"Average guy" leads extraordinary life

From serving as White House physician to writing the book on bioterror preparedness, Navy Capt. Robert Darling, MD, is living the adventure.

By Markian Hawryluk, amednews staff. Jan. 27, 2003.

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Doctors serve America at all levels of government. This occasional series explores how their medical background influences what they do.

Navy Capt. Robert Darling, MD, didn't set out to be an expert in bioterrorism. Or a physician to President Clinton. Or to help land a burning aircraft on the deck of a carrier, saving the lives of its crew.

"I didn't go to Harvard or Yale. I didn't graduate at the top of my medical school class," Dr. Darling said. "I was a pretty average guy, and all these neat things have happened to me."

Capt. Robert Darling, MD
Topic: Terrorism in America

But Dr. Darling is no real-life Forrest Gump who just happens to be in the right place at the right time. Case in point: He was recently named senior medical adviser to the Navy Medicine Office of Homeland Security. This post places the 44-year-old Dr. Darling on the front lines of one the nation's scariest battles -- protecting the country against a bioterrorist attack.

"Fighting terrorism is the single most important objective to ensure our national defense, and we need our very best talent dedicated to the cause," said Rear Adm. Donald C. Arthur, MD, deputy surgeon general and chief of the Medical Corps. "Capt. Rob Darling is our most highly qualified expert and will guide us well."

Dr. Darling grew into the role starting with his experience at the White House. In 1996, the Clinton administration was looking for a new White House physician, a post generally filled by internists, surgeons or family practitioners. Dr. Darling was the first emergency physician to win the assignment.

At the White House, the Secret Service asked him to help them better understand the threat of a biological attack from a medical perspective.

One of the few resources available to him was the expertise of the U.S. Army Medical Research Institute of Infectious Disease at Ft. Detrick, Md. The more Dr. Darling learned about biological agents, the more he became concerned.

"I was really worried when I opened my eyes to the possibility of biological warfare or biological terrorism," he said. "It's a totally different ball game." Unlike many other weapons of mass destruction, biological attacks are fairly inexpensive and relatively simple to devise.

After three years at the White House, Dr. Darling was invited by his colleagues at the research institute to continue his work at Ft. Detrick. One of the anthrax-laced letters sent to the U.S. Senate in 2001 was opened in its laboratories.

"It was frightening," Dr. Darling said. "The quality of this anthrax weapon was so far superior to anything that we thought others might be capable of. This stuff was good."

The letters gave his message new meaning. "Before Sept. 11, I had to hype up the current threat portion," he recalls. "Now that's the focus."

Because the Ft. Detrick facility is run by the Army, he had to get special clearance to be the only naval person assigned there.

"He has a very good reputation within his Navy community and within the biodefense field," said Lt. Col. Scott Stanek, MD, chief of the operational medicine division at the research institute. And although there often can be a staunch rivalry between branches of the military, the Army physician said Dr. Darling fits well in their biodefense team. "It's gets a little more interesting around the times of the Army-Navy game."

Capt. Dale Molé, MD, an emergency physician who trained with Dr. Darling in San Diego, attributes much of his friend's success to his ability to get along with people and his outstanding clinical skills. He also has watched him learn the nuances of getting things done in government.

"It's great to have a good idea, but a lot of times to make something a success, you have to understand the politics as well," Dr. Molé said.

Dr. Darling epitomizes the old Navy recruiting slogan "Live the Adventure!" Dr. Molé said. "He always seems to be where the action is."

Flying in the face of danger

Dr. Darling spent two years as a flight surgeon on the USS Theodore Roosevelt, a nuclear-powered aircraft carrier. He routinely flew in some of the most modern aircraft to help him understand the stress the pilots under his care experienced.

"They're flying multimillion-dollar aircraft onto the decks of a cork in the ocean," Dr. Darling said. "If they screw up, not only do they kill themselves, they may kill hundreds. It's the most dangerous occupational environment in the world. We could never prove that we prevented a crash, but I would argue that we did."

In 1998, as the co-pilot of an E-2C "Hawkeye" aircraft on a routine operational flight, Dr. Darling had a more palpable impact. After a catapult launch from the carrier deck, the main power distribution panel in the rear of the aircraft burst into flames. As the pilot maneuvered the plane back toward the carrier, Dr. Darling unstrapped himself from his chair -- and his parachute -- to pass a fire extinguisher to the crew fighting the fire and then conveyed the pilot's plans for an emergency landing. He was awarded the Navy Commendation Medal.

He was also decorated for his three years of White House service. He traveled to more than 40 countries and one of his duties was to plan for any medical contingency, to choreograph where the president or first lady would be taken and what supplies they would need to bring along.

"When Mrs. Clinton did her Africa trip, she went to some God-awful hell holes," he recalled. "We went places where the plan was if she got sick, let's get her on the airplane and get the hell out of Dodge."

While his political leanings often conflicted with that of the Clintons, Dr. Darling said he always appreciated the way the president treated his staff. "He was an extraordinarily kind and personable man," Dr. Darling said. "He did things for us that he really didn't need to do."

Dr. Darling recalls in particular Clinton taking 10 minutes out of his busy schedule to meet his family, and to chat with every relative.

Family is important to Dr. Darling, although his busy schedule leaves him precious little time to spend with his wife, Shari, and his three daughters, ranging in age from 9 to 13.

Much of his work as lead editor of a primer on bioterrorism published this year was completed at night after his girls went to sleep. The book, Bioterrorism, is geared toward emergency practitioners, who will likely be the first to encounter the results of a biological attack.

Dr. Darling still sees patients, logging about 10 hours a month at the emergency department of Washington County Hospital in Hagerstown, Md. He could make a lot more money doing that full time, but he says service to his country is more important.

"I've had a marvelous, rewarding career," he said. "It ain't over yet."

Not bad for an average guy.

ADDITIONAL INFORMATION:

Capt. Robert Darling, MD

Position: Senior medical adviser, Navy Medicine Office of Homeland Security
Born: Jan. 2, 1958
Family: Married with three daughters
Specialty: Emergency medicine
Medical degree: Uniformed Services University of the Health Sciences School of Medicine, Bethesda, Md., 1985
Residency: Emergency Medicine, Naval Medical Center, San Diego
His friends say: When asked if he would recommend Dr. Darling for a job as White House physician during the Clinton administration, his reference -- a right-wing friend -- jokingly responded, no, he would have suggested Jack Kevorkian, MD, as an alternative.