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DUKE ANESTHESIOLOGY ALUMNUS | 30 NOTES PUSHING THE SCIENCE The Wall Street Journal, in its ongoing coverage of the war in Iraq, recently published an article, “U.S. Tent Hospital Offers a Close-Up View of Attacks in Iraq,” featuring improved medical care techniques performed on what is now termed “routine medical emergencies,” where the casualties of American soldiers continues to escalate. The article states that not since the Vietnam War has there been such an inflow of casualties on a daily basis. American medical personnel, the physicians, and nurses, both active duty and reserve, are keeping more soldiers alive because of advances in medical care. Lt. Col Chester “Trip” Buckenmaier, a U.S. Army reservist and former associate in the department’s Division of Ambulatory Anesthesia, recently completed a tour with the U.S. Army’s 21st Combat Support Hospital in Balad, Iraq. Buckenmaier’s expertise in regional anesthesia afforded him the opportunity to practice his skills to save the lives and limbs of U.S. soldiers. He and other personnel worked in a tent that served as an emergency room. An excerpt1 from the article highlights the state-of-the-art care that Buckenmaier and his associates provided: It was dark outside as Lt. Col. Trip Buckenmaier, an anesthesiologist from the Walter Reed Army Medical Center in Washington, walked into Sgt. Bartels’s tent and Lt. Col. Chester "Trip" offered him a new procedure that would take Buckenmaier, MD. away the pain. Col. Buckenmaier pierced the skin atop Sgt. Bartels’s shoulder and then tried to locate with an electric stimulator the nerves responsible for the hand and the arm. As the sergeant’s body convulsed, the surgeon kept talking: “Chuck, I know you don’t have a hand, but can you feel your fingers moving? Now? And now?” After finding the nerve, Col. Buckenmaier inserted a catheter linked to a painkiller dispenser that Sgt. Bartels could control with the other hand. This procedure—tried on battlefields for the first time during the Iraqi campaign—allows patients to stay conscious and in control while disabling only the nerves that produce pain from injuries. “We’re kind of pushing the science right now,” Col. Buckenmaier said. “War tends to do that.” He hadn’t finished the procedure when an assistant walked in to say that choppers were bringing in a new load of casualties... Buckenmaier’s colleague, Susan Steele, MD, chief of ambulatory anesthesia, says that Buckenmaier “has done some fantastic work and compassionate care for our soldiers using continuous peripheral nerve blockade to comfortably transport wounded soldiers back to Walter Reed Hospital. His wife and three daughters went to the hospital to visit his patients when they were safely returned to the U.S. to further bolster their spirits. We are very proud of his contributions to our soldiers, wounded Iraqi citizens, and our country.” Buckenmaier, along with Steele and other colleagues, will give a workshop, “Upper Extremity, Lower Extremity, Paravertebral/Neuraxial: Regional Anesthesia—Single Injection and Catheter Techniques,” at the 19th Annual Society for Ambulatory Anesthesia this April in Seattle, Washington. He can be contacted by e-mailing ccbiii@yahoo.com 1 Yaroslav Trofimov, “U.S. Tent Hospital Offers a Close-Up View of Attacks in Iraq,” Wall Street Journal CCXLII (2003): 1-3.
DUKE ANESTHESIOLOGY ALUMNUS | 31 LIBBY’S “REAL WORLD” “I had the opportunity to see Libby Dalamangas recently. Libby was a resident at Duke from 1995 through 1998 and then completed a one-year fellowship in the Division of Cardiothoracic Anesthesia. After her fellowship, Libby moved to the Deborah Heart Institute in New Jersey, where she met her husband, Christos Liakonis. They worked together at Deborah until 2001, after which they moved to Michigan, where Christos works as a cardiothoracic surgeon, and Libby works part-time doing all types of cases. Libby is very happy with her career and says Duke did a good job preparing her for the types of cases that she deals with daily. However, Libby did wryly note that surgical and anesthetic private practice (the “real world”) is much different than academics with a focus on preservation of a referral base from community primary care physicians! That is, lots of socializing and “face time” are musts! Oh—and it’s Libby Liakonis now!” OLD AGE? KATHERINE GRICHNIK “It is so good to hear from Duke anesthesia. Barbara and I are fine, maybe just a bit older, but fine. Our two boys Alex (16 already) and Jeff (10) are keeping us busy. I’m still at Virginia Mason doing cardiac anesthesiology and training residents and fellows. I also run a venture fund and do a good deal of consulting for a number of investment-related groups.” NAIROBI CALLING KEITH KNOPES Between a daughter getting married soon, and trips to Durham for, of course, Duke basketball, Lynn and Ruth George still manage to help out medical missions (see page 7), providing complimentary anesthesia and nursing services for children in developing coun- tries. This summer, they’ll return for a month stint in Nairobi. MARK GERHARDT was recently awarded an FAER/SCA Research Grant, investigating Beta-adrenergic receptor desensitization in a large animal heart fail- ure model. MARK PHILLIPS sends his greetings from Jacksonville, Florida. For the past 11 years, he has been practicing exclusively in an outpatient surgery center. CARYN HERTZ is currently director of anesthesia at the Chapel Hill Surgical Center. RATAN ALEXANDER currently works at Worcestershire Royal Hospital as a con- sultant anaesthetist. The hospital serves a population of approximately 500,000. Worchester is famous for producing brown sauce and having a namesake near Boston, Mass. He says he’s always happy to accommodate oversees trainees if any- one is interested in a bit of UK experience. Contact him at Ratan.Alexander@worcsa- cute.wmids.nhs.uk. NOTES
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