Tales from the Battlefield

Posted on Thu, May 07, 2015
Tales from the Battlefield

An EmCare Medical Director Shares his War Experiences

Practicing medicine in a hospital is chaotic – patients arriving, noise, colleagues and environmental challenges all impact a physician’s ability to deliver the best care. Practicing in a military “box,” however, may be even more chaotic – add dangerous environments military protocols, civilian as well as soldier input adding to the distractions.

For military physicians and surgeons, practicing and operating in a war zone is a whole other kind of chaos. One of these military surgeons is Stephen Flaherty, M.D., FACS. Dr. Flaherty is currently a regional medical director of trauma surgery for EmCare, but for more than two decades he served the U.S. Army. During that time, he took several tours to the Middle East, treated soldiers stateside and became a leader for Army surgeons. “I went into the Army right after medical school and did my internship and residency in the Army,” said Dr. Flaherty. “I served one year as staff general surgeon at Fort Hood in Texas, then back into training with a fellowship at Boston City Hospital.”

One unique facet of the Army Dr. Flaherty points out is the opportunity to take on great responsibilities early on. “Practically the day after my fellowship, I became the trauma medical director for Brooke Army Medical Center in San Antonio,” he said. After six years in that role, Dr. Flaherty considered leaving the military to become a civilian surgeon. But then came 9/11.” “I was watching the towers come down,” said Dr. Flaherty. “I remember I looked at my wife, and I told her ‘I know something’s going to happen. I don’t know what, but I want to be a part of it.’”

Shortly after that, Dr. Flaherty shipped out to Bosnia. It wasn’t a combat zone, he recalled. He and his crew were mainly there “in case something happened” which, of course, it did. “Our base came under attack by an F-15,” he said. “No one was hurt, but it was an… interesting experience.” While in Bosnia, Dr. Flaherty says he mainly performed appendectomies in deployable field hospitals. By the time he left Bosnia, the field hospitals had given way to fixed structures with plywood walls and intended to be temporary. Surgeons wear military protective gear – helmets and vests – along with their surgical gowns and masks.

After several months in Bosnia, Dr. Flaherty returned home to become chief of surgery at Fort Bragg in North Carolina. “That was a great job,” said Dr. Flaherty. “I learned a lot about administration, running a department. That’s one of the things folks in the military get that folks in civilian practice don’t always get – that deeply ingrained recognition of hierarchy and teamwork, management and leadership training. In the Army, it’s very structured. Along with a focus on patient care, there’s a lot of attention on developing junior officers. My leaders spent a lot of time developing me; I developed junior officers in return. There’s a clear progression of responsibilities.”

While at Fort Bragg, Dr. Flaherty became involved with the special operations community. He began deploying with “special ops” groups to Iraq and Afghanistan. “Honestly, those missions are classified stuff,” said Dr. Flaherty. “What I will say – what I remember about Iraq is obviously the incredibly large number of casualties. I remember thinking that the American public didn’t have a good idea of the tempo of the war. When you’re at home, you see stories on the news, you know we’re at war. But when you’re there – it’s amazing to see all the moving parts and how much more is going on than people realize.”

In Iraq and Afghanistan, the facilities were austere – metal structure boxes, a bit like railway cars. Sometimes the Army surgeons operated in a structure akin to an R.V. All the structures had generator power and were outfitted with all of the normal equipment you’d see in a civilian operating room. “You’d never know you were in Afghanistan by looking at the equipment,” said Dr. Flaherty.

Along with the classified missions, Dr. Flaherty has fond memories of the Afghan landscape and people. “It struck me as a really beautiful country,” he said. “Desert with lots of mountains and lush river valleys. But the people – they had so very little. Their existence is totally day to day. Every day for them is where to find water, food. And I was amazed that people have no concept of dates – a lot of them aren’t sure when they were born. I remember a strong feeling of how glad they were to have the U.S. military there, but at the same time they had no resources to be able to help us.”

Along with providing medical care for soldiers, Army surgeons are often called upon to treat civilians. “Civilian cases are not rare,” said Dr. Flaherty. “There are a lot of civilians that get injured as a result of our battles. I saw a lot of burn injuries. As happy as we were to help them get better, it was difficult knowing they don’t have access to resources for long-term care. Physical therapy, that sort of thing, they’re not going to get.”

Dr. Flaherty considers his last deployment his favorite – he was central command and the theater trauma director. “I didn’t have a job in a specific hospital,” he explained. “I monitored happenings all over Iraq and Afghanistan. I got on helicopters and flew around to surgical sites, talked to all the surgeons, made sure they were all up to date, listened to their problems, operated with them. For eight months, I ran the whole system of combat casualty care.”

While acting as central command, Dr. Flaherty earned a bit of history for himself by operating on a pirate. “I’m the only one who’s done that on a Navy vessel,” he said. “These pirates attacked a Naval ship at night. It wasn’t a fair fight, to say the least – the pirates got all shot up. But, being good Americans, I was able to fly to the ship and take care of their injuries.”

Dr. Flaherty left the Army in 2010. He now lives in El Paso, Texas with his wife and two children. In 2013, he joined EmCare. “I love EmCare,” he said. “I appreciate their investment in leadership development. I miss Army life all the time, but what I loved about it was being deployed. It sounds corny, but you’re there for your country. Especially when you go to war. There’s nothing that compares to being in an E.R. waiting for combat casualties. There’s such a sense of purpose.” 

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