A Lion in Autumn

Dr. S. Ward Casscells was a successful middle-aged cardiologist with a national reputation in his field and an endowed chair at the University of Texas Medical School. One day in November 2004 he was telling his son Henry about his father, Henry's grandfather, S. Ward Casscells. "Was Granddad in a war?" asked Henry. Casscells took Henry to show him the army uniform worn by Capt. Casscells in World War II. Henry, normally a fidgety boy, grew very still. He stretched out his finger to touch the uniform but hesitated. He looked up searchingly at his own father. "I was filled with shame," Casscells recalled. Regretting his own avoidance of any kind of military service during the Vietnam War, Casscells announced to his wife Roxanne that he was going downtown to the Army Recruitment Center. "Sure," said Roxanne. "Sure you are."

But he did. He had to get a medical waiver, because he was still on chemo for prostate cancer, but Ward Casscells, or "Trip" as he is called, became a lieutenant colonel in the Army Medical Corps at the age of 52.

In January 2006 he was told he was going to Iraq. As his July departure date drew near, Casscells became fearful. The war was worsening and the casualty rates were rising. Casscells did not want to go. Although he told no one, he began having panic attacks. He gently suggested to Roxanne that he stay home. "You have to go," she said, knowing her husband at this moment better than he knew himself. "The invitations to the going-away party have already been sent out." (What she meant was, "What would you tell Henry?")

With the quiet help of a good Army psychologist, Casscells went to Iraq and served a four-month tour of duty. He was shelled and once got caught in an ambush, with insurgents blocking his convoy on both sides. (He injured his elbow as his Humvee swerved to get away—providing him the opportunity to personally experience the Army's high-quality frontline medical care.) Casscells's closest friend over there, Col. Brian Allgood, was killed when his helicopter was hit by an RPG.

Casscells, promoted to colonel, was asked to stay on in a civilian role as assistant secretary of defense for health. He is a high-level bureaucrat now, fighting for more money for humanitarian relief and psychological care and trying to buck up morale in the military's medical service, which has suffered the same kind of recruiting shortfalls as the rest of the armed services. In Iraq his hair turned all white. As a civilian doctor who often dealt with mortality, he had to learn not to get too emotional. But after returning from Iraq, he finds now that he tears up easily. "You'd think that Iraq would give you a stiff upper lip, but to the contrary," he says. But he clearly has no regrets.

© 2007