Respiratory care instructor Joseph Buhain is back from the Middle East war zone with a perspective on care-giving--and a new appreciation for his career at Saint Paul College.

Earlier this year, U.S. Army Reserve Staff Sergeant and medic Joseph Buhain was awarded the Bronze Star, one of the military's highest honors, given to soldiers who have distinguished themselves by heroic or meritorious achievement.

Buhain, who has since returned from active reserve duty to his civilian career as a respiratory therapy instructor at Saint Paul College, was awarded the honor for service during a year-and-a-half tour of duty in Afghanistan and Iraq. By any measure, it was quite an 18 months for him. In that span, he served in Kuwait, Iraq, and Afghanistan, and regularly faced danger in combat zones, taking part in more than 150 missions, including several high-risk missions with the coalition forces. He also helped treat injured soldiers, and touched numerous lives. For example, while serving as an instructor and mentor at the Mier Weis Hospital in Kandahar City, Afghanistan, he trained more than 350 medical students in CPR. He also helped secure more than $100,000 of free medical equipment for the hospital from the Mayo Clinic's Respiratory Therapy unit, coordinated donations of desperately needed medical books, and helped rebuild the hospital's infrastructure. On a personal level, he and his wife are also involved in "Support the Children," a program that aims to help reduce poverty in Afghanistan.

In short, he left behind a full legacy--as a soldier, educator, and a humanitarian. The Bronze Star summary noted that, thanks to Buhain's work, hospital personnel were able "to save several lives which would not have been possible otherwise." It wasn't always easy, however.

Home and away

During a patrol mission in Afghanistan, Buhain was positioned in the back seat of a Humvee in a convoy motoring at high speed through Kandahar. The convoy passed an open-air market filled with people, and in an instant, an insurgent ran up and threw a grenade at the Humvee. It exploded under one of the vehicles, and smoke, noise, and the chaos of war quickly filled the scene. After some tense moments, the U.S. and Afghan Army soldiers in the convoy got the situation under control and continued their mission with minimal downtime. Buhain wasn?t so lucky. His knee was mashed, caught between falling pieces of the Humvee's armor during the fight.

While it's largely healed, the injury still bothers him. On some days the pain is severe, and he occasionally limps to and from his classes. Still, he understands that sacrifice is an essential element of service. He describes himself as a "Navy brat." Both of his parents were connected with the military; his mother worked as a nurse in the V.A. hospital system and his dad served on U.S. Navy aircraft carriers. After graduating from Baker College in Michigan, Buhain worked as a respiratory therapist, providing respiratory support for patients in intensive care units and those undergoing physiotherapy. He eventually accepted a position with the Mayo Clinic in Rochester that included some teaching duties. He found that he enjoyed the educational side of the field, and decided to pursue a full-time teaching career. But only a year after accepting a teaching position at Saint Paul College, he received orders to report for active duty in the U.S. Army Reserve. He had four days to pack up and get to Fort Hood, Texas. From there, it was off to the deserts of the Middle East, where, as a respiratory therapist and medic working in a Mobile Army Surgical Hospital, he acquired a deeper, more instinctive understanding of how people attempt to save lives, even under conditions of great stress. And it was stressful; he regularly endured enemy fire while he treated combat trauma-related injuries. "I learned techniques such as mass trauma triage," he notes. "That has enhanced my ability to teach students at the College the fundamentals of CPR, who to treat, and airway assessment. CPR was a skill I had learned early on and had done it previously in civilian hospitals. But when there are 20 people who require it simultaneously, well, you have to learn to contend with that. You learn to prioritize."

The everyday world is a bit calmer for Buhain these days. Back at the College, he's preparing students to become respiratory therapists in what has become an exciting and promising field. In a nutshell, respiratory care practitioners evaluate, treat, and care for patients with breathing or other cardiopulmonary disorders. According to the U.S. Bureau of Labor Statistics, job prospects look extremely bright for program graduates. The profession is expected to expand quickly over the next 10 years, thanks in part to growth in the numbers of middleaged and elderly U.S. citizens-a development that will heighten the incidence of cardiopulmonary disease.

Thanks to Buhain's experiences in Afghanistan and Iraq, he brings an uncommon perspective and richness to his teaching. "I want my students to learn not only from textbooks but from the world," he says. "The world around us teaches more than any text can. [For example], there are things one learns during a military situation that can be brought into the classroom."

Some lessons, such as those involving CPR and mass triage, are technical. But other aspects focus on outlook and perspective. For example, Buhain tells his students that the world is a changing place and they must adapt to changes. In his classroom, "students must make decisions quickly and stick with them," he says. "At the same time," he adds that "constancy to core values is equally as important. Hold on to your beliefs and values to the utmost and most of all, never give up. As long as you do not quit, you will make it."

Buhain is once again teaching full-time at in the College's Respiratory Therapy Department. His courses include Management of the Critically Ill, Survey of Human Diseases, and Ethics for Health Care Professionals. While the transition from educator and caregiver to soldier and back again hasn't always been easy, he's glad to be home, and glad to be back at Saint Paul College. During his tour of duty, he was sustained by the support he received from his colleagues and coworkers at the College. "The staff and leadership here supported me from day one," says Buhain. "I received e-mail from Saint Paul College people every day; I'd talk to several people back here every week about what was going on.

"I want to work at a place like Saint Paul College," he adds. "It's a place that instills values and respect for people."

--Article by William Gurstelle
First photo courtesy of Joseph Buhain: JBuhain provided CPR training to more than 350 students at the Mier Weis Hospital in Kandahar City, Afghanistan.
Second photo courtesy of Dan Marshall: Joseph Buhain, Saint Paul College respiratory therapy instructor, and staff sergeant, U.S. Army Reserve.