Motivation

Our group's t-shirt design says it all.

Well, I'm coming up toward the end of this deployment and although our group has had its share of frustrations dealing with the administrative side of the Navy, we have all grown as providers, gotten smarter and hopefully done some good.  I do have to admit, however, that it does become difficult every day for 6+ months to look down at your most recent trauma page and see that 4 more servicemen/women are coming in a after an IED and know that those four lives (and their families lives) will forever be changed.  I would be lying if I said I had a steady level of motivation to deal with this everyday.  As with most trying times, though, I had a defining moment earlier this week that will no doubt give me the motivation to continue to do what I do until my time is done.  It went something like this...

Jason and I were finishing a case early in the morning - around 9:30 -when both of our pagers went off alerting us of another casualty coming in.  'CAT A x 1 - IED - Bilateral Amputations'.  We get this page quite a bit, however, it can run the spectrum of mild soft tissue injures to 2, 3 and 4 extremity amputations, sometimes including the chest, abdomen, pelvis and eyes.  This particular one was bad.  They were already doing CPR when they came through the doors.  (As an aside, the chance of survival from blunt trauma where you lose vital signs prior entering the hospital is well less than 1%).  Despite this, we went to work.  Intubated, two large IV lines, blood, hemorrhage stopped, tourniquets applied, CPR continued - Chest thoracotomy in ED (Cracking the chest to do open massage of the heart).  Result - spontaneous cardiac activity returned.  His inital Ph of 7.0 was low, but not horrible.  We went straight to the OR.

For four fours the General surgeons explored his chest and abdomen.  The Ophthomologist and Neurosurgeon cleaned and sutured his face.  The anesthesiologist did a bronchoscopy to look at the airway.  The Ortho surgeons found all the arteries, veins and nerves and tied them off as well as cut away all dirty tissue.  During this whole time the soldier coded 4 times, but cardiac activity always returned.  No matter how hard we worked we could not stop the bleeding from his pelvis.  I performed a surgery I've only done once before and that time it wasn't during an emergency.  I took out the entire right side of his pelvis and was finally able to determine what was bleeding and stop it.  However, by then, it was too late.  The surgeon had been doing internal chest compressions for 45 straight minutes and we all finally knew the obvious.  Immediately after, a young Sailor came into the room along with the Chaplain and stood at attention.  The nurses cleaned the patient and draped him in an American Flag.  An announcement came over the hospital loudspeaker stating they would render honors to a fallen soldier.  Every single one of us - Doctors, Nurses, Corpsman, even the janitors - lined the wall exiting the hospital and gave this warrior one final salute.   

My motivation you ask?  Never to have to have this type of ceremony in my hospital again as long as I am here.

'From a distance we hear it

The sound of the helo's blades chopping the wind

And we run to it

Immobilize the spine, keep them warm, what are the injuries?

Airway, Breathing, Circulation

This one's bleeding out, that one's lost a limb

Together we work

Different nations coming together to save a life

Everyday we stare death in the face and say, no

We will prevail

Even with the lives of our adversaries in out hands

We prevail

We have no preference

We have no discriminations

We have no limits

We will walk through the fires of Hell with you

And bring you back alive

We will not be discouraged

We will not be disheartened

We will not give up

We are Role 3

And we are up to the challenge'

177 Days BOG, 204 away from home!

All for now.