Picture taken along the Green Road Project trail.

 
Dr. Fred Foote enlisted in the Navy during the 1970s, working as a hospital corpsman before spending his undergraduate years at Middlebury College, St. Johns College Annapolis, and the University of Chicago. After graduating in 1980, he went on to earn a medical degree at Georgetown while in his 30s and he subsequently pursued a residency in neurology at Yale.

He spent his years in clinical medicine as a Naval physician, working at sea for 6 years and spending most his time at Bethesda Naval Hospital until it combined with Walter Reed. Since 2000, Dr. Foote has been focused on pushing for the utilization of holistic medicine to treat wounded soldiers.

After 29 years of service, he retired in 2009, but he continues to work with the military from his home base in Bethesda, Maryland. In addition to his clinical work, he has published a book of poetry, Medic Against Bomb: A Doctor’s Poetry of War, spearheaded the Green Road Project, directed the Warrior Poetry Project, and led the Epidaurus Project to implement holistic care in the Military Health System. He is now a scholar at the Institute for Integrative Health in Baltimore. He continues to practice some clinical medicine and he is currently working to become certified in acupuncture.

After driving around in his dented Honda Civic (which remains dented so he can identify it), I had the chance to interview Dr. Foote as we sat in the beautiful natural environment of the Green Road on the Walter Reed grounds.

Ryan: What prompted you to join the Navy?

Dr. Foote: I’m a military brat and every male in my family that we can record back for 1500 years has been in the military, so there wasn’t really a choice. I’m not a military type of person and my real love is poetry. We raised money for the Green Road Project with the proceeds from my book.

I originally joined the Navy when I was 19, first to pay for college, and never thought I’d be staying for 29 years. To some extent, the military is my family. I understand them and I don’t always fit in that easily with them, but I love them and so it made sense to me to continue to serve the military through my medical career.

Ryan: You picked the specialty of neurology, but the work you are doing seems to fall more along the side of psychiatry and psychology. How has your specialty helped or hindered you in these areas?

Dr. Foote: People always wanted me to go into psychiatry and I always resisted that. I guess I wanted more of a hard-nosed science approach. But, I am comfortable with psychiatry and I do somewhat of a minor in it as a neurologist. The two are really the same, and the more forward-looking training programs are now combining psych and neuro into neuropsychiatry which is a good thing to do for a person going into the field.

Ryan: How did you come up with the name and function of the Epidaurus Project?

Dr. Foote: Back in 2000, when I tried to develop holistic medicine here, I gathered together a working group of renowned scholars to define the nature of patient-centered care. Because I had visited the Greek medical school at Epidaurus when I was young and I was struck by the beauty of it, I named the whole project after it. Epidaurus in Greece was home to the 6th century BC Hippocratic medical school and it is still a beautiful site today.

Ryan: How does the Military Health System stand in its efforts to employ holistic medicine?

Dr. Foote: At this point, we lead the nation in this area. Part of the reason is that we have the money to try things in the middle of a war. We also have an urgency. The real driver in the last 10 years has been having had an enormous number of casualties with brain injury and PTSD.  Conventional care did not work very well for those conditions, so we had to find a fix because we could lose the war by running out of people if we couldn’t get those soldiers back to active duty. There has been tremendous emphasis on new therapies, allowing us to capitalize on that to make new holistic medicine projects.

The basic theory of my work over the past 20 years has been based on the fact that there are two types of medical care. There is organ system medicine, in which you treat one part of the body at a time, and there is whole body medicine, which is less used, but has a rich history. The components are evidence-based design, family centered care, integration of care, and wellness (including nutrition, exercise, stress management and, alternative medicine), and healing through the arts and nature. All of them treat the whole body rather than just one organ, something that we are trying to harmonize with conventional care. We’ve tried these and they have worked.

Ryan: Tell me about the inspiration for your book of poetry, Medic Against Bomb.

Dr. Foote: The trigger for that particular book was my deployment to the Iraq War in 2003 on the hospital ship Comfort. That was where I treated the war-wounded myself for the first time. That led to a lot of poems which became my first book, Medic Against Bomb. It was published in 2014 and has done very well. We needed a way to raise money for the Green Road and the Arts Program. We were raising money from civilians, but we had to have them understand the life of a soldier to raise money from civilians. It turns out that if I say 10 minutes of poetry and show images of the wounded warriors to a civilian audience, they instantly understand and give money. I’ve raised over $500,000 for the Green Road with those readings across various civilian audiences: as varied as medical groups, arts groups, car dealerships, universities, and business people. Everyone responds to the impact of poetry when it’s about something they feel strongly towards. You could say that Medic Against Bomb has been the face of the wounded warrior for this project and others. Another similar book that is worth checking out would be Here, Bullet by Brian Turner. He is a good friend of mine who has worked with the Creative Writing Program at Sierra Nevada College in California.

Ryan: What are some interesting stories you have about your experiences with this work?

Dr. Foote: When you come to the Green Road, it’s a total gestalt effect. We’re accustomed to thinking poetry and medicine are totally different, but they’re not. Everything really is connected. You can move people to a healing place or engage people to do medicine through art and poetry. I’ll tell you a story about the impact that it has had.

In June, I was invited to present poetry and the Green Road at the international literary festival in Busan, South Korea. Once I had accepted the invitation and I was on the way there, the U.S. State Department decided that it would be good idea for me to talk about these things to a wider Korean audience. The embassy in South Korea commissioned 10 presentations for me throughout the country to talk about how the military was using art to heal patients. The response of the Koreans to this was overwhelmingly positive. It really is true that you can cross boundaries with art and medicine. You don’t have to live in silos and remain isolated. Life can grow organically, like these trees around us.

Ryan: How long have you been involved in writing poetry?

Dr. Foote: I started as a teenager and then I had a hiatus in my 20s. I thought poetry was making me crazy. I was crazy, but it wasn’t the poetry. By 1995 I figured that out and my poetry came back to me, so I’ve been writing steadily ever since. I have several manuscripts that aren’t just about the military.

Ryan: You’ve faced a lot of resistance to these treatments during your time in the medical field. What has led you to persist in the face of such opposition?

Dr. Foote: It was loyalty to the military and love for the soldiers that helped me. You’d die for these soldiers any day since they are just such salt of the earth people. You really develop a love for them that drives you. That’s the main force pushing us all in military medicine.

The military is a difficult place to innovate in. The military’s job is to control, channel, and manage violent behavior. This is a difficult task to do, so they must be very conservative, bureaucratic, and authoritarian in nature to complete it. These traits lead to years of peace being years of stagnation. Ironically, to bring out this other side of medicine for healing, we have needed a war. We may develop things more rapidly during war since we have an extra push to improve the kind of care we offer. The Iraq and Afghanistan wars have provided the impetus for us to improve care and to employ my ideas.

Ryan: What is your biggest piece of advice for anyone interested in combining medicine and writing?

Dr. Foote: That’s a difficult question. First of all, say that it is possible. You’re going to have very few free hours, but the two will feed each other. The art helps you become a better healer and the healing gives you a lot in the realm of art.

My most basic advice would be, to save time, you should give up TV. I don’t even have one myself!