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Post-deployment let down...


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I've been home from Mosul for 16 days and still wish I was there. It is tough going from a situation in which you are working 24/7 doing meaningful, life saving work back to the regular practice of medicine, which typically involves a few cool cases per week. In Iraq we were dealing with 20-60 significant trauma presentations per 24 hr period. many burns, shootings, IED victims, etc. I wish I could do this kind of work all the time. I've actually been looking longingly at positions with RMI and other govt contractors in Afghanistan, Iraq, Alaska, etc. hard to do as a married person with a family. I'm sure military folks have experienced this kind of thing before. It is nice being home and seeing my family, but I miss the sense of doing regular meaningful, life-affirming work. I enjoy my rural em jobs, but a few cool cases per week does not hold a candle to multiple major trauma cases per day. not depressed or PTSD now, just miss my colleagues from NYCM and the work we did there. They are recruiting for the next stage of the operation and now offer a stipend of $500/week for deployment with a min commitment of one month, all expenses paid. Unfortunately, I am committed at work and to other missions through the end of October. I may go back if the battle for Tal-Afar lasts into 2018.

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most trauma team positions involve a lot of OR and floor work. I have no desire to go to the OR or do floor scut. I like acute trauma resuscitation (and codes, procedures, etc). In Mosul, we had all of our patients in/out in 15 min or less, most 10 min or less with lines in, airway managed, splints applied, bleeding controlled, abx and analgesics on board, burns dressed, etc. A full time critical care or ICU position would be too cerebral for my taste. I have no desire to do acid/base equations, tinker with vents all day long, deal with multiple consultants, etc I think rural EM or working on a contract basis for the govt is about the closest thing to occupational happiness out there for me. I am still considering a clinical medical director position I was offered at a rural hospital in Ethiopia when I finished my global health doctorate 2 years ago. Might still do that for 6-12 months after I retire from full time clinical practice in 12-15 years. I think I will likely do part time or per diem ED work until I am at least 70 and volunteer work as long as I am able.

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