Thank you very much for the chance to be involved in OpEdNews! I'm just coming to you after finally getting home at 1a.m. I had a long day of operating at my new hospital, Geisinger Medical Center in Danville, PA. It's a long way from my work with the Air Force in Iraq, but in some ways, surgery is the same all over.
My book, Coppola: A Pediatric Surgeon in Iraq is the result of many letters home I wrote during my deployments to Iraq in 2005 and 2007 into 2008. I worked at the 332nd Air Force Theater Hospital in Balad, just north of Baghdad. Our hospital was designed to care for combat injured troops, but, in practice, we saw troops, enemy detainees, and civilians, including children. It is horrific to see the incredible injuries that are possible in wartime. For hours on end, we would work together to try and save the lives of so many who had been injured by bullets and bombs. There wasn't much time to think about it; we just moved from bed to bed and did our best.
When there were lulls in the action, I would lie awake at night, trying to sleep, but the terrible images of broken bodies would swim before my eyes. I began writing long letters home to try and ease my mind. Once I was home again with my family, I was overjoyed to be reunited with them, but I suddenly felt like I was doing nothing for the troops, when shortly before, I had spent every day trying to help them. I gathered my letters and edited them into the book, as a way of preserving the experience of so many brave troops and civilians I had met in Iraq.
Your father is an obstetrician. So, it was natural that you had an interest in medicine and followed that path. But how did you find yourself in the Air Force?
Joan, it is very appropriate that you mention that my father was an OB/GYN doctor. He is still practicing gynecology today. Observing his model treatment of his patients is a big part of why I am a doctor today. When I feel that I have communicated well with a patients and families, I know that I am putting the lessons my father taught me to good use. My father never pushed me to become a doctor, and, in fact, when I was very young, I thought that he worked way too hard. But by the time I was a high school student, I knew I wanted to be a doctor. In fact, I knew I was going to be a pediatric surgeon after learning about the life of C. Everett Koop, who had just become surgeon general.
My parents were very generous and paid for my college education. As
the start of medical school approached, I knew that I had to find a way
to pay for medical school. I am the oldest of five children, and it was
sacrifice enough that my parents had gotten me that far. During school,
I had taken a semester's reprieve from a busy biochemistry major to
study in Cordoba, Spain. I spent the months studying language, art,
history, and traveling around the country.
I was amazed to find that in Spain, even though it was exciting, vibrant and beautiful, it also had double digit rates of unemployment, much poverty, and difficulty with infrastructure. In spite of this, my Spanish friends were all expected to serve a year of military service. When I returned home, I looked around and saw how well we had it in the US with such extensive social services, and I was amazed that we were not required to give something back. I talked about it so much that I eventually decided to walk the walk. I signed up for a military service commitment in exchange for financial assistance with medical school. The reason that I chose the Air Force was quite selfish. I didn't think I could survive six months at sea with my motion sickness, and it seemed like the Air Force bases were on the prime real estate.
Well, you certainly picked up your father's wonderful bedside manner. Your book is infused with compassion and humanity. For contrast, you tell of a plastic surgeon you worked with during your residency "who told me all surgeon needs to know in another language is the phrase 'Hurry up!' He could recite it in twenty different languages..." Because of your training in pediatrics, you were not always in sync with the rest of the medical staff about the importance of treating Iraqi children. How did you work this out?
Well, I do have to mention that the doctor who advised me to learn "Hurry Up!" in multiple languages was one of the most educational and entertaining professors I've had the fortune to meet. I still pass my needle from needle holder to forceps the way he told me. One other bit of advice he gave me: When starting in a new OR, treat everyone harshly, until you find out who are the best assistants. Then, only treat them nicely and only the best will want to scrub on your operations! Effective advice, perhaps, but I've never had the audacity to try it!
It is true; in Iraq, I quickly discovered that my true passion was doing whatever I could to help children who came to our hospital with serious injury or illness. I understood full well that the purpose of our hospital was to treat combat injured troops, but as doctors, we all carried the idea that we would treat any person in need to the best of our ability.
In general, I received wide support and help in my care of children. We all cherish our own children, and I think that for many of us missing children at home, taking care of Iraqi children was a way to express that longing for our own loved ones. I did note that for doctors and nurses who were not accustomed to treating children, it often made them nervous and even afraid when they were faced with an injured child.
They had the idea that our tiniest patients were more fragile, but the truth of the matter is that children are often much more durable than adults and can bounce back quickly. Fortunately, besides myself there were also a handful of nurses who were experienced in the care of children and they did their best to educate the others.
A few of my colleagues felt that I was taking it too far, and they argued that bringing too many children into the hospital ran the risk of crippling our resources when they might be needed for the troops. I asked them to simply imagine how the Iraqi people felt about their children, and how important is was for them to get them well. Iraqis were so appreciative for anything we could do for their children. In reality, there was no worry that the troops would ever be left without care. The wonderful people I worked with would increase their efforts tenfold, fortyfold if they had to, whatever it took to take care of the troops.You wrote about having doubts about the war and yet giving your all. You also wrote about stitching up insurgents and those injured by those insurgents. How did you deal with these rather large dichotomies, day after day?
Even though I thought the war in Iraq was and continues to be an error, it was always clear to me what my job was. I am a doctor. I help the sick. It doesn't matter who the person is or what they have done, when they come to my OR [Operating Room], I do everything in my power to keep them alive.
I did disagree with the war, but I was an officer. I had taken my oath, swore my loyalty to defend the Constitution, and to fulfill my duties. I didn't promise to only do the duties I agreed with; I swore to fulfill all my duties. With this promise made, it didn't matter how I felt about the war, I was going to keep my promise.
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