Col. Walter “Sparky” Matthews graduated with a Bachelor of Arts degree in biology from Baylor in 1992. The former pre-med student went on to become both a doctor and a decorated officer and flight surgeon in the U.S. Air Force. In May 2017, Matthews became the commander of the American medical task force in Afghanistan, as well as commander of the 455th Expeditionary Medical Group at Bagram Airfield in Afghanistan. In this Q&A, Randy Fiedler talks with him about what he and his team are doing to provide quality healthcare in one of the world’s most war-torn areas.
You’ve spent much of your career either working as a flight surgeon or supervising medical teams containing flight surgeons. What exactly does a flight surgeon do?
Aerospace medicine (the discipline practiced by a flight surgeon) is occupational medicine for a very specific occupation –– flying. Every other discipline of medicine deals with abnormal physiology in a normal environment, while aerospace medicine deals with normal physiology in an abnormal environment. Flight surgeons are the personal physicians for pilots, other aircrew and their families. We apply medical standards to the environment of flight, ensuring pilots are physically qualified and maximally prepared to endure the rigors of flight. Flight surgeons also ensure the work and living environment at an Air Force installation is safe and healthy. We tie together public health, bioenvironmental engineering, occupational and environmental medicine, ergonomics and workplace safety. The bottom line is, if something can affect the human weapons system, the flight surgeon seeks to harness and control it.
What part do flight surgeons play in the Air Force mission?
One might say that flight surgeons are the “warrior class” of Air Force medicine. We’re the bridge between the operational (warfighting) and medical worlds. The physician is the natural enemy in a pilot’s mind because he or she can ground a pilot forever for something beyond the pilot’s control. Flight surgeons spend much of their time building trust and confidence in their aircrew –– we fly with them, work with them, play with them, go to war with them and live next door to them. We become one of them –– it’s how we earn a pilot’s trust. This trust is tremendously powerful –– when a pilot goes to war, they don’t worry about their family at home because they know the flight doc is going to take care of their family, no matter what. This frees the warfighter to fight the war, without worry and without fear. When you consider that an aircraft, missile or satellite is the weapon of war for the Air Force, and the pilot, missileer or satellite operator is the brain at the center of that weapon, you should realize that the flight surgeon is the maintainer of that weapon’s brain.
I understand that for security reasons you cannot discuss some of the things that you do in your current position, but as much as you are able to, can you tell us what your current duties are?
I wear two hats in my current assignment. As the 455th Expeditionary Medical Group Commander, I lead the busiest Role III medical facility in Afghanistan, which includes the aeromedical evacuation origination hub for U.S. and NATO forces in Afghanistan. A Role III facility is a hospital with emergency/trauma resuscitation services, outpatient services, inpatient and intensive care, advanced trauma surgery and medical/surgical subspecialties. As the Task Force Medical-Afghanistan Commander, I command all U.S. Role II and Role III facilities in Afghanistan, with the exception of Special Forces medical units. Essentially, if U.S., NATO or Afghan military personnel require surgical care in Afghanistan, they receive care from one of my Task Force Role II teams, and usually end up in the Craig Joint Theater Hospital at Bagram. U.S. and NATO military personnel are then typically moved to Landstuhl Regional Medical Center in Germany, either by traditional aeromedical evacuation or by Critical Care Air Transport Teams. These teams turn the back of a cargo aircraft into a flying Intensive Care Unit.
In my job, I ensure that the Craig Joint Theater Hospital is ready to receive any and all casualties in Afghanistan, day or night, 365 days a year. I also work with Combined Joint Operations Area-Afghanistan Command (NATO), U.S. Forces-Afghanistan Command, Air Force Central Command and the U.S. Central Command to ensure the right personnel and equipment are placed strategically throughout Afghanistan. The strategic placement of our medical forces ensures that no military operation involving U.S. forces occurs with more than 60 minutes transport time from a surgical resuscitation team.
What is the quality of medical care that soldiers are receiving from your team?
The family of medics –– U.S. and NATO –– at Craig Joint Theater Hospital is simply beyond belief. We recently received an Afghan military casualty with a Grade 5 liver laceration. Essentially, his liver was fractured, and the blood vessels feeding the liver were torn away. This is an injury that has an 80 percent mortality rate, even at a hepato-biliary surgery center of excellence in a U.S. major medical center. My two trauma surgeons and my general surgeon spent five hours in surgery saving this man’s life –– they removed half his liver and reattached his vasculature. As we speak, the patient is recovering in our ICU. No hospital in the world could have done better. On Fathers’ Day this year, we received six trauma casualties –– four American and two Afghan. Our operating rooms ran all night, and in the morning all six men were recovering in the ICU. We gave six fathers back to their kids that day. That is why I do what I do.
How did your career begin? Did you know from a young age that you wanted a career in the U.S. Air Force?
I never considered the Air Force at all until college. From my earliest memories, I always wanted to be a doctor. When I was a senior at Baylor, my mentor, Dr. Bill Hillis, announced at the end of immunology class one day that Army and Air Force medical recruiters were on campus. As I left the lecture hall, Dr. Hillis grasped me on the shoulder and said, “You should really talk to the Air Force recruiter. I was a flight surgeon in the Air Force, and I think that would be a really good fit for you.” That was more than enough for me. I visited with the recruiter, applied for the Health Professions Scholarship Program, and the rest is history. Twenty-five years later, I would make that decision all over again. I owe an unpayable debt to my friend Bill Hillis–– he’s the reason I am a career Air Force officer.
Were you in Air Force ROTC at Baylor?
Believe it or not, I was not. I was just a plain vanilla pre-med student. I am a mentor for the Baylor AFROTC detachment now, particularly for the pre-med cadets.Did you enjoy your time at Baylor?
That question is incomprehensible to me –– of course I enjoyed my time at Baylor! To this day, they remain the best four years of my life. I enjoyed performing in the Baylor University Golden Wave Marching Band, pledging Kappa Kappa Psi, serving at First Baptist Church and singing in Thee Power and Light. I loved learning for a living, and preparing for my life as a doctor. But most of all, I enjoyed meeting the love of my life, my wife Monica. If I was to list all the things I look back on fondly, this magazine issue would be two volumes.
Any favorite professors?
I have several, primary among them Dr. Bill Hillis (biology) and Dr. David Pennington (chemistry). I have maintained a relationship with these mentors, visiting them every time I return to campus. Sadly (for me), they have now both retired. Dr. Lynn Tatum (religion) is another favorite, from whom I learned the history of the Bible. Finally, Dr. Ken Wilkins, my comparative chordate anatomy professor, has become a good friend. My ambition, after retirement from the Air Force, is to join them as a Baylor professor and be for students what these great men have been to me.
You were invited back to Baylor in March 2017 to give a lecture, and you spoke on General George Washington and the inoculation of his soldiers against smallpox. Why did you choose this as your subject?
My talk was based on a paper I wrote as a student at the National War College. It examined the strategic impact of the decision by General Washington to inoculate the Continental Army against smallpox at Valley Forge. Benjamin Franklin stated that this decision was Washington’s most important of the entire American Revolution. Essentially, for America to gain its independence, the Continentals simply had to not lose the war. Ultimately, the smallpox epidemic in North America at the time posed a greater risk to Washington’s army than the British –– it was the only enemy that truly threatened the Army’s existence, because they could not escape it.
Is medical history a special interest of yours?
I have always loved history, and the American Revolution is my favorite time period. Medical history is a more recent, but no less fascinating focus for me. In fact, my hope is that, after retirement from the Air Force, I might return to Baylor University and teach the history of medicine.
Finally, are we as aware as we should be what the U.S. Air Force is doing now in Afghanistan? Is there something about your mission that we don’t appreciate?
The U.S. Air Force delivers air power –– at the right time, every time, all the time. As a medic, my part of that delivery is to provide world-class medical care and aeromedical evacuation to support our U.S. and partner nation forces. One thing about our medical mission in Afghanistan that may not be obvious to the public is the morale our safety net provides. I hear daily from U.S., NATO and Afghan leaders that the assurance of the world’s best medical care emboldens our fighting forces to dare great and courageous action on the battlefield. To quote a senior Afghan military officer, “Our fighters have courage to do great things because they know, if they are injured, they will come to your hospital and then go home to their families.” At the same time, we are helping the Afghan government and military develop their own medical capabilities. Our goal as U.S. Air Force medics in Afghanistan is to work and teach ourselves out of a job.
This article appeared in the Fall 2017 issue of Baylor Arts & Sciences magazine