I write this with the intent of starting a conversation. Just when I think I've prepared myself for any given situation, all I need to do is ask someone else's thoughts and I start learning again. I fully expect that to be the case today, and I eagerly await your thoughts--especially those of my prior-military classmates and professors who have very much "been there, done that" before us.
As we watch events of different timbre develop across the world, this provides a poignant opportunity to consider what our contributions may entail as military docs...the situations we may have to rationalize...the array of patients we will see...the sacrifices we will make...the incredible good we can do for patients across the globe.
In the Western Pacific, our medical personnel with all four serivces, under the direction of Commander, U.S. Pacific Command, have been mobilized to aid Japan's response to and recovery from last week's immense natural disasters. Medical crews are dealing with everything from dehydrated crewmen who are working at unreal length and tempo on the flight deck to civilian crush and exposure casualties to some of the most dangerous potential radiation injuries in recent memory.
On the other side of the world and in a very different disposition, more than 200 years after LT Decatur's attack in Tripoli Harbor, the U.S. Navy is back in armed conflict in Libya. Again, our doctors, nurses and the enlisted medics they train and lead are caring for the 19-year old sons and daughters who have gone into harm's way at the request of their country. Combat and industrial injuries will happen; some crews will undoubtedly see civilian refugee patients as well (malaria, malnutrition and "collateral damage" trauma).
These two very different crises both necessitate short-notice deployments...families will miss parents and spouses for a few days to months while the docs that stay home will cover extra shifts, more rounds and an increased patient load. These are sacrifices to be sure, but they are also opportunities to help our best people in a time of need and to care for civilians in a time of dire distress. Rarely elsewhere in medical practice will we have the opportunity to make such an impact!
The two operations are also distinct in the motivation (aka politics) surrounding them, and our personal thoughts may range from full support on one extreme to full opposition on the other. As medical staff who are also junior officers, whatever our personal thought are, we must realize that when orders are given, we execute. Our leadership role here becomes perhaps even more important than on a normal day. Our Sailors, Soldiers, Airmen and Marines will also have those personal opinions of our operations, will also be separated from their families when deployed and will also be working extra patients and extra hours during what we call "high operational tempo."
While we're here, still as students, is a great time to prepare ourselves for the demands of future leadership. How will I handle the overly gung-ho Marine ("let's kill all those [insert expletive--he's a Marine, after all] Libyan bastards") who doesn't realize that "Libyan bastard" is also someone's father...or the melancholic Sailor who doesn't want to be deployed as humanitarian aid ("this blows...I joined the Navy to be in the military, not to be a charity worker") or their families, who just want their father/mother/wife/brother to come home and fix the dishwasher that broke the day after they deployed?
How will we further motivate ourselves to studying OMM/EPC so we can care for casualties in an austere environment, where meds are short and the nearest x-ray machine is 500 miles away? What 2 extra journal articles can we read each week so we can help a young mother decide what's best for her baby while her husband is in a tent in Japan handing out drinking water, unreachable by phone for two weeks?
We have an incredible scope of practice as future military physicians, with a range of possible patients wider than we can guess. Thank you for making the choice to dedicate yourself to serving our Sailors, Soldiers, Airmen and Marines--and their families--and whomever else our patients may be. This is a life not all can handle, but with benefit and fulfillment few will ever see. What will each of us do TODAY to make ourselves ready?
