Comfort Deployment 2019: From a Surgical Doctor’s Perspective

By: LCDR Steven Bradley, MD, USN

LCDR Steven Bradley is a staff anesthesiologist stationed at Naval Medical Center Portsmouth

U.S. Navy Lt. Cmdr. Steven Bradley, an anesthesiologist aboard the hospital ship USNS Comfort (T-AH 20), preps a man with a broken ankle before going into surgery off the coast of Kingston, Jamaica Oct. 28, 2019. Comfort is working with health and government partners in Central America, South America, and the Caribbean to provide care on the ship and at a temporary medical treatment site, helping to relieve pressure on national medical systems, including those strained by an increase in cross-border migrants. (U.S. Navy Photo by Mass Communication Specialist 3rd Class Maria G. Llanos)

Sitting in the wardroom, I reflected on how quickly the last four months have passed aboard the USNS Comfort. It seemed like only yesterday that taskers were going out and bags were being packed in preparation for Comfort Deployment 2019. In May, word quickly spread that the USNS Comfort was going out on a mission. As time passed, more details became available. The mission would be five months and include 12 mission stops. Some were excited at the prospect of deploying, others were hesitant.

In May, I reported as a critical core member of the Full Operating Status (FOS) crew. As the Department Head of Anesthesiology, I reviewed notes and numbers from previous missions to gather an idea of the breadth and scope of the deployment we would soon be embarking upon.

In June, additional members of the FOS crew arrived. Physicians, nurses, and corpsmen from duty stations across Navy Medicine reported aboard the ship. They came from CONUS and OCONUS commands, including Hawaii, Japan, and Naples. Supporting personnel were also sent from the Army, Air Force and US Public Health Service, as well as from partner nations such as Mexico, Brazil, Ecuador, Canada and Argentina. As we sailed out of Norfolk on June 14, 2019, our extremely diverse crew had already begun assimilating to the new environment and collaborating with each other.

After embarking on our voyage, the USNS Comfort sailed south, stopping in Miami briefly. After Miami, we sailed through the Panama Canal, a once-in-a-lifetime experience for many, and then on to the first mission stop in Ecuador. During the first week underway the crew reviewed instructions and set-up several committees for Medical Training Facility (MTF) Comfort. I participated in the cardiac arrest committee, which updated the ten-year old instruction. Emergency medicine physicians and our trauma surgeon worked on the mass casualty instruction and ran a full-scale mass casualty drill involving the entire ship.

In Ecuador, we saw the realization of many hours of mission planning for this specific deployment. Each mission stop was scheduled for ten days. On mission day one, supplies were off-loaded from the ship via the embarked helicopter squadron. Teams went ashore to set up two medical engagement sites. On mission day two, surgical teams went ashore to screen patients for surgery. Day three was the first of six operative days, as well as the first day for physicians, dentists, optometrists, and providers to see patients at the medical engagement sites. Mission days nine and ten were spent breaking down the medical engagement sites before setting sail to the next stop. This formula was repeated during the following stops in Peru, Costa Rica, Panama, Colombia, Trinidad & Tobago, Grenada, St Lucia, St Kitts, Dominican Republic, Jamaica, and Haiti.

The USNS Comfort has 12 operating rooms, including an interventional radiology suite. Comfort Deployment 2019 was staffed with two general surgeons, and specialist surgeons in orthopedics, plastics, trauma, urology and pediatrics. The anesthesia department included four nurse anesthetists and four anesthesiologists, including one pediatric and one critical care specialist. Together, we were able to perform and facilitate an incredible variety of surgical procedures. The general surgeons performed mostly laparoscopic cholecystectomies and hernia repairs. CDR Ortiz, the plastic surgeon, fixed over thirty-five cleft lips and palates. Our pediatric surgeon and anesthesiologist greatly expanded the age range of patients we treated, the youngest of which was seven weeks old. The urologist performed pubic sling procedures, effectively treating several incontinent patients. The orthopedic surgeon worked closely with a partner nation orthopedic surgeon from Brazil, and together, they repaired several fractures and provided many non-surgical consultations for patients with chronic concerns.

At the conclusion of the mission, we have performed more than 1,200 surgical procedures. However, it is not about the numbers, but about the outstanding patient care that has been provided across South and Central America and the Caribbean. As the deployment draws to a close and I reflect on the last several months, the words of CDR Mark Johnson, director of surgical services, echo in my mind, “It’s gonna be great, you’re gonna love it.”

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