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CARBONDALE SURGEON IS DOING HIS PART: ARMY RESERVIST HELPING THE INJURED IN AFGHANISTAN'S LARGEST HOSPITAL

BY CALEB HALE
THE SOUTHERN

Wednesday, January 19, 2005 7:29 AM CST

BAGRAM AIR BASE, Afghanistan -- Carbondale surgeon Joseph Rubelowsky is working at the most high-tech hospital in Afghanistan -- the one made of plywood, not the standard-issue military tents.

Serving as a United States Army Reserve surgeon, Rubelowsky has spent the last three months in and around Bagram Air base, located in Parvan Province between the cities of Charikar and Kabul. He is one of three general surgeons assigned to the 325th Combat Support Hospital, but he's also gone out in the field with soldiers as part of a forward surgical team.

Rubelowsky left his family, patients and fishing trips in Southern Illinois behind for a few months to help nearly 18,000 soldiers and countless Afghan locals. He left the comforts of home for a small tent and cot, which hardly ever offers complete protection from the elements.

The dry, arid weather Rubelowsky complained about early in his stay has been replaced with the rainy and snowy season. Both types of weather have disturbed his sleep.

"The only thing worse than a dry Afghanistan is a wet Afghanistan," Rubelowsky mused in a telephone interview from the air base.

Afghanistan is somewhat familiar territory for Rubelowsky. He spent several months as a reservist surgeon in the region in late 2002, little more than a year after U.S. forces invaded the country in response to the Sept. 11 terrorist attacks.

In 2005, Rubelowsky said, Afghanistan has undergone some noticeable changes, particularly after experiencing its first democratic election in October. However, despite those changes and a significant shift in attention to the U.S. campaign in Iraq, Afghanistan is still a combat zone, he said.

The evidence is everywhere, he added.

"You can't even go for a walk here," Rubelowsky said. "There are landmines across half the country."

Landmines aside, Rubelowsky said the environment is one in which he can focus simply on being a doctor.

As a surgeon in the country's largest and best-equipped hospital, Rubelowsky deals with the most serious injuries. He has treated the results of landmine explosions, gunshot wounds, stabbing injuries, even holes in the skull caused by lobbed rocks.

Rubelowsky recently treated a young boy who was severely burned after he fell into the open fire pit his family was using to heat their clay hut. The boy is expected to recover, and Rubelowsky offered the child a stuffed animal to help him in the process. It was a small token, but he suspects it will make a difference.

"On a day-to-day basis, it's tough to live here if you are a kid," he said. "Sometimes it becomes dog-eat-dog out there. People do what they have to do for survival."

Rubelowsky said in such an environment compassion often isn't expressed, so a little bit of it goes a long way with patients.

"These people are turned away from their local hospitals, because sometimes there is nothing they can do," he said. "We're sort of a last resort. If you can save a child's life, you make a friend for life."

Not every patient's wounds are a testament to a war-torn country. A majority of Rubelowsky's days are spent treating common ailments for both soldiers and Afghanis.

He said he has handled everything from appendicitis to kidney stones. At home, Rubelowsky is a heart surgeon. In Afghanistan, he said, he is treated more like the local expert on all medical conditions, something he wouldn't dare try in Carbondale.

The pressures of being a physician and owning a practice in Illinois are non-existent in Afghanistan, Rubelowsky said.

One example -- he said he doesn't have to worry about patients suing him for malpractice.

"There aren't any lawyers in town," Rubelowsky said. "I haven't seen one since I've been here."

The administrative work of running a practice is also gone, leaving Rubelowsky to focus solely on making patients feel better.

"You are just focused on one thing. It is actually somewhat refreshing," he said.

No doctor can afford to worry about what might happen if he or she treats a patient.

"We have to do it, or people are going to die," Rubelowsky said.

He has found part of the challenge is getting the Afghan locals to seek medical attention in the first place.

Rubelowsky has conferred with other field doctors in the region; sickness and disease in Afghanistan go far beyond the stages they generally reach in the United States.

Rubelowsky recalled one patient, an Afghani man, had grown a tumor in his one of his eyes so large it protruded out of the socket. He said the patient only sought medical help when the growth began affecting the vision of his good eye.

While field surgeons generally spend three months in a U.S. military campaign setting, Rubelowsky expects his stay will be extended for several more weeks.

He said he may return home in March; then again, the United States has various military and humanitarian aid campaigns going simultaneously throughout the world at this point. Every doctor's time in the field could be extended.

caleb.hale@thesouthern.com 618-529-5454 x15090