Fighting for his patients' rights: Dr. Mark Tenerowicz, Associate Medical Director
Mark Tenerowicz was just a few weeks into his deployment to Bagram Air Base in Afghanistan when he fought what might have been the most important battle of his military career.
He was a Major in the United States Army Reserve Medical Corps, an emergency medicine physician attached to the 325th Field Hospital. He worked in an ER that handled a huge number of amputations – soldiers and civilians who had been wounded in Russian mine fields – but the case that stands out most in his mind was one called in over the phone.
A colonel stationed in remote eastern Afghanistan had suffered a heart attack and there was no sufficient facility in the area to treat him. After hearing the details of his condition, Dr. Tenerowicz recommended that he be airlifted to Bagram immediately. The major on the other end of the line, at the Tactical Operations Center,refused, saying the colonel would be taken to the nearby Salerno forward operating base because he could not spare the aircraft for the longer flight to Bagram.
Dr. Tenerowicz insisted. What followed was a standoff between the two majors.
“I told him, ‘Look, we’re the same rank,” Dr. Tenerowicz recalled. “I can’t tell you what to do with your aircraft, but I can tell you, if you take him to Salerno instead of here, he will die.”
Dr. Tenerowicz spoke to a sergeant at the TOC and pleaded with him to convince the major to spare the aircraft. He finally did. When the colonel arrived in Bagram, he looked ashen and gravely ill. Dr. Tenerowicz administered medication to break up the clots in his blood vessels and begged the transport office to take him to Europe right away.
They conceded, and the colonel went on to make a full recovery.
“That was a big win for me,” Dr. Tenerowicz said. “It was very analogous to what we do at Global Rescue. First and foremost, we’re patient advocates.
“It may be unpleasant, but I spend an awful lot of time getting people to do what is right for our clients.”
As the Associate Medical Director for Global Rescue, Dr. Tenerowicz is one of the first doctors to hear about a patient’s case from the triaging paramedic. He supervises the initial medical recommendations offered to the member, advises on cases when appropriate and directs specific cases to other physicians at Global Rescue or specialists at Johns Hopkins Medicine. At the end of the day, his job is to make sure the patient is getting the best medical care and advice available. He has been an integral part of a team that has saved many members’ lives.
Dr. Tenerowicz started off his career in the emergency room of Hartford Hospital in Connecticut, where he worked as a nurse’s assistant the summer after his junior year at Trinity College. While it wasn’t the career as a firefighter he had dreamed about after watching “Emergency!” on TV as a kid, the visits to the emergency room had him hooked on the field.
“I remember thinking, “You know what? This is a blast. I enjoyed coming to work,” he said.
The trouble was, in order to work full time as ER nurse he’d need to spend two more years on the other floors. Instead, he decided to apply to medical school, and was accepted early decision at Brown University.
After Brown, he performed his Emergency Medicine residency at the University of Massachusetts Medical Center. One huge advantage of that program for Dr. Tenerowicz is that they operated a medevac helicopter. In fact, working aboard as a flight physician is one of the requirements of the residency. If you’re not comfortable working on a helicopter, you won’t be admitted.
After a year as an observer, second-year residents are promoted to flight physician. The day that Dr. Tenerowicz entered his second year, the radio sounded at 1:30 AM with the brief instructions, “Life Flight Crew One, Code 1, general direction: south.” (Dispatchers there do not describe the case in detail, so that a pilot cannot take the nature of the emergency into consideration when deciding if the weather makes it permissible to fly.)
In this case, it was a very serious car accident. So serious, in fact, that there was very little that could have been done for the patient. His upper body was already turning a deep purple as they were loading him onto the aircraft – he had ruptured his heart when striking the steering wheel.
For the next six months, Dr. Tenerowicz said, he was scared to death the radio would go off. He revisited the case over and over in his mind, wondering if he could have done more.
After he completed his residency, he realized his dream of becoming an attending physician on an emergency room at the Jordan Hospital in Plymouth, MA, and later became its EMS Medical Director. He heard about Global Rescue from one of the paramedics he supervised there, and joined the company in 2008.
When he points to his motivation to assist travelers in need, the backdrop to the stories is often a military hospital in the Middle East, from one of his three separate deployments to Kuwait, Iraq and Afghanistan.
At the emergency room in Bagram, for example, he remembers a woman came in exhibiting signs of liver failure. Although Dr. Tenerowicz said the joke around the base was that he was the cardiologist, neurologist, etc. at the sparsely equipped outpost, he readily admits that none of these fields are his specialty. When he encounters a patient with serious signs such as these, he knows exactly where to refer them.
Unfortunately for the patient with the failing liver, she was a civilian – an expat who had been living there for years – and therefore ineligible to be medically evacuated by the U.S. Government. But she needed to be seen by a Western-trained cardiologist immediately. Dr. Tenerowicz told her that she needed to raise just enough money from family and friends for a one-way ticket to Boston, to get in a cab and go to the emergency room at a certain hospital. The next day when he came to see her on his rounds, she was gone.
Dr. Tenerowicz has experienced first hand that sound and timely medical advice, and the ability to get to the right medical care, is often the difference between life and death.