From a war-torn country to the land of the torn ACL
February 23, 2013
Drew Kosmowski is a doctor on the move. From the Vail Valley to Breckenridge, from Colorado Springs to Grand Junction and many places in between, Dr. Kosmowski lends his 25 years of medical experience to people in need.
Kosmowski has been to Afghanistan multiple times. In 2006, he was there fulfilling his duties as surgeon for the 10th Mountain Division of the U.S. Army and also acting as medical advisor to the commanding general. He’s also been deployed to Iraq four times, including his last deployment, in 2010, when he served as advisor to the Surgeon General of Iraq, Major Samir.
This past April, Kosmowski retired from his position as physician in the U.S. Army. Now, he resides in Breckenridge with his wife and two children and works as a locum tenens physician, meaning he travels around to various hospitals, emergency rooms and clinics, stepping in to temporarily fill another physician’s position, or anywhere else where help is needed. Doing so allows him a way to transition from military medicine to that of a civilian practice.
“I’ve been deployed in combat 43 months over the last 12 years,” Kosmowski said. “It’s nice to be home for a while.”
Kosmowski credits his decision to become a doctor to a dedicated eighth grade science teacher.
“I was being a little lazy because I didn’t have to work hard much in school,” he admitted. “So he actually kept me after school, doing projects and got me thinking about science.”
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During his freshman year of high school, Kosmowski’s father, who had recently retired after 21 years as an Army logistician and working in the Pentagon, passed away.
“That solidified that I wanted to go into the Army and medicine,” he said. He spent the next years studying and working hard, with the aim of attending the Uniformed Services University of the Health Sciences in Bethesda, Md., after a neighbor, also a former member of the armed forces, handed him a cut-out advertisement of the school. It seemed the perfect fit.
“I kept that little advertisement on my mirror all through high school to motivate me to want to go to that school,” Kosmowski said. “I’m glad I did, because I certainly got a lot of opportunities as an Army doctor that I wouldn’t have got otherwise.”
As a surgeon with the 10th Mountain Division, Kosmowski went to Afghanistan. As the division surgeon, he was in charge of the other doctors and often advised the commanding general on medical matters. He performed medicine not only on sick and injured American troops, but on Afghani civilians as well.
“Mostly we were trying to help the medical system to care for the locals. A lot of it was winning hearts and minds,” he said. “So if we were going into an area where we were eliminating where the bad guys were, we would also go in there and have clinics and things and support the people, and that would give legitimacy to the Afghan government.”
Kosmowski worked side-by-side with Afghani doctors, helping the local population in the various locations he was stationed in. The American soldiers would clear an area of enemy fighters and then the medics would come in with the purpose of showing the people that the Afghan government would help them where the Taliban would not. Kosmowski said he believed it was effective.
“It was working at the time,” he said. “That was 2006. A lot has happened since then.”
Kosmowski said he still has at least one colleague, who he worked with in both Afghanistan and Iraq, who is still working there as the chief medical advisor to an Afghan general.
Kosmowski himself is no stranger to high-level advisory positions. He had worked in Iraq before, but this last time his job was to act as advisor to the Iraqi surgeon general.
“I worked with the Iraqi military and Iraqi surgeon general to get them completely on their feet and not need us anymore,” Kosmowski said. “It was really rewarding.”
Kosmowski not only spoke directly with the surgeon general, but worked with Iraqi doctors, medics and hospital staff, training them to make the best use of equipment and streamline their systems to be more efficient.
“Every Monday I would take an armored convoy out into the Red Zone and go to their military hospital and teach all kinds of things to their medical staff,” Kosmowski explained. “All kinds of advanced trauma life support, cardiac life support, basically how we run our emergency rooms to teach them emergency medicine that way. For every week of the year, we went out there and helped teach them.”
Kosmowski speaks positively of the experience, although it wasn’t always easy, particularly when he would come up against culturally related difference.
“We’d visit where they’d have medical maintenance training for their soldiers and teach them how to maintain their medical equipment and that was huge because prior to that they were a fairly disposable society,” he said, explaining how they would tend to throw away a broken monitor, rather than fix it.
One thing he’s particularly proud of is helping the Iraqis put together a simple, all-encompassing electronic medical records system called World Vista. Doing this not only helped patients, but worked to unify the various Iraqi provinces, particularly the three in the northern Kurdish region. Part of the problem, he said, was that the region had two different ministers of health, who generally contradicted each other and refused to work together.
“With the electronic medical records, we were able to bring them together and have them work together on this” Kosmowski said. “I’ve heard that they’re now implementing World Vista in 36 Iraqi hospitals across the country. So they’ll have a single unified instead of disjointed medical record system. They’re getting off on the right foot.”
Kosmowski also speaks well of the surgeon general, with whom he worked closely.
“He is like a rock star amongst military medical, in the U.S.,” Kosmowski said. “He is well-known by a lot of military doctors who have worked with him. He is hugely successful and hard-working and just – he’s done magical things for his country.”
Although Kosmowski said he’s picked up some Arabic, he was lucky in that the surgeon general speaks English. The two would discuss all manner of medical manners and ideas, after which the surgeon general would work with his staff to implement the discussed changes and improvements.
“It was fun,” he said. “I would talk to General Samir and I’d express, ‘hey this is, I think, a good idea and this is why and this is what you might want to do’ and whatever. We’d do a lot of meetings sitting down and drinking tea with different ministers of health, and then I might introduce the topic and they’d start taking over talking in Arabic, and I’d pick up a few words here and there, because I knew the topic really well, and it became their ideas to run with and you’d see them convincing other people within their ministry of defense.”
Kosmowski enjoyed the process, he said.
“It was just fascinating to see that you could plant the seed and that idea would grow and they’d spread it amongst themselves and convince themselves that it was their idea, which was fine,” he said with a laugh, “but it was their win ultimately.”
Kosmowski was not new to the traveling doctor method of locum tenens when he retired in April. Years before, he had used it to make some extra money while serving at Army bases in the states he’s practiced in, including Pennsylvania, North Carolina, Indiana, Nebraska and Colorado.
Here in Summit County, Kosmowski works with the Breckenridge and Keystone clinics, as well as emergency rooms throughout the Vail Valley and house call work with Alpine Mobile Physicians. He often splits his time between Breckenridge and Colorado Springs, where he just recently helped start First Choice ER, a stand-alone emergency room that has no affiliation to any hospital, giving it the freedom to choose where it sends patients.
One of the big differences Kosmowski sees between his military and civilian practice is the type of patient. Before, he dealt with younger, generally healthier patients, whereas now he said he sees more cases of cardiac diseases and obesity. Working in the mountains, he also sees his fair share of orthopedic injuries incurred by skiers and snowboarders.
The hardest part, he said, is having to constantly adjust to different hospitals and locations.
“I guess maybe just adjusting to different hospitals. I’ve worked in about 10 hospitals in a year,” he said. He then added, “The medicine is often the same, but it’s the peripheral stuff that’s interesting.”
Kosmowski says his hardest struggles are more often with paperwork and the logistics of working at a variety of locations.
“Just going in, seeing a patient, caring for them, it’s easy,” he said. “Medicine is easy, it’s the rest of the stuff that makes it challenging.”
Despite the difficulties, Kosmowski said he likes variety, and the very last thing he wants is to have things become stagnant.
“I wanted a broad exposure to different types of medical processes and I’m seeing how people are doing it. A lot of folks have great ideas out there, some not so good,” he said with a laugh.
But whether he’s performing triage on a mountainside in Afghanistan or setting a broken bone in Breckenridge, Kosmowski said he’s just happy to be doing the job he loves.
“I love the variety. I love it that one patient can have a torn ACL and my next patient can have an ear infection and the next one can have appendicitis. I love that you don’t know what you’re going to face next. It’s a lot of diversity,” he said.
But most importantly, “we’re helping people. Bottom line, that’s why people go into medicine, to try and help other folks.”