Medical Community Starts Feeling Strain of Call-Up : Health care: Deployment of doctors, nurses hasn’t affected O.C. much yet, but that could change soon.

Dr. M. Mark Hoffer, chairman of orthopedic surgery at UC Irvine School of Medicine, is working out of a tent hospital somewhere in the Saudi Arabian desert. At 55, Hoffer is an expert in hand surgery and treating crippled children, but for now the skills he will rely on most will be those of a trauma surgeon.

Garden Grove urologist Stanley G. Cohen is on call nearly 24 hours a day because the doctor who used to back him up was called to active reserve duty. And with two of four urologists in his community called to military service, Cohen worries about a shortage of doctors “to cover urologic emergencies” in Westminster and Garden Grove.

And at Saddleback Memorial Hospital in Laguna Hills, oncology nurse Sue Pomeroy flinches whenever the phone rings. An Army Reserve nurse assigned to a MASH (mobile army surgical hospital) unit, the 45-year-old widow has been on alert since early December.

“I’m ready,” she said quietly last week, one day after U.S. fighter jets bombed Baghdad. “My will is done. . . . I’ll just pack my duffel bag and I’m gone.”

A growing number of Orange County doctors, nurses and medical technicians are being deployed to military hospitals in the United States or the Persian Gulf. The military call-up has created some personnel problems at hospitals and medical offices as colleagues try to handle their work. And it has taken an emotional toll on those who remain.

In Mission Viejo, Mission Hospital Regional Medical Center lost several nurses and a pharmacist to the military. Hospital operations are normal but the mood of the staff is not.

“Certainly everybody’s hearts and minds are with them,” said vice president Gary Fybel.

For now, the overall number of medical personnel deployed from Orange County is not large; hospital and government officials say only a handful of their medical workers ever joined the reserves. So the national call-up of reservists so far hasn’t caused major gaps in medical care.

But with the United States at war with Iraq, that could quickly change, hospital leaders warned. “The problem we’re going to have is manpower,” said Russell Inglish, Orange County vice president with the Hospital Council of Southern California. “We’ve already had some people called up. I’m assuming we’ll have more.”

And with a national shortage of nurses and medical technicians, temporary registries might not be able to fill the need.

Inglish’s words proved prescient. Late Friday, President Bush expanded the call-up, authorizing the Pentagon to put up to 1 million reservists on active duty. Until then, the Pentagon had been limited to 200,000 reservists.

By late last week, only 130 Orange County Army Reserve medical personnel had been called to active duty, officials reported. Cmdr. Bill Gay of the Navy Reserve Readiness Command in San Diego said just seven doctors and 75 corpsmen were deployed from the Santa Ana Reserve Center. Air Force figures were not available.

Hospital and health officials reported only a few of their workers are on active duty. At the Orange County Health Care Agency last week, just three nurses had been called to active duty.

And at UCI Medical Center in Orange, two radiology technicians, a transportation worker and five doctors--among them pediatrician H. David Mosier, his wife, ophthalmologist Marjorie Mosier, and Hoffer--were on active duty. But with 600 full-time faculty and 2,500 other employees, “we haven’t felt any great impact,” spokesman Fran Tardiff said.

But in Laguna Hills, several orthopedic surgeons were struggling to continue a busy medical practice after one doctor was called to active duty and another was placed on alert. “They don’t have time to return your call,” a receptionist told a reporter last week. “They don’t even know if they’ll have time to get home for supper.”

At St. Joseph Hospital in Orange, two registered nurses and a respiratory therapist are on military duty. Although only a few people have been called up so far, this was only the beginning, hospital spokeswoman Joanne Rogers warned. “There will be many more called up. We don’t know how many.”

Dr. M. Mark Hoffer, chairman of UCI’s orthopedic surgery division, was scheduled for weekend duty with his Army Reserve unit just before Thanksgiving.

He was worried, his administrative assistant Toni Schoby recalled. Since August, the Army had been calling up reservists--particularly orthopedic surgeons--as part of Operation Desert Shield, a show of U.S. force in the Saudi Arabian desert.

“He said, ‘You know they could pull me in,’ And I said, ‘Nah,’ ” Schoby said. “I figured they’d wait until something started before they started pulling people in. And then he came in the following Monday and he said, ‘Guess what. I’m going.’ ”

Colleagues describe their chairman of six years as a skilled administrator, a gifted teacher and a superb surgeon, internationally known. Also, he is probably one of fewer than five Orange County doctors who are full-time pediatric orthopedists, said Dr. Robert Baird, who now serves as acting chairman of orthopedics.

At 55, Hoffer has a wife, three grown children and, in addition to his UCI job, a full-time post as a surgeon at Rancho Los Amigos Hospital in Downey. Also in his background: a four-year stint as a Navy lieutenant plus five years as a colonel in the Army Reserve.

He joined the reserves after Army officers recruited him, saying they desperately needed orthopedists. But he never expected to go to war, his wife, Margo, said.

Hoffer’s colleagues say they miss him deeply. Some surgeries that Hoffer used to do--on indigent pediatric patients--may be delayed a few months before other doctors can take them, one orthopedist said. But overall, “We are taking care of his administrative duties and taking care of his patients,” Baird said. “We will handle things.”

Added Hoffer’s longtime secretary, Isabelle Cohen, “Let’s hope that this war is over shortly and Dr. Hoffer will be back with us. I worry about him.”

Urologist Stanley Cohen has been on call nearly every night since his associate, Dr. Robert Stevenson, was called to active duty.

Cohen, who shared emergency calls with Stevenson for three years, never expected this. But now instead of handling emergency calls at his own hospital, AMI Medical Center of Garden Grove, he carries a pager and takes emergency calls day and night at hospitals Stevenson used to cover--Humana Hospital-Westminster and Humana Hospital-West Anaheim.

In addition to handling more emergencies, Cohen now has all of Stevenson’s office patients--up to “10 patients a day several days a week” who need follow-up care for prostate cancer, bleeding kidneys and other problems.

That means Cohen’s regular patients must wait 10 to 15 minutes longer. And some of them don’t like it. “I have lost a couple of patients because they’ve had to wait longer,” Cohen said, “sometimes 45 minutes now.”

Still, Cohen said he wants to keep Stevenson’s practice alive. When Stevenson was called to active duty, “he had to practically close his office,” Cohen said. Stevenson laid off two office workers and is still in business now only because his wife is answering the office phone, giving patients their charts and referring them to Cohen.

“I’m trying to preserve his practice,” Cohen said. “I really don’t want to take it.”

On alert since December, oncology nurse Sue Pomeroy has already watched at least 30 friends, also Army nurses, leave for active duty, mostly in the Persian Gulf.

It’s an odd feeling, said Pomeroy, a lieutenant in the Army Nurses Corps Reserves. But since her friends are gone and she’s still here, “I am very torn. All of us still here have said goodby to all our friends and you feel guilty about it.”

If deployed, Pomeroy would work as an intensive-care nurse in a MASH unit. Recently, her team has had training on heat- and desert-related injuries. Though she is resigned to going to the gulf, Pomeroy also worries about going to the war zone. If she goes, her daughter, a Saddleback College freshman, will move in with relatives.

And she wonders how civilian hospitals will survive when all the Army Reserve nurses and technicians are deployed. “Some people that are surgical nurses--they float between three or four different hospitals from the area,” she said. “And you know, they’ll be feeling the crunch.”

Still, now that war has been declared, “I guess I’m ready,” she said. But, “You know a part of me wishes mankind was civilized enough to stop this bloodshed,” she said sighing. “Everybody’s too young to go to war. I don’t care if you’re 108. Everybody’s too young.”