This afternoon, from 12:45 to 1:45 pm in Room 202B, Rocco A. Armonda, MD, will deliver the Charles G. Drake History of Surgery Lecture: “Evolution of Combat Neuro-Trauma from Cushing to Ukraine.”
The Advisory Council for Neurological Surgery established this lecture to explore the historical development of surgery and honor Dr. Drake, a leader in neurological surgery. Dr. Armonda, who is the director of neuroendovascular surgery at MedStar Washington Hospital Center and MedStar Georgetown University Hospital in Washington, DC, will examine the history and current practice of neurosurgery in the context of armed conflict.
Although grounded in history, much of Dr. Armonda’s expertise arises from experience. Dr. Armonda is a West Point graduate who spent 31 years in the military, including a year forward-deployed in Iraq in 2003–2004, for which he received a Bronze Star. His military service, career as a neuroendovascular surgeon, and volunteer work in Ukraine provide firsthand perspectives that will inform the lecture.
The lecture will begin with the innovations of Harvey Cushing, MD, FACS (1869–1939), who created the foundations of neurosurgery while treating massive numbers of military casualties in World War I.
Dr. Armonda will then draw on his own clinical experience caring for and studying US military personnel hospitalized at Walter Reed Medical Center in Bethesda, Maryland, after his return from Iraq.
“I basically was receiving all the patients coming back from the combat zone that had severe traumatic brain injuries, and studying those patients for other occult vascular injuries,” he explained.
Dr. Armonda and colleagues published research characterizing two major conditions in such patients: traumatic blast-induced vasospasm, which occurs several days after an initial blast exposure and leads to secondary stroke, and pseudoaneurysms, which are common in patients with blast or penetrating brain injuries.
Building on the distant and recent past, Dr. Armonda will focus his lecture on how neurosurgery must continue to adapt emerging forms of warfare. “It's basically making the connection between how we are trained as neurosurgeons and how we adapt to the changing combat environment,” he said.
The armed conflict in Ukraine presents a markedly different combat environment, including the widespread use of drones, limited ability to rapidly evacuate casualties, and a much higher volume of patients, according to Dr. Armonda.
To illustrate how these challenges are affecting combat casualty care, Dr. Armonda will draw on his experiences and those of several close colleagues. Retired from the military since 2013, he has volunteered as a neurosurgeon in Dnipro, Ukraine, at a hospital near the front lines that has received more than 52,000 combat casualties over the course of the war.
“It's almost like if you transported the tertiary medical center of Walter Reed right into Baghdad,” he said. The location allows surgical care to be delivered closer to where injuries occur, but it also exposes healthcare teams to the ongoing threat of drone and missile attacks.
There, he collaborates closely with Ukrainian surgeons in direct clinical care and “reciprocal learning: I learn from them, they learn from me,” he said.
Dr. Armonda said the lecture will have relevance for “anyone who's interested in medical care, geopolitics, the history of medicine,” as well as those considering “what it means to be a resilient, ingenious, and brave person in terms of being able to operate in these conditions.”
The lecture honors Charles George Drake, MD, FACS (1920–1998), a Canadian neurosurgeon known for advancing the treatment of intracranial aneurysms and arteriovenous malformations in the mid-20th century. Dr. Armonda described Dr. Drake as “an amazing example of how our patients become our teachers and the art of basically learning from our patients.”
This lecture will be available on demand soon after its conclusion.
