Doing Right at Any Cost

   I recently had the honor of meeting a true American hero! I was asked to speak at a regional wound care meeting in Toledo, OH, and noted that a military surgeon, Lieutenant Colonel John S. Oh, was also on the program presenting his experience with treating war wounds from the Middle East Conflict. These presentations are very impressive because they illustrate the skill and dedication of our military health care providers in taking care of those who are fighting for us, and the commitment of our soldiers in uniform to endure those injuries for a just cause. In my opinion, there can never be enough praise and adulation given to either of those groups. After arriving at the program site, I was introduced to LTC Oh. He has served several tours of duty as a combat surgeon in Afghanistan and is now co-director of the surgical intensive care unit at Walter Reed National Military Medical Center in Bethesda, Maryland. After a brief conversation with LTC Oh, I was turning to find my seat when someone touched my arm and asked, “You do know that he is a true hero, don’t you?”

   When he was introduced from the podium before his talk, I heard the story. As a surgeon at one of the very busy trauma hospitals in Afghanistan, he operated on the worst injuries. One wounded soldier was a gunner in an armored vehicle when the enemy fired a rocket-propelled grenade at the vehicle. The grenade went through the windshield and struck the gunner in the lower abdomen yet, miraculously, did not explode. He was carefully extracted from the vehicle and taken to the hospital for care.

   Apparently, if this happens, the patient is placed well away from all other patients and staff in case the device should explode. Treatment decisions are then made on the basis of safety for others and not so much for the patient. Instead of denying care to the wounded soldier, LTC Oh asked for volunteers to give anesthesia, to scrub with him in the operating room, and to circulate in the operating room. He could not let the soldier die without doing all he could. The volunteers came forth knowing full well that if the grenade exploded in the operating room, they could all be killed. The soldier underwent the procedure, had the grenade successfully removed, and is alive and well today.

   Why, you ask, would LTC Oh and the others do such a thing? Why would they risk their lives for someone they most likely did not know and who would possibly die anyway? They did it because that is what they were supposed to do; it was the right thing to do. There is a degree of bravery involved in their decision to help the soldier, but I think there was more to it that just “being brave.” The ancient philosopher Confucius said, “To know what is right and not do it is the worst cowardice.” Bravery is not the absence of fear, but it is having the courage to do what is right despite the potential consequences. That is why they did it—it was the right thing to do.

   For the most part, we do not risk our lives to take care of our patients, but how many times do we know what we are supposed to do, what is the right thing to do, but fail to do it for whatever reason? Is it too hard, too dangerous, too inconvenient, too expensive? We have discussed in this column about cutting corners and doing the minimum to get by in treating patients.¹ What is it going to matter? It matters to our patients and it should matter to us. I know that the actions of these brave people mattered to that soldier!

  LTC Oh, it was truly an honor to meet you and learn of your actions and those of your colleagues. I hope that all of us will look to you as an example of doing what is right for our patients no matter what the potential cost.