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Interview by Gabrielle H. Lyon
Dr. Tim Lyman
A lone camel and veiled
rider approaches the excavation pit. "Tim,
looks like you've got a customer," someone
announces. Tim Lyman puts down his mallet
and chisel, unstraps his knee pads, climbs
out of the pit and goes to work: diagnosing
his newest patient. With the help of not
one, but two translators (one to translate
from English to French and one from French
to Tamacheck), the carefully chosen questions
begin and a medical history of a local nomad
is pieced together.
Expedition doctor for
the 18-person crew of the 2000 Expedition
to Niger led by paleontologist Paul Sereno,
Tim Lyman is learning about dinosaurs -
and putting his experience as a general
trauma doctor to work not just for the team,
but for the nomads of Niger, as well.
One of nine children,
Tim grew up on the North Side of Chicago.
Under the influence of a dynamic high school
teacher who taught both physics and art
a passion for physics blossomed, and Tim
earned his BS and MS in Physics from the
University of Chicago.
Continually fascinated
by "what makes things work," Tim turned
from theoretical physics to the physics
of the human body as a career. Medicine
presented a way to pursue science, but also
to help people, "and make them better."
Tim has been practicing
medicine for 16 years - the last eight of
them as the Urgent Care Medical Director
at West Suburban Medical Center in Oak Park
Illinois. Perhaps no other practice could
so have so well prepared him to be the expedition
doctor for during a four-month quest for
dinosaurs in the Sahara.
I interviewed Tim Lyman
in mid-November at Camp 4 during excavation
of a new species of titanosaur.
What kind of medicine
did you think you would pursue when you
went to medical school?
I actually went to med
school thinking I would be a neurosurgeon.
But I soon found out that surgeons spend
their whole time studying techniques. What
I enjoy is the sleuthing aspect of general
medicine - figuring things out through people's
medical histories. I ended up going into
internal medicine and studying adult medicine
and the physiology of organ systems. After
finishing my residency, I starting working
for an immediate care organization. The
work I do now is really ideal.
Dr. Lyman examines
the eyes of a Toureg boy
What is your life
like when you aren't in the field?
I'm the medical director
for the urgent care network. It's about
50/50 administrative and clinical. Usually
in the mornings I am in meetings and my
clinical shifts are usually in the afternoon
and evening. It's a walk-in urgent care
clinic, that is, non-life-threatening emergencies.
It's never dull. People walk in with an
enormous variety of traumas - chest pain
and abdominal pain, cuts that have to be
repaired, minor surgical procedures, sudden
illnesses. There are always things in the
eye, beans up the baby's nose, flu, nosebleeds
that won't stop, burns, rashes, and allergic
reactions. That's why I enjoy it; the variety
is exciting. The lifestyle point of view
is also attractive to me. When I leave the
office, I leave the office. I can take vacations
without problems. I don't have to worry
about my patients.
How did you come
to be the doctor for an expedition led by
Paul Sereno?
A friend and patient
of mine, Mike Hettwer, left a long message
on my machine and mentioned that he had
met Paul and that he was helping with an
expedition website project and had been
invited to be the photographer on the next
expedition.
I was really jealous
when I heard about the message and spent
a week complaining to everyone that "Mike
gets to do all of this stuff," and talking
about the kind of life he leads. When Mike
called again jokingly I said, "Ask them
if they need a doctor on the expedition,"
and he said "They have one."
The next week he left
a message on my machine that said, "I sent
an email to Paul about you. Their doctor
fell through and Paul wants to know if you
would still be interested in taking his
place." I was stunned - all of a sudden
this dream I had was being presented to
me.
Things started happening
really fast. I had approval from my department
chairman and the Vice President of West
Suburban before I ever met Paul?
What primarily attracted
you about being the expedition doctor?
The science, adventure,
travel - all of these things. The Sahara
has always been at the top of my list of
places to go. The idea of doing some sort
of dig - paleontology or archaeology - has
always fascinated me. I love adventure travel,
especially to third-world countries. And,
simply, the science of it - paleontology
is a little more accessible than theoretical
physics.
Originally I thought
the trip was only 6 weeks. Then I found
out the expedition was for four months.
When it came time to decide if I wanted
to go for the whole time, it was a difficult
decision. What finally decided it for me
was the concern, "what if I go for the first
half and then they make an incredible discovery
the second half?" I'd never forgive myself.
Faced with the
responsibility of being the expedition doctor,
what were your main concerns?
Because I do urgent
care and see a variety of things - illness,
trauma, nosebleeds, burns - I know the kind
of things that happen to people, and I was
pretty confident I could handle everything
except snakebites and scorpion bites. Those
were things I'd never come into contact
with in the States. I probably reviewed
every single wilderness medicine book and
based on what I was reading, I spent a lot
of time worrying - should I bring anti venom,
how do you get it, how is it used?
I decided that it was
completely impractical to carry it - it's
fragile and would be destroyed in the heat.
Generally you need a lot for one dose, so
you have to have a big supply. And regardless
you still have to get someone to a hospital.
So I decided to concentrate on emergency
evacuation plans instead.
I always knew if I really
was in a pickle I could use the satellite
phone to call the emergency room at West
Suburban and get advice 24-hours a day.
Caring for an
epileptic child
How did you know
what to bring? How did you prepare?
I spent some time analyzing
the situation to try to anticipate what
we would face. As a doctor in any situation
there are a few things you need to take
into account.
Firstly, you need to
know the people you're treating. In this
case it was a young, fairly healthy group.
I wanted to know the medications they're
on, their blood type, basic medical histories.
Secondly, you need to
know the environment and what to expect.
In this case, that meant heat, a lot of
sun, UV exposure, dryness. The other important
factors were the remoteness and that it's
a camp existence for a long period of time.
The third part is that
you need to know about the work that's involved.
If we were tourists, there are a lot of
things I wouldn't have brought. But I knew
we'd be doing excavation and that we'd be
working with tools and sharp instruments.
You know automatically to prepare for injuries
from those things. The final thing was insurance
coverage and evacuation plans. Those four
things are the things you need to think
about.
The thing that is hardest
to predict is the quantities. One year you
might be plagued with vomiting and diarrhea.
The next trip you might have three people
that have bad cuts.
What kinds of
problems have you treated the team for?
The most common things
were gastro-intestinal problems, although
we went through two months with very few
of them. There were also a lot of little
abrasions and injuries - people needing
band-aids, wound-cleaning, blisters. People
don't give minor wounds much thought out
here - they put duct tape on them and forget
about them. From my perspective, though,
those are the kinds of things I worry about
in terms of infections and getting worse.
You have to take them seriously.
What were some of the more serious
things that have happened to the team?
There were some interesting
things that happened. One of them was an
ingrown toenail. It happened the first week
in the field. I was amazed. It's common
in the States, but not the kind of thing
I was thinking I'd be dealing with. It's
kind of a major thing out here and requires
a surgical procedure, but the person didn't
want it touched so they suffered for two
months on antibiotics.
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