Remembrances - Ronald Lee Samson, MD

Ronald Lee Samson, MD
September 22, 1940 - April 17, 2019

By Michael B. Strauss, MD, FACS, AAOS

Ron Samson was a “special” person to many, many people. For me, he was a brother I never had. I first met Ron when we entered the Navy Submarine Medical Officers School in Groton, Connecticut, in July 1967. He was 26 years old and just finished an internship at the St. Albans Navy Hospital on Long Island, New York. Maybe it was fortunate that we were not brothers before that time since Ron was always the intellect, the wit, the great swimmer and the focus of attention—and I am sure I would have been intimidated in his presence if I had known him then.

Ron was raised in Asbury Park, New Jersey, a beach town on the shoreline. Ron “sailed” through his pre-med education at Rutgers University where he was a star on the swimming team. He then graduated from the State University of New York Medical School in Syracuse, New York, in 1966. From his incredible ability to absorb and to recall information, I wondered how much Ron really studied to obtain his degrees. After completing his rotating internship, he entered the Navy Submarine Medical Officer School at Groton, Connecticut, in July 1967.

My first recollection of Ron occurred when we had our swimming “test” at the school. I recall him sitting alone on a bench in the corner of the pool deck looking rather pensive. To “qualify,” we were supposed to swim 25 yards underwater. While our other classmates struggled to pass the test, both Ron and I easily swam two lengths of the pool, 50 yards, underwater to impress the onlookers. This happening launched a 52-year friendship and multiple shared activities. Later in “sub” school, we were required to swim around a small lake with scuba gear. Ron and I, as swim buddies, completed two circuits of the lake before the next fastest pair finished the first circuit. With this, we became swim and scuba buddies for life.

After submarine medical officers school, we moved on with about a dozen classmates to the Navy School of Diving and Salvage in Washington DC where we shared an apartment. On the first hard hat dive in January, there was still ice on the Anacostia River. In retrospect this was probably fortunate as the bottom four feet of the river was an accumulation of silt and sewage—an ideal medium for every infection known to humans. At diving school, Ron was trained in hard hat diving with air and helium, open and closed-circuit rebreather scuba gear and hyperbaric chamber operations. Included in his training was a “narcosis dive” in the chamber to 220 feet of seawater (FSW) depth, oxygen tolerance testing at 60 FSW, and hard hat dives to 280 FSW with air and 320 FSW with helium-oxygen. As usual, Ron “breezed through” the academic portions of these training programs in the top third of the class—and without much studying for the tests. If this was not enough, between submarine and diving schools, he was a contestant on the Jeopardy TV program. Although not a “big” winner, he was a substantial threat to the lady who had been a recurring winner on the program. When I asked Ron how he studied for the Jeopardy competition, he said, “I just read the New York Times every day.”

After submarine and diving schools, Ron (accompanied by his family) was transferred to Hawaii and assigned as the Fleet Ballistic Polaris Submarine Medical Officer for the nuclear submarine, the Kamehameha (SSBN 642). He served as the medical officer on two Western Pacific patrols out of Guam. I wondered how Ron would be able to handle the isolation and confinement of a 60-day submarine patrol knowing his active lifestyle. Ron told me, “It was easy. All I did was sleep and awaken for the meals.” However, Ron showed his mettle during a patrol when the commanding officer of the Kamehameha was discovered to have lung cancer, and Ron handled the medical decisions in an adroit manner. This incident was somewhat an introduction reflecting Ron’s remarkable ability to handle crisis situations involving scuba diving accidents and in the operating room handling anesthesia challenges.

After Dr. Samson’s submarine patrols, he finished his navy experiences as the Medical Officer for Naval Special Warfare Group 2 in Little Creek, Virginia. This assignment included diving and parachute jumping with Underwater Demolition Team (UDT) and SEAL (Sea Air and Land) teammates and was more to Ron’s likings—especially the winter training activities at Roosevelt Roads Navy Facility in Puerto Rico. Upon completing his obligated military commitment in 1970, Ron had to make another major decision: stay in the navy or enter an anesthesia residency program at Jackson Memorial Hospital in Miami, Florida. He chose the latter and completed his residency in 1975. During his residency, Ron provided humanitarian anesthesia services in Jamaica, did bradycardia research with turtles on Grand Cayman Islands, and shared in Modell’s seminal research on oxygen deprivation in drowning and near drowning. Subsequently, he organized a “Water Sports Injury Program” for the American Academy of Orthopedic Surgeons in Bal Harbor, a Miami, Florida suburb and later co-chaired a “challenging” jointly sponsored NOAA (National Oceanic and Atmospheric Administration) and Undersea Medical Society (UMS nee UHMS) workshop on “Free Ascent Training” in Bethesda, Maryland.

Ron joined the anesthesia staff at Jackson Memorial after completing his residency. He soon became recognized as the “can do” anesthesiologist in a program that had a staff of 60 anesthesiologists and 100 residents in the program. He regularly provided anesthesia for liver transplants, some requiring transfusions of 50 units of blood, and never lost his composure while maintaining control of the challenges. When he took his anesthesia boards, Ron told me he partied all night before and was lucky he arrived in time for the testing. Not surprisingly, Ron “sailed through” the exam with “flying colors.”

Later Ron became chairman of the anesthesia departments at Victoria Hospital and subsequently at Cedars Medical Center, both in Miami. At the Victoria Hospital, Ron was the only anesthesiologist that Dr. Tony Wolf (who was the worldwide authority for handling the most severe congenital cranial facial disfigurements) would allow to anesthetize his patients. The administrative work was not to Ron’s liking, and he returned to the University of Miami as a staff anesthesiologist in 1999. Again, he was recognized for his clinical anesthesia skills. For example, whenever an airway problem occurred, Ron was called to solve it. The anesthesiology residents “loved” Ron, citing him as one of the top two or three most enlightening mentors in the program. The Chief of Neurosurgery, Dr. Barth Green, preferentially used Ron for his complex spinal surgeries. Ron will always be remembered for citing jokes which he was able to recite with the skill of a professional comedian and for saying things as he saw them, often using colorful as well as profane language to illustrate his messages. This frequently happened at surgeries when Ron would curse the surgeons for screwing-up the case or prolonging the operation.

With Ron’s navy submarine and diving medical officer experiences, he volunteered as the medical director for the NOAA hyperbaric facility on Virginia Key, Florida. At the time, it was the facility that handled almost all the decompression sickness and air embolism cases for the Florida and Caribbean scuba divers. Many of the divers arrived in “extremis.” As a result, Ron had to start IVs, intubate apneic and/or hypoxic patients, place chest tubes for pneumothoraxes, and perform advanced cardiac life support, all with the minimum of resources, no X-rays exams and limited cardiac monitoring while attending the patient in the hyperbaric chamber. Ron’s amazing clinical skills resulted in incredibly good outcomes. Such feats further reflect Ron’s astounding diagnostic acumen and clinical skills. During this time, he remained on call 24/7 for diving emergencies over a 25-year period.

Later, when NOAA retired the Virginia Key facility, Ron co-founded and assumed the same medical role at Miami’s Mercy Hospital. At this facility, identified by the Divers Alert Network as the country’s busiest sport scuba diving treatment center, he had physicians to monitor hyperbaric treatments but was always available to answer questions or come to the facility to assist the physicians for the treatment of diving casualties regardless of the time of day or night. For the 40 years he treated divers, he personally managed over 500 cases, and his programs treated over a thousand more. Ron, as a diving physician, probably had more personal experiences for handling these problems than anyone else in the world.

While Ron was doing these amazing things on the East Coast, I was doing somewhat the same things on the West Coast at the Navy Special Warfare Group 1 and later under my hyperbaric medicine mentor Dr. George Hart. Dr. Hart fully supported my diving activities and hence, when Ron conducted diving medical programs in the late 1970s in Miami and the Caribbean, I was always “freed” to assist Ron with the academic activities and scuba dive with him between classes. Later, when I began conducting similar courses worldwide, Ron was a welcomed faculty member giving talks on drowning/near drowning, arterial gas embolism, and his extraordinary NOAA experiences treating divers. Naturally, for the scuba diving activities, we were dive buddies and loved to “cruise the environment” rather than remain at a fixed site where other divers would be trying to get the penultimate macro photo of a nudibranch or some other tiny marine animal. We jointly participated in over 20 diving medical programs. Ron always kept us entertained with his humor, his recitations of his anesthesia and diving medical experiences, and his dealings with professional athletes, such as Sal Bando in baseball and Ken Avery in football. Ed Scura an entrepreneurial aqua farmer, Richard Rutkowski a NOAA diving officer, Navy SEAL Richard Marcinko of “Rogue Warrior” fame and Marc Kaiser, NOAA diving officer and Co-Founder the Mercy Hospital’s HBO Facility were also friends and subjects for Ron’s highly entertaining experiences with them. He was always the consummate host when I was in Miami, being a chauffeur, guiding kayaking in the channels of Coconut Grove, ocean swimming in Biscayne Bay and bicycling to Key Largo, as well as taking me to his favorite eating haunts.

While Ron did not profess orthodox religious preferences with an Italian Catholic mother and a Jewish father, he was totally devoted to his family, his profession, and his passion for fitness. His family, with his dedicated wife of 39 years, three children, and three grandchildren were always foremost in his mind when planning activities. Whenever feasible, they traveled with him for hyperbaric medicine meetings, diving programs, and family get-togethers. For his father’s 100th birthday he brought the whole “clan,” 12 in all to Los Angeles for the celebration. Although remarkably fit, Ron had coronary artery disease and stenting done about 10 years ago. Subsequently, he was managed for a head and neck tumor, but unfortunately in the process ended-up with end-stage renal disease, for which he, with his perceptiveness, clarified why the kidney failure occurred.

Ron loved water sports and had over a dozen paddle-type watercraft in his collection. Even with a fistula in his arm, he resumed swimming a mile or more three times a week and also paddled for two to three- hour sessions on his stand-up board. On one kayak excursion Ron paddled from Miami to Key West, Florida. During a recent phone call, he related a very proud moment: he had competed in a mile open-water swim with his son and grandson as swimming companions. Eventually, Ron apparently collapsed following a cardiac arrest, unresponsive to resuscitation efforts, after exiting from a swim at the University of Miami Pool.

Although Ron was not one to write professional papers and renounced “climbing” the academic ladder, his promotion to clinical associate professor at the University of Miami Anesthesiology Department was an acknowledgment of his exceptional clinical skills. Much of what is known today as safe and effective treatment for seriously injured scuba divers was developed by Ron and his colleagues. I am hopeful that the Undersea and Hyperbaric Medicine Society will give Ron the credit he deserves as one of the most experienced physicians in the world for handling severe decompression illness cases. A small token of my esteem for Ron was demonstrated by using his photo (while scuba diving) for the cover of my Diving Science text. I am grateful to have the opportunity to share my recollections of Ron Samson, an exceptional physician, athlete, family man, and in all accounts, a “brother.”

With great respect and reverence,

Michael B. Strauss, MD, FACS, AAOS

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