Portland, Ore.

Richard Mullins, M.D., now hopes to encourage other surgeons to serve their country through an article in the Archives of Surgery

Oregon Health & Science University trauma surgeon Richard Mullins, M.D., returned from serving in the Iraq war with a new mission: encourage other young physicians to put aside their opinions of war and focus on the men and women fighting it. At 55, Mullins was the second-youngest of eight general surgeons in the Navy Reserve serving in Iraq. The youngest was 42. He believes there aren't enough young surgeons offering to serve their country and hopes a historical perspective will remind surgeons that Americans need them. Mullins' essay, "A Tradition of National Service in Times of Crisis," is featured in the December issue of the Archives of Surgery.

Mullins' essay chronicles how three American surgeons in the prime of their careers enlisted other health care providers to volunteer for service in France during World War I, then went on to serve in the U.S. Army Medical Corps. The surgeons survived and returned to their families, academic positions and resumed their professional careers. Mullins said "Nearly a century ago, George W. Crile, Harvey Cushing and George E. Brewer were surgeons who responded to the national crisis of their time. Contemporary surgeons can learn from their example."

Mullins learned from their example and the role model provided by his father, a veteran of World War II. The OHSU trauma surgeon was called up to serve in the Iraq war in the prime of his career, leaving behind his wife and two children. His was a similar situation to his own father's, whose photo is on Mullins' office wall.

"In his 20s, he left his family to serve in the Army from 1941 to 1946. What a sacrifice," said Mullins. "I was influenced by my father. The new generation doesn't have those same role models."

He enlisted in the Navy Reserve eight years ago. Donald Trunkey, M.D., OHSU trauma surgeon and professor of surgery, was then chairman of the Department of Surgery in the OHSU School of Medicine and had just returned from serving in the Gulf War. Trunkey told Mullins there was an insufficient number of trauma surgeons to care for the causalities during that war. After talking it over with his family, Mullins decided his country needed him if the United States should ever go to war again.

"Rich Mullins is to be commended. He has a real sense of duty and patriotism," said Trunkey. "It is a sad commentary, but most young surgeons do not support the reserve or the military mission. It is such a pleasure when a person like Rich does what is right."

The United States needed him in March of 2003 after waging war with Iraq. Mullins, the chief of OHSU's trauma service, was deployed to serve in Iraq and traded his title for the rank of captain in the Navy's 4th Medical Battalion. His first stop was Camp Pendleton in Southern California. There his battalion joined the 1st Marine Division. He and his comrades were immunized against smallpox and anthrax. In mid-April they flew to Kuwait, where they lived in Camp Okinawa, a tactical staging area in the desert near the Iraq border.

In mid-May, Mullins was assigned to the Forward Resuscitative Surgical System #1 (FRSS1) at Camp Babylon near Al Hillah, 100 kilometers south of Baghdad. This nine-person unit's mission was to provide "life- and limb-saving" care. The unit had two hospital tents that featured pre- and post-operative care areas in the corners of one tent and the single operating table was set up in the second tent. FRSS1 remained at this camp until end of August.

Mullins is candid about how uncomfortable his tour of duty was. He says it was a long, largely unpleasant experience. It was hot, with an average midday temperature of 120 to 130 degrees. They lived in tents and felt like prisoners with severe restrictions on what they could do and where they could go.

The trauma surgeon who usually puts in 80-hour workweeks at OHSU was bored between May 15 and the end of August because there was little need for his services. The Shock Trauma Platoon in the tent next door to the FRSS1, which functioned like OHSU's emergency department, treated Marines and a few civilians with a wide range of problems, including dehydration and kidney stones, but only rarely were there patients who needed the skills of a surgeon.

The next stop on his tour was Al Najaf with the Marines' 1st Battalion, 7th Regiment. Mullins FRSS1 was sent there at the end of August in case fighting broke out after Ayatollah Mohammed Baqer al-Hakim was assassinated in car bombing attack at his mosque, which left dozens of worshippers dead. There was no civil unrest and three weeks later Mullins drove with the 1/7 in a convoy to Kuwait. Demobilized in San Diego, Mullins finally returned home to Oregon Oct. 10.

"What sticks out in my mind was that I was there to help Marines. I have great admiration for what the men and women in the military do," said Mullins. Back in his office at OHSU his computer screen is filled with a scene of Marines sitting on their backpacks, huddled in a group under palm trees and covered in dirt. "Seeing them live in dirt, 120-degree temperatures, riding exposed in convoys, layered in clothes and flack jackets and drenched in sweat, I wonder - how do they do it," Mullins reflected.

Would he be willing to go to war again? Mullins replied, "I'm too old. This experience was really hard on my body - but if they needed me, I would."

It's a message his essay reflects as well. When referencing Harvey Cushing's response for a call to duty on the day before Christmas 1914, Mullins' included the old surgeon's reply "I should of course be glad to go ... with an idea of service." The young trauma surgeon who just returned from service in Iraq followed that with, "In the 21st century, terrorists have threatened America's civilian populations, and we find we are engaged in a new kind of war. American surgeons are once again called to continue a tradition of national service in a time of crisis."

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