Remembering Dr. Paul Ambrose

There are many sides to every story and the story of Dr. Paul Ambrose is no different. The loss of Ambrose, who was on board American Airlines Flight 77 when it crashed into the Pentagon on Sept. 11 last year, is perhaps best summed up by his friend Chris Durso, who says, “I can’t be the only person right now who feels that he lost a brother. Or rather, two brothers: a trailblazing, peculiarly wizened older brother and a goofy, idealistic younger brother—all in one.”

That goofy side—full of charm and a zest for new experiences—may have earned him an upgraded hotel room or an invitation to go behind the bar to compete in a margarita-mixing contest with the bartender every now and then, but it also helped him in his health policy career. Ambrose used his charm to work the health policy system to his best advantage, racking up accomplishment after accomplishment in his short but wildly successful life.

A native of Huntington, West Virginia, Ambrose stayed close to home for medical school, graduating from Marshall University School of Medicine in 1995. While there, he became active with the American Medical Student Association (AMSA), landing the job of AMSA’s legislative affairs director in 1995.

It was at AMSA where he really began to flex his health policy muscles. “He had such a command of health policy that most people would be jealous of,” says Dr. Paul Jung, a friend who met Ambrose through AMSA. “Very few people are successful with health policy. He knew that knowing this policy exists is not enough—you have to know what to do with it.” And he wanted other medical students to understand this as well.

That’s why Ambrose created AMSA’s Political Leadership Institute, Jung says. The institutes, which AMSA renamed in Ambrose’s honor, are annual weekend sessions that use lectures and role-playing examples to teach medical students political advocacy skills.

“He wanted to do things bigger,” says Dr. Travis Harker, a medical resident who is one of Ambrose’s many mentees. “He really wanted to see if he could move the whole system forward.”

After earning his medical degree, Ambrose went on to do a family practice residency at Dartmouth Medical School. He had wanted to enter a residency program with a health policy component, but none existed at the medical school at the time. So Ambrose, in his typical fashion, created his own health policy learning experiences and began to forge a close relationship with former Surgeon General C. Everett Koop, eventually bringing Koop to Marshall for a presentation on public health and preventive medicine and home for supper at his parents’ house. The story goes that his mother burned dinner that night. Later, Ambrose worked with Dartmouth in his post-residency years to form the public health and family medicine program in which Harker now participates.

Ambrose was successful at meeting new people and making things happen. Jung recalls the first trip the two took together: the annual meeting of the Nonprescription Drug Manufacturers Association (NDMA) in Colorado in 1996 at which Ambrose wanted to lobby the NDMA for some project funding. Using his powers of persuasion, Ambrose was able to get the organizers to pay for everything from a side trip to Pike’s Peak to the buffalo burgers he and Jung ordered from room service. “So technically, they were paying us to lobby them. Only Ambrose could swing a deal like that,” Jung says, ruefully noting they didn’t get the project funding.

But Ambrose may have reaped something better. At the conference’s black-tie banquet, Ambrose spotted keynote speaker Mario Cuomo across the lobby. “He says, ‘Hey, there’s Mario Cuomo. Let’s go talk to him,’” Jung says. “And I said, ‘You can’t do that. He’s the [former] governor of New York.’” But Ambrose paid no mind to his friend, sauntering up to Cuomo and asking him about his flight. “Just regular elevator talk,” Jung says. “We wound up getting some great pictures with some very important people.”

Jung says tales like the ones from Colorado tell the real story of Paul Ambrose. “[His versatility is] what made Paul Ambrose. When you first looked at him, he looks like this really hip surfer dude, but after awhile, you realize this isn’t some punk guy. He could talk to one person about health policy, and then he could go talk to someone else about astrophysics.”

Which may have been one reason Ambrose earned himself so many admirers in so many fields. Erin Fuller, a former AMSA colleague, says Ambrose made friends with a librarian friend of hers at a New Year’s party, talking for hours about the First Amendment. He also bonded with Fuller’s younger brother—they liked the same alternative heavy metal bands—and her venture capitalist husband, with whom he enjoyed discussing financial issues.

“One of the amazing things about Paul is that he could move very easily between those…worlds,” Harker says.
Fuller says being able to succinctly describe Ambrose has always been difficult for her. “This is my friend Paul. He watches crazy movies; he climbs rocks; he listens to Goth music; he’s a doctor.” It’s the doctor part that makes her chuckle, given everything else Ambrose was into. “I always looked at it as one of his crazy hobbies.”

Hobby or not, being a physician was his calling. After residency and earning a master’s degree in public health from Harvard University, Ambrose landed the competitive Luther Terry Fellowship from the Association of Teachers of Preventive Medicine, which gave him the opportunity to work in the Office of Disease Prevention and Health Promotion (ODPHP) at the Department of Health and Human Services (HHS) in Washington, D.C.

Ambrose was put to work as part of the team writing Surgeon General David Satcher’s “Call to Action” on obesity. “As he worked on this project, he really began to take a professional interest in it,” says Kathryn McMurry, an ODPHP nutritionist who worked on the call. “He took what he was working on and put it into practice.” Which would explain the giant bottles of protein powder and vitamins in Ambrose’s office. The free weights he kept there were so big, McMurry says she doesn’t know how he got them there.

“We thought since we were working on [HHS initiative] Healthy People 2010, we should live Healthy People 2010,” says Harker, who also worked at ODPHP and calls Ambrose one of the best attendings he’s ever had. The two went to the gym daily, and when they couldn’t, they did curl workouts in Ambrose’s office.

Ambrose’s physique and good looks were legendary—and his friends say he played them up. “He took longer to get ready than anyone else I know,” says Durso, who compares traveling with him to traveling with his wife. But friends were accustomed to waiting for Ambrose. Anyone who went with him to lobby at the Capitol had to allow for extra time at the metal detectors so guards could check the steel-toed boots he wore everywhere and with everything. “He had very definite fashion phases,” Fuller says. “He was in his Donna Karan phase…last year.”

As a consequence of all that waiting and primping, Ambrose was rarely on time. The fact that he arrived on time for the flight to Los Angeles on that early September morning is the great irony of his death. “He was very much looking forward to [the obesity conference he was traveling to],” McMurry says. “He’s always late, and this is the one time he was on time for the airport.”

And while his HHS job ended up being the last move in a promising career, friends and colleagues say Ambrose’s on-target mind and dazzling charm could have taken him anywhere. This was supposed to have been only the beginning. “He was just so far and away more capable than any of us ever were,” Jung says.

“Paul Ambrose would have been surgeon general” is a phrase many friends and colleagues now speak with a melancholy wryness that captures the tragedy of this particular Sept. 11 loss. “He was a fantastic physician leader,” Fuller says, “and he would have been surgeon general, but he was so many other things.”

Durso and Harker both heard Ambrose talk about his ambition to become the public health commissioner for West Virginia, while others say they knew he never wanted to get too far away from the family medicine he practiced three days a week at a clinic for Spanish-speaking patients outside of Washington, D.C. Friends say one of Ambrose’s strengths was his ability to work the system. “Paul would have taken advantage of whatever options were in front of him,” Harker says.

We can almost be assured that those options would have been many. At Dartmouth’s memorial service for Ambrose, Koop told a story about a letter he wrote to Sen. John D. Rockefeller IV (D-W.Va.), telling him to keep his eye on Ambrose—the senator’s homegrown rising star. “We already know about Paul Ambrose, and we’ve been keeping our eye on him for some time now,” Rockefeller wrote back. It is in Ambrose’s death that the rest of the world now sees what Rockefeller long had recognized.

“People may have been put off by his initial appearance, thinking he was more style than substance, but anyone who talked to him for more than a minute knows that wasn’t it,” Jung says.
Fuller agrees. “He was…the real deal.”