INTERVIEW: Dr. Jean Cournoyer

Dr. Jean Cournoyer is an orthopedic surgeon from Riviere-du-Loup, Quebec.  He became a reservist three years ago and re-joined full-time two years ago when it became clear that physicians with his skills would be essential to the medical teams working in Afghanistan. He was stationed at the Role 3 hospital from November 2007 to January 2008. It was his second tour of duty at the KAF hospital. Watch the interview online.

Gillian Findlay: Just take me back. As I understand it you only joined the armed forces two years ago in order to do this.

Dr. Jean Cournoyer: Since the age of 18 I trained as a pilot. I didn't finish my training. But I already knew the military environment. I was in the Air Cadet before and then in the Reserve a little bit after. And I rejoined as a reservist three years ago. I always wanted to rejoin the military since I was in med school but they didn't need specialists at the time. I was told that.

But since, now the needs – they do need specialists for mission and I rejoined, knowing that I might come to Afghanistan. Actually it was one motivation.

Gillian Findlay: Why?

Dr. Jean Cournoyer: Well because it's a different experience. And you know, as the medical team here, we know that it is like any military person trains for that and we know it's going to be an experience. It's going to be something different from what we live back home. And also I always ah wanted to maybe do some humanitarian aid at the same time, help in the world, be part of the improvement, we could say, of the world. I don't know if the word is too strong.

But that was also why I wanted to join Medecins Sans Frontieres at one point but as an orthopedic surgeon I wouldn't have the same need as I have now with the military.

Gillian Findlay: So do you believe in the mission here?

Dr. Jean Cournoyer: I certainly do believe that what I do here and what we do here helps them. I do believe that we make a difference. I've seen that with helping the Afghans, seeing Afghan patient. Yeah we do make a difference.

…

Gillian Findlay: What is the difference that you think you've made in terms of helping Afghans?

Dr. Jean Cournoyer: Oh it's improved in the sense that now the [Afghan] medics are more capable of providing health care. I had some feedback from my last tour where an Afghan orthopedic surgeon was following me for the two months I was here.

And afterward apparently just those little things that, well asking him, what would you do with this case looking at the x-ray. Then he would answer me, well I would try this, I will try – well alright, then we'll go ahead and try it. And apparently that built up his confidence so that back at his hospital it make a tremendous difference. And then kind of contaminated the other physicians too. Oh yeah, well we could do that. We'll try this and we'll be there to support you. But you have to, to begin working by yourself. Apparently it made a difference from what I've heard as feedback. So I was very delighted about that.

…

Gillian Findlay: Looking back is there a particular patient that you remember, particular situation that sticks with you?

Dr. Jean Cournoyer: Oh yeah.

Gillian Findlay: What's that?

Dr. Jean Cournoyer: Oh I will not say. In the sense for confidentiality. But I will just say that a Canadian soldier that was greatly mutilated, he's not part of the statistics of the dead people but there's the statistic of the people who have great injuries, that you remember those patients. And all our soldiers who are on the fields because they're fit and when you're fit and you lose a limb it's quite a grief that you have to – when you're 20 something.

I'm already in my 40s so I have the experience and the feeling, oh well I know how I was when I was that age and I have all the life in front of me. I have all those projects. All of a sudden, whoops, when you have a great injury those projects are changed. Not necessarily terminated but certainly changed.

Gillian Findlay: And you're the person that has to break the news. You're the one that has to say this is what has to happen.

Dr. Jean Cournoyer: Yeah. Bringing the news is not one easy thing but it's not the hardest part. It's like not being able to repair. Because we have limits. Like a mangled, blown injury that is all like ground meat it is obvious that you cannot really change that. But the other time, maybe could I, could I? And you work, you work, you work and then ah, I was not able to save that limb or I was not able to save that life. You always, aggh, I could maybe or what.

There's always that, well I tried the best, I try the best but still – maybe we could have done something. I always quote the Mash sitcom. There was Colonel Blake that one time told to Hawkeye when he had a patient that didn't go well, he said to him – I keep telling that saying in my head from time to time – like the first rule of war is that young men die. The second rule of war is that doctors cannot change rule number one. And I have to keep on remembering that and the same thing applies to limbs. One rule to war is that people will be mutilated. And the second rule is that doctors cannot change that – although we try.