01 January 2010

Vascular surgeons volunteer at Landstuhl

Dr. Vincent Bertin, right, performs surgery at Landstuhl Medical Center near Ramstein Air Force Base in Germany.

Dr. Vincent Bertin of Ohio, a vascular surgeon with Southwest Vascular, Inc. and on staff at both Southwest General Health Center and Parma Community General Hospital, tells of the 17 days he spent volunteering at Landstuhl hospital.

“It was an eye opener. The way the military treats the injured soldiers is very, very impressive,” he said. “Landstuhl is the largest American hospital outside the U.S.”

While he was there, planes brought in 38 injured members of the military. Of those, 22 were on ventilators and severely wounded. The most significant injuries were to Marines, he said.

“We didn’t lose any of them,” he said.

The system works because of the skill of medical personnel on the front lines and the forward operating bases in the two countries, he said. They do what they can to stabilize the patient, who is then flown to Germany. The next phase of treatment starts right after the plane lands. ...

Bertin heard about the need for surgeons in Landstuhl in 2008, at the annual meeting of the Society for Vascular Surgery. The group schedules the volunteers, usually for two weeks at a time. He had never had any previous military experience, but decided to go.

“There’s a need for it,” he said. “I’ve been doing this for 25 years. I’m at the age where I still have good physical ability and good judgement. It was my window of opportunity.”

As a vascular surgeon, Bertin’s job was to repair veins in organs and “just about any major extremity.” A common injury happens when a soldier steps out of a Humvee onto an explosive device that is then detonated by remote control.

“The leg — usually the right leg — is blown up and the rest of the soldier’s body is shot up through the roof of the Humvee. There is usually severe head trauma and injuries up to the mid-portion of the spine,” he said. “I did exposures of the spine for the orthopedic guy to fix the spine.”

One patient who sticks out in his mind was a Navy man who had been flown in from Kuwait.

“The kid was on leave, when an insurgent drove a car into him at 120 miles an hour,” he said.

I've thought of that patient often as well.

On Thanksgiving Day, a plane brought in six patients from Afghanistan, four of them on ventilators and four with massive injuries to the upper and lower extremities, plus the abdomen. He was in surgery from 8 a.m. to 9 p.m.

“The good news is, we didn’t get any new flights the next day,” he said.

No Iraqis or Afghanis were brought in for care while he was there, but he treated one Australian and one Canadian, both who had been in Afghanistan.

Bertin has been on staff at trauma centers in San Francisco and Cleveland, where the most severe injuries are treated. Other doctors who worked with him in Landstuhl had similar experience.

“None of us ever saw anything that severe as we did in Landstuhl,” he said.

One soldier had a fragment go right through his pancreas, missing the main portal vein by one millimeter.

“To have that big of a pancreatic injury and not have a vein I had to repair was incredible. If it had hit the portal vein, he would have died,” he said. “We drained it and did the best we could.”

The patient left Landstuhl and Dr. Bertin lost track of him until he read a newspaper article about a rare pancreatic cell transplant procedure the patient underwent at Walter Reed.

There are two other incidents he will remember. One was when he had to return to the operating room at night to close a surgery. It was the beginning of the second week of his stay, and someone had forgotten to put his name on that week’s access roster.

“Security was so tight, if you weren’t on the roster you couldn’t get in. They wouldn’t accept my passport ID. I had to get the staff surgeon upstairs to walk me in,” he said.

Then, shortly before he left for home, he met actor Gary Sinise at the hospital. ...

“Lots of people (entertainers) come through the USO part, but he is one of the very few that come into the intensive care unit. He was very concerned and helpful with the injured soldiers,” Bertin said.

My post about Sinise's visit is here.

According to Bertin,
The best part was seeing the excellent, well-organized care by all the staff, and the cooperation between doctors, nurses and operating room techs, no matter what branch of the military they were from.

“We’re all on the same side,” he said. “The family of any injured soldier can take solace that they are getting the best care.”

The slots for volunteers is filled for next year, but he plans to return in 2011.

Another vascular surgeon from Florida talks about his recent stint at Landstuhl:

A member of the Society for Vascular Surgery, [Dr. Faro] volunteered to help staff the Landstuhl Regional Medical Center, which was in need of vascular surgeons.

During his stay, he and a team of physicians managed the care of 12 acute trauma patients who had been injured during combat in Afghanistan.

"They were mostly blast injuries, gunshot wounds, spinal injuries, things like that," he said. "I did the vascular part. As a team, we had multiple surgeons and medical personnel, all in critical care."

After treatment, the troops were flown to the United States or their home countries for continuing care. When they left, others would arrive.

"You didn't know what you were going to get," said Faro, who has four grandchildren. "You could get no planes, or two or three planes full of people." ...

"It was an honor to do it," he said. "I was in Guam at the end of the Vietnam War, and we were transferring sick patients and refugees. It served a purpose. This really serves a purpose. It's something you can give back to people."

What a great program. Our thanks to the docs for coming here. I'm sure it's something they will never forget.

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