Vascular Surgeons Aid Soldiers in Need

BY DOUG BRUNK

When Dr. William Oppat learned about a 2-week volunteer opportunity for Society for Vascular Surgery members at Landstuhl Regional Medical Center in Germany helping soldiers injured in Iraq and Afghanistan, he jumped at the chance to serve.

"I live in this wonderful country; we have everything at our access and yet I have really given nothing up to have it," said Oppat, program director in surgery at Providence Hospital and Medical Centers, Southfield, Mich. "I wanted to participate and give back and experience what these kids are going through because they give so much so that I can continue to live my life here."

On his first day as a volunteer in October 2007, he was asked to consult on the cases of two female soldiers in their mid-30s who lost their left legs after an improvised explosive device detonated outside of a mess tent in Afghanistan. "Both of them had children and were trying to make a better life for their families by serving in the military," said Dr. Oppat, who is also a clinical associate professor of surgery at Wayne State University School of Medicine, Detroit.

"They were both going home without their left legs and it really shook me up. That was my first day there, seeing the amount of devastation and how these injuries change people's lives," he added.

Dr. Ruth L. Bush's first day as a volunteer at Landstuhl in September 2007 was also sobering. She was asked to perform an ultrasound on a solider who had undergone a bypass repair prior to arrival at the medical center and began to collect basic information from him, including his year of birth, which was 1987.

"So you're 20 years old?" she asked him.

"No, I'm only 19," he replied. "I'll be 20 in a few months."

At that point, "I looked at him and thought, 'this kid has been through more than people double and triple his age,' " said Dr. Bush of the division of vascular surgery at Scott and White Hospital and Clinic, Temple, Tex. "But none of the soldiers are bitter. They all want to get back to their buddies."

Dr. Bush was the first SVS member to serve in the ongoing 2-week volunteer rotation program at Landstuhl Regional Medical Center, which was coordinated by Dr. David L. Gillespie, an SVS member and chief and program director of the vascular surgery service at Walter Reed Army Medical Center in Washington, D.C. The U.S. Army pays for the volunteers' transportation and housing, and the American Red Cross covers their malpractice insurance. As of Jan. 8, 2008, eight vascular surgeons have rotated through Landstuhl, which has volunteers scheduled through August 2008.

"None of these surgeons had prior military experience, but all had vascular trauma experience through residency, fellowship, and current respective practices," Dr. Gillespie said of the participants. Most of the definitive vascular repairs are performed on soldiers prior to their evacuation to Landstuhl, so volunteers mainly serve as clinical consultants, most often for wound examination under anesthesia for which intraoperative vascular consultation is requested. Other procedures have included IVC filter placement, thrombectomy and revision of lower and upper extremity interposition vein grafts, retroperitoneal spine exposures, and diagnostic and therapeutic carotid angiograms.

"For vascular surgeons who have been looking for the right volunteer opportunity, this is clearly it," said Dr. Ronald M. Fairman, professor of surgery and chief of the division of vascular surgery at the Hospital of the University of Pennsylvania, Philadelphia, who volunteered for 2 weeks in October 2007.

He said he was impressed by the high level of medical care and teamwork at Landstuhl, which is a level II trauma center. "It's a wonderful atmosphere to pitch in and help because there are no turf issues," he said. "Everybody just wants to do the most that they can for the injured soldiers. You get the feeling that nothing is spared in terms of caring for these guys."

One case he consulted on involved a young soldier who had been shot through his maxilla. Upon arrival, "he had swelling in his neck and a CAT scan demonstrated that the bullet had damaged several branches of the distal external carotid artery above where you could get to surgically," Dr. Fairman said.

"I was able to take him down to the cath lab and embolize the branches that were bleeding. So I felt like being there made a difference for that one patient, because there was nobody there at that time who had the skills to do it. For me that was very meaningful."

Another volunteer, Dr. Daniel S. Rush, remarked about the camaraderie he observed at Landstuhl. "If you listen to the news reports back home here, you would think that everybody was jaded and burned out," said Dr. Rush, director of the division of vascular surgery at East Tennessee State University, Johnson City. "That is not true. Our troops and the people who are supporting them are enthusiastic, and they're there to do their job. They want [the war] to be over, but they have a great attitude and great dedication to what they're doing. It shows through at all levels. You didn't hear anybody grumbling that they had to get out of bed in the morning and go do their job."

To inquire about volunteer opportunities at Landstuhl Regional Medical Center, contact Dr. David L. Gillespie at david.gillespie@na.amedd.army.mil.