Another lifesaving tool was the Belmont Rapid Infuser: We could put 6 units of blood into a patient in under 5 minutes with this device. It was nothing short of amazing. We also used pneumatic tourniquets. Patients with lower-extremity amputations would begin bleeding through the field-applied tourniquets once we put blood back into them, but two or three pneumatics on a stump would stop the bleeding and help get the patient to the OR alive.
Are there clinical and/or organizational strategies learned from your time in Iraq that you apply in your current practice?
I learned an amazing amount about leadership. As chief of the department, it was my job to satisfy the requirements of my commanders. However, I also had to earn the respect of my subordinates and peers. I've always thought that you could tell a soldier to "charge a hill" for you, but you will not succeed if he does not believe in you or the cause. A good leader will have soldiers who want to charge that hill for them. I'm not sure if I obtained that level, but that is the definition of leadership to me. As the premier combat hospital in the world, we also had to deal on a weekly basis with visiting senators, congressmen, generals, and even the president, when they came through to meet and greet. I got into a little bit of trouble for insisting that these visitors leave the ER when the patients arrived, but patient care came first. I try to utilize these principles in my everyday practice here in the United States now.
Do you have any messages for primary care clinicians about the potential physical and mental health issues of combat-wounded soldiers they might see in their practices?
These soldiers have run the gauntlet and back, some of them multiple times. They deserve our compassion and gratitude, but most importantly our respect. Many have undiagnosed posttraumatic stress disorder or other psychological issues, and we have to give them a chance to deal with them. Nightmares, social phobias, and other issues are nothing new - we've all endured them since returning home. It doesn't mean we can't hold a job or that we need medicine; it just means that these men and women need some room to breathe, some understanding. I think these issues will be around for years, and as physicians we all can help by sitting back and listening with an open mind. These men and women are my heroes, our heroes. They deserve everything we can give them.
For more about Dr. Baker's experience and to order his book, "Baghdad ER: Fifteen Minutes," go to www.baghdader.com. Dr. Baker has no financial interest in the products mentioned in this column.
- Interviewed by Heidi Splete