They have X-ray Vision Published Sept. 6, 2010 By Staff Sgt. Nika Glover 379th Air Expeditionary Wing SOUTHWEST ASIA -- Make no bones about it, when it comes to figuring out what's going on inside a broken body, the ionizing radiation machine is the tool of choice for most doctors. Seeing past skin, veins, blood cells, body fat and muscle tissue; it can literally see right through you. While the X-ray machine itself can be quite fascinating, it's the X-ray technicians who really make the magic happen. With a keen eye for spotting even the slightest hint of trouble, radiology technicians are at the forefront of helping doctors figure out how to fix what's broken. Locally, the 379th Expeditionary Medical Group's medical facility is equipped to handle the vast majority of cases requiring an X-ray specialist. Those experts come in the form of Staff Sgt. Jahmal Nicholas and Master Sgt. Bruce Milbrath. As the only two X-ray technicians here, they work as a team, simultaneously ensuring every broken bone, twisted ankle or dislocated joint gets the attention it deserves. While they each have their own individual tool chest of experiences, together, they bring almost 30 years of X-ray knowledge to the base. All in the family Having grown up with a parent who was a medical professional, Sergeant Nicholas was bound to have some of it rub off on him. His mother was not only in the Army but was also a nurse. "Ever since I was a child, I've liked the medical field," he said. "I knew I'd be doing something in a hospital one day." After high school, he decided he'd like to become a nurse, as well, and began college in pursuit of a nursing degree. "The military was once the furthest things from my mind, but it's just something that I decided to do for the experience," Sergeant Nicholas said. "Then I discovered the radiology career field and I went for it." That was 10 years ago. Since then, he's become one of the top radiology technicians at his home station of MacDill Air Force Base in Tampa, Fla. While there, he was voted from amongst his peers to become an assistant phase two instructor, teaching students who have completed the first round of training and are transitioning to the next level. "I've enjoy teaching students the knowledge I've acquired over the years and teaching them what others have taught me," Sergeant Nicholas said. Having reached the halfway point to retirement, he said he plans to make being an Airman and a radiology technician a career. "I'm definitely a career Airman," he added. " I love what I do and while I'm in, I can still work toward getting my nursing degree." His love for the medical career field transitioned to his love for a woman who also had an appreciation for radiology. "My wife, Shirley, is a radiology technician as well," said Sergeant Nicholas. "However, she works in mammography." They have a 2 year old daughter together, whom Sergeant Nicholas says he misses very much. However, since this is his first deployment, he said he's also thrilled to see what goes on in the rest of the Air Force. "I've met a lot of people from different bases here," said Sergeant Nicholas. "We've also gotten the opportunity to meet and greet with the coalition forces and the host nation forces." Coming full circle While Sergeant Nicholas is experiencing radiology in the deployed environment for the first time, Master Sgt. Bruce Milbrath is no stranger to deployments. Having gone from radiology technician, to ultrasound technician to flight chief and now back to doing radiology again in the deployed environment, Sergeant Milbrath has come full circle. His home station is at Keesler AFB, Miss. As a flight chief there, he's in charge of 92 staff members and rarely gets to see the X-ray machine. Being here has allowed him to revive his skills and brings him back to his radiology roots. He comes to the 379th EMDG with an added incentive -- he is also an experienced ultrasound technician. Having gone through mandatory retraining, Sergeant Milbrath was taught to walk on a different side of radiology. With his dual experience, he has become a valuable member of the 379th EMDG. "I just so happen to have the ultrasound experience that was needed here," Sergeant Milbrath said. "It's the reason I was able to get the assignment here, however, it's a 'shred out.' As in, I don't do the job anymore, but the experience I have will always be there. After I leave, they will seek out someone who is an actual ultrasound technician, but while I'm here, I'm enjoying it." Sergeant Milbrath is from a small town in Tennessee where he was just one of 13 seniors to graduate from his class. Now a father of two boys, he recently sent his oldest son off to college and has another at home who is a junior in high school. He said he uses his parental nurturing side to look out for the Airmen in his unit. "We're definitely very close here," he said. "So I try to keep up with people and ensure everything is going great with them and their families. We do what we can to keep people's spirits up." A typical day Like most deployed personnel here, Sergeants Nicholas and Milbrath work 12 hours or more, six days a week. On Mondays and Wednesdays, they see orthopedic patients. This typically involves hand and foot injuries. Then,once a week they transport patients to a host nation hospital for testing that requires the capabilities beyond what the base medical facility can handle. On top of their daily duties, they also run into the occasional emergency patient. "On most days, we start off by coming in and warming up both machines, the X-ray and (computed tomography) scanner," Sergeant Nicholas said. "During the orthopedic days we have a lot of patients." The radiology clinic typically gets between 250 and 300 patients per month. Many of them have minor injuries, but Sergeant Nicholas said the injuries span from minor to serious. "We have a lot of knee, ankle, foot and hand injuries," he said. "They're mostly caused by people running on or along the rocks. Occasionally, we get patients from down range who need acute medical care. For those patients, we often do shrapnel removal." He said recently he had a patient who came in needing to have shrapnel removed from his knee. "We also recently had to do a portable chest X-ray and we had to take the patient downtown," Sergeant Nicholas said. "We do patient transfer in the mornings and we also take patients to the larger host nation hospitals. In emergency situations, we ensure the patients are stable and transport them. We've had roughly one emergency patient per week since I arrived, of those only two or three needed X-rays." Sergeant Milbrath said when doing patient transport, he and Sergeant Nicholas act as liaisons between the patient and host nation hospital administration. "We ensure their paperwork is in order and their payment information is correct," he said. "Unlike in the United States, you will not be seen here unless the money is there." He said when a patient's exam is complete they collect the result and bring them back to the base for review. The good, bad and the ugly While deployment injuries are common, most people don't get to see what happens past their own units. Sergeants Milbrath and Nicholas are the exception, and they each have a book's worth of stories to tell regarding the most interesting injuries they've come across. "You wouldn't believe the amount of people who have injuries from falling here," Sergeant Nicholas said. Although their patient workload is constant, Sergeant Nicholas said having a master sergeant who is an expert at the job has given him the opportunity to explore other areas of the clinic and see some interesting things. "I had the opportunity to assist with a toenail removal. That was mind blowing!" he exclaimed. "I've never done that before. I got to put the Novocain in and actually help remove it. Watching someone's toenail come off can be pretty exciting." Aside from ingrown toenails, Sergeant Milbrath said they see something new almost daily. "I've seen a lot of hernia repairs recently," he explained. That's where there's a slight muscle tear at the floor of the muscle and the bowel protrudes it," he said. Sergeant Milbrath said the most interesting injury he's had was a shoulder dislocation in a patient who got it while boxing at the gym. "We've also seen patients who have shredded their fingers in a paper shredder," he said. "I don't know how that happens, but it does. We've seen the occasional nasty dog bite. We often measure patient lab values, which is basically where something in the labs comes back unusual. So we do a CT scan or an ultrasound to evaluate to see if the person has gall stones or to see if they are having bowel issues." As a result of those tests, he said they've had several patients with positive tests for kidney stones here. "I've seen more of those here than back home," Sergeant Milbrath said. "The scan will show us exactly where the stone is. If it's too big, we'll go in and take it out. If it's not, unfortunately, the patient has to pass it and that can be pretty painful." Just the two of us Since they are the only radiology technicians here, Sergeants Nicholas and Milbrath have a respect for each other that can only come from sharing the same experiences. "I think Sergeant Milbrath is a great guy who's really down to earth," Sergeant Nicholas said. "He's very knowledgeable in the career field." "He's a nerd-slash-computer whiz," Sergeant Nicholas laughed. "I've seen him do some things to our machines when they break that actually makes them work better!" On a more serious note, Sergeant Nicholas said Sergeant Milbrath has leadership qualities he seeks to emulate. "He's a real mentor and has told me what to look for at the next level of our job and in my progression as a noncommissioned officer," Sergeant Nicholas said. "He's told me how to talk with people and how to get people to do what they should be doing. My teammate takes care of me. " "Sergeant Nicholas is a great guy," Sergeant Milbrath added. "We're definitely very close here." To ensure a radiology technician is available at a moment's notice, Sergeant Milbrath and Sergeant Nicholas alternate on-call duty. This means they never share the same day off and don't get the opportunity to hang out together very often outside of work. However, Sergeant Milbrath said as a team, they are seamless. "Although one of us is always on call, if one of us is already working late and the other is on call, we will take the on-call assignment so the other one doesn't have to come in," he said. "That's team work." While Sergeant Nicholas is the outspoken social butterfly and Sergeant Milbrath is more of the quiet, reserved, computer savvy one, the camaraderie they share is extended to the patients they meet and they both agree it's the part of the job they enjoy the most. "I'd have to say patient interaction is pretty important to me," Sergeant Nicholas said. "I'm very social. I like to meet new people. I like to keep them smiling and having a positive attitude." "I only get to see patients occasionally back home," said Sergeant Milbrath. "But, I get to see almost every one that comes through here. I definitely like the personal interaction I get with the patients here." With a tool box of technologically-advanced machines and a lighthearted rapport between them, Sergeants Milbrath and Nicholas are dedicated to seeing through patients to see the bigger picture, which helps get them back on the job in one piece. "I'm a firm believer in we take care of the patient and the patient takes care of the mission," Sergeant Nicholas said. "If we weren't able to get these Airmen up and running, the mission couldn't continue."