The bond between Marines and their docs is unique in this world. “Docs” in this context can mean physicians or corpsmen; but the shared honor, courage and commitment between hospital corpsman and Marine epitomizes this bond. Just read Flags of Our Fathers and you will get an inkling of what I mean. Or consider this true story:
Two Latino-Americans grew up in the Texas Hill Country, not far from each other. Both entered military service soon after high school. Staff Sergeant Ramirez, USMC, and Hospitalman (HN) Alvarez, USN (not their real names) became  friends when both were assigned to a Marine Corps Logistics unit just prior to Operation Iraqi Freedom (OIF). Staff Sergeant Ramirez was a regular Marine. HN Alvarez was a Navy hospital corpsman assigned as medical support to that Marine unit.

Navy Medicine provides health care to the Marine Corps, which owns no intrinsic medical assets. Navy doctors, dentists, nurses, medical service corps officers, and hospital corpsmen assigned to the Marines wear Marine Corps uniforms, drill and exercise with their Marines, adhere to the same physical standards — fully integrating into the units they support. The most revered relationship is that of a hospital corpsman to his Marines. Every Marine depends on his doc to save his life or limb.

Which one is the Doc?

In the early days of OIF the two friends traversed southern Iraq, miles behind the initial assault. The unit had stopped for rest and chow. Diving into his MRE, Staff Sergeant Ramirez strolled around the vehicle. A sudden, deafening explosion rocked the area, followed by a primal scream. The young Marine had stepped on a concealed Iraqi land mine. He lay in agony on the sand, blood gushing from the remnant stump of a leg blown away.

“CORPSMAN UP!” Hospitalman Alvarez, as any corpsman would do, rushed to the aid of his fallen comrade, disregarding his own personal safety. As he knelt beside the victim, another explosion scrambled the scene, this time the primal scream coming from HN Alvarez. His knee had detonated another concealed mine, whereupon he became not the rescuer, but the second casualty to lose a leg.

Thanks to the most sophisticated and capable field trauma care in military history, The two friends were medevaced to a nearby emergency resuscitative surgery site. They underwent immediate life-saving operations to control bleeding from their traumatic amputations. Then they were air-lifted out of Iraq to the Landstuhl Regional Medical Center in Germany, where they received secondary definitive surgery. Within three days of the initial explosions, the two comrades in arms arrived at the National Naval Medical Center (NNMC) in Bethesda, MD. They were two of the first four OIF casualties received there.

Even though ensconced in a hospital room thousands of miles from the war, both were still in combat — emotional and physiological. The support they gave to each other in those first few days aided them in that battle — Marine and doc bonded in blood and honor. Both survived their initial wounds, and ultimately wore state-of-the art-prostheses. If you passed either of them on the street six months after their injuries, you would not recognize him as an amputee.

Once he recovered from his injuries, newly promoted Hospital Corpsman Third Class (HM3) Alvarez elected to stay in the Navy and requested orders to NNMC Bethesda. He wanted to continue caring for wounded Marines.

The year after his knee hit that land mine, he and his spouse (also a corpsman) were honorees at the annual Hospital Corpsmen Ball, ill at ease sitting at a head table with a Navy Medical Corps Captain and his equally uncomfortable spouse.

The HM3 didn’t feel particularly worthy of all the honor and attention. He never considered himself a hero. He was just the doc taking care of a wounded Marine.

Similar scenes occurred thousands of times since OIF began in early 2003, and will recur as long as any conflict involves Marines going into harm’s way. Their doc will always be with them, ready to do whatever it takes to care for that Marine.

Without doubt, one of life’s higher callings.

Semper Fi, Marines

Patrick Winslow — Boy Adrift?

I traveled to visit family last week, so missed my usual post. Now I’m rolling back in, as a tactical aviator might say.

For this week I vector away from aviation topics, to begin the first of several intermittent explorations into the main characters in RIVEN DAWN. None represent real people; it is a work of fiction after all. But each was crafted around personality traits common to many human conditions, not just military service. Each character has his or her own positive traits and negative flaws. That’s literature — and life, right?

The fictional Patrick Winslow is the disaffected son of Kate Mahoney and Dean Winslow. His parents’ marriage ended violently when Patrick was a toddler. For her own reasons — which we will explore in a future post — his mother cut his father off from any further communications with their son. Patrick grew up as the only child of a single mom married to her military career; and he spent many of his formative years in the care of Kate’s sister, while Kate deployed to locations around the world.

We first meet Patrick through Kate’s inadequate attempts to maintain a long-distance relationship with him across 6,000 miles and fourteen time zones while she deploys at sea in the fleet flagship. She relies on Facebook chats, e-mails, and an occasional Skype conversation to bridge that time/distance gap — lacking insight into the emotional chasm that runs far deeper. Disenchanted, Patrick finds meaning to his life in on-line video gaming, and through an attachment to a gaming friend/predator whom he knows only by his screen name, Fuchou.

As the story progresses, the mysterious Fuchou holds more sway over Patrick than his mother does — to the point where Patrick acts out in a self-destructive way under the direct influence of his Internet mentor. The outcome forces Patrick and his mother into a tense struggle in coming to terms with their own interpersonal conflicts.

Patrick’s character is largely based on a book that I read a few years ago, and reviewed on Goodreads: BOYS ADRIFT, by Leonard Sax, M.D.

Boys Adrift by Leonard Sax

The author describes a pattern of listlessness and dependency among boys and young men, a cadre of “man-boys,” twenty-something young men who live with their parents, work (if at all) in non-challenging jobs such as fast food, and seem perfectly content with their unambitious conditions. Sax attributes five causal factors: 1) Boy-unfriendly changes in schools and teaching methods, such as forcing early reading and writing at a time when boys are less developed than girls — resulting in females advancing at a faster rate. 2) Video games, a more controllable alternate reality than the academic or competitive marketplace where boys feel inadequate. (Sax also describes a correlation between video gaming and addiction to pornography, a trait that Patrick Winslow shares.) 3) Overuse of ADHD medications. 4) Environmental toxins that adversely affect immature male endocrine systems. 5) Decline of strong male role models and nurturing male communities. 

As with any sociological or psychological treatise, Sax’s theories are subject to debate. But for purposes of our story, Patrick Winslow is indeed a boy adrift, suffering not only from the generic factors that Sax describes, but also from his parents’ immature and dysfunctional relationship when they were young adults. Patrick’s own coming of age and resolution of his parental conflicts comprise a compelling sub-plot in RIVEN DAWN and its pending sequel.

A Most Dangerous Place

Imagine taking a stroll on a busy urban freeway during rush hour, wearing nothing more than a soft padded vest and flimsy helmet — and it’s your job to see and avoid all the traffic.

A more dangerous environment challenges the sailors who work the flight deck of an aircraft carrier for launch and recovery of jets. During high tempo operations, these men and women put in long hours in a tense and risky environment. The threats to their lives come from all directions, not the least of which are the jet engines spooling up all over the deck. “Head on a swivel,” they are told. Be on constant lookout, because your life could be in danger from even a split second distraction.

The event depicted in this video occurred about a year before I walked on board USS THEODORE ROOSEVELT as an air wing flight surgeon. It became a standard training video across the Navy, a chilling example of what can go wrong, and how quickly it can happen:

Man Sucked Into Jet Engine

Midway through our deployment, we suffered a more tragic flight deck mishap than the A-6 event. The A-6 sailor survived. Ours did not.

During day operations in the Red Sea, a sailor walked along the deck edge behind an F-14 Tomcat just as it spooled up its engines to taxi to the launch area. The jet blast blew the sailor off the flight deck for a 60-foot free-fall to the water’s surface.

“Man Overboard, Man Overboard,” sounded immediately over the carrier’s 1MC system. The medical teams mustered in the flight deck battle dressing station and in the main medical department, ready to do the trauma resuscitation for which all had trained. It was not going to happen.

The rescue helicopter located the sailor floating atop the water. A rescue swimmer dropped into the water, to hoist the unmoving body up to the helo. The swimmer could not tell if the victim was dead or just unconscious. Something went wrong in the process, so the crewman in the helo grabbed the sailor’s float coat by the back to pull him into the aircraft. The victim’s arms lifted up, and his body slid right out of the float coat and back into the sea, where it immediately sank. The aircrewman was left with the empty float coat in his hand.

The body was never recovered. We believed the sailor died on first impact with the water. Nevertheless–

On the brighter side — if there is such a side to accidental death —  this mishap resulted in a redesign of the standard float coat, which now includes groin straps to prevent a body from slipping out. Too late for our sailor, but quite possibly has saved other lives.

Not all who go into harm’s way risk death from bullets, IEDs, or missiles. Data shows that in all conflicts we lose more warriors from accidental injury than enemy action. Those victims are just as much our American heroes, losing life without warning or apparent reason. God bless them all.

Not With Guns Alone

Melodic interlude at the end, but first…

The primary mission of the forward deployed naval force — indeed any forward deployed force — is to win the peace in world places where potential troublemakers might prey on weaker neighbors.

We picture power projection as military hardware: ships, airplanes, missiles, guns; and as warriors — men and women prepared to fight for peace; and those who support them, such as doctors, lawyers, logisticians and chaplains.

While military might can deter aggression, that power alone will never win a lasting peace. Enduring peace and security are brokered by the men and women who win hearts and minds, one encounter at a time, over the long haul. Humanitarian missions such as Pacific Partnership earn media recognition for extending the hands of peace to people at risk of adopting terrorism or succumbing to totalitarian despots.

Less often hyped, but just as effective, are the professional musicians and singers who perform in fleet bands around the world. Sailors first, these dedicated artists also bring unique and varied musical talents to the cause of international peace. Music doth have charm, not only to soothe the most savage of beasts but also to touch the hearts and souls of diverse peoples. Music also motivates, and boosts the morale of entire armies and navies.

The Seventh Fleet Band plays a singular role in promoting international peace through music. These unsung American heroes work long and hard to perfect their art. They travel far and wide across the Western Pacific, sometimes under harsh conditions at short notice. Often they ride the flagship, not only to play their parts in its unique ambassadorial mission, but also to inspire the crew and staff on board.

Their repertoire extends well beyond martial music. Many Americans would gladly pay good money to hear these talented professionals perform. If I found myself overwhelmed or discouraged in my duties on the flagship, a chance to hear the band always buoyed me up.

As we move beyond another anniversary of the tragedy of 9/11, and we suffer the current world upheaval over despicable “art,” I invite you to take a moment, sit back, relax, and enjoy the special talents of the 7th Fleet Band in the following clips:

Navy Friendship Day

Navy Friendship Day 2

7th Fleet Band with Yokosuka Symphony

Band in Fukuoka

Band in Cambodia

Check out their website as well.

Holes in the Cheese

Why would an airplane manned by five professional aviators (two pilots, three flight officers) fly directly into the water from 250 feet above the surface? That question vexed the aviation mishap investigation board (MIB), of which I was the flight surgeon member, for the two weeks following the E-2C Hawkeye mishap that I described in a prior post (

The E-2 executed a normal foul deck wave-off procedure from the aircraft carrier at night in marginal weather. As it climbed to 1/4 mile ahead of the ship, the Hawkeye nosed over and impacted the water at high speed. No one on board survived, nor were their bodies recovered.

A Navy aviation mishap board consists of five members. The board conducts a meticulous investigation of all factors that may have contributed to the mishap. The MIB does not assign blame, nor does it single out any individuals for disciplinary action. Its deliberations are held confidential, the sole raison d’etre being to identify correctable causal factors in hopes of preventing similar mishaps in the future.

One member of the board must be a designated naval flight surgeon. By virtue of our training in aviation medicine, and our direct familiarity with the aviation environment, we flight surgeons bring the tools and skill to identify human factors that may have been involved in the event. The board also looks for mechanical or structural issues with the airframe, training of air and ground crews, operational issues such as crew rest and readiness, and other factors.

Seldom does a single factor emerge as the sole cause. Most aviation mishaps — indeed most “accidents” in life — occur at the end of a chain of events, any one of which, if avoided, could have altered the outcome. A common analogy is that of Swiss cheese. If all the holes ever line up just right, the mouse can run straight through the cheese.

Our job on the MIB was to find the links in the chain, or holes in the cheese, that led to the tragic outcome. The evidence at hand consisted of the videotape that recorded the approach, waveoff, and descent of the aircraft (All carrier launches and landings are videotaped); assorted fragments of the aircraft, including a large chunk of the radome and several hundred other pieces no larger than a meter square; the crew’s service, aviation, training, and medical records; the aircraft’s maintenance records; and various other squadron documents. All that, and our collective expertise.

We found no suspect mechanical, operational, or training issues. The largest hole in the cheese came down to a human factor: spatial disorientation in an environment devoid of visual references. Several types of spatial disorientation exist, most of which involve either the visual or vestibular systems (eyes and inner ears). The specific condition that we believed initiated the mishap was the head-up somatogravic illusion:

Bodies in motion tend to head up or down with acceleration or deceleration. Think what happens if you put pedal to the metal in your automobile (We’ve all tried it at least once, right?). The front end lifts up. Conversely, tromp on the brakes, and the front end noses down. In the flight environment, the inner ear’s vestibular system acts like an accelerometer and interprets that sudden forward acceleration as an excessive head up motion, and sudden deceleration as an abrupt head down movement.

After four hours of flying oval patterns in a virtual milk bowl, the E-2 broke out of the overcast and made a normal descent to landing on the carrier’s deck. Just as it came over the ramp it was waved off for another aircraft still in the landing area. Per procedure, the pilot immediately applied full power and started a climb back toward the black night and the cloudy goo. We reasoned that the acceleration into total darkness caused the pilot to believe the nose of the aircraft was rising too fast, risking a stall. He pushed the yoke forward to compensate, and flew the airplane into the water.

“Yeah, DoK, but…”

Indeed, the explanation generated more questions than answers. There had to be more holes in that cheese. What were the other four crewmembers doing? The co-pilot could have grabbed the controls. The flight officers in the back could have raised an alarm. Why would they all sit there, unless they were distracted by something else? What?

And why would a seasoned aviator succumb to an illusion for which he’d been trained and experienced? Perhaps fatigue? We questioned the leadership judgment of conducting night flight operations in bad weather at the end of a long day following a difficult trans-Atlantic passage. Was the mission flown worth the lives of five men?

We could not prove our theory. The only ones who could say what happened in the aircraft that night did not survive to tell their stories. At the very least, we felt we succeeded in finding most of the holes in the cheese, and raised awareness of these human factors for future training — to possibly avert similar events in the future.

For the five men who died that night, it was perhaps a legacy.

Author, Arriving

I’ve left the blog dormant, I know. I’ve been otherwise engaged in retiring from the Navy, moving back home to Norfolk, VA, and publishing my debut novel — Thanks to the wonderful folks at Purple Papaya. 

Available at Amazon Kindle and Barnes and Noble Nook. Also on iTunes, and soon on Kobo.
A senior naval aviator/single mother at the pinnacle of her career deploys in a Navy flagship as director of operations for the U.S. 7th Fleet, where she confronts a cross-fire of military and personal challenges. A conniving superior seeks to discredit her, while an enigmatic yet alluring colleague cycles between nemesis and confidante.

As she struggles to defuse escalating military tension in the western Pacific, her rebellious teenage son — beguiled by a mysterious Internet predator — acts out and forces her to re-evaluate life choices and to face down personal demons from her past. As her self-assurance crumbles, she confronts and overcomes her own history of an abusive childhood and toxic marriage. When the unexpected specter of her destroyed marriage threatens to take her son, she brings to bear her aviator instincts and combat-honed courage in a desperate battle far more dangerous than a shooting war.

Note: Adult content.

Kudos and thanks to the outstanding professionals at Purple Papaya and their affiliate,


“Plane in the water, port side. Man the starboard lifeboats.”
The 1MC announcement shattered the silence of the night. I bolted upright in my rack and looked at my watch. Just after 2 a.m., our first night in the Adriatic Sea. I threw on my flight suit and rushed to the combat information center. Most of the air wing staff was already there.

“What happened?” I asked.

“E-2 went down after a wave-off.” 
One event that changed the lives of many, some for just a week or two, some for the entire six-month deployment, and an unfortunate few for the rest of their lives.

We had completed a rough eleven-day Atlantic crossing wherein even our mighty aircraft carrier was tossed about like a child’s bathtub toy. At one point, waves crashed over the flight deck, 60 feet above the water’s surface. When we finally arrived in the more peaceful waters of the Mediterranean, a visiting admiral told us that our first port visit would be cancelled so that we could take up immediate station in the Adriatic. (Cancelled port visits would become the norm for this deployment.) Our mission: To fly combat air patrol over Bosnia in support of NATO’s Operation Deny Flight.

Earlier in the day two aircraft carriers sailing alongside each other inspired images of the U.S. Navy’s massive power projection capability. We spent the day turning over the watch with JFK. By dusk she had turned west toward home, while our crew and air wing cycled into flight ops. As the air wing flight surgeon, I expressed my concerns about our pilots conducting night operations in marginal weather after the long transit and a full day of turnover. We had no choice, I was told. Our Air Force counterparts would not fly that night because their crews had not yet familiarized themselves with the 11,000 foot runway at their base in Italy.

But it’s okay for our guys to make night landings on the bobbing deck of a carrier. Go Navy.
So our planes launched into the goo of a low overcast wherein they flew mostly on instruments. The only visual reference they would sight would be the carrier itself when they returned to Mother at the end of their flights. One pilot described the experience as flying around in a bowl of milk, then suddenly flying out of the impenetrable whiteness into a sea of black — without a visible horizon between the dark sea and the night sky.

In that environment, the lights of the distant carrier as the only visual reference made the perfect setup for visual disorientation. One experienced F-14 pilot had to wave-off his approach because he became so disoriented he felt like he was doing barrel rolls around the ship.

The E-2 Hawkeye descended through the overcast after 4 hours of flying racetrack patterns in the muck conducting radar surveillance and traffic control — two pilots in front and three naval flight officers in the back. The pilots made a normal approach behind an A-6 that trapped on the carrier ahead of them. But something delayed the A-6 getting out of the landing zone, making it unsafe for the E-2 to land.

Just as the Hawkeye came over the ramp, the landing signal officer (LSO) made the call. “Wave-off, foul deck.”

As they had practiced so many times, the pilots immediately added full power, arresting the descent and bringing the aircraft into a climb away from the deck. Per standard procedure, they flew straight ahead to gain altitude before they would circle around for another approach. But then — with no warning or communication from the aircrew — a quarter of a mile ahead of the ship and 250 feet above the water, the E-2 nosed over and flew directly into the sea.

The recovery effort persisted through the night and most of the next day, but netted only chunks of aircraft — the largest being a portion of the radome. The water in that area is very deep. The five men on board never surfaced.

For the next two weeks, as a member of the mishap investigation board, my only assigned duty would be to try to figure out what happened.

No Kidding Panic in a Drum – Part I

Older readers may recall a panic scene from An Officer and a Gentleman, the 1982 drama featuring Richard Gere as an aspiring naval aviator suffering through preflight indoctrination. Along with Top Gun, this film became a positive recruiting tool for Naval Air. (What red-blooded American male wouldn’t want to end up with Kelly McGillis or Debra Winger at the end of the story?)

The film does a credible job of depicting the challenge and stress of Aviation Preflight Indoctrination (API). API includes a series of didactic and physical tests to achieve two primary purposes: 1) Weed out the weak and marginally motivated before the Navy invests millions of taxpayer dollars training them as naval aviators, 2) Build confidence in the strong, preparing them to withstand the risks and rigors of the unforgiving aviation environment.

Water survival training addressed both purposes. In the film, one young man who lacks the right stuff nearly drowns after failing to negotiate the Dilbert Dunker. The apparatus simulates egress from a jet cockpit after an unscheduled water landing, also known as a crash. The never-gonna-be-a-naval-aviator chump fails to egress, forcing a dramatic rescue/resuscitation by the drill sergeant (played by Louis Gossett, Jr.).

Student Naval Flight Surgeon Class 92002 endured API. In addition to other water survival exercises, we did the Dilbert Dunker. After the dramatic movie scene, the Dunker itself turned out anti-climactic. No big deal. Hold your breath, release your harness, swim to the surface. Pass. Confidence built.

But the movie didn’t show the REAL challenge, the Helo Dunker. Fondly known as “Panic in a Drum,” that torture device simulates a helicopter crash into water. The You Tube clips below show a modern version of the Helo Dunker. Ours was more primitive, and really did resemble a super-sized tin can with 8 seats inside.

Because of all the engine weight on top, helicopters roll inverted after hitting water. The occupants must remain strapped in their seats and hold their breath as the aircraft, or tin drum, rolls upside down and sinks. Of vital importance is holding onto a reference point (window, seat, etc.) as water rushes in from all sides.

Once “all violent motion stops,” you then release your harness and egress the aircraft/tin can. Easy, eh?

In 1992 we had to pass four rides in the helo dunker: Nearest exit/window, then main exit; first times with eyes open, second times blindfolded to simulate night operations.

The final, blinded, main exit ride resulted in me replaying the Louis Gossett, Jr. rescue — for three takes.

Book Review: “Boys Adrift”

Boys Adrift: Five Factors Driving the Growing Epidemic of Unmotivated Boys and Underachieving Young MenBoys Adrift: Five Factors Driving the Growing Epidemic of Unmotivated Boys and Underachieving Young Men by Leonard Sax

My rating: 4 of 5 stars

A must read for anyone with a son or brother, or who is one. The author, a pediatrician and psychologist, describes a pattern of listlessness and dependency among boys and young men that he attributes to five factors: 1) boy-unfriendly changes in schools and teaching methods, 2) video games, 3) overuse of ADHD medications, 4) environmental toxins that adversely affect immature male endocrine systems, 5) decline of strong male role models and nurturing male communities. While a bit preachy and borderline histrionic at the end, the book is sufficiently evidence-based and annotated to be provocative, and frankly sad-making.

View all my reviews