Providing care in a changed world

Exotic travel is nothing new for David Hilmers, M.S., M.D., M.P.H. Hilmers has already landed in dozens of countries as a Marine pilot and orbited the Earth 400 times on the space shuttles Atlantis and Discovery. But for Hilmers, an assistant professor of pediatrics and medicine at Baylor College of Medicine, the chance to go to Bolivia as a Yale/Johnson & Johnson Physician Scholar in International Health is appealing. The former astronaut looks forward to learning about tropical diseases like leishmaniasis during two months working in a Bolivian hospital.

Sponsoring established physicians like Hilmers is new for Yale’s International Health Program, which has been sending residents overseas since 1981 [“A World of Difference,” Autumn 2001]. With continuing support from Johnson & Johnson, the program is expanding. This year a $500,000 grant will fund trips for 14 career doctors, 53 Yale residents and 15 residents from other medical centers. Participants will spend six to eight weeks in 17 foreign countries and at two Indian Health Service clinics in the United States. Despite terrorism, the war in Iraq and SARS, co-director Michele Barry, M.D., HS’77, said interest in working abroad remains strong. “We got hundreds of applications for these 82 spots.”

Increasing hostility to Americans has raised safety concerns. “The aura which kept an American off-limits to some threats has diminished,” said co-director Frank J. Bia, M.D., FW ’79. But anti-Americanism may, paradoxically, motivate some physicians to go overseas, Barry said. “When there’s so much anti-Americanism, physicians applying to our program seem to be committed to working in underserved areas overseas in an effort to mitigate this sentiment—to prove that Americans do care past their own self-interests and borders.”

That global perspective became clear to Hilmers from 300 miles above Earth. It motivated him to begin medical school at age 42, after 12 years with NASA. “During the dark times of your orbiting … you see the backdrop of the stars, and you see the earth as this tiny little rock,” recalled Hilmers, now 53. “You get a different perspective—that we have to take care of each other, and to survive, everyone has to survive together.”