World Medicine
Nurse of All Trades
By Megan Rowe

MAJOR CHRIS KEITH WITH AFGHAN CHIlDREN.

Nursing is challenging even in the most modern of hospitals, but when Major Christopher Keith, R .N ., had to train anywhere from 50 to 150 Afghan soldiers in combat medicine, he didn’t have technology by his side.

Afghan hospitals, Keith soon discovered, operate at a 19 th-century medical level. “And we’re trying to train them on 21 st century techniques,” he said. Sterility was an issue. And hospital staff had to be taught lab techniques and usage of x-ray machines.

After all that, Keith’s 12-hour nighttime shifts at the University of Virginia Medical Center don’t seem so hard. He’s glad to be in an advanced hospital, which has a wealth of technology, teams of highly-skilled colleagues, and recently earned the American Nurses Credentialing Center’s Magnet Recognition.

The 40-year-old Keith has been a nurse for eight years and a National Guardsman for 22. Last year, he got called to Afghanistan – but not to fight. Instead, he was embedded in the Afghan Army and assigned to train 50 Afghan soldiers, including 12 doctors and one nurse, in medical fields. And when he wasn’t training, Keith captured or destroyed enemy ammunition as the Explosive Ordinance Officer for Northern Afghanistan.

That’s probably what he means when he says, “The army trained me as a jack of all trades.”

Keith grew up in Dayton , Tennessee, where he joined the U.S. Army at age 18 and became a combat paramedic. He then decided to seek a degree in biology from the University of Tennessee. But after college, he wound up building and running nursing homes with his family. He served as the administrator, and when he needed to hire a director of nursing, the choice was obvious.

“I went ‘I’ll do it myself,’” Keith said. “So, I got my RN degree” in 1998, from Chattanooga State. He remained at his retirement home and worked part-time in local emergency rooms and ICUs until 2001, when he moved to Virginia, with his wife and two children, to pursue a nursing career in intensive care.

There, he was hired by the University of Virginia Health System as a critical care nurse, where he now floats between the emergency room and critical care units. The military had trained him to easily adapt to and overcome situations, making him right at home as float nurse.

At the same time, Keith continued his National Guard training, reporting to a Tennessee base one weekend a month, and for an 8-week stint every year. His training and excellent performance as a field artillery officer and a warrior came to a climax when, in March 2005, he got the call: his civilian medical skills were needed in a war zone in Afghanistan. It was time to teach Afghan soldiers combat medicine so they would be prepared once American troops withdrew. After training in Mississippi, Keith arrived in northern Afghanistan on July 6, 2005, ready for just about anything.

The assignments were daunting and offered no set schedule. Keith trained Afghan soldiers, helped remodel a 100-bed hospital for military use, and built another hospital and emergency room. He destroyed captured enemy ammunition or salvaged it, if possible, while leading International Coalition Forces EOD teams. He communicated with the soldiers through two interpreters and struggled to simplify 21 st-century medical terminology.

“The biggest thing I taught them was sterile techniques and keeping their hospital areas clean, keeping the dust out to prevent infections,” he said.

The heat was searing. One day, Keith recalls, the temperature hit 140. In his Humvee, it was 160 degrees.

Meanwhile, he adjusted to different customs. When one small boy was struck by a car while riding his bike, Keith rushed him to the emergency room. The family was unable to afford any care, but Keith traded a case of antibiotics to pay for the visit. The family never saw a bill.

To help meet these challenges, Keith had the UVa Medical Center on his side. He kept in touch with his family and colleagues via a satellite phone and laptop and was grateful for their support, particularly that of his nursing supervisor, Patricia Burke, R.N. “She made sure that I was plenty well stocked on food by sending out care packages once a week,” he said. “And she paid for it out of her own pocket.”

Keith’s stint in Afghanistan lasted “seven months and seven days.” “Not that I was counting,” he joked. “You want the hours?”

It might have been longer, but the cumulative effects of deactivating more than 500 tons of ammunition took their toll. The result was his closed-head injury, which he discusses with his usual easygoing demeanor.

“I was going on a three-day pass to the country of Qatar, and when I finally got to an American treatment facility, I stopped in and said, ‘Hey, I’ve got a headache, been going on for awhile,’” he said. “They put in me in the CAT scanner and lo and behold, I was in the ICU.”

Keith spent two weeks in a German hospital before he was flown to Eisenhower Medical Center in Georgia. He was there for two months before being sent home with the Army’s Bronze Star medal, his second. He received the first one in Iraq during Desert Storm in 1991.

Keith returned to his night shifts at the University of Virginia. “UVa has been extremely flexible,” he said. “They support me well.”

He worked only a few months before returning to active duty. This time, he’ll stay in the United States, training other units for six months, and he’ll be working at UVa on weekends.