by Zach Read - firstname.lastname@example.org
For eight months, Richard Vinroot Jr., MD, MPH, has been living in a shipping container – also known as a containerized living unit, or CLU – at Camp Lemonnier, the U.S. Naval Expeditionary Base in Djibouti, on the Horn of Africa.
A window and door have been cut into the CLU and a bathroom has been added on the back.
“All of us live in them,” says Vinroot Jr., speaking directly into his laptop – surprisingly, his Skype connection remains strong enough to hold an uninterrupted conversation. “They’re stacked on top of each other and stretched out on a concrete slab on the southwest side of Djibouti-Ambouli International airport, in the desert – mine is right on the airfield, overlooking the Special Operations compound.”
For Vinroot Jr., a New Orleans-based emergency medicine physician who joined the military three years ago, learning to live in a CLU hasn’t been difficult. He’s practiced medicine in austere environments around the world: as an HIV/TB field physician for Doctors Without Borders in the Mathare slum of Nairobi, Kenya; caring for citizens of New Orleans during – and in the aftermath of – Hurricane Katrina; treating Haitians in Jacmel La Valee, southern Haiti, five days after the 2010 earthquake; and serving as a Trauma Team Leader during Operation Enduring Freedom in Kandahar, Afghanistan, in 2014.
He admits, however, that CLU living in this part of remote Horn of Africa consists of a different set of challenges than he’s used to; best practice for CLU living sometimes means remaining inside for extended periods. The base, located across the Gulf of Aden from Yemen, is not far north of the Equator. The weather is often “oppressive” and “practically inhospitable.” It is the hottest year-round inhabited place on earth. During cyclone season, severe storms roll in from the Indian Ocean, overwhelming the sun-baked earth, causing flooding; last fall, one such swell killed a number of people in Yemen. The CLUs leak – and even flood – during these storms.
Despite the unforgiving elements and modest accommodations, life could not be better for him.
“I truly believe I’m the luckiest man alive,” he says. “I’m a 46-year-old man who’s doing exactly what he wants to do.”
Service through Medicine
At the urging of his parents, while an undergraduate at the University of North Carolina in the late 1980s, Vinroot Jr. spent the summer after his sophomore year in West Africa, in Ghana. That summer he picked corn, worked in a brick factory, and helped build schools. He lived by himself for half his time in Ghana; the other half he lived with a family.
“The experience opened my eyes to service and the diverse needs of the rest of the world,” he says. “I realized then that I wanted to travel throughout my life and to possibly provide aid in underdeveloped areas, and it crept into my mind that one day I might want to become a doctor.”
But Vinroot Jr.’s path to medicine wasn’t conventional. Two years after traveling to Ghana, he graduated with a degree in history from UNC and moved to Charlotte, where he had grown up, to work as a banker and also for a portfolio management firm. After a few years in the firm, the economy was improving and his career looked promising. The future in finance was bright. But despite the career he was building, he couldn’t shake the feeling that something was missing.
He recalls his intense reflections at that time: “I was living in Charlotte, where I was born and raised. I had lots of friends who lived in the area. But I didn’t see myself staying there and continuing a career in business – it was too familiar. I needed to carve my own path – medical school was a way for me to break away and fulfill an interest of mine. So, I went into the office one day and put in my two weeks’ notice. I made the decision with my gut and asked for no advice from others. I went back to do the necessary prerequisites before applying to the UNC School of Medicine.”
Today, he laughs about the reactions he received from colleagues, friends, and family at the time.
“People thought I was out of my mind,” he says.
Over the course of a year and a half, Vinroot Jr. fulfilled his prerequisites, and before long returned to Chapel Hill, this time for medical school. At UNC, he developed an interest in emergency medicine – the thrill of dealing with trauma, working under pressure, and making quick decisions appealed to him. But so did a life of international travel.
“At the time, the School of Public Health was offering a Master’s of Public Health (MPH) degree with a certificate in global health,” he continues. “While the MPH was a common degree for medical students to pursue, those specializing in emergency medicine didn’t often pursue it. My roommate and I were actually two of the few who did and were the first medical students to obtain this global health certificate at UNC, and it has created multiple opportunities and allowed for very diverse experiences ever since.”
Vinroot Jr. completed his MPH one year after his MD – timing-wise, it was another uncommon educational decision, as most students pursue their MPH between years three and four of medical school – and afterward did residency at Louisiana State University/Charity Hospital in New Orleans, Louisiana, where he became chief resident. During that time, Hurricane Katrina steamrolled through the Gulf Coast – he threw himself into relief work to help those affected by the storm.
“Being there at that time was like a disaster medicine fellowship,” he says. “I was essentially living in a hospital in New Orleans and treating all kinds of illnesses that resulted from the storm and from the living conditions that followed. And actually, throughout that period, I was also being flown around in helicopters by the Navy to treat others in the region affected by the storm, which probably contributed to my interest in the Navy when I eventually decided to serve.”
The years after the storm were so unique that he couldn't picture himself going straight to work in a conventional hospital setting following residency. Instead, he volunteered and joined Medecins Sans Frontieres/ Doctors Without Borders. He served as a TB/ HIV Field Physician in the Mathare Slum, in Nairobi, Kenya for a year. This led to him being sent to Haiti during the earthquake disaster, one year later. Going forward, both experiences had a huge impact on his life.
Vinroot Jr.’s father, a lawyer, former mayor of Charlotte, and North Carolina gubernatorial candidate, never shared much about his experiences in Vietnam. But when he did speak about those he knew who had served, he spoke fondly of them, and his words had an impact on Vinroot Jr.
“As I was growing up, I recall hearing that a couple friends of his who had been drafted were killed in Vietnam, which led him to join the National Guard,” says Vinroot Jr. “He felt that he should also be willing to serve his country if so many others he knew had been drafted. He lasted one Reserves meeting, though, before deciding he wanted greater involvement in the war than the Reserves allowed, so he volunteered and signed up for the Army.”
The elder Vinroot’s interest in service skirted around draft protocols of the time; at 6’8”, the former Tar Heel basketball player under Dean Smith had a medical “disability” that excluded him from being drafted: height. He also had privilege: he was married and working as a lawyer in Charlotte when he joined the Army.
“If he’d had a draft number, it would not have been at the front of the line,” says Vinroot Jr. “In fact, because he was a lawyer, the Army encouraged him to go to Officer Candidate School – this might have kept him from seeing combat – but he refused. He wanted to go to Vietnam and serve, like other draftees, so before long, against the advice of so many and despite his medical waiver, he was a grunt with a law degree serving on the ground in Vietnam….In the back of my mind, because I’ve always looked up to my father, military service has been something I’ve wanted to do. I felt that because I was privileged, that shouldn’t separate me from others. I learned that from him and wish more people would think that way.”
Three years ago, Vinroot Jr. joined the Navy – he was 43 years old at the time – with the understanding that he would only serve if he were sent to Afghanistan or Iraq. After completing officer school in Newport, Rhode Island, he was traveling in South America when he received a call about a need for a Trauma Team Physician in southern Afghanistan – whether he took that particular deployment was up to him.
“I said, ‘Say no more,’ and returned home to New Orleans to prepare for my deployment.”
In 2014, Vinroot Jr. spent eight months in Kandahar, southern Afghanistan, as part of a Role Three, or mid-sized unit. Other FOBs around the country flew their injuries to his base for treatment. The injuries he saw in Kandahar were unique for him in that many were blast injuries from IEDs; as an emergency room doctor in New Orleans, he had been used to dealing with gunshot wounds, which had become routine for him from a medical treatment standpoint.
“It was a different caliber of injury in Afghanistan,” he says. “And it was a different experience for me compared to where I am now, in Djibouti. In Afghanistan, in the back of your mind you always worry about when something bad is going to happen – when certain injuries and how many of them are going to arrive.”
One month after returning from Afghanistan, he again volunteered for forward deployment, this time to the Horn of Africa. Camp Lemonnier, a base of roughly 4,000 U.S. military personnel and Coalition forces in Djibouti, is a station for counterterrorism, antipiracy, and humanitarian work. Special Forces leave from the base on operations, but there are many fewer injuries for him to treat. Most of the medical issues include tropical diseases and heat injuries.
“Here, we’re not as worried about when something bad is going to happen,” he says. “The problem is more that there are a lot fewer of us to take care of injuries. So, if something bad does happen, there aren’t very many of us, unfortunately. That’s the added pressure.”
Vinroot Jr. recalls an email his father sent to him when he was in Afghanistan in 2014.
“He never said much to me about my decision to serve, but in this email, he wrote me that not a day would go by that I wouldn’t be proud of myself for doing this,” shares Vinroot Jr. “He was right. I was able to serve my country and serve soldiers who needed my help, and since I joined, I’ve met people I would never have otherwise met – some of the greatest people you could know.”
He credits the support he has received from his colleagues in New Orleans, at Ochsner Medical Center, the flagship hospital for Louisiana’s largest, nonprofit academic health system, for making this professional flexibility possible.
“They’ve really allowed me to pursue international service – whether humanitarian, disaster, or military medicine,” he says. “It wouldn’t be possible without their support.”
His gratitude also extends to his alma mater, where he received three degrees. When he arrives in New Orleans this month he’ll catch up on his alumni magazines from UNC, the UNC School of Medicine, and the Gillings School of Global Public Health.
“I’ve had a lot of people to look up to, from my father to the many people who have mentored me and so on,” he says. “But I always look forward to reading about what people at Carolina are doing with their lives. I also would read the obituaries, which report accomplishments and what their contributions were. I see incredible people whose military service to their country is part of their story after Carolina. It inspires me and helps me think, ‘If they did so much, then I should too.’”
While Vinroot Jr.’s interests have taken him around the world – and will continue to do so in the future – he maintains close connections in Chapel Hill and at UNC. For years he served on the UNC Board of Visitors and the School of Public Heath Alumni Board, and today he’s on the board of the Medical Foundation of North Carolina and the Center for the Study of the American South.
“It’s a special place,” he says. “It’s given me so much – I was able to have my cake and eat it while there, enjoying a fun undergraduate career and following that with medical and public health education. One of my hopes in sharing what I’ve been doing overseas is that it helps younger students think about ways they might serve throughout their careers, whether through medicine and organizations like Doctors Without Borders or in the military.”
As his time in Djibouti winds down and he prepares to return to New Orleans, he remains open to the possibility of future deployments, no matter where in the world they may be. He has already reached out to his military specialty leader regarding future needs in Iraq/Syria.
Meanwhile, he’s already preparing for his next area of interest to add to civilian emergency medicine, humanitarian medicine, disaster medicine, and military medicine: tropical medicine. And New Orleans is the perfect staging point for him to pursue it – Tulane University offers a degree in tropical medicine.
“If you think about it, New Orleans is really the northernmost Caribbean city,” he says. “It has almost tropical-like medicine. It’s hot and we have a lot of poverty and a lot of disenfranchised urban folks and a lot of rural health issues. It’s agricultural with the sugar and rice farming, as well as fishing, but also industrial with regards to the petroleum industry, and because of all that I get to be good at a lot of things that help me to be a better doctor in other parts of the world. I couldn’t have picked a better place to practice civilian medicine.”
Wherever medicine takes him after Djibouti and from New Orleans, he’s confident that his choices have made him happy. He returns to Chapel Hill a few days after his deployment in Africa and will share his unique medical experiences with the UNC School of Medicine Alumni Association, where, he jokes, most of those doctors also “feel as if I might have a screw loose.”
“In the future, my feeling is whatever happens, happens,” he says. “I’ll continue to go with my gut and do whatever I feel is the right thing to do next. It’s been an unconventional path and it’s all worked out great, and as I’ve said, I’m doing exactly what it is I want to do, and I truly believe I’m the luckiest man alive.”