Dr. David M. Lichtman

When Saddam Hussein invaded Kuwait, the USNS Mercy was there to provide assistance to American soldiers. And it was Rear Admiral David Lichtman, M.D., past President of the American Society of Surgery for the Hand (ASSH), who was in charge of outfitting the ship.

Dr. Lichtman, now Chair of Orthopaedics at the University of North Texas Health Sciences Center, and John Peter Smith Hospital in Fort Worth, came by his interest in military medicine honestly…he inherited it from his father. “I often traveled around my native Brooklyn with my dad, a general practitioner, as he made house calls. He had been an Army doctor in WWII and I recall how moving it was to see people salute him. My dad’s extreme dedication to medicine rubbed off on me, as did the message that medicine could be a fulfilling way to spend one’s life. As for my mom, she was old fashioned by today’s standards as she used her energies to support his career and our family.”

Time spent on the water, and between the pages of great literature, briefly led David Lichtman in another direction. “As a teenager I wanted to exert my independence and I swore off medicine. I spent a lot of time on fishing boats, read The Caine Mutiny, and decided to become a naval officer.”

As I was applying for the Naval Academy, however, talks with my father made me realize that in my heart I wanted to be a physician. He is the one who convinced me that I could be a part of both worlds—the military and medicine.

And he would do it without a college degree. Dr. Lichtman: “I attended Tufts College, but did not graduate because I received an early acceptance to medical school. After I accumulated a ‘bank’ of life accomplishments, someone wrote a letter to Tufts saying, ‘Your institution never granted Dr. Lichtman a degree—and he is a Rear Admiral and was President of the American Society of Surgery of the Hand.’ I received a belated degree from Tufts in 2009.”

Graduating from the State University of New York, Downstate Medical Center in 1966, Dr. Lichtman moved on to the University of Minnesota. “I had joined the Navy in medical school and was actually on active duty during that time. After doing an internship at Minnesota in ‘straight’ surgery (they didn’t have any orthopedic internships available), I then moved my family to Pensacola, and earned my Navy Flight Surgeon wings.”

For the next two years I flew in F4 Phantoms and took care of the pilots and their families. Part of my job was to perform aircraft accident investigations, which was very similar in concept to doing operative postmortems. You are essentially saying, ‘What could we do better next time?’

After serving as a naval flight surgeon for two years, Dr. Lichtman then headed to California for his orthopedic residency. “I was stationed at Oakland Naval Hospital during the Vietnam era, which meant that I treated a lot of amputees. I loved the sense of patriotism there, as well as the esprit de corps.”

Under the sponsorship of the Navy, Dr. Lichtman undertook a hand fellowship—part private, part military—with Dr. James Wilson in San Diego. “After my exceptional training with Dr. Wilson, I boarded the USS Independence as a flight surgeon and went to the Mediterranean. There were numerous shipboard injuries, including a case where a soldier was pumping a tire and the gauge was set incorrectly and caused the tire to explode. An innocent bystander then had to have an amputation.”

The next phase of Dr. Lichtman’s career would involve a bit of an academic mutiny. “I was named the Chief of the hand service at Bethesda Naval Hospital and took the opportunity to start an academic practice.”

“Why hand? Because hand surgery combines the delicacy and aesthetics of plastic surgery with the bioengineering and structural mechanics of orthopedics. Kienbock’s disease, an avascular necrosis of the lunate bone in the wrist, became my particular passion. I offered up a completely new classification system that is now used worldwide.”

“The old system required examining the lunate bone in the pathology lab under a microscopic; the problem was that you didn’t have a good clinical idea of what you were dealing with so no one was using it. ‘The Lichtman classification’ as it is now known, is based on symptoms and X-ray.”

From ‘flyboy’ to Chair, Dr. Lichtman was increasingly in demand. “I had almost completed my time in the Navy and was getting several offers from private practices. The Navy had a problem, however. All of those who had deferred their military service via the Berry Plan were returning to private practice, meaning that the Navy didn’t have many senior people to run their training programs. They got desperate and asked me to return to Oakland and be the Chair—only four years out of residency. The program was on the rocks because a lot of faculty had left. I was 37 and was used to being a cutup and flying in jets. It was time to take a chair.”

The Navy, recognizing that it had put a “green” doctor in a significant position of responsibility, checked in on him. “The Surgeon General of the Navy called me once a month for a year until it was clear that I was establishing a solid program. I was then named Director of Surgical Services and was asked to spend most of my time on administration. My passion for operating was still intact, however, so I transferred to Bethesda and became the head of orthopedics. I got them off probation, increased the number of residency slots, and was again made Director of Surgical Services.”

Ready to turn in his stars for time at the podium, Dr. Lichtman was “saved” by a phone call. “At that point I had 20 years in the Navy and I figured that it was time for an academic job. I was just about to become the Chief of Hand Surgery at the University of Washington in Seattle when I received a call from a former patient—a very highly placed military man. He said, ‘Your name has been put forth for consideration as an Admiral.’ Two months later in January 1985 I was made a one-star admiral. Years later I learned that I was selected because I was the only person who had so much administrative and clinical experience.”

“I was assigned to the Oakland Naval Hospital and was placed in charge of all the naval medical facilities in the Pacific Northwest; later on I was also head of Letterman Army Hospital after the San Francisco Joint Military Command was established. I never gave up operating, however, something that dates back to when I was a flight surgeon on the Independence. The Commanding Officer (CO), Captain Jim Service, regularly flew with the squadrons so that he would maintain his skills as a pilot. This is an essential component of leadership…keeping close to people on the front lines.”

By the time Dr. Lichtman’s duty at Oakland was coming to a close, his country was in the middle of Operation Desert Storm. “I started out on the West Coast and dispatched the USS Mercy; then I was transferred to Bethesda where, six months later, I welcomed the USS Comfort home.”

Leadership sometimes means keeping those in power out of the cookie jar.

“After I arrived at Bethesda as CO I was made a two-star rear admiral. During this period I met two U.S. Presidents and their families when they came to the hospital for physicals and treatment…I was the official maitre d’ and made VIP rounds in the evening. It was a humorous running theme that the senators and representatives would often say, ‘How can we get into the presidential suite?’ I would tell them, ‘First you have to run for president and then get elected.’”

Dr. Lichtman and President Bill ClintonFinally succumbing to the siren song of academia, in 1994 Dr. Lichtman became the Chief of Hand at Baylor College of Medicine. “After four years at this wonderful institution, I was invited to John Peter Smith Hospital and the North Texas Health Sciences Center where I accepted the roles of Chair and Residency Director. During this time I was chairing several committees for ASSH; in 2005 I became president of the organization. The ASSH is a true multispecialty society, with a mix of orthopedists, plastic surgeons, and general surgeons. Something else that distinguishes ASSH is that you must have earned a Certificate of Added Qualification (CAQ) in Hand Surgery from the American Board of Orthopaedic Surgery, the American Board of Surgery or the American Board of Plastic Surgery to become a member.”

And aside from the challenges of the healthcare legislation and changes in government reimbursement, what is the field of hand dealing with? Dr. Lichtman notes, “In the hand subspecialty, we are now reassessing the educational requirements for CAQ eligibility. There is some interest in either creating a two-year hand fellowship curriculum or adding more hand training into the orthopedic or plastic residency curriculum. These curricular changes—if and when fully developed—would have to be coordinated with and/or approved by multiple specialty societies and regulating authorities. We are also very engaged in supporting innovative research, especially for well-designed multicenter clinical outcome studies.”

Despite professional changes, things on the home front stay the same…exciting. “My wife Frankie and I have been married for 46 years! We have many common interests, including travelling with family, opera and spoiling our chocolate lab. I love professional sports and all water activities (especially fishing and sailing). And while I like to cook what I catch, Frankie refuses to clean or cook the fish. Our daughter is an artist and our son is an attorney with NBC/Universal and lives in California. My two grandchildren are ‘Hollywood types’ and hope to have careers in the movie/theater industry.”

Dr. David Lichtman…a star in any realm.