Hudak’s medical school and residency years were supported by the Health Professions Scholarship Program, an initiative of the U.S. military that pays for medical education for those enlisted to military service who agree to fulfill residency training requirements at a military hospital.
“My time at Iowa was no different than anybody else; we have a Match Day similar to the civilian Match, except it occurs a couple of months before.” Hudak says. “Residency is just like residency in the civilian sector, except you’re wearing a uniform and caring for active service members, their families, and veterans.”
By the end of Hudak’s fellowship training, the greatest need for reconstructive urology care came from previously injured servicemen who were in the later stages of healing from catastrophic injuries sustained while serving overseas in Iraq or Afghanistan. When a service member is seriously injured in combat, Hudak explains, there may be widespread damage to multiple organ systems and areas of the body, requiring a long, complicated healing and rehabilitation process. Restoring the urinary tract is unlikely to be the first priority.
“Imagine someone has a head injury, bad burns, broken limbs, and a broken pelvis,” Hudak says. “The act of breaking their pelvis can also cause internal damage to the urinary tract. But rather than fixing that right away, we temporarily manage it with a drainage tube.”
This approach often put Hudak in the position of performing the last big operation someone experiences before they can return to their “new normal.”
“It can be very gratifying,” he says. “But then there are many times when other, nonsurgical things need to be addressed down the road—what we call the ‘forgotten wounds.’”
The effects of major injury to the genitourinary system can include incontinence, impotence, or the inability to have children.
“There is a mental health impact to all of that,” Hudak says. “There are things that we can help people cope with, but at times, you cannot make something completely normal again. It can be very difficult to help individuals cope when perhaps their injuries were too severe to be entirely fixed or replaced.”
Even through the challenges, Hudak feels it is a privilege to be allowed into his patient’s most personal and intimate life experiences.
“To be able to restore things that an individual thought couldn’t be done, but all they needed was the connection and access to specialized care—that can be extremely satisfying,” he says.
