Service and Pediatrics

Service and Pediatrics

I hope today is a day you will take a moment to have a conversation with your child about Veteran’s Day and who a veteran is. We’re not animal doctors (veterinarian) or members of the AARP (retiree), although it is possible for a veteran to be both. Veterans are individuals who served in the active military, naval, or air service and were discharged or released in conditions other than dishonorable. All took an oath to defend the Constitution of the United States of America. Those who died in combat we celebrate with greater reverence on their own holiday– Memorial Day. But today is for all those who served, whether in wartime or peacetime, who handled their responsibilities to our nation in an honorable manner and were discharged at the end of their service accordingly. All veterans signed the same agreement and took the same oath. Some were deployed overseas. Some saw combat. Some died. All signed an oath and served honorably.

In honor of the veterans I served with and in awe of the courageous warfighters I was deployed with, here is a piece of my veteran’s story:

February 2005 I received notice I would train with and be deployed for one year as a physician with the First Brigade of the First Armor Division. Although a Board Certified Pediatrician, I would deploy as a Battalion Surgeon and care for soldiers on the battlefield. By this time, I had graduated medical school, completed a military pediatric residency, married, and been assigned as a Pediatrician for the military community of Heidelberg, Germany.

In January 2006, I arrived on the military post near Tal Afar, Iraq, not far from Mosul in the province of Ninevah. It was mind-boggling to think this was the area Jonah had been sent so long ago. And I, like Jonah, had no desire to be there.

Early May 2006, a truck stacked with flour entered the marketplace of Tal Afar and began selling flour at ½ price. As crowds surrounded the truck wanting to buy the inexpensive flour, the truck exploded killing twenty people and injuring over a hundred more. US Army soldiers stationed nearby reacted by rushing to help the injured Iraqis and carried them to their military aid station located on the edge of town. When I arrived, the injured–half of them children–moaned beneath blood-stained bandages as they waited atop stretchers lined up near the helicopter landing pad. Scanning the scene, I noted an older boy laid on his stomach, a sucking chest wound bandage adhered to his back, his respiratory rate surprisingly normal and unlabored. With others wearing bandages covering head injuries, some woefully quiet, I had to make decisions about who was the most critical. I continually reassessed those who were waiting and selected the four most urgent who would then be flown by Blackhawk to the more extensive Army combat hospital in Mosul. Helicopter after helicopter would land, be loaded, and leave as we evacuated the casualties. Climbing aboard after loading the last casualty, I flew into Mosul where I briefly spoke with the hospital commander whose military trauma center we had just overloaded with civilians. “Who targets children?” he muttered. While my pediatric training had been the perfect need for the night, my heart and mind were overcome with the reality of evil that caused the death and injuries of so many innocents.

The First Armor Brigade of the First Armor Division was built for combat and the blast in the Tal Afar market was a singular event highlighting our unit was needed where we could do more. One major explosion in almost five months was too peaceful for our combat mission so on Memorial Day weekend 2006 I was flown with the majority of our medical team ahead of our combat unit to begin training under the outgoing unit as 1AD took over the American military post in Ramadi.

Ramadi didn’t waste time introducing me to casualties. Our medical team was replacing an exhausted and seasoned medical team who had experienced more battle trauma than they cared to talk about. Days after I and the rest of the medical team arrived and before the majority of our combat unit arrived, the enemy launched mortars into our camp. Three successive blasts hit about a hundred yards from the aid station front door destroying a group of plywood huts being assembled for the soldiers who were in route from Tal Afar. One of the soldiers working on the huts had been hit. Carried into the aid station by his friend and placed on my trauma table, a guttural groan was one of the few signs indicating life as I stared at his blood-soaked uniform. Shell-shocked with the severity of the moment I did my best to direct the medical team. Recognizing my state, a physician from the experienced group nudged me aside with a command to stand nearby, observe, and learn. After the team had done all they could do and the unresponsive soldier was pronounced dead, this same doctor guided my gloved hands around the back of the head. Shrapnel from the mortars had removed most of the back of the soldier’s skull. We had done everything we could do to save him. The only thing preventing him from being DOA was how close he was to our aid station when he was hit by the shrapnel. He was my first trauma patient in Ramadi and a nauseous welcome to the reality I was now in a hot combat zone where casualties came from just outside my door.

Over the following eight months, I became more comfortable with handling and directing trauma. Along with another Pediatrician, a Neurologist, and three Physician Assistants, we functioned as ER physicians, stabilizing casualties for surgical intervention and caring for the intermittent medical needs of soldiers, defense contractors, and civilians. We were supported with a top-notch Navy Surgical Team who took over the surgical trauma cases. If blood was needed, a call would go out through the post with the needed blood type(s) and soldiers would line up single file in front of the aid station entrance as a living blood bank, each eagerly waiting their turn to donate, often knowing who the recipient of their lifeblood would be. Fresh, matched and crossed, still warm from the donor, whole blood transfusions were often necessary to keep a soldier alive who had lost a limb and/or was near death from blood loss.

I saw the carnage of battle up close, became too acquainted with the smell of burnt flesh, and observed the grief of officers and the agony of soldiers mourning their friends and fellow warriors. Battle trauma and concussions, most often resulting from IEDs, became my temporary specialty as our unit was embedded in the deadliest place in Iraq (Time Magazine December 11, 2006). We provided medical care to all—friend or foe—and did our best with each and every situation. By the end of the deployment, a casualty who entered our aid station could be assessed, have IV access placed, monitors placed, be intubated and sedated, stabilized, and moved to the operating room within minutes.

Once back home, I began noticing and appreciating the little things I had previously taken for granted. The grass looked greener and the sky appeared a brighter blue than I remembered. Returning to pediatrics, the typical anxieties of a previously emergent or dramatic situation now seemed to be much less severe or worrisome. Handling the rare urgent issue or newborn resuscitation at delivery, I was comforted that even in the worst situation every one of my patients had four extremities and could be intubated.

My experiences as a physician in the United States Army has fostered an ongoing appreciation for life and a more acute recognition of the freedoms I am given as an American. God has blessed me beyond measure to have been born a citizen in a country that allows the freedom of speech, the freedom of religion and the freedom to peaceably assemble and worship. My children have access to education and my wife has equal rights under the law. Although distraught by the destructive evil of an enemy restrained only by force, I have been awestruck by the selfless sacrifice of the heroic warrior motivated to save his fellow man. As a result, my experience has knitted within my soul a deep appreciation and respect for the American soldier who has given us the land of the free and the home of the brave.

Scott Huitink, MD FAAP

Dr. Scott Huitink loves being a Pediatrician and strives to support parents in the care of their children by encouraging, educating, and providing them with up-to-date medical expertise. His passion to provide high quality, personable, pediatric care can be seen in his face-to-face visits with children, his insights provided through his Facebook Page–“Compass Peds”, and his interest in improving the well-being of the community around him. Dr. Huitink has a wide array of experience in the care of children from newborns to young adults and has been instrumental in the education and implementation of clinical standards. He is Board Certified in Pediatrics and is a member of the American Academy of Pediatrics and can be found seeing patients in the Nashville area at Compass Pediatrics.