Perfect Practice: A Navy Captain’s Surgical Journey: CAPT (Ret) Paul B. Roach, MD, FACS

WarDocs - The Military Medicine Podcast

Listen in as we explore the journey of retired Navy Captain Paul B. Roach, MD, FACS, where he shares his valuable deployment experiences that led to significant improvements in combat casualty care. From his early deployments as a flight surgeon in Okinawa to his gritty 14-month stint in Afghanistan, Dr. Roach offers a riveting account of combat surgery that will captivate and enlighten. There, he learned the delicate dance of trauma algorithms and rhythms of combat surgery.

Dr. Roach explains his motivations to capture his experiences, trials, and triumphs in his memoir, Citizen Surgeon. His deeply moving recollections underscore the critical importance of training and preparation for those deployed, and his mantra of "perfect practice makes perfect" will leave lasting impressions. In an in-depth discussion, we delve into the American College of Surgeons' military-specific curriculum and how it prepares surgeons for the realities of the battlefield.

Finally, we navigate the evolution of Military Medicine through Dr. Roach's lens. His career trajectory showcases not just the rigors of deployment but also the harsh reality of transitioning home and the importance of family support. As a Navy Medical Corps Officer, a physician, and a mentor preparing the next generation of Military Medical professionals, Dr. Roach's narratives are an essential listen for anyone interested in the converging worlds of medicine and the military. This episode promises a wealth of insights and real-world experiences from the frontline of Military Medicine.

Chapters:

(0:00:00) - Early Military Medical Experiences

(0:07:06) - Surgical Oncology Career Path & Specialization

(0:15:38) - Combat Surgery

(0:29:18) - Military Specific Curriculum for Combat Surgeons

(0:34:46) - The Evolution of Military Medicine

Chapter Summaries:

(0:00:00) - Early Military Medical Experiences (7 Minutes)

We talk with retired Navy Captain Paul B. Roach, MD, FACS about his experiences from deployments and the important lessons learned that have led to improvements in combat casualty care. We also discuss his memoir Citizen Surgeon and his work to prepare the next generation of military medical professionals, as well as his work with the American College of Surgeons. Dr Roach also recounts his experience as a flight surgeon in Okinawa with the Marines, including a medevac mission he was involved with.

(0:07:06) - Surgical Oncology Career Path & Specialization (9 Minutes)

Dr. Roach's deployments and the lessons he learned from them have shaped his career. He transitioned from his military service back to training and offers advice for those returning to their residencies after a break. His assignment to NAS Sigonella, Italy, gave him a unique opportunity. He decided to do fellowship training in complex surgical oncology.

(0:15:38) - Combat Surgery (14 Minutes)

Dr. Roach recounts his experience from his 14-month deployment in Afghanistan. He explains how his training in surgical oncology prepared him for any area he was called upon to work in and how he had to adjust to the trauma algorithms and rhythms of combat surgery. He shares his experience of writing his memoir, Citizen Surgeon, as a way to process his experience and to understand his deployment. He dealt with situations that were outside of his comfort zone, such as pediatric gunshot wounds, and used his med school and residency training to remind himself that he was capable of carrying out the mission.

(0:29:18) - Military Specific Curriculum for Combat Surgeons (5 Minutes)

Dr. Roach's experience with the American College of Surgeons' military-specific curriculum and exam is discussed. He explains how his training and practice prepared him for his deployments, including his stance on providing care to enemy combatants. He shares how his team was able to handle the Mass Casualty drills, even with members who were new to the experience, and his mantra of "perfect practice makes perfect" and the importance of training and preparation for those deployed.

(0:34:46) - The Evolution of Military Medicine (12 Minutes)

Paul shares his own journey from being a medical student dressed as a Naval Officer to becoming a Naval oOficer who happens to be a physician. He also explains how the transition home from deployment can be difficult and how his family has been his anchor. We explore the differences between Role 2 and Role 3 facilities and how to best prepare for deployment in either scenario. Finally, we discuss the importance of tumor boards in the care of cancer patients and how a multidisciplinary team can craft an individualized solution for each patient.

Take Home Messages:

1. Transitioning from point-of-injury battlefield care to an operating room requires immense adaptability and resilience, as both environments demand unique skill sets and mental preparedness.
2. Military medicine plays a crucial role in shaping an individual's career, especially when they transition from military service to civilian life.
3. A compelling narrative of frontline experience can provide valuable insights and lessons, contributing to improvements in combat casualty care.
4. The importance of 'perfect practice' is highlighted as a key to achieving excellence in the medical field, especially in high-pressure situations.
5. The evolution of military medicine has seen a convergence of medical expertise and military discipline, which has led to more effective healthcare for both military and civilian populations.
6. Multidisciplinary tumor boards play a vital role in cancer patient care, emphasizing the importance of a team-based approach to healthcare.
7. Continuous training and preparation are crucial for medical professionals, particularly those deployed in combat zones.
8. Writing and sharing personal experiences can help medical professionals process their experiences and understand their roles better.
9. Deployed medical professionals face unique challenges and require certain skill sets that differ from those used in traditional hospital settings.
10. The transition from military service to civilian life can be difficult, underscoring the importance of having strong support systems in place.

Episode Keywords:

Military Medicine, Combat Surgery, Surgical Oncology, Mass Casualty Drills, Flight Surgeon, Medevac Mission, Okinawa, American College of Surgeons, Role 2 Facilities, Role 3 Facilities, Multidisciplinary Team, Tumor Boards, Combat Casualty Care, Perfect Practice, Memoir Citizen Surgeon, Transition Home, Deployment Preparation

Hashtags:

#wardocs #military #medicine #podcast #MilMed #MedEd #MilitaryMedicine #CombatSurgery #MedicalJourney #FromBattlefieldToOperatingRoom #CitizenSurgeon #DrPaulRoach #MilitaryToMedicine #NavyCaptain #MedicalExcellence #OncologyTraining

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