Blogs & Comment

The Performer: Maj. Marc Dauphin, military physician

On the art of triage, facing death and the similarities between soldiers and spaghetti.

Maj. Marc Dauphin of the Canadian Armed Forces (Photo: Roger Lemoyne/CB)

After 27 years as a doctor in the reserves, Maj. Marc Dauphin specialized as a flight surgeon treating aviation personnel, and working in intensive case units and emergency rooms. Doctors with his skills were in high demand as the Afghan conflict heated up, and in 2009 he went to Kandahar, where he became the last Canadian in charge of the Role 3 Multinational Hospital at Kandahar Airfield. This month sees the debut of the TV series Combat Hospital. Set at a facility inspired by the one at KAF, the character played by Elias Koteas is loosely based on Maj. Dauphin. He spoke with Canadian Business features editor Andrew Potter.

Born: 02/06/53
Years of military service: 31
Decorations: CD1 (Canadian Decoration and bar) and MSM (Meritorium Service Medal)
Total staff at Role 3 hospital: 225-250
Role 3 capacity: 8 trauma bays, 10 ICU beds

How did you first get into military medicine?
I enrolled in 1972. I was a medical student at the time, and I needed the money for my studies. I had a wife, young children and was always going everywhere, so I got out and served as a reservist for the next 27 years. I was into emergency medicine and ICUs. This is what I liked. In 2007, the military called upon me because the number of casualties was increasing in Afghanistan. They started pulling in the reservists who had experience with emergency medicine. So I went to Germany, where I was the liaison officer for the air-evacs [air ambulance teams]. I was supposed to stay six months, ended up staying a year. When I returned home, I decided to take a couple of months off, and while I was off they called and said, “Would you like to go to Kandahar?” And I said, “OK, but not as a reservist. I want you to take me on as regular force.” We got hit very, very hard at the end of the first Obama surge, while I was commanding the international hospital there, and there were a lot of casualties. We broke all kinds of records over there.

Does the training for combat medicine differ from civilian medicine?
Yes, of course. War wounds are much different. The training we went through at Wainwright, Alta., is the best I’ve ever had. They intensely analyze every roto [troop rotation] to see how tactics and wounds are changing, so they can be up to date. In those three weeks at Wainwright, they gave us three months’ worth of simulated casualties. It was very intense, day and night, very tough. I also had to get up to date on the flight surgeon and air-evac stuff. When I was in Germany, I spent most of my time at the Landstuhl hospital, which is one of the best in the world, and that helped me a lot. After that, we still had three or four months, so my instructions were train, train, train. I took courses in airway management and pediatrics, and I spent a month in an ICU, just to get my hands back in the game.

Aside from the training, are there any temperaments or dispositions that help someone perform in a war zone?
I can see through your question. You never know who you are dealing with until you get to the war zone. They seem so confident, then over there they underperform, worry, fall apart and break down. It is rare, but it happens. It is never the ones you expect. Well, sometimes it is. Before you go, you face the possibility that you might be injured or killed. And one of the things we do is come to peace with that, and abandon everything we like in life, including relationships. And when you come back, they are hard to build back up. Soldiers’ spouses complain about the detachment. “You want a divorce? Sure, no problem,” you know?

Were there any techniques you used to prepare yourself mentally?
Not really. I just concentrated on my work. I know there’s a course soldiers get for mental resilience, but I wasn’t there the day they gave it—I was doing some ICU training that was probably more useful to me. What helped me was my age. Being old, I’ve seen a lot of stuff, and it is amazing—you forget how young these kids are. They don’t have a lot of experience.

How did you approach your role as a team leader?
I had one speech that I kept in my pocket, figuratively: it was the St. Crispin’s Day speech from Henry V. I needed it almost as soon as we got there, and I thought, “Jesus, what am I going to do now?” But I just kept going, and things went OK. I guess it comes from the military principle that troops are like spaghetti: you can’t push them, you have to pull them. So I was in front, and I was pulling all the time, trying to be cheerful.

Was there any time in theatre to relax?
It was go, go, go the entire time. I had so many responsibilities. I was the officer commanding the hospital, responsible for making the place run day to day. Then I had a clinical role: I was the triage officer. I thought it would be easy, the guy at the gate going “You go there, you go there.” But it’s far more than that. You have to decide who goes first to OR, who gets what treatment. You have to co-ordinate all the injured guys when they come in, and they never come in onesies or twosies. They come in five or six at a time. Our holding capacity was very small, but because I’m an ER guy it helped, because the first question ER docs ask is not “What is the diagnosis, or what is the treatment?” It is “How do I get rid of this patient?” You want to flow them through. So I did that at the level of the whole hospital, figuring out who would go to England, to Germany and so on. At the same time, I was responsible for every patient that went on a plane, even if he was never admitted to the hospital. So to answer your question: most of my people, if you stopped talking to them for 30 seconds they’d fall asleep. It was a big roto.

Beyond saving lives, what was most rewarding about the job?
Apart from the adrenalin high—and man, what a high—the biggest was being a part of history. And knowing that I am part of history gives me a sense of accomplishment. Knowing I was the last Canadian officer commanding Role 3, they can’t take that away from me. You know, I went to the cinema, back in the ’70s, and saw this film about military surgeons wearing Hawaiian clothes, saving lives in a war, and I thought, “This is the neatest thing there is. I want to do that sometime.” And when I was in KAF, there was a Hawaiian party one night, and we received 20 casualties in a few hours. And all these guys were coming back to the hospital in their Hawaiian shirts, getting covered in blood. And it hit me: “Be careful what you wish for, son, for you sure as hell got it.”