How many alumni of the Physician Associate Program receive visits at work from U.S. senators, the secretary of defense and President George W. Bush?
For Amanda Turner Magee, PA-C, M.M.Sc. ’03, it’s a frequent occurrence at Walter Reed Army Medical Center, where she is a physician assistant for inpatient amputee and blast injury care in the Physical Medicine/Rehabilitation Department. She’s part of a team that cares for injured soldiers returning from Iraq and Afghanistan. This team includes physiatrists, surgeons, physician assistants, physical and occupational therapists, nurses, prosthetists, social workers and psychologists.
“The workings of military medicine and the logistics that go into treating combat-injured soldiers are new things I’m learning,” said Magee, who previously worked in an emergency room in Pennsylvania and was a physical therapy tech before coming to Yale. As a large teaching facility, however, Reed resembles the “big academic hospitals I rotated through at Yale.” But in her current job, “… we are often in the public eye.”
Politicians, military leaders and celebrities often visit the soldiers at Walter Reed. “The president comes every few months, sometimes completely unannounced,” Magee discovered. “One particular visit was announced because he was presenting Purple Hearts, some to patients I had treated. I was selected to attend the ceremony and the informal gathering where he spoke individually with the recipients and other patients. A few weeks later, the White House sent me a photo of the president, my patient, the patient’s wife and myself. It was a lovely surprise.”
Her department averages 15 to 25 inpatients, flown by MedEvac twice a week from a hospital in Germany to nearby Andrews Air Force Base. Most patients have been involved in some type of blast. “An amputee patient not requiring ICU support is usually admitted to our service about a week from his or her injury date. They have multiple medical issues, including infections, orthopedic injuries and often severe pain syndromes,” said Magee. “We provide general medical care, including treating infections and blood clots, preand post-operative care, pain management and wound care. … We initiate their rehab process, including educating the patient and family, and oversee their progress in therapy to establish their long-term rehab plans.” Patients’ co-morbidities often include vision loss; brain or spinal cord injury; fractures; severe nerve or vascular injury; and post-traumatic stress disorder.
“Most of our patients adjust remarkably well. They have great support here in PT, OT and prosthetics, surrounded by soldiers who are the same age with similar injuries,” Magee said. “When they’re well enough to leave their rooms and become more involved in rehab, they improve psychologically, feeling they’re part of a group again, and seeing progress.”
On their first extended breaks at home, patients suddenly face the reality of civilian life as an amputee. “We try to anticipate [the physical and often emotional difficulties they will face after discharge], and help send patients home with a plan—such as a job or college enrollment—so ideally, after months of rehab, they know what they’ll be doing if they’re getting out of the military,” said Magee.
Initially, a series of articles in the Washington Post in February that outlined neglect and deficiencies in treatment of outpatients at Walter Reed didn’t affect Magee’s team. “I truly feel that patients get very good care here. We have a comprehensive amputee rehab program which focuses on returning patients to their highest possible level of functioning. Some go on to complete marathons, skydive and return to active duty service,” Magee said. Since the media attention to difficulties at Walter Reed and the resignations of key officials, however, a recent hospital-wide emphasis on administrative issues keeps her busier than ever. “We’re following new policies when they become outpatients. We’re doing a better job of tracking them after discharge and making sure that patients [continue to] get mental health support, too.”
Mary L. Warner, M.M.Sc., PA, assistant dean and program director of the Physician Associate Program at Yale, remembered Turner standing out during clinical training. “She demonstrated excellent relationships with patients and staff, which has likely been crucial in her work at Walter Reed. I am sure the patients benefit from the breadth of her knowledge base and true enthusiasm for providing outstanding health care.”
Her experiences have created deep bonds between Magee and her patients. Magee senses that she’s “becoming committed to veterans’ health care. I’d like to stay in it—it is a privilege to be involved in people’s lives at a time like this, to be able to help them. The patients are wonderful and it’s very rewarding.”