Aviation medicine came into existence as a recognized entity when certain s
tandards were established during and shortly after World War I.(1) During t
his time, accident rates were high.(2) In fact, a larger number of pilots w
ere dying in accidents than in combat. Figures from Great Britain's casualt
y list at the close of the first year of World War I indicated that for eve
ry 100 aviators killed, 60 died as a result of some individual physical def
ect, 30 from some form of recklessness or careless behavior, 8 as a result
of some mechanical defect in the airplane, and only 2 at the hands of the e
nemy.(3) Aviators were found to be in poor physical condition. Because ther
e were no established regulations with regard to workloads, aviators were f
requently found to have been flying to a point beyond exhaustion. Because o
f workload, chronic fatigue, and emotional stress, aviators were constantly
called upon to perform superhuman feats when not in peak physical conditio
n. Errors in judgement were common. The majority of pilots lost weight as a
somatic sign of stress. This was recognized by Theodore Lister who had rec
ently been appointed as the Chief Surgeon, Aviation Section of the U.S. Arm
y. Such problems were not diagnosed by medical officers because they were n
ot trained to recognize them.
Theodore Charles Lister was the son of Captain William J. and Martha Dought
y Lister. He was an Army "brat" who entered the world on July 10, 1875. His
childhood was spent in various posts around the country. At the age of 7,
Lister contracted yellow fever while living in Fort Brown, TX. The boy was
treated by William Gorgas, a young post surgeon. Gorgas was credited with t
he young boy's recovery. Later, Gorgas was to marry Lister's aunt making Li
ster his nephew by marriage. Having survived the yellow fever infection, yo
ung Lister had a lifelong immunity to the disease.