Hello all and Happy New Year!
This week has been exhausting and difficult, yet it feels like the most significant time in military medical career.
On one day this past week I diagnosed a patient with a superficial blood clot in his arm (likely brought on by his arms being the size of a normal person's thighs and wearing an iPod band made for an arm my size while he worked out daily), reduced a finger dislocation that was 90 degrees to the right of normal and generally continued to supervise and be responsible for all of the clinic activities and issues.
The most significant aspect of this week was what happened Tuesday night after those other two patients above. A 20 year old male collapsed (no pulse, not breathing) after running and I was called just after midnight as CPR was ongoing by fire and EMT. I arrived and we administered 2 shocks (5 total for him from an AED) and got him intubated (tube down his throat to allow him to breathe) and got his pulse back. I then rode with him in the ambulance to the local ER, where he was admitted to the ICU. Ultimately, he was without oxygen for 4-6 minutes before CPR was started. He likely suffered significant brain injury, the cause was thought to be an arrhythmia (for the medical folks, he was later found to have dilated cardiomyopathy). After spending the night with him in the ICU, I became the liaison between medical and his unit, as well as talking with his family across the ocean several times per day. I spent time at the hospital each day, around my normal meetings and clinic and other patient issues. I met with doctors and helped to facilitate his transfer via a Critical Care Air Transport Team (flying ICU). I spent 7 hours at the hospital on Friday negotiating his release (basically asking the same question over and over until I spoke to the right person, and then waiting, and waiting, and waiting), and then met the plane that brought the team in at 0230, drove to the hospital, helped them pack him up (they put in an arterial line, a central line and we transferred all of his ventilator and IV tubes in less than 1 hour!) and brought him back to the base. The host nation gate guard (wearing his M-4 machine gun) would not let us back onto base, which led to a standoff for 24 minutes at the front gate. Ultimately, we made it to the flight line and the patient was flying at 0600. I then met and briefed his unit and then went to talk to his commanding officer back home and his parents. Long night...
However, I really felt that this experience (providing medical care, educating his unit, comforting his parents, talking with the medical group, clearing up misconceptions for host nation doctors and military personnel) was amazing. Hard to describe I guess, but I just felt that I could make a huge difference, and I was trying to really live in the moment. The patient has responded to voice, and is on his way back to the US as I write this. Long road ahead, and his full recovery status is unknown, but I felt very proud to be a part of a team that had saved his life.
So, my plan to have the General (Wing Commander) not know who I was lasted about 18 days:) Briefing him 3 times in 2 days changed all of that. It seems that the medical group image had previously taken a hit with the rotation before us, and I hope that this starts to offset that.
I have continued to try to work out as much as possible. I loved the opportunity to skype with Steph and the kids and also my folks and my niece, brother and sister-in-law over the holidays. I hope that you all had the opportunity to connect with your loved ones as well.
Happy 2012 to you all. Stay safe. Thank you for the love and support that you have given me and especially Steph, Brayden and Sophie during our separation. Steph would love to hear from you at: stephkwhite@yahoo.com if you get the chance.
I, of course, would love to hear from you whenever you get the chance.
Love,
Chris
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