STEVE INSKEEP, HOST:
Now we have a follow-up to several NPR exclusive reports on a crisis in military health care. The Pentagon was trying to privatize and outsource health care for troops and their families. NPR found there's a shortage of health providers nationwide, which has hurt the military's ability to keep its fighting force healthy and even to keep its medics trained and ready. Now there is a start at solving the problem. NPR's Quil Lawrence reports from Charlotte, North Carolina.
QUIL LAWRENCE, BYLINE: David Callaway became a Marine Corps surgeon just in time for 9/11. He saw the military quickly learn lessons that cut battlefield fatality rates in half.
DAVID CALLAWAY: We need to capture all of these lessons learned from Iraq and Afghanistan and what they call the war dividend.
LAWRENCE: Because Callaway later discovered that the military had already learned those lessons in Vietnam and in Korea and then forgotten - he wants to preserve the war dividend this time.
CALLAWAY: The idea is we've invested trillions of dollars, thousands of lives. We have to take lessons out of this that help our community members in the U.S. and then also help our men and women serving overseas.
LAWRENCE: Callaway says that is starting to happen with civilian-military partnerships funded by the Mission Zero Act that Congress passed in 2019.
CALLAWAY: The idea behind this was, how do we get to zero preventable deaths from trauma?
LAWRENCE: Mission Zero collaborations do more than preserve knowledge. They solve a staff shortage.
CALLAWAY: He's stable there.
LAWRENCE: Callaway is chief of crisis operations at Atrium Health here in Charlotte, North Carolina, where active-duty docs and nurses from nearby Fort Liberty come and work shifts, like army doc Michael Clemens.
MICHAEL CLEMENS: I am a surgeon for the United States Army's Special Operations Command.
LAWRENCE: Clemens finished med school as Iraq and Afghanistan wound down. He's with special forces, so he still goes all over the world. But between trips, he ran into what's now a widely recognized problem for military providers. The Pentagon has outsourced so much that he can't get enough practice for his next combat deployment.
CLEMENS: It was a very stark contrast. I see appendicitis, I see hernia repairs, and I'm treating those kind of daily processes. All of a sudden, I'm thrown into a war zone where the majority of my patients are now coming in multiples.
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UNIDENTIFIED PERSON: C-O-C point 0-1, Special Care 3 (ph) is 15 minutes out to...
LAWRENCE: Working shifts here in the ER, Clemens can stay sharp and even practice battlefield techniques. One example is a way to stop blood flow at the aorta with a balloon.
CLEMENS: That is something we use to decrease bleeding in traumas. That is a skill that has evolved and been used commonly on the battlefield. And so I get to have firsthand experience with that device before I go use it in a more austere environment.
CALLAWAY: So, Quil, the important part of what Dr. Clemens is talking about is...
LAWRENCE: Dr. Callaway again.
CALLAWAY: ...This device was specifically created because we were seeing so many servicemen and women get their legs amputated in Iraq and Afghanistan, and they needed a way to stop the blood flow. And so this device that was designed to save amputees in war zones is now saving mothers who are having high-risk pregnancies.
LAWRENCE: Civilian-military collaborations like this are now happening at dozens of hospitals around the country. But here in North Carolina, the partnership got tested this year in a way no one ever wanted.
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JOHNNY JENNINGS: Today is an absolute tragic day for the city of Charlotte and for the profession of law enforcement. Today, we lost some heroes.
LAWRENCE: That was Police Chief Johnny Jennings last April on the day Charlotte lost four police in a shootout that also wounded four others. The casualties went to Atrium Health.
KATHY BARNARD: My name is Kathy Barnard. I am the nurse manager here in the emergency department.
LAWRENCE: Barnard was working that afternoon when the ambulances started arriving.
BARNARD: So, you know, we started getting the calls. Obviously, there's lots of law enforcement showing up.
LAWRENCE: Here's Dr. Clemens again.
CLEMENS: We had, you know, eight shooting victims that involved a rifle with high-caliber wounds. And so when they come into Atrium Health, on call that day were two military surgeons fully integrated with our civilian partners.
BARNARD: Everybody had a role. Everybody knew what room they were going to. A well-orchestrated dance.
CLEMENS: And I will say, the triage officer that day did look to one of my surgeon colleagues, who is a combat surgeon, and said, hey, I'm going to give you this first patient because we know that you're ready for this.
BARNARD: I pray we never ever experience that again, but we had the right team here to carry out the amazing care we gave everybody that hit our door that day.
LAWRENCE: Dr. Callaway worked that day as well on the scene of the shooting and back at the hospital, and he says there's one last thing this kind of mentoring can provide when the immediate trauma work is done. That's to have an experienced surgeon - maybe one who's seen war - be able to tell someone they did everything they could.
Quil Lawrence, NPR News, Charlotte, North Carolina.
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