#1 Vacation Destination: BAGDAG !!!

[USAFdoc]

Call 1-800- 123-4567 be be one of the first to enjoy what is sure to become the #1 vacation destination in the world! Enjoy the tropical climate, wonderful scenery, and native people that are world renowned for their hospitality and love for Americans and Europeans alike. Visit the museums, Presidential Palace and Gardens and more. Feel safe under the most modern police force in the world. Take the Iraqui-Amtrak and visit friendly neighbor countries of Syria and Iran. All this and more can be yours! Round trip tickets starting at just $100.


The above is obviously ridiculous, untrue, and laughable.

Unfortunatley, the current advertisements for military medicine I see on a daily basis are just as ridiculous, untrue, and laughable.

If the military wants to tap into our patriotism, our concern to treat troops etc....ok

What the military is currently doing is more of the same; it's all about business; making money; appearances.

Integrity and doing the right thing have no place in todays military medical world (or at least thats what many of the leaders directing military medicine have shown through their actions).

Good luck to all those still living in that world, and heres to hoping people reading/watching all those milmed ads have the wisdom to see through the smoke screen of lies.

---

Members don't see this ad.

 

[MedicalCorpse]

Unfortunatley, the current advertisements for military medicine I see on a daily basis are just as ridiculous, untrue, and laughable.
...
Integrity and doing the right thing have no place in todays military medical world (or at least thats what many of the leaders directing military medicine have shown through their actions).

Good luck to all those still living in that world, and heres to hoping people reading/watching all those milmed ads have the wisdom to see through the smoke screen of lies.

Also remember, medical students reading this forum: some of the posters here are recruiters being paid to get you into a uniform by any means necessary. If they don't scrounge enough bodies, they are reprimanded; given bad OPRs/EPRs; sent to remote locations; or all of the above. The military cannot by law pay active duty/reservist recruiters extra money for performance; they only use sticks, not carrots. This is but one reason why the military is starting to outsource recruiting to civilian contractors:
http://www.washingtonpost.com/wp-dyn/content/article/2006/09/05/AR2006090501508.html

Each regular soldier sweet-talked into signing up is worth a $5,700.00 bonus to the civilian recruiters...imagine how much the military is willing to pay civilian contractors for future doctor bodies?

Because that is just what you are to the military system: a body, to be plugged in to whatever gap some computer says needs to be filled, whether that be in Bunghole, TX or Downrange Secretstan. You are not valued by the system whatsoever; your average civilian contractor janitor can expect, nay, demand more basic human dignity than you can under the UCMJ.

How Do I Recruit Thee? Let me count the ways:

1) Appeal to patriotism (flagwaving)
2) Appeal to shortsighted greed (lack of educational debt; big bucks as student NOW-- little bucks as staff for years in the future)
3) Appeal to adventure (one of our LtCol anesthesiologists claims he was promised by his recruiter that he could administer anesthesia on airplanes on a daily basis as an Air Force officer; I almost fell on the ground laughing at his naivete). Take up base jumping or paragliding if you want adventure. The military offers you tens of thousands of hours of tedium for every second of adventure...and, nowadays, the adventure may well be the short-lived bright light you see just before you die from an IED. Hint: you don't live long enough to hear the "boom", and if you do, you'll wish you didn't. Ask the brave young men and women at WRAMC's amputee rehab center...
4) Appeal to shared suffering (You think docs have it bad? Your average grunt/marine/airman suffers 1000x times as much, and they don't bitch! YEAH BUT when a soldier is undersupported [air support, artillery, ammo], he/she dies; when a doctor is undersupported, SOMEONE ELSE (the patient) dies. Big Difference Ethically. Think about it: you have to live with the guilt...which is harder than sacrificing one's own life for one's country, when the rubber hits the road).
5) Appeal to training opportunities: read the threads re: Air Force dragooning everyone into flight surgeon bag rather than residency training--> years of your life wasted treating jock itch and ignoring the symptoms of URIs in your pilots so that they think you're a good guy/gal, not a DNIF snitch. Face it, by the end of medical school, very few just want to be General Practitioners. If that's you, great, more power to you. However, most of us know we want to specialize in some area of medicine. You have zero control over that in the military medical corpse.
6) Appeal to patriotism
7) Patriotic appeal
8) Flagwaving patriotic appeal
9) Even more anti-terrorist, "Be part of the solution, not part of the problem", you-can-help-secure-our-homeland-so-this-puppy-doesn't-get-shot-by-Osama, jingoistic, blind appeals to the natural instinct of the citizen of any country at any point in history to do what people in authority tell them is the patriotic thing to do, whether that be executing counter-revolutionary "Rightists" (Mao's China), reporting Jewish neighbors to your local Gestapo office (Hitler's Germany), saving the world from godless Communist hegemony (Reagan's America, ca. 1981, when I raised my right hand), or signing up to fight the unending Global War On Non-Christian People Who Use Sharp Sticks To Hurt Us When We Bring Them Democracy (and Jesus) With the Muzzles of Our M-16s (Bush's America, ca. 2006).
10) Have I mentioned appeal to patriotism yet?

--
R
http://www.medicalcorpse.com

 

[MedicalCorpse]

.

 

[colbgw02]

okay, we get it.

 

[backrow]

Now THAT was an informative post

 

[MedicalCorpse]

Now THAT was an informative post

So was yours.

--
R
http://www.medicalcorpse.com

 

[backrow]

So was yours.

--
R
http://www.medicalcorpse.com

True

 

[8744]

Also remember, medical students reading this forum: some of the posters here are recruiters being paid to get you into a uniform by any means necessary. If they don't scrounge enough bodies, they are reprimanded; given bad OPRs/EPRs; sent to remote locations; or all of the above. The military cannot by law pay active duty/reservist recruiters extra money for performance; they only use sticks, not carrots. This is but one reason why the military is starting to outsource recruiting to civilian contractors:
http://www.washingtonpost.com/wp-dyn/content/article/2006/09/05/AR2006090501508.html

Each regular soldier sweet-talked into signing up is worth a $5,700.00 bonus to the civilian recruiters...imagine how much the military is willing to pay civilian contractors for future doctor bodies?

Because that is just what you are to the military system: a body, to be plugged in to whatever gap some computer says needs to be filled, whether that be in Bunghole, TX or Downrange Secretstan. You are not valued by the system whatsoever; your average civilian contractor janitor can expect, nay, demand more basic human dignity than you can under the UCMJ.

How Do I Recruit Thee? Let me count the ways:

1) Appeal to patriotism (flagwaving)
2) Appeal to shortsighted greed (lack of educational debt; big bucks as student NOW-- little bucks as staff for years in the future)
3) Appeal to adventure (one of our LtCol anesthesiologists claims he was promised by his recruiter that he could administer anesthesia on airplanes on a daily basis as an Air Force officer; I almost fell on the ground laughing at his naivete). Take up base jumping or paragliding if you want adventure. The military offers you tens of thousands of hours of tedium for every second of adventure...and, nowadays, the adventure may well be the short-lived bright light you see just before you die from an IED. Hint: you don't live long enough to hear the "boom", and if you do, you'll wish you didn't. Ask the brave young men and women at WRAMC's amputee rehab center...
4) Appeal to shared suffering (You think docs have it bad? Your average grunt/marine/airman suffers 1000x times as much, and they don't bitch! YEAH BUT when a soldier is undersupported [air support, artillery, ammo], he/she dies; when a doctor is undersupported, SOMEONE ELSE (the patient) dies. Big Difference Ethically. Think about it: you have to live with the guilt...which is harder than sacrificing one's own life for one's country, when the rubber hits the road).
5) Appeal to training opportunities: read the threads re: Air Force dragooning everyone into flight surgeon bag rather than residency training--> years of your life wasted treating jock itch and ignoring the symptoms of URIs in your pilots so that they think you're a good guy/gal, not a DNIF snitch. Face it, by the end of medical school, very few just want to be General Practitioners. If that's you, great, more power to you. However, most of us know we want to specialize in some area of medicine. You have zero control over that in the military medical corpse.
6) Appeal to patriotism
7) Patriotic appeal
8) Flagwaving patriotic appeal
9) Even more anti-terrorist, "Be part of the solution, not part of the problem", you-can-help-secure-our-homeland-so-this-puppy-doesn't-get-shot-by-Osama, jingoistic, blind appeals to the natural instinct of the citizen of any country at any point in history to do what people in authority tell them is the patriotic thing to do, whether that be executing counter-revolutionary "Rightists" (Mao's China), reporting Jewish neighbors to your local Gestapo office (Hitler's Germany), saving the world from godless Communist hegemony (Reagan's America, ca. 1981, when I raised my right hand), or signing up to fight the unending Global War On Non-Christian People Who Use Sharp Sticks To Hurt Us When We Bring Them Democracy (and Jesus) With the Muzzles of Our M-16s (Bush's America, ca. 2006).
10) Have I mentioned appeal to patriotism yet?

--
R
http://www.medicalcorpse.com

Bull****. I know a little about the Marines and while nobody could ever accuse the Corps of holding yer' stinking hand and agonizing over your self-esteem, you are not just a "body." Every Marine starts as a small unit leader and the respect you learn for your men does not diminish just because you end up as the Regimental Combat Team Commander or the Commandant. It is true that Marine leaders have to make difficult decisions that put their Marines in potentially lethal situations but to imply that these decisions are undertaken lightly, even frivolously, is nothing short of slander. The fact that you may not want to do what you are ordered is a personal problem and a lack of self-discipline on your part.

And if you can't distinguish legitimate patriotism from "jingoism" and propaganda...well...you probably had a problem with this before you went into the military.

 

[USAFdoc]

Every Marine starts as a small unit leader and the respect you learn for your men does not diminish just because you end up as the Regimental Combat Team Commander or the Commandant. It is true that Marine leaders have to make difficult decisions that put their Marines in potentially lethal situations but to imply that these decisions are undertaken lightly, even frivolously, is nothing short of slander. .

You make a great point and your example points out perhaps one of the biggest problems in military MEDICINE.

You mentioned how the MARINES have a "leadership progression" in which you work your way through the ranks to end up leading men now doing the job you used to do.

That is a great way to build leaders and have them be trained and credible to make decisions, even the tough ones.

Now consider military medicine. Our leaders usually have the background of having NEVER done our (physicians) job. Most of my "supervisors" were decent people, but they had no clue (and why should they, they never did my job) on how to run a primary care clinic, let alone how to run one safely with 15% manning. They had no idea what would make our clinic run smoother, more safely etc.

At the same time, they have MAJCOM breathing down their neck demanding the "METRICS" to look better. So what do you think became the priority of a non-physician leader, planning on a career in USAF admin..........................the metrics became the priority !

Again, if I not true, I would think much of military medicine as some bad joke.

 

[MedicalCorpse]

Bull****. I know a little about the Marines and while nobody could ever accuse the Corps of holding yer' stinking hand and agonizing over your self-esteem, you are not just a "body." Every Marine starts as a small unit leader and the respect you learn for your men does not diminish just because you end up as the Regimental Combat Team Commander or the Commandant.

Name me one Marine Corps physician, just one, and I will retract my entire post.

Tick tock tick tock.

Your response is nonsequitur.

Next.

--
R
http://www.medicalcorpse.com

 

[MedicalCorpse]

The fact that you may not want to do what you are ordered is a personal problem and a lack of self-discipline on your part.

When you have been a physician for 15 years in the military, and have seen your own orders countermanded by nurses, to the detriment of patients, then you will understand. If a Colonel ordered you to kill your patient with a lethal injection because your unit was evacuating, would you comply? If not, why not? If a Colonel ordered you to provide anesthesia to a patient directly while simultaneously overseeing three nurse anesthetists, in direct violation of published standards of the ethical practice of anesthesiology, how would you respond? Yours is not to reason why, huh?

If you think that taking orders blindly is the hallmark of an officer, there is an opening for you in your local S.S. Totenkopf regiment. All you need is to fire up your time machine, and you can return to an era before My Lai, when the concept of "illegal order" was unknown. Arbeit Macht Frei.

This tweenage concept that military leadership at all levels (officer, NCO, small unit leader) means doing what you are told vs. doing what is right is the key to the conundrum of Abu Ghraib, Haditha, Treblinka, and future crimes against humanity, which the current crop of military members will commit if they do not learn the REAL meaning of officership AND the lessons of the past.

Do not even get me started on this topic.

--
R
German/Welsh/Italian American fluent in German,
both of whose grandfathers fought for America during
WWII, so don't even start with me regarding my references
to the NSDAP.
http://www.medicalcorpse.com

 

[former military]

Panda Bear,
I visited your blog. I found out you are an intern from Duke FP who moved to be an R2 resident for an EM civilian slot? Former Marine Infantry? You will learn the difference between a civilian doctor, regular military, and military doctor are 3 different worlds... and ours is one you have not, but will eventually appreciated.
Judging from the rant about the FP Duke residency you will really enjoy military medicine. I had the benefit of training in the military so when things fell on me I wasn't suprised. But you, you will be trained by civilians so when you go active duty and the military wants to undo your concept of the doctor patient relationship it may hit you harder. Good luck.

 

[8744]

When you have been a physician for 15 years in the military, and have seen your own orders countermanded by nurses, to the detriment of patients, then you will understand. If a Colonel ordered you to kill your patient with a lethal injection because your unit was evacuating, would you comply? If not, why not? If a Colonel ordered you to provide anesthesia to a patient directly while simultaneously overseeing three nurse anesthetists, in direct violation of published standards of the ethical practice of anesthesiology, how would you respond? Yours is not to reason why, huh?

If you think that taking orders blindly is the hallmark of an officer, there is an opening for you in your local S.S. Totenkopf regiment. All you need is to fire up your time machine, and you can return to an era before My Lai, when the concept of "illegal order" was unknown. Arbeit Macht Frei.

This tweenage concept that military leadership at all levels (officer, NCO, small unit leader) means doing what you are told vs. doing what is right is the key to the conundrum of Abu Ghraib, Haditha, Treblinka, and future crimes against humanity, which the current crop of military members will commit if they do not learn the REAL meaning of officership AND the lessons of the past.

Do not even get me started on this topic.

--
R
German/Welsh/Italian American fluent in German,
both of whose grandfathers fought for America during
WWII, so don't even start with me regarding my references
to the NSDAP.
http://www.medicalcorpse.com

Boo friggin' hoo. I don't doubt that military medicine is screwed up. On the other hand I've heard plenty of "I was too tough for the Corps" stories. If you don't like it, then do your tour and get out.

I guess expecting military doctors to act military is a little much which is probably the root of the problem, namely that the type-A prima donnas who are over-represented in medical school have egos too large for self-discipline.

 

[8744]

Name me one Marine Corps physician, just one, and I will retract my entire post.

Tick tock tick tock.

Your response is nonsequitur.

Next.

--
R
http://www.medicalcorpse.com

We have Navy corpsmen and doctors and our corpsmen are some of the most fearless guys you will ever meet. I didn't hang with the doctors when I was a Marine but they all looked pretty squared away to me. When you are with a good unit, esprit de corps is infectious.

 

[7by11thenout]

Boo friggin' hoo. I don't doubt that military medicine is screwed up. On the other hand I've heard plenty of "I was too tough for the Corps" stories. If you don't like it, then do your tour and get out.

I guess expecting military doctors to act military is a little much which is probably the root of the problem, namely that the type-A prima donnas who are over-represented in medical school have egos too large for self-discipline.

your above post shows your ignorance of the problems that exist.

1. all physician have discipline - you can not get into or through Med school and residency without it.

2. If I got one tenth the respect as an O4 in medicine that my O4 counterparts get in the line then I would be able to deliver decent medical care. The problem is the Physicians do not run the hospital and no one works for the physicians so you get problems like this:

- 6 months ago while trying to get 3 OR rooms started on time I asked the E3 sitting down discussing weekend plans with the other E3 to get the 90 y/o patients records for me - he replied "that is not my job"

Well I lit him up, but Lets just understand if I had a dollar for everything that isn't my job that I do then I would be rich. This includes taking out the trash since our janitors only have to empty the trash can in our office shared by 3 majors and a captain once a week... (this is an improvement because at my last base I shared an office with 3 LT cols...)

Today my peditrician friend called me at home from work at 1830hrs becasue she was still at work entering her patients vital signs in the computer because the Technicians in her clinic refuse to do their job, and since she does not write their EPR's she has no way to make them. If you do something like I did two PCS's ago when I had a similar problem... I ordered all the techs since they werent doing or recording vitals and I had to do them - that they could not leave clinic that day until I did which was usually around 1900 hrs. The Major Nurse pulls me aside and says..They don't get paid the money you do you cant keep them here that late. I said Yes Maj I may only be a captain, but their job is important and by making me do vitals and weights on every patient when I have 30 patietns schedule to me today you add 3-5 min per patient x 30 = 1.5-3hrs a day so since they wont do their job and I am doing it for them the least they can do is not go home until I do.


Do you get the point You have no authority as a doctor to do anything, but you still have all the responsibility to do the right thing your patients and your career depend on it. If these lazy enlisted people dont do their job and I don't do it for them and there is a bad out come the patient suffers and I get sued - I do not want either to happen so I do the PROFESSIONAL thing and do the right thing for the patient who is stuck in the broken system. To see a comment like yours above is appauling to Physician like me.

"Dont try to describe the ocean if you've never seen it. Dont ever forget that you just might end up being wrong".... Jimmy Buffet

 

[IgD]

The reason why you don't kill your patient is it is an unlawful order. I believe the second issue is also an unlawful order because you have a line officer telling a medical officer what to do. The real issue is that it is a leadership issue. Sometimes you have to say no. For example, a Marine artillery GySgt is asked by his CO to lend the vehicles that transport the artillery pieces to a different unit. The GySgt stands up to the CO and refuses. The CO realizes he has made a mistake and backs down.

Nurses refuse to cooperate in the civilian world too. The answer is diplomacy and good interpersonal skills.

If a Colonel ordered you to kill your patient with a lethal injection because your unit was evacuating, would you comply? If not, why not? If a Colonel ordered you to provide anesthesia to a patient directly while simultaneously overseeing three nurse anesthetists, in direct violation of published standards of the ethical practice of anesthesiology, how would you respond? Yours is not to reason why, huh?

 

[USAFdoc]

Nurses refuse to cooperate in the civilian world too. The answer is diplomacy and good interpersonal skills.

In my civilian FP office I NEVER, NEVER, NEVER have to negotiate with the staff to get a job done. Why is that???????

As I will continue to repeat; THE USAF has designed a military healthcare system that is flawed to the bone. What planet was somebody visiting when they decided to remove all admin authority from the people respomsible for patient care? (the physicians)

I have no doubt that if an E-3 med-tech's supervisor (an 0-5 Sgt) asked the E-3 to get a job done, they would do it without question, for many reasons, and certainly because that person does their evals.

The idea that the doc should have to "negotiate" with the techs and similar people to assist with patient care goes right to the heart of the matter.

"Its not my job" has NEVER been said in my current civilian clinic, by anyone.

Sounds like it should be the new USAF military motto. I know it would represent the SG office well.

 

[IgD]

When I was an intern, I was taking care of a 50 something year old guy with HIV who was crashing on the medicine ward at a busy metropolitan hospital. I think the nurses were in a labor union. I was in my first month and didn't know what I was doing. The nurse blew me off. I called the medicine resident and the patient was whisked right away to the ICU!

Another time I was working at a VA hospital. A nurse told me flat out "I aint doing that". I saw another nurse tell a surgeon a similar thing. I think fondly of those memories!

 

[MedicalCorpse]

We have Navy corpsmen and doctors and our corpsmen are some of the most fearless guys you will ever meet. I didn't hang with the doctors when I was a Marine but they all looked pretty squared away to me. When you are with a good unit, esprit de corps is infectious.

Nonsequitur. Corpsmen, although they are outstanding, brave, fearless, intrepid, highly skilled, and save lives, are not physicians.

We are talking about physicians here, on the student DOCTOR network, not para-professionals, no matter how wonderful and critical they may be to patient care. My point was and is: there is no such thing as a Marine physician, because every Marine, from the lowest recruit to the loftiest General, is (or aspires to be) an elite, trained killer of the enemies of our Republic. That is his/her role, and Marines do it well.

The role of a physician, on the other hand, is to save lives. This requires a diametrically opposite world-view (Weltanschauung) from that of a Marine. Yes, a Marine may heroically sacrifice himself/herself for his/her buddies on the battlefield...but, again, this is comparing apples and oranges. The Marine is still using his/her weapon to lay down suppressing fire, etc. Would that military physicians had the capability to lay down suppressing fire on the hundreds of factors which interfere with the provision of good medical care in the military!

As 7by11 states, your Marine line experience has zero to do with providing medical care to patients as a physician. You are like the fish trying to describe what it's like to walk around on land. It's simply embarrassing to read your posts:

"I served with puppies. Puppies are cuddly and warm. How dare you say anything bad about puppies! My deep knowledge of puppies from my years holding them makes me an expert on quantum mechanics, which is why I strongly feel that your opinion on the relationship between the Schrödinger equation and Hamiltonians is slander."

Cut hair, shined shoes, snappy salutes, and a buff midriff will not help you when your ruptured AAA patient is bleeding out on the table. Medical knowledge and skill might.

At this point, if you were enlightened, you would post: After thinking about what you said, Rob, you were right. I need about a decade more experience as a medical officer before I earn the right to argue with you about what it takes to provide quality medical care to our brave troops. I'll try to "empty my cup" of my Marine line training, and fill it up with doctor training, and get back to you in (checking watch) 2016.

Given your previous posts, however, I am not holding my breath.

--
R
Ex-LtCol, USAF, MC
etc.
http://www.medicalcorpse.com

 

[MedicalCorpse]

Nurses refuse to cooperate in the civilian world too. The answer is diplomacy and good interpersonal skills.

The difference is this: when and if they do, they can be written up (as in the military) and fired (unlike the military). Any nurse who directly refused to carry out my instructions regarding patient care, whether it be getting an old chart from records, getting on the phone to a PCM's office for medical "clearance" (note quotes) for surgery, or giving the patient medications I ordered, would be summarily fired by the administration of my (doctor-oriented) civilian hospital.

A few anecdotes from my book:

When I was administering a perineal dose of 2% lido into the epidural of an active duty LtCol family physician boss of my wife, the RN took the blood pressure cuff off of the patient's arm.

"Capt. M., what are you doing?" I asked.

"It's uncomfortable for her, so I'm taking it off."

"Do you know what I'm doing here? I'm giving her medicine that could drop her blood pressure or, worse, cause a seizure...put that back on."

"No, you do it yourself," she snapped, and walked out.

When I went to my spineless LtCol anesthesiologist Flight Commander, Dr. "Wrong", he didn't want to get involved. He told me to take care of it, and shut the door on my way out. I set up a meeting between the Chief OB nurse, the perinatologist in charge of OB, and myself, wherein the Chief OB nurse stated: "She used her nursing judgment. You used your doctor judgment. Her nursing judgment is at least as important as your doctor judgment, because she cares about the comfort of her patients. You should just accept that."

The Army perinatologist didn't know what to do. He didn't have any direct authority over the nurses under him *medically*, albeit not *militarily*. Nothing ever happened to change the militant ignorance of (some of) the OB nurses at Travis...including the one who, as a captain RN, ordered me only to give 500 ml of IVF total to a patient with pre-E undergoing C-section, because that's what the ignorant/arrogant (previous) perinatologist had told them to do for pre-E patients on the labor deck. I politely instructed her about where she could stick the blanket instructions any non-anesthesiologist might try to give me regarding intraoperative care of my patients.

Both of those nurses would have been severely reprimanded and/or fired in any civilian setting. Note that the VA is not a civilian setting, per se: it is a governmental bureaucracy at least as F-d up as the Military Medical Corpse...but that book will have to wait a few years, given that I am still awaiting my C&P determination more than a year after my separation.

--
R
http://www.medicalcorpse.com

 

[8744]

Nonsequitur. Corpsmen, although they are outstanding, brave, fearless, intrepid, highly skilled, and save lives, are not physicians.

We are talking about physicians here, on the student DOCTOR network, not para-professionals, no matter how wonderful and critical they may be to patient care. My point was and is: there is no such thing as a Marine physician, because every Marine, from the lowest recruit to the loftiest General, is (or aspires to be) an elite, trained killer of the enemies of our Republic. That is his/her role, and Marines do it well.

The role of a physician, on the other hand, is to save lives. This requires a diametrically opposite world-view (Weltanschauung) from that of a Marine. Yes, a Marine may heroically sacrifice himself/herself for his/her buddies on the battlefield...but, again, this is comparing apples and oranges. The Marine is still using his/her weapon to lay down suppressing fire, etc. Would that military physicians had the capability to lay down suppressing fire on the hundreds of factors which interfere with the provision of good medical care in the military!

As 7by11 states, your Marine line experience has zero to do with providing medical care to patients as a physician. You are like the fish trying to describe what it's like to walk around on land. It's simply embarrassing to read your posts:

"I served with puppies. Puppies are cuddly and warm. How dare you say anything bad about puppies! My deep knowledge of puppies from my years holding them makes me an expert on quantum mechanics, which is why I strongly feel that your opinion on the relationship between the Schrödinger equation and Hamiltonians is slander."

Cut hair, shined shoes, snappy salutes, and a buff midriff will not help you when your ruptured AAA patient is bleeding out on the table. Medical knowledge and skill might.

At this point, if you were enlightened, you would post: After thinking about what you said, Rob, you were right. I need about a decade more experience as a medical officer before I earn the right to argue with you about what it takes to provide quality medical care to our brave troops. I'll try to "empty my cup" of my Marine line training, and fill it up with doctor training, and get back to you in (checking watch) 2016.

Given your previous posts, however, I am not holding my breath.

--
R
Ex-LtCol, USAF, MC
etc.
http://www.medicalcorpse.com

No. Your problem is that you expected your military service to be a cushy, all-expense paid vacation where something like war or deployments never occurred. In other words, the military was a fine lifestyle until you had to suck a little dust or sweat a little in the field and now you're so spitting mad that you are asked to do something else.

The other problem is that you are an "officer" but don't have the bearing, the endurance, or the military training to be an officer. This is your personal problem. That's how the military is run. Nobody twisted your arm to get you in and nobody twisted your arm to keep 15 years to keep you in except that you might have been chasing after your pension n a true "lifer" fashion.

You seem to have been fairly resistant to learning anything about leadership over the last 15 years as well and seem proud of this. LTCol my ass. You're a sorry LTCol to blame your troops and the system instead of taking charge, cutting a wide swath, and not worrying about "getting in trouble."

 

[former military]

No. Your problem is that you expected your military service to be a cushy, all-expense paid vacation where something like war or deployments never occurred. In other words, the military was a fine lifestyle until you had to suck a little dust or sweat a little in the field and now you're so spitting mad that you are asked to do something else.

The other problem is that you are an "officer" but don't have the bearing, the endurance, or the military training to be an officer. This is your personal problem. That's how the military is run. Nobody twisted your arm to get you in and nobody twisted your arm to keep 15 years to keep you in except that you might have been chasing after your pension n a true "lifer" fashion.

You seem to have been fairly resistant to learning anything about leadership over the last 15 years as well and seem proud of this. LTCol my ass. You're a sorry LTCol to blame your troops and the system instead of taking charge, cutting a wide swath, and not worrying about "getting in trouble."

To quote Platoon..."Seems what we got here is a Crusader"

 

[Galo]

No. Your problem is that you expected your military service to be a cushy, all-expense paid vacation where something like war or deployments never occurred. In other words, the military was a fine lifestyle until you had to suck a little dust or sweat a little in the field and now you're so spitting mad that you are asked to do something else.

The other problem is that you are an "officer" but don't have the bearing, the endurance, or the military training to be an officer. This is your personal problem. That's how the military is run. Nobody twisted your arm to get you in and nobody twisted your arm to keep 15 years to keep you in except that you might have been chasing after your pension n a true "lifer" fashion.

You seem to have been fairly resistant to learning anything about leadership over the last 15 years as well and seem proud of this. LTCol my ass. You're a sorry LTCol to blame your troops and the system instead of taking charge, cutting a wide swath, and not worrying about "getting in trouble."

You are a complete *****!!

The last time I had to call someone that, it was followed by a post calling them a f***ing ******!!.

Young man, you are way ahead on both. You are speaking from your ignorant heart, and not using your brains. You have NO WAY of understanding what we went through, and will not for a number of years. Also you have not walked in our shoes, and CANNOT be our judge to propose we went into the military expecting it to be cushy. First and foremost, all us, and those who have problems with military medicine are physcians first. I did not expect surgical residency to be "cushy". After 6 years of very difficult training that no one else will be able to experience because of the 80 hr work week crap, I wanted to work, and do surgery, and take care of patients, things that were made increasingly difficult by the many aspects of a broken medical system that we are trying to explain to you. SO keep your crap to yourself, and when you are an attending, and are under the same constrictions that we were, then report back here and tell everyone your EXPERIENCE, because right now you have NONE. Stop being as ASS.

 

[MedicalCorpse]

Your ignorance is exceeded only by your arrogance.

No. Your problem is that you expected your military service to be a cushy, all-expense paid vacation where something like war or deployments never occurred. In other words, the military was a fine lifestyle until you had to suck a little dust or sweat a little in the field and now you're so spitting mad that you are asked to do something else."

WRONG. When I was deployed in support of OEF, I was proud. Yes, I missed my wife and three kids, but I was put up in the VIP suite of the Hodja Inn at Incirlik AB, Turkey. Air conditioning. Full size fridge and freezer, fully stocked. Fully stocked bar-- which I never touched, given that I was on call 24/7 as the only anesthesiologist working with three CRNAs. Hardly "sucking dust". If you read any of my posts or my website, you would realize this.

The other problem is that you are an "officer" but don't have the bearing, the endurance, or the military training to be an officer. This is your personal problem.

WRONG again. My military bearing was excellent...a tribute to ROTC Det 365. What do you know of my bearing or endurance? I just could never endure fools like you, that's all.

Nobody twisted your arm to get you in and nobody twisted your arm to keep 15 years to keep you in except that you might have been chasing after your pension n a true "lifer" fashion.

WRONG yet again. "Might have been" is the refuge of the stupid. I owed 4 + 7 + 4 years of service to my country. Do the math, PandaBearhead.

You're a sorry LTCol to blame your troops and the system instead of taking charge, cutting a wide swath, and not worrying about "getting in trouble."

If you even bothered to read my website, you would know that I became infamous within the incestuous confines of Air Force medicine for taking charge, cutting a wide swath, and not worrying about getting in trouble. I have an LOR, and LOA, and an LOC to prove it (one each: a hat trick!). In every single one of them, I was accused of speaking out "inappropriately" regarding "Quality Assurance Issues" involving patient safety. No drunk driving. No chasing young female airmen. Speaking out for patient safety in a way that embarrassed Command. So stick that up your Marine pipe and smoke it, mister.

Now, if you please, allow someone less anencephalic than yourself to post here. You are bringing the entire profession of medicine, let alone military medicine, to the level of the gutter with your stubborn ignorance. As Galo says, learn something, suck some dust as an attending physician, break some sweat trying to get good care for patients you are personally responsible for as staff, then come back here and talk to us as equals.

Because, son, you are not yet there.

--
R
http://www.medicalcorpse.com

 

[8744]

...9) Even more anti-terrorist, "Be part of the solution, not part of the problem", you-can-help-secure-our-homeland-so-this-puppy-doesn't-get-shot-by-Osama, jingoistic, blind appeals to the natural instinct of the citizen of any country at any point in history to do what people in authority tell them is the patriotic thing to do, whether that be executing counter-revolutionary "Rightists" (Mao's China), reporting Jewish neighbors to your local Gestapo office (Hitler's Germany), saving the world from godless Communist hegemony (Reagan's America, ca. 1981, when I raised my right hand), or signing up to fight the unending Global War On Non-Christian People Who Use Sharp Sticks To Hurt Us When We Bring Them Democracy (and Jesus) With the Muzzles of Our M-16s (Bush's America, ca. 2006).
10) Have I mentioned appeal to patriotism yet?...

--
R
http://www.medicalcorpse.com

This exemplifies your unfitness to be an officer and a leader in the American military. The fact that you would equate the American military to the Gestapo says it all about your attitude.

See my point? You've gone from hating military medicne to hating the entire armed forces which, based on your justifications, is replusive and ignorant. Go ahead and rip on military medicine but leave the rest of the armed forces out of it.

 

[8744]

...You are bringing the entire profession of medicine, let alone military medicine, to the level of the gutter...


http://www.medicalcorpse.com

And what precisely have you been doing on every thread you post?

 

[orbitsurgMD]

This exemplifies your unfitness to be an officer and a leader in the American military. The fact that you would equate the American military to the Gestapo says it all about your attitude.

You're pretty obnoxious too, Panda Bear.

My guess is that you aren't on any short lists to decide anyone's fitness for anything. So far, all your bluster hasn't convinced me you know anything worth knowing about officership yourself, only noisy opinion and inexperienced judgement.

 

[8744]

You are a complete *****!!

The last time I had to call someone that, it was followed by a post calling them a f***ing ******!!.

Young man, you are way ahead on both. You are speaking from your ignorant heart, and not using your brains. You have NO WAY of understanding what we went through, and will not for a number of years. Also you have not walked in our shoes, and CANNOT be our judge to propose we went into the military expecting it to be cushy. First and foremost, all us, and those who have problems with military medicine are physcians first. I did not expect surgical residency to be "cushy". After 6 years of very difficult training that no one else will be able to experience because of the 80 hr work week crap, I wanted to work, and do surgery, and take care of patients, things that were made increasingly difficult by the many aspects of a broken medical system that we are trying to explain to you. SO keep your crap to yourself, and when you are an attending, and are under the same constrictions that we were, then report back here and tell everyone your EXPERIENCE, because right now you have NONE. Stop being as ASS.

I spent longer in the Marines than you did in your residency and I'd be embarrassed to be as big of a whiner. The problem is that military doctors have no real military training and are generally, if I understand the career path correctly, civilians in uniform. A typical Marine or Army grunt would love to have your job, working in air-conditioning and getting paid five times as much.

 

[orbitsurgMD]

I spent longer in the Marines than you did in your residency and I'd be embarrassed to be as big of a whiner.

What is your point? Are we supposed to think there is some equivalency in that?

The problem is that military doctors have no real military training and are generally, if I understand the career path correctly, civilians in uniform. A typical Marine or Army grunt would love to have your job, working in air-conditioning and getting paid five times as much.

Well that pretty much explains the gulf of understanding. And enlisted troops aren't unique in that; I have seen it in line officers and of course, civilians. As you ought to know, the job just isn't for the having, which is some don't want to understand: it's hard work, mostly, not a lucky day.

 

[DropkickMurphy]

Opposites end of the spectrum PandaBear. While you have my respect as a Marine, and while I personally know Rob and will openly admit that while he tends to get hyperbolic at times, he does make a point with reference to the Gestapo analogy. Blind faith simply because you are a member of an organization is a slippery slope.

And if you don't think that anyone is capable of sliding down that slope, I offer the example of one of my ancestors who was the commander of the Gestapo and RHSA until his assassination in 1942. A bright, a talented musician, he gleefully followed the orders of his superiors due to blind allegiance to his government, including leading the conference that laid out the basic tenets of the "Endlösung der Judenfrage". No one is exactly sure WHY he did what he did.....what made him turn from a rather cultured person to a man Hitler himself eulogized as having "a heart of iron" (and that's saying something).

To use another less offensive analogy, as a senior fire officer I expected and demanded that my lieutenants and sergeants spoke up, as well as my line firefighters, if they saw something that was not working or was just not as efficient as it could be. My chiefs demanded the same from me, and from those I was appointed to lead. You know what....despite a hierarchial structure, the system did not fall apart because of this approach. In fact, quite the opposite....our department excelled. It didn't flounder and wallow in excess or ego like a lot of departments that adopt an approach more akin to the military's "Shut up or you're going to Leavenworth" approach. Doing things one way simply because they have always been done that way "out of respect for those who went before you" is an utter fallacy. Relying on experience alone simply results in you becoming ever more confident in making the same mistakes over and over.

Look at how many of the truly well regarded military leaders were "traditionalists"- Curtis LeMay, a hard-nosed son of a bitch who got the job done but he looked out for his men and their families; Billy Mitchell, who was court martialed for his blatant disagreement with his superiors but is now regarded as one of the fathers of modern air power, etc, etc. The list goes on and on.

Great minds do not disregard the heritage of those who went before, nor do they simply desire to perpetuate the same standards onward into eternity. They advance the ideals while not foresaking those whom they rely upon to get the job done or crucifying those who speak out. That is the true and defining difference between a leader and someone who simply outranks those around them.

 

[USAFdoc]

I spent longer in the Marines than you did in your residency and I'd be embarrassed to be as big of a whiner. The problem is that military doctors have no real military training and are generally, if I understand the career path correctly, civilians in uniform. A typical Marine or Army grunt would love to have your job, working in air-conditioning and getting paid five times as much.

You are quite mistaken on your assumptions;

1) You seem to think that myself and other physicians joined the military to be in an airconditioned room and make $$$$$$..............................wrong assumption Pandaman...............I joined the USAF to serve the troops their families, and make a career of USAF Family medicine. I left USAF Family Medicine because what the USAF was "serving up" was against everything I believe in as a physician and an officer and I am not, and will never be a "look the other way" "yes sir no matter what kinda man".

2) A typical person of any background does not spend 11-15 years of thier life getting trained to be a physician and everything that goes into that. Yes, they ("marine grunts") may wish to have the job, but they will probably decline on what amount of studying, perseverence, and skills it takes to get there. Now I appreciate and respect every bit what a Marine can do, and I expect that they respect me as well.

3) You should be embarrassed to assume that somehow you have all the answers and somehow all the physicians exiting the military must have some type of personal problem AND dismiss what myself and NUMEROUS other physicians and other military people are repeatedly saying and backing up with EVIDENCE:

Military Medicine is a BROKEN system is need of an immediate overhaul. It is shameful what has been made of the current system and doubly shameful about the lies the military continues to make regarding the state of military medicine.

 

[USAFdoc]

and you Pandaman, are perpetuating the lies about Military Medicine.

 

[DiveMD]

A typical Marine or Army grunt would love to have your job, working in air-conditioning and getting paid five times as much.

They all can have a medical job if they want. If they go to college, medical school, internship and residency they could also be part of the "air conditioned dream" you seem to know a lot about. Apparently perusing a medical career is like a walk in the park... BTW, you can make your point without being disrespectful. Be an officer. Good luck.

 

[DropkickMurphy]

Hell, when I seperated my pay as an RT jumped about 5 times from what it was as an enlisted person (if you adjusted for the decrease in number of hours worked from about 72 to 36-48 hrs per week; from roughly $4.05 an hour to about $23 an hour). So you don't have to be a doc to make 5 times as much, you just have to get out of the military.

 

[USAFdoc]

Hell, when I seperated my pay as an RT jumped about 5 times from what it was as an enlisted person (if you adjusted for the decrease in number of hours worked from about 72 to 36-48 hrs per week; from roughly $4.05 an hour to about $23 an hour). So you don't have to be a doc to make 5 times as much, you just have to get out of the military.

I was working 275-400 hours a month in the military which comes to about a couple bucks an hour. If I worked that much now as a civ FP, Id be pullin 200-300K a year.

 

[DropkickMurphy]

If I worked 72 hrs a week as a civilian.....

$23 an hour x 40 hrs x 50 weeks = $46,000
$34.50 an hour x 32 hrs x 50 weeks = $55,200
And if I'm working nights (which I prefer) add about $2 an hour extra to that as a shift differential: $7200 per year

$46,000 + $55,200 + 7,200 = $108,400 per year before taxes

Not bad for an associates degree level job

 

[Mirror Form]

If I worked 72 hrs a week as a civilian.....

$23 an hour x 40 hrs x 50 weeks = $46,000
$34.50 an hour x 32 hrs x 50 weeks = $55,200
And if I'm working nights (which I prefer) add about $2 an hour extra to that as a shift differential: $7200 per year

$46,000 + $55,200 + 7,200 = $108,400 per year before taxes

Not bad for an associates degree level job

I currently make the equivalent of $102,000 before taxes . . . and I work less than 72 hours per week. Not bad for a military pgy-2

Especially since I'll be making more and working less in the future (of course one year of that will be Balad, but oh well).

 

[Mirror Form]

Hey Guys, Panda is definitely one of the most reasonable debaters on SDN. His viewpoint isn't surprising at all. When one thinks about the kind of crap marines infantry go through (while we're seeing patients for 36 hours straight as interns, they're crawling through the mud for 36 hours straight in subzero temperatures, etc), it's easy for them to get pissed when they see us pampered docs complaining about our not enough support staff, etc. And honestly, we're some of the most pampered people in the military (forget about comparisons to civilian doctors for a second, we're in the army now).

But that's not really what the core of the issue is. The main problem is that medicine is just too long and hard of a training process for you to lose all control over it. For example Panda, you were able to apply to both FP and ER in the civilian world. That would have been difficult in the military. And switching directly to a pgy-2 ER would have almost certainly not happened. You would have been under ten times more stress during this whole process b/c if you didn't match into ER, what then? GMO tour for four years until your commitment is up? What if you owe 8?

Also, the thought of not being able to always provide the best possible treatment due to the socialized nature of the healthcare system is also a concern. Although, this is probably going to be the trend in the future. For example, the best treatment for Macular Degeneration has a 400 buck co-pay with medicaire, meaning many civilian patients won't be able to afford it.

 

[DropkickMurphy]

I currently make the equivalent of $102,000 before taxes . . . and I work less than 72 hours per week. Not bad for a military pgy-2

Especially since I'll be making more and working less in the future (of course one year of that will be Balad, but oh well).

Yeah, but at least if I get in a position where I don't want to be, I have the option to quote the legendary Jonny Paycheck. "Take this job and shove it."

That and you have a lot more schooling at this point than I do. How many community college grads do you know that could pull down that kind of cash (legally)?


I do agree that Panda is one of the best debaters on SDN, and one of the few people who I actually have utmost respect for, regardless of whether I agree with him on a particular matter or not.

 

[Homunculus]

I was working 275-400 hours a month in

400 hours? 13 hour days every day of the month??? let's see, with just 4 days off that's like 15 hour days every day. no staff physician i know works those kinds of hours-- were you moonlighting or something?

i'm sure it was just for effect, but try not to exaggerate too much

--your friendly neighborhood calculator using caveman

 

[DropkickMurphy]

I know the pulmonologist I worked with most frequently was often there 5-6 days per week, often 16-18 hrs per day. That's what? 108 hrs a week?

 

[Mirror Form]

I know the pulmonologist I worked with most frequently was often there 5-6 days per week, often 16-18 hrs per day. That's what? 108 hrs a week?

Staff pulmonologist? Or a fellow? I find that a bit surprising if he was staff. I've worked in two army med cen's, and have yet to see any staff with a schedule even remotely like that. Although it would make more sense if he was a fellow.

 

[DropkickMurphy]

Nope, it was just a lack of coverage and way too many patients....there should have been at least 3 or 4 pulmonologists to handle that caseload there but there were only two (one of whom was TDY for quite some time). By the time they were done with outpatients, bronchs, inpatient consults, hindering the med students and junior FP residents' best efforts to kill the patients in the ICU through blind ignorance and refusal to listen to enlisted personnel, and then charting, etc....the doctor in question was often there late into the night.....

 

[USAFdoc]

400 hours? 13 hour days every day of the month??? let's see, with just 4 days off that's like 15 hour days every day. no staff physician i know works those kinds of hours-- were you moonlighting or something?

i'm sure it was just for effect, but try not to exaggerate too much

--your friendly neighborhood calculator using caveman

The typical month was 275-325 hours per month; thats going to work at anywhere from 0300 (paperwork)-0500 (mando PT); and staying till 1800-2100 depending on the paperwork/mando training etc. Thats coming in every Sat for either weekend clinic or more admin paperwork. It was the norm to see most all the docs in the clinic on the weekend, even when we were not on duty/call.

One month I was ordered by the Chief of Staff to produce a Manual for all Docs/Providers that was basically to include "everything about everything". (How CHCS operates, how to enter meds, how pharmacy , STD clinic, Radiology, Sick Call....basically every function or related function to the medical clinic). I was given a few manuals from other bases as examples. I was given ZERO time off work/zero reduction in patient load and told "you got 2-3 weeks". Needless to say the research, typing, etc added about an extra 40 hours that month (I lived at the clinic that month). That was an example of a 400 hour month.

Some of the other providers thanked me for the quality of the manual, but the Commander(s) that gave me the order never even said thank you/good job etc.


"Do every job as unto the Lord"

 

[8744]

Hey Guys, Panda is definitely one of the most reasonable debaters on SDN. His viewpoint isn't surprising at all. When one thinks about the kind of crap marines infantry go through (while we're seeing patients for 36 hours straight as interns, they're crawling through the mud for 36 hours straight in subzero temperatures, etc), it's easy for them to get pissed when they see us pampered docs complaining about our not enough support staff, etc. And honestly, we're some of the most pampered people in the military (forget about comparisons to civilian doctors for a second, we're in the army now).

But that's not really what the core of the issue is. The main problem is that medicine is just too long and hard of a training process for you to lose all control over it. For example Panda, you were able to apply to both FP and ER in the civilian world. That would have been difficult in the military. And switching directly to a pgy-2 ER would have almost certainly not happened. You would have been under ten times more stress during this whole process b/c if you didn't match into ER, what then? GMO tour for four years until your commitment is up? What if you owe 8?

Also, the thought of not being able to always provide the best possible treatment due to the socialized nature of the healthcare system is also a concern. Although, this is probably going to be the trend in the future. For example, the best treatment for Macular Degeneration has a 400 buck co-pay with medicaire, meaning many civilian patients won't be able to afford it.

I did not switch to PGY-2, I am repeating my PGY-1 year in EM. I assure you it was a stressful switch and if I hadn't matched I would have quit medicine and gone back to structural engineering.

I don't doubt that military medicine is screwed up. My only beef is extending this to the rest of the military. The Marine Corps, for example, is not perfect but it is not a malignant organization, Marines are not just pegs to fit in holes, and if anything the quality of Marines, their training, and the general outlook of the service has improved considerably since 1991 when I was discharged. This does not mean that everything is perfect or that everybody is thrilled to death about everything. We called it "The Suck" for a reason. In hindsight, however, most of the things we used to bitch about are the result of the inevitable friction that results from any military operation.

I also object to the general outlook that if you say anything good about the military you are a lifer or a suck ass. I was not a lifer and I got out because I didn't want to do it anymore. But I at least have the honesty to admit that I just got tired of humping a pack, getting up at 0530, and deploying every 18months.

If you say something bad about the military you have instant credibility. Say anything good about it and you have to prove that the military is perfect.

 

[MedicalCorpse]

I don't doubt that military medicine is screwed up. My only beef is extending this to the rest of the military. The Marine Corps, for example, is not perfect but it is not a malignant organization, Marines are not just pegs to fit in holes, and if anything the quality of Marines, their training, and the general outlook of the service has improved considerably since 1991 when I was discharged. This does not mean that everything is perfect or that everybody is thrilled to death about everything. We called it "The Suck" for a reason. In hindsight, however, most of the things we used to bitch about are the result of the inevitable friction that results from any military operation.

Sigh. I had hoped to let this conversation go, but I just have to say this:

I have never impugned the loyal, brave, lethal members of the United States Marine Corps at any time. If anything I have ever written appears to you to be insulting or denigrating the U.S. Marine Corps in any way, I apologize. If so, you have obviously misunderstood both my words and my intent.

I have documented my opinion regarding the propagandistic techniques used by recruiters to get people to join the military, and military medicine in particular. I have never impugned the sincerity, loyalty, or honor of young people who decide to join the military based on the false/misleading/exaggerated information fed to them by recruiters. I am sure that many of the troops marching with Gaius Julius Caesar IV in Gaul were promised they would be given endless vineyards in the countryside, fully stocked with partially clad maidens of every beauteous description. Some things never change. This does not make the troops bad people...just misled.

I have objected to your assertion that taking orders is key to officership, vs. doing the right thing at all times to support and defend the Constitution (not the military leadership or its civilian bosses, the Constitution) against all enemies, foreign and (now, more than ever) domestic. I have argued that, throughout history, doing the right thing *sometimes* involves disobeying orders that constitute crimes against humanity. I hope we can both agree on that.

In the end, we seem to be going around and around arguing about two different Corps.

The U.S. Marine Corps is filled with brave, selfless, and dedicated elite warriors who have protected our great nation since its inception. They deserve only the very finest medical care from the brave, selfless, and dedicated Navy, Army, and Air Force physicians who care for them around the world. Yes, at Andrews AFB, I, a lowly LtCol Air Force puke anesthesiologist, had the distinct honor of caring for many of our wounded Marines, as they went back and forth to the O.R. for debridements while awaiting air evac. I treated each and every one with respect, courtesy, and recognition of their status as Marines, vs. airmen, by addressing each by his (they were all guys) rank, as in "Lance Corporal" vs. "Dave" or "hey you" (7by11 can vouch for this as being my way with everyone, regardless of service or active/retired status).

On the other hand, the Corps I am talking about are the military M E D I C A L Corps, which, when I joined in 1981, did a pretty damned fine job caring for our troops of all services around the globe. My website, my book (if I ever finish it), and every single post here document in excruciating detail how grief-stricken I am that a proud institution I grew up in since age 17 should be brought so low by 2006, due to sheer mismanagement, neglect, greed, and poor planning. I would be lying if I said that I wasn't crying right now writing these words.

The one, good Corps (the Marine Corps) has been betrayed by the sick, corrupted, bad Corps (the tri-service Military Medical Corps, or Corpses, as I think of them).

I hope this gets my point across. Semper Fi! Now, can we please move on?

--
R
http://www.medicalcorpse.com