At Saint Peter's University Hospital, Dr. Peter N. Fish has a unique but powerful informal protocol -- every patient admitted is asked: Are you a veteran?
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ANTHONY MENTO Mento survived Iwo Jima. He was on the island when the historic flag was raised on Mount Suribachi.
A few years ago, Mento learned that he was scheduled to receive a Meritorious Service Medal from the state of New Jersey. He was as excited as a child, says his daughter, Diane D'Imperio, and constantly reminded everyone in the family to attend. "You're going to be there? You're going to take off from work?"
But Mento never made it to the ceremony. Instead, he was in the intensive care unit of Saint Peter's University Hospital in New Brunswick. But, says D'Imperio, God was watching over their family.
Witness the work of Peter N. Fish.
An internist at Saint Peter's, Fish, too, had spent time in the service, more than a decade as a flight surgeon and Army medical officer, with tours in Iraq and Afghanistan.
He is the author of "Army Medical Officer's Guide," (Stackpole Books, 2014), a primer considered so critical that it's now given to all medical recruits. He also is an expert on men's health, and connects with patients by using metaphors of maintenance and repair.
At Saint Peter's, Fish has a unique but powerful informal protocol. At his request, every patient admitted is asked: Are you a veteran?
It's a simple question, but it yields potent results.
First, in diagnosis. Fish discovered, for example, that an 80-year-old white man from New Brunswick actually was suffering from a strain of malaria, the result of his tour in Africa decades ago. As a doctor, a diagnosis like that makes you look like a genius.
Second, to honor. For each veteran admitted, Fish makes a plaque to display outside their hospital room, indicating the patient's name and branch of service. It's an honor for the patient to be recognized, and it's an honor for members of the hospital staff, who are glad for the opportunity to give back.
Third, in results. Fish makes a point to talk to as many veteran patients as possible (about four or five are admitted each week).
What happens is amazing. Veterans with dementia, when asked about their war experiences, suddenly are lucid. One veteran, fidgety and restless for years, became quiet and focused during a visit with Fish. They talked about World War II and listened to Fish's iPod, full of music from the 1940s. Wives and children gathered at the veterans' bedsides, often hear war stories for the first time. And families sometimes learn about veterans' benefits for which they didn't realize they were eligible.
If you've served, says Fish, you understand. It's a powerful connection.
Peter N. Fish, an internist at Saint Peter's University Hospital in New Brunswick who also served as a medical officer in Afghanistan and as flight surgeon at a combat hospital in Iraq, stands in front of an MRAP (mine resistant ambush protected) ambulance at the "Queens Palace" near Darul Amanm, outside of Kabul, Afghanistan. Ask Fish about his time in the service and he'll likely focus on his experiences at a combat hospital in Iraq. The facility was understaffed, so Fish held several roles, as needed -- flight surgeon, communications officer, acting medical officer. Combat treatment, as Fish notes, was just one aspect. Most often the hospital dealt with the medical issues of any emergency room -- basketball injuries, stabbings, rape.
But, to Fish, a history buff, the geography is what was most inspiring. This region of the world is the cradle of civilization, the birthplace of Abraham, where the wheel was invented. Fish could see the Ziggurat of Ur.
"It felt sacred. When we had bad days, I liked going out and watching the sun rise over that pyramid and thinking about my small contribution to the history that was there."
Fish -- tall, cheerful and confident, and with the straight-line posture championed by the Army's field manual -- is matter-of-fact about his efforts. Others may find it extraordinary that he seeks out and honors veterans, including the patients themselves and their families, and even members of the hospital staff, who, frankly, are accustomed to extraordinary things happening in the ICU.
To Fish, it's a simple duty. "I'm honored to be able to do it," he says.
"It's hard to put into words. These guys sacrificed everything for us. But they would be first to say that the real heroes are the ones left behind on the battlefield."
To the Mento family, Fish's efforts went above and beyond.
Mento had been a parachute rigger in the Navy, a job that required his hands remain soft. He had no business being sent to Iwo Jima, but managed to survive that bloody, fierce battle. In the last years of his life, Mento was in and out of the hospital. More often than not, says D'Imperio, Fish was at his bedside. "Dad was a great storyteller, but there were some stories he never shared with us," she says.
D'Imperio is particularly grateful that Fish was somehow on rotation every time her father needed him. She's grateful, too, that the doctor agreed to speak on Veterans Day to the residents of Spring Hill in Somerset, where her parents lived, even though she was sure some residents fell asleep during the speech and even though she discouraged her father from asking the doctor in the first place. "Daddy, you can't bother him. He's a busy man."
To which her father countered: "Well, he gave me his phone number."
But her father's last day? She coughs with emotion.
Mento, 88, was in a coma, on life support and not expected to survive.
D'Imperio's brother-in-law had picked up Mento's Meritorious Service Medal and the family had been debating who should pin it on. Fish intervened. "It would be our honor to pin it on him."
It was Thursday, April 3, 2014. The family had decided to let their dad go. With 28 family members gathered around the hospital bed and with the national anthem playing from an iPhone, Fish and another physician, Douglas Frenia, a lieutenant colonel in the Army, both in full uniform, conducted the medal ceremony for Anthony R. Mento Sr., veteran of the U.S. Navy Air Corps serving during World War II. The ceremony ended with a salute and Fish pinned on the medal.
It was bittersweet, says D'Imperio, who, when she looking up, realized the hospital staff was crying just as hard as members of the family.
Mento died the following day.
"What they did was a beautiful thing. My father would have been so damn proud," she says. "I like to think he knew."
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