Day in the Life
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slug: /burdash-civilian-jobBurdash Civilian Job description: "I'm almost finished with my shift at my civilian job, where I work as an emergency medicine physician in the emergency department of the University of Minnesota Medical Center. Now I just have to get home, see my husband and dogs, get a bit of dinner and pack for my drill weekend with the National Guard." transcript: columns: normallinkTitle:More about careers and lifestyledoctorSlug: /sara-burdashdoctorName: Sara Burdash, M.D.time:Time Hour:0Time Text:12:50 AMtrackingCode:
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slug: /burdash-why-national-guard-videoBurdash Why National Guard (video) description: Sara explains why she chose to be a part-time physician in the Army National Guard. transcript:
BURDASH: When I came into the military, it was, I was looking into going to medicine, and I knew that there was an opportunity to be a medic. And so, I actually enlisted into the North Dakota National Guard as that one weekend a month, two weeks in the summer, when I was in high school thinking that man, being an Army medic is really going to prepare me for my career. So, I started there, I actually did some ROTC time in undergrad, and actually took my direct commission through the state of Minnesota, because this is where I did my medical school. And became an officer, and so when I look at my time, I started off almost kind of what can the Army give me, I’m going to be a medic, I’m going to learn the skill set, I’m going to get some experience, now that I’m older and I’m in medicine, I really see where the need is.
columns: normallinkTitle:More about applying and what to expectdoctorSlug: /sara-burdashdoctorName: Sara Burdash, M.D.time:Time Hour:17Time Text:05:00 PMtrackingCode: -
slug: /burdash-shooting-targetBurdash Shooting Target description: "This is one of the pop-up targets from our weapons qualifications range. They say that you're supposed to aim for center mass or the middle of the body. They fall backward when shot and it's also computerized, so you know if you hit it or not." transcript: columns: normallinkTitle:More about military trainingdoctorSlug: /sara-burdashdoctorName: Sara Burdash, M.D.time:Time Hour:16Time Text:04:47 PMtrackingCode:
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slug: /burdash-military-friendsBurdash Military Friends description: "This has to be my favorite picture. These are all medical providers, my peer group if you will ŰÓ a lot of different physicians from different specialties. They are a great group of people. I see them at drill weekend, but sometimes we hang out in our free time, too. Some were even at my wedding. Just like a sports team, you always know your team well. They are people I trust implicitly. " transcript: columns: normallinkTitle:More about careers and lifestyledoctorSlug: /sara-burdashdoctorName: Sara Burdash, M.D.time:Time Hour:19Time Text:07:00 PMtrackingCode:
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slug: /burdash-bonfire-videoBurdash Bonfire (video) description: At the end of the day, Sara is released from her duties and takes the opportunity to enjoy some downtime at a barbecue on post. transcript:
BURDASH: During the drill date, if we have little moments to kind of sneak away and go get a soda, or go get a coffee and catch up a little bit, we’ll do that. We’ll sometimes have time to grill out, watch sporting events if it’s a big sporting event weekend. We have holiday parties, we have usually one in the winter, and then a family day kind of in the summer where we’ll get groups together, and we get to hang out with everybody’s significant others. A whole bunch of these guys came to my wedding. We’ve got a whole crew here we can introduce them to. We’ve got Captain Ellenbos here, he’s one of our nurse corps. So, he keeps us grounded and keeps us moving and efficient. We’ve got Lt. Samberg here, he’s our -- yeah. So, he’s our fitness guru, physical therapist. Tentis, who works at urgent care down at Mayo Clinic, fancy. Then our good major, fearless leader. He’s a PA at the emergency room at the Mayo Clinic so good, smart guy. Quality gentleman. And then our wonderful dentist we told you about. Hey!
FEMALE: Hey.
BURDASH: Captain Miller, Captain Hunter, they try to keep me from losing all my teeth. So now we’re just enjoying our chance to have a little time off before finishing up our work here at drill.
columns: widelinkTitle:More about community and lifestylelinkHref:doctorSlug: /sara-burdashdoctorName: Sara Burdash, M.D.time:Time Hour:20Time Text:08:13 PMtrackingCode: -
slug: /burdash-weapons-rangeBurdash Weapons Range description: "Here are the range safety personnel receiving a briefing about the weapons qualification so that they can keep everything running smoothly and safely.ŰÜ" transcript: columns: normallinkTitle:More about the Military working environmentlinkHref:doctorSlug: /sara-burdashdoctorName: Sara Burdash, M.D.time:Time Hour:16Time Text:04:18 PMtrackingCode:
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slug: /burdash-tactical-gearBurdash Tactical Gear description: "This is some of my tactical gear. It's military property that's issued to me from the CIF (Central Issue Facility). It's like checking out a library book that you wear. The vest has pockets inside the front and back for hard plates to make it even more bulletproof." transcript: columns: normallinkTitle:More about Military working environmentlinkHref:doctorSlug: /sara-burdashdoctorName: Sara Burdash, M.D.time:Time Hour:16Time Text:04:10 PMtrackingCode:
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slug: /burdash-weapons-training-videoBurdash Weapons Training (video) description: Sara's primary responsibility as a Guard physician is to be a solider, and to know how to defend herself, her patients and her peers. She's required to participate in an annual weapons qualification to ensure she's proficient in her assigned duty weapon. transcript:
BURDASH: Right now, we’re at our nine millimeter weapons range. So we’re getting ready, we’re getting all set up for the day. All the safety staff are getting here, and we’re starting to get all the ammo ready, and what we’ll be doing is firing at these, actually. They’ve changed the regulations, so now the way we fire, not only we’ll be standing and firing at the targets, but we also get to walk towards them and fire that way. So, that’ll be a new adventure. Like you see, you can see all the range; these will actually pop up and pop down. And then we’ll have multiple firers going at once. So I’ll be one of those firers. We’ll actually be changing magazines while we walk forward towards the firing line, from the back. So it’ll be a little bit more dynamic, a little bit more realistic.
This is part of our annual qualifications. We have to make sure that we are proficient in whatever our assigned duty weapon is. Last time I shot, I shot expert. So, that’s my goal. And if not, at least we’ll have a good time, and try to hit as many targets as we can.
MALE: Firers, at this time, go ahead and move out. Cease fire there, cease fire. Clear off make sure that it’s clear.
BURDASH: So, not quite as good as I did last year, but still not too bad. You know, sharpshooter is OK. I would have preferred expert like last year, but considering it was the first time doing walking, not too bad. Next time I’ll practice up and try to beat these guys.
columns: widelinkTitle:More about education and trainingdoctorSlug: /sara-burdashdoctorName: Sara Burdash, M.D.time:Time Hour:16Time Text:04:00 PMtrackingCode: -
slug: /burdash-responsibilities-videoBurdash Responsibilities (video) description: Sara takes a moment to talk about the advantages of being in the Army National Guard and the importance of being a mentor. transcript:
BURDASH: As a physician in the Guard, we have multiple responsibilities. First and foremost is to be a soldier. When I say be a soldier, it’s to know how to defend yourself, defend your patients, defend your peers. There’s the education of soldiers. Working in a medical unit, I have people who signed up to be combat medics, and they might have done it to pay for school, they might have done it to prepare themselves because they’re going to go into PA school, or nursing, or dentistry, and we have lab techs, we have all kinds of folks who are going into the medical field. And maybe they’re using this as their opportunity to educate themselves. As a provider who got all of that civilian experience, trained at, you know, well known programs, I get to use that experience to help those young folks, and that’s the same thing that happened for me, I had an ER doc train me when I was a medic. So, I feel to pass that along is really helpful, and I think a good responsibility to try to further and mentor the next generation of medical providers.
columns: normallinkTitle:Learn more about careers and benefitsdoctorSlug: /sara-burdashdoctorName: Sara Burdash, M.D.time:Time Hour:15Time Text:03:00 PMtrackingCode: -
slug: /burdash-stitched-pigs-footBurdash Stitched Pigs Foot description: "We got pigs feet today from a local butcher in a nearby town. We've also gotten tracheas (windpipes), ribs and various other things for our training exercises. I think it aids the learning by making it more engaging." transcript: columns: normallinkTitle:More about training and developmentdoctorSlug: /sara-burdashdoctorName: Sara Burdash, M.D.time:Time Hour:14Time Text:02:45 PMtrackingCode:
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slug: /burdash-suturing-toolsBurdash Suturing Tools description: "That thing that looks like pliers is the needle driver. It allows you to have good control of the curved needle without having too much wiggle. The string is called a suture. Commonly, suturing needles are curved to allow the natural turn of your wrist to go through the tissue more easily." transcript: columns: normallinkTitle:More about medical trainingdoctorSlug: /sara-burdashdoctorName: Sara Burdash, M.D.time:Time Hour:14Time Text:02:17 PMtrackingCode:
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slug: /burdash-suture-class-videoBurdash Suture Class (video) description: During her monthly drill weekends, Sara hosts a variety of classes to teach medics information or skills related to their military and medical roles. Today, she has them practice their suturing skills using a pig's foot. transcript:
BURDASH: So, let’s come on down here, and now we’ve talked about those wound cares a little bit. So, let’s give a quick demonstration. And then we’ll break into stations here and you all can give it a try.
Simple wounds like this are so, so common. They don’t have to be combat-related. This is, you know, somebody cutting themselves trying to open a package, this is, you know, falling out of a truck, you know, you stumble out and you scrape your leg. So this is something that’s very common, and something we’re guaranteed to see at some point in our careers.
Needle at 90 degrees. And then you go through the skin, and try to come out on the other side of your wound, about the same distance that you went in on. Yeah, and that’s great, what you did right there.
We have a nice partnership actually with a local butcher who gives us a good deal on pig’s feet. We’ve done classes where we do a cricothyrotomy, or cric, and so you have to make a cut into the airway, and place a breathing tube through that. So we’ve bought pig tracheas before, and we’ve also bought racks of ribs to practice doing chest tubes, as if we would between human ribs. And so, I think the butcher gets good business out of us on things that maybe nobody else is buying, so he can’t be wrong with that. But it gives us a really good, tangible experience because a lot of the stuff, you just can’t learn unless you feel it. To put a chest tube in, you have to feel what it feels like to go in between the tissue of ribs. To have the confidence to do a procedure where you have to use a tool on another person, it’s helpful to have done it at some point before, so that, you know, the first time that they’re doing some sort of lifesaving procedure, and they’re realizing they’re going to have to make a cut in somebody’s throat, they aren’t having to do it for the first time just brand new, having never actually held a scalpel and cut something. And so this is what we try to do to prepare them to be safe to be able to do their jobs.
columns: widelinkTitle:More about medical specialties and rolesdoctorSlug: /sara-burdashdoctorName: Sara Burdash, M.D.time:Time Hour:14Time Text:02:00 PMtrackingCode: -
slug: /burdash-hip-pocket-2Burdash Hip Pocket 2 description: "During hip-pocket training we talk about random things the medics want to learn about or topics we think they would benefit from and we'll just go down either a figurative or literal list until we've covered all of the topics or run out of downtime. There was a question about respiratory infections and this was a drawing I made as we talked through where patients can get respiratory infections." ŰÜ transcript: columns: normallinkTitle:More about medical trainingdoctorSlug: /sara-burdashdoctorName: Sara Burdash, M.D.time:Time Hour:13Time Text:01:21 PMtrackingCode:
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slug: /burdash-hip-pocket-videoBurdash Hip Pocket (video) description: In between training exercises, Sara gathers the medics for a quick, on-the-spot medical lesson known as "hip-pocket training." Here she applies her emergency medicine expertise to teach them when to suture or staple a wound. transcript:
BURDASH: All right. Next topic, who’s got one?
FEMALE: Things that you would suture of staple, and why one versus the other.
BURDASH: Sure. Yeah, that’s a great one. The idea is, is you want to do the best to help the body heal without doing any harm. That's key. You know, it’s the first rule of medicine is first do no harm. Primum no killum. I like to do stitches on almost all things, unless they are very big, or sometimes scalps are a nice place to do staples. Or if you’re in a situation where speed is of the essence. So if you’ve got a cut like that, all we want to do is bring these edges together to be able to let the body heal itself. And so, we can do that with staples, where we’ll push the skin together, so we’ll push it and hold it like that, and then we put staples in to hold the edges together. Or, we can kind of bring the skin together, and we put a needle in here through this part of the skin, out through this edge, on this side, into the skin here. And out on the other side. And we get to tie it in a knot.
So we just finished some hip pocket or just in time training where we had a little lull while we were waiting for some additional equipment before our next class, so we basically just talk about whatever the soldiers want to talk about. Or whatever would be helpful at the time. We’ve talked about all kinds of things in the past. This time we just talked a little bit about wound cares, and respiratory infections. But we’ve just been informed that our equipment has arrived for the other class that we’re going to be doing, so we’re stopping this as needed type training, and we’re going to be moving over to our actual next class.
columns: widelinkTitle:More about medical trainingdoctorSlug: /sara-burdashdoctorName: Sara Burdash, M.D.time:Time Hour:13Time Text:01:00 PMtrackingCode: -
slug: /burdash-lunchBurdash Lunch description: "Before my next training, I stop to grab a grilled chicken wrap from the snack shack on base. They are actually quite delicious. Our unit has cooks in it and they make spaghetti, hamburgers and all kinds of stuff." transcript: columns: normallinkTitle:More about the Military working environmentlinkHref:doctorSlug: /sara-burdashdoctorName: Sara Burdash, M.D.time:Time Hour:12Time Text:12:10 PMtrackingCode:
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slug: /burdash-inside-helicopterBurdash Inside Helicopter description: "The inside of a UH-60 Black Hawk has an elevated platform that allows two patients to be stacked, one on top of the other." transcript: columns: normallinkTitle:More about medical trainingdoctorSlug: /sara-burdashdoctorName: Sara Burdash, M.D.time:Time Hour:11Time Text:11:23 AMtrackingCode:
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slug: /burdash-helicopter-videoBurdash Helicopter (video) description: One of Sara's responsibilities as a National Guard physician is to train the Guard's medics to be prepared for any situation. Today her team is training on how to load and unload patients onto a UH-60 Black Hawk. transcript:
BURDASH: We’re going to do some drills with our medics with helicopter loading and offloading. We have physicians that help lead classes; we have PAs that help lead classes. We actually rotate a little bit who gets to teach the classes, and then it lets everybody use their expertise.
This is so important, especially for us as our role in an area support medical company, because we may be in a position to both be sending and receiving patients. Our role is a little bit versatile in that regard. And so, our team may very well be loading patients on helicopters. Maybe taking them off.
We’re going to be practicing our hot loads. And so basically practicing loading with the helicopter blades going, just as if it would be in real life. So they’re moving now to the bird, to the helicopter. Moving as one. Once they get instructions from either the crew chief or the medic who’s in the helicopter, they’ll be able to load the patient in. They’re just trying to slide the litter into a safe position so that the helicopter crew can safely take care of the patient. And then they’re all going to hold onto each other to make sure they can move as a unit away from the helicopter as a safe group, and they don’t lose anybody in the process.
Helicopter crews are very good about giving us the sickest patient first. So they’ll usually bring the patient into our facility, where myself, a team of medics, will receive them, assess them, and get the sign out from the helicopter crew about what’s happened, what’s been done. What needs to be done, and take care of the patient from that standpoint.
columns: widelinkTitle:More about education and trainingdoctorSlug: /sara-burdashdoctorName: Sara Burdash, M.D.time:Time Hour:11Time Text:11:00 AMtrackingCode: -
slug: /burdash-captain-patchBurdash Captain Patch description: "This is a spare patch that represents my rank. I'm currently a captain, and I've been getting my paperwork together for consideration to be promoted to major. Before we had Velcro patches, our rank was typically pinned on. They still call it 'pinning your rank on you' at promotion ceremonies."ŰÜ transcript: columns: normallinkTitle:More about officer training and rankdoctorSlug: /sara-burdashdoctorName: Sara Burdash, M.D.time:Time Hour:10Time Text:10:07 AMtrackingCode:
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slug: /burdash-extra-uniformBurdash Extra Uniform description: "I like to bring an extra uniform or two for drill weekends because they can get dirty and sweatyŰÜ. My uniform is one of the newer ones cut to better fit females. They also have Velcro, so you can remove your patches before washing them. When you first join, you are given a $400 clothing allowance. Officers need to buy their own uniforms, and we get them from the clothing store on post or from a military website." transcript: columns: normallinkTitle:More about applying and what to expectdoctorSlug: /sara-burdashdoctorName: Sara Burdash, M.D.time:Time Hour:10Time Text:10:05 AMtrackingCode:
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slug: /burdash-quarters-videoBurdash Quarters (video) description: After formation, Sara goes to her room to unpack and settle in before starting the rest of her day. She's staying in the officer quarters, which provide her with everything she needs for the weekend. transcript:
BURDASH: All right. So, just head on in. Here in one of, actually one of our kind of one of the buildings where the officers stay often. Just a little bit more space than the usual barracks. And so we’re coming in, and we have to find out which room we’re in this time. Think it's in room seven. All right. Well, here we go then. Got a microwave and a TV. And here’s the sleeping quarters. Not too bad. I’ll take it. Better than a twin size. Always hard to do Army hair? There’s a little bit more space than the barracks. A little bit more to work with. And extra uniforms, just get some of these out so we’ll have them ready in case we need them. OK.
columns: normallinkTitle:More about the Military working environmentlinkHref:doctorSlug: /sara-burdashdoctorName: Sara Burdash, M.D.time:Time Hour:10Time Text:10:00 AMtrackingCode: -
slug: /burdash-unit-flagBurdash Unit Flag description: "Our guidon distinguishes our medical unit from other units. I belong to the 204th Area Support Medical Company."ŰÜ transcript: columns: normallinkTitle:More about careers and lifestyledoctorSlug: /sara-burdashdoctorName: Sara Burdash, M.D.time:Time Hour:9Time Text:09:05 AMtrackingCode:
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slug: /burdash-formation-videoBurdash Formation (video) description: Once Sara arrives to Camp Ripley, she attends military formation, a formal gathering that kicks off drill weekend. transcript:
BURDASH: All right, so we just got here at Camp Ripley, that’s the area where we’re going to be doing our formation, and so we’re going to walk over and meet the rest of the crew, and get ready to start the weekend. Being in the National Guard has its own sense of community, and you go through some hard times, and you go through some great times. And so you really do get to bond, and it’s almost like a little family, really.
MALE: Stand at.
CROWD: Stand at.
MALE: Ease. Morning 204.
CROWD: Morning sir.
MALE: All together again. Thank you for your performance and exemplary representation of our unit during annual training. So, nice job.
BURDASH: I think the formation does two big things. The first one is that it’s an accountability situation. And so, we’re able to verify that everybody got here safely, everybody’s here when they should, so that we can execute our missions. But the other thing that it lets us do is I think it reminds us that even though we’re a medical unit, is that we’re still soldiers.
MALE: Company.
MALE: Attention.
CROWD: Heal the warrior.
columns: widelinkTitle:More about the Military working environmentlinkHref:doctorSlug: /sara-burdashdoctorName: Sara Burdash, M.D.time:Time Hour:9Time Text:09:00 AMtrackingCode: -
slug: /burdash-camp-ripley-gateBurdash Camp Ripley Gate description: "Passing through the main gates of Camp Ripley reminds me of walking into a sporting event center. I know I'm here to play ball. I'm here to do work and to do business. You put your game face on." transcript: columns: normallinkTitle:More about the Military working environmentlinkHref:doctorSlug: /sara-burdashdoctorName: Sara Burdash, M.D.time:Time Hour:8Time Text:08:45 AMtrackingCode:
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slug: /burdash-camp-ripley-videoBurdash Camp Ripley (video) description: This morning, Sara is driving to Camp Ripley instead of the armory, a National Guard military building, where she typically trains. Her unit goes to Camp Ripley a few times a year to participate in a consolidated drill weekend and use the camp's more robust facilities. transcript:
BURDASH: Camp Ripley is a bigger facility, almost like the more formal military forts, but smaller than that. But bigger than our individual armories that we usually have for our monthly drills, where we can go and execute more what we call consolidated drills. So we’re an individual company, which is a group of soldiers that work as one together unit. And we are part of then a bigger unit above that. And so, by going to Camp Ripley, it allows our next step up, the bigger unit all to get together in what we call a consolidated drill, where we’re all at the same place. And so, there’s our medical company, a headquarters company, a financial group, a transportation group. We have all kinds of different types of groups involved within that one bigger group, and we all get to be at the same place at the same time. There’s more resources up here, and so we have weapons ranges, we have treatment facilities, it’s more so like a classic military base, but just a little bit on a smaller scale.
columns: normallinkTitle:Learn more about military medical facilitieslinkHref:doctorSlug: /sara-burdashdoctorName: Sara Burdash, M.D.time:Time Hour:8Time Text:08:34 AMtrackingCode: -
slug: /burdash-national-guard-videoBurdash National Guard (video) description: As she leaves for once-a-month military training, Sara explains her part-time commitment as a member of the Army National Guard. transcript:
BURDASH: In the National Guard, we have two roles. We have duties both to our state and our local communities, as well as to the nation. And so, we all have civilian jobs that we work at mostly. And then, one weekend a month, and two weeks in the summer, we get to go to our National Guard training, and whether it be locally for us, or a little bit further away, like we’re going today to Camp Ripley. If we are needed, either nationally if there’s a national disaster or something like that, where they need a medical unit in this case, we’ll go assist with that. Or if there’s an international need, a peace treaty, some sort of combat mission, then we get to go to those as well. So, we have multiple purposes we can fill.
columns: normallinkTitle:More about applying and what to expectdoctorSlug: /sara-burdashdoctorName: Sara Burdash, M.D.time:Time Hour:7Time Text:07:10 AMtrackingCode: -
slug: /burdash-scheduleBurdash Schedule description: "This is my general work schedule. The hospital is typically really good about scheduling my shifts around my military responsibilities. You also can see there are blocks of days off in between, so I definitely feel like I have enough days to enjoy free time." transcript: columns: normallinkTitle:More about medical specialties and rolesdoctorSlug: /sara-burdashdoctorName: Sara Burdash, M.D.time:Time Hour:2Time Text:02:02 AMtrackingCode:
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slug: /burdash-whiteboardBurdash Whiteboard description: "This whiteboard proves that being a nerd can be fun. My life motto is to be so organized that I have time to be spontaneous. We have a list of the fun things we want to do so that when we have downtime, we're never wondering how to use it. I make so many decisions at work that when I come home, it's nice to not have to make more." transcript: columns: normallinkTitle:More about work-life balancelinkHref:doctorSlug: /sara-burdashdoctorName: Sara Burdash, M.D.time:Time Hour:1Time Text:01:49 AMtrackingCode:
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slug: /burdash-home-videoBurdash At Home (video) description: Sara is a full-time physician in the emergency department at the University of Minnesota. She often works a late shift, so she and her husband have late-night dinners to accommodate her schedule. Tonight, they are spending quality time before she leaves for the weekend for her monthly military training. transcript:
BURDASH: I’m Sarah Burdash, and I’m an emergency medicine physician at the University of Minnesota, but I’m also a captain in the Minnesota National Guard. Most of my hours in the emergency department are in the afternoons and evenings, so the earliest shift I usually work starts around 1 p.m. The later shifts start around 4:30 or 5 p.m. Tonight I’m going to have to get all packed up, and tomorrow morning I leave bright and early. We’re going to be driving up to Camp Ripley in Minnesota; it’s about two, two and a half hours away. This particular drill weekend, we’ll be doing our periodic health assessments, we’ll be doing training.
Oh, Hi guys! Hello! Hey.
AARON: How are you doing?
BURDASH: Good. We should eat, I’m hungry.
AARON: Yeah? I can get it started for us.
BURDASH: OK. The other thing we get to do tomorrow is the aviation unit’s bringing the Blackhawk over, so we’ll be able to practice hot loads, cold loads, and get the medics in on that. So that should be good. So we’re doing that, we have some PHAs to do. And we should be able to do some medic classes. So.
AARON: That’ll be fun.
BURDASH: Yeah.
AARON: That’s good. Do you teach them also, or?
BURDASH: Some of them. Yeah. So some of the NCOs are teaching some of them, and I’m just adding on.
So we’ve finished dinner, and now I’m going to start getting ready.
I am notoriously not a morning person. It’s the advantage of those evening ER shifts, but I like to pack as much as I can the night before a drill. All right. So, we definitely want to make sure we get this in the vehicle the night before. So this little bin here, I actually keep out in the garage, it’s got my tactical stuff in it. So this way, with it being all in one spot, got my helmet, my vest, I don’t have to go looking for all the individual pieces each time that I need it. So, I’ve got this already all loaded in here. Basically at this point, all I’ve got to do now is get a good night’s sleep so we can get on the road first thing in the morning.
columns: widelinkTitle:More about work-life balancelinkHref:doctorSlug: /sara-burdashdoctorName: Sara Burdash, M.D.time:Time Hour:1Time Text:01:00 AMTime Hour:2Time Text:02:00 AMtrackingCode: -
slug: /burdash-dogsBurdash With Dogs description: "This is my French bulldog, Lucy, and my Boston terrier, Frank. We also have a new puppy! They're quite funny. Three dogs can be hard to manage, but we don't have kids, so it's all relative. My husband and I have different schedules, but someone is always around to give them attention." transcript: columns: normallinkTitle:More about military benefitslinkHref:doctorSlug: /sara-burdashdoctorName: Sara Burdash, M.D.time:Time Hour:1Time Text:01:05 AMtrackingCode:
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slug: /winegarner-figure-8-videoWinegarner Figure 8 (video) description: Hunter demonstrates the figure-eight technique he learned to fold his parachute so that it fits neatly into the bag. transcript: columns: normallinkTitle:More about education and trainingdoctorSlug: /hunter-winegarnerdoctorName: Hunter Winegarner, M.D.time:Time Hour:9Time Text:09:50 AMtrackingCode:
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slug: /winegarner-snowmanWinegarner Snowman description: "Cormac and I made a snowman out of ice shavings. I've been playing hockey all my life, so it's really important to me to be out here on the rink and spend this kind of time with my family." transcript: columns: normallinkTitle:More about community and lifestyledoctorSlug: /hunter-winegarnerdoctorName: Hunter Winegarner, M.D.time:Time Hour:18Time Text:06:55 PMtrackingCode:
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slug: /winegarner-hockey-glovesWinegarner Hockey gloves description: "I put these gloves down on the rink so that Cormac can learn how to make turns on his skates while keeping the puck in control with his stick." transcript: columns: normallinkTitle:More about work-life balancelinkHref:doctorSlug: /hunter-winegarnerdoctorName: Hunter Winegarner, M.D.time:Time Hour:18Time Text:06:41 PMtrackingCode:
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slug: /winegarner-morgan-and-reeseWinegarner Morgan and Reese description: "This is my wife Morgan and my two-year-old daughter Reese. This is Reese's first time on skates, and that's right around the age we started Cormac." transcript: columns: normallinkTitle:More about community and lifestyledoctorSlug: /hunter-winegarnerdoctorName: Hunter Winegarner, M.D.time:Time Hour:18Time Text:06:27 PMtrackingCode:
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slug: /winegarner-ice-skatesWinegarner Ice skates description: "Last weekend, we bought Cormac a new pair of hockey skates. He says they make him go super fast." transcript: columns: normallinkTitle:More about benefits of the militarylinkHref:doctorSlug: /hunter-winegarnerdoctorName: Hunter Winegarner, M.D.time:Time Hour:18Time Text:06:11 PMtrackingCode:
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slug: /winegarner-hockey-jerseyWinegarner Hockey jersey description: "This is my hockey jersey from when I was in med school at USUHS [Uniformed Services University of the Health Sciences]. We were called the Fightin' Docs. I made some really good friends on the team who I still keep in touch with today." transcript: columns: normallinkTitle:More about military medical schoollinkHref:doctorSlug: /hunter-winegarnerdoctorName: Hunter Winegarner, M.D.time:Time Hour:17Time Text:05:39 PMtrackingCode:
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slug: /winegarner-ropes-training-videoWinegarner Ropes training (video) description: Hunter trains soldiers on how to perform a high-angle rope rescue. It's not a clinical medicine skill, but it's an operational skill that Hunter teaches his medics if they need to move a patient up difficult terrain. transcript:
WINEGARNER: So thanks for coming out. We're going to do a little bit more advanced rescue training today, so this is something that you might need to use in the field if you're ever moving a patient over long distances or over difficult terrain. What this is called, it is called a three to one pulley system, to help you get a mechanical advantage to move somebody heavy, like our patient here today, up over difficult terrain.
Bit of a hike.
So we're going to run our anchor all the way around this, and then we're going to — it'll be in a straight line all the way down to our patient, so this is like the perfect spot, OK?
MALE: Pull. Pull. Pull. Pull.
WINEGARNER: So Roger, you safe there?
ROGER: Yeah.
WINEGARNER: You can probably unstrap. You guys want to come over here and see what — see what I'm seeing?
I was a little surprised we were having to work as hard as we were to get both Roger and the patient up, so we gotta make sure that the rope goes through the pulley, right? It's the first time, it's no big deal. You've never done anything like this, so next time you won't do that, right?
MALE 1: No, sir.
WINEGARNER: Good job, guys. That's your intro to high-angle rescue.
columns: normallinkTitle:More about training and developmentdoctorSlug: /hunter-winegarnerdoctorName: Hunter Winegarner, M.D.time:Time Hour:16Time Text:04:17 PMtrackingCode: -
slug: /winegarner-family-hockey-videoWinegarner Family hockey (video) description: When Hunter is off-duty, spending time with his family is top priority. Tonight after work, Hunter and his family head to the local ice rink to meet with friends and skate with members of his son's ice hockey team. transcript:
WINEGARNER: So we're getting on home, and spending time with the family at five o'clock or so every day is enough time before my kids go to bed — they usually go and do something fun. A couple times a week we'll go and do some ice hockey with my son.
CORMAC: Daddy's home! Yay!
WINEGARNER: Hey, buddy.
CORMAC: Hi!
WINEGARNER: How's it going? You guys ready for hockey tonight?
REESE: Yeah!
WINEGARNER: Yeah?
MORGAN: Are you ready?
WINEGARNER: Yeah? Cormac, can you help me with any of these? I need some help, big guy.
REESE: I'll drive.
MORGAN: Reese wants to drive. (laughter)
WINEGARNER: We started Cormac out when he was — how old were you when you first started skating?
CORMAC: Two.
WINEGARNER: Two. I think we got him on his first set of skates pretty quickly after he learned how to walk, but now how old are you?
CORMAC: Four.
WINEGARNER: He's four, and that's kind of when kids can start skating with a group and doing actual hockey stuff.
Good. Coming around. All the way around. And when you get it, take a shot. Oh my goodness, you shot all the way down the ice! Holy cow!
I guess I started skating when I was five, and growing up in Alaska it was kind of the thing to do. And I've continued to play, even as a doctor. Some of the guys that came out today are guys that I've met with my unit that also play hockey, and it continues to be a big part of my life and something that's really important to me. It's a misconception if people think that being an Army doctor is going to be too busy to have a life outside of work. As this guy can attest, there's times where it's busy and there's times where it's hard to make it happen, but for the most part it's part of the lifestyle of being an Army doctor that you get time with your family.
columns: widelinkTitle:More about work-life balancelinkHref:doctorSlug: /hunter-winegarnerdoctorName: Hunter Winegarner, M.D.time:Time Hour:17Time Text:05:00 PMTime Hour:18Time Text:06:00 PMTime Hour:19Time Text:07:00 PMtrackingCode: -
slug: /winegarner-pulley-systemWinegarner Pulley system description: "Here is the pulley and ropes we use to make the three-to-one pulley system, which helps give us a mechanical advantage to move somebody heavy up over difficult terrain. The pulleys themselves are actually what's called a Prusik Minding Pulley." transcript: columns: normallinkTitle:More about training and developmentdoctorSlug: /hunter-winegarnerdoctorName: Hunter Winegarner, M.D.time:Time Hour:16Time Text:04:33 PMtrackingCode:
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slug: /winegarner-sim-dummy-videoWinegarner SIM dummy (video) description: Military medics train with advanced trauma mannequins designed to simulate common field injuries. Hunter demonstrates how they can be used during training exercises. transcript:
WINEGARNER: These are very advanced SIM, SIM men. These ones in here are fully electronic. We have the ability to hook them up to monitors, and they'll give real live feedback as far as pulses go. They'll breathe, you'll see the rise and fall of the chest; if you were to listen to them you could hear the heart rate, you could hear the lungs. At times during this scenario we can make them talk, we can make them blink, we can make them look around, we can do all kinds of things with these guys. Being able to set them up for IV or IO access, doing these escharotomies, these are all things that we're able to do, so. In this day and age we try and make it as realistic as possible, and these SIM men, they're very expensive, but they do a very good job of doing that.
So yeah, there's — there — simulation tools that we have come a long way over the last decade, so that's really nice.
columns: normallinkTitle:More about military medical advancementslinkHref:doctorSlug: /hunter-winegarnerdoctorName: Hunter Winegarner, M.D.time:Time Hour:15Time Text:03:47 PMtrackingCode: -
slug: /winegarner-common-injuries-videoWinegarner Common injuries (video) description: Hunter explains common injuries received during conflict and why it's important that all soldiers learn basic medical skills. transcript:
WINEGARNER: The common wounds that we really want to train hard are the ones that are — that we've identified as being causes of death that are preventable. So there's been some landmark studies out of Iraq and Afghanistan that have looked at what people die of on the battlefield, and the big things that we've identified that guys can basically intervene on and make a difference on are the massive hemorrhage, and so putting tourniquets on and stopping the bleeding as fast as we can is the biggest thing. And then we've also developed even more to get at more of the junctional wounds, which would be kind of up here in the armpits or down here in the groin area. Those parts of the body are really hard to put a tourniquet on, and you can't necessarily stop the bleeding with that, but we’ve developed special gauzes and even some clamps that we can use in the field to stop those bleeding sites. And so, so massive hemorrhage is always something that we're always going to train when we do this TC3 training. And then the pneumothorax, which we also simulated outside, that's another thing that's been identified as potential intervention that guys can do in the field and will save a life, because with penetrating or blunt-chest trauma, there can be basically a ruptured lung and then air leaking into the chest that collapses the lung, and then can even compress on the heart and cause circulation problems. And so just by simply putting a needle in and decompressing that, we can release the tension that's inside the chest and get the blood pumping again.
columns: normallinkTitle:More about military medical advancementslinkHref:doctorSlug: /hunter-winegarnerdoctorName: Hunter Winegarner, M.D.time:Time Hour:15Time Text:03:35 PMtrackingCode: -
slug: /winegarner-escharotomy-burnWinegarner Escharotomy burn description: For the escharotomy training, the MSTC guide placed a piece of skin over the mannequin and used a blowtorch to create the burn appearance. Underneath that was a thin piece of foam and Saran wrap with some simulated blood, and underneath that was a yoga mat, which was supposed to be more deeper muscle tissue. This helped to simulate the various layers of tissue you'd encounter as you cut through the skin and the fascia. transcript: columns: normallinkTitle:More about military medical advancementslinkHref:doctorSlug: /hunter-winegarnerdoctorName: Hunter Winegarner, M.D.time:Time Hour:15Time Text:03:22 PMtrackingCode:
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slug: /winegarner-escharotomy-videoWinegarner Escharotomy (video) description: Hunter supervises his medic Nick as he performs an escharotomy on a simulation mannequin. transcript:
WINEGARNER: At this point, this patient is simulating the same patient that we brought — uh, that we collected and brought to the helicopter. Now he's in a higher level of care. He should have most of the same injuries that he had before; they're going to find some more injuries.
For some of these guys, it's going to be the first time they see anything like this, because they're not medical guys at all. So the medic and I will be kind of geeking out on medicine and stuff, and we'll be trying to teach some of these non-medicine folks a little bit of what we're doing.
MALE: We need an escharotomy here. His compliance isn't good, and he's not moving a lot of air right now.
WINEGARNER: OK.
MALE: Because he feels really tense in his chest
WINEGARNER: So explain to me how you're going to do that.
MALE: Gonna clean the area with betadine, and then we're going to go with either a scalpel and cut anterior axillary line from just below the clavicle all the way down to the costal margins —
WINEGARNER: OK.
MALE: And see if that affects — do that bilaterally.
WINEGARNER: OK.
MALE: And if his breathing gets better, we're going to...
WINEGARNER: You probably want to cross here too.
MALE: Roll with that, but we might have to go one across the diaphragm.
WINEGARNER: OK.
MALE: We're going to go until we see the subcutaneous fat, and the skin is going to separate due to the pressure.
WINEGARNER: One thing I've had to learn as a doc in a leadership role is that it's not my training — it, I'm leading the training and these guys are the ones who are reaping all the benefits.
With you guys not being medical people, this was a whole — this was a high level of medical s— medical things going on, OK? So we were trying to walk through it with you; mainly we wanted you guys to just be exposed to it, and, you know, in the future, worst-case scenario, who knows, you might find yourself having to help out in this kind of setting. So at least now you've been through it once. I know this was a first for a lot of you guys, so thanks a lot for coming out, and Nick, I know you definitely got a lot out of this, so good job. Good work. Proud of you guys.
M: For sure? Thanks, sir.
columns: widelinkTitle:More about medical trainingdoctorSlug: /hunter-winegarnerdoctorName: Hunter Winegarner, M.D.time:Time Hour:15Time Text:03:00 PMtrackingCode: -
slug: /winegarner-marchWinegarner M.A.R.C.H. description: "The M.A.R.C.H. algorithm is a good way to remember every problem that needs to be addressed when encountering a trauma patient. We check for massive hemorrhage, alertness and airways, respiration, circulation and hypothermia." transcript: columns: normallinkTitle:More about medical trainingdoctorSlug: /hunter-winegarnerdoctorName: Hunter Winegarner, M.D.time:Time Hour:15Time Text:03:01 PMtrackingCode:
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slug: /winegarner-mstc-insideWinegarner MSTC inside description: "This is inside the Medical Simulation Training Center, which is set up to mimic a field hospital. We can create a more intense environment in here by turning down the lights, adding strobes and piping in combat-type sounds and music." transcript: columns: normallinkTitle:More about the work environmentlinkHref:doctorSlug: /hunter-winegarnerdoctorName: Hunter Winegarner, M.D.time:Time Hour:14Time Text:02:55 PMtrackingCode:
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slug: /winegarner-needle-dWinegarner Needle D description: "Nick and the medics diagnosed the trauma SIM patient with a bilateral pneumothorax, so they tried a needle decompression to alleviate the pressure. This is a common field intervention, and the patient usually responds pretty quickly." transcript: columns: normallinkTitle:More about medical trainingdoctorSlug: /hunter-winegarnerdoctorName: Hunter Winegarner, M.D.time:Time Hour:14Time Text:02:37 PMtrackingCode:
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slug: /winegarner-air-compressorsWinegarner Air compressors description: "These are simulation IEDs [improvised explosive device] we use to make the training atmosphere more realistic. You want your trainings to be as lifelike as possible so that the medics learn how to remain calm in a stressful situation. I think adding an element of stress leaves a lasting impression and helps them retain more information." transcript: columns: normallinkTitle:More about military medical advancementslinkHref:doctorSlug: /hunter-winegarnerdoctorName: Hunter Winegarner, M.D.time:Time Hour:14Time Text:02:12 PMtrackingCode:
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slug: /winegarner-sim-man-remoteWinegarner SIM man remote description: "The folks at the Medical Simulation Training Center use this device to control the rescue mannequins during the training exercise. They can move the limbs, simulate arterial bleeding and add sound effects, such as breathing. It's pretty neat." transcript: columns: normallinkTitle:More about military medical advancementslinkHref:doctorSlug: /hunter-winegarnerdoctorName: Hunter Winegarner, M.D.time:Time Hour:14Time Text:02:10 PMtrackingCode:
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slug: /winegarner-medical-skills-training-videoWinegarner Medical skills training (video) description: Special operations physicians are responsible for training the medics who practice medicine in the field during deployments. This afternoon, Hunter oversees a medic who is training a group of soldiers during a Tactical Combat Casualty Care (TC3) exercise at Fort Carson's Medical Simulation Training Center (MSTC). During the training, they use simulated mannequins to practice their medical skills. transcript:
WINEGARNER: All right, guys, thanks for coming out this morning. So we're here today to do some good TC3 training. Nick, you're our medic today, and so you're going to be kind of taking point, and he's going to be the boss. I'm going to be in the background; I'll be helping direct what's going on.
All right, Nick, take it from here.
NICK: And you'll be point man on the patrol. You'll be on the right side of the wedge, along with you. When we take casualties, I'll assign roles when we get there.
WINEGARNER: All right, guys, you've got superior firepower.
NICK: Left side, move to the vehicle. Right side, move to us. Get on the front side of the vehicle.
MALE: Hey, we need a hand over here.
WINEGARNER: At this stage, which we would call care under fire, is managing massive hemorrhages.
NICK: You get the bleeding stopped?
MALE: Bleeding's stopped.
MALE 1: Bleeding's stopped.
WINEGARNER: So we're moving from...
NICK: You with me? OK.
WINEGARNER: What we would have considered care under fire out there, where all they really did was stop the bleeding and get him somewhere more secure, to what we would call tactical field care here. So this is where our medic's going to take charge; he's going to start addressing every problem that he can find. Nick, what's something that you might have to worry about on this guy with a chest wound, now you've occluded his chest wound?
NICK: Might have to needle d him.
WINEGARNER: OK.
NICK: We're going to check for bilateral rise. He was good; his respirations weren't too high either. [booming noise]
MALE: We gotta get going.
WINEGARNER: All right, guys, it's not safe anymore. Let's get going. [sounds of gunfire] Move out, move out. So this is simulating — we would, you know, probably have to move him to somewhere safe for a helicopter to land, and then from here we're going to take the patient to a higher level of care. You know, now we're more in a field-hospital setting.
columns: widelinkTitle:More about medical specialties and rolesdoctorSlug: /hunter-winegarnerdoctorName: Hunter Winegarner, M.D.time:Time Hour:14Time Text:02:00 PMtrackingCode: -
slug: /winegarner-mstc-outsideWinegarner MSTC outside description: "Just arrived at the Medical Simulation Training Center (MSTC) to lead a training exercise for one of my medics. This area is designed to mirror various scenarios you might come across in a field trauma environment, and we use simulated mannequins to practice our medical skills." transcript: columns: normallinkTitle:More about the work environmentlinkHref:doctorSlug: /hunter-winegarnerdoctorName: Hunter Winegarner, M.D.time:Time Hour:13Time Text:01:55 PMtrackingCode:
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slug: /winegarner-military-benefits-videoWinegarner Military benefits (video) description: Hunter explains the many benefits that help support his family and his career. transcript:
WINEGARNER: You know, there's so many benefits, it's hard to even count, but really, the things that drew me into being an Army doctor was, first and foremost, they paid for school, which is awesome. I also was at the military's med school, which was great because I got married while I was there, and so not only did I have health coverage through the military for myself but my wife also received healthcare and all the perks of being active-duty military then. And then during residency, we got all the same perks. So we were commissioned as captains in residency, and we were paid as active-duty captains in the military, which is much higher pay rate than a civilian in a similar job would be paid.
I like pretty much everything about my job, really. I like the flexibility that I'm allowed to have, I like the way we run our clinic. There's a lot of autonomy in our job, and we have multiple hats that we wear, and so we'll be here in clinic and we'll wear our doctor hats and we'll do regular doctor things where we see patients and do regular doctor-type stuff. And then we'll also go over to our battalion, where we're also a member of the staff for our battalions. The role there is we advise our commander for medical issues that might come up for missions or training, that kind of thing. If you want to have that kind of -- chaotic at times, but also very fun lifestyle where you get to go and jump out airplanes or, you know, go learn how to be a combat diver, and take care of that kind of soldier, then yeah, it's a pretty good job, so.
columns: normallinkTitle:More about careers and lifestyledoctorSlug: /hunter-winegarnerdoctorName: Hunter Winegarner, M.D.time:Time Hour:13Time Text:01:10 PMtrackingCode: -
slug: /winegarner-sam-splint-videoWinegarner SAM splint (video) description: Hunter explains a multi-use medical tool that can be used by soldiers when they're out in the field. transcript:
WINEGARNER: If I'm going climbing or going hiking or doing any type of outdoor activity, and I've got enough room in my backpack, the SAM splint is pretty much the most useful tool to bring with you. This one thing, it looks like a piece of foam, but it's got some aluminum in it, and it's very malleable. And so you can take this, and if somebody has a really bad fall and you're worried about a C-spine injury, you can create a C-collar with it, and basically there's different techniques for creating C-collars where you can really immobilize the neck. And just by putting a couple kinks in the SAM splint, you can get some good immobilization of the neck. Same thing for splinting a broken arm or a broken leg: you can just take this, shape it, you know, size it to where you want it to go, and then if you just put a couple little kinks in it, this then becomes a nearly rigid splint that you can duct-tape to somebody's arm, or just use an extra shirt or an extra layer that you have and tie it on there or anything you got, and that'll at least provide some pain relief while you're evacuating somebody.
columns: normallinkTitle:More about military medical advancementslinkHref:doctorSlug: /hunter-winegarnerdoctorName: Hunter Winegarner, M.D.time:Time Hour:12Time Text:12:47 PMtrackingCode: -
slug: /winegarner-clinic-patient-visit-videoWinegarner Clinic patient visit (video) description: A typical day for Hunter is spent in the clinic providing routine patient care for the Army's most elite soldiers. Many of his patients are in top physical condition, but often suffer from musculoskeletal injuries received during training exercises. transcript:
WINEGARNER: Hey, it's me, Dr. Winegarner.
MALE: Hello, sir.
WINEGARNER: How's it going, man?
MALE: Good.
WINEGARNER: What brings you in today?
MALE: Uh, back's been hurting me for a while now. I've been doing a lot of PT, a lot of weight lifting, and I'm getting pretty, pretty sore in my lower back. It's starting to shoot down my leg.
WINEGARNER: Is that new or has that been going on for a while?
MALE: Off and on for probably about a year.
WINEGARNER: Most of our Green Berets are in top physical condition. They're much more physically fit than your average soldier, just because of the physical requirements of their training. That's a standard that they're held to.
Really what we're worried about is any type of nerve problems, so if our guys have just jumped out of an airplane and all of a sudden have back pain, they can sometimes cause some bulging in one of their desks in between the vertebrae, and that can press on a nerve and cause some pain in some of the radicular symptoms that he's kind of describing, with pain shooting down his left leg. What I'll do with these guys is I'll make sure that on their way out they'll go and check in with our physical therapist that's here in the building and get on the schedule with them, and that allows for some good continuity of care. We have some systems in place to inform our command, the commanders of the soldiers, as to what limitations they might have, medically speaking. So that's a big part of being a military doctor, is just keeping in mind that our soldiers are very active, and what kind of -- we have to always think of what kind of limitations they might have as far as their job is concerned.
From here, we'll walk down the hall to our physical therapist and go get him on the schedule for some back rehab.
columns: widelinkTitle:More about the work environmentlinkHref:doctorSlug: /hunter-winegarnerdoctorName: Hunter Winegarner, M.D.time:Time Hour:11Time Text:11:30 AMtrackingCode: -
slug: /winegarner-vaccinesWinegarner Vaccines description: "This is our collection of vaccines that we keep on hand here in our clinic. Our Special Forces guys are always going in and out of different countries, so we have a pretty long list of vaccines they're required to take." transcript: columns: normallinkTitle:More about military medical advancementslinkHref:doctorSlug: /hunter-winegarnerdoctorName: Hunter Winegarner, M.D.time:Time Hour:11Time Text:11:14 AMtrackingCode:
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slug: /winegarner-clinic-tour-videoWinegarner Clinic tour (video) description: Hunter gives a tour of the 10th Group Special Forces clinic, which has adopted the Soldier Centered Medical Home model where soldiers receive one-stop medical care. transcript:
WINEGARNER: So here we are. We're at the 10th Group Special Forces Clinic that we share with Robinson Clinic. This is where we see all our patients every day. And this is also where patients would come if they were injured on the jump for Airborne Jumps.
We've actually just recently gone to what's called the Soldier Center Medical Home Model. And so basically the Soldier Center Medical Home is a place where a soldier can come and get all the things that they need in one stop. This hallway is mostly all exam rooms; they're multipurpose exam rooms. We have these treatment rooms; it's pretty nice to have something like this here in our clinic because we can take care of some of the sicker patients without having to send them up to the ER. We have our physical therapy room, and this is where we do a lot of our musculoskeletal physical therapy rehab. At the end of this hallway we would run into our pharmacy and our lab, and that's where patients can go and get their meds after they see us, and they can go and get blood drawn or do urine studies, those kind of things. So it's a one-stop-shop for them, so to speak.
Working here in this clinic is great, because, you know, we're a pretty small little family; this is a one place where all our patients can come and just get everything that they need, and we're here basically every single day, from morning till evening, unless we're out in the field doing something with the guys. And so our guys know that they can come here and find this if they need something from us.
columns: normallinkTitle:More about the work environmentlinkHref:doctorSlug: /hunter-winegarnerdoctorName: Hunter Winegarner, M.D.time:Time Hour:11Time Text:11:00 AMtrackingCode: -
slug: /winegarner-checkWinegarner Check in description: "Here's where I check in with my jumpmaster to turn in my parachute. Now it's time to head over to the clinic to see some patients." transcript: columns: normallinkTitle:More about the work environmentlinkHref:doctorSlug: /hunter-winegarnerdoctorName: Hunter Winegarner, M.D.time:Time Hour:10Time Text:10:32 AMtrackingCode:
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slug: /winegarner-med-vehicleWinegarner Med vehicle description: "Usually there's a medical vehicle waiting in the drop zone in case anyone gets injured and needs a medevac. I'm not personally in charge of today's medical plan, but that's not to say I wouldn't help someone next to me who was hurt." transcript: columns: normallinkTitle:More about the work environmentlinkHref:doctorSlug: /hunter-winegarnerdoctorName: Hunter Winegarner, M.D.time:Time Hour:10Time Text:10:01 AMtrackingCode:
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slug: /winegarner-helicopter-jump-videoWinegarner Helicopter jump (video) description: As an Army Special Forces surgeon, Hunter is required to complete operations training. This morning, he jumps out of a helicopter to maintain his airborne status within his unit. transcript:
WINEGARNER: My name is Hunter Winegarner. I'm a Captain in the Army, and I'm stationed with the 10th Special Forces Group here at Fort Carson, Colorado. I'm a doctor for our unit, and our unit is an airborne unit, which means we jump out of helicopters or airplanes on a pretty frequent basis. Myself and a lot of the guys that will be jumping today are cooks and medics and other MOSes that help the Green Berets get their job done.
This is me, in a parachute, ready to go.
Today we're going to jump out of Chinooks, which are CH-47s. They're the double-rotor, kind of funny-looking helicopters that kind of look like big school buses up there.
The helicopters will pick us up here and they'll bring us up to about 2,000 feet, and we'll fly at about 90 knots.
It's a static line jump, which means that we don't pull the rip cord - the rip cord's actually attached to the aircraft, and as we jump out it gets pulled. And then they give us the signal that we're one minute out, 30 seconds out, they tell us to stand by, and then somebody says "go." Before you know it you can see outside the door, and as soon as the arm goes up you just kind of charge off the back and get into position, chin to your chest, and then pretty hard shock as soon as the chute opens. Jumping out of a helicopter is probably the most extreme thing that we do, as far as adrenaline goes.
All right. So we just landed. Pretty sure my feet still work. Aah, gonna shake it out a little bit, put that off to the side. We've got our chest strap, leg lift, leg loops, throw all that stuff out. This is where I sit up straight and start putting stuff away. After the jump we need to go check in with the jump master at the chute turn-in, one, to let him know that I'm safe, I'm OK, and the other, to turn in my parachute, because I don't want to be walking around with this thing the rest of the day. And then we're free to go.
linkTitle:More about education and trainingdoctorSlug: /hunter-winegarnerdoctorName: Hunter Winegarner, M.D.time:Time Hour:8Time Text:08:00 AMTime Hour:9Time Text:09:00 AMTime Hour:10Time Text:10:00 AMTime Hour:6Time Text:06:00 AMTime Hour:7Time Text:07:00 AMtrackingCode: -
slug: /winegarner-parachute-gearWinegarner Parachute gear description: "Here's all my gear, ready to go. I have my 'chute, a helmet, my reserve 'chute, and the bag to pack our parachute in after we land. I also brought a backpack full of warm clothes and snacks because sometimes we can be out here for hours." transcript: columns: normallinkTitle:More about education and trainingdoctorSlug: /hunter-winegarnerdoctorName: Hunter Winegarner, M.D.time:Time Hour:7Time Text:07:03 AMtrackingCode:
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slug: /winegarner-drop-zoneWinegarner Drop zone description: "It's about a 30-minute drive out to the drop zone area on base. Drop zones generally have flat ground with limited obstacles. After getting off the bus, I line up with my group and wait for the parachutes to arrive." transcript: columns: normallinkTitle:More about the work environmentlinkHref:doctorSlug: /hunter-winegarnerdoctorName: Hunter Winegarner, M.D.time:Time Hour:6Time Text:06:32 AMtrackingCode:
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slug: /winegarner-roll-callWinegarner Roll call description: "Today I'm jumping out of a helicopter as part of a training exercise for my unit. It's first thing in the morning, and I'm at the 'final manifest' waiting for my name to be called. We'll also get instructions on what to do once we get to the drop zone." transcript: columns: normallinkTitle:More about military officer trainingdoctorSlug: /hunter-winegarnerdoctorName: Hunter Winegarner, M.D.time:Time Hour:6Time Text:06:00 AMtrackingCode:
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slug: /winegarner-jumpmasterWinegarner Jumpmaster description: "Jumpmasters are identified by these red name bands. We have a jumpmaster for every group of soldiers that exits the aircraft, and we also have some non-flight jumpmasters on the ground who inspect our equipment. They are responsible for coordinating the jump and ensuring everyone's safety. Jumpmasters receive special training, and that's actually a school my unit wants me to go to." transcript: columns: normallinkTitle:More about education and trainingdoctorSlug: /hunter-winegarnerdoctorName: Hunter Winegarner, M.D.time:Time Hour:7Time Text:07:43 AMtrackingCode:
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slug: /trentini-academics-videoTrentini Academics (video) description: Once a week, John attends classes, lectures and conferences that help him prepare for the board exam. In addition, he spends time in the simulation lab training for patient care and in the research lab developing ways nanoparticles can prevent damage caused by an acute stroke. When he returns to active duty, he will use this academic training to identify and solve operational gaps on the battlefield. transcript:
TRENTINI: Alright, so part of residency is academics, so every Tuesday morning we have a conference where all the residents get together, military and civilian. The first thing on the agenda — there’s always an oral boards case. In that situation, one resident’s called up in front to sit with one of the board examiners, and they go through an oral board case in front of the entire residency program. So it’s a little nervewracking. After that we’ll have some simulation sessions to go through, so busy day today.
The simulation center is about as close as you can get to a real-life patient encounter. All the residents go through multiple sims throughout their career, and you can do — almost everything that you can do on a real patient, you can do in the simulation center. The experiments that we conduct in the lab downstairs are slice culture experiments. And so what we can do then is change the environment to simulate a stroke. This is the brain slice, again, that’s cut like a piece of pepperoni, lying flat on the grate, and what we’re interested in studying is this part of the brain, which is the cerebral cortex, which is the outside of the brain, which in humans is all the sulci and gyri, all the gray matter of the brain, OK? We’re interested in studying these cells and how these cells respond to an acute stroke, and if our nanoparticle treatment can prevent the damage caused by an acute stroke.
I was awarded an ROTC scholarship, which paid for college, and then in return I owed four years of active-duty service to the Air Force. So that’s when I decided to go to USUHS where — it’s a military medical school. There I did my medical degree and also did my Ph.D. degree, and it was entirely funded by the Military. And then after medical school you choose a residency, and so emergency medicine for me fit in perfectly. When I’m done, I’ll go back to an active-duty job using all the knowledge and all the experiences that I’ve built along the way to really serve my country better.
TRENTINI: Alright, so part of residency is academics, so every Tuesday morning we have a conference where all the residents get together, military and civilian. The first thing on the agenda — there’s always an oral boards case. In that situation, one resident’s called up in front to sit with one of the board examiners, and they go through an oral board case in front of the entire residency program. So it’s a little nervewracking. After that we’ll have some simulation sessions to go through, so busy day today.
The simulation center is about as close as you can get to a real-life patient encounter. All the residents go through multiple sims throughout their career, and you can do — almost everything that you can do on a real patient, you can do in the simulation center. The experiments that we conduct in the lab downstairs are slice culture experiments. And so what we can do then is change the environment to simulate a stroke. This is the brain slice, again, that’s cut like a piece of pepperoni, lying flat on the grate, and what we’re interested in studying is this part of the brain, which is the cerebral cortex, which is the outside of the brain, which in humans is all the sulci and gyri, all the gray matter of the brain, OK? We’re interested in studying these cells and how these cells respond to an acute stroke, and if our nanoparticle treatment can prevent the damage caused by an acute stroke.
I was awarded an ROTC scholarship, which paid for college, and then in return I owed four years of active-duty service to the Air Force. So that’s when I decided to go to USUHS where — it’s a military medical school. There I did my medical degree and also did my Ph.D. degree, and it was entirely funded by the Military. And then after medical school you choose a residency, and so emergency medicine for me fit in perfectly. When I’m done, I’ll go back to an active-duty job using all the knowledge and all the experiences that I’ve built along the way to really serve my country better.
columns: widelinkTitle:More about medical school programslinkHref:doctorSlug: /john-trentinidoctorName: John Trentini, M.D., Ph.D.time:Time Hour:11Time Text:11:00 AMTime Hour:12Time Text:12:00 PMTime Hour:13Time Text:01:00 PMTime Hour:14Time Text:02:00 PMtrackingCode: -
slug: /emergency-medicine-residency-overnight-shiftEmergency Medicine Residency Overnight Shift description: John's day-to-day medical service is very similar to his civilian colleagues. He goes on rotations, is mentored by attending physicians and receives on-the-spot training. During his overnight shift at Good Samaritan Hospital, John sees a patient who he puts on cardiac alert. The fast-paced, unexpected nature of emergency medicine is preparing him for a career in the Military. transcript:
TRENTINI: Being an emergency medicine resident, we train in the most part in civilian hospitals — from the Air Force’s perspective is to train a good emergency department physician.
TRENTINI: So it’s about — about ten to 11:00 or so now, so getting ready to start our night. Kind of always take a peek at all the rooms, see what’s going on in the way in. These are some of the higher-acuity rooms, so if there’s anybody that’s real sick that needs some help right away, I can always peek in, but everybody looks pretty stable right now. So we’re getting checked in and settled in here. Hi, sir.
PATIENT: Hi.
TRENTINI: I’m Dr. Trentini. Nice to meet you.
PATIENT: Nice to meet you.
TRENTINI: I’m going to just shake this hand, they’re working on you over there. What brings you in tonight?
PATIENT: I’ve — chest pain. A really bad pressure right here. And I can feel it all the way down my left arm.
TRENTINI: OK.
PATIENT: It’s almost like somebody’s sitting on my left shoulder.
TRENTINI: OK.
PATIENT: Real bad pressure.
TRENTINI: When did it start?
PATIENT: About — about two hours ago.
TRENTINI: OK.
PATIENT: It started out real slow, and it just got gradually worse and didn’t go away like normal.
TRENTINI: OK. Hey, Dr. Fish? FISH: Hey.
TRENTINI: I’ve got a gentleman that I just put a cardiac alert out on. He is stable, but here’s his EKG. So, I mean, he’s got some ischemic changes here in V2, V3, V4. He’s probably having an anterior wall MIT. Yeah, so when you’re working with an attending, basically you’re working under their supervision, and so for me, I try to practice independently. In my mind, I pretend like they’re not there. So I’m on my own, and I need to make all the medical decisions. But in the back of my mind I know that they’re there, and they’re watching me, and they’re — they’ve got my back.
FISH: His cardio back yet?
TRENTINI: Not yet, we just put out the cardiac alert, so — so I’ll take a look at his chest ray, we’ll push with 5,000 to heparin, put him on a heparin drip, we’ll start him on a nitro drip, his pressures will tolerate it — his pressure’s been 190 throughout, so.
FISH: Alright.
TRENTINI: And then we’ll get his pain — pain under control.
FISH: Alright, so we’re going to get things taken care of, alright?
PATIENT: Thank you.
TRENTINI: Alright. Alright, sir. I’ll come and check on you in a bit, OK? Let me go and put it — talk to Chuck and get your medicines ordered, OK?
PATIENT: Thank you.
TRENTINI: Alright. Emergency medicine, in my opinion, is the best medical specialty because it’s the most interesting, it’s the most fun — you’ve got to be on your toes — and you take care of people that are pregnant and take care of babies all the way up to 100-year-old patients, with a wide variety of illnesses and a wide variety of acuity as well. So it’s fun, and it’s fast-paced, and so you get to see a lot of people on a shift and you get to see a lot of different things on a shift.
columns: widelinkTitle:More about military residenciesdoctorSlug: /john-trentinidoctorName: John Trentini, M.D., Ph.D.time:Time Hour:23Time Text:11:00 PMTime Hour:0Time Text:12:00 AMTime Hour:1Time Text:01:00 AMTime Hour:2Time Text:02:00 AMTime Hour:3Time Text:03:00 AMTime Hour:4Time Text:04:00 AMTime Hour:5Time Text:05:00 AMTime Hour:6Time Text:06:00 AMtrackingCode: -
slug: /trentini-dog-trick-salute-videoTrentini Dog trick salute (video) description: Smiley earns a treat after he salutes John on command. transcript:
TRENTINI: Sit. And sit. Present arms [dog barks] Salute. Good boy, good boy.
columns: normallinkTitle:More about careers and lifestyledoctorSlug: /john-trentinidoctorName: John Trentini, M.D., Ph.D.time:Time Hour:21Time Text:09:17 PMtrackingCode: -
slug: /trentini-grilling-videoTrentini Grilling (video) description: After a long day of work, farm chores, classes and training, John relaxes around the fire with his friends. transcript:
TRENTINI: We’ve been doing tactical medicine training all afternoon, and we’re going to have a quick meal here and then do another night operation. And then after that put our feet up, open some beers, light a bonfire and we’re done. Take it easy and take a break, so.
(laughter) (overlapping dialogue; inaudible) Hear, hear, guys. Here’s to a good day of training.
columns: normallinkTitle:More about work-life balancedoctorSlug: /john-trentinidoctorName: John Trentini, M.D., Ph.D.time:Time Hour:21Time Text:09:10 PMtrackingCode: -
slug: /trentini-moose-patient-simulator-videoTrentini Moose patient simulator (video) description: Meet Moose, John's high-fidelity patient simulator mannequin that he uses for the tactical medical training exercise. Moose can be intubated, pumped full of blood and used to practice applying tourniquets to in any environment. transcript:
TRENTINI: This is Moose. This is our high-fidelity simulator. He’s a really rough and tough guy who we can intubate, we can start an IV on, we can do assessments on, put tourniquets on, pump him full of fake blood, and it makes it very realistic. And so we’re going to practice both tending to him out in the field and then extricating him out from some difficult environments and taking care of him from the back of a truck, so — should be a good day.
columns: normallinkTitle:More about education and trainingdoctorSlug: /john-trentinidoctorName: John Trentini, M.D., Ph.D.time:Time Hour:17Time Text:05:18 PMtrackingCode: -
slug: /trentini-tactical-exercise-videoTrentini Tactical exercise (video) description: At the end of the day, John hosts a tactical medical training exercise on his farm. Teams of emergency medicine residents get together to simulate a hostage situation in which an officer is shot while trying to make a rescue. The training is focused on medical care in the field vs. medical care in the hospital. transcript:
TRENTINI: One of the things that this residency program has, one of the components of it that’s pretty unique, I think, is the tactical medicine program that we have that allows especially the military residents to at least keep a feel in terms of tactical field care. It allows you to keep your skills honed and keep your skills sharp. You know, when we’re here in the emergency department, we have all of our tools, I’ve got a respiratory therapist, I’ve got nurses, I’ve got technicians — well, when you’re out at a house serving a warrant and a police officer gets shot and you’ve got to go in and provide point of care — point of field care, you’ve got to carry everything that you have with you. So we want guys practicing their skills with kind of limited resources. Welcome to our semiannual skills verification training. So you guys are all active members of the tactical residents’ interests group. You all have team assignments. You’ve all been out on operations and training. This is a chance for us to kind of practice our skills and polish up what you norm — what you know, and work under a little bit of stress. I’m going to be out in the woods, and Dr. Springer’s going to be out in the woods as well. We’re going to have orange vests on. That means we are not in play. We are facilitating the exercise. So when you get out there and you see a casualty that you’ve got to attend to, and you say “Is he breathing?” — it’s going to be Moose, OK, so it’s going to be the mannequin — so you’re going to go and assess him, and you’re going to say, “OK, I’m assessing is he breathing?” And I’m going to tell you, “He’s breathing, he’s not breathing,” OK? And then based on what I tell you, do what you need to do.
MALE: We need a medic.
TRENTINI: Medic. Yeah, breath sounds, he’s unconscious, he’s bleeding in his right arm and his right thigh. What else do you have? What else could you bind that thigh with?
MALE 1: Thigh wound is up at the groin.
MALE 2: I gotta pack in.
MALE 1: There you go, now you’re getting it.
TRENTINI: The bleeding is starting to slow down now. So go, go, go, go, go. Get him out of there, guys, get him out of there. Get him into the trail. Let me know when you guys have the airway secure and IV access.
MALE 1: He’s got a second chest wound as well.
TRENTINI: Doc, you ready to move?
MALE 2: Supracranial bleeding?
MALE 1: Alrighty, go.
TRENTINI: Let’s get to the hospital now. All right, guys, end exercise. Good job. So Mike, you had a nice low crawl in, and then Doug finally got his butt down and you got out to him, and, you know, your goal is just to get him, get him out of there. Just drag him out, do whatever it takes, just drag them out of there. And best-case scenario, there would just be peppering, peppering, peppering, peppering, you’re dragging, dragging and dragging to cover. So — so that was good. And then you guys just kind of — you kind of just scooped and ran. You threw a tourniquet on and you ran. I had a hard time catching up with you — you guys were really fast. So that was good. Let’s take a break, and we’ll set up another scenario. So get your headlamps and get everything you need for nighttime operations, OK? Any questions? Alright. Break.
columns: widelinkTitle:More about the military working environmentlinkHref:doctorSlug: /john-trentinidoctorName: John Trentini, M.D., Ph.D.time:Time Hour:17Time Text:05:00 PMTime Hour:18Time Text:06:00 PMTime Hour:19Time Text:07:00 PMTime Hour:20Time Text:08:00 PMtrackingCode: -
slug: /trentini-inside-medical-bag-videoTrentini Inside a medical bag (video) description: As an emergency medicine resident, John carries his medical bag with him wherever he goes. He takes a moment to describe what's inside. transcript:
TRENTINI: So in here I’ve got my laptop, small textbook, my stethoscope is here, always have a 14-gauge needle, tube of toothpaste. I do happen to carry a headlamp. Here’s a bottle of Motrin. Tongue depressor, some scissors — somebody came over and they were like, “Hey, do you have a tuning fork?” And it’s (inaudible) suture. These are calipers. Airway card. Oh, and a tourniquet, of course. You never know when you’re going to need a tourniquet, so. OK, that’s it.
columns: normallinkTitle:More about education and trainingdoctorSlug: /john-trentinidoctorName: John Trentini, M.D., Ph.D.time:Time Hour:15Time Text:03:50 PMtrackingCode: -
slug: /trentini-lists-farm-animals-videoTrentini Lists farm animals (video) description: John tells the story of how he acquired several farm animals, including chickens, alpacas, sheep and his 160-pound pig, Abigail. transcript:
TRENTINI: Well, it’s kind of a funny story. I started out with just chickens, because I like the fresh eggs every day, and then I went to a chicken swap, and then the next guy was selling alpacas for pretty cheap. And so I had the pasture, I had the space, so I said, what the heck. So I got them, and then I got the sheep to kind of mow down the pasture a little bit and eat it down. And they’ve all been kind of living together and having a good time together. And then Abigail, the pig, I rescued. She was supposed to be a miniature pig, only supposed to be about 30 pounds, and now she’s about 160 pounds. So I think I got duped. But it’s OK. She’s part of the family now.
columns: normallinkTitle:More about work-life balancelinkHref:doctorSlug: /john-trentinidoctorName: John Trentini, M.D., Ph.D.time:Time Hour:8Time Text:08:21 AMtrackingCode: -
slug: /trentini-life-farm-videoTrentini Life on the farm (video) description: John lives on a 10-acre farm in Ohio where he has several animals he tends to on a daily basis. When he arrives home from work, he goes outside to clean the barn, feed his animals and shave his alpaca, Carl. His farm is his sanctuary. It's a welcome reprieve from a hectic day in the emergency room. transcript:
TRENTINI: You know, a lot of times I’ll work very strange shifts in the ER, where I’ll get home at sometimes midnight or sometimes work an overnight shift and get home at about 8:30 in the morning.
[whistles] Hey, guys. Hey, mister. Hey, Abigail. Hey, Abby girl. You hungry for breakfast?
We’ll usually just have some coffee and a little bit of breakfast, do some reading about some of the cases — interesting cases I saw the night before, and then come out here and check on the animals and get — kind of get the day-to-day things taken care of before passing out (laughter) and going to sleep and getting some rest and getting ready for the next night.
People always ask me why — you know, why farming is — like, why’d you get a farm? You know, you’re doing residency and you’re busy and all this stuff. And I’ve always wanted to have a lot of space and land and I grew up, you know, kind of around farms and cow farms and horse farms and always wondered what it’d be like to have one of my own. They’re really actually not a lot of work, to be honest. It’s just coming out, making sure they’ve got plenty of food, plenty of water. And they’ve got a good pasture out that they eat plenty of grass in, so. Well, after we get this cleaned up a little bit, we’ll put down some fresh bedding, and then I think it’s time for Carl to get a haircut.
I really connect with my patients a lot, because you’d be surprised how many alpaca farmers are in the area here, so it’s not uncommon where I’ll be talking with somebody that’s in the ER who has got a farm, a sheep, or a livestock or something, and sometimes I’ll get advice from my patients in terms of how to do stuff, so — so it’s a great connection with folks in the area here, so. And, you know, I’ve got to take care of these guys just like I take care of my patients, although I will say I’ve never given a haircut to any of my patients in the ER before.
columns: widelinkTitle:More about work-life balance as a military physicianlinkHref:doctorSlug: /john-trentinidoctorName: John Trentini, M.D., Ph.D.time:Time Hour:7Time Text:07:20 AMTime Hour:8Time Text:08:00 AMTime Hour:9Time Text:09:00 AMTime Hour:10Time Text:10:00 AMtrackingCode: -
slug: /trentini-residency-rotations-videoTrentini Residency rotations (video) description: John explains the joint residency program between Wright-Patterson Air Force Base and Wright State University. The program is split 50/50 between military and civilian residents, and the majority of his rotations are at civilian hospitals in the Dayton area. transcript:
TRENTINI: The residency program here at Wright State and at Wright Patterson Air Force Base, it’s a kind of a combination program between civilian and Military. It’s 50/50. So we’re side-by-side with civilian residents, and we do the majority of our rotations down at civilian hospitals. So this month in particular I’m here at Good Sam, which is sort of our inner-city, urban hospital, sort of our underserved community. You see a lot of acuity here, a lot of very sick people. We do rotations here, we do rotations at Miami Valley, at the level-one trauma center. We do rotations at Kettering and at Sycamore, as well as rotations at the base as well.
columns: normallinkTitle:More about residencies and Match DaydoctorSlug: /john-trentinidoctorName: John Trentini, M.D., Ph.D.time:Time Hour:3Time Text:03:10 AMtrackingCode: -
slug: /nguyen-recreation-videoNguyen Recreation (video) description: Josephine enjoys living in the Pacific Northwest and takes advantage of her beautiful surroundings. She especially loves kayaking in Gig Harbor, a picturesque bay in Puget Sound. transcript:
NGUYEN: In the Military, hospitals open at sometimes six or seven o’clock, but by the time the hospital hits 1600, or 4 p.m., it’s 95 percent empty. They encourage you to have strict hours and they encourage you to leave and go home and take care of your family, because they know that if you’re not having that relaxing time and having family life, you won’t be able to contribute at work fully.
One of my favorite activities is kayaking. It combines some of the best natural elements that are available to you — one, being outside in nature, and two, being surrounded by one of the most peaceful things in the world, which is water. Water is known to be therapeutic, and to be surrounded by it and watching and hearing the waves, is very — it’s so soothing for anybody.
I think the best part was actually just hanging out with your friends on the water, where you’re just away from everybody, everything and the noise. And the awesome part is that it’s my job that took me out here. I never would have thought to even come out to the Pacific Northwest, because I grew up in DC. And that’s what’s the great part about the Military — it takes you out of your comfort zone and puts you — transplants you somewhere that you’d never even think about, and my gosh, that’s been the whole story of my career in the Military, is this continual growth, expansion and meeting new people from all walks of life.
columns: widelinkTitle:More about work-life balancelinkHref:doctorSlug: /josephine-nguyendoctorName: Josephine Nguyen, M.D.time:Time Hour:17Time Text:05:00 PMTime Hour:18Time Text:06:00 PMTime Hour:19Time Text:07:00 PMtrackingCode: -
slug: /nguyen-telehealth-videoNguyen Telehealth (video) description: Josephine leads the hospital's telemedicine initiative, and has one scheduled appointment every day that occurs via videoconference. transcript:
NGUYEN: One of the leadership projects that I oversee and I’m actually in charge of for the whole hospital is the telehealth initiative. My job specifically is to see what needs there are for military patients that are spread out in smaller locations that don’t have access to specialists, and I help ensure that they get the care that they need quickly and expediently.
So today I have an active-duty male that was not able to see a dermatologist in his local area, because there is no military dermatologists available nearby him.
Clinically, looking at it, it doesn’t look concerning for melanoma.
PATIENT: OK, that’s really good news. I appreciate it. That makes me feel a lot better about it. I was concerned, you know, because of the changes that I’ve noticed over time. So I really appreciate that advice.
NGUYEN: Wonderful. Thank you so much, and please make an appointment again if you have any other questions.
PATIENT: Yes, ma’am. Thank you.
NGUYEN: Thank you.
columns: normallinkTitle:More about the military working environmentlinkHref:doctorSlug: /josephine-nguyendoctorName: Josephine Nguyen, M.D.time:Time Hour:14Time Text:02:30 PMtrackingCode: -
slug: /nguyen-light-box-videoNguyen Light box (video) description: Josephine uses light therapy to treat a young patient with vitiligo, a disease that causes a loss of skin color. transcript:
NGUYEN: The use of ultraviolet light to treat inflammatory skin conditions like vitiligo or chronic itch — it’s a very powerful tool because there’s no ingestion of medication, and you’re using a natural form of therapy to suppress the immune system. Obviously this is something that you use for a very limited time. You don’t want to use it for a long period of time because of the risk with skin cancer and photo-aging. I’m excited because I believe that this patient will respond well to the light therapy.
columns: normallinkTitle:More about interaction with patientslinkHref:doctorSlug: /josephine-nguyendoctorName: Josephine Nguyen, M.D.time:Time Hour:13Time Text:01:23 PMtrackingCode: -
slug: /nguyen-clinical-videoNguyen Clinical (video) description: Josephine is the Navy's only dermatologist serving the entire Pacific Northwest. Her patients are active-duty service members, dependents and retirees of all ages with a variety of skin conditions. Today, she uses a laser hair removal treatment on a petty officer suffering from pseudofolliculitis barbae. transcript:
NGUYEN: The best of my job is, people come in with a wide range of knowledge about their skin. Some people know all about gentle skin care; other people are like, “I don't even know what moisturizer to use.” So it’s exciting for me to be able to see where patients are at, and then imparting them a certain amount of knowledge and then having them come back and continue to layer knowledge. Hi, good morning, how are you?
PATIENT: Good morning, how are you?
NGUYEN: Good to see you again.
PATIENT: Good to see you as well.
NGUYEN: Petty officer is here to treat PFB, or pseudofolliculitis. Because of the thickness and curliness of the hair, when the hair gets cut, it curls back into the skin and causes a keloidal papule, or a scar. So this is extremely tender, painful and itchy and cosmetically disfiguring. So we’ve found that use of the laser hair removal to target the hair follicles to actually decrease the thickness in the caliber of the hair. How did you feel the last treatment went? No side effects?
PATIENT: No, ma’am.
NGUYEN: OK, so maybe we can be more aggressive then. So the hair bulb, which is below the skin surface, is the target, and that’s where the origin of the hair is from. And — so you’re not destroying the hair itself — you’re trying to target the origin of the hair, which is the bulb or the bulge. I currently serve as the sole Navy dermatologist for the Pacific Northwest. Because of the Military, I had the best dermatology education in the country, and I want to ensure that I take great care of my patients. So I teach them how to take care of themselves, and then they come back to me to fine-tune their regimen.
columns: widelinkTitle:More about careers and lifestyledoctorSlug: /josephine-nguyendoctorName: Josephine Nguyen, M.D.time:Time Hour:13Time Text:01:30 PMTime Hour:14Time Text:02:00 PMTime Hour:15Time Text:03:00 PMTime Hour:16Time Text:04:00 PMtrackingCode: -
slug: /nguyen-lunch-run-videoNguyen Lunch run (video) description: Military physicians have an hour blocked off each day free of patient care. Josephine takes advantage of this time by going for a run on base with her two dogs. transcript:
NGUYEN: We’re often so busy running around either taking care of patients, doing administrative work, counseling people, that we have an hour blocked out in which you do not have patient care. And that allows you to just take a step away and get a mental break.
columns: normallinkTitle:More on benefits of the MilitarylinkHref:doctorSlug: /josephine-nguyendoctorName: Josephine Nguyen, M.D.time:Time Hour:12Time Text:12:00 PMtrackingCode: -
slug: /nguyen-pathology-videoNguyen Pathology (video) description: After she performs the melanoma excision, Josephine prepares the specimen for pathology. transcript:
NGUYEN: So it’s important for every specimen that we — we take out, we submit for pathology. And the pathologist will then take slices through this whole thing to evaluate if any of the edges have any residual cancer in them. So it’s important for me to hear from them, to make sure that this whole thing is clear of cancer. So then I put this specimen into formaldehyde, and that prevents bacteria or fungus from growing into it. So — and that’s our specimen cup, and we label it with the patient information.
columns: normallinkTitle:More about medical roles and specialtiesdoctorSlug: /josephine-nguyendoctorName: Josephine Nguyen, M.D.time:Time Hour:11Time Text:11:55 AMtrackingCode: -
slug: /nguyen-dermatology-videoNguyen Dermatology (video) description: Josephine explains what she likes most about being a Navy dermatologist. transcript:
NGUYEN: So the neat thing about dermatology is it allows you to not only do patient care but do a lot of procedures, the surgeries, lasers, biopsies, excisions, and your patient pool is both kids, young adults and the elderly. So it allows you to see — do a wide variety of things and see a lot of different patients.
columns: normallinkTitle:More about medical roles and specialtiesdoctorSlug: /josephine-nguyendoctorName: Josephine Nguyen, M.D.time:Time Hour:11Time Text:11:38 AMtrackingCode: -
slug: /nguyen-surgery-videoNguyen Surgery (video) description: Josephine performs a skin cancer excision on a patient's shoulder. transcript:
NGUYEN: Hi, sir. How are you?
PATIENT: Fine.
NGUYEN: It’s good to see you again.
PATIENT: Yeah, same here.
NGUYEN: So this is my corpsman who’s going to be working with us today.
PATIENT: Hello.
CORPSMAN: Hello.
NGUYEN: And I’d like to go over with you what the diagnosis was and what we will be doing.
PATIENT: OK.
NGUYEN: Is that OK?
PATIENT: Yes.
NGUYEN: So when we biopsied this lesion, it was a melanoma. So melanoma is from long-term sun damage, and it’s cancer of the pigment cells. The good news is that it was a very early melanoma, so we look at a certain depth — it was less than .75 millimeters. We’re going to take a one-centimeter margin around the whole thing, so when we take it out, you’ll end up with a scar probably about four to five centimeters long. Alright, sir, you ready to rock and roll?
PATIENT: Yes, ma’am.
NGUYEN: I actually just want to cut down to the subcutaneous fat, so I know that that’s exactly where I want to hit, and that’s as far as I need to go — go to cut this melanoma out. Mr. Gordon, you’re doing great. So we have the skin cancer out, so now we’re going to run all the edges with my corpsman and just make sure all the pinpoint bleeding is done, so this is where we have the teamwork. That’s what’s great about the Military, is you use their leadership to train the people to help you. It makes my day overall a lot less hectic and more efficient. Perfect. At this point I’m very happy, I’m not concerned that this is going to rip at all. Today I was able to cut out a melanoma, which, luckily it was a very early, thin melanoma, but if left for another year, it could have quickly gotten a lot thicker and metastasized and the patient could have died within a couple of months.
columns: widelinkTitle:More on medical specialties and rolesdoctorSlug: /josephine-nguyendoctorName: Josephine Nguyen, M.D.time:Time Hour:10Time Text:10:00 AMTime Hour:11Time Text:11:00 AMtrackingCode: -
slug: /nguyen-talking-residents-videoNguyen Talking to residents (video) description: Josephine explains to residents attending the morning report the benefits of practicing medicine in the Military versus the civilian sector. transcript:
NGUYEN: I know you guys are still in the learning phases, but even, like, you would think, like, even beyond — after residency and taking your patients, like, you all — there’s always a transition phase of your career, where you’re like, “OK, I’m good seeing patients now, I want to do something else like run hospitals, or do international aid.” And that’s what’s awesome about medicine, is that the civilian side, people pretty much have to stay in that pathway, or, I mean, or then they can transition, but then to transition to the executive level, it takes a big — a big transition, while for the Military, like, you can just jump from one to another, and then just still go back and take care of patients. So it’s been — I mean, it’s just — just to encourage you that your choice to go Military was great.
columns: normallinkTitle:More on benefits of the MilitarylinkHref:doctorSlug: /josephine-nguyendoctorName: Josephine Nguyen, M.D.time:Time Hour:8Time Text:08:11 AMTime Hour:8Time Text:08:11 AMtrackingCode: -
slug: /nguyen-teaching-videoNguyen Teaching (video) description: As head of the dermatology department, Josephine is responsible for mentoring residents who are training in the specialty. She works closely with Dr. Matt Parrott and teaches him how to provide exceptional patient care and treatments. Today they see a young child with a sebaceous cyst. transcript:
NGUYEN: Lieutenant Matt Parrot is an awesome intern that’s been rotating with me for the past two weeks in dermatology. So we’re heading down right now to morning report for all of family medicine, and Matt and I will be giving a morning report. And that includes case reports as well as a talk about the importance of sunscreen use.
PARROT: I’m Lieutenant Parrot. I’m on derm right now with Dr. Nguyen. So we’re going to start off with some cases that I’m going to present and then Dr. Nguyen’s going to talk about some of the specific details of that, and then if we have time we’ll go on to just a brief sunscreen talk.
NGUYEN: I get the privilege of working with residents, including medical students and interns. I see their strengths, I work with their weaknesses and help them round that out, and I teach them how to not only be a better physician, but be a physician leader.
PARROT: Yeah, so I know on the scalp you can get these pilar cysts, which are sort of like an epidermal inclusion cyst, kind of a cousin to that —
NGUYEN: Yeah.
PARROT: — which are a little more firm. That’s typically what I see on the scalp that’s like that. I don't know if that happens in infants though.
NGUYEN: It’s un — you don’t commonly see it in infants, you’re right. It feels like some — like what we call a sebaceous cyst. However, in a young child, you always want to make sure it’s not something like a tumor, something of — or something that is vascular, of blood origin. So I thought — so before we refer him to a surgery, I think we should order — what? What do you think we should order?
PARROT: Do an ultrasound.
NGUYEN: Yeah. Thank you. You were a good patient today. Alright, thank you. It was nice to meet you.
columns: widelinkTitle:More about the military working environmentlinkHref:doctorSlug: /josephine-nguyendoctorName: Josephine Nguyen, M.D.time:Time Hour:7Time Text:07:35 AMTime Hour:8Time Text:08:00 AMTime Hour:9Time Text:09:00 AMtrackingCode: -
slug: /forsberg-sailboat-roles-videoForsberg Sailboat roles (video) description: Jonathan talks about his role on the sailboat during the race. transcript:
FORSBERG: I drive the boat, which, you’ll be surprised to hear that that’s the least important job on the boat. My wife is running around on the bow, making sure the sails go up and down properly. And then we had Lexi trimming the sails and calling tactics, and I drive the boat wherever she tells me to drive it, so it’s not a very important job. It looks like it is, but it’s not.
columns: normallinkTitle:More about community and lifestyledoctorSlug: /jonathan-forsbergdoctorName: Jonathan Forsberg, M.D., Ph.D.time:Time Hour:20Time Text:08:23 PMtrackingCode: -
slug: /forsberg-sailing-videoForsberg Sailing (video) description: Jonathan loves the technical and physical challenge of sailing and says it's a nice distraction from the stresses of work. He and his wife compete as a team in a weekly regatta at the Annapolis Yacht Club. transcript:
FEMALE: Thinking about the wind tonight, with the storms coming.
FORSBERG: Yup.
FEMALE: So the question is, if the storms go north of here, if we’re going to have any wind or if we’re going to have a lot.
FORSBERG: Do we have Lexi and Imre?
FEMALE: We do.
FORSBERG: OK, great.
FEMALE: So we’re good on —
FORSBERG: I think we’re going to go to the north, so I think there’s going to be a breeze.
We’ve been doing Wednesday night races for about six years now. A lot of camaraderie in the fleet. It’s like therapy. You get out on the water, you forget about the stresses of the week, you relax, you’re with your friends, competing against world-class sailors — it really is a nice distraction from the stresses of work. I love it. Love the challenge. It’s technically demanding, physically demanding. We live in a perfect place to sail — Annapolis is the sailing capital of the East Coast, although Newport’s a close second.
Yeah, it didn’t go as well as expected, but that’s sailboat race, and we got caught on the wrong side of the course when the breeze filled in. But I felt like our boat speed was good, tactics were decent, but, you know, we sail against a bunch of great sailors. You know, they’re master’s champions, they’re North American champions, so I think we did well. Yeah, we had a really good time, and that’s the whole point. You know, we come out here to blow off steam and to sail with our friends and family.
columns: widelinkTitle:More about community and lifestyledoctorSlug: /jonathan-forsbergdoctorName: Jonathan Forsberg, M.D., Ph.D.time:Time Hour:19Time Text:07:00 PMTime Hour:20Time Text:08:00 PMTime Hour:21Time Text:09:00 PMtrackingCode: -
slug: /forsberg-beer-videoForsberg Beer (video) description: Jonathan is a homebrewer, and he invites a colleague over to his house to brew a new lager. transcript:
FORSBERG: Alright. So everything’s ready. Temperature is — I think the temperature is just right, so we’re going to go ahead and go in.
MATT: Alright.
FORSBERG: Whenever you want. I’ve been doing this for a while. Ten years, maybe. Technology’s changed a lot in that time. Had a chance to accumulate some of this equipment and make some of it from scratch.
MATT: I think the best one that we did was a recreation of the Founder’s Breakfast Stout, which was a dark chocolatey stout. We put it on nitro tap, which was — can’t get it anywhere like that, so.
FORSBERG: Oh, it was great. And Matt and his wife Lindsey got married, and we brewed the beer for their wedding reception. That was a lot of fun.
columns: normallinkTitle:More about life in the MilitarylinkHref:doctorSlug: /jonathan-forsbergdoctorName: Jonathan Forsberg, M.D., Ph.D.time:Time Hour:18Time Text:06:45 PMtrackingCode: -
slug: /forsberg-family-time-videoForsberg Family time (video) description: Despite a busy career, Jonathan still finds time to spend with his family at their home in Bethesda, Md. When he gets home from work, he helps his daughters with their homework then sits down for dinner. transcript:
FORSBERG: I did get into some civilian medical schools, but my wife and I decided this would be the best course of action, and looking back, I’m convinced that that’s the case. The Military afforded me a world-class medical education, and also the opportunity to be exposed to health care in a variety of settings, not just in this country but abroad, deployed upon ships, in the middle of the desert — I mean, these are very challenging places to deliver health care. It’s great to come home after a long day, obviously. You know, my family’s my support staff, quite frankly. They do so much for me behind the scenes, and they really allow me to be as successful as I can be, knowing that they’re here. I think working as much as I do allows me to maintain a work-life balance on certain days. For instance, on a clinical day, I’m tied to the hospital until the work is finished, period. And on a lab day I get a bit more flexibility to go in between institutions. That still allows me a lot of time to spend time with my family, and I’m grateful for that. So what — what do you think is the difference between all of these numbers?
SOPHIA: Oh, they’re plus ten and minus one.
JONATHAN FORSBERG: Which is? Plus ten and minus one equals?
SOPHIA: Nine.
JONATHAN FORSBERG: There you go. We went over Sophia’s homework and then we played lacrosse, played a little game of keep-away.
SOPHIA: Yeah
FEMALE: It’s above my waist!
FORSBERG: You can go barefoot.
FEMALE: (laughter)
FORSBERG: We’re about to have dinner as a family, and then after dinner, assuming the weather holds up, we’re going to head out to Annapolis and do a little bit of sailing.
columns: widelinkTitle:More about work-life balancelinkHref:doctorSlug: /jonathan-forsbergdoctorName: Jonathan Forsberg, M.D., Ph.D.time:Time Hour:17Time Text:05:00 PMTime Hour:18Time Text:06:00 PMtrackingCode: -
slug: /forsberg-prosthetic-model-videoForsberg Prosthetic model (video) description: Jonathan is developing an innovative prosthetic that can attach directly to bone, which will help patients with blast-wound injuries. transcript:
FORSBERG: So I have in front of me a prototype, and this prototype is designed to be attached to — attached to the skeleton. And the patient’s skin is here. And we’ve had an opportunity over the last couple of years to develop this porous material and test it in our preclinical model, to ensure that we have adequate blood supply in this area. So by ensuring that we have adequate blood supply to this area allows us to treat an infection with antibiotics, should it occur. We’re very hopeful that this technology will be useful in patients with amputations that are complicated by wound failure and heterotopic ossification.
columns: normallinkTitle:More about military medical advancementslinkHref:doctorSlug: /jonathan-forsbergdoctorName: Jonathan Forsberg, M.D., Ph.D.time:Time Hour:13Time Text:01:10 PMtrackingCode: -
slug: /forsberg-heterotopic-ossification-videoForsberg Heterotopic ossification (video) description: Jonathan speaks more in depth about his research on bone growth in soft tissue. transcript:
FORSBERG: Heterotopic ossification is bone that forms in the soft tissues. Now, this particular case was a patient without an amputation, but the bone formed right next to his sciatic nerve. Heterotopic ossification is caused, we think, from inflammation in the muscle. We can feel it as we debride the muscle tissue during the debridement process. Before the wound is closed, we can feel the tissues become woody, and that woody consistency is the bone forming in the muscle. And it can be problematic when you consider that the patients with amputations require a socket to bear weight. The end result is patients will sit in a wheelchair rather than be functionally mobile.
columns: normallinkTitle:More about research opportunitiesdoctorSlug: /jonathan-forsbergdoctorName: Jonathan Forsberg, M.D., Ph.D.time:Time Hour:12Time Text:12:30 PMtrackingCode: -
slug: /forsberg-research-nmrc-videoForsberg Research at NMRC (video) description: After spending the morning at Walter Reed and seeing patients at the National Institutes of Health (NIH), Jonathan travels to the Navy Medical Research Center (NMRC). He is head of the regenerative medicine department and leads a team of investigators who work to develop treatments to stop the spread of tumor growth in amputees suffering from blast injuries. transcript:
FORSBERG: After finishing up at Walter Reed and attending morning rounds, I go to the Naval Medical Research Center to touch base with the basic science team. And they’re engaged in pre-clinical research, benchtop research, if you will. So I’ll meet with them and go over the projects and make sure everything’s on track.
I serve as department head for the Naval Medical Research Center’s regenerative medicine department. So we focus on complications like heterotopic ossification, which is the formation of bone in soft tissues. We focus on wound healing, and we also focus on improving the lives of patients with amputations.
So let’s go take a look at the lab. One of the experiments that’s ongoing right now is to determine whether a nerve injury commonly seen after a blast requires surgical treatment. If the nerve doesn’t recover, it requires surgery to be replaced. If the nerve is going to recover or has the capacity to recover, it’s better off if it were to recover on its own, without surgery.
So the purpose of this experiment is to differentiate between nerves that have the capacity to heal from nerves that don’t. The ultimate goal would be to use this technology to help guide surgical decision-making in the early phases of wound debridements.
One of the biggest benefits of being in the Military is being put into a leadership position relatively early in your career. I’ve had the opportunity to do that, both on the clinical side and on the research side. And this is not something that would happen in the civilian setting until much later in one’s career.
columns: widelinkTitle:More about research opportunitiesdoctorSlug: /jonathan-forsbergdoctorName: Jonathan Forsberg, M.D., Ph.D.time:Time Hour:11Time Text:11:00 AMTime Hour:12Time Text:12:00 PMTime Hour:13Time Text:01:00 PMTime Hour:14Time Text:02:00 PMTime Hour:15Time Text:03:00 PMTime Hour:16Time Text:04:00 PMtrackingCode: -
slug: /forsberg-nih-work-videoForsberg NIH work (video) description: Jonathan enjoys working at the National Institutes of Health (NIH) because he sees difficult cases that can't be treated anywhere else. It also provides him the opportunity to work with other leading experts across multiple specialties. transcript:
FORSBERG: So one of the most interesting and unexpected parts about being a military physician is the ability to deal with not only military patients in a variety of settings but also civilian patients. My affiliation with the National Institutes of Health allows me to do that. For many years the National Institutes of Health didn’t have an orthopedic oncologist on staff. I liked to come over here because the cases were all very interesting, investigators over here are the world’s foremost experts in certain types of diseases. So the patients are interesting, the cases are interesting, the procedures are complicated, and I really enjoy that challenge.
columns: normallinkTitle:More about medical specialties and rolesdoctorSlug: /jonathan-forsbergdoctorName: Jonathan Forsberg, M.D., Ph.D.time:Time Hour:10Time Text:10:17 AMtrackingCode: -
slug: /forsberg-joining-military-videoForsberg Joining military (video) description: Jonathan talks about the path he took to becoming a Navy physician: it was a circuitous route through the Marine Corps. transcript:
FORSBERG: I grew up in a little town in Montana, and my father was in the Military, my sister was an Air Force Academy graduate, and there was a strong sense of patriotism in Montana. So after high school I joined the Marine Corps, and as a Marine, applied to the Naval Academy for college. And then after that went to medical school. So I always wanted to be a doctor. Took a circuitous route through the Marine Corps, but I wouldn’t — I wouldn’t trade that for anything.
columns: normallinkTitle:More about applying and what to expectdoctorSlug: /jonathan-forsbergdoctorName: Jonathan Forsberg, M.D., Ph.D.time:Time Hour:9Time Text:09:21 AMtrackingCode: -
slug: /forsberg-clinical-practice-videoForsberg Clinical practice (video) description: Jonathan's day is split among three institutions: Walter Reed National Military Medical Center (NMMC), the National Institutes of Health (NIH) and the Navy Medical Research Center (NMRC). He starts his morning at Walter Reed, where he meets with a patient who was recently transferred to the hospital from the NIH after having a hemipelvectomy. transcript:
FORSBERG: Usually my day is split between three institutions — Walter Reed, the National Institutes of Health and also the research lab — Naval Medical Research Center.
I’m an orthopedic oncologist in the Navy, and I specialize in the treatment of tumors of the bones and soft tissues. So this is a typical morning at Walter Reed. I come in, check emails, review the X-rays of any cases that came in over the weekend.
DJ has neurofibromatosis, which predisposes him to certain types of nerve tumors. And he had a very large nerve tumor in his thigh and groin, and it became cancerous and turned into a sarcoma. So unfortunately, the only way we could safely remove the tumor was to do what’s called a hemipelvectomy, which is a very high amputation of the lower extremity. So he’s transferred here to Walter Reed to do his rehabilitation. DJ’s actually the first patient to be transferred from the NIH to Walter Reed for rehab, under a Secretary of Defense special designation. So we’re very excited about that process.
Well, we’ll check in on you every day, and although you’re on the rehab service, my team will check in on you. And if you need anything from me, just let them know and they’ll contact me, no matter where I am. Thanks for letting us come in to talk to him.
FEMALE: Thank you.
FORSBERG: I love to take care of cancer patients. I mean, it’s not for everybody, but I truly feel like I can identify with them, and helping improve their quality of life is very important.
columns: widelinkTitle:More about the work environmentlinkHref:doctorSlug: /jonathan-forsbergdoctorName: Jonathan Forsberg, M.D., Ph.D.time:Time Hour:6Time Text:06:00 AMTime Hour:7Time Text:07:00 AMTime Hour:8Time Text:08:00 AMTime Hour:9Time Text:09:00 AMtrackingCode: -
slug: /nguyen-restaurantNguyen Restaurant description: "I have friends I've made from meet-ups in Tacoma, at work, school and church, and the best part of the day is getting to relax with them after work. Tonight, we're all having dinner together at a local restaurant." transcript: columns: normallinkTitle:More about work-life balancedoctorSlug: /josephine-nguyendoctorName: Josephine Nguyen, M.D.time:Time Hour:19Time Text:07:26 PMtrackingCode:med-j0
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slug: /nguyen-gig-harborNguyen Gig Harbor description: "I live in Gig Harbor, Washington and the bay is literally two-and-a-half miles away from where I live, and so any day of the week I can drive or run down to the water." transcript: columns: normallinkTitle:Military medical facilities maplinkHref:doctorSlug: /josephine-nguyendoctorName: Josephine Nguyen, M.D.time:Time Hour:17Time Text:05:17 PMtrackingCode:med-j0
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slug: /nguyen-leadership-speakerNguyen Leadership speaker description: "Each month, we invite a speaker to our leadership development initiative lecture series. This afternoon, I'm meeting with HM1 Aragon, who spent time overseas as the sole corpsman to a Marine Corps battalion. I want him to talk about the reality of his experience in the battlefield and how it shaped his own views on life." transcript: columns: normallinkTitle:More about careers and lifestyledoctorSlug: /josephine-nguyendoctorName: Josephine Nguyen, M.D.time:Time Hour:16Time Text:04:21 PMtrackingCode:med-j0
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slug: /nguyen-uniformNguyen Uniform description: "The whites are our formal uniforms that you would wear for special functions like promotion ceremonies or official duties. The reason I have these out today is because we just had a uniform inspection to make sure all the insignia are on correctly. If I wasn't wearing my scrubs at work, I'd be wearing my working uniform, which is either my blue cammies or my khakis." transcript: columns: normallinkTitle:More about applying and what to expectdoctorSlug: /josephine-nguyendoctorName: Josephine Nguyen, M.D.time:Time Hour:15Time Text:03:52 PMtrackingCode:med-j0
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slug: /nguyen-laser-machineNguyen Laser machine description: "The laser on the right is for hair removal, and the one next to it is the pulsed dye laser used for vessels. The hair removal laser I used on my patient today has a pedal that I pump with my foot to activate." transcript: columns: normallinkTitle:More about medical roles and specialtiesdoctorSlug: /josephine-nguyendoctorName: Josephine Nguyen, M.D.time:Time Hour:15Time Text:03:36 PMtrackingCode:med-j0
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slug: /nguyen-cameraNguyen Camera description: "I use this camera for my telehealth appointments. Our setup is fairly portable. I can do real-time, synchronous visits using the camera, speakers and a microphone." transcript: columns: normallinkTitle:More about the military working environmentlinkHref:doctorSlug: /josephine-nguyendoctorName: Josephine Nguyen, M.D.time:Time Hour:14Time Text:02:41 PMtrackingCode:med-j0
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slug: /nguyen-markersNguyen Markers description: "Since I have two rooms, these indicators let me know the status of each patient. If the first patient is there, it's marked yellow and green, if the second patient is there, it's green only, and then if I'm done, I flip it to red." transcript: columns: normallinkTitle:More about the military working environmentlinkHref:doctorSlug: /josephine-nguyendoctorName: Josephine Nguyen, M.D.time:Time Hour:13Time Text:01:47 PMtrackingCode:med-j0
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slug: /nguyen-chiliNguyen Chili description: "We have social events, like today's chili cook-off, at least once a month, and I try to attend whenever I can because I enjoy the camaraderie. I'm vice president of the wardroom, and here I am with the social chair who helped organize the event. I'm holding a bowl of my favorite chili, which is made with venison." transcript: columns: normallinkTitle:More about life in the MilitarylinkHref:doctorSlug: /josephine-nguyendoctorName: Josephine Nguyen, M.D.time:Time Hour:13Time Text:01:04 PMtrackingCode:med-j0
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slug: /nguyen-dogsNguyen Dogs description: "I adopted Peter and Kippy from my brother about three years ago. Kippy is a Maltese poodle and Peter is a Maltese poodle Shih Tzu, and Peter is Kippy's son." transcript: columns: normallinkTitle:More about careers and lifestyledoctorSlug: /josephine-nguyendoctorName: Josephine Nguyen, M.D.time:Time Hour:12Time Text:12:37 PMtrackingCode:med-j0
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slug: /nguyen-nature-trailNguyen Nature trail description: "This is the nature trail we have on base. Many of the trees have been here for hundreds of years and they're marked so that they're not cut down. It's almost like a historical landmark in a way. I love that I can take my dogs here to let them run off leash." transcript: columns: normallinkTitle:More about benefits of the MilitarylinkHref:doctorSlug: /josephine-nguyendoctorName: Josephine Nguyen, M.D.time:Time Hour:12Time Text:12:07 PMtrackingCode:med-j0
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slug: /nguyen-anestheticNguyen Anesthetic description: "We use local anesthetic to numb the area around the patient's shoulder before we start the procedure." transcript: columns: normallinkTitle:More on medical specialties and rolesdoctorSlug: /josephine-nguyendoctorName: Josephine Nguyen, M.D.time:Time Hour:10Time Text:10:38 AMtrackingCode:med-j0
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slug: /nguyen-surgical-toolsNguyen Surgical tools description: "This is the excision kit that the corpsman set up for me to use for today's surgery. It includes all the typical tools that you use during an excision including a scalpel, dissecting scissors, forceps, blunt scissors to cut sutures and skin hooks." transcript: columns: normallinkTitle:More about medical specialties and rolesdoctorSlug: /josephine-nguyendoctorName: Josephine Nguyen, M.D.time:Time Hour:10Time Text:10:07 AMtrackingCode:med-j0
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slug: /nguyen-rosaceaNguyen Rosacea description: "Matt and I got to see a wide variety of patients with skin conditions, including psoriasis, dermatomyositis and rosacea. What I teach Matt is to take a step back, look at the patient overall and teach them how to take care of themselves." transcript: columns: normallinkTitle:More about medical specialties and rolesdoctorSlug: /josephine-nguyendoctorName: Josephine Nguyen, M.D.time:Time Hour:9Time Text:09:03 AMtrackingCode:med-j0
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slug: /nguyen-bremerton-hospitalNguyen Bremerton hospital description: "I arrive to work around 7:30 a.m. I've been at Naval Hospital Bremerton for about a year now and it's a great experience to work at a smaller hospital." transcript: columns: normallinkTitle:Military medical facilities maplinkHref:doctorSlug: /josephine-nguyendoctorName: Josephine Nguyen, M.D.time:Time Hour:7Time Text:07:30 AMtrackingCode:med-j0
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slug: /nguyen-conference-callNguyen Conference call description: "I serve as chairman of the Women Physicians Section of the American Medical Association, and today I'm expecting a call from Harley Grant, who's the civilian director and my staff liaison. We're discussing the impact of working together to increase membership within the section." transcript: columns: normallinkTitle:More on military medical advancementslinkHref:doctorSlug: /josephine-nguyendoctorName: Josephine Nguyen, M.D.time:Time Hour:6Time Text:06:32 AMtrackingCode:med-j0
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slug: /nguyen-dog-foodNguyen Dog food description: "So I'm a big proponent of natural foods for my dogs. I feed them a mixture of raw beef, oatmeal, carrots, apples, spinach, kale and a concoction of other supplements including B vitamins and fish oil." transcript: columns: normallinkTitle:More on physician benefitslinkHref:doctorSlug: /josephine-nguyendoctorName: Josephine Nguyen, M.D.time:Time Hour:5Time Text:05:55 AMtrackingCode:med-j0
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slug: /nguyen-family-photoNguyen Family photo description: "Here's a photo of my sister and me at the baptism of our niece, Isabella. My sister encouraged me to join the Military and go to the Naval Academy." transcript: columns: normallinkTitle:More about medical schoollinkHref:doctorSlug: /josephine-nguyendoctorName: Josephine Nguyen, M.D.time:Time Hour:5Time Text:05:51 AMtrackingCode:med-j0
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slug: /nguyen-morning-workoutNguyen Morning workout description: "A typical day for me involves getting up around 5 a.m. I workout for about an hour, then I make my dogs breakfast and get ready for work. For me, the mornings are my personal time of self-reflection and meditation." transcript: columns: normallinkTitle:More on benefits of the MilitarylinkHref:doctorSlug: /josephine-nguyendoctorName: Josephine Nguyen, M.D.time:Time Hour:5Time Text:05:23 AMtrackingCode:med-j0
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slug: /forsberg-spinnakersForsberg Spinnakers description: "During the race, I felt like our boat speed was good and our tactics were decent. Here we're seen rounding the windward-most mark [green spinnaker] just ahead of another competitor [red spinnaker that has not yet filled]. The spinnakers are used to sail downwind. The smaller triangular jib is used to sail upwind." transcript: columns: normallinkTitle:More about work-life balancedoctorSlug: /jonathan-forsbergdoctorName: Jonathan Forsberg, M.D., Ph.D.time:Time Hour:19Time Text:07:50 PMtrackingCode:med-j000
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slug: /forsberg-boat-nameForsberg Boat name description: "The name 'Solsidan' is a Swedish word that loosely translates to 'bright side' or 'sunny side.' It's also the name of a Seinfeldesque comedy in Sweden. Hilarious." transcript: columns: normallinkTitle:More about careers and lifestyledoctorSlug: /jonathan-forsbergdoctorName: Jonathan Forsberg, M.D., Ph.D.time:Time Hour:19Time Text:07:10 PMtrackingCode:med-j000
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slug: /forsberg-hopsForsberg Hops description: "These hops are a Father's Day gift from my wife, Dawn. They were planted about three weeks ago and you can see they grow like weeds. I plan to use these for my next IPA." transcript: columns: normallinkTitle:More about careers and lifestyledoctorSlug: /jonathan-forsbergdoctorName: Jonathan Forsberg, M.D., Ph.D.time:Time Hour:18Time Text:06:50 PMtrackingCode:med-j000
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slug: /forsberg-brew-panelForsberg Brew panel description: "I built this temperature control panel while I was deciding whether or not to enter a Ph.D. program. I ordered the parts and found some plans on the Internet, but modified it a little bit to fit my needs. It helps control the mash temperature and automates the process of beer brewing to make it more reproducible." transcript: columns: normallinkTitle:More about work-life balancedoctorSlug: /jonathan-forsbergdoctorName: Jonathan Forsberg, M.D., Ph.D.time:Time Hour:18Time Text:06:47 PMtrackingCode:med-j000
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slug: /forsberg-college-photoForsberg College photo description: "I was in college racing on an offshore sailing team. Since I was the lowest-ranking guy on the boat, I'm seen here pumping out the holding tanks from the head [toilet], seemingly with a big smile on my face." transcript: columns: normallinkTitle:More on medical schoollinkHref:doctorSlug: /jonathan-forsbergdoctorName: Jonathan Forsberg, M.D., Ph.D.time:Time Hour:17Time Text:05:25 PMtrackingCode:med-j000
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slug: /forsberg-thesisForsberg Thesis description: "My Ph.D. thesis started out as a collaboration between the Memorial Sloan Kettering Cancer Center and the Karolinska Institutet. I had been exploring ways to estimate the likelihood of survival in patients with metastatic cancer using a variety of machine learning techniques. This work helps guide surgical and medical decision-making in patients with metastatic bone disease." transcript: columns: normallinkTitle:More about medical schoollinkHref:doctorSlug: /jonathan-forsbergdoctorName: Jonathan Forsberg, M.D., Ph.D.time:Time Hour:17Time Text:05:23 PMtrackingCode:med-j000
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slug: /forsberg-rocket-launcherForsberg Rocket launcher description: "The girls have a pneumatic rocket launcher they like to play with. It's a little bit of science, a little bit of fun, and I think they respond to that. Compressed air will propel a homemade rocket made out of pink duct tape (it has to be pink apparently) into the sky. One's aim has to be good so that the rocket doesn't land on any cars or anyone. There are several rockets that are sitting on the roof right now." transcript: columns: normallinkTitle:More about work-life balancedoctorSlug: /jonathan-forsbergdoctorName: Jonathan Forsberg, M.D., Ph.D.time:Time Hour:17Time Text:05:15 PMtrackingCode:med-j000
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slug: /forsberg-luminexForsberg Luminex description: "Our Luminex system measures inflammatory proteins. We can profile of all the inflammation that's going on in the body by measuring a series of cytokines and chemokines. We have thousands of samples from hundreds of patients over the last decade. This data allows us to build models to estimate the likelihood of certain complications that will help treat future combat casualties." transcript: columns: normallinkTitle:More about research opportunitiesdoctorSlug: /jonathan-forsbergdoctorName: Jonathan Forsberg, M.D., Ph.D.time:Time Hour:15Time Text:03:10 PMtrackingCode:med-j000
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slug: /forsberg-scanForsberg Scan description: "Here's a piece of histology from the Raman mapping system. This is a wound biopsy from a combat casualty and we use Raman spectroscopy to interrogate tissue to determine what it's doing on the molecular level. For example, Raman can tell us what types and proportions of collagen are forming and also whether the patient is a risk for the development of heterotopic ossification." transcript: columns: normallinkTitle:More about research opportunitiesdoctorSlug: /jonathan-forsbergdoctorName: Jonathan Forsberg, M.D., Ph.D.time:Time Hour:14Time Text:02:55 PMtrackingCode:med-j000
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slug: /forsberg-boneForsberg Bone description: "This is a patient from the National Institutes of Health who had the top part of his tibia resected because it contained a rare bone sarcoma. I reconstructed it with a bone from a cadaver of similar size that had been selected from a bone bank. One can see a point on the side of the bone with three plates and several screws, which are holding everything together while the patient's bone heals to the new bone. He's now cancer free, and he moved back to India with his parents." transcript: columns: normallinkTitle:More about medical specialties and rolesdoctorSlug: /jonathan-forsbergdoctorName: Jonathan Forsberg, M.D., Ph.D.time:Time Hour:14Time Text:02:34 PMtrackingCode:med-j000
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slug: /forsberg-journalForsberg Journal description: "One of the most comprehensive assessments of heterotopic ossification was accepted by the journal, 'Bone.' We analyzed heterotopic ossification from the patient featured on the cover and several others to characterize what's going on inside each of those lesions." transcript: columns: normallinkTitle:More about current military medical research projectslinkHref:doctorSlug: /jonathan-forsbergdoctorName: Jonathan Forsberg, M.D., Ph.D.time:Time Hour:14Time Text:02:11 PMtrackingCode:med-j000
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slug: /forsberg-whiteboardForsberg Whiteboard description: "We use the whiteboard to communicate with our investigators, residents and collaborators, and we use the boards from the protocol development stage to the experimental design stage to the prepublication stage. When we analyze data, I like it to be displayed a certain way and you can see a box plot, some graphs and experimental groups." transcript: columns: normallinkTitle:More about current military medical research projectslinkHref:doctorSlug: /jonathan-forsbergdoctorName: Jonathan Forsberg, M.D., Ph.D.time:Time Hour:13Time Text:01:40 PMtrackingCode:med-j000
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slug: /forsberg-3d-modelForsberg 3D model description: "This patient had a very severe blast injury and sustained the highest level of amputation of any survivor from the previous two conflicts. Heterotopic ossification, a kind of maladaptive healing response, formed all along his residual pelvis and perineum. This is a model we made from the patient's CT scan using a 3D printer that prints in resin." transcript: columns: normallinkTitle:More about medical specialties and rolesdoctorSlug: /jonathan-forsbergdoctorName: Jonathan Forsberg, M.D., Ph.D.time:Time Hour:13Time Text:01:15 PMtrackingCode:med-j000
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slug: /forsberg-booksForsberg Books description: "These books were gifts from my parents. The book in the middle, 'The Principles and Practice of Medicine,' was written by Sir William Osler and is extraordinarily rare. Osler was a giant in the field of medicine. I occasionally flip through them and draw parallels between what physicians wrote about more than a hundred years ago and what we see today." transcript: columns: normallinkTitle:More about military medical advancementslinkHref:doctorSlug: /jonathan-forsbergdoctorName: Jonathan Forsberg, M.D., Ph.D.time:Time Hour:5Time Text:05:17 AMtrackingCode:med-j000
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slug: /forsberg-medalForsberg Medal description: "I received this award from the Italian Society for Orthopaedics and Traumatology for an ongoing collaboration. The project involves a worldwide effort designed to estimate the likelihood of long and short-term survival in patients with metastatic cancer." transcript: columns: normallinkTitle:More about military medical facilitieslinkHref:doctorSlug: /jonathan-forsbergdoctorName: Jonathan Forsberg, M.D., Ph.D.time:Time Hour:5Time Text:05:11 AMtrackingCode:med-j000
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slug: /forsberg-home-officeForsberg Home office description: "I usually wake up at around 5 a.m., have a cup of espresso, check some emails then go over the schedule for the day." transcript: columns: normallinkTitle:More about licensed physician optionsdoctorSlug: /jonathan-forsbergdoctorName: Jonathan Forsberg, M.D., Ph.D.time:Time Hour:5Time Text:05:10 AMtrackingCode:med-j000
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slug: /trentini-workstationTrentini Workstation description: "Right now we're at my workstation looking at a chest X-ray. This is where I access electronic medical records, write my notes and look through patient charts." transcript: columns: normallinkTitle:More about the military working environmentlinkHref:doctorSlug: /john-trentinidoctorName: John Trentini, M.D., Ph.D.time:Time Hour:23Time Text:11:15 PMtrackingCode:med-j00
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slug: /trentini-arrives-hospitalTrentini Arrives at hospital description: "So my shift starts at 11 p.m. and I got here a little bit early. I usually grab a cup of coffee and a bite to eat before heading to my workstation. I always hope it's busy when I go to work. It provides me an opportunity to help people and to learn." transcript: columns: normallinkTitle:More about the military working environmentlinkHref:doctorSlug: /john-trentinidoctorName: John Trentini, M.D., Ph.D.time:Time Hour:22Time Text:10:50 PMtrackingCode:med-j00
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slug: /trentini-maskTrentini Mask description: "Looks like someone was shot with a paintball during the medical training. This is why it's critical we use safety masks when simulating care under fire." transcript: columns: normallinkTitle:More about medical trainingdoctorSlug: /john-trentinidoctorName: John Trentini, M.D., Ph.D.time:Time Hour:19Time Text:07:28 PMtrackingCode:med-j00
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slug: /trentini-tree-standTrentini Tree stand description: "I set up a hostage rescue situation out in the woods on my farmland. We have Moose on the ground and a simulated sniper situated in the tree stand for a more realistic training exercise." transcript: columns: normallinkTitle:More about medical trainingdoctorSlug: /john-trentinidoctorName: John Trentini, M.D., Ph.D.time:Time Hour:18Time Text:06:25 PMtrackingCode:med-j00
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slug: /trentini-tactical-suppliesTrentini Tactical supplies description: "This box contains all of our training supplies. We have a lot of pressure dressings, training tourniquets, airway adjuncts and things that you need to take care of someone out in the field." transcript: columns: normallinkTitle:More about the working environmentlinkHref:doctorSlug: /john-trentinidoctorName: John Trentini, M.D., Ph.D.time:Time Hour:17Time Text:05:12 PMtrackingCode:med-j00
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slug: /trentini-tactical-groupTrentini Tactical group description: "I'm chief of a tactical resident interest group, which means I oversee the residents that are involved on local SWAT teams. I help them with their assignments, make sure that they have all the skills that they need, and that they're going to be a good asset to the team that they're assigned to. We do semi-annual skills verification. In a hospital, they have lots of resources, but here they have their skills, knowledge and what they can carry on their backs." transcript: columns: normallinkTitle:More about education and trainingdoctorSlug: /john-trentinidoctorName: John Trentini, M.D., Ph.D.time:Time Hour:17Time Text:05:10 PMtrackingCode:med-j00
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slug: /trentini-brain-sliceTrentini Brain slice description: "What we have here on the TV monitor is connected to the microscope. This is the cortex, which is the outside part of the brain, so we're looking at the cells in the cerebral cortex and how they respond to an acute stroke." transcript: columns: normallinkTitle:More about research opportunitiesdoctorSlug: /john-trentinidoctorName: John Trentini, M.D., Ph.D.time:Time Hour:14Time Text:02:48 PMtrackingCode:med-j00
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slug: /trentini-nanoparticlesTrentini Nanoparticles description: "This is a small incubator that has the same composition of chemicals that your brain is perfused with. I can simulate a stroke by changing the environment and taking away all of the oxygen and all of the sugars. Then we can simulate with medicines or interventions ways that we can prevent damage from that stroke." transcript: columns: normallinkTitle:More about research opportunitiesdoctorSlug: /john-trentinidoctorName: John Trentini, M.D., Ph.D.time:Time Hour:14Time Text:02:45 PMtrackingCode:med-j00
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slug: /trentini-dr-liTrentini Dr. Li description: "Dr. Li is a research professor at Wright State University, and he works in the lab to handle all the technical aspects of the research. The project I'm working on is called 'The Effects of Nanoceria on Acute Stroke.'" transcript: columns: normallinkTitle:More about research opportunitiesdoctorSlug: /john-trentinidoctorName: John Trentini, M.D., Ph.D.time:Time Hour:14Time Text:02:23 PMtrackingCode:med-j00
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slug: /trentini-intubatingTrentini Intubating description: "In the simulation lab we can practice intubating a patient, which means to put a plastic tube through their vocal cords and secure their airway. In a trauma, if someone has a major injury to the neck or the mouth and you need to protect their airway, this is the way to do it." transcript: columns: normallinkTitle:More about medical schoollinkHref:doctorSlug: /john-trentinidoctorName: John Trentini, M.D., Ph.D.time:Time Hour:13Time Text:01:32 PMtrackingCode:med-j00
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slug: /trentini-sim-lab-operatorTrentini Sim lab Operator description: "The control room in the simulation center is where whoever is running the scenario for the residents can speak to them through the microphone and can change the vital signs settings on the mannequin. The operator drives the case throughout the procedure." transcript: columns: normallinkTitle:More about education and trainingdoctorSlug: /john-trentinidoctorName: John Trentini, M.D., Ph.D.time:Time Hour:13Time Text:01:13 PMtrackingCode:med-j00
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slug: /trentini-ultrasoundTrentini Ultrasound description: "During a cardiac arrest, one of the tools you can use is the ultrasound to look at the heart directly to see whether or not it's beating. The equipment that we have here in the simulation center is exactly what you would find in a real emergency room." transcript: columns: normallinkTitle:More about residency programsdoctorSlug: /john-trentinidoctorName: John Trentini, M.D., Ph.D.time:Time Hour:12Time Text:12:20 PMtrackingCode:med-j00
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slug: /trentini-oral-boardsTrentini Oral boards description: "This is the 'random resident generator,' and every week our program director spins the wheel, pulls out a number and chooses a resident to do an oral boards case in front of everyone. I got lucky today and was picked." transcript: columns: normallinkTitle:More about medical schoollinkHref:doctorSlug: /john-trentinidoctorName: John Trentini, M.D., Ph.D.time:Time Hour:11Time Text:11:25 AMtrackingCode:med-j00
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slug: /trentini-alpaca-woolTrentini Alpaca Wool description: "This is Carl's wool we trimmed up, and you can see how soft and warm it looks. It's in a bag now and hopefully I'll spin it down and make some socks. I've never made socks before; we'll play it by ear." transcript: columns: normallinkTitle:More about careers and lifestyledoctorSlug: /john-trentinidoctorName: John Trentini, M.D., Ph.D.time:Time Hour:10Time Text:10:41 AMtrackingCode:med-j00
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slug: /trentini-carl-selfieTrentini Carl selfie description: "Here's Carl and me after his haircut. He's still a little wet from the rain." transcript: columns: normallinkTitle:More about work-life balancedoctorSlug: /john-trentinidoctorName: John Trentini, M.D., Ph.D.time:Time Hour:10Time Text:10:27 AMtrackingCode:med-j00
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slug: /trentini-usuhs-tshirtTrentini USUHS tshirt description: "This is my class of 2013 T-shirt from the Uniformed Services University of the Health Sciences (USUHS). I spent seven years there to earn my M.D. and Ph.D. USUHS is the only medical school in the country where you're going to get dedicated military-specific training. Also, it's free, and you can maintain your salary while you're going to medical school, which is a great perk. Then when you retire from the Military, those four years you were in medical school will get tacked on to your retirement." transcript: columns: normallinkTitle:More info about salary and benefitslinkHref:doctorSlug: /john-trentinidoctorName: John Trentini, M.D., Ph.D.time:Time Hour:8Time Text:08:47 AMtrackingCode:med-j00
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slug: /trentini-farmlandTrentini Farmland description: "So where I live is in Sugar Creek, which is a small township just east of Dayton. This is the kind of a place where you can get some land, get some space, and get out of the city a little bit, but still be close enough to everything you need." transcript: columns: normallinkTitle:More about community and lifestyledoctorSlug: /john-trentinidoctorName: John Trentini, M.D., Ph.D.time:Time Hour:7Time Text:07:27 AMtrackingCode:med-j00
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slug: /trentini-cardiac-monitorTrentini Cardiac Monitor description: "Tonight I had to order an EKG for the patient that we put on cardiac alert. This is the cardiac monitor and it shows you where to connect EKG leads." transcript: columns: normallinkTitle:More about the military working environmentlinkHref:doctorSlug: /john-trentinidoctorName: John Trentini, M.D., Ph.D.time:Time Hour:1Time Text:01:22 AMtrackingCode:med-j00
Topic Categories
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Military Medicine 101
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Applying + What to Expect
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Education + Training
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