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Sunnybrook surgeon treats trauma on two battlefields


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Congratulations to Dr (Lt Col.) Homer Tien on his promotion to Head of Trauma Surgery at Sunnybrook hospital in Toronto.


Sunnybrook surgeon treats trauma on two battlefields

October 03, 2010
Megan Ogilvie

Health Reporter

Homer Tien has treated patients on two kinds of battlefields.

As lieutenant-colonel in a Kandahar field hospital, he has pulled shrapnel from the bodies of soldiers torn apart by roadside bombs.

As trauma surgeon at Sunnybrook Health Sciences Centre, he has resuscitated civilians rushed to the hospital on the brink of death, shattered by a car accident on Hwy 401 or bleeding from a gaping gunshot wound in the chest.

It is this combination of skilled surgeon and seasoned military man that uniquely positioned Tien to lead Sunnybrook’s trauma centre, the largest in Canada.

The 42-year-old has 20 years experience with the Canadian Forces, and has served overseas in Croatia, Bosnia, Africa, Burma and, most recently, in Afghanistan.

Those who work with him say he is an accomplished surgeon, a compassionate doctor and trusted colleague and, most importantly, someone who can stay preternaturally composed in the face of chaos.

“Homer has a very desirable calm and confident leadership style,” says Barry McLellan, Sunnybrook’s president and CEO. “That is very useful in the sometimes chaotic environment of trauma resuscitation.

“There is no question that his military experience has helped him to develop that very desirable style of leadership. The combination of skills he brings to the table is very unique.”

As medical director of the Tory Regional Trauma Centre at Sunnybrook, a role he took on in July, Tien is responsible for some 1,200 patients and for the large team of doctors, nurses, anesthesiologists and specialty surgeons who treat them.

He credits the military for teaching him how to be a leader, and says caring for wounded soldiers has helped to make him a better surgeon for his Toronto patients.

“As a junior physician, you learn clinical medicine, but you don’t learn leadership,” says Tien, who first led a platoon of medics on an overseas mission at the age of 24. “In the military, you start very early in terms of formal and informal leadership training and you quickly gain that experience.

“There are a lot of issues in managing and leading people that don’t necessarily come intuitively, that you sort of have to learn the hard way. Little things, like if someone has a complaint about something, how do you manage that complaint? You don’t learn that in medical school, really.”

Tien enlisted in the Canadian Forces in 1990, while attending medical school at McMaster University. He was the first person in his family — and the only one of his classmates — to join the military.

“I only joined to pay for medical school,” he says. “So my intention was to serve my time and get out.”

But Tien, who first served with the Royal Canadian Regiment, First Battalion and was stationed at CFB Petawawa, quickly realized that he enjoyed being a member of the Canadian Forces.

“It was being part of a unit, the camaraderie,” Tien says. “There would be about 600 to 800 people, depending if you were in Canada or overseas. The camaraderie comes from some mutual dependence; everyone has a function in that unit.

“As a general duty physician, your job was to look after those soldiers. But, when we were out, say, in Croatia, part of their job — besides doing their mission — was to provide security for the unit . . . It’s a slightly different relationship than the average general practitioner would have with his patients.”

Tien served overseas in Croatia, Bosnia, Burma and in the Middle East. He also spent two years with Joint Task Force Two, a Special Operations Forces unit whose primary role is counter terrorism.

When his obligatory years of service were up, Tien decided to stay in the military and train to be a general surgeon. He completed his training, which was funded by the Canadian Forces, at the University of Toronto, followed by a two-year fellowship with Sunnybrook’s trauma team. He also received a Master's degree in clinical epidemiology from the University of Toronto.

Tien says training at Canada’s busiest trauma centre prepared him in the best possible way for being a combat field surgeon.

“It’s like anything that requires a hand skill: you have to keep doing it. If all I did was go overseas intermittently and then come back and not work in a trauma setting, you become rusty, you’re not sharp when you are working.”

In 2006, Tien was deployed to Kandahar with the first Canadian surgical team to be sent overseas. He went to work with a standard-issue 9mm Browning pistol strapped to his leg.

“One of the first cases that made me realize that we are in a different situation (than a peacekeeping mission) was when I saw a young Canadian infantry officer who had some shrapnel in his leg. He had been driving in a convoy and a rocket-propelled grenade was fired at his vehicle. It passed through his window, out the other window and exploded, showering his side with shrapnel. He was fine. But I remember thinking at the time: this is very different from Croatia or Bosnia.”

Just as training in Toronto helped him prepare for Kandahar, Tien says being a combat surgeon has honed his skills as a civilian trauma surgeon.

In Toronto, the majority of trauma patients suffer from blunt wounds, primarily from car accidents or falls. About 20 per cent of patients who come to Sunnybrook with trauma injuries have, what doctors refer to as, penetrating wounds, usually inflicted by gunshots or a stabbing.

“Because — thankfully — we don’t see a lot of gunshot wounds, some trauma surgeons will go to the United States or South Africa to gain more experience,” says Tien. “Like everything it’s about practice — if you only see it once a year, you’re going to be rustier. Kandahar provides an abundance of practice. So you gain proficiency with penetrating injuries.”

Tien, who has taken on the additional role of trauma adviser to the Canadian Forces, returns to Kandahar as a surgeon in January 2011.

In some ways, Tien says he looks forward to his two-month tour of duty since it lets him immerse completely in caring for patients, with few administrative duties. And it’s a chance to catch up with the friends and colleagues he usually only sees while overseas.

“It’s hard, too, because my family is here in Toronto,” he says. “I have three young kids, and they are of the age now that they know Daddy is going somewhere where people have died. So they get worried. I always feel bad leaving.”

Dr. Fred Brenneman, a Sunnybrook trauma surgeon and former medical director of the trauma centre, says Tien has the necessary skills — talent, attention to detail and strong managerial skills — to run Canada’s busiest trauma centre.

“He’s a good organizer and he is good at organizing teams, which is what our trauma team is all about,” Brenneman says. “It’s a team effort, not about an individual or even a few people.”

Like others, Brenneman also notes Tien’s calm and steady personality as an asset in the high-pressure, high-pace environment of a trauma room bay.

“That’s pretty important in the job we have,” he says. “When it’s a life and death situation, the worst thing that can happen is for you to panic. Especially if a trauma team leader or leaders of the team panic, that’s not a good thing. Then whole team can disintegrate.”
I've known Homer for almost 20 years.  He is an outstanding Medical Officer and a credit to the CF.

We have a good guy as our trauma advisor.
Congrats to the good MO, certainly one of the most prestigious trauma positions in Canada.  I'm assuming that he is a reservist now despite returning to Kandahar in 2011?
I am sure you are mistaken. I believe he is part of 1 CFH. It is not unusual, as there are many medical specialists (surgeons, anesthetists) who work out in "civvie street" plying their trade.
He is indeed a member of 1 Canadian Field Hospital and is Regular Force.  He is also one of the key advisors for the start-up and ongoing development of the TCCC.

How Sunnybrook handled the mass shooting
Theresa Boyle
18 July 2012
Dr. Homer Tien had already put in a full day’s work and was relaxing, watching TV news at home Monday night when his pager went off. A surgeon at Sunnybrook Health Sciences Centre, he was needed at the hospital ASAP. There had been a mass shooting and Sunnybrook was the designated trauma centre where the most seriously injured would be taken.

When a nurse told Tien over the phone what had gone down in Scarborough, he admits, he had an “oh sh—moment.”

As medical director of the trauma centre, he had to scramble into action. Responsible for overseeing the emergency response, Tien activated a modified Code Orange, essentially the hospital’s disaster plan. In his five years of working at Sunnybrook, there had never been a Code Orange.

Still, Tien was prepared. While he has never seen this magnitude of serious casualties at Sunnybrook before, he has seen worse elsewhere. Tien moonlights as a trauma surgeon with the Canadian Armed Forces and five tours in Kandahar have taught him how to prioritize under incredible pressure.

“You are always a bit nervous because you don’t know what’s going to come in. I don’t actually know how many patients are going to come in yet and I don’t know what injuries they are going to have. It’s always a matter of hoping we have enough resources,” he explains.

When Tien arrived at the hospital shortly after 11 p.m., he marched straight over to the nurse in charge of the emergency department. She was patched through to EMS at the scene of the shooting and was getting an idea of what kind of casualties to expect. But in the chaos of the evening, the numbers kept changing.

Initially they were told there were “multiple” casualties; then they were told 20 had been shot. The next update had the number at 10..................
Continues at the link above.

Unlike safe and secure Canada where stuff like this makes the headlines because of its rarity, Col Tien handled situations like this on a no-less frequent than a weekly interval.

His experience saving lives in KAF probably directly helped save lives in Toronto this week.
Rider Pride said:
Unlike safe and secure Canada where stuff like this makes the headlines because of its rarity, Col Tien handled situations like this on a no-less frequent than a weekly interval.

His experience saving lives in KAF probably directly helped save lives in Toronto this week.

Forget Combat Hospital (well, forget it more...), there should be a doco on him.  Would make for some interesting watching, especially (but not exclusively) to the Asian-Canadian community. 
Rather than start a new thread on the amazing life of Col (ret) Homer Tien, I'll just leave this here.
Congratulations Sir.


MISSISSAUGA – Ontario‘s air ambulance service has named a former hospital executive and top military surgeon as its new president.

Ornge says Dr. Homer Tien will take over as president and chief executive officer, replacing Dr. Andrew McCallum as he retires after seven years in the top job.

Ornge says Tien comes to the role after working as the medical director for the Tory Regional Trauma Centre at Toronto’s Sunnybrook Health Sciences Centre.

Before that, he served as a colonel in the Canadian Armed Forces, where he worked as a frontline doctor in combat zones such as Afghanistan and the former Yugoslavia. 

More at link.
I knew Homer when he first started practicing medicine in the CF. He is definitely one of the good ones!