INTERVIEW: Major Terry Ratkowksi

Major Terry Ratkowski completed his dental degree in the Canadian Forces Dental Officer Training Program at the University of Alberta in Edmonton in 1994. He specialized and received his certificate in Oral and Maxillofacial surgery from the medical department of the US army in June 2006. In July of that year he was posted at CFB Edmonton where he will serve after returning from Afghanistan in March 2008. He arrived at the Role 3 hospital in August 2007.

Watch the interview online.

Gillian Findlay: You say you didn't know an awful lot about this. What were your expectations when you came to this hospital and what surprised you?

Major Terry Ratkowski: The knowledge that I had prior to arriving here was based on what others have provided and there were others before me who have done the same job and have worked in the same facility. I was surprised to see the minimal amount of resources placed into the facility. The facility is literally made out of wood and you know what they say about the three pigs and you know it's better to have a brick house than a wood house.

Same thing would be said for this as a health care facility. It's not ideal. What has amazed me is how much we've been able to accomplish as a group here and I think it's the combination of factors. The professionalism of the people that come here to do their work, including civilians, including health care providers, nurses, medical technicians, it's a real team approach. I think we've accomplished so much more than the wooden exterior of the building would indicate that we can do here. So in that respect, I've learned and grown a whole bunch with respect to what you can do.

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Gillian Findlay: But they must be difficult decisions. How to you reconcile all of that when you're going through the process of making that decision?

Major Terry Ratkowski: Well there are a lot of factors that come into play, but the main factor that we have to use and utilize is that in this particular facility we have limited resources with respect to bed space, with respect to surgical expertise, with respect to supplies. At some point we reach the end where we no longer are making any gains with respect to the recovery of the patient, or with respect to further care of the patient.

At those points, it's where we're open to further discussion, but at some point there just is the difficulties to overcome are too great and usually it takes a group to discuss all the issues to really understand that this is it, this is all we have to offer.

Gillian Findlay: And then you return them to their own system of health care?

Major Terry Ratkowski: Right yeah.

Gillian Findlay: Were they clear conscience?

Major Terry Ratkowski: Yes, I think so because as I indicated, we really do reach an endpoint that we can provide here as health care providers, so at that point you know that may have been several hours whereas a surgery several attempts at surgery, as well as multiple use of resources maybe weeks here at the facility which was never our intent, however some of those cases developed that way. And you know at some point we understand that it's just something we have to accept and some people never leave the facility you know. Some people die here in facility but not because we're not doing all that modern medicine has to offer, it's just the nature of their injuries are so severe and acute that they can't be overcome.

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Gillian Findlay: Is it different when a Canadian soldier comes in for you as a Canadian physician?

Major Terry Ratkowski: For me no. I have not changed the way I look at the causalities that come through the door. On a personal level, I think it may effect me. On a professional level, it doesn't. We treat all people that come through this facility as people who are injured and who would want to receive the best absolute best care that they could receive in this particular facility.

So the fact that they're Canadian or another nationality doesn't enter into the actual amount of care that anyone receives here. On a personal level, I think I'm proud of what the Canadian coalition force is doing here and you know my heart goes out to the families back home, 'cause it's a long way from home and many of them are wondering quite possibly what good is coming out of this. It's important to realize I think that although we as a nation have lost several people here in Afghanistan, and often the story that's untold is the number of actual Afghan people that are lost here probably on a factor of 10-15, so for every coalition soldier from a democracy that's participating in this war, there's probably 10 or 15 Afghan people that are losing their lives in a struggle to get control of a country that has largely been lawless for quite some time.

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Gillian Findlay: But you come for a long period of time, you're away from your family for a long period of time, when does it get most difficult for you? What are the dark days?

Major Terry Ratkowski: Well there were days when it was extremely busy. Many unfortunate cases, sad cases that remind you of certain things, maybe of certain people back home.

Gillian Findlay: Can you give a for instance?

Major Terry Ratkowski: A young lady about age of 7 was brought to the facility, had been struck by a vehicle 12 hours prior previous to her arrival here. She had been at a local facility, but they had not recognized certain parts of her injuries. She arrived to the point at the point where she was essentially non-resuscitatable. You know attempts were made but failed here at this facility. And it just struck me as I looked at her you know lying there this is my daughter, this is my daughter you know. She looks about the same size, skin colour is different, but at that particular point it was hard.

Gillian Findlay: So what did you do? How do you cope?

Major Terry Ratkowski: Well unfortunately I didn't have too much time to think. There was another case that came in right after that, so we got busy again.

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Gillian Findlay: So what will be your overriding emotion when you start getting on that plane to take-off?

Major Terry Ratkowski: Well I'm certainly going to be happy to go back home and live my life the way I'm accustomed to living. I look forward to returning with my family and continuing my professional growth, but at the same time I think it's been a positive experience in the sense that I've gained a lot of how should I say? – more experience in these types of injuries and caring for these patients with these types of injuries. I've had the experience of working with many other professionals closely on several cases.

It's been rewarding on several levels, professional and personal so overall I would say I'm going to go home with a with a double-positive. I'm going back to where I want to be, and I'm going back with something I think I can be proud of so.