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

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)

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.

Offer: Join the Army (Reserve) of One

I got a phone message the other day, and today I got around to returning it.

 

“You are an ER Doctor, correct?” was the question.  Yep.

“As you may know, we’re experiencing a critical shortage of Emergency Physicians in the Army Reserve, and I’ve been commissioned to contact as many Emergency Physicians as I can to offer them information about the Army Reserve.  Are you interested?”.  Nope.  (I was nicer than that, but that was the gist of it).

 

I’m wondering how they got my number; since they called the work number, I’m guessing they got hold of an ACEP directory.

Nice article about the US Navy Corpsman

I served with a lot, and respected them for the hard work they did.

There’s a nice write-up about Corpsmen at the Atlanta Journal-Constitution.

Baghdad ER

If you don’t get HBO, you should, just to see this documentary.

 Baghdad ER is an HBO documentary, filming (a few) of the soldiers, Iraqis (and one Marine) who come through the Army’s 86th Combat Support Hospital in the Green Zone of Baghdad.  It’s not to be missed.

First off, as an EM doc, I have absolutely no quibbles with the medical care shown.  None.  (You say: well, sure, you spent time in the military medical system, of course you’d say that.  You couldn’t be more wrong.  This is an Army Hospital, and I was in the Navy: there’s a friendly rivalry, to be polite.)  I was very very pleased at the level of care shown.  It didn’t, frankly, look any different than the care in any stateside hospital I’ve been in (except not enough use of emergency sonography is shown, but who knows if sonos were there and just not shown).

Second, this is a film for those who support the war and those who don’t.  It’s just a good study of America’s all-volunteer military, and their all-volunteer healthcare providers.  It’s neither pro- nor anti-war, and for this sort of film that’s all the balance you can hope for.  Frankly, I found it a lot more even-handed than I expected.

Lastly, I’m very proud of my profession as it’s being practiced in Iraq by the US Army.  This shows the US military as they are: individuals putting themselves out for each other.  Wonderful.

Oh, and I was literally moved to tears, and I’m not easily emotional.  I found myself wishing, briefly, I was back in uniform caring for the troops.

 Highly recommended.

 

ASA March 2006 Newsletter – Military Medicine

via MedGadget (who I don’t link to nearly enough):

ASA March 2006 Newsletter: “March 2006
As warfare changes, so too must the care provided to injured soldiers. And at no time in history has military medical care been so advanced and so effective. This NEWSLETTER is devoted to the stories of those who have integrated educational advances into the combat care of our troops overseas.”

A series of articles about anesthesia care in combat environments. Excellent not just for the information, but also the insight to their practice environments.

Nurses Week Tribute: Grace under fire

Excellent article about Military Nurses in Iraq: NursingCenter.

WE SEND OUR American patients home?sometimes on their feet, sometimes in wheelchairs or on crutches or stretchers. Some of our patients are badly disfigured, and some have horrendous scars that can’t be seen. Others we send home in black body bags, after we lovingly wrap their bodies in woolen Army blankets.  But send them home we do. We’re nurses of the 31st Combat Support Hospital in Baghdad, Iraq, and soldiers pass through our hands by the hundreds.

Besides American soldiers and marines, we care for coalition troops, Iraqi and foreign dignitaries, and ordinary civilians, including children and babies. We also take care of Iraqi soldiers, whether friend or foe. They all need our caring and our compassion, so we push ourselves to do more than we’d ever have thought possible.

Being a caregiver in a combat zone takes a special set of skills, and a lot of compassion.  Thanks to all of you, from me.

Hat tip to reader Janelle for the link.

Setting the Record Straight: Kathleen Whitney and CNN

I am acquainted with an excellent ER nurse, who was recently made mildly famous in a CNN profile for being recalled to active duty.  However, while she knew she was being interviewed for an article about the difficulties of family separation, she expressed to me that the article was edited in a way that made her sound less than committed  (‘sandbagged by the editor’ is how it was put to me), and wants to set the record straight.

I asked her to write whatever she wished regarding the CNN piece, and here’s what she has to say:

My name is Kathleen Whitney and I am an emergency room nurse and a 1st Lieutenant in the Army reserve.  A few weeks ago I was featured in a story on CNN.com.  Let me start out by saying that the author of that article was my aunt, and I don’t believe she would ever intentionally misrepresent me.  However by the time the story got through the editors there was a definite liberal slant to it.

It is true that my plan when I became an officer was to remain in an army reserve unit until I became pregnant and then transfer to the IRR – (Inactive ready reserve) until my children were old enough to understand if I had to be deployed.  So when I got the letter calling me out of the IRR it was quite a shock and I was a little angry.  However what the article does not go on to say is that after much worrying and soul searching I came to this conclusion.  It’s a war.  It wasn’t meant to be easy on anyone.  Many, countless people have already sacrificed more than I have even begun to.  So right now my family and I just focus on ways to make things easier on my little boy, Matthew, if I do have to deploy somewhere.  I feel no animosity towards the military or President Bush for recalling me and others out of the IRR. The needs of the country have to come first.  And part of being a good parent, I think, means helping to make the world a better place for our children.  I remember Sept. 11.  I hope Matthew never lives to  see another day like that – where Americans are attacked on our own soil. 
 
One other thing that they neglected to mention in the article which I talked about in my interview was the guilt I already feel for not having been deployed.  When I was eight months pregnant my unit deployed to Baghdad, Iraq.  Of course there was no way I could have gone with them at eight months pregnant.  So I kept in touch with them as best I could via e-mail and care packages.  It never slipped my mind that while I was sitting in my air conditioned house rocking my new baby, my unit- the people I trained with, some of my best friends- were baking in the hot desert, enduring untold hardships.  It is hard to describe the feeling I had then, and still have now.  If I don’t deploy I am abandoning my country and my unit.  If I do deploy I am abandoning my family.  I am truly torn.  In the end if I am called to go, I will go and be happy to serve.  But I can not volunteer.  Because me volunteering would also mean volunteering my mother to take care of my child full time.  It would also mean volunteering my child to do without one of his parents for a year a more. 
   
I hope that this rebuttal or addendum to the CNN article will clear up any questions of my loyalty that may have been brought up.  Only time can tell what will happen from here.

emphasis mine

Good to hear from the source, we never questioned your patriotism.  And, thank you for your service to our country.

Welcome Home Mercy!

CNN.com – Hospital ship back from tsunami region – Jun 9, 2005.

SAN DIEGO, California (AP) — The hospital ship USNS Mercy returned home from Indonesia after treating thousands who survived the tsunami in December and thousands more who survived an earthquake in March.

The floating medical center and 270 crew members docked Wednesday at Naval Station San Diego to the cheers of families waving signs and balloons. The ship left port on Jan. 5.

"If you haven’t cried on this mission, you haven’t been on this mission," said Capt. Mark Llewellyn, repeating what he told his staff several times during the mission.

Arriving in Banda Aceh, Indonesia, in February, the Mercy’s advanced treatment facilities filled a desperate need. The tsunami, caused by a December 26 earthquake, killed more than 176,000 people in 11 countries and left about 50,000 missing and hundreds of thousands homeless.

The first 10 days of the mission, the Mercy’s first deployment since the Persian Gulf War more than a decade ago, saw nonstop orthopedic surgeries on injuries that had gone untreated for 11/2 months. By March, the military and civilian medical staff had treated 9,500 survivors.

"We saw a resiliency in those people that was hard to imagine," said Llewellyn, who ran the ship’s 1,000-bed hospital.


Bravo Zulu
to the USNS Mercy!

Military Censorship Closes Medical Blog

Mudville Gazette

A Bucks County military doctor serving in Iraq says he was forced to shut down his Internet war diary last week after Army officials decided his gripping accounts of frontline medicine constituted a breach of Army regulations.
Maj. Michael Cohen, a doctor with the 67th Combat Support Hospital unit, had chronicled the bloody aftermath of the Dec. 21 mess-hall bombing in Mosul that killed 22. That account and 12 months of other postings on his Web log, www.67cshdocs.com, were replaced with a short notice:

“Levels above me have ordered, yes ORDERED, me to shut down this Web site. They cite that the information contained in these pages violates several Army Regulations,” Cohen wrote, adding that he disagreed with the ban…

This is the kind of crap that drove me out of the service. Some pinhead gets a bug in their ass, and we’re all expected to squirm.

I hope he keeps some sort of journal and publishes it when he’s out of the service (this should help the military doc reserve retention, eh?). Dumbasses. Quote me.

HM1 Gallardo, (IDC), USN

Devil DOc in IraqLast April, during the Iraqi invasion, I was watching MSNBC and saw one of my former corpsmen on TV. He made me proud of him and those like him, and I blogged about him at the time.

Last night, he found me through that entry here! My then HM3 Joe Gallardo is now HM1 Gallardo, and is an Independent Duty Corpsman (think PA school focused on the active duty person). He sent me the picture that accompanies this post, and that’s him in Iraq.

He also bragged on his family, three good looking kids, one on the way, and a spouse strong enough to raise a family and support a Navy man. I hope to hear more about him in the future, as his is as bright as I can imagine.

I said it then, and I’ll keep saying it: I’m glad he, and others like him are out there for us.

Letter from a Navy Doc

BLACKFIVE: Iraq – The Things That Were Good And The Things That Were Not Good

I cannot abstract just a little for you, you’re just going to have to go and read it yourselves.

via Blackfive

NAS Lemoore SAR search

I got this today, and in the spirit of public affairs, here it is:

Hello

Saw your posting on a website and would like to inquire if you have any info on lemoore sar. I am currently the senior medic at lemoore sar and we are being decommisioned. We are looking for any info of people who knew lemoore sar or worked with them. Any help you can provide would be much appreciated.

HM2 Stephen Taylor
Lemoore SAR
stephen.taylor@navy.mil

There you are. I’m not going to turn this into a “lost my buddy” board, but as this is the first of these I’ve gotten, I felt it was interesting.

Marine Corps Moms

Marine Corps Moms is a website that I’m going to be reading frequently, and I’d encourage the three of you to have a look!

Added to the sidebar under miscellaneous excellence.

Basra Beach

selling real-estate the hard way

Minds for medicine, hearts for real estate. Another in a series from my friend, returned from FH3.