UT Physician Serves with Critical Care Air Transport Team in Iraq
HOUSTON – (July 3, 2007) – Exposure to novel situations and the ability to explore various niches within my field of trauma care are two of the benefits I find in my career in academic medicine. My duties with The University of Texas Health Science Center at Houston allowed me enough flexibility that I was recently able to explore those benefits when I volunteered for a few months of active duty with the United States Air National Guard.
Richard N. Bradley, M.D.
Despite 11 years’ experience in the Guard, this March–May deployment for Operation IRAQI FREEDOM was my first time in a combat zone. Although the separation from my family was a burden, the deployment was tremendously satisfying on both a professional and personal level. While in Iraq, I served as the physician member of a Critical Care Air Transport Team (CCATT).
A three-member CCATT consists of a critical care physician, a critical care nurse and a respiratory therapist. The team's mission is to operate an intensive care unit in an aircraft cabin during the five-hour flight from Iraq to Landstuhl Regional Medical Center in Germany. CCATT patients – primarily combat casualties being evacuated from the combat zone – have received initial stabilization, but still are so critically ill they require transport to a more fully capable hospital.
During these flights, I talked with several of our wounded service members. One man I met had been part of a team that entered an Iraqi house to take custody of some suspected enemy personnel. Things did not go as planned, and a firefight broke out. One shot severed the soldier’s rifle sling. Another penetrated his left arm, causing him to drop his rifle. The soldier retreated into the depths of the house where, under fire, he lost contact with the rest of his team. Even though he received several additional gunshot wounds, he was able to draw his sidearm and successfully defend himself against several attackers armed with automatic weapons.
Although awake in-flight, his injuries were serious. When I met him, he was just hours out of his first surgical operation, and fitted with an external fixator on his left upper extremity. He had several surgical drains that accompanied his new colostomy. Dark purple bruises marred the skin over his liver and heart – undeniable evidence that his body armor saved his life.
Despite his condition, this wounded soldier was in good spirits – joking about his injuries, looking around the aircraft, and offering words of encouragement to other injured patients. He asked me how long it would be until we could “fix him up” so he could get back to his unit. He explained that the enemy had killed one of his team members and he wanted to be back in action as quickly as possible to continue his mission and help prevent future American casualties.
Lt. Col. Richard Bradley, M.D., in-flight with a critical patient. "We did not lose a single patient during our missions from Iraq to Germany," Bradley says.
I took great pride, not only in the excellent men and women like this we cared for, but also in the high caliber of the other physicians serving in Iraq.
For example, one morning at 3 a.m., while preparing for flight, I had a question about the management of a patient with an open thoracic spinal cord injury. I asked one of the nurses to get the trauma surgeon for me. I expected to discuss the case with him on the phone – but I was delighted to see that, despite the early hour, he came to the ICU to meet with me personally. In his competent, unpretentious style, the surgeon told me that he had the same question and had consulted the base neurosurgeon just a few hours earlier.
Likewise, I always found the staff radiologists happy to discuss their findings at any hour of the day or night.
The professionalism of my fellow Guardsmen serving in Iraq was another source of great pride for me. While all of the other CCATT teams in the country were composed of active-duty military personnel, all three members of my team were from the Air National Guard.
Guardsmen have not always interacted so seamlessly with their active-duty counterparts during wartime. After mobilization during Operation DESERT SHIELD, rather than filling the combat assignments that they had trained for, highly qualified members of my unit backfilled military hospitals in California and Great Brittan. Given the drawdown in the size of the active-duty military over the past decade, the United States cannot afford to operate that way any longer.
Members of the Reserve component in the Iraq combat zone are now indistinguishable from active-duty service members. This is particularly true in the medical fields. Not only are today’s Guardsmen and Reservists just as well qualified as their active-duty counterparts, they tend (like me) to be a bit older.
On this deployment, my team had decades more experience than the younger active-duty crews. My status as a Guardsman did not hinder me at all when I found that, due to my rank, I was the senior CCATT physician in Iraq.
Our service in Iraq gave us physicians unmatched professional benefits. Military airlift is an important resource for civilian disasters, yet few physicians understand its capabilities and limitations. I saw first-hand how critical it was after Hurricane Katrina, when I deployed to Louisiana with the Texas Task Force One Urban Search and Rescue team. My new knowledge of the aeromedical evacuation system while serving in Operation IRAQI FREEDOM, from both a professional and an administrative perspective, will allow me to contribute more to planning for the medical response to catastrophic disasters in my own community.
I also took tremendous personal gratification from knowing that I had truly made a difference. Our military heroes deserve the best care possible – I feel honored and humbled that I had the opportunity to play a small role in caring for our nation’s finest, who had sacrificed so much to serve and protect our country.
By Richard N. Bradley, M.D.
Clinical Associate Professor of Emergency Medicine, UT Medical School at Houston
Chief of Emergency Medicine, Lyndon B. Johnson General Hospital