Through Dr. Margaret Curtis, WCI Columnist
I’m lucky sufficient to be married to a real Renaissance guy. My husband, Mike, is a urologist, a hockey rink builder, a highschool hockey crew announcer (GO RED RIOTS), and an novice stonemason. He’s a former Military reservist and an skilled world help employee who has completed scientific reduction paintings in Bangladesh, Bosnia, and Macedonia (with Docs With out Borders) and within the Western Province of Zambia.
In February 2022, he used to be additionally completely burned out.
Mike were hired via a small neighborhood clinic in Maine for 12 years. In 2021, his clinic used to be obtained via the most important well being gadget in our state, and on most sensible of the standard pressures of training drugs, the brand new management added a brand new EMR, a couple of further layers of management, and a bigger catchment house. One spouse retired, and every other stopped taking name. Unexpectedly, Mike used to be operating 80 hours every week and taking name each different night time. He went from preternaturally vigorous and enthusiastic to irritable and exhausted. He began having nightmares and a PTSD-like reaction to his beeping pager.
We made up our minds we needed to trade one thing—if truth be told, there wasn’t a lot of a call to be made as a result of he couldn’t perhaps proceed as he used to be. He gave his realize, to take impact June 2022, and he deliberate a longer holiday ahead of beginning a brand new process on the VA. Then, on February 24, 2022, Russia invaded Ukraine.
Mike adopted the warfare in Ukraine very intently proper from the beginning and appeared for methods to donate to reduction efforts. He additionally, in some way this is conventional of him, began attempting to determine how he may just get there to lend a hand in individual. We mentioned this at period, in fact. If I had requested him to stick house, that might had been the tip of it. However I knew who he used to be after I married him, and I knew how unsatisfied he were for the prior yr.
He contacted World Reaction Drugs (GRM), a global help group began via former army scientific team of workers. Its purpose is to supply “the most efficient imaginable care at the worst day of anyone’s existence.” GRM used to be sending a surgical crew to Ukraine to supply direct affected person care along Ukrainian scientific groups. If this “evidence of idea” used to be a hit, it deliberate to use for long-term investment. Mike used to be authorized onto the crew.
In April 2022, Mike traveled to Ukraine, by means of Zurich and Warsaw. His crew incorporated two former US Particular Operations medics, a retired Military CRNA, and an EM doctor who used to be within the Austrian army particular ops and now practices in Michigan. They have been supported via interpreters and a logistics crew in Poland.
The Ukrainian ICU crew at Health center #5. Again row (L-R): anesthesiologist, leader of ICU; Center row: GRM crew member (on left), nurses (heart), and anesthesiologist (on proper); Entrance row: scientific assistant, GRM interpreter, and Michael Curtis.
He spent the following 3 weeks dwelling and dealing in two other hospitals about 10-15 miles from the entrance traces in Mykolaiv, close to Odessa. His process used to be to beef up the clinic team of workers whatsoever wanted; that incorporated a variety of wound control and primary helping in surgical circumstances that incorporated trauma, burns, and orthopedic surgical operation. Some days, he noticed a couple of burn sufferers; different days, he would possibly lend a hand with one complicated OR case. Mike’s basic surgical operation coaching of the early Nineties used to be very best for the extent of care that used to be imaginable to supply on this atmosphere: debride, rainy to dry dressing, debride once more.
To start with, he cringed when he noticed hydrogen peroxide and Betadine poured into wounds (in the United States, those had been phased out in want of fancy vacuum dressings). However he learned that, within the cases, this used to be an effective way to regulate the injuries: combating an infection with a low cost, broadly to be had choice is definitely worth the extend in therapeutic from the inflammatory response that this induces.
The clinic used to be constructed within the Soviet generation with two-foot-thick concrete partitions and underground passages that, mockingly, allowed it to stay functioning in spite of Russian shelling. One thing else you don’t see regularly in American hospitals: the pleasant canine who are living within the hallways.
Consider seeing this face for your approach to morning rounds.
What inspired Mike essentially the most used to be the team of workers’s resolution and talent to make do with sources that the majority North American physicians would imagine completely poor. Nobody complained in regards to the plywood window within the OR as a result of shrapnel had blown out the glass the week ahead of or scrubbing in with boiled water poured from a beaker. A Ukrainian world-class weight-lifter had simply began that week because the older orthopedic surgeon’s assistant to use traction. In 3 weeks, Mike by no means as soon as reviewed a CT scan.
Scrubbing in whilst you don’t have operating water (and having to make use of boiled water from a beaker).
He additionally got here away with an abiding recognize for Ukrainians’ toughness. Everybody he met there spoke of “once we win the warfare” and “once we ship the Russians again house.” No longer one individual expressed doubt or any hobby in capitulating.
Rather than lacking his circle of relatives, Mike used to be utterly content material in Ukraine. I inform other folks he would slightly chance being hit via Russian drone moves than whole even yet another prior auth, and I’m no longer truly joking. A ways from being depressed via the ugly accidents he noticed, he used to be glad to be the usage of all his abilities and effort for a worthy reason and for an admirable other folks. He describes a nearly Zen second of perfection in a seventh-floor OR with large home windows whilst prepping a affected person:
“I knew I used to be the place I belonged: I used to be chatting with the affected person (beneath spinal) in his damaged English about which AC/DC music to hear, chatting with the Ukrainian orthopedic surgeon in mutually damaged French in regards to the incision, after which, because the air raid siren went off, talking in German to the anesthesiologist about giving the all at once worried affected person some Diazepam.”
Mike got here house from Ukraine drained however exhilarated. He used to be fascinated by drugs once more, and I felt like I had my husband again. The previous couple of months of his outdated process have been nonetheless challenging, however Mike navigated them with a few of his outdated power and humor.
He began his new process on the VA in August 2022 however stored in shut touch with pals and co-workers in Ukraine. One among them, a Croatian heart specialist who lives in Italy, got to work with a Ukrainian help group known as Stellar Ukraine. Stellar’s challenge is to supply hospital therapy and humanitarian help to non-combatants dwelling within the Kharkiv area close to the entrance traces. Stellar volunteers come with medics and ambulance drivers who can give elementary first help and shipping sufferers to hospitals. A purpose is to create cellular number one care clinics to take care of citizens, a lot of them aged, with continual well being issues.
Mike recommended Stellar follow for a grant from the Global Rescue Committee (IRC), funded via the US Company for Global Building (USAID). The founders produced a unfastened narrative description of the gang, and Mike revised it right into a grant utility that might meet the necessities of each IRC and USAID (The Ukrainians have been slightly bewildered via pieces like, “How can you measure affected person pleasure?” and, “Describe your worker complaint procedure”). The grant used to be given initial approval in January 2023, and we made plans for him to go back to Ukraine in February to satisfy with the crew.
The grant would pay for team of workers and provides however in particular excluded any apparatus which may be utilized in struggle, together with non-public protecting tools. We felt a accountability to the Stellar team of workers who can be taking good care of civilians in and close to the frontline, so Mike put out the phrase to his colleagues at former and present employers and requested for donations for protection provides. We concept possibly he would lift cash to shop for a few flak jackets. His pals and co-workers answered with overwhelming generosity. In 10 days, they contributed over $8,000. One be aware mentioned, “1. Watch out 2. F*** Putin.” Mike purchased 17 flak jacket tactical vests ($300 each and every), seven Kevlar helmets, an evacuation sled, and trauma provides like chest seals.
Our front room the day ahead of departure again to Ukraine in February 2023.
In this commute, he spent his time in Lviv and Kharkiv, assembly Stellar team of workers to talk about organizational construction and to scout places for logistics operations. In many ways, this used to be tougher than operating in a clinic beneath fireplace. Struggle-zone humanitarian paintings draws other folks (Mike incorporated) who’re impartial and action-oriented and who’ve little endurance for niceties like team of workers conferences. When he arrived, the group used to be in some disarray, and when he left it used to be . . . smartly, in much less disarray. If he used to be not sure about Stellar’s construction, he had no doubts in any respect in regards to the competence of the team of workers. He passed over the provides he introduced with self belief that they might be put to excellent use. He additionally met an injured member of Frontline Medics and helped him to use for a grant as smartly.
Since he returned house from his 2d commute, Mike has settled again into his paintings on the VA. He loves his sufferers and understands them slightly higher now. He nonetheless advises Stellar. His time in Ukraine has given our entire circle of relatives a brand new point of view: on how fortunate we’re to do paintings that issues, to have each and every different, and to are living in a unfastened and secure nation.
Mike taking a wreck whilst in Ukraine. There’s a 100% probability there’s a espresso cup in his left hand.
I’ll finish via answering a couple of questions that we’re requested ceaselessly.
- Since it is a monetary weblog: how did you find the money for those two journeys? Mike’s first Ukraine commute used to be paid for via GRM. He used 3 weeks of collected holiday time. He extensively utilized PTO for his 2d commute. It used to be if truth be told more straightforward to get this absence authorized on somewhat brief realize. Through then, he used to be hired via the VA, and his supervisors thought to be this one of those deployment. We paid for his go back and forth ourselves (about $6,000 overall), and we now have asked repayment from the grant. If the repayment doesn’t come via, we will be able to imagine it cash smartly spent. For each journeys, his colleagues have been extremely beneficiant in providing to hide his name (despite the fact that he did take further name to pay them again when he were given house).
- Have been you frightened about his protection? Sure, in fact. I used to be reassured understanding that Mike had lived and labored in warfare zones ahead of (in particular, 8 months in Tuzla, Bosnia, all through the Bosnian warfare in 1993), and he can be accompanied all the time via very savvy and skilled protection team of workers. The Ukrainian team of workers would know what spaces have been kind of secure. I began to fret in April 2022, when the clinic the place he used to be stationed misplaced operating water (that used to be why they’d to make use of beakers of boiled water). This recommended the entrance used to be getting nearer and that town can be shelled. Simply ahead of he left for his 2d commute in February 2023, a GRM founder used to be killed via a Russian missile assault in Bakhmut. (One among his partners used to be stored, no less than partly, via the protecting vest he used to be dressed in on the time; Mike used to be ready to interchange it with a brand new one donated via our neighborhood again house.) This indisputably gave us pause, however once more, we knew he can be in excellent fingers and would use his very best judgment.
The media’s process is to file on demise and destruction (and it’s essential that they achieve this), however they don’t give a lot airtime to the relative normalcy that also exists in lots of portions of a rustic at warfare. In some portions of western Ukraine, the notable absence of small children and the indicators pointing to the closest bomb safe haven are the one proof that there’s a warfare happening.
A couple of miles away, at the outskirts of Kharkiv.
I don’t imply to attenuate the dangers of going right into a warfare zone, however we additionally felt there have been dangers to NOT going.
Mike used to be depressing in his outdated process. I don’t imagine he used to be as regards to substance abuse or suicide (despite the fact that those are rampant amongst physicians), however he simply couldn’t stay going at that tempo and in that atmosphere. Going to Ukraine helped him really feel like he used to be the usage of his coaching to give a contribution to one thing essential. He does no longer all the time really feel that means operating in our US healthcare gadget.
And in an ironic twist: although he got here house from Ukraine unscathed, he suffered a compression fracture of a thoracic vertebra on a circle of relatives ski commute in March. Seeking to stay alongside of your teenage children is bad, people.
Will he return to Ukraine? Completely. Mike would like to return once paintings and circle of relatives commitments permit. He’s hoping to do extra world reduction paintings as a part of his segue into retirement, and we are hoping to spend a yr primarily based in Japanese Europe whilst he volunteers. In my opinion, I’m really not lower out for warfare zones, however I look ahead to visiting Ukraine as soon as the Russians are despatched again house. There are some canine I need to meet.
Have you ever completed any world help paintings? Have you ever ever needed to apply in a warfare zone? What used to be it like? Remark under!
