Operation: You can do better

NAVY SURGEON: Capt. Michael Langworthy began his career in the U.S. Navy Reserve after being encouraged to “do better” by his chemistry teacher at Morley Stanwood High School. Langworthy served as a Naval surgeon in Afghanistan earlier this year with German and Dutch colleagues. (Courtesy photos)

Morley Stanwood grad shares his story of how teacher’s ‘inspiring words’ helped him grow up, see the world

By Capt. Michael J. Langworthy
United States Navy Reserve

So how does a U.S. Navy surgeon find himself in the Afghanistan desert in 2012?

It all began in Morley Stanwood in 1978 …

My father retired from the U.S. Air Force and moved us in to a rented farmhouse right next to the old high school. I played football for Coach Vizitum, took chemistry and biology with Mr. Yeager and government with Mrs. Hanna.

Early in the school year I received a C+ on one of Mr. Yeager’s chemistry exams. I don’t know why, but he took the time to write on the top of the paper “you can do better.” I’d have been alright if he left it there, but my mother was one of the school bus drivers. As the buses pulled in and circled up in front of the schools he opened the window of the class room and yelled out at my mom that “he can do better.”

I didn’t hear the end of it. I sure didn’t slack on the chemistry study time anymore, either.

In the latter half of the year, I was in Mrs. Hanna’s government class when some of the senior girls decided to win the prom dance band in a huge west Michigan radio show promotion. I don’t know what prompted the ladies to decide they could do this because Morley Stanwood was a very small school and was going to have to go head to head with all of the schools from Grand Rapids, Lansing, Kalamazoo and Battle Creek. In essence, a small-organized force would have to yield great influence with tenacity, cunning and sheer will power. All a student had to do was to print the name of their school on an index card and send it to the radio station.

The plan spilled out of Mrs. Hanna’s senior government class, out in to the hallway, into the study halls and after a couple of weeks, the ladies had even organized the kindergarten class to give up their nap time so they could print in kindergarten handwriting “Morley Stanwood” in crayon on cards.

Our school won the prom band! This was just after the movie “Saturday Night Fever” came out so you can just imagine the prom outfits and dance styles that were represented that night in a community that at the time held claim to the second largest Buffalo herd in the United States.

The next time I would witness such a small group yield such a big outcome was when I worked as surgical support with Navy SEAL teams.

With the school year over, I had to get a couple of summer jobs to help pay for college. The State of Michigan had seen fit to give me a PELL grant but that only covered tuition. I spent most of the summer working with the Department of Natural Resources fencing in rivers with Jim McDougal, who also would be my college roommate, and doing odd contracting jobs with Tom Hansen from Grant Center.

(Courtesy photo)

Mr. Hansen was instrumental in helping to develop my subsequent sense of direction.

One day, Mr. Hansen and I had left a roofing job and he decided to take a shortcut. There was no shortcut. It was two parallel deer trails that entered a steep hill drop to the west of Pogie that was covered with logged off stumps. By the time the LTD came to rest at the bottom of the hill the entire exhaust system, as well as the break hydraulics, was gone and the engine was hitting on only five of eight cylinders. Mr. Hansen was able to plug the broken hydraulic line with binder twine. He used a hammer to impact it and we were able to limp the vehicle home.

I made a mental note at that point to always maintain a sense of where I was and know the direction of where I was going.

A number of my Morley Stanwood classmates ended up in the military. I’ve known Scott Davidson since the fifth grade and he joined the Navy right out of high school. He had the honor of being the “Chief of the Boat” of one of our country’s elite submarines. Several other classmates served and others were commissioned. I was fortunate that the Navy picked me to attend the University of Michigan medical school as part of its health professions scholarship program. I was deferred to complete an orthopaedic surgery residency and then a fellowship in trauma and adult pelvis reconstruction at the University of California in San Diego.

In 1998, I headed up the orthopaedic trauma division at the Naval Medical Center in San Diego and by late fall had been given a small trailer facility right on the beach in Coronado so that I could take care of Navy SEALS who had been injured during training.

I was an advanced trauma life support instructor while training in Michigan and pretty soon was asked to teach at the elite Combat Tactical Casualty Care course that SEALS use to train their medics and platoons. The teaching cadre was heading to Thailand, and I was invited to help evaluate some of the wounds and burns that the Thai military had sustained while battling pirates. The wound work turned out to be quite productive and my team was able to characterize specific wound events. We eventually turned these in to a number of articles that were published concerning wounds and blast injuries.

This data turned out to be significantly valuable when we went to war in 2001. Last year, I was asked to edit a special edition of “Techniques in Orthopaedics” that dealt specifically with combat related joint injuries and burns.

In 2011, I was called to Walter Reed National Medical Center to facilitate orthopaedic trauma care. I cannot put into words the sacrifice the young men and women of our armed services at times endure.

(Courtesy photo)

Operation Enduring Freedom has been the longest war in America’s history. The casualty care at Walter Reed is phenomenal and truly state of the art. There is a multitude of dedicated surgeons and ancillary staff who attend the wounded. It was on a June rotation at Walter Reed that I was promoted to Navy Captain, and also given notice that I would likely be deployed to Afghanistan as part of the Combined Joint Special Operations Task Force (CJSOTF). This forward surgical team, or FST, is a small, specialized unit. My team could go into just about any environment and provide damage control trauma care for NATO troops and their local alliances.

In March, I packed my bags and headed off to do some Army small arms weapons training and arrived in Afghanistan in April.

Our Navy FST was assigned to a German forward operating base in the Northern Afghanistan territory of Kunduz. The Germans, the Dutch and the United States maintain three trauma teams to provide emergent surgical care for NATO troops as well as local Afghans. The Germans actually own the medical facility and they had made a solid decision to provide care to Afghan locals who would not otherwise receive first-world care. There is a significant number of Afghans with chronic orthopaedic problems, such as contracted joints from burns, clubfeet and infected long bones. In many of the rural communities, oil is still utilized on an open flame for cooking and toddlers will frequently pull the pot over on them generating tremendous truncal and extremity burns. We don’t see neglected burns in the U.S., and we don’t see neglected clubfeet. The Germans opened the clinic doors to the local community and some of the hardest cases I have ever had to deal with were presented to me in Afghanistan.

In mid-May, we had two, 7-year-old girls, both named Sarina, present with extensive contracted burns to the lower extremities. Neither child was able to walk secondary to the contractures and crooked bones. The Michigan Army National Guard First Battalion 125th Infantry Regiment had been on patrol when they came across one of the kids and they brought her to the attention of the clinic. I took pictures and x-rays of the children’s deformed legs and sent them back to some university friends in America.

No one had seen cases like this, but my one of my partners in Battle Creek, Dr. William Comai, had some thoughts about what to do with the bone corrections and after some extensive discussions with my German and Dutch colleagues we made surgical preparations. We would operate on one Sarina on Tuesday, and the other on Wednesday. The first child required a multiplanar distal femoral osteotomy where we broke the femur and aligned it in the correct plane.

We had to meticulously separate the knee cartilage from the scar tissue so that she would have some knee range of motion. We freed up the scarred muscle and put orthopaedic plates on both sides of the corrected bone. School kids always complain that they are never going to use the algebra and trigonometry they get from school, but the geometric surgical correction that this little girl underwent came directly out of a late ‘70s math class in Morley Stanwood.

The second Sarina had a more complex, soft tissue problem. The burns she had received had traveled all the way from her hip to her ankle. Her knee was locked at almost 40 degrees and her foot was tethered to her calf. She was unable to apply any weight on this limb. A Dutch vascular surgeon and I spent the better part of Tuesday night rendering and re-rendering complex combinations of four-coupled Z-plasties on paper in preparation for the second Sarina’s surgery. The Z-plasties would allow us to remove underlying scar tissue while providing soft tissue coverage from her hip to her ankle.

We take a lot of pictures to document what we do surgically and I could tell that the kids found this a little unsettling. So one afternoon I turned the two of them loose so they could shoot pictures of the hospital and us.

I can see how all of the uniformed hospital staff could be frightening to a little kid.

Both Sarinas did very well and with a little work should be able to walk. They both will certainly have a more normal life now.

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