For a surgeon from UNC, a midlife crisis turns into military service.

By Rose Hoban

For some men, a midlife crisis means a new car, a new hobby, a walk on the Appalachian Trail, or – to the chagrin of their wives – a mistress.

But for Tim Weiner, it meant enlisting to go to Afghanistan.

Weiner, 51, a pediatric surgeon at UNC Hospital, said he started having a feeling like there was something more he had to do – more than the hundreds of children he’s cared for over the past 25 years, more than the occasional medical missions he’s taken to Nicaragua, Cambodia and Malawi to perform surgery for free.

“I was sort of struggling with some of the midlife crisis sort of stuff of being at the top of my career job-wise and not feeling entirely fulfilled,” Weiner said. “I was looking for a new challenge. And this was as far afield as I could think of.”

That was a little more than three years ago. And what started out as a personal challenge has evolved into something much deeper for Weiner.

Coming to terms with Vietnam

As an undergraduate at the famously liberal Oberlin College, Weiner said he didn’t think very highly of the military, despite the fact his father had served time in the Marines.

“At Oberlin I was progressive enough to think that eventually there would not be a need for the military,” said Weiner who came of age as Vietnam was winding down.

“I was old enough at the tail of the Vietnam War to always wonder what what I have done if I had faced the draft.,” he said. “You wonder what you would have done in that situation.”

Weiner came in contact with hundreds of military families during his work at UNC Hospital and came to respect and admire them.

“I was really struck by how decent they are, how technical, and professional they are,” he said. “I don’t know how they do it frankly, military families, being deployed, three, four times, five times, with a lot less financial resources than I enjoy.”

Weiner eventually came to the conclusion that the military is an essential institution. “War is unfortunately with us and the military is needed,” he said. “The structure for security is just a natural progression of human existence.”

He can’t put a finger on when, or how, but slowly, the idea of deploying as a military surgeon began to grow on Weiner, and he broached the idea to his wife, Meredith.

“I guess people think I was crazy, but my dad was a fighter pilot in the Air Force and in the Air National Guard for more than 20 years. I just understand the military lifestyle,” Meredith Weiner said. “I just thought it was an admirable thing to do. We don’t have kids, so I said sure, if that’s what you want to do, and that’s your dream, we should do it and we can figure it out.”

Service-to-need

Before Tim Weiner could get to Afghanistan, first he had to enlist. And having the opportunity to do surgery in Afghanistan was not guaranteed.

He admits he had a certain arrogance at first.

“I thought, I’m a highly trained surgeon coming to you free… I sort of pooh-poohed the idea that I had to learn the military hierarchy, sociology,” Weiner said. “I was like, ‘I’m offering my services, just put me to work.’”

At one point, he actually wrote to a Navy rear admiral that he wasn’t willing to be a fill-in surgeon for someone else who had been deployed to Afghanistan to do the “fun stuff.”

“In one e-mail I think I wrote, ‘I don’t want to go to Guam and drain pus from your guys’ butts.’ I wrote that to a rear admiral!” Weiner said, shaking his head. “Now I’m very respectful of the rank. And he was very patient with me.”

One of his friends, UNC burn surgeon Bruce Cairns, had been in the Naval Reserve and had some sharp words for Weiner.

“He said ‘Tim… it’s service-to-need. If they tell you to go to Minot, North Dakota, and fix hernias on recruits you’re going to do it, because once you sign up they own you. You better deal with that before you sign up.’” Weiner remembers. “In the end, I decided I think there’s a call to duty that I need to answer. So I was hoping they wouldn’t do that to me but I was prepared for it.”

It turns out that only a few months after being commissioned, Weiner was tapped to go to Afghanistan for eight months. He was assigned to a surgical team that would operate in the desert in southeastern Zabul Province, about 60 miles from the Pakistani border.

“Vividness and sense of mission”

“Every little tidbit of life over there fascinated me,” Weiner said. “But that’s all compressed in my mind to the real high points because it wasn’t a routine to me, like it would be to a 20-year military person.

By Weiner’s estimate, he and the team saw about 400 trauma cases over the eight month period. That time included Ramadan, when there was no military activity for close to a month.

“It’s all compressed in my mind to the real high points because it wasn’t a routine to me, not like a 20-year military person who’s seen it all already,” he said.

Some episodes stick out.

“We got an Afghan policeman who had been shot across the neck. It was a big hit, but it hadn’t hit any of the jugulars, or carotids, or his airway, it just went across and tore a chunk out,” said Weiner who recalled it took time for the Afghan police to get permission to take the officer to the base because of previous incidents of Afghan-on-American violence.

“The report came from the trauma people that he was being belligerent, so that made everybody nervous,” he said.

“He came off the ambulance with his eyes the widest I have ever seen in a patient. And he was holding himself up on the stretcher with these bugged-out eyes, and they took him into the clearing area, where they stripped them down and wand them to make sure there is nothing that’s dangerous before they come in,” Weiner remembered. “And in that period of 60 seconds he basically died. His bugged out eyes were basically his death throes, and that’s why he was being belligerent.”

“He looked unrecoverable.”

Weiner’s team revived him. By the next day the police officer was stable enough to be transferred to a hospital in Kandahar.

“He was awake, he couldn’t talk, but he was communicative,” he said. “So that was pretty dramatic, to know that because we were there in the middle of the desert, with $2-3 million worth of equipment behind us, for that particular patient, it made all of the difference.”

More important, Weiner said, is what having a sophisticated medical installation in the desert means to American military personnel.

“The guys that go out are grateful knowing that they are going to get what we think is world-class medical care in Qalat, Afghanistan. It’s just a morale builder for them,” he said. “Whether they use it or not, to know that they are backed by this kind of medical infrastructure is important.”

Weiner also talked about the losses: the children who stepped on landmines and came to him torn apart, the Romanian NATO soldier who is still recovering a year later from losing his legs and an arm to a landmine, the Afghan elder who came in after an assassination attempt.

“He was a teacher, which of course the Taliban targets,”  said Weiner who recalls the team used 52 units of blood on the teacher.

“He came in basically unrecoverable. We operated on him twice in 24 hours in an attempt to save him. And and we went out with trepidation to the family to tell them he was not going to survive,” he said. “You go out with such anxiety to talk to these families and it’s almost embarrassing how much they thank you for everything you have tried to do. And you are thinking that you have not succeeded as a physician and surgeon, and they are so grateful that you even tried… they almost end up being more supportive of you.”

“It’s just nice to see that 8000 miles away in a different culture with people that I can’t communicate with… this universality of that experience is…” Weiner hunted for a word as he played a video clip of an Afghan man praying next to the bed of his injured child. “It’s inspiring.”

Weiner has hundreds of photographs and hours of amateur video he took during his months in Afghanistan, of co-workers, of soldiers his team patched up, of helicopters arriving. And during quiet times, Weiner would pull out a sketch book and watercolors and jot down impressions of what he was seeing.

“I remember sitting on the top of the (base) that’s built out of these Conexes, and I was just enjoying the sunset more than I had ever done before in my life,” he said. “The good part is that now I come home and I enjoy the sunset even more at home.”

Weiner said he now drives the speed limit (something his wife confirms). He said he is less apt to become testy when something goes wrong at work.

“There is so much cruelty out there and people have it so much worse that it gives you a perspective to step back from the sort of mundane, stupid complaints in the situations you encounter.”

Weiner still has years in his Naval Reserve commitment, but he doesn’t expect he’ll be deployed again anytime soon. Nonetheless, the experience stays with him. His wife said he wakes up most nights for an hour or two, before drifting back to sleep.

Weiner said he’s still processing what he saw, and how it’s changed him.

“It’s those little epiphanies that suddenly, I don’t have to hold onto them necessarily, I just enjoy them, and I can live much more in the present,” he said. “Whether I had to go to Afghanistan to do this, I don’t know, but it certainly has changed me in that I enjoy my life in the present more.”

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