In honor of Veterans Day, Duke Orthopaedics welcomed Mark E. Fleming, DO, FAAOS, FAOAO, retired U.S. Navy Captain, orthopaedic trauma surgeon, and Clinical Professor at the Keck School of Medicine of USC, as our Visiting Professor. Fleming delivered an insightful presentation that bridged military medicine and orthopaedic innovation, drawing from his extensive experience treating traumatic injuries during the War in Afghanistan.
Fleming highlighted the importance of adaptability in high-pressure situations.
“Self-awareness is often the lesson. When it’s time to catch the wire, success is not always tied to executing Plan A, but adapting with good sense and humility to execute Plan B.”
Many of these lessons are found in his book, Learn How to Swim, which promotes resilience and leadership: "Learn how to swim—not just to survive, but to lead—the water’s cold. The current is strong. But you were built for this.”
Research and Innovations in Combat Care
Fleming’s research focuses on interdisciplinary solutions for amputee care, inspired by the significant number of lower extremity injuries caused by improvised explosive devices (IEDs) during the Afghan War. These injuries often required rapid decision-making to control hemorrhage and prevent infection.
Key advancements included:
- Stop the Bleed Campaign: A nationwide initiative that trains soldiers to use newly developed field tourniquets.
- Surgical Algorithms: Tools to help surgeons determine when to preserve tissue and limbs versus perform complete amputation.
- Medivac System Overview: Dr. Fleming detailed the five levels of U.S. military evacuation, ranging from field care to stateside facilities, such as Walter Reed National Military Medical Center.
Prosthetic Advances and Interdisciplinary Care
“The biggest advancement has been in prosthetics,” Fleming noted. His ongoing research aims to develop more effective methods for helping amputees regain function and improve their quality of life. This work led to the creation of the Interdisciplinary Care Model for Amputees Network, fostering collaboration across specialties to optimize recovery.
Fleming’s presentation was a powerful reminder of the intersection between military service, surgical innovation, and patient-centered care. His experiences continue to shape best practices in trauma and reconstructive surgery—both on the battlefield and in civilian medicine.
