Meet our Docs: Dr. Lee Warren recounts his time as a combat surgeon in Iraq

*(Casper, Wyo.)* - W. Lee Warren, Jr., M.D., joined the U.S. Air Force, in part, to help pay for medical school. In the long years of peace that followed, he never dreamed that he may be called to war. But he was called – six months before he was supposed to be discharged. Dr. Warren became only the second U.S. Air Force neurosurgeon deployed to a wartime hospital since the Vietnam War. He spent 125 days performing combat brain and spinal surgery in a tent hospital in Balad Air Base during Operation Iraqi Freedom. Balad troops nicknamed it Mortaritaville for its high frequency of rocket and mortar attacks. “Most days, we were working 24 hours and we’d grab a few hours of sleep where we could. There were many days when we did 10 to 12 cases in a 24-hour period,” said Dr. Warren who recently joined Advantage Orthopedics and Neurosurgery in Casper. “We were pretty much on call 24 hours a day, seven days a week. That’s why the Air Force only deployed us for four months at a time.” Dr. Warren is a board-certified neurosurgeon and a retired major of the U.S. Air Force. In this interview, he talks about how those four months as a combat surgeon made him the doctor he is today. *What types of injuries were you treating in Iraq?* The vast majority of the people we saw were victims of mass casualty situations such as IEDs, truck bombs and that sort of things. We had a lot of penetrating brain injuries, closed head injuries, spinal injuries and those types of things. I did more than 200 craniotomies and brain surgeries while in the tent hospital. We also did a little civilian care. If an Iraqi family had a baby that had some problems, they would walk up to the gate and ask if we could take care of the child. I took a brain tumor out of a 13-year-old Iraqi girl who was having seizures. I did a spina bifida myelomeningocele repair on an Iraqi infant. The parents just literally walked this kid up to the gate with the spinal cord hanging out of its back and said, “Can you help our baby?” At the time, it was the first myelomeningocele repair ever done in a deployed hospital in the world. *Explain the differences between working in an American operating room and a tent hospital in a combat zone. * The combat-related cases usually involved many injured people who would come in with bad brain injuries, with fragments in their heads, skull fractures, broken necks and small-arms wounds and burns. Many patients had multiple traumas. It was routine to have a neurosurgeon, an ENT, general surgeon and orthopedist operating on a patient at the same time. It was crazy. We had four operating rooms, each with two beds so we could have eight people undergoing surgery at the same time. More than once, we were mortared during surgery, so we would be in the middle of an operation and the lights would go out. It took about 30 seconds for the generators to kick in, so we would all just hold still and wait until the lights came back on. We were operating with flack-jackets and carrying weapons in the operating room. It was a totally unique experience. *What was the hardest thing about practicing medicine in a war zone?* I guess the thing that was the hardest was learning how to deal with losses that we never had to deal with in the United States. The most common thing was somebody bleeding to death. In most American hospitals, patients hardly ever die from bleeding to death as we can just get more blood products. You can decide to let somebody go if they are not salvageable, but you are not going to lose them because they are bleeding out and you cannot stop it. In Iraq, if we had 20 marines in the ER, and one guy was so badly injured that he was going to use up all the blood, we had to decide to let him go so we could save somebody else with that two units of blood that we had left. You got used to being mortared, you got used to being shot at because you could not control that. You got used to terrorists blowing somebody up and having to deal with taking care of both the American and the guy that hurt them. You got used to all that, but it was really hard to get used to just not having enough blood, platelets, or something else to actually decide whether this person is going to die and you have stop the care. We almost never have to do that in the U.S. *Do you think the experience changed you as a doctor?* It absolutely did. First, I learned how blessed we are to have the gross excess of resources that we have available to us in the United States, and also how most of the time we do not need everything that we have. I learned to not be a prima donna in the operating room. It started making me mad when I would hear somebody in the U.S. say, “I cannot operate under these conditions. I cannot work without this $3,000 pair of scissors,” or whatever. I would say, “Really? I took out a brain tumor with a spoon in Iraq.” Without any question, this was a defining period for my professional and personal life. It is the thing of which I am the most proud professionally, and I think it defined me as a surgeon more than any other thing I went through as a human being. I know that when my country asked something of me, I did it and I did my best job that I could do. I feel good about that. Read the full interview with Dr. Warren at The Pulse . *Feature Photo: W. Lee Warren Jr., M.D. scrubs up before surgery strapped with the 9mm pistol on Iraqi Election Day in 2005. The surgeons were ordered to remain armed at all times in case of an attack.* #news #sponsored #oilcity #wmc