After a 20 year journey as a civilian emergency room doctor, one woman has found it was her enlistment in the U.S. Army Reserve and a recent deployment that has given her a newfound appreciation for advances in her field and the Army healthcare system as a whole.
Dr. Rachel Kaiser is the middle member of a third generation military family, spanning three different branches. She is an ER doctor in the U.S. Army Reserve whose father served in the Navy during the Korean War. Her son is currently in the Marine Corp Forces Reserve. Kaiser is assigned to the 4203d U.S. Army Hospital, Nashville, Tenn., and works as an ER doctor at St. Thomas Hospital in Nashville, her home town.
Kaiser initially began her military service in the National Guard while in medical school in the 1980's. She then left the military to work solely in civilian hospitals. Three years ago, she enlisted in the U.S. Army Reserve. Well into her career as a civilian ER doctor, she felt the time was right to expand her career goals and pursue her options in the military healthcare system.
"I felt like I could contribute if I came back in as a physician. I had a lot more to offer," she said.
Kaiser felt drawn to emergency medicine in the U.S. Army Reserve because of the high quality of medical care. She was also impressed with the sophisticated medical facilities.
"The Army has taken the lead in the advances in trauma care in the last 10 years," she said. "Advances in massive transfusion and brain injury treatment are all from the military side [of medicine] from the wars, and are now being utilized in civilian trauma care."
Kaiser is dedicated to emergency medicine in both military and civilian facilities for the same reasons. She calls emergency medicine an intellectual challenge. She refers to it as an "action-oriented specialty."
The highlight of her enlistment in the U.S. Army Reserve was her 90-day deployment last summer to Camp Arifjan, Kuwait. She had the chance to serve as part of the 48th Combat Support Hospital. Kaiser felt it was a great opportunity to serve the troops.
"Walking up the steps to the airplane to go to war, I felt apprehension and pride that I could take part," she said.
Kaiser credits the Army with allowing reserve doctors to serve 90 day deployments, as longer deployments would be difficult considering the doctor's civilian practice and patient load. She encourages other medical professionals to take advantage of similar opportunities in the Army healthcare system.
Kaiser's time in Kuwait was at the height of summer, with 120 degree days as the norm. Between the extreme heat and sandstorms, Kaiser saw many heat-related and sand abrasion injuries, notably cornea abrasions. She also treated major traumas she likens to the mix of injuries she typically saw in her Nashville emergency room. These included car accidents, stomach viruses, and she also experienced treating a soldier who presented with what was diagnosed as early colon cancer.
There were several differences between the Nashville ER she calls home and the combat support hospital she called home last summer. These differences are what made the experience all the more valuable and rewarding for Kaiser. As a medical professional deployed with the 48th CSH, Kaiser took part in medical evacuation missions, transporting soldiers for further medical treatment in Germany in C130s. She also had the chance to take part in health fairs specifically geared toward the needs of the local civilians who worked alongside the U.S. Army personnel at Camp Arifjan. These health fairs provided monthly screening checks, such as cholesterol, blood pressure, and sugar levels, for those who otherwise may not have had access to such care.
When it comes to the healthcare system and mindset of the U.S. Army compared to that of the civilian medical field, Kaiser found specific aspects refreshing and liberating. Treating emergencies in a civilian hospital can be constrictive in the areas of follow-up care and prescription medications. Kaiser contends lack of insurance for emergency room patients is the cause for the lack of follow-up care and inability to simply prescribe what is needed. Kaiser praised the ability to disregard the cost of prescriptions as a benefit when treating patients in a military facility. She also enjoyed knowing there was the assurance that follow-up care or more extensive testing would be done if needed.
"Because all patients had insurance, they all had follow-up care the next day. They could also get the meds they needed," she said. "In the civilian world, you can't do that with meds and follow-up care."
Aside from the medical career-oriented benefits, Kaiser gained a great deal of personal satisfaction from her time at Camp Arifjan, Kuwait. She noted her admiration of the fellow U.S. Army medical professionals she got to know and learn from.
"I was with extremely dedicated and high caliber medical professionals with a high level of motivation," she said.
"During a 4th of July picnic behind the hospital, it hit me that these were people from all over the United States, all with a different skill set, all with a unity of purpose," she said. "I hadn't experienced that in civilian life and it really impressed me."
Kaiser added that she planned to continue her work in the U.S. Army Reserve Medical Corps for as long as she possibly can.