Malcolm Grow legacy still strong in Air Force medicine Published Dec. 20, 2017 By Peter Holstein Air Force Surgeon General Public Affairs FALLS CHURCH, Va. -- A pioneer in flight medicine, Malcolm Grow was a strong proponent of an independent Air Force Medical Service. He was the first Air Force Surgeon General, when the AFMS came into existence in 1949. Grow was a pioneer of military medicine, and one of the earliest and most effective advocates for moving medicine out of the clinical, textbook setting, and responding to the real needs of warfighters. Although he retired a Major General in the U.S. Air Force, Grow’s first experience with combat medicine came in infantry, but not for the U.S. In 1915 while visiting Washington, D.C., Grow met Dr. Edward Egbert, who was the chief surgeon of an American Red Cross hospital in Kiev, Russia. Egbert’s descriptions of wounded Russian soldiers with limited access to doctors moved Grow. He decided to travel to Russia to seek a commission in the Russian Army as a medical officer. Arriving in Russia, Grow received a commissioned as a Captain in the Russian Army. He served briefly at a military hospital near Saint Petersburg, but soon took the long train ride west towards the front lines. His experiences there gave him a true appreciation for the hardships faced by common soldiers, and the need to develop innovative solutions for complex medical problems on the fly. These experiences would help shape the rest of his career. Grow evacuated wounded troops and treated them within 100 yards of the front lines. As trench warfare raged, he saw firsthand the horrors of gas attacks, and how bleak Russian winters affected troops on both sides. Grow also participated in an air reconnaissance mission, giving him an early appreciation for the value of flight, both as a weapon and for the strategic advantage of observing enemy formations. Grow returned from Russia in 1917 following the Bolshevik Revolution. When the U.S. joined the war later that year, Grow had experience with combat medicine that few American physicians could match. He was appointed a Captain in the Medical Reserve in December 1917, holding several posts during the rest of the war, although none compared to his experiences on the Russian front. Once the war ended, Grow received his commission in the regular Army Medical Corps in 1920, and held several positions, before enrolling in the School of Aviation Medicine at Brooks Field in Texas in 1928. Unlike many of his peers in the Army Medical Corps during this time, Grow kept his focus on field medicine. With battlefield medicine experience far beyond most officers, Grow knew how delivering care in a field setting differed from traditional clinical settings. This separated him from many of his peers in the Medical Corps, giving him a different vision than other future leaders of military medicine. Once he completed the Aviation Medicine courses, his first assignment was as base surgeon at Fairfield Air Depot, Patterson Field, Ohio. Building relationships with test pilots at nearby Wright Field, Grow began tackling some of the thorny medical issues affecting them, like carbon monoxide poisoning, extreme cold, and redesigning flight clothing to meet the pilot’s needs. This began Grow’s long association with research and development relating to aviation medicine and technology. Grow’s thorough understanding of these issues fueled his drive for an independent AFMS to address problems unique to flight medicine. As Grow’s career progressed, he ascended through the ranks and left a legacy of solving flight medicine problems. In 1935, as chief of the medical service division in the office of the Chief of the Army Air Corps, he fought to establish the Aeromedical Laboratory at Wright Field, which became the hub of U.S. aeromedical research and development. As the world went to war again in the late 1930’s and early 1940’s, Grow again helped a future U.S. ally in their efforts, aiding British medical staff solve health problems experienced by their pilots during the Battle of Britain. Seeing the strain that near-constant sorties placed on fliers, Grow advocated for rest and recreation centers to help them relax and relieve stress. Grow’s connection to front line soldiers and aviators helped him find new solutions to little-understood medical problems. During World War II, Grow engaged in strategic planning for some of the largest operations of the war, including Operation TORCH, the Allied invasion of North Africa. However, his primary contribution came in the research and development field, where he cemented a reputation as an innovator and advocate for the safety and well-being of aviators. Grow’s experience on Russian battlefields in World War I left him all too familiar with treating shrapnel wounds. Realizing that many of the injuries sustained by aviators were from low-velocity fragments, Grow helped design body armor and helmets that saved the lives of countless aviators. He contributed to specially heated clothing, boots, gloves, and hats for gunners exposed to the elements at high altitude, decreasing cases of frostbite. Grow again focused on the mental health of aviators, implementing a system of regular downtime, and special training for medical officers to recognize when a flier needed time off from flying missions. After the war, Grow became the U.S. Army Air Surgeon in January 1946. He turned his innovative and front line-focused perspective to the still new discipline of aviation medicine, becoming a tireless advocate for an Air Force Medical Service distinct from the Army Medical Corps. Grow had an understanding of the unique medical problems posed by combat flight and the benefits of light, airborne hospitals with their own logistics requirements. However, when the Air Force split from the Army in 1947, the medical service stayed with the Army. Grow continued to advocate, arguing that the difference in medical organization between the Army and the Air Force required a separate medical command. In 1949, his argument was finally successful. The Air Force Medical Service came into being in June 1949, and on July 1, 1949, Grow became the first U.S. Air Force Surgeon General. Although Grow only served briefly in the position, retiring from the military just a few months later in November of 1949, his legacy in the AFMS, and in U.S. military medicine was secure. Even today, after nearly 70 years as an independent medical entity within the Air Force, the AFMS still prioritizes many of the values Grow espoused. Care for the warfighter, mental health, and innovation remain staples of the AFMS, a testament to Grow’s contributions to American military medicine.