Docs in Black -- the tactical medicine of life-saving 'SWAT Docs

      This Asian Hopkins doc dresses in black for a reason: If he’s called into a nighttime sniper situation, he’ll blend in with the shadows. “We try not to carry bright, shiny objects,” he says, flashing the glint of a steel surgical tool. “Something like this can get you killed. You’re lit up in a field somewhere. You’d be the first target.”       Increasingly, he explains, makers of instruments intended for “tactical medicine” tailor the devices for the “light discipline” so valued by police SWAT teams—all-black stethoscopes, scissors and scalpels. “Stealth is an important consideration,” says him.

      As a physician who heads up special operations for emergency medicine at Johns Hopkins, Tang occupies a unique place in tactical medicine’s vanguard. With armed violence on the rise, emergency responders have sought ways to combine firepower with quick life-saving skills, prompting SWAT teams to include physicians when responding to hostile incidents. Hopkins has emerged as a leader in this new approach, hosting a modern training center on the Mt. Washington campus where physicians and police groups at every level of government can share skill sets.

      After completing his medical residency at Hopkins and joining the medical faculty in 1997, he found himself serving part time with Presidential Secret Service units by 1999. The war on terror then spawned the Department of Homeland Security, which selected Hopkins as one of its key centers two years ago. Hopkins is now one of the nation’s only academic medical centers to specialize in tactical medicine, with five faculty members and two full-time paramedics.

      Taking their cues from combat medicine, tactical physicians don protective gear and deploy with “entry teams” made up of four to six people. The only distinction for the team’s physician—always the last to enter any hot spot—is that the doctor carries a medical “go bag” instead of a weapon.

      Traditionally, physicians or paramedics would wait at a mobile unit some distance from the danger zone until given the “all-clear” signal from police. The lag time inevitably raises the risk of losing lives to blood loss. Skilled SWAT docs are on the scene instantaneously—potentially shrinking the long-revered “golden hour” of trauma medicine to mere seconds.

      When he needs to travel light he favors the “M-9” go bag, which contains “all the immediate essentials,” he says. These include packets of powder designed to quickly stanch bleeding on multiple victims—a terrific asset in cases where the injured can’t be moved, “as in a barricade situation,” he explains. The bag is also equipped with a small skin-stapling kit for closing wounds, along with the basic items for restoring fluid levels via IV lines.

      Though he has donned his gear countless times, he has not yet been exposed to an active shooting case. Yet you get the sense he’d keep his cool under fire. “I’ve had a lifelong interest in law enforcement,” he says. “My best friend is now a police officer.... Maybe this bridges the gap.” 


      At the vanguard of tactical medicine, life-saving "SWAT Docs" like him are poised for peril.