Cedars-Sinai Medical Center

medical staff pulse newsletter

Text size: A A A
A BI-WEEKLY PUBLICATION FROM THE CEDARS-SINAI CHIEF OF STAFF November 16, 2018 | Archived Issues

Meetings and Events


Grand Rounds


Upcoming CME Conferences


Milestones

Do you know of a significant event in the life of a medical staff member? Please let us know, and we'll post these milestones in Medical Staff Pulse. Also, feel free to submit comments on milestones, and we'll post the comments in the next issue.

Submit your milestones and comments.

Share Your News

Won any awards or had an article accepted for publication? Share your news about professional achievements and other items of interest.

Click here to share your news

A Trauma Surgeon on the Front Lines

Pasleyportrait480px.jpg

Jason Pasley, who joined the Department of Surgery in August, served two tours of duty as the director of the trauma unit at Bagram Airfield in Afghanistan.

A Veterans Day Story

Even for a trauma surgeon who had worked inner city hospitals in Baltimore and Los Angeles, what Jason Pasley, DO, saw come through the swinging doors of his military hospital in Bagram, Afghanistan, was a shock.

A suicide bomber had detonated his explosive vest near a local playground. The bomber's target was a group of Allied soldiers, but among those caught in the hail of flying rock and hot metal were three kids—ages 6, 12 and 17.

"It was scary," said Pasley, who joined the Department of Surgery in August, about the bombing that occurred during his second deployment to Afghanistan. "We had three critically injured kids that all needed surgery. For most people working that day this was their first deployment. They weren’t trauma specialists and they didn’t expect to see that."

During both his deployments, in 2014 and 2017, the Air Force Lt. Colonel served as the trauma director of the 455th Expeditionary Medical Group, 455th Air Expeditionary Wing at Bagram Airfield, which is about 30 miles north of Kabul. Over both tours, he ran the central command’s busiest hospital, supervised scores of surgeons, nurses and technicians, performed hundreds of surgical operations and saved lives. He called directing the medical unit "balancing the chaos."

Most of the hospital’s patients were soldiers—American, Allied, Afghan and even Taliban. But sometimes, as in the case with the suicide bomber, the patients were children.

"After the initial shock of getting pediatric patients," he said, "we treated them like we would anyone else and got to work."

One child needed a two-hour surgery to wash out a leg wound and repair a major vein, which had been lacerated by shrapnel. Another required an hour-long surgery to remove part of their small intestine, and the third was relatively lucky, suffering a broken bone. All the children survived and were discharged from the military hospital within a week or two.

"After a couple of days, their parents got security clearance and they were able to visit them," said Pasley. "They were very appreciative. And we were able to find some Disney movies for the kids in their native language."

Traits of a Trauma Surgeon

Part of the eight-square-mile military base, the hospital had an ebb and flow to its volume of patients. Sometimes, Pasley’s unit, which had about 30-beds, would receive five to 10 patients at once. Other times, up to 20. And, still other times, they’d get one, two, or—if they were lucky—zero.

As the only trauma surgeon at the hospital, he was on-call 24 hours a day. He was one of the few medical personnel that had a room in the hospital, which is where he slept.

"I would leave the hospital to go eat, and I’d try to see a movie every once in a while," he said. "But we were still always on the compound."

It takes a special personality type to be a trauma surgeon, especially in a war zone, said Pasley. After searching for the right words, he quickly settled on the occupation’s most salient trait: "You have to work well under pressure."

"I love the adrenaline, you never know what’s going to come through the door," he added. "Nobody intended for this to happen to them on that day. So, you’re taking care of the patient and helping out the family. I like being there to support the patient and family in a time of crisis and start the healing process."

Pasley-Dodgers220px.jpg

Pasley says hello to Los Angeles Dodger Justin Turner at a ball game this summer at Dodger Stadium where Pasley was recognized for his military service.

Getting Used to Rocket Attacks

The transition from civilian to military life wasn’t made any easier for Pasley by the random shelling of the Bagram base. The military outpost was a frequent target of rockets from the surrounding hillsides. For Pasley, the attacks led to their own set of self-preservation rituals.

First, an alarm goes off, said Pasley, then you put on body armor. You drop to the ground and lay there until the all-clear signal sounds. The episodes can last minutes, as anti-rocket measures are deployed to knock down, or at least break up, the rocket. The attacks would occur day or night—sometimes once a day.

"It was terrifying, especially at first," said Pasley.

The hardest part about his deployment was being away from his family. Pasley had just gotten married—his wife is also a surgeon—about a month before he shipped out.

"My wife was going through a move and starting a new job and I was trying to be her support," said Pasley, who stayed in touch through Facetime, texting and email. "But it’s hard to be her support if you’re half a world away."

The Worst of Days

A month into this first deployment, Pasley had one of his worst days on the job. An American soldier had been shot, leaving terrible wounds to his chest and abdomen. Medics had been giving the soldier CPR for 15 to 20 minutes before arriving at the military hospital, Pasley said.

The soldier’s chest was opened up, a clamp was placed on aorta, as Pasley and his team desperately tried to get the young man’s heart started again. Their efforts to revive the soldier furiously continued for a half-hour.

Finally, they stopped.

"There was nothing we could do for him and he passed away right there," said Pasley. "It was the hardest thing I had to do because it was the first American soldier I had to declare dead. It was more than a little emotional for me."

Pasley-Obama480px.jpg

Pasley shakes hands with President Barack Obama when the nation's chief executive made a surprise visit to Afghanistan in 2014.

Being Each Other’s Wingman

After such upsetting events, Pasley and his team would hold a de-briefing session. They would talk about what happened, what went right, what may have potentially gone wrong, and what they could do better next time.

"Most of the time, there wasn’t much we could have done better," he said. "We always talked about being each other’s wingman to make sure everyone was okay emotionally."

During his first tour, if someone reached their unit alive, they had a 97.7 percent chance of survival. On his second tour, the unit’s rate of survival went up to 99.3 percent. As a result of his leadership, Pasley was awarded the Meritorious Service Medal and the Commendation Medal.

A Presidential Visit

Around Memorial Day in 2014, Pasley received an unusual order—to temporarily give up his sidearm, something most personnel were expected to carry in a war zone. The reason was a special visitor was coming, but there was no mention of who.

It turned out to be President Barack Obama. Pasley ended up shaking hands with the former President and also held a brief conversation. The 44th President thanked Pasley for his work at the hospital.

"He was very genuine and very nice," said Pasley. "It was a pleasure to meet him."

Salute to Veterans Serving Now

Pasley’s focus at Cedars-Sinai now is on his patients and his research. As a surgeon with combat experience, he is especially interested in developing better ways to control bleeding. He’s been an instructor for the Stop the Bleed campaign, which seeks to teach ordinary citizens how to help reduce the loss of life due to traumatic bleeding.

Though he’s far away from a war zone in Afghanistan, he often thinks of the friends he made there and those serving now.

"Even though you don’t hear about it in the news much anymore, there is still a war going on," said Pasley. "There are still many people a long way from home, away from their families, defending our country. I'm thankful for them, and I’m thankful for what the military has done for me."