Deploying to Afghanistan

Dr. Gilbert Preparing for a mission

After enlisting, Dr. Gilbert hoped to be deployed to Afghanistan. He felt that he could be of value to soldiers—including his son Kevin, a corporal in the U.S. Marines—fighting in Afghanistan. “Soldiers are always getting skin diseases, especially on their feet,” says Dr. Gilbert, adding that having a dermatologist in the theater could mean the difference between having to send a soldier to Germany for treatment versus providing on-the-spot care and getting the patient back in the field in just a few days. But the one dermatology deployment available at the time Dr. Gilbert enlisted was based in Hawaii: “It sounded wonderful, but was not what I was looking for.”
When the opportunity arose to go to Afghanistan in the Fall of 2011, it was not for a dermatology deployment. Rather, Dr. Gilbert was selected to serve as a brigade surgeon. He assumed responsibility for the healthcare of more than 10,000 soldiers on the Kabul Base. “I had to ensure that all the medical assets were in the proper place at each of nine forward [operating] bases,” he explains. “You constantly have units moving in and out of the bases and some have doctors, medics or PAs attached to them and some don’t. That means there is a lot of shuffling of personnel as each unit changes locations to ensure appropriate medical coverage.”
Dr. Gilbert was also responsible for calculating the appropriate numbers of medical providers for several bases in light of the ongoing troop drawdown. “As we consolidate our forces, we will be closing some bases and relocating personnel to others,” he says. “The Army would like us to do more with less so it’s a compromise to staff all our needs.”
During his four-month deployment to Afghanistan, Dr. Gilbert went out on 18 missions to visit forward operating bases. “Usually the brigade surgeon either stays on base or just goes out a few times due to the danger, but I was aggressive about making sure things were OK at the forward bases,” he says. “When the lieutenant colonel shows up, people start hustling to get things done. I know my wife would have preferred me to stay on base but going out on those missions was the right thing to do.”
Despite his relatively short deployment, Dr. Gilbert points to several other accomplishments with pride. “I was able to start a walking blood bank. These bases are not huge, so they don’t have great storage capacity,” he says. “What if there was a mass casualty under these conditions?” Dr. Gilbert and his team recruited 100 volunteers at each base, confirmed their blood types, screened them for contagious diseases and assigned them numbers based on their blood types. “This way, they only have to remember their numbers, not whether they are A-positive or O-negative. Then we would do a drill and announce over the loudspeakers that we need numbers 32-45. Those people would come running,” he says. “Thank God we never needed it, but the system worked really well and now we have a process in place that these medical staff members can carry with them wherever they are deployed.”
He also increased the amount of training time field medics receive. “Some trained medics aren’t acting as medics because they’re needed to do other jobs. But if they’re not doing full-time medical work every year, they aren’t getting all the training they need to stay current,” says Dr. Gilbert. “I set up a program where medics work with simulation dummies every two to four months, and that is working really well.”
True to his dermatology roots, Dr. Gilbert also screened soldiers for skin cancer. “Out of 200 soldiers, we found five cancers and one severely atypical nevus that needed to be excised, plus eight or nine atypical moles that will need treatment when the soldiers get home,” he says. “Among the older soldiers in command positions, we found maybe 10 actinic keratoses, so I felt the whole effort was quite successful.”

Lt. Col. Gilbert preparing for a mission. (photo courtesy of Dore Gilbert, MD)