By Samuel King Jr.
/ Published March 15, 2021
Capt. (Dr.) Shawn Bishop, 96th Medical Group, deployed to Afghanistan in 2020. He and the medical staff at the Bagram hospital created the procedures to battle COVID-19. The team was responsible for more than 90 COVID-19 cases during the six months Bishop was there. (U.S. Air Force graphic/Samuel King Jr.)
Mere hours into his first day on the job in Afghanistan, a 96th Medical Group doctor was slicing through an accident victim’s chest cavity, then opening the hole with his finger to insert a chest tube.
This was not a procedure Capt. (Dr.) Shawn Bishop performed before. He said he thought he’d just watch and learn, but when the trauma physician turned to him and said “you’re a doctor right? Then get over there and get it done,” he did just that. The tube relieved the pressure in the patient’s chest due to a collapsed lung.
“I jumped right in,” said Bishop, an enlisted Marine turned Air Force physician. “This experience set me up for success for the remainder of my deployment. I kept this same attitude the best I could, so I was generally the doc who would do many of the procedures. I would volunteer and learn new things.”
Bishop would perform three more chest tube procedures during his six-month position as a physician at the Bagram Air Base inpatient care unit in 2020. The assignment is a rarity within the more than 50 deployments family medicine doctors support annually, according to Col. (Dr.) Michelle Anton, the 96th Healthcare Operations Squadron commander.
Upon his arrival in May, the COVID-19 pandemic was rampant worldwide, but the base had no cases at the time.
As symptomatic patients began to show up, Bishop and his team created the policies and procedures the hospital would use to battle the virus.
“The numbers were scary in that we projected worst-case outcomes where we would need four to five times as many beds as we currently had,” said the 35-year-old Iowa native.
The medical specialists established a field hospital exclusively for COVID-19 patients, so they could be separated from traumas and the sick. This was basically a large tent that required beds, supplies, oxygen and communications, all of which had to be procured and set up.
“Even though it was located next to the hospital and all its capabilities, it still felt like we were practicing in an austere environment,” said Bishop, a family physician at Eglin Hospital. “You take so many things for granted when working in a hardened, fully operational hospital.”
The staff and patients discovered a significant problem with the tent hospital one night when the incoming fire siren blared out its warning. Everyone must get into a bunker or hardened facility during this time.
The staff moved approximately four COVID-19 patients, some very ill and unable to walk, out of the tent and into a bunker as quickly as possible.
“It was dramatic. There were no injuries and nothing landed near us in the end,” said Bishop, who as a Marine, completed a year-long tour in Iraq in 2006. “It was a new issue we had to deal with we hadn’t really thought about to that point.”
During his deployment, Bishop managed 270 patients, more than 90 were COVID-19 related. Bishop and his team of around 30 people witnessed the number of COVID-19 patients rise in his first three months. Many of those COVID-19 patients were placed on breathing ventilators.
Bishop never performed this procedure on a patient outside of the operating room in medical school or in residency so it was another new experience for the doctor. By the end of his deployment, his team managed approximately 40 intubated patients, 14 who had COVID-19.
“This is generally not something a family med doc is expected to do as a routine duty, but it is something I got to do and manage over there,” said Bishop, who joined the Air Force as an officer in 2012, after a four-year break from the Marines. “This procedure is often the last resort side of things, when other changes and interventions are not working. I believe in several cases for us, it prevented death. It worked wonders.”
The last three months were filled more with trauma patients with injuries from gunshots, falls, crashes and improvised explosive devices.
“That transition was actually the hardest,” said Bishop, who said he joined the military after 9/11 to do his part. “You get used to mostly managing one thing, get comfortable, in a groove, then it changes.”
He said he felt the most overwhelmed during those situations. One day, a full trauma, meaning more than four patients, came into the hospital. He was in charge of one of the patients. He described it as a fast-paced situation with five trauma patients and five staff members working on each patient, all in an overheated room.
“I trained for a situation like this, but I felt I was out of my realm of expertise, definitely outside my comfort zone,” said Bishop, who leaned heavily on his experienced nurse and focused on his training. “Falling back on things we are taught over and over worked well, which is why we practice hard, so when these situations come up, training can take over.”
That training, part of his Family Medicine residency here, provided a sturdy foundation and flexibility to do essentially whatever is needed within the medical unit, according to Anton
“Dr. Bishop’s performance highlights the value of our military graduate medical education because we deliver the necessary medical capabilities to the AOR (area of responsibility),” said Anton. “He is a well-rounded team player and the future is bright for him.”
During the deployment, Bishop used his pediatrics experience for a 3-year-old patient with a skull trauma. The doctor and staff also inevitably dealt with death as well. Five people died while in his care from COVID-19 or trauma.
He said the team members put forth their best efforts with each patient, but sometimes the trauma, virus and pre-existing conditions were too much to overcome.
Bishop said he found strength and positivity from his family through the calls and Facetimes during those low moments. His team of doctors, nurses and technicians also provided a strong connection.
“We worked to keep it a positive environment, so when one person might be feeling down, we lifted each other up,” he said.
The doctor, who graduated from his residency training in 2019, said the six-month deployment made him dramatically better, both as a doctor and as leader.
“It taught me I need to step up when I have the ability to because sometimes there isn’t anyone else,” said Bishop. “When you are forced into a situation where folks are looking to you for answers, you either grow into it or flounder. I feel like I grew into it.”