Robert J. T. Joy (April 5, 1929 – April 30, 2019) was an American physician and career Army Medical Corps officer who was an internationally recognized scholar in the field of the history of medicine. He was also a key leader in U.S. Department of Defense Medical Research and Development. He served as one of the key founding staff members of the Uniformed Services University of the Health Sciences, where he served as the first commandant of students, chair of the department of military medicine, and, after he retired from military service, first professor and chair of the section of medical history at the university.
Early years Robert John Thomas Joy was born in Narragansett Village, Rhode Island, the only child of Angelo Francois Joy, an Italian immigrant hotelier, and his Narragansett-born wife Mary F. (Egan) Joy. His mother Mary was a first-generation American born of Irish Immigrant parents, and Joy described his upbringing as "lace curtain Irish." His primary and secondary education moved between Narragansett in the spring and St. Petersburg, Florida, in the fall as his family moved between their hotels with the tourist trade.
After completing High School, Joy enrolled in the Rhode Island State College, receiving a Bachelor of Science with a dual major in pre-medicine and pre-law in 1950.
Joy then attended the Yale School of Medicine while participating in an Army Reserve Officers Training Corps Medical Corps scholarship—in the 1950s, the Army had such programs—and completed his medical training in 1954.
It was at Yale that his lifelong love of the history of medicine—and his association with the American Association for the History of Medicine began. He and a classmate restarted the Nathan Smith Club, the school's student History of Medicine Club, which had lain dormant for several years. The club met monthly at a faculty member's home, a student would present a paper, and other members would critique the paper. Joy volunteered to present the first paper when the club re-launched, and his paper would eventually be published and awarded the Association's Osler Medal for the "best unpublished essay on a medical historical topic written by a student enrolled in a school of medicine or osteopathy in the United States or Canada."Joy, R.J.T. "The Natural Bonesetters, with Special Reference to the Sweet Family of Rhode Island." Bulletin of the History of Medicine 28: 416-441, 1954."
Joy was married twice. His first marriage ended in divorce and produced two children, a son and a daughter. His second wife preceded him in death by about 1 year.
Career
Internship, residency, and early assignments
Joy was awarded a reserve commission in the Medical Corps upon his graduation in June 1954, and was ordered to active duty in the Army of the United States later that month to complete an internship at the Walter Reed Army Medical Center in Washington, District of Columbia. Joy later commented that while he had been offered the choice of deferring his active duty service obligation until after he had completed a civilian internship, attending an Army internship at Walter Reed made much sense to him, not only because of the quality of the training that Walter Reed would afford him, but because a First Lieutenant in the Medical Corps was paid about $250 a month, while a standard civilian intern's salary in those days was about $50 a month, and he had a wife and young child to support.
After completing his internship, Joy was commissioned in the Regular Army and transferred to the Army Medical Service School at Fort Sam Houston, Texas for completion of the Army Medical Department Officer Advanced Course. Joy would later remember the course as six months of instruction on the proper way to apply wax to hospital floors and fill out utterly meaningless paperwork—and that he was called before the Commandant of the School for allegedly serving as the ringleader of a group of Medical Corps officers who had shelled the Garrison Commander's quarters with golf balls one night using the post's salute cannon.
Following the Advanced Course, Joy was sent to serve as the Battalion Surgeon of the 714th Tank Battalion, stationed at Fort Benning, Georgia. As the battalion surgeon Joy served as a staff officer to the battalion commander, but he also served as the battalion's medical platoon leader at the same time, and led his platoon as the battalion engaged in a series of maneuvers at Fort Polk, Louisiana in preparation for rotation to Germany in 1956 as part of Operation Gyroscope, where the battalion would become part of the 4th Armored Group—without Joy, who by that time had moved on to his residency training in internal medicine at Walter Reed Army Medical Center.
In the summer of 1956, Joy returned to the Walter Reed Army Medical Center, where he spent the next two years completing a residency in internal medicine, followed by a year-long fellowship program in medical research at the Walter Reed Army Institute of Research. It was during his fellowship at the Walter Reed Army Institute of Research that Joy met Jay P. Sanford, another young Army doctor, a draftee who was serving out his commitment under the Berry Plan. Joy and Sanford would remain professional colleagues and friends for the rest of their lives.
United States Army Research Institute of Environmental Medicine
Following completion of his residency, Joy and his family moved to Fort Knox, where he was assigned to the newly constructed hospital on post, where he would practice medicine in the cardiology service while simultaneously serving as the assistant director, and later director, of the Environmental Division of the U.S. Army Medical Research Laboratory at Fort Knox. He would serve in that position for two years, until the laboratory was reorganized, shifting its focus towards blood transfusion, biophysics, and psychophysiology. The U.S. Army Medical Research Laboratory at Fort Knox had originally been established as the Armored Medical Research Laboratory in the early 1940s and had focused its research since that time on the physiological effects of armored vehicles on their crews.
In 1961, the environmental division of the Army Medical Research Lab at Fort Knox was moved to Natick, Massachusetts, redesignated as the United States Army Research Institute of Environmental Medicine, and collocated with the Quartermaster Research and Engineering Command. Because portions of the Quartermaster Center were being incorporated into the new lab, and because the Quartermaster Center's Commanding General would remain in the laboratory director's rating chain, the Medical Department had difficulty finding a senior officer willing to assume command. Joy, still only a Captain, volunteered to command the lab and, appointed to command "at the direction of the President" by then-current command policies to exercise command over officers senior in date of rank to him, moved to Natick and assumed command of the new lab when it was activated on 1 July 1961.
After a year in command without apparent harm to his career, Captain Joy was replaced as commander by Lieutenant Colonel William H. Hall, MC, who would command the lab from 1962-1965. Joy assumed the position of Research Internist until 1963, when he began a period of government-funded civilian training at Harvard University, being awarded a Master of Arts in Physiology in 1965. He had curtailed his education to assume a position as the commander of the U. S. Army Medical Research Team (WRAIR) in the Republic of Vietnam.
United States Army Medical Research Team, Vietnam
In July 1962, shortly after the first U.S. Army medical units were deployed to Vietnam, the Walter Reed Army Institute of Research deployed a small survey team to evaluate available resources for conducting medical research and plan for necessary expansion. That team recommended that existing medical research programs be expanded to include a research team from WRAIR, to be located in Saigon, similar to teams already operating in Bangkok and Kuala Lumpur which would conduct studies of U.S. personnel and local national troops and civilian populations.
The U. S. Army Research Team (WRAIR), Vietnam was established in November 1963 with seven officers and 12 enlisted, under the command of then-Lieutenant Colonel Paul E. Teschan, MC, USA. With the established 12-month rotation cycle, Joy, now a Major, rotated to Vietnam as the third commander of the research team, replacing Lieutenant Colonel Stefano Vivona, MC, USA.
Joy's tour as commander of the medical research team coincided with the initial buildup of U.S. combat forces, with the concomitant increase in exposure to tropical diseases by U.S. forces, primarily malaria, and it was in this area that much of the team's effort was focused during Joy's tenure in command. As data indicated a potential rise in the number of cases of chloroquine-resistant falciparum malaria, and the team focused their efforts in this area. One of their discoveries was "asymptomatic malaria," which was a possible threat to the continental United States, as it could be imported by redeploying service members. They also documented failures in malaria prophylaxis discipline and use of personal protective measures, which helped provide information to improve malaria control, and the introduction of new drugs for malaria control, including Fanasil and pyrimethamine.
Another major contribution to the control of malaria in Vietnam was the introduction of diaminodiphenylsulfone (DDS). The efficacy of this drug as a prophylactic agent was confirmed in volunteers in the United States, and in 1966, a field test in Vietnam proved its value in combat troops. Subsequently, it was routinely used by military personnel in Vietnam for prophylaxis against falciparum malaria.Barr, Justin. "A short history of Dapsone, or an alternative model of drug development," Journal of the History of Medicine and the Allied Sciences, 66:4 (October, 2011)
The team also recommended that a central rehabilitation facility for malaria patients be added to the troop list and simultaneously be used as a facility for studying the disease and treatment regimes for it. The Army Surgeon General approved the recommendation and added the 6th Convalescent Center to the deployment list. The Center was activated on 29 November 1965 at Fort Sam Houston, Texas, arrived in Vietnam on 16 March 1966 and was inactivated at Cam Ranh Bay on 30 October 1971 when its staff was used to resource the U. S. Army Drug Rehabilitation Centers at Cam Ranh Bay and Long Binh.
Under Joy's leadership, the team also conducted extensive research into neuroendocrine stress caused by combat, in helicopter crewmen and Special Forces "A" Detachment members, which contributed significantly to the understanding of the pathophysiology of stress in the soldier. Studies of heat stress incurred by crews of the Mohawk (OV-1) aircraft led to changes in clothing and to ventilation of the cockpit, measures which materially improved crew comfort and efficiency. Collaborative studies with the Department of Neuropsychiatry of the ARVN Cong Hoa Hospital led to a better understanding of the stresses of combat affecting both American and Vietnamese soldiers. It was this research that led to Joy's receipt of the Air Medal, as well as linking into his previous research into environmental medicine.
In later years, Joy would use his experiences as the "nameless staff consultant in malaria" in his lectures on the commander's role in maintaining the health of the command, comparing his experience in Vietnam with that of Field Marshal William Slim in Burma. He would compare malaria rates in the 1st Cavalry Division (Airmobile) against that of Slim's Army, and then quote Slim's command philosophy from his book Defeat into Victory: "You doctors think you can cure malaria, but you can't. I can and I'm going to."