MCMS Physician Fall 2017 - 10

mon t m e d s o c .c om

Serving Our Nation's Heroes

continued from page 9

patients are the critically injured - typically intubated and on
multiple IV meds.

altitude, 30,000 feet, things were usually quiet enough to be able
to take a short break.

Around this time in my career, I was accepted into the training
matrix for CCATT. In order to keep up with critical care, I
arranged with my colleagues at Lansdale Hospital to allow me
to make rounds in the ICU with them. I quickly realized that
this did not provide the level of acuity that would be necessary,
and was able to make similar arrangements with the intensivist
group at Abington Hospital. After completing additional training
at Brooks Air Force Base and Camp Bullis in San Antonio, I
attended the CSTARS program at the University of Cincinnati
for final training and validation. There we performed simulated
missions in a mockup of a KC 135 tanker plane. We spent
hours in the equipment lab becoming intimately familiar with
transport ventilators, IV pumps, defibrillators and ventricular
pressure devices. I worked in a team with the nurse and respiratory
therapist and we each learned basic components of each other's job
so that we would be able to cover as necessary.

Upon arrival at Andrews, we would exit the flightline for
the 45-minute trip to Walter Reed. Unlike the ambulance trip
in Germany, this route was on a major highway at the height of
rush hour, so there was a lot of stop and go, swerving and loud
sirens, which often created difficulties in maintaining lines and
airways. After delivering our patients to the ICU at Walter Reed,
giving report and completing our paperwork, we would return to
Andrews for dinner and a chance to finally sleep after a 22-hour
mission. Although we were fairly well-exhausted, we had a sense
of accomplishment that was more than anything I have ever felt
before.

In June 2012, I flew to Ramstein Air Force Base, Germany, to
begin my first active-duty deployment. Our assignment was to fly
critically-injured service members who had already been evacuated
to Landstuhl Army Medical Center from Ramstein to Andrews
Air Force Base in Washington, and then transport them to Walter
Reed Military Medical Center at Bethesda. Since this was a short
deployment (one month), I was able to do some shifting of
appointments with my regular patients, and tried to make sure
that all routine preparations were made before I departed. I was
extremely fortunate to also have partners who were willing to pick
up some of the extra work that this created. Our EMR also let me
handle routine review of labs and test results from halfway around
the world.
During my month in Germany, I flew three missions in
rotation with three other active duty teams. A typical mission
day would start with our arrival at Aeromedical Operations at
0600, where we would prepare our 450 pounds of equipment,
worth a quarter million dollars, for flight. We would then travel
from the flightline to the hospital at Landstuhl, a trip of about
20 minutes. Upon arrival at the ICU, I would make final rounds
with the staff on the patients that we would be transporting,
usually no more than three. During this time, my nurse and RT
would begin packaging the patients for transport. This would
involve changing over to our transport ventilator and IV pumps,
and getting the equipment situated on the litter. We would pack
up any medications or blood products that were required, and
then transport them back to the flightline. Since our patients
were the sickest, they were loaded last on, first off. After hooking
up to the plane's internal power and oxygen, we would set up a
portable ICU in a dark, noisy and dusty environment, and make
sure our patients were stable for transport. Takeoff and landing
were always our nervous times, when the patients were subjected
to considerable movement and pressure changes. Once we got to

I returned home a month later to a warm welcome from both
my family and office staff. Having just done something totally
different from my usual activities, I felt refreshed and ready to
get back to the routine. Ten months later, I found myself back in
Germany on my second deployment, also one month long. As
I was in billeting getting my room assignment, I ran into one of
the downrange teams from Afghanistan. Amusingly, it turned out
that the nurse on the team had been my patient when he was a
child. Two thoughts occurred to me - one, that it is indeed a small
world and two, that I was getting old.
I flew an additional three missions during this time, and
occasionally patients' family members would accompany us on
the flight. We would have some time to talk and learn more about
our patients and I could tell them how honored I was to be able to
care for these heroes.
Four months later, I returned to Germany, having responded
to a short notice request to deploy for six weeks. Unlike my
previous deployments, however, the active duty CCATT teams
were short-staffed due to recent rotations. This meant that we
would be forward deployed to Bagram, Afghanistan. My first
mission went to Bagram, then Kuwait and back to Germany,
lasting a total of 54 hours.
Arriving back at Bagram on Christmas day, the base was on
heightened alert because the Taliban liked to attack on religious
holidays. It was a somewhat surreal experience having a holiday
dinner in the dining facility that was decorated for Christmas,
while wearing my full "battle rattle" (body armor). Later that
night, while I was Skyping with my wife, part of the base actually
did come under attack. We heard a few thuds, and the sirens went
off and immediately everybody grabbed their helmets and ducked
under the desks. Thankfully the rest of my time was uneventful,
and I ended up completing a total of five missions. I have not
deployed since January 2014, as the CCATT mission activity has
decreased dramatically, and an additional mission has kept me
busy.
One of the differences between the Air Force Reserve and the
Air National Guard is that the Guard, being state chartered, has a

M C M S P H Y S I C I A N 10 F A L L 2 0 1 7
https://www.montmedsoc.com/
Table of Contents for the Digital Edition of MCMS Physician Fall 2017
