Ward Cates Remembered

The passing of a public health hero, trusted adviser, colleague and friend
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Peggy Bentley, Ward Cates and I joined in celebrating the 10th anniversary of the FHI 360-UNC Fellowship program last year.

I use the word “hero” rarely. The word should mean something.

Ward Cates was a public health hero.

As did so many others, I adored, admired and was awed by Ward Cates, who was, to our great fortune, a valued member of the Gillings School’s Advisory Council. As word traveled quickly online and across the School that Ward had passed away March 17, there seemed to be a collective gasp in the universe, a communal Oh no!

I want to share some personal reflections.

Before Roe v. Wade, cell phones and social media

From 1967 to1970, I was part of an abortion counseling network in Ann Arbor, Mich. From our apartments, we counseled women about the pros and cons of abortion, and we kept a running list of doctors who performed abortions, what they charged and how to reach them.

Usually, a woman had to pay upfront, before the abortion. Typically, she was not given anesthetics, because speed was essential to protect medical personnel from being arrested. Women were left pretty much on their own after their procedures. It could be a terrifying, lonely experience and often a terribly dangerous one.

Generations of young women now have grown up in the U.S. without having to seek care from back-alley abortion doctors.

After finishing medical school, Ward Cates joined the CDC’s Epidemiologic Surveillance Unit, where, in 1974, he was responsible for abortion monitoring. Using irreproachable, rigorous scientific methods of surveillance and remarkable innovation, Cates, as reported in Inside the Outbreaks: The Elite Medical Detectives of the Epidemic Intelligence Service, demonstrated that the number of births and abortions were about the same after the Roe v. Wade decision. What did change with legalization was the number of abortion deaths, which declined sharply, from 39 in 1972 to 3 in 1975. (See sidebar.) His extraordinary career was dedicated to saving women’s lives, from the start.

From Inside the Outbreaks

A Safe Bet

insidetheoutbreakscover-001-198x300New EIS officer Ward Cates took over abortion surveillance in 1974. He analyzed data from the Joint Program for the Study of Abortion, a large prospective cohort study of some eighty thousand women. He demonstrated that the impact of the 1973 Roe v. Wade decision had been to move abortions from the back alley to safer facilities, but that the number of births and abortions were about the same. “Legalization of abortion has been accompanied,” he wrote, “by a sharp decline in abortion deaths—almost entirely due to the drop in illegal abortion deaths, from 39 in 1972 to just three in 1975.” Antiabortion activists protested that the CDC was undercounting. “So we offered a bounty,” Cates recalled: $100 to anyone who identified an abortion death not already in their database. “We paid out zero money.”

Cates and EIS officer David Grimes also definitively shattered a harmful myth. Based on a misreading of data, it was standard practice to avoid performing abortions on women thirteen to fifteen weeks pregnant, because it was supposedly unsafe during that time. “Our findings clearly demonstrate that any delay increased the risk of complications to a pregnant woman who wishes an abortion,” they wrote.

A legacy of training new leaders

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Dr. Willard (Ward) Cates, Jr.

Ward Cates was a courageous, charismatic, exuberant and brilliant leader whose positive outlook on life was not dimmed by a devastating diagnosis. He was important to the Gillings School in many ways. Ward, Peggy Bentley and Gretchen Van Vliet began the FHI 360-UNC fellowship   for Gillings students more than 10 years ago, and it immediately became a go-to internship for which students clamored to be chosen. Dr. Cates, who was President Emeritus and Distinguished Scientist of FHI 360, was a member of our School’s Advisory Council, and we valued his clear, knowledgeable and upbeat advice. He had a great sense of where the future of global health is headed and the kinds of opportunities that would be available for our graduates, and we benefited from that .

Ward was one of the first people with whom, along with Peggy Bentley, I broached the idea of adding “global” to our School’s name, and his unequivocally positive response was important feedback. For a number of the Gillings School’s faculty, including me, Ward was a trusted adviser, colleague and friend. For some, that relationship stretched back more than 20 years to CDC days. We are deeply saddened by the void left in the wake of his passing.

Saying goodbye

Ward was indomitable, curious and forever learning. At a celebration of the 10th anniversary of our internship with FHI 360, chronicled in the opening photo, Ward gave me a tour of the wonderful downtown Durham building where they’d moved a few years ago, overlooking the Bulls’ ballpark, a wonderful workspace. We looked out on the ballpark, and he talked openly about his diagnosis and prospects, without anger, sadness or despair. He was looking to the future, however long that would be. That was classic Ward Cates.

In January 2016, in a new year’s letter to our Gillings School community, I wrote about gratitude, based on Oliver Sacks’ posthumous book of the same name:

Eight years after being diagnosed with ocular melanoma, Dr. Oliver Sacks, noted neurologist and writer , learned that his cancer had spread and death was imminent. And yet, he found that the deepest emotion he experienced on learning this news was gratitude for his life. He determined to live his remaining time with purpose, work, friends and family, music, swimming and joy.

A few weeks later, after he’d entered the hospice program, Ward wrote :

Hi Barbara…Sorry I’m so belated in getting back to you… [He’s apologizing to me!?] AW and I were especially moved by 1st paragraph…we’ve lived it…we’re considering our ‘epidemiologists’’ response to Oliver’s poignant messages…

That was one of our last exchanges, and it says so much about Ward’s zest for life and his unstoppable will to live and learn from each day and to share with others. He and a colleague were planning to write about their cancer experiences so others would benefit from what they’d learned. I miss him!

We extend our condolences and friendship to his wife, Dr. Joan Cates, who is a collaborator, colleague and friend of many in the Gillings School, and to their daughters, Deb and  Sarah.

 As one of Ward’s final and intentional acts of generosity, he requested that donations in his memory be made to the Guttmacher Institute, which advances sexual and reproductive health worldwide through research, policy analysis and public education. If you would like to make a gift to honor Ward’s legacy, please click here and select “I would like to honor someone” on the donation form.

Barbara

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