put people together that had never interacted, and it was wonderful. But I saw how dramatically it worked in a different community. I had urologic researchers and prostate cancer survivors in the same room, and they all had to listen to each other's thing, what their priorities were. The senior, senior prostate cancer researcher said, “My life is changed, absolutely changed. I'm sitting here pondering interesting questions, my friend that I made is going to die unless I kick butt in my lab,” and that connectedness, the public-private partnership and the bringing consumer advocates into the equation is a marvelous experience. I had people leave that meeting saying, “Our lives are changed,” when the NCI representatives went back.

BC:

What a wonderful process.

IR:

And it works and it's a permanently—when new money comes, there's a process for how you decide to do it, and you bring as many groups, even if they're very adversarial with one another, and bring them to the table and make them agree on an investment strategy. Then our job was to take—the goal of the scientific program is to do dah, dah, dah, dah, dah, and write that into language that was clear enough that the scientific community worldwide could apply for grants and do it quickly and then have the right peer reviewers come to the table to review that science and everybody, it's a circle, you know, with the feedback group. We articulated it and designed it so it would work well. Magnificent.

Well, Rick Klausner was the director of National Cancer Institute and they started their progress review group structure. They did one for prostate cancer and one for breast cancer. They did that [whispering], and I was the only nurse to sit on breast cancer harvest review group at NCI, and that continues on, by the way. This is their 2004—that's my only copy of that, so I might like to keep it. But I was ad hoc to the prostate cancer, and they did the same strategy, but they could do it on a much grander scale because they had more money and they brought every player in and they started that system of coming up with a long-term vision and a strategy for how to do it.

A lot of that, by the way, was based—a big measure of it was based on advocacy, strong advocacy from a lot of camps, insisting that public money for research be more focused and that people, survivors of whatever cancer, be allowed at the table to—So the next big thing we did was, after the first initiative of breast cancer, we used our integration panel and we developed a charter for them, and how people would rotate on and off and whatnot, and let them help us with guidelines for the program, and there was an enormous debate. They wanted survivors to sit on scientific review panels, and that was scientific heresy unless they were a PhD. Man, there was such a flutter at National Cancer Institute over it, and our integration panel that voted on policy to recommend to the army about how to do it, voted to do it, but all of the scientists were beside themselves. So I said, let's do this as a research project. We're equipped to try something. If it doesn't work, as long as we're doing evaluation research as we go, and finding out what it means to the scientists and the advocates and even analyze scoring and such as that, then we have data and we can write articles and we can inform the nation about, is it appropriate to put laypeople onto scientific review panels.

BC:

Did you try it?

IR:

We did it, and I published an article on that process, which I didn't have in that box, but my reprints. But I brought you the one reprint of another article that I could find.

BC:

That's great. Thank you.

IR:

Yes, so we did, and we did it as a research study, and so we had a whole group of people that interviewed every—well, we came up—the National Breast Cancer Coalition came up with a training program to train laypeople about scientific process, and they did that on their own. Then we had a training program with a rigorous selection process for consumer members of panels and trained them. We did interviews before and after with all parties in the peer review process and scientifically. I mean I had people say I was a heretic, and if tarring and feathering was still happening, I'd have been out of town. It was transformational. Within the first cycle, the scientists loved it, by and large, and now it's just an accepted part of a lot of scientific process. We developed a whole guideline manual and briefed it to the PROG, Peer Review Oversight Group, at the director of NIH, and a couple of institute directors really got into it and so we did that. But we did a lot of really innovative things with peer review as well. We did electronic voting for the first time and spearheaded a lot of initiatives on electronic submission.

BC:

Was it difficult to walk away from all that when you retired?

IR:

Well, I retired two years earlier than the thirty-year mandatory retirement. The in-laws became ill and it put them in a nursing home, and at the pace I was working, these people who had been there every time my life got tough were in a terrible predicament, and it felt like the right decision to retire. So I retired and I had Papa on hospice care for a year, and he passed away, and Nana was diagnosed with cancer and she was on hospice care for a year. So I was home for two years. So I went from that to—which is a different.

BC:

Very different.

IR:

Very different. A life does that.

BC:

Was it a difficult adjustment to civilian life, although you really, even though you were in the military, were doing kind of—were in the States in a—

IR:

It was just an antithesis. It was very different. Every step of life is a big learning, and I said every assignment I've ever had I had the best of the times and the worst of times, and that's true with the hospice. It was the best unifying thing for family I've ever done. My daughter was headed off to college as that was happening, so truly sandwich generation issues. How do you role model what family is about to a child differently? So it was wonderful because I was there at their bedside, had to hire nursing support to keep them in the home. But I heard stories and all the old—I bring family [unclear] and they'd have family dinners, and finally got her home from college and they'd talk about all the old days and the Depression, and I wouldn't trade either experience for anything.

So, what next? Nana passed away, and in three months I took a position to run a contract for—what I had learned is scientifically, you can learn what you need to using that process, it works. So I was hired as a contractor to oversee a project, a valuation research project, in the substance abuse treatment. Completely new, but you get smart on it. So I started this twenty-five million dollar contract as a contractor and hired the staff to do the work, got them oriented. About three months in, I knew that I did not want to be the contract person doing that. That was not my shtick. So I told the company president that I'd stay three more months, I'd hire a deputy, get the deputy up to speed, and then I was going to go. So I worked at that for nine months. I found them who liked being the contractor because you're locked into contract specifications, and look how creative all this is, and so it didn't have appeal. And the other thing, I worked at a real fever pitch and hospice care for two years and then intensely worked again. I had a need. I wanted to do it differently and have family time. I learned that from that two years, so I worked part-time as a parish nurse and director of congregational care of our church and had then Honduras missions and set up all kinds of things. I am actually looking to—what I found is that what I do is wonderful, but it doesn't tap my scientific part. So I have a couple of positions I might apply for, but to be choosy.

BC:

Right. You have the background and the skills and experience to really be able to be choosy and find the right nook.

What was the hardest thing you had to do physically while you were in the service?

IR:

The hardest thing physically?

BC:

Does anything stand out?

IR:

They were really into physical fitness testing and stuff. I deployed with—I was a member of the [unclear] Contingency Hospital and it was the European Rapid Response Hospital team. Back during Vietnam, they had hospitals that were inflatable with jet engines, and the hospital system they had now—so they had MASH [Mobile Army Surgical Hospital] hospitals, tents. Then they did these big inflatables. And then when terrorism became an issue in Europe, they did a Rapid Response Hospital strategy where they wanted the hospital to go, load it on a plane and a full cadre of hospital people. So in Europe, they took one or two people from every facility who had not worked together and put us in this European Contingency Hospital. Our [unclear] the globe was Europe all the way down, and any contingency requiring American hospital response, we were on a twenty-four-hour to go, have your duffle bags packed. So I was one of the nurses on the Contingency Hospital.

Do you remember the [hijacking of the cruise ship] Achille Lauro, when [passenger Leon] Klinghoffer got pushed?

BC:

Yes, right.

IR:

Well, we alerted for that, but we were at, of course—we were going to have a field hospital able to, and that resolved itself, but we supported a major NATO [North Atlantic Treaty Organization] exercise, and they didn't have their new hospital DetMed [Medical Detachment] system in place. We went to Pisa, Italy, and took out of mothballs an old Korean War MASH unit and took it to support a major NATO exercise in Turkey, way in the outback of Turkey. That was pretty physical. [laughing]

BC:

I would think so.

IR:

Yes. It was very interesting. What was interesting about that experience is you had most military units have worked together and they—but we took people that had never worked together, and at a hospital that nobody knew how to use. It had in these old—like I was in charge of the emergency room, so I had a tent and we had to hoist the tent and we didn't do a very good job. Well, we were in—

[End Tape 1, Side B—Begin Tape 2, Side A]

IR:

Anyway, so we had to set our tents up. Well, we got there and we didn't have—we had wooden tent stakes, which would not go through the baked dirt, and so we couldn't get our tents up well. So we tied ropes to trucks and vehicles, and we had this jerry-rigged whole combat hospital stuck all over. The interesting thing about our hospital group is it was the last of the Vietnam veterans that had worked with those hospitals or anything similar to it had retired, so we had a crew that had never really done this. We had whiteboards and we mapped out how we'd set up the hospital and we had the perfect diagram, so we set it up and couldn't get out tent stakes in. But the hospital came in during rough seas into Turkey, and we lost some key pallets, and so we didn't have everything we needed, like emergent heaters for our MREs [Meals Ready to Eat], so we were eating that freeze-dried food dry and not hot.

But we had these old kits from Korea and we opened them up, and if someone has a pneumothorax, they put in a drain, you know, a pleurovac, and it drains it out. We had bottles, and I had this staff of people. I said, “Okay, which one of you got an A in physics? These bottles make a closed chest drainage system, you know, put a needle in and you run tubing. You've got to figure out how to make it work.” Went off and they did it. “Who's done anything with orthopedics?” I said, “We've got these old splints, I believe they are, got to figure out how to make them work.” Because we had all this stuff, and I opened this thing and it was old needles that we had to clean and sharpen by yourself. We're not using these. But we were calling with lists of stuff that they had to bring in on the next plane, and the rain started and it was monsoon. All that dried dirt became mud, this deep mud. So you'd step out and you'd muck through mud. Our tent stakes that were wooden wouldn't hold, and so our tent would come down and fill with rain. We took crutches, we issued them to every tent, got the rain off of these pockets.

BC:

Off the roof.

IR:

Yes. We only had one heater, because that's one of the things we lost in our mishap, and we were the only warm spot, because it turned a little cold. But the things we—we got our tents up and the next thing you know, the 82nd Airborne did a skydive under adverse conditions and had a mass casualty. Our reserve unit that was supposed to give us back facilities, the commander and the chief nurse had gone offsite for a two-day thing, and the exercise was not supposed to start for like another three days. So we were not set up, number one, and they left me in charge of the ER. We got notified that we were twenty minutes away from about fifty seriously injured, tents falling and so we had this mass casualty. I was in my tent and somebody had gotten excited and said, “Oh, we can't handle fifty people in the emergency room.” My group, we had drilled and worked and worked, and we'd gone through every contingency, and we could do our job.

Oh, and half of the camp, we had a reserve unit that was supposed to do a shower facility and they could never get it to work, so we'd been there all this time and we kind of smelled. So half the camp was in this Turkish town in a Turkish bath, so we were without people. Balikesir, that's the Turkish town.

So people got excited and they went into the ER and they took everything and started running in different directions. I had this wonderful sergeant in the ER. I said, “Do you know where the stuff is?”

He said, “Yes, ma'am.”

I said, “Get it back. That's an order.”

“Yes, ma'am.” He came back and we handled that mass casualty. But the doctors, you know, would treat it like a regular hospital. They'd say, “Go get me this and go get me that,” and I'd have teams of them and they'd be gone. I got a reserve person. I had to get the cooks a half mile down to come help the hospital because we had not our staff. I said, “Okay, you have a pool of people outside this door, and I'm going to tell you what I want and you figure out how to make it happen.” They'd like—we had tied the tents overlapping, and if you were taking a patient to x-ray with a broken neck, you were having to jump over ropes, the fewer, the better. We made the heliport right next to the emergency room so that when the first helicopter landed, it was blowing stuff through and our medicine kits fell over. So we learned everything the hard way about doing business. That was pretty hard.

BC:

But you handled all of that.

IR:

Yes, yes, that was—like we set up our outhouses next to our trash point, and in Turkey they have wild packs of dogs that look like wolves, so if you went to the outhouse at night, these dogs would low-crawl up on you.

BC:

What about emotionally? Was there any particular time that was difficult to handle?

IR:

I think in every assignment there were things that were difficult and things that were wonderful and I think life does that in every site. If you took every whatever period in your life you wanted to talk about, five years, ten years, you could say the best of times were and the worst of times were, and there was that here, too. The benefit and the kind of—I'm a glass is half full person, so the benefits for me, who gets the opportunities I've had to do this stuff? It's been wonderful, you know, absolutely wonderful.

BC:

How do you feel about women who today are not technically in combat positions but still on the front lines in combat situations?

IR:

Anybody in the military now is front line. There is no line. There is no rear. There is—so if you go, you are at risk, and nurses have always been in that circumstance.

BC:

Right. I don't have any more formal questions. Is there anything that we haven't talked about or covered that you'd like to add?

IR:

Well, you know that Fort Detrick, when I went up there, that was a real transformation for them as well because their research area director, the people had been groomed through military labs and they'd never had—and the directorate, you know, the director of each research area, had the budget. So they'd never had a woman with money, and they'd never had a clinically focused director. So I was the first person whose background was not big science, and so there was a lot of breaking glass ceiling stuff. I went in and met with my colleagues the first time and a couple of the old guys came in and said, “You know, if you want to get along with us, you've got to get rid of the nails.” I said, “You know, we'll get along. The nails are mine.”

BC:

Were there other times that you felt that you met resistance because you were a woman?

IR:

I think it was the right time to be in the military, because I would look at myself as a nurse and there are nurse-physicians issues always everywhere, and that's because historically physicians were mostly men and nurses were mostly women. There was a lot of the male-female issues with that. But because in the military you had the same rank and the same status as—I think the army was a good place to be. As I got more senior in rank, then young doctors would be much younger than me and captains. I was able to go to doctors and say, “You know what, you can't yell on my unit. Not a behavior I allow. Now, if you need to cool off, you know, you can go do this but you just can't behave that way. If you want, we can go to talk to the hospital commander, but I don't allow it. I don't care.” In most hospital settings, nurse physicians in the eighties and nineties, it was harder to be really cognizant, collegial, and the army was a good place to survive all that.

BC:

Well, thank you so much for talking with me today. It's been a pleasure.

IR:

Yes, my pleasure as well.

[Recording paused]

IR:

The other thing in my spare time I do now, after 9/11 [September 11, 2001], I volunteered with the Citizen Corps, and I'm with Fairfax County Medical Reserve Corps, and I'm the incident coordinator for one of the high schools. So if there's a terrorist attack or any kind of incident, then every high school in our county becomes a medical treatment facility. But we've actually done drills on that and what I find, my counterpart—you have a twelve-hour daytime incident coordinator for our neighborhood high school. My counterpart is retired Marine Corps, and that military background always helps in civilian. Old soldiers don't die. They volunteer to do stuff like that.

BC:

So would you recommend the service to young women today?

IR:

Oh, yes. Oh, yes, I would.

BC:

Has your daughter ever expressed any interest?

IR:

My daughter's real interest is public policy, so and she, right away, went to work for the Senate and she has interesting stories, but I don't see her going to the military. I would, of course, be like my parents, worried about her safety.

BC:

Yes. That's great, thank you.

[Recording paused]

IR:

Yes, I received the Daughters of American Revolution [DAR] Award for Outstanding Army Nurse Corps Officer, it's a Career Achievement Award, in 1994. What was interesting, that was when my husband was in Korea and I had my daughter up on the podium with me and gave this speech to the twelve hundred delegates at the DAR, and went offstage to find out President [Richard M.] Nixon had just passed away. My daughter and I had been sitting on a couch where they, from their era, somehow donated by them. It just all tied together in an interesting way.

BC:

Right.

IR:

We left that DAR convention and went to one of the first scientific meetings of our advanced scientific panel to select grants, that nobody knew from working on, and started, and got there about eleven at night and worked all through the night, getting ready to start that the next day.

BC:

That's wonderful. It's a great achievement.

[End of Interview]