BOND OF BLOOD AND HONOR

 

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

“Better to Win a Heart…

…than to pierce it.”



Which of these youths is more likely to become a suicide bomber?

Iraqi boy stares at the rubble of his former home after an American strike.

Indonesian child greets U.S. Navy helicopter flying in water and supplies after the 2004 tsunami.

Sometimes, we have to blow things up, and people get hurt — even innocent people. Then our military medical forces try to put them back together, no matter for which side they fought, or from where they came.

Medical personnel assess an Afghan man on Forward Operating Base Farah,
Afghanistan, Dec. 26, 2012. The soldiers are assigned to the 541st Forward
Surgical Team. (DOD Photo)


U.S. Navy Lt. j.g. Laura Cook performs an ultrasound on a wounded Afghan
policeman to determine the presence of internal injuries on Forward
Operating Base Farah in Afghanistan’s Farah province, Dec, 31, 2012. Cook is
a physician assistant for Provincial Reconstruction Team Farah. Medical
personnel assigned to the team, the 541st Forward Surgical Team and
coalition medics treated four members of the Afghan National Police injured
by improvised explosive devices. (DOD Photo)

In ten years of supporting combat forces in the Middle East, military medicine has achieved unprecedented success in saving lives. The reason: Bring world class medical resources and rapid evacuation as close as possible to the point of injury. The result: If you are wounded in action and arrive with a pulse at a forward surgical resuscitation site, your odds of survival are 98% unheard of in any other conflict since the world and its wars began.

What if we never had to use that world class capability to patch up victims of warfare? What if we could deploy our medical forces to win the hearts of minds of people before they become our enemies?

We’ve been doing that too, all around the globe, all military services, all operational platforms. Much of that effort has concentrated on the Western Pacific, a volatile area that our national leadership has designated as the next focus of national defense attention.

Military medicine has been there for decades, extending the hand of peace to a diverse range of people and places — most notably our response to natural disasters such as the 2004 tsunami that impacted Indonesia, and the recent triple disaster (earthquake, tsunami, nuclear power meltdown) that affected our friends in Japan.

Personnel from the Air Force HARRT (Humanitarian Assistance Rapid Response Team) unloads supplies in relief for the 2009 Indonesian earthquake disaster
Less than a day after they flew into the disaster zone, the Air Force medics were fully operational and treating victims of the disaster

Every year the U.S. Navy deploys one of it’s hospital ships on a humanitarian assistance mission, alternating between the Western Pacific and the Caribbean/South America. Staffed with medical expertise from all services, international military medical partners, and non-governmental volunteers, these missions bring world class medical care to people whose lives have not been as fortunate as ours. More important, they bring caring and friendship that endures long after the ship sails away to its next port.

USNS MERCY sails near Southeast Asia in Operation Pacific Partnership


As we begin a new year, the conflicts in the Middle East move into their second decade. Let us earnestly hope and pray that we will begin to see the end of wars, and the emergence of world peace — and, all around the globe, the faces of happy children.



 — With thanks to my good friends and colleagues: Bob Kiser, who provided some of these photos; and Doug Anderson, who coined the phrase, “Better to win a heart than to pierce it.”



Bonded in Blood

Today marks the 237th birthday of the United States Marine Corps; and tomorrow (not Monday) is Veterans Day. In honor of those two events, I’ve reworked some prior posts to reflect on the deeper meaning of these two events:
 
Two Latino-Americans grew up in the Texas Hill Country, not far from each other, and both entered military service soon after high school. Staff Sargeant Alameda, 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 Alameda 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 be prepared 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 Alameda strolled around his vehicle. A sudden, deafening explosion rocked the area, quickly 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 remant stump of a leg blown off.

“CORPSMAN UP!” Hospitalman Alvarez, as any corpsman would do, rushed to the aid of his fallen comrade, mindless of his own personal safety. As he knelt beside the victim, another explosion scrambled the scene, the primal scream coming from HN Alvarez himself. 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, both amigos 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, and that given from fellow Marines, aided them in that battle. Both survived their initial wounds, and ultimately wore stateofthe artprostheses. 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!

Tank

The President of the United States didn’t really bestow the nickname, “Tank,” on the young Marine, although that made a good story. POTUS did meet Tank at the National Naval Medical Center, and he took an immediate liking to the charming young man. But he didn’t coin the nickname. In typical Marine camaraderie, Tank’s fellow wounded combatants bestowed the moniker.

Tank arrived at NNMC Bethesda in that first wave of injured Marines. He was a victim not of enemy fire, but an equally dangerous threat called “DNBI,” for “Disease/Non-Battle Injury.” Simply defined, DNBI is death or disability that we inflict on ourselves. Looking at any conflict in our history you will find that DNBI usually exacts a larger toll on battle effectiveness than does any enemy action.*

A U.S. Abrams tank caused the non-battle injury to its namesake Marine. In the heat of sustained combat operations, Marines rest when and where they can. Tank dozed with his back warmed by the Iraqi sand. By design, his desert camoflague uniform blended right into the terrain, and the driver of the maneuvering vehicle never saw him. One track of the Abrams ran over Tank’s body at pelvic level. If laying on asphalt or concrete, he would have been killed almost instantly. But the soft sand absorbed enough crushing pressure that he sustained reparable injuries, a fractured pelvis and ruptured bowel.

He came to Bethesda with a repaired bowel, temporary colostomy, and still bedridden from the fractured pelvis…physically and emotionally still in combat. His indomitable spirit rapidly overcame the restriction to bed. No wallowing in the rack for this Marine! Before we knew it, he was up on crutches. Every day he made his own rounds on the ward where about 30 wounded Marines recovered from a variety of injuries. He exhorted them, cajoled them, encouraged them. “Oo-rah, Marine,” he would say. “Look at me. If I can do this, so can you!”

Most of those wounded Marines did survive and got on with their post-traumatic lives, in or out of the Marine Corps. But in truth, our advanced trauma care and sophisticated technology were merely adjuncts to the primary healing force on that ward: Tank and other Marines like him who simply refused to quit, refused to consider themselves disabled, and rallied each other to health.

I recall another recovering young Marine’s immediate response when asked where he wanted to go for convalescent leave upon discharge from acute care in the late spring of 2003.

“Bagdad,” he said.

Semper Fi, Marines!

*In my early flight surgery days I did a little study demonstrating how injuries sustained in hangar bay basketball games and other recreational sports negatively impacted the medical readiness of an aircraft carrier’s crew. The conclusion asked for improved safety measures, not cessation of these important recreational outlets for deployed sailors.

…Fi!

The two Latino-Americans grew up in the Texas Hill Country, not far from each other.  Roughly the same age, they both entered military service soon after high school. Staff Sargeant Alameda, USMC, and Hospitalman Alvarez, USN (not their real names) met and became good friends when both were assigned to a Marine Corps Logistics unit shortly before Operation Iraqi Freedom (OIF). Staff Sargeant Alameda was a regular Marine. Hospitalman (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. Many Navy doctors, dentists, nurses, medical service corps officers, and hospital corpsmen are assigned to the Marines over the course of a career. They wear Marine Corps uniforms, drill and exercise with their Marines, adhere to the same physical standards, and otherwise become an integral part of the units they support. Above all, the relationship of a hospital corpsman to his Marines is the most important and revered. Every Marine depends on his “Doc” for his life, and he knows that the Doc is prepared to make heroic efforts to save the life or limb of a Marine.

So there they were, in the early days of OIF traversing southern Iraq, miles behind the initial assault. The unit had stopped for rest and chow. Diving into his MRE, Staff Sargeant Alameda strolled around near his vehicle. A sudden, deafening explosion disrupted the tranquility of the place, quickly followed by a primal scream. The young Marine had stepped on a concealed Iraqi land mine. He lay in agony on the sand, bleeding profusely from the remant stump of a leg blown off.

“CORPSMAN UP!” came the immediate call. Hospitalman Alvarez, as any corpsman would do, rushed to the aid of his fallen friend and comrade, mindless of his own personal safety. As he knelt beside the victim, another explosion unexpectedly scrambled the scene. The ensuing primal scream came from HN Alvarez himself. He had knelt onto another concealed mine, whereupon he suddenly became not the rescuer, but the second casualty. And he too had lost a leg in the detonation.

Thanks to the most sophisticated and capable field trauma care in history, both amigos were rapidly medevaced to a nearby emergency resuscitative surgery site, where they underwent immediate life-saving operations to control bleeding from their traumatic amputations. They were then air lifted out of Iraq to the Landstuhl Regional Medical Center in Germany where they received their 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 they were now safely ensconced in a hospital room thousands of miles from the war, emotionally and physiologically they were both still in combat. The support they gave to each other in those first few days, and that given and received from fellow Marines, made a huge difference. 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 either one as an amputee.

Once he recovered from his injuries, newly promoted 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 were honorees at the annual Hospital Corpsmen Ball. They seemed 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 have occurred thousands of times since OIF began in early 2003, and will recur as long as this or any conflict involves Marines going into harm’s way. It’s what Hospital Corpsmen do. It’s what all of us in Navy Medicine do when called the serve the Marines.

We remain supremely honored to do so.

Semper Fi, Marines!