Doc Gurley – Haiti Journey: Hitting the ground — Doc Gurley.

Doc Gurley’s in Haiti.  Will be fun to follow her.

Perhaps to the surprise of some, I won’t blast President Barack Obama on his inability to pronounce the word “corpsman” (which he pronounced “corpse man”). Instead, I’d like to take the opportunity to give much-needed praise to Navy/Fleet Marine corpsmen who are, as you will see, a special breed of warriors.

via TheTandD.com | Call me corpsman, call me ‘Doc’.

Nice article by a former Corpsman.

Washington (CNN) — All U.S. military health facilities around the world will now carry the emergency contraception pill known as Plan B One-Step, according to a new Department of Defense policy.

The decision to carry the pill, often referred to as the morning-after pill, was based on a recommendation by the Pentagon's Pharmacy and Therapeutics Committee, an advisory panel made up of medical professionals from the military services, Pentagon officials said Friday.

Many military hospitals already carry the pill, but the new action means it will become a standard part of every medical facility's stock of drugs, including those on bases in Iraq and Afghanistan, the officials said.

via Military increases availability of morning-after pill – CNN.com.

Mostly right, I’d say.  I do wish it was OTC (for installations large enough to have a store of some sort) and not force women into Medical for it (it’s OTC in the US), but it’s better than not having it.

RealClearPolitics – Video – Obama Mispronounces “Corpsman” At Prayer Breakfast.

And, I don’t care.  Yes, he mispronounced a word I think he should have known, or asked about.  He didn’t, and that’s just one of many things I wish he’d done differently.  Who cares.

He did recognize the service of this corpsman (pronounced cor-man), and to me that’s what matters.

Thank you Navy Corpsmen: what you do matters, and you’re appreciated.

Victory! Team Marine got to the Goal first! (But keep giving…) 11/10/09 @ 1524

Bumped to the top.  Still a good idea.

Give Here.  Pick any team

(but I’m on the Marine team…)

Here’s a worthy project, supporting wounded troops with technology to help their recovery.  Soldiers’ Angels has been running this for at least the past 3 years (and somehow I didn’t participate last year, for which I am duly ashamed).

Please read about what they do, and how you can contribute.

Project Valour-IT, in memory of SFC William V. Ziegenfuss, helps provide voice-controlled/adaptive laptop computers and other technology to support Soldiers, Sailors, Airmen and Marines recovering from hand wounds and other severe injuries.  Technology supplied includes:

• Voice-controlled Laptops – Operated by speaking into a microphone or using other adaptive technologies, they allow the wounded to maintain connections with the rest of the world during recovery.
• Wii Video Game Systems – Whole-body game systems increase motivation and speed recovery when used under the guidance of physical therapists in therapy sessions (donated only to medical facilities).
• Personal GPS – Handheld GPS devices build self-confidence and independence by compensating for short-term memory loss and organizational challenges related to severe TBI and severe PTSD.

I joined the Marine Team.  Yeah, my Uniform said US Navy, but 4/5 of my AD time was with the grunts, and that’s where my interests lie.

Should you want to participate, there are other services represented, and you can join any team here.

And give to whichever team you wish, jut give.

  It was a shot heard ’round the PA world.

The U.S. Army and Baylor University created a stir when they announced their PA clinical doctorate degree residency program in emergency medicine at the Physician Assistant Education Association forum in Tucson, Ariz., in November 2007.

Doctorate degrees have been increasing among health care professionals for more than a decade. Audiology, physical therapy, occupational therapy and pharmacy, for example, have all moved to the entry-level doctorate degree. The nurse practitioner profession adopted the entry-level doctorate degree in 2006, and the DNP will be mandated for all advanced practice nursing graduates by 2015.

Even though the specter of doctorate degrees has been hanging over the PA profession for years, the formal announcement of the Army program brought the controversy to the forefront. News of the Army’s program roiled educators at the PAEA forum and sparked furious debate about clinical doctorate degrees and PAs

It’s a very well-written article, and the included sidebar points out one of the biggest problems with a ‘midlevel doctorate’ for PA’s: they’re dependent on their relationship with Physicians in a way NP’s definitely aren’t.  No support for this from docs=real problems for the PA programs (and not just the doctoral programs, all of them).

We live in interesting times.

That’s one of my favorite medical aphorisms, taught to me by Dr. Peacock in El Paso.  He was one of the trauma surgeons there, and it nicely summed up an approach to medical care in the acutely traumatized.

I thought that when I read this:

Army halts use of battlefield first aid item after test found it might cause blood clots

By PAULINE JELINEK | Associated Press Writer

10:25 PM CST, December 23, 2008

WASHINGTON (AP) — Until more testing can be done, Army medics are being told to stop using a new product just sent to the war front to help control bleeding among wounded troops.

Officials were in the process of distributing some 17,000 packets of WoundStat, granules that are poured into wounds when special bandages, tourniquets or other efforts won’t work. But a recent study showed that, if used directly on injured blood vessels, the granules may lead to harmful blood clots, officials said Tuesday.

To recap: a medication to be used as essentially a last resort when a trauma patient is bleeding to death cannot be used because …it might cause blood clots.  Bleeding that cannot be controlled with direct pressure, tourniquets or the newer ‘combat gauze’ with pro-coagulants built in. 

I have to say that, were it me in that situation, I’d risk some clots elsewhere to get clots to keep me from literally bleeding out.  But that’s just me.

It’s commendable the Army takes the medical care of its troops seriously, but there’s a disconnect in this case.

That’s a much better deal than I got…

Military sweetens the deal to entice medical students

A beefed-up scholarship program now offers a $20,000 signing bonus as well as full tuition and an increased monthly stipend.

By Myrle Croasdale, AMNews staff. July 7, 2008.

---

Katie Doyle could have borrowed $200,000 to get through medical school. Instead, when she enters Nova Southeastern University College of Osteopathic Medicine in Fort Lauderdale, Fla., this fall, she won’t borrow a dime.

Doyle accepted a military scholarship that will pay her tuition, books and other school fees. A monthly stipend will cover living expenses. The scholarship, called the Health Professions Scholarship Program, or HPSP, also comes with a new $20,000 signing bonus.
…
…, Congress authorized the three branches to bolster their recruitment packages, resulting in the $20,000 bonus, along with a $300 hike in the scholarship’s monthly stipend, which is now $1,900. The money comes from military appropriations earmarked for medical corps recruitment. In 2007, the Air Force recruited 211 medical school students; the Army, 242; and the Navy, which also recruits for the Marines, 181.

That’s got to be a BIG shortfall for the Navy.  My Intern class in San Diego had over 100, and that was only one of two big NAVHOPS’s, with several smaller facilities.  Thus, the enticements.

A reminder: the Navy HPSP Wki

Niels Olson is a medical student at Tulane, and also a Navy Line Officer now going to med school through HPSP.

He’s done prospective students a HUGE service by creating a Navy HPSP Wiki, which he describes as:

The Navy HPSP Wiki – NavyHPSPWiki
This wiki is here to collect and disseminate information about Navy HPSP, whatever you’ve got, we want. Organized. The big ticket on the google group seems to be clerkships, but add what you got, where ever you can.

It’s up and running, and it’s about time something like this was started. Good for Niels, and now I finally have a good resource to refer the emails I get to for more current information.

ABC News: Dramatic Sea Rescue: Sick Teen Saved

Laura Montero never thought her fun cruise to Mexico would end on a U.S. naval carrier surrounded by 3,000 sailors.The 14-year-old owes her life to the men and women of the USS Ronald Reagan, one of the largest aircraft carriers in the Navy, who saved her in a mission worthy of Hollywood script.

Montero was aboard the Dawn Princess cruise ship off the coast of Baja, Mexico, Saturday when her appendix burst.

“It was a matter of life and death so it wasn’t very good at all,” said Montero’s mother, Trudy LaField.

The crew of the Dawn Princess put out an SOS, and the U.S. Navy heeded the call.

I supported this non-partisan worthy effort before, and will continue to. From their description:

Every cent raised for Project Valour-IT goes directly to the purchase and shipment of laptops for severely wounded service members. As of October 2007, Valour-IT has distributed over 1500 laptops to severely wounded Soldiers, Sailors, Airmen and Marines across the country.
..
Originally Valour-IT provided the voice-controlled software, but now works closely with the Department of Defense Computer/electronic Accommodations Program (CAP): CAP supplies the adaptive software and Valour-IT provides the laptop. In addition, DoD caseworkers serve as Valour-IT?s ?eyes and ears? at several medical centers, identifying possible laptop recipients. …

Thanks to the efforts of the Military Order of the Purple Heart, Valour-IT is also able to reach patients in VA hospitals who would benefit from a Valour-IT laptop.

I’ve donated, and will either keep bumping this to the top periodically, or will put it in the sidebar (when I can figure out how to without flanging the display):

Troops unite to save soldier knifed in head – Army Times
Troops unite to save soldier knifed in head
By Patrick Winn – Staff writer
Posted : Wednesday Oct 24, 2007 14:01:27 EDT

It felt like a nasty sucker punch. Yet when he strained his eyes to the hard right, there was something that didn’t belong: the pewter-colored contour of a knife handle jutting from his skull.Sgt. Dan Powers, stabbed in the head by an insurgent on the streets of East Baghdad, triggered a modern miracle of military medicine, logistics, technology and air power.
…
His survival relied on the Army’s top vascular neurosurgeon guiding Iraq-based U.S. military physicians via laptop, the Air Force’s third nonstop medical evacuation from Central Command to America, and the best physicians Bethesda National Naval Medical Center in Maryland could offer.

It required extraordinary hustle from a string of ground medics, air medics, C-17 pilots, jet refuel technicians and more. Not an hour after the attack, Powers, a squad leader with the Army’s 118th Military Police Company, was draped in sheets on a medical gurney bound for Balad Air Force Base, about 30 minutes away by helicopter.

Watch a video of the examination of Sgt. Powers in Iraq, with the knife still in his head, here, courtesy of MilitaryTimes.

And, if you want to see one example of how hard the services work to save one life,

…the operations center was telling him to change planes, directing him toward a different C-17 Globemaster, one with a plus-sized fuel tank. Red 7, the center said, would be picking up a severely injured soldier from Balad to fly him nonstop to Andrews Air Force Base, Md., just outside Washington.

“Our initial reaction was, ‘I don’t believe you,’” Bufton said. “Nobody goes to Andrews Air Force Base from Balad.”…

Watch the video, and marvel that he wants very much to go back to active duty.

A warning to trolls on this post: your comments will be deleted and your IP address banned.

Hat tip to FFM.

Nurse Ratched’s Place: It’s Military Week at Grand Rounds

This week at Grand Rounds we are honoring health care professionals who serve their country by serving others. I want to thank Dr. Nick Genes for letting me host Grand Rounds this week, and I also want to thank everyone for all of their great submissions. The number of submissions that I received overwhelmed me, and apologize that I didn’t have room for every post. The artwork found in this week’s edition of Grand Rounds illustrates the history of military medicine, and the dedication of the men and women who care for patients in military medical facilities and outposts around the world. In the 1944 painting above by Jack McMillen, the artist depicts life at the Forest Glen annex of the Walter Reed Army Medical Center. The annex served as a holding and rehabilitation unit for medical patients, including psychiatric patients during World War II and in subsequent wars.

I’m embarrassed I couldn’t write a suitable post. I appreciate the hard-charging, dedicated and self-sacrificing Navy Corpsmen and Docs (I’m sure the lesser services have good people, too, but I didn’t live and work with them) and they deserve the respect of all, in and out of the service. It’s hard in a weird way to be the one whose role is to be ‘the soft one’, the one who cares for the warriors. It’s a job sometimes unappreciated by the warriors themselves, but that doesn’t make it any less important; in fact, that magnifies its importance.  19 year old males believe they’re bulletproof, and it’s our job to be there when reality strikes.  My service was blessedly between wars, and nobody wanted to hear that Things Happen.

I genuinely liked my corpsmen, and hope they’re doing well, now 9-13 years since I was their leader. I hope they have the pride of a job well done, and understand the thanks of at least one ex-Navy Doc.

Why the heck couldn’t I write THAT before the deadline?

Pros and Cons of military service to pay for medical / professional school- HPSP (the health professional scholarship program)

In this article I want to write about the pros and cons of the military as a way of financing medical education. I may not be fully aware of the recent changes to the HPSP program but I did a fair amount of research about the topic before I ended up not going though with it. I want whoever is thinking about doing this to think seriously and give it some critical thought before signing up.

A very thorough look at the dollars and decisions of being a military physician.