At an age when most orthopaedic surgeons contemplate retirement, 61-year-old William B. Krissoff, MD, left a flourishing practice for a new life as a lieutenant commander in the Navy Medical Corps. Dr. Krissoff may be deployed to Iraq as early as this fall, to treat wounded Marines as a member of a combat surgical team.

Although Dr. Krissoff says he feels “honored and privileged” to be part of the 4th Medical Battalion, the path that led him there is one that no parent wants to travel.

His decision to enlist was inspired by his eldest son—1st Lt. Nathan (“Nate”) Krissoff—who was killed on Dec. 9, 2006, by a roadside bomb in Iraq. Dr. Krissoff’s other son, Austin, is also a Marine—a 2nd lieutenant, currently stationed at Camp Pendleton, Calif.

“Nothing prepares you for the loss of a son,” Dr. Krissoff says. “It goes against the natural order of things. It’s just not the way life should be.”

According to life’s “natural order,” fathers set the example for their sons. But the news of Nate’s death reversed that dynamic for the Krissoff family.

“I’ve always been inspired by my sons’ dedication to service in the Marines, so I’m following their lead,” Dr. Krissoff says. “It seems the right thing to do.”

Getting up to speed
Dr. Krissoff and his wife, Christine, have shuttered his solo orthopaedic practice in Truckee, Calif.—where he worked for 28 years—and relocated to San Diego, closer to his reserve center.

Dr. Krissoff is training to be part of a forward resuscitative surgical system (FRSS) team—a mobile surgical unit consisting of an orthopaedist, a general surgeon, an anesthesiologist, and five or six corpsmen and nurses. As an FRSS orthopaedist, he will do early stabilization, clean wounds, apply fixators, and help the general surgeon in lifesaving techniques.

His goal is to be “deployable” by early summer. He’s already attended Navy Officer’s School in Newport, R.I. Next is a combat casualty care course at Fort Sam Houston in Texas, followed by a field medicine course at Camp Pendleton.

“Nothing is the same for us”
As “right” as it felt to join the Navy Medical Corps, the decision took some soul-searching.

After Nate’s death, the Krissoff family received “huge support” from family, friends, colleagues, patients, and the Marine Corps. By January 2007, Dr. Krissoff and his wife had reopened their Truckee office.

“It was good to go back; it helped us get up in the morning and get through the day,” he says.

But it wasn’t the same, and it never would be.

Last summer, Dr. Krissoff mulled over the idea of doing something different with his life. He reflected on his sons’ devotion to service in the Marines.

After speaking to a good friend—a colonel in the Army Reserves who had been deployed to Iraq several times as a general surgeon—Dr. Krissoff applied to the Army Reserve.

His heart lay with the Marines, though, so he also contacted Lt. Cmdr. Ken Hopkins, a Navy recruiter in the San Francisco area.

The Navy’s initial response was disheartening. The cutoff age for Navy medical officer enlistees is 42, and Dr. Krissoff was then 60 years old.

“It’s possible,” he was told, but it would be a long and difficult process. “We haven’t taken anybody your age in this area,” Lt. Cmdr. Hopkins warned him.

Karl Rove to the rescue
An unexpected call from the White House would turn his fortunes, however, and kick his plans into high-gear.

In August 2007, the Krissoffs were invited to meet President George W. Bush, who was traveling to Reno, Nev., to speak to the American Legion. They accepted.

The small group included the Krissoffs and others who were grappling with the loss of loved ones in Iraq and Afghanistan. Anticipating a quick “meet and greet,” they were pleasantly surprised at the personal nature of the meeting.

“It was a solemn experience,” Dr. Krissoff recalls. “We all sat down with the president and talked for about an hour. It felt like he had all the time in the world to spend with us.”

As the meeting drew to a close, President Bush asked if there was anything he could do for them.

Dr. Krissoff seized the moment.

“There is one thing! I want to join the Navy Medical Corps, but they discouraged me because I’m too old … And I’m younger than you are, sir!” he joked.

The president deferred to Mrs. Krissoff, who steadfastly supports her husband’s decision. With her “thumbs up,” the president said, “We’ll see what we can do.”

Karl Rove approached Dr. Krissoff with a card and said, “Fax your papers to my office at the White House today.”

“You’ve got your age waiver!”
Two days later, Mr. Rove hand carried those papers to the chairman of the Joint Chiefs of Staff. The next morning, Lt. Cmdr. Hopkins called Dr. Krissoff, saying, “You’ve got your age waiver!”

“That day, Lt. Cmdr. Hopkins drove to my office in Truckee with a stack of 30 documents,” Dr. Krissoff recalls. “I had to go through a lengthy credentialing review—virtually back to high school—along with Navy documents, professional references, and a security clearance. It was pretty exhaustive, but we managed to do a year’s worth of work in 2 months.”

On Nov. 17, 2007—surrounded by family and friends—Dr. Krissoff was commissioned as a Lieutenant Commander in the Navy Medical Corps. His 4-year commitment with the 4th Medical Battalion—a reserve unit “on the green side”—means he’ll be treating Marines.

The typical Marine deployment rotation is 7 months, which can be stressful for young orthopaedists.

“These docs are home for 6 or 7 months, and then they’re getting ready to deploy again,” he says. “So to a certain extent, it’s easier for someone who’s older and has already raised a family.”

Military docs “get it”
There are those who ‘get it’—the concept of service to one’s country—and those who don’t, Dr. Krissoff says.

“This isn’t like World War II where everyone’s involved in the war effort,” he says. “I’ve been called ‘nuts’ for leaving my busy elective practice in Truckee.”

But the medical professionals, nurses, techs, and corpsmen of the 4th Medical Battalion—they all ‘get it,’ he says. “These men and women come from all over the country—on their own nickel—to work for their reserve weekend. They don’t get paid a lot to be there, either, but you never hear a complaint about reimbursement. They do it for the chance to give back. I think they have a ‘higher calling.’”

The contrast between military medicine and private practice is stark, Dr. Krissoff says. “There’s just a different focus; it’s all about getting up to speed and caring for injured soldiers. It’s clear cut.”

The Navy: “We’re hiring”
“The 4th Medical Battalion is hiring,” Capt. John Williams, MD, Dr. Krissoff’s commanding officer, wants orthopaedists to know.

“If you are looking for a new challenge, whether it’s volunteer work or service or giving back, this is something to consider,” Dr. Krissoff says. “There truly is a need on the reserve side—that’s something I didn’t understand before.”

The Navy is looking for orthopaedists, anesthesiologists, and emergency medicine physicians. Recruits like Dr. Krissoff—who qualify in every other category—will receive an age waiver. He just got his a little quicker.

“If you’re in good health, the fact that you’re in your late 50s or early 60s won’t preclude you from service,” he says. “They want experienced guys. They couldn’t be happier to have me on board.”

Of course, you have to be prepared to essentially close your practice and devote time to service, he points out. “That’s why I feel so lucky this came at this time.”

Service is “a good thing”
Dr. Krissoff is quick to deflect any praise for his decision to enlist.

“I’m just a doc who’s got some skills that I can apply here,” he insists. “This is really about the marines and soldiers and sailors who put their lives on the line. Some—like Nate—have made the ultimate sacrifice, and others have sustained severe injuries but are determined to get back to active duty. If I can help them, then that’s a good thing.”

Carolyn Rogers is a staff writer for AAOS Now. She can be reached at rogers@aaos.org

Losing Nate
Commissioned in August 2004, 1st Lt. Nate Krissoff was deployed to Iraq on Sept. 11, 2006—the fifth anniversary of the 9/11 attacks. The affable, energetic young man served as a counterintelligence officer (CI) with the 3rd Reconnaissance Battalion, patrolling the smaller towns outside Fallujah.

“CI officers typically work with a HET—a Human Intelligence Exploitation Team,” explains Nate’s father, William B. Krissoff, MD. “They conduct on-the-ground interviews, seek out local intelligence, and sort out the players in their area of operations.”

This time, however, there was no HET; Nate was “the guy”—the sole CI officer in his 250-member battalion.

In the early morning hours of Dec. 9, 2006, as Nate and three fellow Marines were returning to their base at Camp Fallujah, their Humvee struck a roadside bomb. Nate bore the brunt of the explosion and was killed instantly. The other Marines were injured, some severely.

“It was bad luck,” Dr. Krissoff says, “but it was also a very dangerous time, during the height of the violence in the Al Anbar province. It’s virtually the opposite today—kids are playing in the markets. From everyone I’ve talked to, it’s night and day.”