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Readers of FRACTURED may wonder about protagonist Mark Thurman’s dual roles in the book. He’s both an orthopedic trauma surgeon at a level I trauma center and the medical officer for the area SWAT Team. While at first, these roles may seem a bit paradoxical they're becoming more commonplace these days. Some might say these dual skills are becoming critically important.

The SWAT team doctor is a new breed of physician, a hybrid of healer and soldier, and an increasingly necessary professional trained to save and defend lives. I first became aware of this type of physician over a dozen years ago when I was practicing at a level I trauma center. The head of the multi-county SWAT team approached me about becoming their SWAT medical officer. Over the last decade the demand for this type of doctor has dramatically increased and physicians are stepping up to fill these roles. For example, the American Academy of Orthopedic Surgeons recently published an article about Alfonso Mejia, MD, MPH an orthopedic surgeon who serves on a SWAT team. Dr. Mejia is a clinical associate professor in the department of orthopedics at the University of Illinois at Chicago and he provides tactical emergency medical support for the South Suburban Emergency Response Team (SSERT). SSERT is a multijurisdictional SWAT team comprising thirty-four police departments, serving approximately 600,000 citizens in a 150-square mile area south of Chicago (Maureen Leahy, AAOS Now, August, 2014).

Medical schools are starting to offer the specialized training required for physicians to carry out these duties. Johns Hopkins School of Medicine has begun offering a Tactical Medicine Fellowship for emergency medicine physicians. Johns Hopkins states the “goal of the Tactical Medical fellowship is to uniquely prepare academic emergency physicians for leadership, field support and medical direction of law enforcement special operations and tactical medicine programs.”

One of the leading institutions where tactical medical training is provided is The International School of Tactical Medicine located in Rancho Mirage, California. Their motto is: “The Best Medicine in the Worst Places.” The program has been endorsed by many outstanding organizations including: the American College of Emergency Physicians, the Department of Homeland Security, and the California Governor’s Office of Emergency Services. ISTM has trained personnel from the ATF, hundreds of police and sheriffs departments across the country, and military physicians including Portsmouth Naval Medical Center where my character, Mark Thurman worked when he was in the Navy. The link below is to a video that gives an excellent overview of the ISTM program.

From a storytelling perspective, I found the dynamic role of today’s SWAT Docs to be fascinating and thrilling. I built the character of Mark Thurman around the brave and talented men and women I have been associated with.

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