Front-line trauma care in Iraq

[Monty Python]

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👍 Thirteen minute clip from a recent broadcast of "60 Minutes." Shows various facets of trauma care on the front-lines from 'copter evacuation to OR to airevac to Germany. Despite the pros and cons of military medicine discussed on this forum, you've got to give thumbs up to these folks in harm's way.

http://www.cbsnews.com/sections/i_video/main500251.shtml?id=2135920n

 

[The White Coat Investor]

Certainly makes me a bit more excited about my deployment to Balad in 10 months.

 

[MedicalCorpse]

Despite the pros and cons of military medicine discussed on this forum, you've got to give thumbs up to these folks in harm's way.

I will give three thumbs up when our brave troops are no longer in harm's way for no good reason.

Listen, if China were invading California, or Russia decided to nuke Germany, I would be the first to stand up to defend our true national interests.

As an Ex-LtCol graduate of Air Command and Staff College, I submit to you that history will prove that not one core national security need was met by the ill-advised and ill-managed invasion of a country which did not have WMD and which did not immediately threaten our national security, especially when one considers the opportunity cost of transferring those military assets, personnel, and dollars away from the hunt for our Al Qaeda adversaries.

I am sure that our soldiers, sailors, marines, and airmen are serving valiantly "in harm's way". The crux of the matter is that they should not have been sent into "harm's way" for this cause in the first place. History will judge.

--
R

 

[HumptyDumptyMil]

Maybe one day I will have the honor to treat these soliders and realize how important my job really is while in the military, despite all the negatives.

 

[former military]

I will give three thumbs up when our brave troops are no longer in harm's way for no good reason.

Listen, if China were invading California, or Russia decided to nuke Germany, I would be the first to stand up to defend our true national interests.

As an Ex-LtCol graduate of Air Command and Staff College, I submit to you that history will prove that not one core national security need was met by the ill-advised and ill-managed invasion of a country which did not have WMD and which did not immediately threaten our national security, especially when one considers the opportunity cost of transferring those military assets, personnel, and dollars away from the hunt for our Al Qaeda adversaries.

I am sure that our soldiers, sailors, marines, and airmen are serving valiantly "in harm's way". The crux of the matter is that they should not have been sent into "harm's way" for this cause in the first place. History will judge.

--
R

ummm... we kind of stole Saddam's lunch money

 

[Ex-44E3A]

For the love of God, don't make this a political thread... it has been debated to death.

 

[mitchconnie]

Certainly makes me a bit more excited about my deployment to Balad in 10 months

Please don’t take this kind of media hype as an accurate reflection of the medical experience in Iraq. Believe it or not, I was at Balad during the filming of the piece, and actually pictured in the video. Yes, we did some great cases and saved some lives, but the same shenanigans that go on in stateside MTF’s also go on in-theater. There is no dichotomy—great care in theater/poor care at home. The same under trained urgent-care staff from your local AFB are manning the ER at Balad. The same clipboard nurses that make your life hell at Travis AFB are there in Iraq showing you hours of Power Point presentations. The same non-clinical commanders hassling you about RVU’s at Wilford Hall remain obsessed with non-clinical endpoints in Iraq.

Examples:

Our ER docs for the most part were FP’s. Nothing against FP’s, but treating diabetes, HTN, URI, sprained ankle, etc. at Offut AFB leaves one woefully unprepared to deal with massive multi system penetrating trauma.

The CT scanner at the only neurosurgical facility in-theater was 3 or 4 generations out-of-date (i.e. 2-slice) and frequently broken down.

I did not have basic equipment to practice my specialty and had to beg my home MTF to mail me supplies which the AF refused to send me.

One of our OR tech’s did not even work in the OR at his home base, but at the motor pool fixing Humvees. He had forgotten all the instrument names, reducing us to asking for “the long skinny scissors with the round ends” (Metzenbaums) or “the long plastic tube thing with the balloon on the end” (Fogarty catheter).

We sat though at least two hours of power point shows about hospital metrics nearly every single day.

Relationships between physicians were not necessarily “all for one and one for all.” There was an obvious and sometimes bitter divide between the careerists looking for OPR bullets, and the rest of us who were just trying to do our jobs, survive the experience, and go home to our families.


The reason that you don’t get a more balanced picture (even from ’60 minutes’) is that there were official ‘minders’ from the Air Force PR dept. present whenever you talked to the media to make sure you stayed “on-message,” and didn’t stray into uncomfortable topics like poor morale, supply shortages, etc.

It was great piece for public consumption, and I wouldn’t change a thing about it, but as a physician I think you need to have a more realistic and balanced view of the experience.

 

[militarymd]

The reason that you don’t get a more balanced picture (even from ’60 minutes’) is that there were official ‘minders’ from the Air Force PR dept. present whenever you talked to the media to make sure you stayed “on-message,” and didn’t stray into uncomfortable topics like poor morale, supply shortages, etc.

It was great piece for public consumption, and I wouldn’t change a thing about it, but as a physician I think you need to have a more realistic and balanced view of the experience.

just as I suspected.

 

[USAFdoc]

👍 Thirteen minute clip from a recent broadcast of "60 Minutes." Shows various facets of trauma care on the front-lines from 'copter evacuation to OR to airevac to Germany. Despite the pros and cons of military medicine discussed on this forum, you've got to give thumbs up to these folks in harm's way.

http://www.cbsnews.com/sections/i_video/main500251.shtml?id=2135920n

I have no problem giving thumbs up for those serving in Iraq; thats everybody..the marines, the military docs, techs, the ARMY soldiers..everybody.👍

The debate on the necessity of the war could be another thread for those interested.🙂

I trust mitchconnie's overall assessment of the medical situation over there. 👍 👎

I trust the vast majority of physicians assessments of military medicine in general. 👎 👎

 

[siinew]

👍 Thirteen minute clip from a recent broadcast of "60 Minutes." Shows various facets of trauma care on the front-lines from 'copter evacuation to OR to airevac to Germany. Despite the pros and cons of military medicine discussed on this forum, you've got to give thumbs up to these folks in harm's way.

http://www.cbsnews.com/sections/i_video/main500251.shtml?id=2135920n

That is very very cool. Thanks for posting that.

 

[MedicalCorpse]

The debate on the necessity of the war could be another thread for those interested.🙂

O.K. Note that "necessity" is but one part of the equation. Competence, integrity, honesty, and accountability each play at least as great a role in the minds of many, including, um, the Army Times:

http://www.cnn.com/2006/POLITICS/11/03/rumsfeld.resign/index.html

However, to get back to medical care of patients while in-country:

I was never deployed to Iraq, but I believe Mitch Connie implicitly.

I wonder what JCAHO would have to say if it inspected our deployed medical sites? Oh, that's right...deployed medical teams are not subject to any civilian medical oversight whatsoever.

This is perhaps why it was common practice during a MEDCAP humanitarian mission to a certain Central American country ca. 2003 to have one anesthesiologist or one unsupervised nurse anesthetist caring for three patients with cataracts at a time in the same room (personal report from the deployed anesthesiologist). Infection control, sminfection control. Vigilance, smigilance. The patients are poor, uneducated locals who have no recourse to a viable legal system if anything goes wrong. Luckily, our brave active duty troops can sue the U.S. government if the care they receive while deployed is substandard.

Oh, wait...http://usmilitary.about.com/library/milinfo/blferes.htm

"Television can have a strong influence on the weak-minded."
--Paraphrase of Obi-Wan Kenobi's famous quote.

--
R

P.S. I encourage y'all to read this Letter from a Battlefield Hospital: http://www.blackfive.net/main/2005/12/letter_from_a_b.html

Take-away lessons I got:

1) JCAHO is a "burdensome" issue that DEPMEDs don't have to deal with
2) Opthalmologist is being allowed to "play" by drilling holes in our soldiers' heads for fun (wonder if he was credentialed to do so? Oh wait, credentialing is yet another "burdensome" issue that deployed medical activities don't have to worry about...)
3) "the anesthesia providers coming around like all of the other doctors" (i.e., CRNAs as M.D.s)
(remainder redacted by author as distraction from primary points he tried to make)

 

[Ex-44E3A]

I guess I wasn't as torqued by that letter as you were, MC.

all surrounded by a toxic miasma of proselytizing, Evangelical Christianity espoused from the top down.

Unless somebody tried to kidnap and baptise you one time, I honestly don't understand your beef with Christians. If you're some kind of Neo-Pagan or agnostic that's fine, but why do you care what everyone else believes? They were praying for a dying man, and it's as easy as looking at a wounded soldier's dog-tags to determine his religious affiliation. I'm not jewish, but I'd never take offense at a jewish patient whose rabbi had come in to pray for him. It may not be my beliefs, but I could care less if they wanted to dance around, paint their faces, and slaughter a chicken (unless they don't clean it up afterwards 😡 )

If people around were "uncomfortable" with that ad-hoc last-rites thing, then that's unfortunate... but would you have preferred if they'd raised an objection or made some kind of scene about it? What kind of solipsistic arch-atheist would it take to polish their anti-theist bona-fides on somebody else's deathbed? That's Fred Phelps territory there...

As for JCAHO, they absolutely are a pain in the ass. Don't you remember all the effort, briefings, coaching, etc that heralded a JCAHO inspection, all so that the facility could "game the system" and pass? All the admin types making OPR bullets for themselves by becoming "deputy JCAHO coordinator consultant specialists?" Didn't that drive you absolutely insane? JCAHO is a ineffective bureaucratic-heavy check-box system that adds little or nothing to patient care... I've never been impressed with them. "JCAHO says X" was one of those clubs that the clipboard-carriers used to bludgeon the physicians, and it was nice not to have to listen to that in the field. We all knew what we were doing.

One a side note: I am truly saddened by mitchconnie's revelation that the clipboard carriers have finally migrated out into the field. The commanders really need to rein that X@!% in and leave the docs alone.

 

[pgg]

Please don’t take this kind of media hype as an accurate reflection of the medical experience in Iraq. Believe it or not, I was at Balad during the filming of the piece, and actually pictured in the video. Yes, we did some great cases and saved some lives, but the same shenanigans that go on in stateside MTF’s also go on in-theater. There is no dichotomy—great care in theater/poor care at home. The same under trained urgent-care staff from your local AFB are manning the ER at Balad. The same clipboard nurses that make your life hell at Travis AFB are there in Iraq showing you hours of Power Point presentations. The same non-clinical commanders hassling you about RVU’s at Wilford Hall remain obsessed with non-clinical endpoints in Iraq.

I easily believe all of this - and to some extent witnessed it myself. I'll just add my experience in Iraq and Afghanistan to the thread ... work environment varies a lot from place to place within each country.

I deployed as a GMO to Afghanistan in 2004 and Iraq in 2005-2006. Both places were mature theaters by the time I got there, and compared to the early days of either invasion, the support:combat troop ratio had tipped toward the support side. Both places now have more support personnel than combat troops, and the ratio is far FAR worse at big bases.

I spent 95%+ of my Iraq deployment at Al Qaim, a small FOB close to where the Euphrates crosses the Syria-Iraq border. A few thousand people were there, the majority of which were combat troops who spent most of their time carrying weapons in the streets of some Iraqi ghetto. There was a FRSS/STP there which varied a little in staffing but had 1-2 anesthesiologists, 2 surgeons, an ER doc, PA, 2 critical care nurses, ~30 Corpsmen. (I think the group that relieved them had a FP instead of the ER doc.) When casualties came in, I'd go over with 5-10 of my Corpsmen to run the overflow bays. There were no sweater commandos, no clipboards save the ones holding the trauma record, no one ever gave us any admin **** about anything. Eat, sleep, wait around, take care of casualties when they arrived. Most of the FRSS staff felt that working there was some of the "purest" medicine any of us had ever practiced - the most deserving patients and an environment completely devoid of any administrative work or non-clinical duties. I felt the same way, until the casualties were gone and I had to go back to my GMO job and deal with all the admin issues in that area. (But that's just GMO life anywhere.) There was a common purpose and camaraderie that I haven't experienced before or since.

A stark contrast to Al Qaim was Al Asad, a fairly large airfield that housed my battalion's Regimental superiors. I passed through Al Asad going to/from Al Qaim, and made a couple of trips there during the deployment for admin issues. Picture a military base in a combat theater where everyone carries weapons, but they're never loaded. The non-combat support staff predominated ... eg, an NCO manning each desk at each base gym, someone has to play the "Salsa Night" music at the disco, someone has to drive the base shuttle to get people from their policy-paper-producing offices to the Pizza Hut or movie theater, etc. I have no trouble at all believing that the metric-measuring, RVU-counting, annual-suicide-prevention-training-verifying Administration Corps has fully infiltrated and taken over all bases in Iraq larger than Al Asad. I suspect there are a fair number of O5's looking for O6, padding their resumes with "combat" tours in an Iraq office that looks just like their US office, producing ... something ... that can be highlighted on their fitreps. Then again, maybe my little O3 self just doesn't grasp the bigger picture or understand how all that crap helps us kill insurgents.

I had similar experiences in Afghanistan, where my time was split almost 50-50 between Bagram (big, central base) and smaller FOBs on the Pakistani border. As a GMO, I spent a little time at the AF hospital in Balad (lots and lots of humanitarian surgeries were good opportunities for me to latch on to someone and get some OR time), and though I was never directly subjected to it, I occasionally witnessed little power struggles between the doctors/staff who just wanted to work, and the clipboard carriers. In contrast, the STP in Salerno was much like the one in Al Qaim.

YMMV. My experiences are probably not typical.

 

[Ex-44E3A]

The same clipboard nurses that make your life hell at Travis AFB are there in Iraq showing you hours of Power Point presentations

Gah... death by powerpoint. A horrible fate indeed.

You know, some soldiers spend their entire time in the desert, hoping and praying they'll qualify for the coveted PPT Ranger Tab . Only a select few can be so elite...

 

[MedicalCorpse]

I guess I wasn't as torqued by that letter as you were, MC.

all surrounded by a toxic miasma of proselytizing, Evangelical Christianity espoused from the top down.

Unless somebody tried to kidnap and baptise you one time, I honestly don't understand your beef with Christians. If you're some kind of Neo-Pagan or agnostic that's fine, but why do you care what everyone else believes?

All right, reverse it then. Alternate reality. You are stuck in Balad as the lone Christian physician among rabidly Evangelical Necronomiconical Satanists. The Fourth Amendment to the Objective Constitution of the United States of Columbia guarantees you freedom from state imposition of religion...yet your Unit Commander, her XO, and everyone around you worships the Great and Terrible Power Pazuzu, Lord of the Southwest, Protector against the Vile One, Lamashtu, Hated Be Her Name.

After almost an hour of frantic attempts at resuscitation, one of your valiant troops dies. Everyone falls silent. Suddenly, the First Apostate Chaplain in the Corner starts to lead the gathered medical and nursing caregivers in an ancient and chilling ululation:

"Hail, Pazuzu! Hail, Chthlhu! Ia Ia Chthlhu fhtagn! Zinaga Ka Oauiao! Let us now join together in Dark Remembrance of the body and spirit of this one, whose immortal soul even now revels in the Unspoken Delights of the Eternal Danse Macabre! Hail to you, Specialist Emanon, for you have crossed over into the Eternal Brilliant Darkness before us! Sing for us, dance for us, **** for us, until one day we too inevitably witness the Unblinking Eye Before Us, world everlasting, Praise Baal!"

You, as the lone Christian among them, gulp in twisting anxiety. Sweat pours from your brow. You don't want to seem different from your colleagues, but...you were raised to believe in the Holy Bible, and Jesus, and God the Father, not the Ancient Ways.

Your Dark Praetorian O-6 looks at you with a quizzical expression...you avert your eyes from her laser-like glance.

"Dr. 44E3A, will you not honor our fallen comrade by consigning his immortal soul to the Dark Abyss from which we all came?"

You swallow your rising bile, clear your throat, and say to your Commanding Dark Praetor, who holds ultimate sway over your military career:

--
R

 

[MedicalCorpse]

The same clipboard nurses that make your life hell at Travis AFB are there in Iraq showing you hours of Power Point presentations

Gah... death by powerpoint. A horrible fate indeed.

You know, some soldiers spend their entire time in the desert, hoping and praying they'll qualify for the coveted PPT Ranger Tab . Only a select few can be so elite...

This is nothing. Witness the August Power and Majesty of the True PowerPoint Ranger:

http://www.medicalcorpse.com/pptranger.jpg

--
R

 

[The White Coat Investor]

Alternate reality.

Sing for us, dance for us, **** for us, until one day we too inevitably witness the Unblinking Eye Before Us, world everlasting, Praise Baal!"

--
R

Is it just me or are Corpse's posts getting weirder every day. Perhaps I'm an anti-Satanist or anti-Pagan or something, but I think I might be weirded out working next to him in the desert for a few months straight. The evangelical Christians I could handle, the Paganism-no problem, the psychotic creativity, however, would drive me nuts. (Too many commas?)

Alternate reality? No kidding.

Nurse- "Dr. Corpse-that ketamine was for the patient."
Corpse- "Look you clipboard toting missionary, back off before I blister your backside with witty comments! Come to the dark side!"

All joking aside, your extremism pushes others away from joining your cause (I'm referring, of course, to your efforts to change military medicine, not evangelize paganism.)

 

[MedicalCorpse]

are[/I] a pain in the ass. Don't you remember all the effort, briefings, coaching, etc that heralded a JCAHO inspection, all so that the facility could "game the system" and pass? All the admin types making OPR bullets for themselves by becoming "deputy JCAHO coordinator consultant specialists?" Didn't that drive you absolutely insane? JCAHO is a ineffective bureaucratic-heavy check-box system that adds little or nothing to patient care... I've never been impressed with them. "JCAHO says X" was one of those clubs that the clipboard-carriers used to bludgeon the physicians, and it was nice not to have to listen to that in the field. We all knew what we were doing.

Ya, I was the JCAHO "champion" for anesthesia at Travis in 1996, and again in 2000. I also witnessed the JCAHO inspections at Andrews in the early 2000s. The JCAHO reps seemed more interested by orders of magnitude in piddling rule adherence than clinical patient care.

The primary "ding" the JCAHO inspectors gave us ca. 1996 was that we didn't have appropriately "empowering" processes implemented for intubated patients in restraints. Thereafter, I guess about 5 or 6 people went into the ground because they were "empowered" to yank out their endotracheal tubes in an "empowered" fashion, while the MICU and SICU residents were incompetent to reintubate them before their terminal desaturation. At Andrews, the air exchangers which regulated the environments of all of the O.R.s literally blew up while the JCAHO inspectors were rounding. Whooomp! We passed anyway. Go figure.

Yes, I agree with you in principle: JCAHO is a self-replicating virus which sets non-clinical rules for clinicians to follow. However, having said that: who sets the rules for "standard of care" in the field (Iraq, Afghanistan, soon Iran): board-certified physicians, or Powerpoint Ranger, clipboard-carrying nurses?

And who in the (fill in adverse afterlife of choice) allows ophthalmologists to drill holes in our troops' heads without specific pre-deployment training or credentialing?

--
R

 

[MedicalCorpse]

Is it just me or are Corpse's posts getting weirder every day. Perhaps I'm an anti-Satanist or anti-Pagan or something, but I think I might be weirded out working next to him in the desert for a few months straight. The evangelical Christians I could handle, the Paganism-no problem, the psychotic creativity, however, would drive me nuts. (Too many commas?)

Psychotic creativity. Like the Tanu of Julian May's cycle.

Thank you very much, Desperado.

That's the nicest thing anyone has said to me in many moons.

Your pal,

Rob

 

[MedicalCorpse]

(redacted by author as distraction from primary points)

 

[MDDOWhatever]

Is it just me or are Corpse's posts getting weirder every day.

No, it's just you. That was a brilliant post by Corpse. His point was very well made.

 

[MedicalCorpse]

No, it's just you. That was a brilliant post by Corpse. His point was very well made.

Thanks.

--
R

 

[Ex-44E3A]

Ahahahahahahahahh! *gasp*

ur Dark Praetorian O-6 looks at you with a quizzical expression...you avert your eyes from her laser-like glance.

"Dr. 44E3A, will you not honor our fallen comrade by consigning his immortal soul to the Dark Abyss from which we all came?"

Man... that was great I can't wait to read your book.

I might be afraid that such a group would use me as a human sacrifice (thank God I'm not a virgin) and then worship their dark master while gorging themselves on my foul, bloated corpse... but I wouldn't have a problem politely telling my commander to sod off... I ain't worshiping Iblis or whatever-his-name-is, and nobody can make me.

Really... I'm puzzled why you find christians that intimidating, even the evangelicals. I find the average Jehovah's witness to be far more proselytizing, persistent, and in-your-face than the average run-of-the-mill christian.

But as long as we're talking Alternate Universe, If I was terribly worried about my career in such a situation (or just that much of a suck-up), I would strategically position myself near that cute Lt. I'd been eyeing (female for me please) bow my head, and pretend to pray to the hoary Lord Of The Underworld, all while using that opportunity to do some worshiping of my very own...😉

 

[The White Coat Investor]

Define extremism. Is it perhaps not agreeing with the Christian majority viewpoint? Is is perhaps not kowtowing to Commanders who want to push Evangelical Christianity down the throats of their subordinates?
R

Definitions of extremism on the Web:

any political theory favoring immoderate uncompromising policies
wordnet.princeton.edu/perl/webwn

Extremism is a term used to describe either ideas or actions thought by critics to be hyperbolic and unwarranted.
en.wikipedia.org/wiki/Extremism

 

[|2idicu|ous]

This thread started out as a simple link to CBS news video that was a testimonial to the hard work that the doctors, nurses, and medics do in Iraq. Now look at where it has been taken. It's sad.

 

[Galo]

This thread started out as a simple link to CBS news video that was a testimonial to the hard work that the doctors, nurses, and medics do in Iraq. Now look at where it has been taken. It's sad.

Once again, you'd prefer people not say anything negative, (true). Unfortunately there is alot of negative, and we are here to tell people about it so they can make more informed decisions. Take your justice elsewhere, as you are in no position to judge us. The whole point, is that the piece is propaganda, and the truth lies in a different way than it was presented. Surpring you cannot grasp that, but then again, you have a relative inexperience in life that you seem to overextend.

 

[Monty Python]

This thread started out as a simple link to CBS news video that was a testimonial to the hard work that the doctors, nurses, and medics do in Iraq. Now look at where it has been taken. It's sad.

Thanks to all for their varied, heart-felt, and honest thoughts on this thread. Time to let it die a dignified death.

 

[Monty Python]

Thanks to all for their varied, heart-felt, and honest thoughts on this thread. Time to let it die a dignified death.

Re-opened at reader's request. Enjoy.

 

[midn]

This thread started out as a simple link to CBS news video that was a testimonial to the hard work that the doctors, nurses, and medics do in Iraq. Now look at where it has been taken. It's sad.

I think the most important point that you missed is that someone was actually there for the making of the video and was able to clarify what was actually going on. I shared similar views to you when I first read this forum also thinking most of these former military doctors (and current) were missing the point of self-sacrifice. What I have come to realize is that most of these doctors were willing to take hardship to better the lives of their patients, but the constraints placed by the military were (and still are) unnecessarily affecting the patients' well being and making quality of life for the doctor worse for no good reason.

During my first year of ROTC, I naively believed that everything that was being done was right, but after starting the second year, I immediately started seeing inefficiencies and realized how this would apply to any future career in medicine I might hold in the military. The military is so slow to change its leadership styles because it fears liberalization. There is unbelievable contempt for liberalism (i.e., incorporating new ideas that allow freedom of thought) in the military thinking that it would make soldiers soft and useless in stressful situations. This gives your superiors pretty much a blank check to do anything to make your life more stressful without necessity as they see it as training for the battlefield ahead. I'm not sure how effective this is since I have yet to be deployed.

It shocks me how many of my peers complain about certain activities, and when they get into a leadership position, enforce that which they hated. There is an obligate gag rule for retaining higher positions. You're to perpetuate the status quo and only speak up when standards are not being met. Do not point out the failure in the standards.

So please, do not become enamored by propaganda and allow abuses in the military to occur because of some martyr-complex. Be assertive, and don't ignore these doctor's opinions just because you don't like it.

 

[|2idicu|ous]

👍 Thirteen minute clip from a recent broadcast of "60 Minutes." Shows various facets of trauma care on the front-lines from 'copter evacuation to OR to airevac to Germany. Despite the pros and cons of military medicine discussed on this forum, you've got to give thumbs up to these folks in harm's way.

http://www.cbsnews.com/sections/i_video/main500251.shtml?id=2135920n

trinityalumnus- why did you start this thread?

 

[Galo]

I think the most important point that you missed is that someone was actually there for the making of the video and was able to clarify what was actually going on. I shared similar views to you when I first read this forum also thinking most of these former military doctors (and current) were missing the point of self-sacrifice. What I have come to realize is that most of these doctors were willing to take hardship to better the lives of their patients, but the constraints placed by the military were (and still are) unnecessarily affecting the patients' well being and making quality of life for the doctor worse for no good reason.

During my first year of ROTC, I naively believed that everything that was being done was right, but after starting the second year, I immediately started seeing inefficiencies and realized how this would apply to any future career in medicine I might hold in the military. The military is so slow to change its leadership styles because it fears liberalization. There is unbelievable contempt for liberalism (i.e., incorporating new ideas that allow freedom of thought) in the military thinking that it would make soldiers soft and useless in stressful situations. This gives your superiors pretty much a blank check to do anything to make your life more stressful without necessity as they see it as training for the battlefield ahead. I'm not sure how effective this is since I have yet to be deployed.

It shocks me how many of my peers complain about certain activities, and when they get into a leadership position, enforce that which they hated. There is an obligate gag rule for retaining higher positions. You're to perpetuate the status quo and only speak up when standards are not being met. Do not point out the failure in the standards.

So please, do not become enamored by propaganda and allow abuses in the military to occur because of some martyr-complex. Be assertive, and don't ignore these doctor's opinions just because you don't like it.

My congratulations on your very keen insight. Keep up your observations, and always remember you're duty as a physician first and foremost. Believe it or not, by being exposed to all the crap that we went through, your navigation through the death field that is military medicine will be much smoother.

 

[Monty Python]

trinityalumnus- why did you start this thread?

To kick the antpile, throw gas on the fire, challenge the paradigm (gag), etc.

No, actually, it was a simple posting for those interested in the topic, complete with video component. No political message was included nor implied on my part.

Plus, I always enjoy guessing (and then seeing) what milmd and medicalcorpse's replies will be.

 

[|2idicu|ous]

No, actually, it was a simple posting for those interested in the topic, complete with video component. No political message was included nor implied on my part.

Thats what I thought. My understanding of your thread was that you wanted to show video of medical personnel in Iraq as a sort of tribute or reminder of what they are doing over there despite the many problems that exist within the system. Your wording was "Despite the pros and cons of military medicine discussed on this forum, you've got to give thumbs up to these folks in harm's way." That sentence says to me "for the moment (ie this thread), lets forget all the pro/con crap and think about those doctors who have to do their duty in Iraq." You could have just said "you've got to give thumbs up to these folks in harm's way" but you included that phrase. To me, it was clear you meant to ignore that part of the debate and just focus on the difficult work of doctors in Iraq. Plus, anyone who has spent anytime on this forum knows that many of the things said within the video were not necessarily true (aka propaganda).

So please, do not become enamored by propaganda and allow abuses in the military to occur because of some martyr-complex. Be assertive, and don't ignore these doctor's opinions just because you don't like it.

If you think I was enamored by the propaganda or that I am ignoring the experienced doctor's opinion, you haven't read any of my posts on this thread. http://forums.studentdoctor.net/showthread.php?t=335222

The point of my post, Midn and Galo, was that I thought it was strange and annoying the direction the thread went. Why strange and annoying? b/c my understanding of the original post was that it was meant to say "hey, despite all the crap involved with military medicine, look at what our fellow docs are doing in Iraq and we shouldn't forget them". [yes, thats the third time I've rephrased] Then it turned into a rehashment of criticisms of the war, Christianity and its role in the military, and who knows what else it may yet find.

As USAFDoc said:

I have no problem giving thumbs up for those serving in Iraq; thats everybody..the marines, the military docs, techs, the ARMY soldiers..everybody.👍

The debate on the necessity of the war could be another thread for those interested.🙂

I trust mitchconnie's overall assessment of the medical situation over there. 👍 👎

I trust the vast majority of physicians assessments of military medicine in general. 👎 👎

I will say this though- MedicalCorpse's reversal post to Desperado was excellent. However, if in such a situation that makes you so completely uncomfortable, I think it would be easy enough to find yourself out of the room (or tent) or, at the least, just politely decline to participate. But I also have to agree with Desperados statement:

All joking aside, your extremism pushes others away from joining your cause (I'm referring, of course, to your efforts to change military medicine, not evangelize paganism.)

I offer this as a service to you (agree or disagree, it is how many feel): I've been perusing these forums for like a month and a half and I'm already tired of seeing MedicalCorpse's (and to some extent the rest of the bitter vets) opinion- and really it's not your opinion that is tiring and annoying, it's the way you express it. For me, it was your constant new threads on the subject. Some of which are definitely stretching for validity- like the abused monkey study. Another thing is the reactionary posts you guys throw out there. Some newbie to the server asks an uninformed question or makes an uninformed statement or someone expresses a contradictory opinion and it seems your first instinct is to say "what an ignorant fool you are". Likelyhood of that person wanting to listen to you in the future < 10%. If your goal is really to help people understand the realities of military medicine and in some way improve military medicine, I would suggest just being more polite and, to some extent, humble. Because whether it is your intention or not, it's beginning to look like your bitterness has consumed you and your manners. Obviously I have no power to change the way you do things, only you or Humunculus do. And it very well may be your decision to keep doing things just the way you like to do them and if so, so be it. It's your cross to bear.(sorry the Christian analogy Rob)

PS- I have to say this everytime I make a post here. Again, I'm not trying to silence you. In fact, I value your experience and opinion and thank you for providing it for us all. I'm going to cross post this too.
PPS- ...i'll save it for another day.