UVa's efforts to help service members just latest challenge for this doctor

Dr. Ray Costabile is the senior associate dean for clinical strategy at the University of Virginia Medical Center. What the big title means is that he helps make change happen, what he calls “being an action officer.”

The latest challenge to which he’s turning his years of military experience is a new national initiative to help medical students learn to better treat returning service members.

Costabile, who comes from a military family, joined the military to pay for school. At the time, recruits were hard to come by, and the perks of joining up were substantial. He figured he could underwrite his education (at Georgetown University), serve a few years and get out. As it turned out, a few years stretched into nearly three decades.

He said he took up urology, a highly competitive specialty, because he liked the people working in that area.

“First of all, urologists are really fun people, and they have the best jokes, most of which you can’t print,” he quipped.

He added, “The surgery is elegant, and most of the patients get better.”

(The UVa School of Medicine website refers to him as a pioneer in male infertility, touting his ability to perform, for example, reverse vasectomies.)

But, because he was in the Army, he was also trained to be a general surgeon when conditions necessitated it.

The Army also provided leadership training, which he said he thinks has helped him excel after his time out of the service.

During his time in the military, he spent 17 years, on and off, at the Walter Reed National Military Medical Center as an academic doctor. And then he was asked to help get a mobile hospital ready to ship out ahead of the Iraq war, not that he thought they’d go.

He was, of course, wrong, and he went with them. At the time, he expected to face chemical and biological weapons.

“We were fully [confident] that, at a certain point, as we cross the Tigris and Euphrates rivers, we were going to get slimed,” he said.

It was what was called a combat support hospital and, once set up, the brass just kept adding stuff to it. By the time he left, the 3,000 troops and 300 beds he started with had tripled, he said.

After that, he said, he realized that his career in the military would almost certainly be in administration.

“Old soldiers don’t die,” he quoted a common amendment to the famous saying, “they just go into administration.”

He decided he’d done everything he wanted to do, and came to UVa, where he’d had a fellowship in the early 1990s.

But at UVa, he started getting put in charge of things.

He came up with the non-compete agreement, when the Medical Center decided it needed to get with the times and implement one. His bosses were, apparently, happy with his work, and he got more tasks added, the latest of which is the initiative kicked off recently by the first lady. It aims to have medical schools across the country improve their curricula’s coverage of issues around brain injuries and post-traumatic stress disorder in returning veterans.

The White House wanted a veteran to be in charge of implementing the program, and as a senior associate dean with a 28-year stint in the military, Costabile “stood out like a sore thumb,” he said.

Dr. Steven T. DeKosky, dean of UVa’s School of Medicine, is enthusiastic about Costabile in the role, praising his extensive military experience.

He still gets to spend about a quarter of his time doing research and teaching, he said.

(He’s currently researching ways to improve sperm function in men with low sperm counts.)

He said he likes to be the one charged with turning a vision into reality.

“I’m not in charge of it,” he said. “I’m an action officer.”