202-A Life in Medicine with Dr Winston de Mello

In this special episode of the CoROM Podcast, Dr Winston de Mello joins Aebhric O’Kelly for a wide-ranging discussion on burns, military medicine, medical education, mentorship, and the evolution of austere healthcare.A founding influence behind CoROM and a former Commanding Officer of the UK military's Battlefield Advanced Trauma Life Support (BATLS) programme, Winston reflects on decades of service, from treating burn casualties after the Falklands War to helping shape generations of military medics, doctors, nurses, and paramedics.The conversation explores prehospital burn care, topical morphine, ketamine procedural sedation, the origins of several austere medicine assessment techniques still taught today, and the importance of lifelong learning and compassionate patient care.Chapters00:05 – Introduction to Dr. Winston DeMello00:53 – Current work in burn care and pelvic pain medicine01:17 – The origins of Severe Burn Life Support (SBLS)02:46 – Burn education at bachelor's and master's level03:29 – How the Falklands War sparked a lifelong interest in burns04:50 – Why severe burns remain a chronic disease06:07 – The importance of burn education in austere medicine06:55 – The fundamentals of burn management07:09 – Why cling film remains one of the best burn dressings08:02 – Infection prevention and moisture control with cling film08:59 – Teaching burn care internationally09:29 – The story behind topical morphine for burns11:11 – Twenty years of experience using topical morphine11:41 – Why morphine should be diluted with water rather than saline12:20 – Topical morphine for ulcers, wounds, and joint pain13:11 – What is a ketamine shower?14:00 – Burn dressing changes under ketamine procedural sedation15:28 – Why ketamine remains underutilised in medicine17:27 – First meeting at the BATLS course18:59 – Teaching catastrophic haemorrhage during wartime deployments21:20 – The importance of passion in medical education24:20 – The multiplier effect of teaching future instructors25:24 – End-of-life care and battlefield medicine26:41 – Burns education and the evolution of austere medicine27:10 – Learning how to teach at BATLS28:29 – The influence of legendary military instructors30:36 – Building the BATLS faculty team31:11 – Teaching others how to teach32:36 – The origins of CoROM and early wilderness medicine training in Ireland33:33 – Persistence, resilience, and building educational programmes34:37 – Mentoring students including Grigory Tisenovich35:14 – The origins of the "Winston Sign" for estimating CVP38:24 – The importance of historical medical knowledge39:18 – The "Palmar Crease Sign" and assessing anaemia40:46 – Treating the future King of Jordan at Sandhurst43:26 – How a military patient inspired a career in pelvic pain medicine45:11 – Meeting Dr. Mallampati and airway management history47:22 – The story behind the Trendelenburg name48:29 – Reflections on mentorship and professional legacy49:25 – Advice for the next generation of austere clinicians50:49 – "Do the basics well, but always in style"51:01 – Closing thoughts and future collaborationGuest BiographyDr Winston DeMello is an anaesthetist, military medical educator, burns specialist, and one of the founding influences behind the College of Remote and Offshore Medicine Foundation.He served as Commanding Officer of the UK military's BATLS programme and has held fellowships from all four Royal Colleges. His career has included extensive work in burn care, military medicine, procedural sedation, prehospital care, and pelvic pain medicine. He continues to contribute to international education through Severe Burn Life Support (SBLS) and advanced burn care training.