Philadelphia University + Thomas Jefferson University

Alumni Spotlight: Life & Limb

Captain John York, MD

When people think of interventional radiology, they usually imagine the IR Suite and all the gadgets and screens radiologists use to treat patients—a set-up that looks like something out of The Fantastic Voyage. Captain John York, MD (Res ’07 IR ’08) worked at the other end of the tech spectrum—in a tent in Kandahar, Afghanistan with a table and a C-arm fluoroscope.

“Envision a sort of open-bay ER and you’re at the PACS station with multiple patients in front of you, reading studies on the fly with surgeons over your shoulders and you’re saying, ‘Here’s this, this, this. Here’s what you need to go for,’” recalls York, his speech mimicking the rapid-fire of the trauma bay. “And then after the initial chaos is over, you have to go back to a quiet room and dictate studies—or go straight to the OR.”

Beginning in October 2009 and stretching into July 2010, the deployment would become a proof of concept for the discipline of military radiology. York and his team would show that, in addition to providing invaluable diagnostics during the high-stakes ballet of triage, radiologists had a place not only beside trauma patients, but inside them as well.

In the OR, York earned his keep using IR fundamentals to treat pelvic bleeding and limb amputations, a result of the many IEDs used by the Taliban in Afghanistan.

An anatomically dense region, the pelvis is hard to treat, but under live X-ray, hidden bleeds are easier to spot, and a well-placed catheter can quickly gain access at relatively low risk. Moving outward, York performed arteriograms of damaged limbs, because “if there is one blood vessel running to the foot, surgeons will try to save the leg.” It was often up to him to find that connection for the trauma team as they fought to salvage a limb.

His work in Kandahar led the military to rethink the way it uses minimally invasive procedures to treat trauma, adding interventional procedures to its standard playbook for treating pelvic bleeding and organ injury, and saving lives and limbs.

“Sound training and solid fundamentals make you more comfortable with uncertainty,” York reflects. “That’s what this whole deployment was—getting comfortable with uncertainty and unpredictability.”

Among his more fraught assignments was placing a drainage catheter in a damaged kidney through a bullet hole in a patient’s liver. “Had I ever done that before? No. Will I ever do that again? Hopefully not. That’s the beauty of my training. It allowed me to do things I’d never even considered.”

View a photo tour from Dr. York's time in Kandahar