Professor of Medicine Charles Carpenter - admired for his humility, compassion and unassuming demeanor - received the Robert H. Williams Distinguished Chair of Medicine Award, the nation's top award in academic internal medicine, March 3. The award recognizes Carpenter's 51-year career in medicine - teaching students, chairing departments of medicine and endeavoring to help the disadvantaged through medicine.
The award is presented annually by the Association of Professors of Medicine to a "distinguished physician who has demonstrated outstanding leadership as a current or former chair of a department of internal medicine," according to the APM Web site.
Carpenter is widely admired for his teaching ability and patient interactions. "He teaches his fellow physicians medical care and how to deal with patients," said Kathleen Hittner, president and CEO of Miriam Hospital, where Carpenter was physician-in-chief from 1986 to 1998. "His interaction with patients is remarkable - he has an ability to communicate with patients in words and expressions they can understand."
"He is an incredibly generous mentor and a remarkably humble person given the magnitude of his achievements and the impressiveness of his international reputation," said Assistant Professor of Anthropology Daniel Smith, who works with Carpenter to improve treatment for HIV patients in Nigeria.
"(Carpenter is) a real humanist who really cares about people and about the consequences of injustice and inequality, and he (is) inspiring to see for me and for his colleagues," Smith added.
After graduating from Princeton University and attending the Johns Hopkins University Medical School, Carpenter's career began with an internship and residency at Johns Hopkins Hospital.
After completing his residency, Carpenter had aspirations to work abroad. "My wife and I decided that we would work overseas," Carpenter said. "It was 1961, and we went down to Washington to join the Peace Corps. However, they would not take couples, and so I came back to Hopkins and asked my chief to see if we could go overseas. He suggested Calcutta."
Carpenter arrived in Calcutta - now Kolkata, India - in the middle of a widespread cholera epidemic. While working in a hospital on the edge of the city, it became clear to him that proper hydration for afflicted patients was one of the biggest obstacles.
"These people just needed fluids to survive. However, there was no water without (fever-causing) pyrogens. People who had over a liter or so of fluid would get fever and chills, and some patients needed over 12 liters per day," Carpenter said.
Between 1962 and 1964, as director of the Johns Hopkins Research Program in Calcutta, Carpenter successfully implemented a method of oral rehydration that allowed patients to ingest filtered fluids free of pyrogens. Though Carpenter left in 1964 to become the director of the division of allergy and infectious diseases at Hopkins, his program would continue to fight cholera in Calcutta for another decade.
Carpenter moved to Ohio in 1973 to take on the posts of director of the department of medicine at the University Hospitals of Cleveland and professor and chairman at Case Western Reserve University. He came to Rhode Island in 1986.
"After 13 years at Case Western Reserve, I wanted to do more patient care and treatment and less administrative work. Brown's program was very young, and it seemed like a very exciting place to come to," Carpenter said.
Carpenter was appointed physician-in-chief of Miriam Hospital in 1986 and established the immunology center there the following year. " 'Immunology center' is actually a euphemism," Carpenter said. "It is an HIV clinic, but to call it that at the time would have been a stigmatizing thing. At that time, in the mid 1980s, HIV was pretty stigmatizing. It still is, to some extent."
Carpenter began his work with HIV because he felt that - like cholera - it was another serious problem not being addressed adequately. "I started seeing people with HIV infections when I moved to Rhode Island, and so began research. We worked pretty well with that and with the community to get rid of obstacles to effective treatment. Because of (the) small state size and eager legislature, we have been able to do a great deal," he said.
In the 1980s, Carpenter worked to reform and improve HIV treatment as well as extend treatments to communities where it was not typically provided. These outreach efforts included Rhode Island's poorer communities and the state prison system.
"At one point, one of my earliest HIV patients was imprisoned. The guards had her in a bright orange jumpsuit that had 'biological hazard' written on the back. This inmate was discharged several days later, but other patients were infected and similarly mistreated," Carpenter said.
Carpenter's HIV research continues today. Currently, he said, he is working to develop a microbicide for women in Africa to use to protect themselves against HIV.
"The idea behind this is that, in the areas of densest HIV in Africa, the vast majority of transmission is heterosexual, and females have no way to force men to use condoms," he said. "This method will allow women to protect themselves and their partners without needing to force their partner to use a condom."
But despite his global work and research, Carpenter said he gets the most satisfaction from training interns and residents. "You see what they accomplish, and they stay in touch with you for years. It's wonderful to hear from and watch these guys and girls and see how they handle their medical careers."
