Doing Double Duty (continued)
It’s not just a job, it’s an
adventure
Before the ambulances ever rolled into
Baghdad, Lee and his unit had more than a little taste of rough
environments. As part of the Army Guard experience, they drill
annually outdoors so they’ll be prepared for harsh
conditions. They’ve also survived jungle training in the
Philippines and Nicaragua as well as war games at home.
Whatever service,
doctors say they can find adventure, not to mention a
humanitarian mission or two. Without the Navy Reserve, Chicago
ophthalmologist Ann Bidwell, MD, wouldn’t have traveled
to Thailand where she provided services to rural villagers.
“It was truly an opportunity to build friendships and
respect.” Without the Air Reserve, Singler couldn’t
practice medicine in a chemical warfare suit or say he made it
through survival training with “some of the meanest guys
you’d ever run across short of war camp…or
prison.” Without the Air National Guard, Hendra
wouldn’t have the opportunity, if she so chooses, to
explore the Antarctic and live at the South Pole. “You
can’t buy something like that.”
But supporting US
soldiers in a war zone may be the toughest terrain of all.
Lee’s unit spent January mobilizing in frigid upstate New
York where soldiers learned to operate in weather extremes.
Fire exercises, body searches, checks for “improvised
explosive devices” (IEDs), deadly homemade bombs that
explode from under cars and beneath rubble, pummeling people
with shards and charred debris. They aren’t your typical
kind of weapon, says Lee, but then again, “this
isn’t your typical kind of war.”
Indeed, for all their
training, Lee and his unit couldn’t prepare completely
for every contingency, especially practicing medicine on the
move. Not only are there practical considerations—dust
seeps into every nook and cranny, making servicing equipment a
daily headache—but with a front line that’s 360
degrees, weapons, helmets, body armor, and other protective
gear are as essential as stethoscopes.
Like his comrades, Lee
travels around Iraq in full combat readiness, with weapons off
safety and close to firing—so, if necessary, he can
engage hostile forces. Has he had any close calls? Yes, but
luckily, no major incidents, even though his convoy frequently
encounters questionable characters trying to block its path by
maneuvering or parking their vehicles. He’s even given
orders several times to ram cars or trucks when drivers refuse
to get out of the way, creating the perfect set-up for an
attack. With gunfire and mortars a constant worry, traveling,
he says, is nothing short of “heart-pounding.” As
for carrying a gun and possibly using it, Lee’s colleague
sums it up best: “When you take the Hippocratic Oath, you
say you’ll do no harm, but if someone is going to hurt
you, you have to react. You start thinking of your family, and
that you want to make it home.”
As one can imagine,
all of it adds to the stress of the day. To accommodate his
24-7 lifestyle, Lee eats less, sleeps less, and works more,
much like he did in residency. While he and his unit are
focused on American soldiers, they’re treating Iraqi
citizens as well. In fact, before he ever left Wisconsin, he
made that his goal. “It may go against protocol,”
he says, “but I’m a health-care provider to anyone
who needs help.”
Yet on most days, the
focus is simply on the soldiers, many of whom often give back
as much as they get. In the midst of one days’ chaos and
horrible injuries, he recalls the gunshot victim who provided a
refreshing perspective on his dangling thumb:
“Don’t worry, Doc. It’s only my hand.
I’m still alive.” Says Lee, “he was
comforting me when he was the one shot, bleeding, and in pain.
I was very proud of that soldier. I got my energy boost from
him.”
Indeed, Lee has found
his greatest strength and support in his soldiers. Those in his
unit, he says, hear an order and “turn into the most
efficient machines I’ve ever seen in my life.”
Those being treated simply remind him of the mission that
brought them all 6,400 miles from home.
While his
physician-colleagues concern themselves with transitioning back
into civilian life, Lee has a ways to go before he sees the
United States. Most doctors benefit from a post-Desert Storm
policy that limits the length of
“boots-on-the-ground” time to 90 days. It’s
too early, say officials, to know if the guideline has helped
in recruiting and retaining doctors since this war is the first
real test. But it’s also a moot point for unit commanders
like Lee, since they can’t rotate out.
As for the experience? Lee
can’t yet pinpoint how it’s changing him, even
though he’s sure he’ll be a better husband, father,
boss, and co-worker for having served in Iraq. One thing is
certain: He looks forward to becoming a veteran,
something he’ll finally have in common with his civilian
patients back in Wisconsin. As for the soldiers counting on his
clinical and leadership skills in Iraq, Lee just recalls his
father’s advice: “‘You joined, so do a
good job. You’re the commander, so make sure you bring
everybody home.’”
g
 |
The Mommy or Daddy Factor
When Leah Lee, age 7, didn’t
understand what her daddy meant by being gone for a “long
time,” he tried to simplify the concept. “He said
‘I won’t be back,’” recalls his wife,
Kate Lee, DDS, “‘until you turn eight or possibly
nine.’” The little girl understood a little better,
even though her brother, Jonathan, age 5, just figured after
awhile that his daddy was simply gone.
As the commander, a
“long time” is longer for Lee than other doctors,
possibly even two years. “I wouldn’t have it any
other way,” he says of the duration, since he’ll be
with his unit. “But I do miss my wife and kids
dearly.”
Kate isn’t
surprised about her husband’s commitment —he joined
the guard before they married, so she had adjusted her schedule
long ago for this part of his life. But when the two heard,
after great speculation, that he’d be headed for a war
zone, she says, “I was a little shocked.”
The notice had
immediate implications. They had scant time to wrap up a home
remodeling project, leaving her with a house in shambles.
Luckily, others rose to the occasion so parts of their job
could be done before he left. Putting a house back in order,
however, is only one of the challenges. Finances, child care,
everyday events. Spouses say they just dig in their heels and
keep themselves busy, trying to be two parents instead of one.
Between her part-time
job as a dentist and her full-time work as mom, Kate has little
chance to dwell on events in Baghdad or entertain any possible
what-ifs. “I think about him,” she says, “but
I don’t have time to sit and ponder it.” Birthday
parties and Brownies, piano lessons and swim meets. Keeping up
with her children’s normal activities has made the days
fly. But, she admits, with months to go until Lee’s
homecoming, “I just hope that he stays safe.”
Peter Matsuura’s
wife and children didn’t have the same worries about the
hazards of a war zone, but they felt an absence just the same.
Since Matsuura, a busy small town surgeon, isn’t part of
his two sons’ 8 to 5 routine, they just reasoned during
the day, “Mom, it’s just like Daddy is at the
office.” But Andy, 9, and Danny, 7, really noticed the
difference during the evening when he’d be there 100
percent. “Daddy comes walking down the hall and the whole
house lights up,” Wendy says. “That’s what
they would miss.”
How did the boys handle the
absence? With the same Christian faith as their parents. She
told them at the outset that the best thing they could do was
to pray. It also helped that Matsuura could call home every
evening, but the beautiful part, she says, is that his
deployment toughened their children. “My seven-year-old
told me, ‘Mommy, I can’t live another day without
Dad.’ Then a day would go by and I’d say,
‘See Danny, you did it.’” g
|
|
Trickle-down Medicine
Kevin White, MD, thought he’d just
focus on his research now that he had finished his
electromyography and spinal cord injury fellowships. After all,
he was anxious to discover how a relatively new colon cleansing
procedure could improve quality of life for spinal cord injured
patients. But when his Veterans Administration colleague,
Kenneth Lee, deployed to Iraq in January, White took a slight
professional detour himself. He traded a full-time research
agenda for a full-time practice —joining a battalion of
civilians who step in when soldier-colleagues step up.
What can they expect?
The truth is, no matter what the configuration (solo practice
versus institution or group), one person’s military
deployment is another person’s extra work. Of course,
larger organizations are better suited than small ones to
redistributing the labor. Still, sharing the load, rather than
bearing it solo, may be little comfort if you’ve been on
call every four nights and now it’s every three.
For everyone
who’s sweating the prospect, others have shown it can be
done. When Robert Singler, MD, announced he’d be deployed
during Desert Storm, his Marin County, California,
anesthesiology partners were “a little
apprehensive.” While he lent a hand in opening an
evacuation hospital in England, “they found out that it
wasn’t as bad as they expected,” he says.
The job is even easier if
the reservist works in an administrative capacity. As
commanding officer for the Naval Reserve Fleet Hospital, Great
Lakes, Ann Bidwell, MD, says it’s unlikely her 800
reservists will ever be deployed to build and operate their
Titanic-sized MASH-type facilities. “It would have to be
a very bad situation. Hopefully, we’ll never see
that,” she says. But as the director of the ophthalmology
residency program at Northwestern University’s Feinberg School of
Medicine, she’s also not
involved in day-to-day decision-making or direct patient care,
so, according to her chairman, Lee Jampol, MD,
“it’s the perfect job for someone who has an
obligation elsewhere for a time.”
When a doctor’s
skills are spread over many places, however, it can’t
help but have an impact. Calling Lee “a vital part of our
department,” Timothy Dillingham, MD, the chairman of the Medical College of Wisconsin’s physical
medicine and rehabilitation program, admits Lee’s absence has stymied what
he’d like to do. But he has faith in his faculty.
“They’ve been instrumental in getting us through
this.” Not only did White get his share of Lee’s
patients, but he agreed to head up two fellowships, among other
duties. “It’s been wonderful just working with
everyone to help out,” he says.
What if there are no
built-in back-ups? Just ask doctors about the risks of working
solo, and they’ll mention physicians who’ve skirted
bankruptcy, folded businesses, or never recouped their losses.
They’ll describe colleagues who chose to end their
service rather than risk being activated again.
When Matsuura received
his orders, he flirted with the idea of shutting down his
practice. After all, as a solo physician, how could he meet his
$1,000-a-day expenses when he wasn’t there to generate
the revenue? He and his wife, Wendy, weren’t worried
about his personal income. With a full-time military salary,
plus certain add-ons for being overseas, he’d be getting
a higher monthly stipend than his usual guardsman pay.
If he had been working for
a larger organization, his financial worries might have ended
there, because he would just be replacing one check for
another. He might even have been lucky like Ronald Renuart, DO,
whose employer, Baptist Health System of Jacksonville,
Florida, made up the difference
between his medical salary and his military stipend while he
was on deployment.
However,
Matsuura’s practice situation was different. While 2003
revenues could carry it part way, they still needed two locum
tenens to cover staff salaries and overhead. In the end,
neither did either.
Not surprising, the
Matsuuras would plan differently next time. But while he
worries about the impact of another rotation on his practice,
Matsuura says he’s in the guard to stay. “My dad
used to tell me, just do what’s right and everything will
work out.” g
Chris Hinz is
a Wisconsin-based freelance writer and a regular contributor.
