born Sep 14, 1940

https://www.whitepages.com/name/Kathryn-V-Holmes/Edmonds-WA/PJyq6V2NXO3

1969 research

https://academictree.org/microbiology/publications.php?pid=345523

1969

Holmes KV, Klenk HD, Choppin PW. A comparison of immune cytolysis and virus-induced fusion of sensitive and resistant cell types. Proceedings of the Society For Experimental Biology and Medicine. Society For Experimental Biology and Medicine (New York, N.Y.). 131: 651-7. PMID 4306811 DOI: 10.3181/00379727-131-33945

1993 to 1994 : President of American Society for Virology

https://en.wikipedia.org/wiki/American_Society_for_Virology

1976

https://www.newspapers.com/image/451935555/?terms=%22Kathryn%20V.%20Holmes%22

https://digitalcollections.lrc.usuhs.edu/digital/api/collection/p16005coll2/id/966/page/0/inline/p16005coll2_966_0

2009-12-03-usa-uniformed-services-university-archives-oral-history-transcript-kathryn-v-holmes.pdf

USU Oral History Interview Transcript

Dr. Kathryn V. Holmes, PhD

December 3, 2009

Interviewed by Emelie Rubin, USU Institutional Archivist

Microsoft Word - HolmesKTranscript.doc

Uniformed Services University Archives

James A. Zimble Learning Resource Center D1016 4301 Jones Bridge Road

Bethesda, Maryland 20814-4799

USU Oral History Interview Transcript

Dr. Kathryn V. Holmes, PhD

December 3, 2009

Interviewed by Emelie Rubin, USU Institutional Archivist

Rubin: This is Emelie Rubin, institutional archivist at the Uniformed Services University of the Health Sciences. It’s December 3, 2009, and I will be interviewing Dr. Kay Holmes for the USU Oral History Program.

Briefly describe your career prior to coming to USU.

Holmes: After graduating from Harvard, I went to the Rockefeller Institute in New York for graduate work in virology and cell biology, and my post-doc was at Harvard Biology Labs with Keith Porter, learning cell biology and electron microscopy.

Then I went to Georgetown University School of Medicine as an assistant professor in the School of Medicine and Dentistry. This was a very interesting thing, because at that time there was a national shortage of physicians perceived, and so the medical schools were given money, which was called capitation funds for each person. In addition that they added to their medical school class, they got some funding which would allow them to hire new faculty and renovate the place to accommodate the additional students. So I was one of three new faculty that were hired at Georgetown in the department that previously had only six people in it. So I was very lucky because there were not very many women who had faculty jobs in medical schools in those days, and I consider that my first bit of luck.

We went there because Randy, my husband, who had been planning to go to The Pasteur Institute for postdoctoral work, went to NIH [National Institutes of Health] instead and became a commissioned officer in the Public Health Service to do research there. It was the time of the Vietnam War, and that was a marvelous opportunity where many physicians who later became heads of departments in all sorts of medical schools around the country earned their training in basic science and research. So that was a wonderful opportunity for Randy, and I was lucky to get a job in the same city, which is what we always try to do and have been successful in doing.

So we were there living in Bethesda [Maryland], and after two years, Randy wanted to do a fellowship in infectious diseases and get a faculty position somewhere after so we could move to someplace where we could both have stable positions for a long period. At that time we had a three-year-old and a new baby.

So we were recruited to Southwestern Medical School in Dallas. Randy’s supervisor, direct supervisor, was Jay Sanford, who became the head of the new medical school, Uniformed Services University School of Medicine.

I was hired by Jonathan Orr [phonetic], and my interview with him was actually in New York because he had not moved to Southwestern at that time. So I was kind of the first hire in his new department. He was also building a very different program than the one that had been in the Microbiology and Immunology Department before, and this was now emphasizing immunology, which was a great, expanding field at that time. So Randy was in infectious diseases as a fellow and also doing research and supervising research of some others, and I was assistant professor in microbiology and immunology, and both of us had a big hand in revising the curriculum there to kind of update it and integrate clinical stuff into the basic science material. That was a wonderful place, wonderful research, great place to be, and we were happy there.

Then Jay Sanford announced that he was going to leave to become the dean of the new Uniformed Services University of Health Sciences, and we were devastated because to be with him was really one of the goals of Randy’s going, and he was just an amazing mentor, a wonderful individual, just a warm and energetic and innovative guy, perfect man for this job as dean of a new medical school.

So as I remember it, we were at a Christmas dance and Jay and his wife, Laurie [phonetic], were there, and I think that he asked Randy and me if we would go with him, to our amazement and surprise, and we were standing at the dance, staring at each other. It had never occurred to us tomove, much less to start a new medical school. It took us maybe a couple of hours do decide that, well, if something worked out, that might be fun.

I have to tell you that things were different in those days, so academicians moved around a great deal, a great deal. It wasn’t like you stayed somewhere twenty years and then maybe you get hired away. People moved pretty often, so it wasn’t that unusual to think of. It was just the idea of a new medical school, and there had not been many new medical schools at that time. So Jay figured, I think, if we went there, I could cover virology because that’s what I do, and Randy could cover bacteriology, and then he could recruit around.

Now, the complication for us was that I could not be in the Microbiology Department; I had to be not supervised by my spouse. So I was allowed to be in a different department and Jay decided that the place for me would be pathology. That worked out pretty well for me because I had, in fact, as a graduate student taken pathology with the Cornell [University] medical students right next door to Rockefeller and had always been interested in viral pathogenesis...

[interruption]

Rubin: I think you were talking about how you were chosen to be in the Department of Pathology.

Holmes: Right. So I was in pathology and also had a joint appointment in microbiology. At that time, it was extremely important that two faculty members couldn’t be in the same department if they were married to each other anywhere.

Rubin: Was that a government regulation?

Holmes: Certainly it is a Department of Defense regulation that you cannot be directly supervised at any level by a spouse, but it was also true nationally that people didn’t want to hire two faculty members in the same department, and since they weren’t hiring very many women in medical school departments, it was pretty easy to solve. So, many of colleagues, women, wound up in clinical departments as an adjunct this or that, and didn’t get full faculty line positions.

One of the things that I have always thought was just marvelous about the Uniformed Services University is it was completely sex-blind with regard to hiring men and women, and so we got wonderful women faculty members because there weren’t so many other jobs available for them at that time. They performed brilliantly, and it was a very successful Department of Microbiology. So that is how I wound up in pathology and Randy in microbiology.

Rubin: How did your prior experiences prepare you for USU?

Holmes: I had always been very interested in teaching programs both at the graduate school level and medical school level, and it was such an exciting time in virology that I really thought it would be wonderful fun to set up new curriculums. I was involved in graduate education, and very much strongly felt that it was important to train very good people very rigorously for careers in science. It was so opened up at that time because women hadn’t had these opportunities for the professional jobs, and it was a wonderful thing to think that we now could double the number of good brains that could be brought into the field. So I was excited about that equal-opportunity aspect of it.

Rubin: You were one of the first professors in the Department of Pathology. What are some of your memories of working at USU in those early years, particularly from 1976 through the early 1980s?

Holmes: The first thing was kind of a personal reminiscence, and that is we had left our tenured positions at Southwestern to come to this new medical school, sold our house, bought a new house which we could barely afford in Potomac [Maryland], started work at the new medical school, and immediately [James “Jimmy”] Carter redlined the Uniformed Services University in the budget. He was the incoming president, and so line items that he could attack, he was attacking in order to try to reduce the government cost. And so there we were, all our eggs in this very fragile basket, Randy trying to recruit new people and set up things and organize everything, and he had to say to people, “If we have a university, would you be interested in being recruited for a job?” So that is a really stand-out kind of position.

The other thing is that we really were some of the very first civilians that were involved in this enterprise, and I say when we went there, it was an office over a drugstore down in, gosh, Bradley Boulevard it was. It was upstairs and there were a couple of rooms, and we held all the meetings for everything. Every piece of paper for a medical school that organizes it had to be created by very few people. So it was a time of great excitement, and for graduate programs, for example, we, as I recall, got documents such as exam things, curricula, all the guidance information that you would need to run a graduate school within a medical school because that was part of the deal. To be a competitive, wonderful university, we had to have graduate education as well as medical education to recruit the best faculty.

So things like recruitment of graduate students, retention, appeals for grievances, all kinds of things about examinations, and what would be the criteria for graduation in a thesis and so on had to be decided. So we got information from other respected schools, put them all together, shuffled them around, and picked the best of each thing, I think, and made up these documents to run that program. Then we said, well, they’re working elsewhere, and so we’ll just do it and then in a couple years when we see where the kinks are, we’ll just change it.

Well, what happened that was so funny to me and it’s really, I guess, in retrospect, part of human nature is that when we were in office over a drugstore, we were thinking of what we could do and doing it immediately, and after significant discussion but not belaboring it, getting on to the next important task, whatever that was. Once we had our new buildings and a campus and students come and the new faculty members began to appear, I remember something happened.

I can’t remember exactly what it was in the graduate program, and I said, “Why don’t we just change that policy.”

And there was this look of horror in the young faculty members’ eyes, and they said, “You can’t do that. It’s always been that way.” [laughter] And I just about fell off my chair laughing, because, you know, we had just tried it and it was an experiment like a scientific experiment, and if something needed to be changed, I thought you could change it. But when people come into an institution and it looks like a solid thing with buildings and policies and this, they spend a lot of time learning it so they can just get around in it and not think about it and get on with their jobs. So we had the fun, if you will, of being involved somewhat in those policy things, and Randy much more than I, of course, and then watching what happened as it unfolded as an organizational experiment, if you will. So that was interesting.

I remember the Admissions Committee that I was on. We all had to do multiple things, and we needed students very soon because the need was very urgent. This is really, I think, the heart of what you’re asking for with an oral history, why was there a Uniformed Services University, and what was different about it? The important thing was there was a doctor draft. You know the military policies better than I at that time, but they were not able to recruit and retain physicians in the military, so they could draft them and they would come and they would stay and do what they were supposed to do, but they had no significant experience with the military methods and communications and how to get things done within that framework, and they would just leave immediately to go to better-paying civilian jobs and so on.

There was perceived to be—and it’s certainly been borne out by history—a need for people who were both acclimated to military organizations and goals, and also were physicians. It has become increasingly important in modern warfare to have wonderful medicine to save increasing numbers of lives.

One of the things that was very attractive to Randy and me about the military medical program was their tremendous emphasis on infectious diseases and preventive medicine globally. This actually happened to me when I was teaching at Southwestern. I gave a talk about diseases of Icelandic sheep that are called slow viral diseases, and a medical student came up to me and said,

“Why are you wasting our time? We are not Icelandic sheep. We’re going to treat humans.” Well, that was the same kind of virus that HIV is, and so we were just a little ahead of our time. We were teaching them principles, and they were wanting specific things they could treat and the epidemic hadn’t happened yet. But at the military medical school, if I mentioned a virus like Ebola virus or Hemorrhagic Fever virus, the students would sit on the edge of their chair and say, “Where was that again?” and be very interested because they might well be deployed there. It might be something that they need to consider as the physician to protect the people from whatever the carriers are of Ebola virus that was passing it to humans. So it was very different, and the infectious disease aspect was just fascinating. We learned as much as we taught.

So I was going to tell you about the Admissions Committee. So, as I said, I was on the Admissions Committee and there were about twelve or sixteen people on this committee, and we had lots of applicants because it was a full ride, fully paid medical education. It’s always been very hard for many families to send people to medical school, so that was very attractive. Also there were people in the military who had been corpsmen and wanted to go on and be physicians. They were already in the military system, and so they were interested. So there were a good number of applicants. We had to devise the criteria and work through all the piles of applications and develop systems for interviews and getting references and all those things.

But I felt a little odd sitting around a table with sixteen colonels, and so I said to Jay Sanford, “You know, Jay, I really feel like a triple minority here. I’m not male, I’m not military, and I’m not an M.D.”

And he said, “Kay, I’ve never thought of you as any kind of minority, so keep doing the work.” [laughter] It was very interesting, because it was the first time I had come into the context of the way the military thinks, and so people would discuss a candidate and go around the table, but when a chairman of the committee voiced his opinion, everybody stopped discussing it, and that was that. And I would be saying, “I don’t see why that’s true. Could we bring up this other issue?”

And they would look at me like, “What are you thinking?” What’s above a colonel? Whatever it is, “Has spoken.” So they got back into free discussion over time, which you have to have if you’re going to pick a good class. And so that was funny.

So there were things like that where we had to see how the military worked as civilians working within the Department of Defense, and it was just fascinating because their taskforce mentality got things done [slaps hands] like that, quickly, efficiently. They knew whom to ask, they knew how to move it, they had logistic support, etc., so it was very good.

One of the things that was very interesting was the handling of that first class that we had. I think there were thirty-two students in it, men and women, and they were the most remarkable collection of students that we ever had while we were there, because they were all older and they were very goal oriented and willing to be part of an experiment, a human experiment. Can we have a medical school within the Department of Defense? They were as important in developing the curriculum as the faculty was, so they would give immediate feedback if something was out of line and if expectations were not clearly enunciated so people knew what to expect and could prepare themselves for it, or if something was offensive.

One of the issues which came up quite early, and which I was very sensitive to, was gender equity and I guess you’d call it sexual harassment, though it wasn’t meant in that way. But the history of military medicine, which was doctors were men, nurses were women, they hadn’t had extensive residency programs in the military for years, and so many of the people, for example, in pathology, who were teaching the pathology course initially, normally would give a series of a dozen lectures on a topic to residents, and when they were assigned to give this topic to second- year medical students, they would bring in stacks and stacks of these carousels of slides and say, “I normally give this in twelve lectures, but I’ll try to do it today in one hour.” And the students would groan, and the slides would go “bam, bam, bam, bam,” one after another. They couldn’t learn at that speed, and it was over their heads. So that was the kind of feedback that they would give, how many slides per hour, and what is a reasonable expectation of what people at our level can learn. So it was very much an iterative process.

The other thing that was important was that the history habits of some of those people had been to use, like, Playboy centerfolds as illustrations of various parts of anatomy or whatever, and the women wouldn’t stand for that. They went to Dr. Sanford, and he put out an edict that said, “This will not be tolerated.” Every time somebody got out of line, the women and some of the men would bring it to his attention and it would not happen again. So those first classes had a big role in shaping what could be done and teaching the teachers what it was like to expect a person in second year, first year, to be able to absorb a lot of material at fire-hose speed in a dignified manner.

Rubin: At what point did you feel like you were over that initial experimental stage?

Holmes: I think we had about thirty-two students in the first class and sixty-four in the second class and went up to around a hundred, a hundred twenty, a hundred thirty, like that. We got to a hundred and thirty, those students had the same feeling that the faculty had, “This is how it’s always been done.” But the rough edges had already been sanded off, thanks to the students and thanks to a lot of hard work by huge amount of faculty, both civilian and military. So they came in and they saw an institution and they just tried to do what they were expected to do.

Rubin: So your experiment must have been successful on most levels for that to have happened?

Holmes: I think it was, because I think the need was really there, and these were highly motivated people who signed on for a big, heavy commitment for medical school, and faculty who believed in the mission. So it was very much cooperative. They didn’t have the stresses of civilian medical students. “I am paying eight dollars a lecture for you. You’d better entertain me with something,” which was something that someone said to one of my colleagues at Georgetown. I believe in entertaining if you’re trying to teach, and you do to a certain extent, but you don’t start telling jokes.

So that pressure of the money was off, and the students could really focus on the learning, which was wonderful, because otherwise, in other places medical students had night jobs and things like that, trying to put themselves through, and that’s just exhausting. Now what’s happened—I have two daughters who are physicians, so I know—their friends, instead of having night jobs, just built up enormous debts from medical school, and that doesn’t happen with a military medical school.

Rubin: You talked about this a little bit, but how did you become a professor in the Department of Pathology?

Holmes: I did explain that already.

Rubin: Okay.

Holmes: I went as an associate professor, and one of the interesting sociological things was that in each department of the medical school—basic sciences we’re talking about—they brought in a chairman and one or two senior faculty and then recruited everybody at the beginning assistant- professor level. So the demography of the departments was very different than it is in most other places where you have maybe people who have been around a long time and have institutional memory, and then some mid-level people, and you bring in one or two new people. This was completely the reverse; very heavy with newbies. So that was very interesting to see how they worked things out and how quickly they grew into the roles that they had to play.

Rubin: Describe your role as the first graduate program director for the Department of Pathology.

Holmes: Pathology is a discipline which is basically medical, and many places have graduate programs where they combine their graduate programs with other ones in order to allow people to study how diseases occur and what you might develop to treat them and what would be a strategy that has never been tried. So we had many discussions in the Department of Pathology. Did we want a graduate program or not? Were we big enough to have a self-sustaining graduate program? That was because we were made in pathology of civilian educators and researchers and military pathologists. The military pathologists were really heavily into the teaching program, and some of them had some research as well, but most of the research was done by the basic scientists, and most of us were civilians. All of us were civilians.

So it was kind of a mixed thing. What would we teach and who would we teach? So people who were attracted at that time to pathology graduate programs might be people who had foreign medical degrees and wanted to come to this country and maybe not be medical doctors. If they couldn’t get a residency or something like that, they would like to do research in disease. Now it’s very different. Pathology in most places is a freestanding department or a cooperative integrated department like it now is at USUHS, where they’ve pooled the Departments of Preventive Medicine, I think, and Micro, and Pathology and something else in this infectious disease pathogenesis program. I can’t remember what the name of it is now. So the discipline and the graduate kind of programs in pathology were evolving.

We attracted quite a varied mixture of people, some Chinese students, I think we had a person from Spain, we had American students, we had a person who had been in the U.S. for a while and was an Argentinean, so complex backgrounds like that. But then they could take pathology with the medical students and they could do advanced studies in different kinds of diseases, cancer and infection and viruses and things like that. They could take courses outside the department, of course, and that’s the nice thing about USUHS and a new school in general, was if we had a cell biology course, it would be likely taken by students from anatomy and pathology

and maybe microbiology, so that you would have a mixture of students in different graduate programs. So they were pretty integrated even at the beginning because there weren’t too many courses. It was beginning to be that the methods of molecular biology were being applied to all kinds of different research, so common methods brought people together across old discipline lines, and that line has blurred in most departments now.

Rubin: Describe your research interests over the course of your tenure at USUHS.

Holmes: I was interested in coronaviruses, which are enveloped RNA viruses with plus-strand RNA genomes, and they cause diseases of mice, and cats, dogs, pigs, cows, etc., and a couple of human diseases; respiratory diseases, but mild ones. They were very difficult to grow, very difficult to study, until the modern molecular techniques were applied, but very interesting. So I was asking a question which we’re still chasing. How does a virus that’s a coronavirus know if it’s a dog virus or a cat virus or a human virus?

While I was there, we were doing some studies actually beginning to look for enterotoxins for coronavirus and rotavirus of mice. Randy was involved in enterotoxins of bacteria, and people at Walter Reed were making little vesicles of intestinal brush-border membranes that could be used to study ion transport and nutrient transport across the apical membranes of the small intestine. So we put all that together, and John Boyle was the post-op in the lab at that time, and we looked to see if we could bind coronavirus, the mouse coronavirus, to intestinal brush-border membranes, which was very pure preparation of the membranes, from susceptible mouse strains and a mouse strain called SJL, which is resistant to mouse hepatitis virus, this coronavirus, and we found that the virus bound to the susceptible mouse intestine and not to the resistant mouse. I mean, that just gob-smacked us and we realized we had a receptor phenomenon.

So since that time, we’ve been looking at receptors. So that was a huge discovery at a time when virus receptor identification was really very new, and I think it was one of the maybe fourth or fifth virus receptors that had ever been identified. So we got very involved in that and species-specific determinants of infection and host range and tissue tropism and so on, which we still study today.

Of course, SARS happened in 2003, after I’d left USUHS, but by that time I had become one of the leaders in the coronavirus field, which was a very small field, believe me. So when the SARS epidemic was found to be caused by a coronavirus, all the work we had done before on the animal coronaviruses really fed into making progress go very quickly on the new human coronavirus. Since that time, since SARS, two additional human coronaviruses have been discovered which cause pneumonia. So, a lot of new viruses out there and we’re always interested in new viruses, but the seminal discovery of the virus receptor specificity and the identification of the receptor was one of the most exciting things we’ve ever done.

Rubin: How does graduate education at USUHS compare to non-military medical schools?

Holmes: The obvious thing is that sometimes we had military active-duty people who were in graduate programs, and we had to try to accommodate to their training schedules, which was not as long as a normal Ph.D. training program would be, and students were put in kind of a bind between, “You’ve got to discover something before you graduate, and we said you could stay for x number of years and you’re almost there, so get out. Get your degree now.” So that was an interesting ongoing discussion. I’m sure it is still today.

But in general, I think the opportunities were terrific in the military medical school, because if people wanted to do research that had to do with clinical specimens, blood from people who had been in the Philippines or some other place, to see what they had been exposed to, for example, that kind of thing would be accessible because at that time, the best kept medical records in the U.S. were in the military. I’m not saying we all use them. I didn’t ever use them, but some people could have used them and it would have really helped their research a lot to do so.

Rubin: So in some ways it was a benefit to be at a military medical school as opposed to a non- military medical school?

Holmes: For a graduate student? I think we were comparable in quality of what we could do. I think that our emphasis in microbiology, Randy’s department, was really in pathogenesis of infectious diseases and the molecular studies that were just coming could open up that and allow people to study at an entirely different level than had ever been done. So because we had all new people, they could jump on those emerging molecular techniques, whereas in schools where they had a range of people at different levels, they already had ongoing programs, and they kept doing what they were doing and maybe incorporated the new things more slowly. But our people just starting up their programs started, boom, with the exciting new technologies.

So I think that was good for the graduate students, but I think the degrees are comparable that people get because we had equally competent faculty as you’d have in a civilian school, but we had all the same kinds of training programs, so journal clubs and seminars and guest speakers and work-in-progress sessions are part of graduate education, a big part of it. The twist that they would see was the emphasis more on global medicine, and the things that they would learn when they took medical microbiology at USUHS with the medical students were more about global aspects of infectious diseases. So I think that was a big plus.

Rubin: You were the initial chair for the Faculty Assembly. How were you involved in the setup of the Faculty Assembly, and what work did the group do in those early years?

Holmes: The Faculty Assembly at many medical schools acts very differently, and its role is generally believed to be, but not always effective, to be a forum where faculty can bring issues to the administration that need to be addressed and make suggestions and help to study how to implement things so it can be bottom-up or top-down, and it’s the organ of the faculty. So I was the first—what was it? Director or something?

Rubin: Chair.

Holmes: And that was for a short time. We had to decide what were our documents going to be. We had to, again, write those documents. What do Faculty Assemblies do? How long should anybody serve, and how should be elected, and should you switch between having a chair in basic science and then a chair in medicine, like this? So while I was doing that, that’s what we spent time doing.

Issues such as faculty grievance procedures, promotion, appointment, promotion and tenure, I was on that committee also. They had to be, again, developed so that there would be fair, due process and everything would be legally fair and apparent, and people would know after this decision is made, what right of appeal do you have, and how many years can you stay before you have to be promoted or leave. Those sorts of things had to be worked out, and the Faculty Assembly was involved in that. They didn’t make the decisions; they made recommendations.

That was a building together of the military faculty with the civilian faculty, and that was a good thing except that the military faculty was mostly not on our campus. One of the problems at USUHS at that beginning was always that the buildings for the medical students were for the first two years, and then they would go out into the military hospitals for their clinical work. So the military physicians who were their clinical mentors in the third and fourth years, they didn’t come to the campus that often. So that was one of the long-term problems, that you didn’t see each other on a daily basis the way we do, for example, at the University of Colorado, where we’re all mixed together and we do things together on the same campus.

Rubin: What was your role on the Faculty Committee on Appointment, Promotion and Tenure?

Holmes: My role was to do what people do, and that’s to consider each case that’s brought up and to, again, help to refine and develop the criteria and the way in which the decision processes are made so they’ll be consistent from one department to another.

Rubin: Were you on that committee when it first started?

Holmes: I don’t think so. I think I came in sort of the middle of the time I was there. I can’t remember the date.

Rubin: You left USUHS in the mid 1990s to become a professor in the Department of Microbiology at the University of Colorado-Denver. What made you decide to leave USUHS at that time, and how did you feel about leaving after nearly twenty years?

Holmes: Excited. Randy and I had gone to USUHS thinking that it would be fun to start a new medical school and we’d do it for about five years and then we’d do something else, because we were young faculty and we hadn’t been any place more than five years anyway, so we didn’t expect to stay for nineteen years. But it was fun, and so we stayed there.

It had become very much institutionalized. Jay Sanford had left, and there was new administration, and the constant pressure that they might close it, I mean every new administration. So this institution the whole time I was there was under the threat of closure. The very military excellence and logistics that helped to build it quickly would have been able to dismantle it equally quickly. Every time it was discussed, what they would do to dismantle the institution, they talked about where they would put the students and they never discussed what would happen to the faculty.

Well, Randy and I had all our eggs in that basket. We were both faculty there, and if it suddenly closed, would we be able to get jobs in the same institution, the same town, whatever? We didn’t know because at the level that you’re at, the senior professor, it’s hard to find new jobs. There are not that many of them open because the people get promoted into them rather than being recruited from the outside. So we began to get a little anxious about that, and I don’t think that issue’s ever been actually addressed or analyzed, and it hasn’t mattered because they haven’t closed it.

So that was a concern, and also financially we could do much better at any other institution than USUHS because there are very strict controls over the maximum salary you can make. But we had to leave hard-money what we call support for our salaries. When we left, we had to use some of the money from our grants to pay part of our salaries. So I think when we went to Colorado it was expected to be 25 to 30 percent of our salary would come from grants, and then it went up to 75 percent very quickly. That was painful, because you could otherwise have used some of that money for post-docs or technicians and multiplied the work of the laboratory.

But that and I think Randy was very excited about building something new in Colorado. The department needed changes, and he had certain faculty lines that he could hire and develop, again, a new program in molecular pathogenesis with infectious diseases. And his department was functioning wonderfully. Everybody knew what they were doing. They did a great job. They were all good. It wasn’t as interesting as building one, I guess. I mean, those are a couple of different motivations for leaving, and our kids had grown up and they had gone to college and they weren’t going to come back, and so we could do whatever we wanted, and Colorado’s very beautiful.

We thought how lovely it would be to be in a place where there’s only one medical school in the state, and they’re never going to threaten to close it, and it would be nice. And there would be no politics. We got there, and almost immediately they decided to move the entire campus from Denver to Aurora, because they were given the Walter Reed Army Hospital campus when they decommissioned that hospital, and we needed to build new buildings. I think there are twenty- four new buildings there. It’s just an amazing endeavor to build a medical school like that, and new hospitals, Children’s Hospital, V.A. Hospital’s going there, the University Hospital and so on. So there was immense logistics in that process as well, and I guess it’s true that there’s always going to be something. We didn’t anticipate that that would happen, but it’s been a good adventure.

Rubin: Do you think that the salary issue at USUHS makes it more difficult for recruiting, and has that affected the university?

Holmes: In two different ways. So the salary issue where USUHS still offers hard-money full- time salaries is extremely attractive, particularly to young people. This is a terrible time to be a young faculty member trying to support yourself doing research and teaching at a medical school. The NIH funding levels are way down, 6 percent NIAID [National Institute of Allergy and Infectious Diseases] for more senior investigators, 10 percent tops, for junior investigators of all submitted grants. The system there only works well when you’re funding 20, 25 percent.

So young faculty right now are under tremendous pressure to try to get enough money to stay as faculty members, and they have to get grants to do that, and at USUHS that’s not true. So offering full hard-money salaries is wonderful. But then when you get up towards the higher levels, the salary increments just aren’t there, and you’ll just be topped out and not get much raise. I don’t know how it is now, but that was how it was when we were there, and just before we left.

There was one other incident too. Perhaps I shouldn’t mention it, but I think I will. And that was, it was very complicated to try to do things there. I was invited to give a lot of speeches. One year I had seventeen different universities or meetings that I was invited to give talks to. For every one, there were a dozen pieces of paper that had to be processed. You had to get the lawyer to agree that it was in the government’s interest that you should do this, and you had to sign all these papers and who was going to pay and how was it going to be reimbursed and this, that. It was very hard to get reimbursed. The paperwork was immense.

We had a very sad incident in which I was not getting reimbursed by anybody for anything, and it turned out there was a secretary there who had not processed any of the papers and told me that she had. “Oh, so-and-so is not doing it. I’ll get on their case.” This was thousands and thousands of dollars which I had paid, expecting to be reimbursed, and I put in all the right papers but they never went beyond her desk drawer. So I was very angry with that, and when we discovered what had happened, nobody helped me in the whole administration. It was my problem. I spent months trying to reconstruct all that stuff and get my money back, and I felt that I was not fairly treated, and that somebody in finance should’ve done it or helped me. That wasn’t fair. So I was really mad. I think when something like that happens and you don’t get support, which wasn’t my fault, it’s easier to leave.

Rubin: What do you feel makes USU different from other institutions?

Holmes: I think it’s the global aspect and the military aspect of all the training programs there, just permeates everything. It’s very interesting. It’s very special. Other places try to emulate the global medicine aspect. Many places are developing global medicine programs or global infectious disease training programs and things like that, and people are becoming more interested in what we used to call exotic diseases like malaria, dengue, things that are just not in the U.S., so they were exotic. USUHS was already there. USUHS had, for example, the best parasitology I think in the whole country. The students had just amazing specimens from all over the world that they could use, and they were taught much, much more parasitology than any civilian medical school, because we just don’t have parasites in numbers that people carry in the rest of the world in this country. So I think the military doctors are much better prepared in that regard.

Rubin: In your opinion, what are the greatest successes that the university has achieved or did achieve during your tenure?

Holmes: I think to establish a very respectable medical school in the Department of Defense was a huge triumph, and I think it directly is related to Jay Sanford. He was the guy who knew the military system so well because he had been on the Armed Forces Epidemiology Board, was it? He had been a consultant as an infectious disease expert to the military for years, and so he knew how the system worked. He blended the military so well with the academic, and really increased, I think, the stature of military medicine considerably by having this dedicated medical school, and by having it teach what the military needed them to know as well as everything else that civilian students learn.

But I think it’s amazing that it works, and it still works, even though they keep trying to close it and whatever. It’s needed so badly because what has happened and what the premise was when the university began was that you wanted people who knew how to operate in the military system to get things done. It’s all about getting things done when you’re talking battle casualties, for example, or people who are deployed in an area with an infectious disease risk.

So when we think about Iraq or places like that when they have combat injuries, which can be horrendous, and Medevac procedures and they have the backup hospitals to triage out the most severely injured people, that has been just phenomenal coming from the military to also help in civilian medicine in other places. So even the people who left USUHS after their obligations were done, they’re in emergency medicine, they’re in public health, civil defense, that kind of aspect. They know in case of a flood or a hurricane or something like that how to make things work, whereas other people may be much more dependent upon the structure of a functioning hospital. They could set up one if they had to do it, and they could do it quickly, and they could do across Army, Navy, Air Force, Public Health Service, whatever. So they’re very special people and they’re trained very specially well.

So I think it has had a ripple effect to the pride of military medicine is that the more senior people are part of an academic institution that’s recognized, accredited training programs, and they have an influence on it. And the students can anticipate maybe coming and being faculty for a while as one of their jobs when they’re out and they finish medical school and they’re going on to do different things within the military.

I think that they would not have been able to do as well with the military medical support for the troops in, for example, Iraq or Afghanistan, because there’s no draft anymore, and you wouldn’t have doctors volunteering in large numbers to go and do that. And these well-trained people know what to do when they get there, how to make it work.

Rubin: What have been the greatest obstacles that the university has faced, other than the threat of closure?

Holmes: Sustaining the rigorous academic standards has been always a challenge, and it’s one everybody recognizes and works to do, and it has worked. But it is a challenge, and it has to be constantly worked at because it’s very easy to settle into something less. But it’s really a fine school.

Rubin: What has been the greatest challenge of your career?

Holmes: The greatest challenge of my career was probably being a woman professor at all, because when I did it, there weren’t so many of us around. So there were organizations like American Women in Science and things like that. Through the AAMC [Association of American Medical Colleges], the program for women faculty that is trying to train them in administration, which was not previously available, programs like that have been developed. But each person who began to do that was a pioneer, and it was very interesting to see how different ones did that. So for a little time I was the women’s liaison officer to the AAMC from USUHS. Every year I would get the women faculty together at a meeting or I would invite them to a meeting, and what are the issues and what can we do to help, and so on.

Some women said, “I’m not coming to those. I’m not different from anyone else and no one should think they are.” So they came once and said that very loudly and then they went away. Other people really were overwhelmed by some of the problems of trying to balance—work and children, because remember these were all young faculty with the very heavy time commitment being a full-time faculty member, and there was no leniency there or anywhere. I think I had two weeks off when I had a baby, and that was at Georgetown. It was different from what it is now. So that was probably my biggest challenge.

The other great challenge for me, which is perhaps unique to me, was that I had to be tactfully quite independent of Randy, my husband, and every time I’ve gone anyplace people will try to get him through me, which is just not done. We just don’t do that. We don’t talk about work at home because it’s home, and people don’t believe that. They have to learn that if they want to talk to him, they talk to him. If they want to talk to me, they talk to me, and it’s not going to go back and forth. It takes a while for people to believe this, because they don’t know. I mean, I guess they go home and tell their wives everything at work. I don’t know. I don’t have any idea. So being seen as an individual instead of being seen as a spouse was not hard, but interesting.

Rubin: What has been the greatest achievement in your career?

Holmes: The greatest achievement. Scientifically?

Rubin: Sure, or whatever you want to talk about.

Holmes: I think the greatest achievement really has to do with being a faculty member at all, and doing it well. I’ve been in four different medical schools, learned a lot from each one, and tried to keep things fresh and new all the time. That’s fun. Working with colleagues who are very, very smart and very excited about what they do is one of the joys of being in a medical school faculty. Working with students who really want to learn is a delight, and that can be graduate students who really get down into the nitty-gritty that is fascinating and compelling to me. Then at a different level, medical students who have their own goals, and I can contribute to them and get them to remember things that I think they need to remember, and that’s fun to try to do that.

Rubin: Those are all of my questions. Did you have anything you wanted to add?

Holmes: I think it’s a very good idea for you to do this background thing. I wonder how it’s going to be used. That’s going to be interesting to hear.

I think I would like to add one thing, and that is a comment about Jay and Laurie Sanford and their huge impact in the military medical school. We knew them very well, and so this was something that I know quite intimately. Laurie Sanford was a parasitologist and a very good one, and she taught parasitology with several others, Dr. Cross and others, in this excellent program, but her major role was as the cheerleader and the spouse coordinator for the medical school. In early days, most of the spouses were women. She had meetings for them and she had people come and talk to them about what to expect of their spouse’s military commitment. What would their role be? What would their support systems be? What would be expected of them in case of disaster? And so on.

She always was a resource for every new incoming class, not only for the students but for the families, and tried to make it a family-oriented program, and that was very special, because at that time most medical schools, I think at the beginning, most medical students weren’t married and they didn’t have kids, but the military medical students did. They often came after military service or they just had had different backgrounds, and so many of them had families, and integrating that into their whole lives as medical students was very important.

Jay and Laurie were intimately involved on a personal level with each of those students. They knew them by name, they knew what the problems were, they helped in every way they could. Jay would go out and bifwhack with the students in their orientation programs when they went out in the field at the beginning of the freshman year, and he would go with them and he would, in his inimitable way, tell stories of rabies in Vietnam and whatever, around the fire or whatever it was. He was not a distant dean, I will say.

One of my fond memories is when they were having a fundraising campaign, and at that same time as the fundraising campaign, some of the students had earned their badge in field medicine, where they had to crawl under live ammunition and pull out somebody, a pseudo patient, and treat him in the field for whatever, and then they earn this very important badge. I mean, it’s really one of the most important things. So it’s a very proud moment.

So it was scheduled for about noontime one day, a bright sunny day, and Jay Sanford was to come and present these awards and talk to everybody. So the whole plaza in the campus was full of people, and Jay wasn’t there. He had always been there. He had always been on time. And people were screaming, “Where’s Jay? Where’s Jay? Where’s Jay?” No one had seen him. Suddenly, from the top of the A Building—that’s what we called it at the time; I don’t know if it’s still there—comes snaking down this big rope, immediately followed by Jay Sanford doing an Australian repel, which is upside down, carrying the flag for this fundraising campaign in his teeth, repelling down the wall, bounced onto the plaza and proceeded to award the Expert in Field Medicine Badge, to roaring applause. I mean, it was just so quintessentially Jay Sanford.

It was just marvelous. It was the kind of thing that he did, just spontaneously for fun.

I think I met him once in an elevator when I’d been there about, oh, a dozen years, and I said, “Jay, I didn’t realize it, but I’ve never met you in an elevator before.”

He said, “This is probably the first time I’ve been in one.” Because he would run up and down the stairs. He was very physically active like the students, and he didn’t ride in the elevators. So that’s the kind of guidance and example that he set, vigorous examples. He tried to insulate the students from political pressures of any kind, and he tried to speak for them and to show what their potential was, which was so clear in his mind. He and Laurie were just a team to make it a terrific event.

[End of interview]