By Darwin Castillo
My training and unique experiences in the military have led me to become a better physician, educator, and leader. Growing up, I never would have seen myself in the military since I envisioned a career in a quiet laboratory, researching treatments for rare diseases. Throughout college and years after, I worked as a research scientist at the University of California – San Francisco, The Salk Institute, and The University of Tokyo. Transitioning into clinical medicine became an obvious choice when the highlights of my work schedule were weekly visits to operating rooms, emergency departments, and clinical offices to obtain samples and data for my research projects. I quickly viewed the emergency department as the most fascinating part of a hospital since trying to piece together a clinical puzzle with limited information and strict time constraints seemed like an exciting challenge. On the other hand, I also saw the difficulties in clinical medicine, observing patients in the direst of circumstances, viewing the effects of abuse and neglect, and giving families bad news.
Shortly after starting medical school at the University of Illinois, a career in the military became more aligned with my interests in emergency medicine. Like the emergency department, the Air Force provided an opportunity to work and train on the frontlines, often with limited resources. Underlying these goals was a deeper sense of duty and service and understanding the importance of being born in the U.S. as a child of Philippine immigrants. I initially expected military training to be difficult, strict, and rigid, especially after graduating from college and gaining my own independence through years of traveling the world. However, I found that such structure established a firm base to grow upon, providing the flexibility to adjust and adapt to any circumstance. The Air Force also offered unique medical training and experiences not found in any civilian residency program. I was sent to the desert for Aeromedical Evacuation and Patient Staging training shortly after beginning my military duty. A few medical personnel and I would quickly construct field hospitals from the ground up, preparing for a heavy influx of injured patients after enemy attacks, and coordinate aeromedical evacuation to transport patients to more secure medical facilities amongst hostile fire. I also trained as a Critical Care Air Transport Team physician, where a nurse, respiratory therapist, and I would establish mobile intensive care units on any aircraft to stabilize injured soldiers too critical for routine aeromedical transport. The demands of flight such as altitude, pressurization, temperature, noise, and low light settings on already unstable patients were also accounted for on the long flights home.
Being stationed in Joint Base Andrews, Maryland also afforded the opportunity to treat veterans, active-duty members, and their families. I would often hear varying stories and backgrounds, including veterans’ gratitude for serving our country and experiences from families living throughout the U.S. and other parts of the world.
Working as an assistant professor in military and emergency medicine at the Uniformed Services University of the Health Sciences Medical School in Bethesda, Maryland was also a rewarding experience. Students were always enthusiastic when we conducted battlefield medicine exercises as future military physicians neutralized enemy combatants, rescuing and resuscitating their injured colleagues in unforgiving environments. Living in a relatively high-threat area such as Washington, D.C., the Air Force also constantly trained our medical units in disaster medicine. I often led medical teams and organized responses to quickly triage, transport, and treat military and civilian victims during drills of large-scale attacks. Such training proved useful when I was deployed to Bagram Air Base, Afghanistan during Operation Freedom’s Sentinel and Resolute Support. Working as an ER physician and Disaster Medicine Team Chief, the Bagram Air Base hospital was frequently overwhelmed with injured soldiers. Short pauses of silence would often be filled with chaos and noise as enemy attacks escalated at any given moment. Being subjected to indirect enemy fire and improvised explosive devices furthered the uneasiness while trying to run a hospital situated in a desert of a foreign country. Yet, throughout such chaos there was an overwhelming sense of camaraderie, duty, and gratitude that stemmed from the unique opportunity of healing soldiers directly in harm’s way.
After fourteen years in the military, I transitioned back to civilian life shortly after returning from deployment in Afghanistan. Experiences in the military solidified my leadership and teamwork skills necessary for managing critical patients in an often unpredictable emergency department. The hospital where I now work is currently upgrading to a trauma center where I share my military experiences through trauma protocols, such as managing stab and gunshot wounds, burns, and traumatic brain injuries. My Air Force training and experience in low-resource settings has also led to the establishment of medical clinics, education programs, and clean water access in remote villages throughout Guatemala, the Dominican Republic, Honduras, and Nicaragua during yearly volunteer trips. As I progressed throughout my career and transitioned into an administrative role in improving the current medical system, I began to realize that health care delivery on an institutional level is more of a business conversation in the context of health care. In order to effectively communicate logistics, value chain management, operation planning, strategy, and finance, an MBA education would be necessary to quickly enhance my knowledge and skillset. The NYU Stern School of Business became a clear choice due to the quality of professors, ability to focus or broaden my perspective beyond a hospital setting, and recognition of Stern as being in the forefront of business education. In addition, the Washington, D.C. Executive MBA class schedule of one Friday, Saturday, and Sunday a month allows me to continue full-time clinical duties as an ER physician while providing the flexibility to contribute in administrative duties and impact patient care on a larger scale.