Civilian Orthopedic Surgeon Witnesses Servicemembers' Sacrifices Firsthand

By Navy Lt. Jennifer Cragg
Special to American Forces Press Service

Dec. 24, 2008 - A civilian orthopedic surgeon who has seen servicemembers' sacrifices firsthand said he believes the nation owes them a debt of gratitude, and that he'll bring techniques he saw in the military health system to his own practice. "I firmly believe as citizens we owe [our troops] great thanks," said Dr. Brendan M. Patterson, chairman of the orthopedic surgery department at MetroHealth Medical Center in Cleveland. Patterson returned in mid-December from Landstuhl Regional Medical Center in Germany after completing the two-week Distinguished Visiting Scholar Program.

Patterson is the 18th scholar to participate in this program since its inception in July 2007.

"We live in an extraordinary country at a critical time in history, and there are a select few members who serve in the military who are on a daily basis are making significant sacrifices of time with their family and loved ones particularly this time of year to protect the interests of the majority," Patterson said yesterday during a "Dot Mil Docs" interview on BlogTalkRadio.com.

The chairman of the Orthopaedic Trauma Association and co-director of Orthopaedic Trauma at Rhode Island Hospital in Providence, retired Army Col. (Dr.) Roman Hayda, said the program was established to provide a link between the civilian and military orthopedic communities.

"The scholars have at least 10 years of trauma experience with demonstrated leadership and dedication to teaching," Hayda said. "They provide some assistance to the experienced military surgeons at Landstuhl while being able to more fully appreciate the complexity of injuries experienced by our servicemembers."

Hayda said scholars volunteer for the service by contacting the Orthopaedic Trauma Association and the American Academy of Orthopaedic Surgeons.

"The selection is then based on a review of their credentials with a panel of tri-service military members, to include a representative from [Landstuhl] and a civilian board member," he explained.

Patterson said his two-week visit to Landstuhl was an opportunity he would be unlikely to have in the civilian sector.

"I don't think experience in a civilian center can prepare one for the type of injuries that these young soldiers experience," he said. "The modern warfare has brought with it the improvised explosive device, which has really dramatically altered the character of injures experienced by people in combat, and the concentration of a blast force on the extremities is truly a different type of injury."

Patterson said he gained a new respect for the orthopedic surgeons he worked with in Landstuhl.

"The orthopedic surgeons are an outstanding group at Landstuhl, and we were able to do a few cases together where some of the soft-tissue techniques are used in civilian trauma centers to cover exposed bone and exposed surfaces," he said. "We were able to use a few techniques mobilizing muscle and putting some traction on some skin that would salvage [or] save some length of a particular injured extremity."

He said he would bring some other techniques witnessed at Landstuhl back to his practice.

"Some of the treatments, particularly with the management of contaminated open wounds, use some of the time-honored approaches of allowing the body some time to respond and not rushing a closure that would potentially lead to an infection," he said. "I think that is one piece [that I will] bring back.

"The other is the commitment to pain management," he continued. "There is a lot of time and effort expended on regional anesthesia. Putting in blocks so that they can make an entire extremity numb to relieve their suffering and pain is quite extraordinary."

Patterson said he was impressed by the screening tests for traumatic brain injury.

"The military has done an incredible job in looking for traumatic brain injury," he said. "Everyone at Landstuhl had a screening test for traumatic brain injury that identified those patients who may have suffered some degree of concussive or head injury. The military medical system has really done a good amount of work on making sure those screening tests are done on every soldier."

(Navy Lt. Jennifer Cragg serves in the New Media directorate of the Defense Media Activity.)