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Modest Major Rengel responds
Thanks to a 10.5-hour time differential, I had little chance of connecting yesterday afternoon with Major Jeffrey Rengel, who is stationed in Afghanistan. Dr. Rengel, a Superior native, is the anesthesiologist who helped shepherd an injured soldier through a delicate surgery to remove an armed but unexploded round of ammunition from his head.
Rengel responded to my e-mail inquiry this morning, however, displaying incredible modesty for his work.
What follows is our exchange.
I spoke to your parents this afternoon, and they were kind enough to provide me with your e-mail address. I read about your role in helping to remove a piece of unexploded ordinance from the skull of an Afghan soldier. I'd like to ask you a few questions.
Q: Your mother said she didn't learn of your brush with danger until it was picked up in the press. She suggested you probably didn't want her to worry. Was this the case?
A: As far as notifying my family of the case, the answer is yes, I try not to trouble them with much of what goes on over here. I do communicate with my wife often and those conversations are usually concentrated on kids activities and what she is doing in an attempt to stay in contact with happenings back home. I know it is inherent in being a wife/husband or a mother/father to worry about loved ones when they are in harms way. I feel that worry is enough without adding to it with things going on over here. Specifically with the case in mention, it was such a peculiar and rare case that the chance of me being in that paticular circumstances again is, I hope, extremely rare.
Q: Your dad said you didn't understand all the fuss being made about your exploits, as fellow soldiers put their lives on the line every day. Could you expound?
A: I see our brave men and women come into our hospital on a daily basis with wounds experienced on the battlefield. After seeing this, I can't imagine what it takes to get in their vehicles or strap on their boots and walk knowingly into that kind of danger. I hate to see the wounded come in to the operating room, but I am never more proud than in those instances when I have the opportunity to care for them and get them back to their families alive. The amazing thing is, when I am able to talk with them, they are often very disappointed that they can't be back out there watching their buddies back. They are very appreciative that we are their to take care of them, the mutual respect between soldier and medic is a very neat thing indeed. As far as this case goes, it was my job to take care of this patient, it is what I have been trained to do. I take a lot of satisfaction in the fact that this afghan soldier is able to go home to his family, just like our soldiers go home to theirs.
Q: Could you tell me how long the injured soldier was in your care before the surgery? I assume he was unconscious at the time of arrival? It sounded like the actual surgery was fairly quick. Your dad said it may have taken only 10 minutes or so from start to finish. Did you don gear designed to offer protection in the event of an explosion?
A: The soldier was in my care for about an hour before the unexploded ordnance was removed. I brought him straight from the CT scanner to the operating room and starting administering a general anesthetic in preparation for his craniectomy. After being in the room for about 20 minutes, we were then informed of the UXO (unexploded ordnance) in the patient's head. During this time, the patient was being prepped for surgery and the neurosurgeon was within minutes of starting the case. Upon learning of the device, it was at that time the OR was evacuated except for me. I donned my body armor to protect me from a possible explosion and went through the process shutting down all the electrical monitoring devices and equipment that were present in the room. These things were done as a precaution to avoid doing anything that might set of the device. At that time, we were not aware of exactly what type of device we were dealing with, just that it did contain explosive material. After notification, it was at least another 30 minutes before the surgeon entered the room with a member of the explosive ordnance team. The removal of the device by the surgeon was fairly quick, somewhere around 10 minutes in all. Ater that, the neurosurgeon came back to begin the craniectomy.
Q: How tense of a scene was it in the operating room?
A: The operating room environment was unusual. After the evacuation, it was very quiet which is not like the typical OR. Usually there are several members of the operating room team present, music is often playing, the constant beeping of the anesthesia monitors and the banter of the surgeon and other people in the room. With just myself and the patient and no electrical devices on, the silence was a bit eerie. I do admit that I was a bit nervous, I thought of my wife and kids, said a little prayer. It was at that time I told myself that this is nothing in comparison to what our soldiers do every day when they go out and face our enemy. With that thought on my mind, I pressed on with the job at hand.
Q: It sounded like you couldn't avail yourself of much modern technology for fear electronics might trigger an explosion? Was it challenging to adapt to these circumstances?
A: Not having the benefit of technology to assist in managing my patient was a bit of a challenge, but during our training in anesthesia, we are always told to focus on the patient and look at the patient. Electrical monitoring is very nice to have and certainly adds to the safety of the patient, but a lot of information can be garnered by careful observation and physical exam skills. It also allowed me to focus on managing the patient rather than on the UXO.