WarDocs - The Military Medicine Podcast Doug Soderdahl, Wayne Causey, Kevin Kniery

   Step into the world of military and civilian medical excellence as we share the stage with Dr. Peggy Knudsen, a leading trauma surgeon whose work bridges these two critical spheres. Her journey from a Minnesota mining town to the front lines of trauma surgery reveals the profound impact of military-civilian partnerships in healthcare. Through stories of her time in Iraq and Germany, Dr. Knudsen unravels the complexities of trauma care and the incredible strides made possible by the collaboration between military-civilian expertise and innovation.
   Imagine stepping off a plane and straight into an active war zone as a civilian surgeon. Our latest episode brings that reality to light, showcasing civilian surgeons who volunteered to serve in military hospitals during the Iraq and Afghanistan conflicts. Their integration into military teams and the skills honed in the heat of battle are not only harrowing tales of service but also invaluable learning experiences that have reshaped their professional and personal lives. Join us as we examine the rigorous process that prepared these civilians for the battlefield, and the indelible mark it left on their approach to surgery back home. These civilian heroes didn't just bring their expertise to the theater of war; they returned with invaluable insights that have since transformed the landscape of civilian trauma care.
    We address the evolving landscape of trauma medicine, where military innovations have found their place in our local hospitals. Dr. Knudsen sheds light on the importance of programs like Stop the Bleed and the pioneering strategies of damage control resuscitation, illustrating the profound influence of military protocols on saving lives in civilian emergencies. As we consider the future readiness of military medical professionals, she eloquently speaks to the importance of ongoing collaboration to maintain a high standard of combat casualty care, ensuring that, even in peacetime, our surgeons are prepared for the realities of war. Her experiences offer a unique lens on the Excelsior Surgical Society's role in nurturing military surgeons' professional development, painting a vivid picture of how these collaborations are pivotal in advancing modern trauma systems.
   As we face concerns over a potential decline in deployment experience among military medical personnel, Dr. Knudsen sheds light on collaborative efforts to ensure that the next generation of military surgeons retains the expertise necessary for future combat casualty care. It's an enlightening discussion that solidifies the critical nature of these ongoing partnerships in trauma care.
 
Chapters:
(00:04) Military-Civilian Partnerships in Trauma Care
(11:56) Civilian Surgeons in War Zones
(24:22) Improving Trauma Care Through Military-Civilian Partnerships
(31:42) Military-Civilian Trauma Care Partnerships
 
Chapter Summaries:
(00:04) Military-Civilian Partnerships in Trauma Care
Dr. Peggy Knudsen's journey in trauma surgery, her role in pediatric surgery, and the importance of military-civilian partnerships in advancing trauma care.
 
(11:56) Civilian Surgeons in War Zones
Civilian surgeons volunteered in military hospitals during Iraq and Afghanistan conflicts, learning from and working with military personnel.
 
(24:22) Improving Trauma Care Through Military-Civilian Partnerships
Military trauma care advancements, tourniquet use, damage control resuscitation, burn care improvements, and preserving surgical skills through partnerships.
 
(31:42) Military-Civilian Trauma Care Partnerships
Firsthand trauma experience, military-civilian partnerships, and readiness of trauma community to respond to large-scale operations.
 
Take Home Messages:
Civilian and military trauma care partnerships are critical for advancing modern trauma systems and ensuring readiness for future conflicts.
Civilian surgeons gain transformative experiences and valuable insights from volunteering in war zones, whic

Join us on WarDocs as we chat with the legend himself, Dr. Norman Rich, who pioneered the field of military vascular surgery. We journey through his life and career, from his humble beginnings in a small Arizona copper mining town to becoming an international authority in his field. Listen as Dr. Rich discusses his groundbreaking work in Vietnam, his creation of the Vietnam Vascular Registry, and the completion of his landmark textbook, Vascular Trauma.Dr. Rich shares insights on his journey of pioneering military vascular surgery and his unique experiences operating on President Eisenhower in this riveting discussion. Hear his fascinating story about meeting with Dr. DeBakey. Discover his career's challenges and triumphs and valuable contributions to the military medicine field. Learn about the unique military pathologies that Dr. Rich brought to light through his extensive research and the role of international collaboration in spreading the word about military vascular surgery. You will also gain an understanding of the importance of having consultants to help with the newly formed USUHS medical school surgical program and the value of the Excelsior Surgical Society in advancing military medicine. Don't miss out on this chance to hear from a true visionary in military surgery.
--------- EPISODE CHAPTERS WITH SHORT KEY POINTS ---------(0:00:00) - Dr. Norman RichDr Norman Rich was a pioneer in military vascular surgery, chairing surgery for 25 years and authoring the landmark textbook Vascular Trauma.(0:17:16) - Vietnam Vascular Trauma and RegistryDr. Norman Rich pioneered vascular surgery in the military, developing a registry system and writing the book Vascular Trauma.(0:33:51) – Walter Reed Fellowship Growth and ChallengesDr Rich pioneered military vascular surgery, strengthened fellowship through general surgery, and reached out internationally to start the Uniform Services University medical school.(0:41:39) - Military Unique Pathologies in Vascular SurgeryDr Rich assembled a team of specialists to pioneer military vascular surgery, addressing unique pathologies like Popliteal Entrapment Syndrome.(0:45:35) - International Collaboration on Vascular IssuesDr. Norman Rich spread knowledge of military vascular surgery, with consultants and Excelsior Surgical Society marketing, emphasizing the importance of expertise.(0:58:26) - Memorable Surgical CasesDr. Rich reflects on his experience operating on Eisenhower, meeting with Dr. DeBakey, and the importance of experience and organization in military medicine.

   Embark on a journey to the front lines of military medicine with our esteemed guest, retired Army Lieutenant Colonel Dr. Randi Schaefer. With her wealth of experience, Dr. Schaefer takes us through the intense world of emergency trauma care and her personal evolution from a college student to an accomplished military nurse and emergency medicine expert. We explore the educational paths and specialization opportunities within the military nursing field and the life-saving innovations in pre-hospital blood administration that have triumphed on the battlefield and transformed civilian emergency care.
   Dr. Schaefer pulls back the curtain on the progressive tactics and challenges that have shaped blood transfusion practices over the years. From the early days of relying on hospital staff donors to the current state-of-the-art application of whole blood in the thick of combat, we discuss the critical observations and strategic collaborations that have driven these practices forward. The role of STRAC in revolutionizing pre-hospital care and the crucial impact of timely blood transfusions in saving lives take center stage in this compelling narrative that intertwines military precision with medical breakthroughs.
   Our final moments with Dr. Schaefer reveal the innovative solutions combat medics deploy to save lives under the most extreme conditions, including providing blood transfusions amidst the chaos of active fire. We also shine a light on the advancements that continue to elevate the field, like the Vampire Program and the Tactical Combat Casualty Care training. Dr. Schaefer's ongoing consulting work and vision for emergency medicine not only reflect her unwavering dedication but also promise to guide the future of trauma care to even greater heights. Join us for this captivating episode where valor meets the rigor of medical science, and discover the incredible impact of one woman's journey on the world of emergency medicine.
 
Chapters:
(00:00) Addressing Hemorrhage in Trauma
(07:22) Early Blood Transfusion in Emergency Settings
(15:49) Pre-Hospital Blood Transfusion and Innovations
(27:57) Enhancing Pre-Hospital Blood Transfusion Rates
(37:26) Consulting on Pre-Hospital Blood Administration
 
Chapter Summaries:
(00:00) Addressing Hemorrhage in Trauma
Army nurse Randi Schaefer discusses pre-hospital hemorrhage control and the potential for future improvements in military and civilian sectors.
 
(07:22) Early Blood Transfusion in Emergency Settings
Nature's role in trauma care: reliance on hospital staff, evolution of transfusion practices, and efforts to improve pre-hospital capabilities.
 
(15:49) Pre-Hospital Blood Transfusion and Innovations
Nature's emergency blood transfusion process in pre-hospital settings, including training, logistics, and clinical guidelines for improved trauma care outcomes.
 
(27:57) Enhancing Pre-Hospital Blood Transfusion Rates
TCCC training, missed transfusion opportunities, and improvements in pre-hospital blood programs for combat medics.
 
(37:26) Consulting on Pre-Hospital Blood Administration
Practical aspects of pre-hospital blood product administration, logistics, military background, and legacy of service.
Take Home Messages:
Military medicine has played a critical role in innovating trauma and emergency care, specifically in the field of pre-hospital blood administration, due to the need for immediate life-saving measures in combat scenarios.
Career progression within the Army can lead to educational opportunities and specializations in emergency medicine and trauma care, as evidenced by the journey of a retired Army Lieutenant Colonel and military nurse.
The shift in blood transfusion practices, such as the transition from crystalloids and component therapy to the use of whole blood, has been influenced by clinical observations and the necessity for timely interventions to reduce mortality rates.
The Southwest Texas Regional Advisory Council (STRAC) has been inst

    Embark on an unforgettable exploration of leadership and resilience with CMSgt Tanya Y. Johnson, the influential senior enlisted leader for the Defense Health Agency. With a legacy steeped in military healthcare and wisdom to impart, Chief Johnson unwraps the layers of her journey, from her roots in an Air Force medic family to her strategic prowess in overseeing the TRICARE Health Plan and combat support missions. This episode is an education in the nuances of guiding with compassion and clarity in the military and medicine high-stress environments.
    As we traverse the landscape of the Military Health System's strategy, Chief Johnson illuminates the importance of transparent communication and the creation of an environment where feedback flourishes and trust is the cornerstone. This dive into the human side of healthcare delivery and the intricate dance of accountability and compassion in leadership is as enlightening as it is essential. Chief Johnson highlights the power of clear communication, the significance of fostering a culture where feedback thrives, and the importance of trust-building Listen in as she shares pearls of wisdom on leadership, especially the art of leading with grace in the high-stakes environment of military medicine.
   Finally, the episode captures the transformative journey of healthcare technology within the military, sharing how it reshapes care delivery and the necessity of readiness in times of crisis. Chief Johnson recounts the poignant memories of her deployment, including the impactful mission during the Ebola outbreak in Liberia, painting a vivid picture of the adaptability and resilience of military teams. Her insights offer invaluable advice for anyone considering a career in military medicine and underscore the profound dedication that defines this noble field. Whether you're a current service member, a healthcare professional, or simply intrigued by military medicine, this episode offers a unique perspective on the dedication and innovation that define the field.
 
Chapters:
(00:04) CMSgt Tanya Johnson's Leadership Journey
(09:02) Military Health System Strategy Discussion
(15:22) Future of Military Healthcare Technology
(28:30) Leading With Grace in Military Medicine
(33:22) Military Career Advice and Deployment Experiences
(38:53) Military Deployment to Liberia Experience
 
Chapter Summaries:
(00:04) Tanya Johnson's Leadership Journey
Chief Master Sergeant Tanya Y. Johnson's military legacy, personal journey in Air Force Medicine, and leadership philosophy in the Defense Health Agency.
(09:02) Military Health System Strategy Discussion
Leadership decisions impact teams through communication, trust-building, and care, as seen in the Defense Health Agency's strategy for modernizing healthcare.
(15:22) Future of Military Healthcare Technology
Medical technology transforms healthcare delivery, addressing staffing shortages and enhancing patient-centric care, while also discussing TRICARE Health Plan administration and DHA's role in combat support.
(28:30) Leading With Grace in Military Medicine
Leading with grace in military medicine, managing expectations, treating professionals with respect, and opportunities for personal growth.
(33:22) Military Career Advice and Deployment Experiences
Military service and recruiting insights from a guest who found a rewarding career in military medicine, advice for young service members, and profound experiences during deployment.
(38:53) Military Deployment to Liberia Experience
Rapid deployment to Liberia during Ebola outbreak, building medical facility, avoiding virus, overcoming challenges through teamwork.
 
Take Home Messages:
Leadership Resilience:
Resilient leadership in high-pressure environments is key to successful outcomes, especially in military medicine where the stakes are high. The ability to maintain composure and lead with empathy and understanding is essential for managing teams effectively in challenging situation

    Embark on a captivating journey with Master Chief Troy Brown, a decorated Navy veteran whose life story unfolds like an epic saga across the globe's most challenging terrains, from the detainee cells of Camp Delta to the bustling medical tents of Camp Leatherneck. As a native of Joplin, Missouri, Troy's life took an unexpected turn during a fateful dinner conversation, setting him on a path that would define his character and commitment to military healthcare. Our latest episode navigates his transition from aspiring serviceman to a revered corpsman, revealing the hurdles overcome and the passion kindled for supporting the well-being of warfighters.
    The echoes of 9/11 resonate through the personal narratives shared in our heartfelt discussion, casting light on the ripple effects such historical moments have on those in uniform. Troy's account of the ethical conundrums faced while caring for detainees at Guantanamo Bay is both enthralling and thought-provoking, offering listeners a rare glimpse into the realities of wartime medical practice. We also delve into the essence of leadership, as seen through the trials and triumphs of military service.
Concluding our session, we admire the indelible mark left by leaders such as Troy, who underscore the value of seizing diverse opportunities and forging robust relationships throughout one's career. Heeding the advice to 'Be the one,' we reveal the transformative power of initiative and the innovative strategies that bolster team support. Troy's reflections on a gratifying career in military medicine are a testament to the impact of dedication and the art of thinking beyond conventional limits.
 
Chapters:
(00:00) Navy Career
(07:24) Challenges of Military Deployments
(22:26) Military Leadership Experiences and Lessons
(36:31) Supporting People in Leadership Roles
(41:49) Career Legacy and Leadership Advice
 
Chapter Summaries:
(00:00) Navy Career
Master Chief Troy Brown's journey from Missouri to Navy corpsman, specializing in physical therapy and preventive medicine, with deployments in specialized roles.
 
(07:24) Challenges of Military Deployments
9/11's impact on military personnel, career effects, and wartime medical ethics in Guantanamo Bay.
 
(22:26) Military Leadership Experiences and Lessons
Veteran instructors' impact on students, adaptability in deployments, leadership in military health system, and low casualty rates.
 
(36:31) Supporting People in Leadership Roles
Flexibility and support in the workplace, prioritizing personnel issues, and the impact of individual initiative in leadership roles.
 
(41:49) Career Legacy and Leadership Advice
Seizing opportunities, valuing diversity, and building relationships are crucial in avoiding career limitations and leaving a positive legacy.
Take Home Messages:
**The Significance of Adaptability in Military Service**: The story underscored in this episode highlights the importance of adapting to diverse and challenging environments, particularly in military healthcare. Multiple deployments, including those to Guantanamo Bay and Camp Leatherneck, demonstrate the need for flexibility and the ability to learn from every situation to provide the best care possible in varying circumstances.
**The Complex Ethical Landscape of War Medicine**: The episode delves into the ethical considerations of treating enemy combatants and the moral obligations of military medics. The experiences shared about treating detainees with combat-related injuries in Guantanamo Bay serve as a poignant reminder of the unique challenges faced by those serving in military healthcare.
**Leadership and Mentorship are Crucial in Military Careers**: Through the reflections shared in this episode, the emphasis is put on the impact that strong leadership and mentorship can have on the careers of those in the military. The stories illustrate how experienced individuals can influence and shape the path of upcoming service members, highlighting the imp

    Retired Navy Commander and Trauma Surgeon Dr. Ramon Cestero joins us to share his remarkable journey from the front lines to the forefront of surgical innovation. Imagine the battlefield's high stakes where every second counts, and the tools at your disposal can mean the difference between life and death. His tales of life-saving speed and adaptability in the most austere conditions reveal the genesis of his revolutionary contribution to surgical technology—a battlefield-optimized surgical retractor. Our conversation with Dr. Cestero isn't just a walk through his experiences; it's a masterclass in the resilience and resourcefulness required in military and civilian trauma surgery.
    Throughout the episode, we witness the evolution of surgical retractors over the past few centuries, from their rudimentary origins to the state-of-the-art devices we see today. From the necessity that birthed his new retractor system to the behind-the-scenes look at transforming a concept into a globally utilized device, the narrative is as engaging as it is instructive. Dr. Cestero's insights into balancing the demands of a full-time surgical career with medical entrepreneurship are a candid reflection on the challenges and triumphs of innovation.
     As we round out the discussion, Dr. Cestero doesn't just rest on his laurels; he casts a strategic eye toward the future of trauma surgery. With a nod to the lessons of past conflicts, we discuss the dynamic nature of military medicine and the implications for surgeons in rapidly evolving combat environments. We get into the Navy's shifting strategies, the importance of adaptable surgical teams, and the next wave of advancements set to revolutionize trauma care. It's a riveting exploration of how technologies like Dr. Cestero's retractor, along with advancements in operating room efficiency and training, stand to elevate patient care in both military operations and civilian trauma centers. Prepare to be inspired by the potential that lies ahead, as we uncover the innovations set to revolutionize the experience of patients and surgeons alike.
Chapters:
(00:04) Military Trauma Surgeon's Innovative Approach
(08:07) Innovating Surgical Retractors
(13:51) From Idea to Global Commercialization
(19:06) Innovative Surgical Retractor System Design
(31:10) Future Innovations in Trauma Surgery
 
Chapter Summaries:
(00:04) Military Trauma Surgeon's Innovative Approach
This chapter features retired Navy Commander and Trauma Surgeon Dr. Ramon Cestero, who shares insights from his multiple global deployments, emphasizing the importance of proper equipment, speed, and adaptability in trauma surgery under austere conditions. I discuss with him how these experiences led to his development of a battlefield-optimized surgical retractor and the challenges of bringing such innovations to widespread use. Dr. Cestero also reflects on the unique aspects of serving as a trauma surgeon in the Navy Reserves, highlighting the balance between maintaining military connection and civilian practice, and offers suggestions for enhancing reserve surgeons' team experience and training. We explore the current gaps in trauma surgery research and what future innovations Dr. Cestero envisions.
(08:07) Innovating Surgical Retractors
This chapter uncovers the pressing need for innovation in surgical equipment, specifically retractors, through a surgeon's experiences working in both austere military settings and a Level 1 trauma center. I discuss the challenges faced during surgeries without adequate resources, such as the absence of platelets and the struggle for exposure in critical procedures, which can lead to life-threatening delays. The narrative is anchored by a poignant case of a young soldier with severe injuries, whose outcome might have been different with better surgical tools. We explore the history of surgical retractors, from their evolution in the Renaissance to modern table-mounted systems, and the inspir