How to Stop a Cannon

Resonance is a student-run podcast aimed at showcasing the science at Baylor through the eyes of young professionals. Each episode is written and recorded by students who have a passion for research and the medical community. Guests on the show include both clinical and basic science research faculty who are experts in their fields.

Dr. Francis Gannon describes how he became involved in helping create body armor for US soldiers, and how body armor is designed and tested. We'll talk about the impact of this technology on our troops and how this information is protected.

Brandon: And we're here.

Erik: And we are here. This is the Baylor College of Medicine Resonance Podcast; I am one of your hosts, Erik Anderson.

Brandon: And I'm another host, Brandon Garcia.

Jennifer: And I was the writer for this episode, and I'm Jennifer Deger.

Erik: And we are going to be talking with Dr. Francis Gannon later in this episode about body armor that he has helped design, but we were gonna first start by just talking a little bit about what the history about body armor is.

Jennifer: Yeah, so today's story starts with a snail.

Brandon: A snail?

Jennifer: A snail.

Brandon: Why a snail?

Jennifer: So, there's a snail that scientists discovered pretty recently in 2001 that has evolved an iron shell to protect it from the extreme heat of the hydrothermal vents at the bottom of the Indian Ocean where it lives. That snail is just one example of animals evolving an amazing form of body armor and something that humans have been trying to copy. From Turtles and dinosaurs to porcupines and snails, humans have been trying to figure out how to protect themselves by copying them or in some cases taking animals protection physically from them. For example, the ancient Chinese would hunt down full-grown rhinoceroses and kill them and then wear their hides as armor, which was effective but yeah...can't imagine what it would have been like to hunt down a rhino in ancient China. And then another example of body armor that's kind of infamous is this outlaw in Australia whose name was Ned Kelly. And he was notorious for kind of copying the medieval suits of the knights in shining armor would wear head-to-toe steel armor he didn't do head-to-toe, but he had body plates made of steel for himself and r his gang members. But they eventually did die in a police shootout.

Erik: I couldn't imagine how wearing a full steel getup in Australia would go down the heat alone would be unbearable.

Brandon: Yeah, you sure they did it for just protection against the police or against a giant tarantulas.

Erik: Yeah, and kangaroos.

Brandon: Yeah, be careful, take that kangaroo jack.

Jennifer: Oh yeah, and the next big advancement in body armor was actually in World War II when ballistics vests came into existence, and really we've been using the same technology since then until one of our faculty members Dr. Francis Gannon helped with this project to make something called the interceptor body armor and it's helped save thousands of lives. It was first tested in Kosovo and seems to be pretty effective.

Erik: Wow, well looking forward to hearing more about this from Dr. Gannon, and Dr. Francis Gannon got his medical degree at Jefferson Medical College in Philadelphia and also did his internship and residency at Thomas Jefferson University Hospital in Philadelphia. So here we go, here is Dr. Francis Gannon.

Jennifer: Hi Dr. Gannon.

Dr. Gannon: Hi, Jennifer.

Jennifer: Could you tell us about your training as a pathologist?

Dr. Gannon: Sure. So, I am a pathologist, and pathology is the study of diseases. I am trained to help clinicians diagnose diseases through tissue, or fluids, or other manners. Pathology is broken down into anatomic pathology and clinical pathology. And the easiest way to visualize that I think is in general—there may be some pathologists who say why didn't he describe it more—but for the general listening audience if you get a tube of blood drawn when every time you go to the doctor that heads on over to clinical pathology. If you have a piece of tissue, skin, or whatever taken out by a surgeon that's going to go towards anatomic pathology. So, we trained for four years and then do a fellowship or two depending upon our likes and what we gravitate to, but that's the most basic way I can break it down. Since this is not about describing pathology, I'll just leave it at that. I went to Jefferson Medical College. It's now called the Sidney Kimmel Medical College, I believe.

Erik: In Philly?

Dr. Gannon: In Philadelphia. And I did the typical two years of preclinical sciences, as I mentioned I didn't like pathology, in fact, I hated it. But for family reasons, Jefferson had just started a program called the post sophomore year in pathology, and that's where ...it's still current in fact Baylor has it. You can take a year out between second and third year of medical school, and you do a year of pathology, at that time it counted for a year of residency. And when I started the year, I absolutely fell in love with the practice of pathology, because the practice of pathology is so very different than just sitting in a class and reading Robbins or Reuben Farber or things like that. You get to do things, you get to do procedures, there is an intellectual challenge, it's always different every day, it's fabulous, and you get to do a lot of teaching and research and things like that. Halfway through that year, the post sophomore pathology, an attending came over from the University of Pennsylvania who was a bone pathologist, and he was absolutely larger-than-life and started teaching bone pathology, and I said that is what I want to do. I finished medical school, got into a residency at Jefferson at the Thomas Jefferson University of Hospital, kept learning about bone pathology, doing research, I finished my residency, and the University of Pennsylvania recruited me to their practice where I was for four years. I was a general surgical pathologist, so surgeons took things out we told them what it was, but I specialized in bone pathology and was working with quite a number of researchers at that time. And then the Armed Forces Institute of Pathology recruited me and that was a national referral center, and I spent the next eight years there doing bone pathology, that's all I did every day, and it was just fantastic. I learned more than I thought that I could ever learn about that. And so, then I got recruited to Baylor College of Medicine, again for the bone pathology expertise, and that was 13 years ago, so I've been in Texas with my family since then.

Jennifer: Wow, do you want to tell us how you got into teaching at Baylor?

Dr. Gannon: Sure, I have loved teaching since I was a medical student. When I was a resident, I helped to teach in Jefferson Medical College, and at Penn, I helped taught. It's just something that I'm drawn to; I enjoy teaching. And then when I got to Baylor, I was busy with a number of grants and other things, and I'm not exactly sure I mean in retrospect that have been clear to me that people would watch me talk and have all of this energy and...a pathologist by the name of Vicky Gresik who was the former long-term pathology teacher said, you know Frank I'm stepping down we would love you to take over this introductory pathology course. And I...I mean I just I love it, I love seeing the light bulb that goes off over students' heads when they say, ahh...

Erik: Eureka?

Dr. Gannon: Right. So that's been my bent is to try and make this overwhelming amount of material that's flying at you all and put it into a schema that you can connect the dots, and I also you all know I love telling dad jokes, that makes things fun so for me. It's the privilege of being able to help encourage and uplift the coming generations of physicians.

Jennifer: Shapes and colors!

Dr. Gannon: Oh, yeah, since you remember that can you tell people?

Jennifer: Yes, I remember like ...it's very intimidating when you're in a lecture hall, and the lecturer throws up an MRI or something, and they're like what do you see here? Tell the whole class! And I was just like I see a circle of gray, and you'd be like that's great, that's awesome. You're so smart! But I really appreciate that like, everyone thinks medical school you're right you're just gonna be insulted by your superiors the whole time.

Dr. Gannon: Which you can be, but if you break things - if you break complicated thoughts and facts down into simple building blocks, like, is it a purple rectangle? Then you say at least I know that and I'm not afraid then to ask Dr. Gannon or whoever's teaching, I see that purple thing but what's the yellow...? Like it takes away the fear of asking that, and that's a large step towards successful maturation, being able to say it's okay if I don't know something because someone's got to help me.

Jennifer: Definitely.

Erik: Would you be able to talk a little bit about the workload like the work that goes into designing a course because obviously, it's... I'm sure it's not minimal.

Dr. Gannon: Sure, I will tell you that the two people that were and I will answer direct...the two people that were instrumental in helping me learn this were Dr. Clay Goodman, who you all have had for neuropathology, and then Dr. Jennifer Christner who is the new dean of the medical school. Both of them really refined my ability to run a course successfully. To teach, maxim is for every hour of teaching you need about three to four hours of preparation, and that's actually true. Because you're looking at your slides, you're reading new literature. You're trying to see, do the students, do they really need to know the cutting edge or do they need to know...? And because, as you all know, it's an art being able to hit that line between too much and too little. But then designing and running a course there are whole other layers on top of that. Test questions, the administrative meetings, making sure the lecturers show up on time. So that's about 50 to 70 hours of extra work before the course starts, and then there's 20 to 30 -ish hours after talking about, what could we do better? How do the students feel about this? So being a teacher is great, but it's often a lot of unacknowledged effort that I mean the teachers here at Baylor are superb by and large, and that's because they put...they're so dedicated, and the deans are so dedicated to making sure that it goes off without a hitch.

Erik: Yeah, no doubt it's the reason we're ranked so highly.

Jennifer: Definitely.

Erik: Maybe it doesn't always come through with our feedback! But we students do appreciate it.

Jennifer: Yeah, I think you were one of the best lecturers, I just wish you lectured more! It was like only two.

Dr. Gannon: I did so. Up until your year I taught 56 of the 70 hours, so I taught most of the course. But because I transitioned my job to something different. Plus...and thank you for the compliment that's really appreciate, but I'm a firm believer in bringing in new people, giving them examples, so there needs to be someone new that can learn and develop their own style.

Erik: Well, and as a shout-out to Dr. Goodman, maybe we can get him on the podcast someday, he's also been great as you said, and so it and it's no doubt in my mind that he would be a good mentor for anybody because his ability to kind of distill down, like you were saying, complex concepts into...even just 20 slides it's very much appreciated on the students.

Dr. Gannon: Oh yeah, and on that note, he's got amazingly good stories, if you can get him.

Jennifer: How did you get to the position of designing body armor in that specific assignment?

Dr. Gannon: That's a great question. I was working out of the Armed Forces Institute of Pathology, which was started at the end of the Civil War by Abraham Lincoln to study battlefield injuries to help surgeons and other clinicians treat wounded soldiers. It then became a pathology Institute and was known worldwide for its expertise. And so, an orthopedic surgeon came, her name was Marlene DeMaio, while I was there and she had realized that the armor that our troops wear doesn't really protect them, so we started to look at that and see if something better couldn't be designed.

Jennifer: And you won a Civilian Service Medal for that right?

Dr. Gannon: I did, I did.

Jennifer: As well as some other things that we'll talk about in another episode.

Dr. Gannon: Thank you for asking. It's the second-highest medal that a civilian can be awarded because the armor is currently what our troops wear, it's called the Interceptor plate, and it has saved tens of thousands of lives and it's something that it was quite a moving thing to be of service in that way.

Erik: How do you test the body armor? Do you like use ballistic gels or...yeah just curious how one goes about verifying this kind of stuff?

Dr. Gannon: Sure, another good question. Um, in the 1970s the Department of Justice, oh, and it may not sound like I'm answering your question, but I am. In the 1970s the Department of Justice had funded a study to look at stopping nine-millimeter bullets, which was the most common type of projectile in the United States at that time. So, a clay dummy the size and shape of a human was made and a bunch of different substances and textiles and things were wrapped around it, and it turned out that Kevlar could stop a 9-millimeter, and slightly higher caliber bullets, which is why police and other people wear Kevlar armor. It's very good at stopping mostly what we see. However, in combat the NATO standard round, I'm holding up my fingers here, it's about three inches, I could be off on that but...but it's very large and the AK-47 fires a similar thing, and it travels at twice the speed of sound. So, it's gonna go through Kevlar like crazy, so there were a number of things that...a steel plate can stop a bullet, but it weighs a huge amount. So, the team, there was a team of six people led by Marlene DeMaio, who I mentioned, who is an orthopedic surgeon and a brilliant woman, started looking at things like ballistic gels and things like that. But the human body doesn't work that way. So we got...we went through a huge amount of permissions and I mean all the regulations were followed, but we used human cadavers, and it turns out that there's a plate underneath the interceptor plate that if you take away the ceramic porcelain part of it and you fire a NATO standard round, what happens is that the amount...it stops the bullet, but the pressure that is released...we saw deviations of the sternum up to 2 to 3 inches. If you can just imagine, and then it would shatter, and it was like emptying a shotgun into a chest. It ruptured the aorta, the pulmonary vessels, ripped through the heart and the lungs, so the secondary projectiles from the actual bone were ...the steel plates weren't effective in that so there had to be something before that that could shatter and diffuse the stress. So, if you're hit with a bullet, it's gonna feel like you're hit with a baseball bat, but you can walk away from it.

Erik: Can you only be I know, or I'm maybe it's just for movies, but with Kevlar, you can only be shot it only works with one bullet, though right? And after that, the tension is released in it? Is that true with the body armor that you designed?

Dr. Gannon: It's the same, yes, and a lot of people ask me why we can't do the same thing for a helmet? And we can. The problem is the helmet will stop the bullet, but the rotational force will snap your neck so unfortunately, that's a problem that hasn't been solved yet.

Erik: Wow.

Jennifer: Jeeze, well to the extent that you can talk about it, could you tell us about the technology behind like something that's light enough to wear but that can't actually stop a bullet of that force and that size?

Dr. Gannon: So, I can't talk about that specifically for two reasons...one, I don't know because I wasn't involved in the polymer polymerization, but I think it is proprietary knowledge. I just know it was it scatters the stress, that I can say.

Jennifer: Okay.

Dr. Gannon: So it weighs, I think it weighs about forty or forty-five pounds, I can't remember, but so if you can imagine our brave servicemen and women, they've got a pack, they've got this I mean, they're carrying a lot of weight but they're now walking away from injuries that would have killed them.

Erik: Wow, that's amazing. So, was your hand in this mostly because you are a pathologist...kind of telling them more about the physiology behind what happens when somebody has a bullet wound?

Dr. Gannon: Yes. So it was that, but it was mostly how the bones are reacting to the stress, and then I did the analyses on the ribs after

Erik: On the cadavers?

Dr. Gannon: Correct, to rule out that there wasn't osteoporosis as a cause of fracture or what was actually happening, and so and then I would talk with Dr. DeMaio about what was going on and the team and so I didn't realize it at the time because I just say I'm a pathologist, I'm just doing my job, I didn't realize it would be as effective or something that I would look back on and say I...I'm really fortunate to be able to serve the country and those that defend it in this way.

Jennifer: Yeah, it's an amazing job to do. I think you answered our next question about this technology so if you want to ask-

Erik: Oh yeah. Yes, so how then has his armor impacted our troops? I assume it's probably decrease casualty rates?

Dr. Gannon: Yes, and it has, and it's hard to get those numbers. The last time I looked was I guess four or five years ago because it's hard to prove a negative, meaning I survived, but I don't know if I would have if I didn't have this. We do know that for those people that are hit and can walk away, and Time magazine did a piece on this, and a number of the national news media did small pieces on this several years ago talking to servicemen and women who had said, yes, I lost my arm, but the chest plate stopped...I'm alive at least now. So, we have that kind of data to look at, but no I don't know if anyone's keeping specific numbers about that.

Erik: When did that start to get circulated into, I guess the current armor that our troops wear?

Dr. Gannon: Sure, it was first fielded in Kosovo back in the 90s or late 90s and then in every conflict since then so if you see stories, and I've seen stories of service people in Afghanistan and in that area saying you know we didn't get body armor or my family raised money to get me a set...this is what they're talking about.

Jennifer: Do you know what made them want to design better armor? So, they sought you out, and they were like, hey can you come help with this? Was there like a world event that happened at that time that they were like, we need to improve our protection for our soldiers? Or...?

Dr. Gannon: A great question. This all came from Dr. DeMaio, who I mentioned. She is just an unbelievable orthopedic surgeon, and most of the injured battlefield injuries and things like that have some sort of orthopedic component to them, and so that's what started her thinking...you know this Kevlar armor, you may as well be wearing a wool sweater with what they're up against. And so that's where she got the idea maybe we can build something better.

Jennifer: Right, it seems like there's kind of an arms race between like the shield, and then the bullet, and then the bullet gets more powerful, and then you have to make a better shield...and then they invent the hydrogen bomb, and nothing can protect you from that, not even 3 feet of concrete!

Dr. Gannon: Exactly.

Erik: Do you know why they closed the Institute?

Dr. Gannon: I do. It was run by the Department of Defense, and it's a much longer story but to run the Institute cost about a hundred million dollars a year and so pathology there was sort of an accounting, and it's fine. Everything runs its course, and I'm really fortunate to have been there and learned what I've learned.

Erik: Well and there's still I know a lot of research going on, so I'm curious because I know Walter Reed is now, I don't know, there's a camp like they consolidated everything?

Dr. Gannon: To Bethesda.

Erik: Bethesda, okay so when you were there it was still in Washington DC?

Dr. Gannon: It was yeah, and I would consult in Bethesda and then teaching them the Armed Forces medical school there, but they collapsed everything.

Jennifer: Does the U.S. collaborate with allies to share this technology? Or is it all just like some lockdown?

Dr. Gannon: That I don't know.

Jennifer: Okay.

Dr. Gannon: Good question, but unfortunately, I don't know.

Jennifer: Did you have to sign away you’re like I will never speak of this?

Dr. Gannon: For a time, it was classified, and actually the other thing that we'll end up talking about for a time was classified as well, but it's been opened up. But there are certain things that I just don't know about because I wasn't part of that the team.

Jennifer: Do you know about the cost of each vest? I know that's probably separate too.

Dr. Gannon: I don't.

Jennifer: But I would imagine it's very expensive, just per vest, and since they're kind of just one and done also.

Dr. Gannon: Well, the backplate you can keep using. It's the ceramic that once it's but a good example, it's an inexact example, but a good example would be a bike helmet, and so when I'm riding my bike if I fall over and hit it then you have to replace it because the inside to the padding. Yeah.

Jennifer: Yeah, kind of surprises me that it's ceramic.

Dr. Gannon: But it's interlaced, so you get that hard. So, if you think about your trabecular bone, trabecular bone has metabolic capabilities, but also it takes stress from the cortical bone and diffuses it and splits it away, so that's what this does. It's not a solid ceramic plate.

Jennifer: Our last question is a little bit more philosophical, so we're talking about body armor, and stopping bullets and everything. So, what do you think about the solution of just not having the war in the first place? Or not having the violence in the first place? Because of course we need to protect our own, but ideally it wouldn't come.

Dr. Gannon: So that is an absolutely fabulous question and one that I'm only going to be able to give you my opinion and how I see things, and I would prefer if there were no wars and the consequences that come with it. Because it's not all as we're seeing in the news ...it's not only the death and destruction on the battlefield but in war-torn areas now, I mean Dr. Hotez points out that Yellow fever, Dengue fever, Polio, measles, there are outbreaks that are catastrophes that are happening because of the effects of combat and war. I do believe in a strong defense, though. I believe that Teddy Roosevelt saying walk softly but carry a big stick is something that that I strongly believe in. That we should have a strong defense and we should honor all those who serve and things like that, but the human heart and condition is what it is, and there are always going to be people who want to take things by force and subjugate other peoples. And so...for me, war if used to help people, it's a thorny issue because you end up hurting some people, but standing for something the way the United States does is what I believe in, without being aggressive and trying to hurt other people is where I stand on my own life.

Erik: Yeah, that's a great answer, and I think you're right; it is definitely a thorny issue. Obviously, if we could have peace...war, what is it good for?

Dr. Gannon: Absolutely nothing.

Erik: Cool, well, thank you so much!

Jennifer: Thank you. It was very interesting.

Dr. Gannon: Thank you, thank you for having me.

Erik: All right, that is it for now. We would like to thank everyone out there who took the time to listen to this episode of the podcast. Special thanks to Jennifer Degerm for writing the episode. Thank you to our faculty advisor Dr. Poythress for helping us put everything together. Thank you to the Baylor communications department for help with the production. And thank you again to Dr. Gannon for taking the time to be interviewed by us. We hope everyone enjoyed it and we hope you tune in again soon. So, goodbye for now!