You gotta figure this guy is really bright to make it through pre-med, med-school, residency, practice, military career, surgical training, etc.
I suspect, though, and I haven't looked at a bio on him, that he must never have commanded. That would have put him in touch.
Beyond that, his innate intelligence should have told him this was a really questionable move on his part.
How do you be around the military that many years and not know this stuff?