From military medics to ER, DeKalb doctor, nurse know triage

DeKALB – Dr. Gregory Conrad, a 15-year emergency department physician at Northwestern Medicine Kishwaukee Hospital in DeKalb, has spent his career marrying medicine and military service.

As a boy growing up in Pittsburgh, he aspired to life as a forest ranger. Then, he moved to Illinois in 1984, graduated from Wheaton North High School, went to college at Saint John’s University in Minnesota and fell into work as an emergency medical technician.

He’s worked ER triage and overseas as a military field medic but said the grisliest scenes he can recall are when he was a paramedic.

Throughout his undergraduate years, Conrad worked as an EMT, got certified and worked as a paramedic in Cicero for 12 years.

“I did everything I was trained and learned to do. I wanted to know more, wanted to do more,” Conrad said. “Then, I got shot at a couple times. That kind of gives you a feeling of mortality.”

Although it admittedly “sounds egotistical,” he said, he’d bring patients into the ER as a paramedic, saw the doctors and thought, “If they could do it, then I could do it.”

He took premed courses at Benedictine University in Lisle and then went to the Chicago College of Osteopathic Medicine in Downers Grove. He graduated in 2004, did his residency through St. James Olympia Fields, graduated from there in 2008 and found his way to Kishwaukee Hospital.

When military meets medicine

How’d he catch the military bug? Conrad said he’s always had an interest, often reading books about World War II as a child. Operation Desert Storm came and went as he worked as a paramedic.

His daughter, now 24, was 1 at the time, and he mulled over enlisting to have the military pay for his medical school.

“The first words out of my mouth to my wife were, ‘Honey, what do you think about the military?’ And she said, ‘No.’” Conrad said, laughing at the recollection. “It had the type of ‘no’ where there was no discussion.”

So Conrad carried on. During residency, one of his attending physicians was a flight surgeon in the 115th Air National Guard Fighter wing out of Madison, Wisconsin. It would be another few years before he made up his mind – and convinced his wife.

Conrad commissioned with the National Guard in October 2010, almost a decade after the events of 9/11, which he said was what inspired him to join.

His field work took him to Qatar in 2016 for three months as an ER doctor with a mobile surgical team, Nicaragua for a week through the State Department, and Myanmar in March 2018 with three surgeons from the Walter Reed National Military Medical Center who helped share the latest treatments and therapies for acutely injured patients.

He served as a flight surgeon for months in Canahar, Afghanistan, in 2019 and Guam for two months in 2023, returning on Christmas Day.

He’s not the only one in the Kishwaukee ER who’s taken military medic experience back to the states.

Randa Melms works as clinical staff nurse in DeKalb and credits her service an asset to the work she does back home. She splits her time in the ER and as a hospital supervisor. She also teaches at the Northern Illinois University School of Nursing and is studying for her doctorate in education.

“In high school, I always had a desire to want to serve my country and take care of soldiers,” Melms said. “It was something I thought would be beneficial for my development as a nurse but also as a young woman. So I just kind of took the leap of faith and [went] for it.”

It’s also in her blood. Melms’ sister works as a nurse. Her mother was a registered nurse for more than 40 years. Her grandmother was a nurse for more than 50. Her grandfather served in World War II and her uncle in Vietnam.

A 2012 graduate of NIU, Melms went into service almost immediately after graduating since she’d been in the ROTC at NIU. She commissioned into the U.S. Army Nursing Corps and served five years of active duty service. She came out as a captain and worked for a time at Northwestern Medicine Delnor Hospital in Geneva in maternal medicine.

She said she missed the ER, so in 2018, she transferred to DeKalb. She finished her military service in 2020.

I think that’s why people in the military make good first responders. I was always told, ‘Sometimes you’re going to make the wrong decision, but you need to make a decision.’ That has carried on to me in the ER. At the end of the day, we’re just making the best decision we can.”

—  Randa Melms

Is military field medicine more intense than an ER stateside? Or is “M.A.S.H.” just Hollywood fluff?

Triage medicine, Conrad said, is about stabilizing the patient.

“The role of us in the ER is to keep them alive to get them to the surgeon. We would put in chest tubes, intubate, blood, then a surgeon would come along and fix the holes,” he said.

Emergency medicine is “damage control,” Conrad said. It’s resuscitation, stabilizing a patient’s vitals or heart, stanching a bleed, holding a patient for up to 72 hours before they’re stable enough to travel.

It’s also learning how to make decisions quickly in (quite literally) a life-or-death situation in sometimes hostile environments.

“Every once in a while, we got rocketed,” Conrad said, recalling his deployment on the flight surgical team in Afghanistan. “So the alarms would go off, you’re putting on body armor, helmets, going to the shelter or, depending on where you are, you just drop to the ground.”

Although Melms did not serve overseas, she deployed to a combat hospital out of Fort Bliss, Texas. She trained in San Antonio and served her first-duty station at Fort Hood in Texas. A year and a half later, she went to Fort Leonard Wood in Missouri and served for two years in a medical surgery unit where they needed an ER nurse.

“Honestly, I was not interested in emergency nursing at all,” Melms said. “But it was the military, so you just do as you’re told. And I went to the ER and absolutely loved it.”

For Conrad, transitioning from military medicine back home to DeKalb brought with it a bewildering juxtaposition.

In Afghanistan, his team cared for paratroopers who had fragmentation in their arms and legs.

“One of these paratroopers, they were kind of filled with metal shards from this hand grenade. I asked him if he wanted anything for the pain. They said no, limped off and wanted to go check on his guys,” Conrad said. “But then I come home to Kish, and someone’s yelling at me for not giving them their narcotics. I looked at them and walked away.”

In the world of emergency medicine, decisions must be made in minutes.

From treating a stubbed toe to cardiac arrest – when someone’s heart has stopped working – it’s up to a team of medical professionals to work cohesively to solve a problem.

Kishwaukee Hospital has a bigger ER than the Army hospital at Fort Leonard Wood, more beds to juggle and more patients coming through the doors. But Melms said she counts her field nursing experience as a vital teaching moment.

“I definitely learned how to make the best of my resources, because you didn’t have a lot,” Melms said. “I think that’s why people in the military make good first responders. I was always told, ‘Sometimes you’re going to make the wrong decision, but you need to make a decision.’ That has carried on to me in the ER. At the end of the day, we’re just making the best decision we can.”

Bringing it home

Kishwaukee Hospital’s ER might see about 90 to 100 patients per day, Melms said.

For a 12-hour shift, nurses might see about 20 patients. For an ER nurse assigned to what they call a “pod” working four rooms per nurse, they might go through eight to 12 patients per shift.

Between overnight hours, always being on call and the fast-paced intensity of holding someone’s life in your hands, Melms and Conrad said their military service helped season them for that lifestyle.

That doesn’t make it easy, however.

“I had to tell a family once that their infant kid who had a cardiac arrest, if they survived this, they will never be the same. I was biting the inside of my mouth, and I tasted blood. So, in the moment you have to do that. Is it a teachable moment? You can never get through those, dealing with little kids,” Conrad said.

More than a decade into her nursing career, Melms said, time doesn’t necessarily make that compartmentalization any easier.

“The longer I’ve done it, it does seem that it has become a little bit harder to manage, especially because we’ve had some pretty heavy cases in the last several weeks,” Melms said on a Friday afternoon as she prepared to work an overnight shift.

It’s important to allow those human moments, Conrad said. And then to let them go so the saving-a-life part can be done.

“You have to be able to put yourself in the box, put that box away and then come back. Whatever it is, get it out of your system in the next 30 seconds.”

Conrad is the medical director for paramedic training at Northwestern Medicine Kishwaukee Hospital.

As he teaches the next generation of paramedics, he said he tells his students to remember they’re signing up to run toward things everyone else runs away from.

“If a patient sees a bunch of crying faces, their confidence in your ability to take care of them is going to be shaken,” Conrad said.

It’s that penchant for caring that’s most important to Melms, she said. The ER is a place where people come in crisis, looking for someone to help.

And crisis is something she and Conrad can do.

“I just want people to know we have a great team and are doing our best,” Melms said. “Some days that looks better than other days. I just want the community to know that we care. Sometimes, I know wait times can be long, or maybe it’s somebody is not seen as promptly as they would hope for, but just know we’re coming to work, showing up, doing our best.”