Hours after the 9/11 attack on the Pentagon, Sean Montgomery stood on the roof of the Malcolm Grow Medical Clinics and Surgery Center at Andrews Air Force Base, where he was doing rotations for his general surgery residency at Walter Reed Army Medical Center. To the northwest, thick plumes of smoke billowed into the sky.
“Andrews Air Force Base went from being a sleepy little Air Force outpost to being seriously committed to defending Washington and the President’s plane, from one guard at the gate to armored vehicles, dogs, and searchlights everywhere,” Montgomery recalls.
Montgomery, today the director of the Surgical Intensive Care Unit (SICU) at UNC Hospitals, was already more than four years into his residency when the 9/11 attacks occurred. He had treated the types of routine trauma injuries found in civilian life. They primarily revolved around blunt trauma and penetrating chest and abdominal wounds. However, after the launch of Operation Enduring Freedom, soldiers were being evacuated from Afghanistan to Walter Reed, sometimes within 24 to 36 hours of being injured. They arrived with massive soft tissue and extremity injuries.
“It was a transformative moment in Army medicine and military medicine in general,” says Montgomery, who wrote a research paper on battlefield evacuation of soldiers with evolving injuries. “It’s commonly assumed that soldiers are healthy when they return to America. The reality is that a lot of injuries are still in evolution when soldiers return and that, given the soldiers’ age and good health, many survive injuries that average civilians wouldn’t.”
They Deserve the Best Medical Care
In 2003, after completing residency, Montgomery relocated to Fort Bragg. Years earlier he’d deferred active duty so that he could attend medical school. He was on base for all of one month when he received his first of three deployments, an eight-month stretch a few miles outside Fallujah, Iraq, with the 82nd Airborne.
“I had one case at Fort Bragg and my next case was in a burned-out bunker,” he says. “Before I left, everyone was asking, ‘Why are you going to Iraq?’ and saying, ‘The Iraq War is already over.’”
Montgomery arrived in Iraq in August, five months after the start of the war. During his deployment, he quickly understood the value of community to military families.
“The military community bonds together when loved ones are deployed,” he says. “The spouses of all the deployed soldiers in our unit came together to pass information along to each other about what was going on with us and to take care of anyone who needed help while we were deployed. You see a real sense of community in the military that can often be missing in regular civilian life.”
Montgomery’s time in Iraq, particularly his first deployment, was challenging. As part of the 3rd Brigade’s medical company, a 20-person team of doctors and medics who resided together on base, his daily life was enmeshed with the lives of soldiers who were regularly engaging in combat with insurgent forces. He saw soldiers at the gym or in the dining hall one day and treated them the next.
“At no point during my training had I treated someone in the trauma bay that I knew as a person,” he says. “It was emotionally difficult. But the soldiers valued us because of how close we were to point of injury. Receiving appreciation from them is one of the ways that you can emotionally sustain the tragedy of seeing daily injuries.”
Mortar and rocket attacks on the base were regular occurrences. On one occasion, the base’s hospital was hit by a rocket-propelled grenade. Montgomery was across the street during the strike, but two members of his team – Lt. Col. Mark Taylor and Sgt. Matthew Sandri – were killed, and many more members of the 20-person unit were injured.
Lt. Col. Taylor, the senior surgeon on the team and Montgomery’s roommate, was supposed to have been home eight days earlier. He had stepped outside to call his family when the site was struck. Sgt. Sandri, a combat medic, had been taking a break when the grenade hit.
Those spared responded to the attack by treating the injured amidst chaos and smoke in the surgical facility.
“Eight of the people you were counting on to provide medical assistance weren’t functional because they were injured,” Montgomery says. “Despite losing two friends we had worked closely with, we went on to do surgery on other people that night who survived. That’s what you have to focus on: accepting that there are certain things that can’t be fixed and trying to focus on the ones that can be.”
The experience made the war personal for Montgomery.
“When someone you ate breakfast, lunch, and dinner with every day for eight months is killed, it makes the war very real,” he continues. “The sacrifices aren’t removed from you – they’re being made by those you know and care about. It raises your commitment to what you’re doing because American soldiers go out and put their lives at risk and you know they deserve the best medical care they can get. They became even more important to me after that event.”
In 2004, the 82nd Airborne Division named a medical training facility at Fort Bragg in honor of Lt. Col. Taylor and Sgt. Sandri: the Taylor/Sandri Medical Training Center. Montgomery remains in touch with the families of the soldiers. Two of Sgt. Sandri’s brothers volunteered as medics in the 82nd Airborne after his death and trained at the training center.
“It’s one thing to volunteer based on a very theoretical thing that may happen, but probably won’t,” Montgomery says. “When you’ve seen war’s impact on your own family, as they have, volunteering reaches another level of courageousness.”
A Mission You Can Be Proud Of
Montgomery signed his Army contract when he was seventeen years old. He went on to complete his trauma and critical care fellowship at Emory University in 2008 and his military service in 2010, after two more three-month deployments in Iraq and Afghanistan.
“I don’t think I ever seriously considered trauma until my first deployment to Iraq,” he says. “I was planning to do something different among the general surgery subspecialties – perhaps surgical oncology or transplant surgery. But working in that environment, under such extreme conditions, pushed me to a higher level of medicine than anything I’d been a part of before.”
Six weeks after returning from Afghanistan, he found a new home in the SICU at UNC Hospitals.
“UNC definitely shares a lot of values with the Army,” he says. “It tries to recruit and retain a family and build a very stable work environment that encourages collaboration.”
He is especially pleased that military families from around North Carolina are welcomed in Chapel Hill.
“We take care of some of the more complicated cases from Fort Bragg,” he says. “We’re still the trauma referral center for Womack, so soldiers who have been injured in training accidents, or if they or their family members have complex medical situations, can receive care here. We see a lot more soldiers than most hospitals, and I love still being part of that.”
Meanwhile, at UNC Hospitals, he has found a medical institution focused on service to the patient, no matter what walk of life he or she comes from.
“We provide a service that many other hospitals aren’t willing to,” he says. “That’s a mission you can be proud of. Personally, that’s important to me. I need that in a job. If you work a weekend or come home late or aren’t around for something your kids want you to be there for, you can, with pride, say what you were doing. I’ve found that here.”