The Air Force: An experience in saving lives

  • Published
  • By By Lt. Col. (Dr.) James W. Freese
  • 509th Medical Group

Before 9/11 - Private Practice

I was in private medical practice in Wheeling, W.V., for almost 15 years. As part of the solo private practice, I was a dying breed. No partners, no groups, just me and my office staff. Even so, it worked and I built the practice up to almost 6,000 patients, attended two hospitals and two nursing homes, and was on the teaching staff for Internal Medicine, Pediatrics, and Family Practice residency programs at the local hospitals. At the time, West Virginia was in a medical malpractice crisis situation and many physicians were leaving the state. Some were going five minutes across the river to Ohio, some going 10 minutes to the East and setting up in Pennsylvania. My wife and I took a vacation to St. Martin in September 2001 to decide what we should do. My decision was made in an instant on the morning of September 11, 2001; I decided to join the U.S. Air Force! It was the greatness of the United States that had allowed me to do my work and become a very successful physician, now it was payback time, and I have never looked back on my decision nor have I had any regrets. 

The road to Iraq 

After a fast 4 weeks at COT, I went to Ellsworth Air Force Base, South Dakota for my initial indoctrination into the workings of the medical corps. Just 18 months later, I was at Eglin AFB, Fla., and was the flight commander of the internal medicine flight there. From September 2005 to January 2006, I served in an expeditionary medical squadron at Kirkuk, Iraq. Without a doubt, those four months were the epitome of medicine. We saved lives there. It was not like in private practice, where I would admit someone to a hospital and give IV Fluids, medications, or antibiotics, and consult a surgeon if needed. We, our EMEDS team, functioned as a well-oiled machine, resuscitated and flew out soldiers to a higher echelon of care, where they then made it back to the states. We worked all hours of the day and night, (unlike private practice in West Virginia where we worked 8 a.m. to 4 p.m. and did the rest by telephone). Our team in Iraq had a fantastic track record for those four months. The patients who made it to us alive, left alive - 100 percent of the time.

I have been asked many times about the experience in Iraq, and if I would ever go back. Without a doubt, I tell them that I had been doing doctor stuff for about 18 years, and those 4 months in Iraq were the best medicine I ever did, and I would go back in an instant!

Benevolence in Peru 

Another of the most enlightening times during my Air Force Career was when I was part of the Peru earthquake relief mission. At this point I was the chief of clinical services at Whiteman AFB, Mo., and was a member of a Medical Readiness Training Exercise to Ariquipa, Peru, scheduled for Aug. 24 through Sept. 8. The lead team was based out of Goodfellow AFB, Texas, with Lt. Col. George Jones as the Team Chief.

The earthquake hit Aug. 15 at approximately 6 p.m. Central Standard Time and registered an 8.0. It was centered just off the coast of Pisco, Peru. The original estimates from the U.S. Geological Survey were more than 514 killed and 1,100 injured.

What was truly amazing was that our mission had changed from the original Medical Readiness Training Exercise to now a Humanitarian Relief, and in just 24 hours, we all had orders and were on our way. I often think back to my days in private practice to see what I would have done for a disaster as such. Most likely, I would not have paid much attention to it as it had no bearing on my practice or income. Also, if I had been asked to join a mission, it would have taken me at least a week or two just to get the practice set up with coverage and back up physicians, and then have to listen to the office manager about the loss of income during that time. So most likely, I would not have gone and not have given it a second thought. I am so grateful that I am no longer in that position.

We landed in Lima, Peru, and after a short reprieve, we then traveled by van to Pisco. Travel was slow, difficult and dangerous because of large, gaping cervices that had formed in the road.

Upon arrival into the Pisco area, two things stuck out in our minds. First was the devastation caused by the earthquake, which left countless families homeless; without electricity, running water, and food. The other thing that stuck out was the resiliency of the Peruvian people, taking everything in stride, just to get by to the next day and praying that help would arrive.

We were not the only relief mission there. We encountered providers from France, Switzerland (with search and rescue dogs) and Cuba, just to name a few. Joint Task Force Bravo from the Honduras was there and I ran into friends I knew while at Eglin, (that just shows how tight a family the Air Force actually is). We also met many Peruvians who were giving of their own time and came from Lima and surrounding areas to help in any way they could.

The mission was to work with the Peruvian Ministry of Health to deliver care to persons in need. Sites were determined for the next day's treatment. Key areas were displaced persons camps (tent cities for those without housing).

We created a clinic wherever we were needed and became extremely efficient, able to set up for five providers, optometry and dentistry, as well as the pharmacy within 30 minutes of arriving on scene.

In a typical day we provided primary care to 400-500 patients. The dentist also performed about 15 tooth extractions while the optometrist fitted 50-60 pairs of glasses a day. The pharmacy was extremely hard working distributing 1,200-1,500 prescriptions a day. We worked long and hard, with the day beginning at 7:30 a.m., traveling to our destination, and finishing up just in time so that we were back at out base camp by dark.
As soon as the populace was aware of our presence, lines would form, sometimes with enough people to encircle the entire clinic area. (We had security present, which helped with crowd control.)

After about 12 days, the numbers of patients started to dwindle and the Peruvian Ministry of Health was getting back on its feet, and their own clinics up and running. When we were finished there, we donated all our leftover medical supplies to the local hospital and clinics. Overall we provided direct and supporting care for over 10,000 Peruvians successfully aiding the recovery effort. I cannot explain the feelings that washed over me when the little children came up and gave our people great, big hugs, followed by a kiss on the cheek!

The members of our team there were, from Goodfellow, Master Sgt. Annette Whitenack, Team NCOIC and medical technician; Capt. Brian Cocke, physician; Capt. Warren Dial, physician assistant; Capt. Stefanie Nance, physician; Capt. Ricardo Ochinang, dentist; Capt. Lindsay Peck, optometrist; Tech. Sgt. Edmundo Cruz, dental technician; Staff Sgt. Michael Marrero, optometry technician; Staff Sgt. Stacie Myers, pharmacy tech; and Senior Airman Gisela Ascanio, medical tech. Also, from Lackland AFB, Texas, there was Lt. Col. Devin Donnelly physician; and Capt. Dalia Wenckus, physician, and finally myself from Whiteman.

Sold on the Air Force 

During my five years in the Air Force, I have seen more than I ever did in 15 years of private practice, and I have done more of what I call "Good Medicine" than I did in my first 15 years. I have often been asked if I regret my decision and would I ever return to private practice. I can answer that in a New York minute and state unequivocally: NO!

I have dedicated myself to my profession and now to the Air Force. As long as I remain healthy and I have God watching over me, my wife and my family, I am in the Air Force to stay.