Dr. Herpen '80 Reflects on Military Experience, Connects it to Podiatry Career
By: Liam Glowacki, SMC, ’17
The choices we make throughout life are often filled with irony, and sometimes, they lead to interesting career paths.
Dr. Robert Herpen ’80 chose to enter the field of podiatry because he never wanted to deal with matters of life and death. However, in an ironic twist, he is one of a few doctors at TUSPM who had a career in the armed forces. Although he never saw combat, the armed forces are known for their members walking the line of life and death on a consistent basis.
Drafted right out of college, Dr. Herpen entered the Corps in January of 1969, which was in the midst of the Vietnam War. It also happened to be the year that US combat deaths exceeded the number of troops killed in the Korean War.
Herpen was stationed as a technician in the Aircraft Wing in Iwakuni, Japan. The Iwakuni Marine Corps Air Station, located just 20 miles south of Hiroshima, was one of the sites of the devastating atomic bombings during World War II. Dr. Herpen was honorably discharged at Cherry Point Air Station in North Carolina, and three years later started at Temple University School of Podiatric Medicine.
According to Herpen, military service can prepare aspiring doctors for their vocation in unexpected ways. “[My time as a marine] was very useful for me,” said Herpen. “In the service, they demand that you’re punctual, thorough, and responsible.”
These are the traits that he has carried over to his current occupation, and relies on to provide quality care to patients. Quick decision making and confidence are taught to both soldiers and healthcare professionals, according to Dr. Herpen, and military service does have other perks.
Most importantly, there are “no maybes or almosts” in the military, according to Herpen. Personal accountability is valued above all else, and both doctors and soldiers must live with and learn from their mistakes and successes.
Herpen also related his controversial experience of returning home from Vietnam, and how our country’s impression of our military has changed since his time. “Now, they really treat our veterans well, and America really appreciates our service now,” said Herpen.
Both soldiers and podiatrists have proven capable of their own forms of heroism, and deserve to be given recognition of this, side by side.
If you are an alumni or current student of TUSPM and have served in the armed forces, we would love to hear from you! Please send us an email at firstname.lastname@example.org.
Podiatry Today Quotes TUSPM Alumni Dr. Meyr
By: Brian McCurdy
View More Articles Here
While physicians can use X-rays or magnetic resonance imaging (MRI) to help diagnose osteomyelitis, a new abstract to be presented at the Symposium on Advanced Wound Care Spring/Wound Healing Society (SAWC Spring/WHS) meeting later this month notes that high-resolution ultrasound is also effective in detecting the bone infection.
The study focused on 68 patients with chronic wounds and a clinical suspicion of bone infection. The abstract authors obtained high-resolution ultrasound scans with a device that had a 5-18 mHz linear array transducer. The patients in the study also had an X-ray and a MRI. Researchers considered patients positive for osteomyelitis if the ultrasound revealed a hypoechoic to anechoic zone adjacent to the cortex of the bone reflecting elevation of the periosteum (subperiosteal abscess) and direct connection of the echoless zone with the wound (fistula formation) and cortical interruption. High-resolution ultrasound had a 97 percent sensitivity and 92.8 percent specificity for osteomyelitis, according to the study.
Andrew Meyr, DPM, sees high-resolution ultrasound as a reasonable option for diagnosing osteomyelitis but no better than radiographs or MRI.
“I would consider it another tool used to help make the diagnosis of osteomyelitis but, in most cases, it should be more of a clinical diagnosis with imaging studies providing some evidence in support of or against the clinical diagnosis,” notes Dr. Meyr, an Associate Professor within the Department of Surgery at the Temple University School of Podiatric Medicine in Philadelphia.
James McGuire, DPM, cites “distinct advantages” in having an accurate modality to perform an immediate clinical assessment of possible osteomyelitis when prompt intervention may be necessary. He says it often takes more than a week to get MRI results back.
Cortical disruption, sinus tracts to bone and deep abscesses with high risk for bone infection are all findings that would show up much earlier on ultrasound, according to Dr. McGuire, an Associate Professor in the Departments of Podiatric Medicine and Biomechanics at the Temple University School of Podiatric Medicine.
The abstract notes that high-resolution ultrasound costs 75 percent less than MRI but about twice as much as X-rays. Since most insurances cover ultrasound diagnostics, once the diagnostic test is more common in clinics, Dr. McGuire says DPMs will find ultrasound machines a very worthwhile investment. Furthermore, he notes ultrasound has great utility and one can use it for many other purposes such as assessing deep wounds, sinuses and deep tissues in addition to soft tissue diagnosis, injection and biopsy guidance.
“These should make the purchase of an ultrasound a wise choice for clinics trying to get fee-for-service reimbursement in addition to better outcomes when/if we move to an outcome-based reimbursement system,” says Dr. McGuire.
Dr. Meyr feels a foreseeable problem with an ultrasound evaluation is that it would be very reliant on the person performing the test. He notes that some clinicians are better than others at reading the results.
“If people are completely dependent on an ultrasound to tell them whether there is osteomyelitis present or not, they are probably in a little bit of trouble. However, I do think it can be a useful tool to provide evidence or clues toward a diagnosis,” says Dr. Meyr.