Howard A. Rusk (1901–1989) From Military Medicine to Comprehensive Rehabilitation
2008; American Public Health Association; Volume: 98; Issue: 2 Linguagem: Inglês
10.2105/ajph.2007.120220
ISSN1541-0048
Autores Tópico(s)Advances in Oncology and Radiotherapy
ResumoHOWARD ARCHIBALD RUSK, MD, is generally recognized as the “father of comprehensive rehabilitation.” In comprehensive rehabilitation, those suffering disabilities that result from illness, injury, or congenital defect are given therapy and training designed to help them to live and work in the community to the best of their abilities. Rusk initially developed this field as a contribution to military medicine during World War II and later broadened it in application to the civilian population. The excerpts reprinted here were taken from his engaging and often humorous autobiography in which he relates the many adventures involved in his life’s work. Rusk was born on April 9, 1901, to Augusta Eastin Shipp and Michael Yost in Brookfield, Missouri. He received his undergraduate degree from the University of Missouri in 1923, then earned his medical degree at the University of Pennsylvania two years later. He returned to Missouri for a one-year internship at St Luke's Hospital in St Louis, married Gladys Houx, and began a private practice in internal medicine. In the early 1930s, he had his own office with a staff of seven—two doctors and five nurses—as well as technical and secretarial staff. In April 1937, Rusk became the second internist in the United States to pass the rigid examination required for membership in the newly created American Board of Internal Medicine.1 In 1932, the first of Rusk’s many articles began to appear in various medical journals. These early papers dealt with the therapeutic use of potassium in treatment of obesity and certain allergies.2 With the entrance of the United States into World War II in 1942, Rusk left private practice to join the US Air Force as a major and was stationed as Chief of Medical Services at Jefferson Barracks in St Louis. There he began to establish a broad and comprehensive program of rehabilitation for his injured patients. It began with a patient who complained when a spider’s web was cleaned from the ceiling above his bed; watching the spider spin his web was, the patient said, his only form of entertainment. Rusk realized that men who were sitting around bored and wasting time during their convalescence needed purposeful activities, and he began offering a series of classes. Eventually, he developed an integrated rehabilitation program with equal emphasis on physical reconditioning, psychological readjustment, and vocational training. Rusk’s program was remarkably successful, and the US Air Force subsequently established a whole series of special convalescent hospitals. Similar programs were later adopted by the US Army as “reconditioning” and by the US Navy as “rehabilitation.” The convalescent hospitals’ staffs were enlarged to include physical therapists, educators, athletic trainers, occupational therapists, social service workers, personal counselors, and vocational guidance experts who worked as a team to treat the needs of the “whole man.” Rehabilitation began the moment the acute illness or surgery terminated. After World War II, Rusk joined the faculty of the New York University School of Medicine and formed a facility for the rehabilitation of individuals with disabilities. Rusk first convinced the medical school at New York University to free up some wards in Bellevue and Goldwater hospitals to rehabilitate civilians. In 1946, Rusk was appointed professor and chairman of a new Department of Physical Medicine and Rehabilitation at New York University College of Medicine, and there he established the first comprehensive medical training program in rehabilitation in the world. In 1951 Rusk opened the Institute of Medical Rehabilitation at New York University and served as its director for 33 years. In 1984, New York University honored Rusk by renaming the facility the Howard A. Rusk Institute of Rehabilitation Medicine. The Rusk Institute today is the largest university-affiliated center devoted entirely to care, research, and training in rehabilitative medicine.3,4 Rusk founded the World Rehabilitation Fund in 1955, which has developed programs for professionals in 110 countries and trained more than 2000 physicians and other health specialists in rehabilitation. Rusk also served on many government panels and commissions and wrote several books and numerous articles. For two decades he served as a contributing editor to The New York Times and published a weekly column on medical issues and rehabilitation. He traveled around the world on behalf of the United Nations and other international organizations. He even worked as a team with Jihan el-Sadat, wife of Egyptian President Anwar el-Sadat, and Aliza Begin, wife of Israeli Prime Minister Menachem Begin, to create a program of cooperation on rehabilitation medicine between Israel and Egypt, announced in Cairo in 1979.5 Rusk was a great supporter of the disabled and argued passionately for the rights of the disabled to contribute to society. He campaigned for medical rehabilitation as a public health issue and argued that the control of many infectious diseases, the consequent lengthening of the lifespan, the aging of the population, and the shift in emphasis from infectious to chronic diseases meant that chronic physical and mental disabilities would continue to increase.6–8 He believed that rehabilitation for all those with disabilities was essential to the health and happiness of the population. Rusk’s ideas and new ways of thinking transformed the response to disability in the fields of public health and welfare and made it possible to rehabilitate millions of people with disabilities and help them to achieve healthier lives.9,10 Among Rusk’s awards were the Distinguished Service Medal, USA, and Lasker Awards in international rehabilitation, medical journalism, and public health. Rusk ended his autobiography with the words, “To believe in rehabilitation is to believe in humanity.”
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