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Medicine, community, and justice intersect

Yale Medicine Magazine, 2013 - Spring


Jeffrey Lowell helps first responders, government officials, and health providers to prepare for disasters.

A few years after Jeffrey Lowell, M.D. ’85, joined the faculty at Washington University School of Medicine in St. Louis in 1994, the liver and kidney transplant surgeon transitioned from spending his protected research time in a lab to spending it in support of the community.

“Initially, I was interested in the intersection of medicine, community, and justice. Physicians and law enforcement are both involved in high-stakes, fast-tempo work, and I thought that medicine could contribute something,” Lowell said.

Completing coursework and training at the St. Louis Police Academy in 2001, Lowell rose through the ranks of community and regional public service—receiving training in tactical medicine as a hostage negotiator and serving as the city’s police surgeon, then serving as the mayor’s regional medical critical incident director—until Tom Ridge, the first secretary of the Department of Homeland Security (DHS), invited Lowell to Washington to be his senior advisor for medical affairs.

When Ridge came to St. Louis in October 2003 on a national tour of town hall meetings regarding the fledgling DHS, he had already heard of Lowell’s accomplishments in the mayor’s office and the St. Louis region. Lowell had spearheaded projects that coordinated the city’s hospitals and its first-response agencies—a need that St. Louis recognized during the 2001 anthrax attacks that followed 9/11. As in every major U.S. city, telephone lines at hospitals, post offices, and police, fire, and public health departments were jammed with calls about the dangers of unidentified white powders.

“We were chasing our tail around and didn’t have any good program to deal with it, so Mayor [Francis] Slay asked if I would build a matrix organization that integrated the region’s medical and health assets with all the other forms of local government, including first response,” he said.

Lowell led the effort to devise and implement the St. Louis Hospital Mutual Aid Agreement, which binds the hospitals of the metropolitan area’s eight counties across two states (Missouri and Illinois) to share staff, beds, equipment, and supplies in the event of a disaster—natural, industrial, terrorist, or other.

“It was a big deal. Hospitals are big business competitors. They would just as soon put a stake in each other’s heart as help one another. But we got every hospital in the region to say that in the event of a disaster, they’ll help one another,” Lowell said.

The agreement laid the groundwork for the St. Louis Area Regional Response System (STARRS), which Lowell led the effort to create. The network coordinates the fire departments, police departments, public health agencies, governments, and NGOs of the two-state metro area for disaster preparation and response. Ridge was seeking just this type of multiagency coordination and integration for his new department that would bring together all or part of 22 federal agencies when he invited Lowell to meet with him in St. Louis.

“When Congress built this department, they didn’t give him a top doctor, but almost everything that Secretary Ridge went to bed afraid of happening to America the next day had a medical or health implication,” Lowell said.

Shortly after the meeting, Ridge asked Lowell to work for him in Washington, D.C., as his senior advisor for medical affairs. In Washington, Lowell defined the role of a permanent medical advisor. Later, he shared these recommendations in a 2005 House Subcommittee hearing. Largely based on these recommendations, DHS launched the Office of Health Affairs and the holder of Lowell’s former position is now known as the DHS Chief Medical Officer and Assistant Secretary for Health Affairs.

Lowell’s recommendations also appeared in a report to Ridge that outlined a strategy to realign and strengthen the Federal Medical Response, which was released in January 2005 and later made national news. Eight months later, his assignment in Washington over, Lowell was back home in St. Louis, when Hurricane Katrina put his evaluation to the test, requiring the biggest National Disaster Medical System (NDMS) deployment to date. The Washington Post quoted officials and NDMS team leaders who strongly supported Lowell’s assessment.

“I think a lot of my recommendations, if implemented, would have greatly improved our Katrina response,” Lowell said.

Back at work in St. Louis, Lowell continues to serve his city as the mayor’s senior medical advisor and director of the health department. As chief of pediatric transplant surgery at St. Louis Children’s Hospital, he has performed a liver transplant on a 10-day-old patient, one of the youngest known organ recipients. He also served on one of the first teams to perform a transplant in which a piece of an adult liver from a living donor was transplanted into an adult recipient.

A commander in the U.S. Navy (reserve), Lowell was deployed to Central and South America on a humanitarian mission and in support of Operation Enduring Freedom to the U.S. Army hospital in Landstuhl, Germany.

“It’s very rewarding, not only to be in health care and do something that people both need and otherwise wouldn’t be able to have, but to do it representing your country. Taking care of injured soldiers and marines has been my greatest honor. I am deeply grateful for having that privilege. ”