Wednesday, August 8, 2007

"Stonewall" and Second Opinions - Update

Last week I posted an entry on an interesting and recent article in the journal, Military Medicine, about a new theory on what caused "Stonewall" Jackson's death after the friendly-fire incident at Chancellorsville. The authors, Drs. Timoth R. Koch and Joseph B. Kirsner, put forward the hypothesis - one of many different ones that have popped up in the literature in the past decade - that Jackson died from complications due to chronic peptic ulcer disease.

Dr. Koch was kind enough to answer some "interview" questions:

1) Some biographical information (Drs. Koch and Kirsner are both distinguished specialists in their field of gastroenterology), including whether his interest in the Civil War is relatively recent or has been brewing for some time? Whether that interest is strictly "professional" or was sparked by something else?

2) The doctors explain the connection between their experience treating Persian Gulf veterans and Stonewall Jackson; what exactly prompted his line of inquiry and publication of the paper?

3) Why was he not "satisfied" with the other explanations for Jackson's death that have already been published?

4) In their article, the doctors comment that Dr. Hunter Holmes McGuire had a broad background in medicine and would have known about diagnosing gastric diseases. I asked him to comment briefly on the history of gastroenterology as a special discipline and the training that McGuire may have rec'd on this subject in medical school?

5) Apart from the mystery of the actual clinical diagnosis of cause-of-death, what was the most interesting part of Jackson's life story to him?

6) The doctors suggest that modern soldiers deployed from areas with high prevalence of H. pylori should be tested before they are deployed. I asked him to comment on other specific challenges that today's military gastric specialists face, especially "in country"?

7) Finally, I asked him what the response has been from both the medical and professional communities regarding their article and conclusions on Jackson's cause-of-death.

Dr. Koch's answers will form the basis for my October 2007 "Medical Department column in The Civil War News (in print in late September) and the column will be posted here online soon after it appears in the paper.

I have a good backlog of material for future columns - including the medical aspects of slavery, "ambulance-chasing" pension lawyers, and other topics. Feel free to contact me if you have any other subjects you'd like to see addressed.

Best Regards,

Jim Schmidt

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