Takeaway
In a field hospital, one learns quickly about clear communication and thoughtful decision making. These behaviors and working collaboratively with others are just as critical across all clinical settings.
Lifelong Learning in Clinical Excellence | May 13, 2025 | 2 min read
By Dimitri Tito, DO, Johns Hopkins Medicine
As a physician, I believed I was prepared. Years of long hours, the weight of critical decisions and complex treatment regimens—these were very familiar to me. Round-the-clock field training exercises, the controlled chaos of field hospital training, and the protocols of Tactical Combat Casualty Care (TCCC) were also familiar to me as a military doctor. Yet, nothing truly prepares you for the raw, visceral reality of war.
Our field hospital was a canvas of tents and equipment in northern Iraq, supporting other military treatment facilities stretching across Syria and Iraq. Our location, strategically close to hostile borders, meant we were the final stop for the most seriously injured soldiers.
The memory of one soldier remains vivid: Specialist BJ, a service member who presented with a traumatic neck injury from a ricocheted object at a weapons range. The immediate, profuse bleeding was initially controlled with on-site compression following TCCC guidelines, paving the way for an air MEDEVAC to our facility. When I first met Specialist BJ, his fear was palpable, overshadowed by severe neck pain, worsening neck swelling, and paleness. He shared with me his deepest hope: to return home to his family. Our trauma team moved with practiced speed through primary and secondary assessments, initiating rapid blood resuscitation. Subsequent neck imaging revealed a bleeding pseudoaneurysm of the common carotid artery. It was a ticking time bomb. We poured every resource and ounce of skill into saving him. From across our field hospital, teams converged as he underwent the delicate surgical repair of his common carotid artery. It was more than a procedure; it was an implicit promise, a clear message to every service member: we will fight for you with everything we have.
Back home, in the familiar rhythm of civilian practice, I carry with me the enduring lessons learned in our dusty field hospital. Here are just a few:
1. Working collaboratively with the entire medical team is critical to delivering excellent patient care, just like we did with Specialist BJ.
2. Collaborate with specialists to give the best care possible.
3. Communicate clearly.
4. Be adaptable.
5. Acting decisively is often needed for critically injured patients.
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This piece expresses the views solely of the author. It does not necessarily represent the views of any organization, including Johns Hopkins Medicine.