We were on deployment in the Western Pacific. A sailor who was recovering from oral surgery in sick bay went into shock and became unresponsive.
The oromaxillofacial surgeon on board diagnosed septic shock versus LAST. After stabilizing the sailor, we had to get him off the aircraft carrier to a shore hospital. The closest being the island of Okinawa, Japan. That very day we had received new portable ventilators and I was tasked with using one for the medevac. About an hour into our flight, I noticed that the E-cylinder gauge was lower than expected. The ventilator was using oxygen at about 3-4 times more than the settings. Then the crew chief of the MH-60 helicopter announced that ALL communications and radar were lost! Added to that we had limited visibility due to inclement weather. We dropped altitude, hoping to see any land outline, birds or ships. I then began alternating use of the ventilator and hand-bagging the sailor. With the copilot and Crew Chief fervently using binoculars to search for land I continued hand ventilating.
Upon spotting land we tried to get our bearings to find Camp Foster and the naval hospital. The oxygen gauge was in the red, but we had no GPS. I handed over the care to the crew chief and surveyed the terrain and told the pilot to fly due west. I am a Japanophile, and I recognized Nakagusuku Castle and what I presumed to be the Futenma River. That river runs through the naval base. After what seemed like an eternity, we spotted U.S. naval hospital, Okinawa and landed with empty oxygen tanks. We were met by the ER staff, who were expecting a patient with malignant hyperthermia. Fortunately our sailor survived and I saw him again in Australia. Suffice to say, I didn’t recommend the ventilator for use.
How do you think your military experience has informed your approach to civilian practice?
When on a cruise, we have 6,000-plus personnel under our charge, plus any victims of war and natural disasters. We have one anesthesiologist, a general surgeon, OMF surgeon, two flight surgeons, and a cadre of corpmen who we train to be our mid-levels. The purpose of an aircraft carrier is to project our military strength beyond the horizon. There can be no flight maneuvers if medical isn’t available. This turned me into a logistician very early. I also learned to use the resources at our disposal and repurpose others. Educating personnel with varying educational and cultural backgrounds was a daily task. Land combat proceeds without us. But we are deployed with the Marine Expeditionary Forces or Joint Command. Our forces fight harder, knowing we are right there to patch them up. Armed with these experiences, I have been able to navigate the business of medicine, the idiosyncrasies of surgeons, the cultural biases which can impede team work and not becoming frazzled with emergencies or difficult interactions. The Navy particularly prepared me for my work in ambulatory surgery. Aboard the carrier, after surgery I had most of the patients ambulate to recovery. No easy feat, since you must walk over the knee-knockers, which tends to injure even sober sailors. I also use collaboration in our approach to patient care. Having been stationed in multiple countries and working with Allied medical personnel, I learned varied and less costly techniques. Finally, I train my CRNAs to do US-guided regional techniques, equipment purchase, and ordering. Because at sea, when there is a fire, we need the best firefighters.
You characterize your current practice, Quantum Anesthesia (in Naples, Florida), as “veteran owned.” Why do you think it’s important to emphasize this aspect of the business?
My business is ambulatory anesthesia. We currently consult for 19 operating theaters and will be adding eight more by years end. High-quality care that is dynamic, by itself, won’t generate new contracts. So we do what most anesthesia groups don’t - we advertise.
Americans thank Veterans and the troops. My staff and I being military veterans, affords them a chance to put their money where their heart is.
If there’s one thing you want your fellow anesthesiologists to know about serving in the military, what would that be and why?
Military life isn’t for all. It isn’t where those who “can’t cut it” go to hide. Remember, we treat the President, Cabinet, Congress and Senate.
If you rely on your physician title for power, you will take orders from Allied Health Superior Officers. We break you, and train you to first take orders before you can give them.
Is there anything else you like to cover that we haven’t yet asked about?
In the military as a physician you can have the adventure of a lifetime and multiple careers. Where else can you get qualifications in weapons, surface and special warfare, trained in dive medicine, slingshot off and trapped on an aircraft carrier. Transforming from a Pollywog to a Shellback when you cross the equator. Or get rocked to sleep by 30 foot waves; listening to whales banging against the vessel and suddenly reacting to a mass casualty from an air crash, natural disasters or war. At your overseas duty station or during port calls you become the face of America - training the local medical personnel, meeting local politicians, and winning the hearts of the populace.
The Navy helped me fulfill my childhood dream.
Gary Lawson-Boucher, MD, is an anesthesiologist with 15 years of experience in the area of ambulatory and general anesthesiology, Over the course of his career, Dr. Lawson-Boucher was granted several military awards for his remarkable achievements during his ten years as an anesthesiologist with the United States Navy. He received his medical degree in 1999 and completed his residency at University of Medicine and Dentistry of New Jersey in Newark, New Jersey, in 2003. Dr. Lawson-Boucher is certified in Anesthesiology by the American Board of Anesthesiology, and he is also certified in Naval Warfare.#MemberSpotlight