MedSchoolFool: I don't know what branch you served it, but most of my troops were brighter than average... I'd say better educated than the civilian population, but you don't have to believe me:
You will note that I have yet to comment on the "education of the troops" issue. In general, I was often impressed by the intelligence and industry of most of the enlisted folks I met. Many in the medical fields were taking pre-med or pre-nursing classes in their "spare" time (calculus, organic chemistry,
etc.). Yes, there were a few junior enlisted (and junior officers) who seemed a bit, um, less than telencephalically well endowed...such as the PACU tech who almost drowned our SGH after her surgery by hooking up water for humidification to the nasal cannula and then UPENDING the water bottle, so that 4 l/m of water could flood the O-6's lungs...or the 2Lt ward nurse who mistook the CME dressing in the suprasternal area for the d/c'd a-line dressing ("Ya, we get very accurate readings by placing the a-line directly into the aorta, Lt.")
However, there is no doubt that I was struck nearly every day by the ignorance and willful lack of insight displayed by allegedly-educated O-6 and above M.D. administrative Outlook Rangers. The stupidity of Colonels and Generals can harm hundreds or thousands through ill-considered policies that endanger patients on a grand scale. After around 2001, there was only one O-6 M.D. I really looked up to (Dr. R., a rheumatologist, who had been my attending during internship). All the rest were either ROAD scholars or well on their way to needing lap colostomies to prevent soiling of their e-mail decubiti. Funny, the worst of the worst were all Academy grads...imagine that. When one's formative college years are spent, not in apprehending the universe inductively, but in being molded into a square peg to fit the square hole the Air Force
thinks it needs to fill, the result, in my personal experience over 19 years, is not a human who values a subordinate who can say "Sir, No Sir."
Moreover, I don't think anyone can argue that the U.S. military is a nurturing place for the truly gifted.
Deru kui wa utareru: The stake that stands up gets hammered down. I found it amusing that, ca. 2004, an officer's higher education and degrees were forbidden from being included in OPRs or promotion recommendations. SSS and other mind-numbingly obtuse PME offal were held in higher regard than, say, an MBA from Wharton.
(from one of my prior threads here:
http://forums.studentdoctor.net/showthread.php?p=4132147 )
Here's an interesting set of articles about the role of intellectuals in the U.S. military:
http://www.carlisle.army.mil/USAWC/P...r/mastroia.htm
Occupations, Cultures, and Leadership in the Army and Air Force
by (Reserve LtCol) GEORGE R. MASTROIANNI
"There is an absolutist and anti-intellectual strain in Air Force culture (as many have observed in military culture more generally) that resonates with a view of the world as simple and clear. Confidence in the intellectual superiority of the Air Force over the other services coexists with what sometimes appears to be contempt for the rough-and-tumble of open intellectual discourse. The paradox of Air Force culture is that it can be decidedly anti-intellectual—a circumstance perhaps not uncommon in authoritarian cultures such as the military—but nevertheless convinced of its intellectual superiority. This tendency is perhaps stronger in the Air Force than in the other services.
These aspects of global Air Force culture also affect organizational forms and penetrate the thinking of the rank and file, implicitly modeling a more hierarchical, executive, personal model of decisionmaking that shapes the culture of leadership in the Air Force. The responsibility of the Air Force for controlling a component of the American strategic nuclear deterrent may also have led to broad institutional reliance on organizational models characterized by concentration and elevation of decisionmaking power in highly centralized structures."
and
http://www.ausa.org/webpub/DeptArmyM...id/CCRN-6CCS4R
The Uniformed Intellectual and His Place in American Arms: Part I
by COL. LLOYD J. MATTHEWS, USA Ret.
In 1890, U.S. Navy Captain Alfred Thayer Mahan published The Influence of Sea Power Upon History, 1660-1783, the most influential book ever written by a serving officer with the arguable exception of Clausewitz's On War. For this feat, his endorsing officer, Rear Adm. Francis Ramsay, rewarded him on his fitness report with the following glowing encomium: "It is not the business of a Naval officer to write books." It is precisely this sort of attitude on the part of the bosses of military intellectuals that has led such thinkers as H. G. Wells to claim that "the professional military mind is by necessity an inferior and unimaginative mind; no man of high intellectual quality would willingly imprison his gifts in such a calling." More amusing than Capt. Mahan's poor fitness report but no less tragic in its import is this lament from a Navy officer passed over for promotion: "I cannot understand why I wasn't selected: I've never run a ship aground; I've never insulted a senior officer; and I've never contributed [an article] to the Institute's Proceedings."
(Of note, both articles criticize the Army as well as its sister services.)
SO, rather than focusing on the educational and/or intellectual shortcomings of junior enlisted and junior officers, what would really benefit U.S. military medicine would be a reformation of its toxic, anti-intellectual, dissent-quashing, sir-yes-sir-I'll-help-torture-that-prisoner-sir culture, which sees questioning as heresy, and principled, ethical refusal to commit medical malpractice on demand as treason. When standing up for what is right, intellectually, medically and ethically, in the face of trenchant (and invariably scientifically incorrect) political opposition becomes a sought-after OPR bullet, rather than a bullet in the back of the head of one's military career, then and only then can U.S. military medicine start the long climb out of the fen of mediocrity it finds itself in now.
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R