West Maui surgeon volunteers to treat wounded soldiers

Through the Society for Vascular Surgery, Dr. George Lavenson volunteered at the U.S. Army’s Landstuhl Regional Medical Center (LRMC) in Germany from May 25 to June 12.
WEST MAUI — For the third time, West Maui vascular surgeon George S. Lavenson Jr. volunteered to spend two weeks treating wounded American soldiers transported from Afghanistan and Iraq to the U.S. Army’s Landstuhl Regional Medical Center (LRMC) in Germany.
“I volunteered for two weeks at LRMC because I wanted to help cover the need for vascular surgery for our military personnel,” said Dr. Lavenson. “Our military must be afforded the best care possible. I provided additional services to the excellent care already afforded by the team at LRMC.
“The experience was rewarding, but somewhat difficult, because of the seriousness of the injuries,” he continued. “I also volunteered because I wanted to be back with my military ‘Band of Brothers and Sisters.’ “
A retired U.S. Army medical officer, Dr. Lavenson served at the 24th Evacuation Hospital in Vietnam in 1968 and ’69.
He returned to active duty during the Gulf War and served at the 44th Evacuation Hospital in Saudi Arabia along the Iraq border.
An adjunct professor of surgery at the Uniformed Services University in Bethesda, Maryland, Dr. Lavenson continues to teach advanced trauma life support.
From May 25 to June 12, Lavenson served as a volunteer vascular surgeon at LRMC, the largest American hospital outside the United States. More than 66,000 military personnel have been treated at LRMC since 2004.
Lavenson explained that the first surgical care given to U.S. casualties when they are injured in Afghanistan or Iraq — “down range,” as it is called — is termed “damage control surgery.” Medical staff perform the quickest and simplest procedures that will control the immediate situation.
This surgery is done by either Forward Army Surgical Teams in the field or at Combat Army Surgical Hospitals.
After what is usually a few days of stabilization, the casualty is airlifted in specially outfitted and equipped C-17s — flying intensive care units — to Ramstein Air Base in Germany, then brought a short distance to LRMC by bus.
At LRMC, the patients are assessed, undergo operations to complete procedures done down range and receive a “wash out” of the wounds to prevent infection.
“After a few days of stabilization, the casualties are returned to Ramstein and flown on C-17s to appropriate military hospitals in the United States,” Dr. Lavenson said.
“All of this takes a good deal of coordination with the Air Force and their medical teams who evaluate the casualties the day before departure, ready all the transportable equipment on the day of travel and accompany the casualties.“
At Landstuhl Regional Medical Center, a wide range of people with diverse backgrounds unite to care for the wounded soldiers.
“It is of note that the medical, nursing, technician and corpsmen caring for our casualties at LRMC are from all services — Army, Navy and Air Force — who all work together seamlessly. It is also of interest that although of different ages and eras, I and others like me were folded in and worked together indistinguishably from the regular crews,” he commented.
“It is a bit hard to convey, but we are all part of the same thing — caring for our casualties — no matter what the age, era or conflict label. And we all bring something to the table.”
Electronic medical records for patients are transmitted between all levels and echelons of care.
“In addition, every week there was a teleconference between the medical facilities down range, we at LRMC and the receiving hospital in the U.S. Each case is discussed to ensure the best of care of specific injuries and coordination of overall care,” Lavenson noted.
Technology has advanced remarkably since Dr. Lavenson treated wounded soldiers in Vietnam, but he was surprised to see that doctors today still learn from their experiences.
“Of particular interest to me was the continued use, with some relearning of things, that we learned and wrote up in the medical literature from our experiences in Vietnam, such as avoiding overloading with fluids, use of Doppler ultrasound to asses blood flow and viability in extremities, and improved care of lower bowel injuries,” he said.
“As a matter of fact, some of the very articles that we wrote were present in the on-call room (in Germany).“
Since September 2007, Lavenson and 71 additional Society for Vascular Surgery (SVS) members have volunteered to supplement the limited number of vascular surgeons at LRMC.
“The Society for Vascular Surgery is proud to have provided continuous two-week rotations of vascular surgeons at LRMC for the past four years,” said 2011-12 SVS President Dr. Richard Cambia.
“As vascular surgeons, we help to repair the damaged arteries and veins of Allied military personnel in the Global War on Terror.“
Lavenson has treated U.S. soldiers in three wars: Vietnam and the first Gulf War in Kuwait on active duty, and Iraq and Afghanistan by volunteering at Landstuhl, one of the world’s most advanced hospitals.
Trained at the University of Washington Medical School, Lavenson served as an Army surgeon for 20 years, then ran a surgical practice for another 30 years in Visalia, California, before “retiring” in 2005.
Between research and filling in for surgeons on vacation, Lavenson remains very busy.
After volunteering in Germany, Lavenson attended a Society for Vascular Surgery conference in Chicago and presented a paper on carotid artery screening for stroke prevention.
Next, he traveled to Bethesda, Maryland, to help teach the Advanced Trauma Life Support course to senior year students at the Military Training Network.
After ten quick days at home in West Maui, Lavenson left for American Samoa, where he took care of surgical patients at the Lyndon B. Johnson Tropical Medical Center in Pago Pago. He is slated to come home this week.