As we enter the season of "peace on earth," Thomas Krueger, MD, is all too aware that in the war-torn countries around the world there is no peace — and often very little medical care.

 

This Southern Hills Medical Center surgeon has recently returned to practice after spending two years serving as a physician with Médecins Sans Frontières, also known as Doctors without Borders, the French humanitarian aid organization best known for projects in war-torn regions and developing countries facing endemic disease. MSF was awarded the 1999 Nobel Prize for Peace in recognition of its members' continuous efforts to provide medical care in acute crises, as well as raising international awareness of potential humanitarian disasters.

 

On his three-to-four month tours of duty, Krueger treated patients in Liberia, Nigeria, Darfur, Sudan and Sri Lanka. His service in those countries is profiled in a new documentary, "Living in Emergency," a riveting film that follows four MSF surgeons at work in a world that is challenging, complex and fraught with dilemma. The documentary — which has been shown at film festivals in Venice, Toronto, Nashville, and California — will have a special screening at the Green Hills and Opry Mills theater complexes in Nashville on Dec. 14. Krueger says the film shows MSF in a realistic way with the inherent frustrations, arguments and difficulties that are part of its work.

 

"The movie illustrates the French word témoigner, which means 'to witness' in either a legal or religious way, as a witness to what is happening and to speak out on things that would jeopardize care. It's not only a reference to witnessing sickness and violence, it is a willingness to stand with those who are suffering," Krueger explained.

 

Growing up in Midwest Ohio, Krueger spent a lot of time witnessing his grandfather, a surgeon, in the operating room … and even as a child, determined he would follow in his footsteps. "I just knew I wanted to be surgeon," he said.

 

It wasn't a straight path: he dropped out of college and spent time studying marine ecology at the Hopkins Marine Station in Monterey — the oldest marine station on the Pacific coast and the marine lab of Stanford University.

 

He graduated from the University of Colorado at Boulder and spent a year at the Universidad Autónoma de Guadalajara Medical School before graduating from the University of Cincinnati College of Medicine.

 

Krueger did his surgical internship and residencies at Vanderbilt University Medical Center where he was Surgical Chief Resident. He met his wife, Liz, a neonatologist at Baptist Hospital, while they were both in medical school.

 

In 1999, Liz Krueger decided to enroll at Vanderbilt Divinity School, and Krueger said he was "jealous — she was enjoying her courses and books so much, so I decided to join her and enrolled in divinity school part time." He completed his course work and was awarded his degree in May 2005.

 

"I began volunteering for the Health Talents program a week a month while I was in school in Guatemala so I knew the way this work feeds you. I was practicing full time, but I got the '20 year itch' to do something different in 2007." It was almost impossible to combine the volunteer work he wanted to do with a full time private surgical practice so he closed his practice, sold all his equipment and signed up with MSF.

 

His wife continued to practice at Baptist Hospital and run their working farm while he was away on his MSF work. "It is good to have somebody fund your altruism … she was really the one who gave me the opportunity," he said with appreciation. "I had a hunger to continue the volunteer work."

 

Krueger listed his heroes as: "Number 1, my wife; number 2, MSF and number 3, the filmmakers who shot and produced the 'Living in Emergency' film in astonishingly difficult circumstances."

 

He continued, "There was a horrific volume of cases, especially in Liberia, a country with 3-½ million people where half of the physicians are supplied by MSF. I did general surgery like my grandfather used to do — pediatric, neuro, spine, you name it — there was a wide spectrum of need. That was what Vanderbilt had trained me for and given me the tools to do."

 

In these countries, he noted, "You were limited by more than your skills. For instance, there were no ventilators, patients wake up and breathe on their own … or they don't."

 

In Nigeria, a country of 7 million, he saw "just trauma;" in Darfur, bladder tumors "the size of a horse" due to iodine deficiencies; and in Sri Lanka, where the civil war had just ended, the most stress and brutality. "It was like getting thrown in with the lions in the coliseum."

 

It was hard being apart from his wife, their daughter who is getting her master's degree at Vanderbilt, and son who is in college in Durango. "Actually re-acclimation was harder than acclimation because the contrast was so great when you got back. Almost the only thing that was the same was that there were cell phones everywhere, even the most primitive places."

 

Krueger, now employed by HCA at Southern Hills and free of some of the responsibilities of running a private practice, would like to continue to volunteer with MSF for a month at a time when he can … and when his wife agrees.

 

"Working overseas changes you in a way; I did lose some faith in humanity because of the cruelty that I saw. It was a wake-up call, and I'm no longer a Pollyanna about the way people can treat each other."