So You Wanna Be a...Flight Surgeon

We talk to Dr. Kenneth R. Harman, Chief, Health Services Division, US Coast Guard Air Station, Cape Cod, MA; flight surgeon for Coast Guard District I, which extends from the Maine-Canada border to Northern New Jersey.

How would you describe your job to our readers?My day-to-day job at the clinic includes seeing patients and performing physicals, but operationally I am involved in medical evacuation and search and rescue with the Coast Guard. If someone calls the Coast Guard and says, “We have someone injured,” the District Main Office will patch me through so I can talk directly with the person requesting medical support. Flight surgeons have a five-question mantra:

1. What does the patient have?
2. What does the patient need?
3. How soon do they need it?
4. Where can they get it?
5. Can we meet that window of opportunity?

I make a recommendation on whether a person needs medical evacuation, but I fi rst have to decide if it’s a valid mission. Th e last thing we want is to launch in horrible weather and dangerous conditions and get somebody who didn’t need saving. If we do launch, it’s my job to make sure that the patient is packaged correctly before putting him or her into our aircraft, and to provide needed care in transit.

Is there extensive use of health IT in your field?Most of the time we’re dealing with commercial fishing vessels out on the Banks, so usually there aren’t any IT resources. There was, however, one case when I was in Kodiak, Alaska, where a fishing vessel was hundreds of miles out in the Bering Sea. One of the crew had injured his ankle, and I was trying to figure out what I could do for this guy, so the captain asked if I wanted a picture e-mailed of the dislocated ankle. I was able to explain the process of how the crew was going to help reduce the man’s ankle. When everybody was in the right position, the captain e-mailed me a picture, and I told them, “That looks right. Now start pulling like I told you.” I heard the patient moan, then the sigh of relief. “That sounds good. Now take another picture.” I told them how to tape the ankle, received pictures of it taped, and communicated with them several times over the next couple of days while they got to port.

Can you give us an idea of what search and rescue and medical evacuation entails?Prior to being stationed in Cape Cod, I was at Coast Guard Air Station, Kodiak, Alaska. It’s a huge geographical area with a fairly small population, so the Coast Guard was relied on a little more heavily compared to Cape Cod, particularly for aero-medical evacuation. We frequently would launch and fly to remote Native American villages, particularly in the Aleutian chain, when women would go into unanticipated labor. I was also Medical Unit Leader for the Coast Guard Incident Command System in downtown New Orleans following Hurricane Katrina. My job was to make sure that Coast Guard personnel responding to the crisis had a medical intervention evacuation treatment plan and appropriate protective equipment, and to set up medical aid stations at the larger Coast Guard response areas and staff them with corpsmen. In 2005, I spent three months on the hospital ship Mercy in Banda Aceh, Indonesia, after the tsunami. My job was to go ashore every day and visit all of the on-land hospital facilities to identify the patients who needed to come aboard the ship for care.

Was it always your intention to become a flight surgeon? I went to medical school on a Navy Health Professions Scholarship and was a medical officer for eight years in the Navy. In 1988, I left the Navy and went into private civilian practice in Alabama. In 2002, I got a call from the Coast Guard, who told me about their critical shortage of medical officers and flight surgeons. My kids were grown and gone, my wife and I were interested in the idea of adventure, and our parents were healthy and retired. We looked at it as an opportunity to return some service to the country. I’m having a great time. I love what I do. The best decision of my career was to have the courage to leave a very comfortable, fun, private practice and do this, because it’s a blast. I would also be very happy and enthusiastic if you would mention to your readers that we are short on qualified individuals for Coast Guard medicine and flight surgery.

Who can our readers contact for information on becoming a flight surgeon?Readers can contact Commander Wade McConnell at the following address:

US Coast Guard Headquarters

2100 2nd Street, SW

Washington, DC 20593

The job is for people who like challenges, problem solving, and are willing to take some risks. If you like adventure, if you like a challenge, if you like never having a dull moment, it’s a great job.