Your last deployment: what was the "routine" day in the life?

[Porthos1000]

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Your last deployment: what was the "routine" day in the life?

Could you describe in terms of:
-how many guys you treated in a given day at the medical base?
-what you usually treated if not combat wound related?
-how you guys approached the traumas that came in -- you stabilize, then medevac to a CSH?
-anyone go on patrols?
-avg #hrs sleep / night?

Thanks.

 

[backrow]

Your last deployment: what was the "routine" day in the life?

Could you describe in terms of:
-how many guys you treated in a given day at the medical base?
-what you usually treated if not combat wound related?
-how you guys approached the traumas that came in -- you stabilize, then medevac to a CSH?
-anyone go on patrols?
-avg #hrs sleep / night?

Thanks.

Was a flight doc in Iraq:

-Guys treated: maybe 10-15, sometimes more, sometimes 1-2
-sprained ankles, booboos, colds, coughs, STD's, more booboos, a sliced finger from trying to open an xbox game, a shredded finger from trying to clean a shredder, oh and more colds and coughs....almost forgot new onset Afib w/ RVR
-Trauma: what trauma? I was a GMO, didn't see anything worse than a self inflicted knife wound. If a trauma had come in they would have immediately been thrown in my truck and taken to the CSH.
-Patrols: went on some flights. Wouldn't go on a ground patrol if they had let me and wasn't allowed to fly with the medevac's due to Navy "wussiness"
-avg hrs sleep/nt: 8-10, with a bunch of broken nights due to someone needing cold medicine and deciding it was important at 2am. Oh and XBOX might have made for some short nights.


Okay, some of the above is in slight jest, but if you're a GMO these days, that's about what it's going to look like. If you are residency trained then plan on being based at a hospital that might have a slightly higher acuity. Also depending on which one you are at and where the fighting is you may be working your tail off.

 

[Porthos1000]

Geez, that's really it, huh.

What about if I'm residency trained in internal med which I am, with mostly outpatient experience to date . Am I more likely to be deployed to a larger hospital in the theater, rather than closer to the front itself? Same for the Family med guys? How the hell does a pediatrician get to do trauma -- like this guy -- google "Erik Schobitz army" and see the pdf file, and also note he's peds trained.

 

[Jet915]

Was a flight doc in Iraq:

-Guys treated: maybe 10-15, sometimes more, sometimes 1-2
-sprained ankles, booboos, colds, coughs, STD's, more booboos, a sliced finger from trying to open an xbox game, a shredded finger from trying to clean a shredder, oh and more colds and coughs....almost forgot new onset Afib w/ RVR
-Trauma: what trauma? I was a GMO, didn't see anything worse than a self inflicted knife wound. If a trauma had come in they would have immediately been thrown in my truck and taken to the CSH.
-Patrols: went on some flights. Wouldn't go on a ground patrol if they had let me and wasn't allowed to fly with the medevac's due to Navy "wussiness"
-avg hrs sleep/nt: 8-10, with a bunch of broken nights due to someone needing cold medicine and deciding it was important at 2am. Oh and XBOX might have made for some short nights.


Okay, some of the above is in slight jest, but if you're a GMO these days, that's about what it's going to look like. If you are residency trained then plan on being based at a hospital that might have a slightly higher acuity. Also depending on which one you are at and where the fighting is you may be working your tail off.

I was a flight surgeon in Afghanistan and it's pretty much exactly the same. I did have the opportunity to do patrols and "village medical outreach" ie giving afghans tylenol and oatmeal but gladly declined. I did get to fly alot out there as an aerial observer (about 100 hours) in combat missions which was fun/exciting. I did see trauma but that's because I volunteered at the trauma hospital, our clinic in a tent saw no real trauma. I did one casevac out there but the two afghans were stable so didn't do anything.

 

[texdrake]

Your last deployment: what was the "routine" day in the life?

Could you describe in terms of:
-how many guys you treated in a given day at the medical base?
-what you usually treated if not combat wound related?
-how you guys approached the traumas that came in -- you stabilize, then medevac to a CSH?
-anyone go on patrols?
-avg #hrs sleep / night?

Thanks.

How about current deployment instead?

1. First don't assume you are going to a medical base (ROLE III or ROLE II). Most first time deployers will actually go to a unit (ROLE I). Especially if you are Army or Navy. I am currently deployed to Middle-O-Nowhere, Afghanistan. I am the doctor for my battalion. However your command can do whatever they want with you so in my case instead of being at a larger base where close to half my unit is located, I am pushed out to a far forward base taking care of a little less than a full company of soldiers (about 100 guys). In a given day I may see two patients. I am here in case there is trauma but for the vast majority of my deployment it has been a waste of my time and skills (However this is preferable to me being used and us having heavy casualties). If you go to a Role II or III you could see anywhere between 5 and 20 patients a day depending on what your job description is.

2. Mostly I see musculoskeletal complaints and colds, and GI issues. I am a glorified army medic out here.

3. Time to treatment is pushed very hard out here. Most bases with ROLE I's (Standard Aid Stations) don't see much trauma unless the base is attacked or the accident happened right outside. If at all possible they will medevac the injury directly from point of contact to a surgical team at an Advanced Role II (Forward Surgical Team) or Role III (Combat Hospital). Our unit hasn't had many casualties thankfully but almost all of them have not come back to me at the Role I. If they do come to you, your job is to stabalize and package for transport. You don't really have the resources in most cases to sit on a patient for to long.

4. You can volunteer for patrols or you can be voluntold in some cases. I am not big on going outside the wire. Personally I think it adds to much risk to my unit (there is no replacement for me) and I have a family I plan to go home to. However if I were a single man I probably would volunteer for a few missions just to break up the monotony. I have done 5 or 6 missions (about 1 every 6-8 weeks), generally the convoy commanders don't let the docs out of the vehicle unless they know it is safe. Most of my missions have been to check on outlying bases or to do medical interaction with locals.

5. As a doc you are the boss in most cases so unless you are at a Role III you can usually set your own schedule. I sleep 9 or 10 hours a night out here because I don't have much to do. In fact I am better rested here than I have been since High School.

I spend my days studying, working out, and watching movies. I don't have great internet access at my base so that hinders my CME big time but bigger bases have wireless and what not. I brought a CURRENT 2010 Diagnosis and Treatment and I am about 1/2 way through it. I also read the medical journals my wife sends me. I got big into fitness when I got here and lost 35lbs. That has since slowed down more due to boredom now. My R&R is only a few weeks away and i am just tired of being here. I hope to pick back up on the fitness more when I return.

My current day:

0800 - Getup
0900 - Internet time
1030 - Workout if I feel like it
1230 - lunch
1330 - Study/Read - I usually have a few patients in the afternoon too
1800 - Dinner
1900 - Meeting
2000 - Call the wife
2030 to 24000 - read/watch movies.

 

[pgg]

4. You can volunteer for patrols or you can be voluntold in some cases.

If you're getting voluntold to go out on patrols, you need to speak to some O5 or O6 in your medical chain so they bring it to the attention of the relevant O6 or O7 line officer so he can put a stop to it. The line needs to be occasionally reminded that doctors are not patrol or "op" material.

 

[bustbones26]

I was a neurologist deployed as a GMO with an infantry battalion. NEVER assume that you are going to be restricted to working at a CSH or large hospital just because you are a specialist.

-how many guys you treated in a given day at the medical base?

Depends, it varied. Depends on how many people felt like showing up in a day to be seen. I don't think I ever saw more than 12 in a day.

-what you usually treated if not combat wound related?

"Diarrhea cha cha cha"!!! Before you think I am making a childish joke, "the skitz is a common problem at a FOB. Easy stuff though. The medics just see the soldier, if diarrhea is severe, maybe give the guy fluids, dispense immodium, ask you if its okay, you say yes, and that is all.

Musculoskeletal and derm issues are a big hit. Too many people hurt their back doing dead lifts. Near the end of the tour when people suddenly have to do a PT test, there is a surge of musculoskeletal complaints. If you are handy doing joint injections, this is easy stuff

-how you guys approached the traumas that came in -- you stabilize, then medevac to a CSH?

Pretty much that is all there is to it.

-anyone go on patrols?

Yeah it happens. I think its kind of fun how some people think that you can convince your leadership that you shouldn't have to go or that maybe you have a choice, but sometimes, you don't. One missions where the unit plans on moving a long distance and perhaps being a far distance from a medical facility, they insist on taking you along. Informing them that even if you happened to be the greatest doctor on the face of the planet, but if all you have at your disposal it the contents of a medic's bag, you cannot do anything more than what a medic can do. That won't fly and they will take you anyways.

-avg #hrs sleep / night?

Slept more in Iraq than I ever slept in the past 10 years. Carried a radio and was "called" only if there was an emergency. If a soldier came in with a BS thing at night, they told them to come back during sick call hours.

 

[Atlas Shrugged]

All of your replies are both saddening and underwhelming.

Maybe milmed isn't for me after all =\.

 

[pgg]

I was a neurologist deployed as a GMO with an infantry battalion. NEVER assume that you are going to be restricted to working at a CSH or large hospital just because you are a specialist.

Well, it depends on the specialty. You won't see any orthopedic surgeons or anesthesiologists filling GMO billets.

 

[Perrotfish]

All of your replies are both saddening and underwhelming.

Maybe milmed isn't for me after all =\.

Boring GMO tours are a good thing. They mean the enemy can't consistently shoot down our helicopters so that we can medevac everyone who needs it. The only thing better would be peace.

 

[brucecanbeatyou]

All of your replies are both saddening and underwhelming.

Maybe milmed isn't for me after all =\.

I'm not saying that the majority of GMO's are shooting dudes with one hand while amputating limbs with the other, but something to think about is who posts on sdn. Is it going to be people who have time to do it.

 

[AF Gas passer]

I am deployed currently at an Air Force Role 2 (FST) in Afghanistan. We are a bunch of airmen fulfilling an army tasking (Joint Expeditionary Tasking). We are here for trauma, so essentially we are on call 24hrs a day. Well, just the anesthesiologists. I'll explain. We are here along with the Polish. They have a Polish medical element to include surgeons, nurses, techs etc. But they couldn't get an anesthesiologists to deploy. Its all voluntary apparently. So, my coworker and I are the only anesthesiologists on the FOB. We alternate days with the Pols as to who takes primary call. If they are on, they take any non-Polish and non-American traumas. We take care of our own regardless of who's on. But, as for anesthesia, we have to support both sides. Also, when the Pols are on, we also have a US Gen Surgeon on with them so they dont muck things up too bad. They are on two nights at a time as anesthesia are as well. That way, one surgeon doesn't get stuck being on call all the time when the Pols are on. So, my day begins when I wake up and skype. Then I go to the gym. Work out for about 1.5-2 hrs and make it back for our morning meeting. Then the rest of the day is fluid. If we have elective cases, then we do them (very rarely). Otherwise, we replenish the OR, play Call of Duty, sleep, read, go to the bazaar, etc. We all have radios and cell phones, so if a trauma comes in we know about it. We are also collocated with the Dustoff medevac guys (10th Mountain) so when their ops ctr gets a call for a mission, we know about it. Cases can come in at anytime of the day, so we're always ready. We get patients directly from the POI (point of injury). We stabilize, resuscitate, perform damage control surgery and then dispo depending on whether they are US, coalition, or local national. We do not go on patrol and should never as physicians especially as an FST.

 

[rotatores]

.

 

[notdeadyet]

I'm not saying that the majority of GMO's are shooting dudes with one hand while amputating limbs with the other, but something to think about is who posts on sdn. Is it going to be people who have time to do it.

Meh, there have been plenty of gung-ho physicians on SDN, some of which have done GMO tours. No one's come back describing their experience as anything other than skills atrophy.

 

[Kris1]

It must be easy to save bank while you're over there.

 

[pgg]

Umm...ya not true at all as I have an ENT deployed as a GMO with me (I'm assuming you were referring to the more specialized fields in general, not just ortho and gas?).

No I meant specifically ortho and gas, two of the so-called 'war critical specialties' for which there is a constant need above echelon 1. Other specialists, whether endocrinologists or urologists or radiation oncologists aren't in as much demand at STP/FRSS locations.

It'd be utterly ******ed to put an anesthesiologist in an infantry battalion GMO position when about half the anesthesia-providing deployed billets are settling for solo CRNAs.

 

[rotatores]

No I meant specifically ortho and gas, two of the so-called 'war critical specialties' for which there is a constant need above echelon 1. Other specialists, whether endocrinologists or urologists or radiation oncologists aren't in as much demand at STP/FRSS locations.

It'd be utterly ******ed to put an anesthesiologist in an infantry battalion GMO position when about half the anesthesia-providing deployed billets are settling for solo CRNAs.

I see...that does make sense.

 

[texdrake]

Umm...ya not true at all as I have an ENT deployed as a GMO with me (I'm assuming you were referring to the more specialized fields in general, not just ortho and gas?).

Actually he was probably refering to just ortho and gas.

Anesthesia, gen surg, orthopedics, ER, and some OB/GYN tend to be what are deployed to the Role III and Forward Surgical Teams.

Just about everyone else is GMO or if you are higher rank a regimental surgeon (which is mostly paperwork).

It's not about "Time". You have to remember that we have 100,000 soldiers in Afghanistan plus about 40,000 coalition forces and total around 50 casualties a month. Those 150 soldiers have approximately 1000 doctors out here to take care of them and the emergency ones are concentrated were they are most useful.

My battalion (850 guys) alone is spread over 17,000 square miles at 7 different bases (use to be nine).

 

[texdrake]

It must be easy to save bank while you're over there.

Yes it is. I make approximately $1600 more a month while I am here. My wife and child live on our previous budget and all of that extra gets put away in savings and what not. Also I got lucky in that my tour is 7 months in one year and 5 in another so it helps signficantly at tax time as all of your bonuses are still taxed by the Army, but you end up getting most of it back because your relative income is so low (most of your pay is non-taxable downrange). My return this year with one child was north of $9,000! I expect next year it will probably be around 7K as well. Basically a third bonus.....

 

[Ascultator]

How about current deployment instead?

1. First don't assume you are going to a medical base (ROLE III or ROLE II). Most first time deployers will actually go to a unit (ROLE I). Especially if you are Army or Navy. I am currently deployed to Middle-O-Nowhere, Afghanistan. I am the doctor for my battalion. However your command can do whatever they want with you so in my case instead of being at a larger base where close to half my unit is located, I am pushed out to a far forward base taking care of a little less than a full company of soldiers (about 100 guys). In a given day I may see two patients. I am here in case there is trauma but for the vast majority of my deployment it has been a waste of my time and skills (However this is preferable to me being used and us having heavy casualties). If you go to a Role II or III you could see anywhere between 5 and 20 patients a day depending on what your job description is.

2. Mostly I see musculoskeletal complaints and colds, and GI issues. I am a glorified army medic out here.

3. Time to treatment is pushed very hard out here. Most bases with ROLE I's (Standard Aid Stations) don't see much trauma unless the base is attacked or the accident happened right outside. If at all possible they will medevac the injury directly from point of contact to a surgical team at an Advanced Role II (Forward Surgical Team) or Role III (Combat Hospital). Our unit hasn't had many casualties thankfully but almost all of them have not come back to me at the Role I. If they do come to you, your job is to stabalize and package for transport. You don't really have the resources in most cases to sit on a patient for to long.

4. You can volunteer for patrols or you can be voluntold in some cases. I am not big on going outside the wire. Personally I think it adds to much risk to my unit (there is no replacement for me) and I have a family I plan to go home to. However if I were a single man I probably would volunteer for a few missions just to break up the monotony. I have done 5 or 6 missions (about 1 every 6-8 weeks), generally the convoy commanders don't let the docs out of the vehicle unless they know it is safe. Most of my missions have been to check on outlying bases or to do medical interaction with locals.

5. As a doc you are the boss in most cases so unless you are at a Role III you can usually set your own schedule. I sleep 9 or 10 hours a night out here because I don't have much to do. In fact I am better rested here than I have been since High School.

I spend my days studying, working out, and watching movies. I don't have great internet access at my base so that hinders my CME big time but bigger bases have wireless and what not. I brought a CURRENT 2010 Diagnosis and Treatment and I am about 1/2 way through it. I also read the medical journals my wife sends me. I got big into fitness when I got here and lost 35lbs. That has since slowed down more due to boredom now. My R&R is only a few weeks away and i am just tired of being here. I hope to pick back up on the fitness more when I return.

My current day:

0800 - Getup
0900 - Internet time
1030 - Workout if I feel like it
1230 - lunch
1330 - Study/Read - I usually have a few patients in the afternoon too
1800 - Dinner
1900 - Meeting
2000 - Call the wife
2030 to 24000 - read/watch movies.

Honestly this sounds spot on with what I'd want from my day.

I dunno if I should be relieved or worried by that fact --- or both?

Thanks Backrow, Bustbones26, Texdrake for the insights.

 

[NavyFP]

As a senior guy in theater......

0530 - wake up call wife (East Coast)
0630 - breakfast
0700 - Check in with Patient Trackers for new/updated events
0800 - Sick Call Starts
0830 - Meeting
1000 - Meeting
1100 - Lunch
1300 - Afternoon Sick Call
1530 - Work out
1700 - Dinner
1830 - Check in with Patient Trackers for new/updated events
2000 - Meeting
2030 - Meeting
2200 - bed time

Throw in the usual admin for various reports, enlisted evaluations, staffing issues, etc.

 

[The White Coat Investor]

Your last deployment: what was the "routine" day in the life?

Could you describe in terms of:
-how many guys you treated in a given day at the medical base?
-what you usually treated if not combat wound related?
-how you guys approached the traumas that came in -- you stabilize, then medevac to a CSH?
-anyone go on patrols?
-avg #hrs sleep / night?

Thanks.

20

Diarrhea, rashes, colds, knee pain. Maybe one "interesting" case a day-chest pain, abdominal pain, ear foreign body etc.

One trauma. We assembled a trauma team. Ended up being an ankle sprain.

No patrols.

6-12 hours

Edit: Remembered another trauma. Base security guy shot himself through the knee while twirling his gun. They didn't even wake me up. Ortho saw the patient primarily.

Day in the life:

Work Day (I worked every other day):
1800 Get up
1810 Eat Dinner
1900 Report for work. See ~ 10 patients
2300 Patients cleared out, check email, surf internet
0100 Go in for Midnight meal (take radio in case a patient comes)
0130 Return to the clinic, play some bubbleshooter
0300 Pull out a table, play some cards with nurses and techs
0700 Off work, catch breakfast
0800 Go to the gym
0900 Bed time, maybe read for an hour before falling asleep

Off Day
1800 Get up, catch dinner
1900 Go by work, say hi to people. Play some bubbleshooter and surf the internet
2200 Watch the football game at work on the big screen in the waiting area
0000 Catch a Hearts tournament over at the game hall
0130 Midnight meal
0200 Catch a movie
0400 Work out
0600 Meet some colleagues for breakfast
0700 Read Harry Potter
1000 Go to sleep

 

[laughandatear]

I was an AF active duty doc deployed in 2008 with the Army on an ILO (precursor to JET) deployment. i was a dual AFSC psychiatrist/flight surgeon who got deployed as a psychiatrist to manage a small combat stress clinic at a small FOB in S. Central Iraq.

we were busy. 15-20 scheduled patients daily plus walkins and command-consults plus a full complement of classes (anger mgmt, tobacco cessation, relationship improvement, financial mgmt, etc). some of the classes probably didn't need an MD to deliver, but i had the credibility and the troops needed them, so i made the time for it. we held "office hours" 6 days weekly, and had somebody (i had a psychologist and a clinical social worker along with me), in the clinic for walk-ins on sunday as well. we traded the on-call radio weekly for whatever came up at night or whenever. as one of only 4 docs on the FOB (2 FP's and one IM subspecialist picked up as a GMO) i would do what i could from time to time in the troop medical facility, and was de facto on call 24/7 if they really needed me.

average day:
0500--wake up/workout
0630--shower/dress
0700--breakfast
0730--at clinic/see patients/meetings/admin stuff
1130--lunch
1200--back to clinic, see more patients
1700--class of some sort (see above)
1800--dinner
1900--command meetings
2030--call family
2100--hit the rack

it was tough to be away from the fam, but those were simpler times...

 

[Ascultator]

Hmm, everyone seems to have Command Mtgs at 1900, interesting.

I notice some folks have more down time than others, I guess owing to the specifics of location...

ActivedutyMD looks like he had the graves shift?

This brings up two "quality of life" questions I have for deployment. 1) So how do "off-days" work then? I mean, I could potentially be the only doctor around the aid station/base/HQ right? maybe a few medics / corpsmen. Should I be prepared to be on the pager I mean radio 24/7 for a few weeks at a time?

2) Dumb question, but how does internet access work there --- is it as easy as using my own laptop on wifi or ethernet cable? or is it a makeshift "internet cafe" tent and you got a line of troops waiting for their 15 min each?

 

[Porthos1000]

Honestly this sounds spot on with what I'd want from my day.

I dunno if I should be relieved or worried by that fact --- or both?

Thanks Backrow, Bustbones26, Texdrake for the insights.

uh I'd be both if I were you....I duonno, it does sound like a rather flat medical practice in terms of acuity......

 

[texdrake]

Hmm, everyone seems to have Command Mtgs at 1900, interesting.

I notice some folks have more down time than others, I guess owing to the specifics of location...

ActivedutyMD looks like he had the graves shift?

This brings up two "quality of life" questions I have for deployment. 1) So how do "off-days" work then? I mean, I could potentially be the only doctor around the aid station/base/HQ right? maybe a few medics / corpsmen. Should I be prepared to be on the pager I mean radio 24/7 for a few weeks at a time?

2) Dumb question, but how does internet access work there --- is it as easy as using my own laptop on wifi or ethernet cable? or is it a makeshift "internet cafe" tent and you got a line of troops waiting for their 15 min each?

Both depend on where you are and what you do.

1. Off-Days: This only happens at Role III and some Role II. I "work" everyday. When I was on the larger base I would take one day a week as my "off day" in which I made the medics come get me if they needed me. It helped with the sanity. I don't carry a radio but I live in the aid station now and before I was two buildings away.

2. Again really depends. Of our 7 bases only 1 has wireless. One has a huge internet MWR though. All the rest are smaller bases. Here we have 5 computers for 100 people. Most of the guys do missions during the day so its easier to get on the computer then. 30 minute limit but in the morning I am usually on it for about an hour.

 

[Mace1370]

Both depend on where you are and what you do.

1. Off-Days: This only happens at Role III and some Role II. I "work" everyday. When I was on the larger base I would take one day a week as my "off day" in which I made the medics come get me if they needed me. It helped with the sanity. I don't carry a radio but I live in the aid station now and before I was two buildings away.

2. Again really depends. Of our 7 bases only 1 has wireless. One has a huge internet MWR though. All the rest are smaller bases. Here we have 5 computers for 100 people. Most of the guys do missions during the day so its easier to get on the computer then. 30 minute limit but in the morning I am usually on it for about an hour.

Out of curiosity would be you allowed to bring a cell phone that doubles as a portable wifi hotspot (ie: using 3G or 4G)? Would it even get reception?

 

[NavyFP]

Out of curiosity would be you allowed to bring a cell phone that doubles as a portable wifi hotspot (ie: using 3G or 4G)? Would it even get reception?

Ummmmmm.........No. Not in Afgn. Extremely limited reception. 3G/4G???? Yeah, they are more like half G. And (at least by my command) personal cell phones are prohibited. They also won't let you set up your own WiFi.

Provided Wifi is free on my base. Connectivity speed depends on how many are on it. (of course) Total speed is 19M down and 8M up. I have been to places where they charged upwards of $100 per month for internet, so it really depends on where you are.

 

[texdrake]

Ummmmmm.........No. Not in Afgn. Extremely limited reception. 3G/4G???? Yeah, they are more like half G. And (at least by my command) personal cell phones are prohibited. They also won't let you set up your own WiFi.

Provided Wifi is free on my base. Connectivity speed depends on how many are on it. (of course) Total speed is 19M down and 8M up. I have been to places where they charged upwards of $100 per month for internet, so it really depends on where you are.

We all have cell phones in my unit. I used mine regularly to call home when I was on the larger base. Now that I am pushed forward I have no reception :-(

Their is no 3g out here.

 

[Jet915]

Out of curiosity would be you allowed to bring a cell phone that doubles as a portable wifi hotspot (ie: using 3G or 4G)? Would it even get reception?

At Camp Leatherneck, they had wifi but it was really slow, like 28.8k or slower. There were a few internet cafes which were LAN lines which were much faster. You sign you name and you get like 30 minutes of computer time.

 

[ArmyFltDoc]

We were in Iraq for 15 months, and it's pretty much as described. Its entirely ambulatory care, though a lot more derm than we saw in the US, and all of our asthmatics went up a notch. My PA would handle mornings and I took the night shift, usually coming in around 1pm and going home around 1am. That may sound rough, but there's really nothing else to do, and by being at work you can put out fires as they arise, rather than having them stack up in your absence.
We had weekly staff meetings, and a good chunk of time is spent tracking people down and managing any guys you have at different medical facilities. I found it was also useful to schedule a regular sit-down with the Chaplain, since he was actually seeing more of the mental health stuff than I was. I was responsible for the medical portion of our MASCAL plan, and for tracking all of the controlled substances. We also had to train the flight and ground medics, fly with the different crews, and check in on the tower guys at different bases. Most days we'd see about 15 people in clinic, though numbers would swell around immunization time. Keep in mind you also have to do travel briefings and medical outreach missions, though we managed to talk our commander out of the latter.
As far as trauma goes, we had a couple concussions from people wrestling, and a broken arm. The most "emergent" thing we saw were kidney stones, which are a nuisance. As others have said, though, if we ever saw anything nasty our priority was to get it to the CSH (2 miles away on the same COB) as quickly as possible, not muck around trying to remember ATLS. For us, going outside the wire on the ground was out of the question. There was simply no reason to do it, and my commander was not about to risk an asset simply to satisfy my macho urges. The CSH commander also put a stop to joyrides on our helicopters for the same reason.

 

[pgg]

Out of curiosity would be you allowed to bring a cell phone that doubles as a portable wifi hotspot (ie: using 3G or 4G)? Would it even get reception?

For roughly $2-3K you can get your own sat modem & dish, and for a $300+/month service fee something in the neighborhood of a 256K-512K 10:1 shared downlink. Dialup modem speeds but good enough.

Sounds expensive but it's pretty reasonable if you get 10 or 15 people in on it.

I had about 200 people in on the last one I set up, $20/month x200 people (yeah, $4000/month to the ISP) bought a dedicated mbit down and 256 kbit uplink. Worked great with some aggressive bandwidth policing but I'll never volunteer for that admin job again. Keeping that network running for all those people was a colossal PITA. Next time I'll be me and a handful of people, everyone else can go to the cafe.


ETA - above are 2006 prices, I shouldn't assume they're the same today

 

[Homunculus]

1) So how do "off-days" work then? I mean, I could potentially be the only doctor around the aid station/base/HQ right? maybe a few medics / corpsmen. Should I be prepared to be on the pager I mean radio 24/7 for a few weeks at a time?

depends on where you are and what you do. we were "on call" 24/7 via radio or medics knocking on the CHU door.

2) Dumb question, but how does internet access work there --- is it as easy as using my own laptop on wifi or ethernet cable? or is it a makeshift "internet cafe" tent and you got a line of troops waiting for their 15 min each?

we had it wired to our CHU's, all you needed was an ethernet cable. the internet was slow during peak times, and was out when we had KIA's until families were notified. it ran i think 70 bucks or so a month for the best package, which was good enough for voice-skype but not video skype. some dudes were WoWing it up, so it was ok for that. some people bought haji-dishes and contracted though the local nationals, but most went with "sniperhill" who contracted the service for the FOB.

It must be easy to save bank while you're over there.

yeah, not much to spend it on.

If you're getting voluntold to go out on patrols, you need to speak to some O5 or O6 in your medical chain so they bring it to the attention of the relevant O6 or O7 line officer so he can put a stop to it. The line needs to be occasionally reminded that doctors are not patrol or "op" material.

yes and no. our BDE surgeon was an O-3. to get to our "medical" O-5 or O-6 would require going to Division, and they could give two sh*ts about the battalion surgeons. the best tactic is to develop a good relationship with your battalion commander, and discuss these things. we were also against them, but there are times when as docs you do have to step into these situations where no, it's not safe, but it could pay dividends for the line-- even if it is some social leverage or negotiating room for the line commanders. it's not like we are on patrol shooting at stuff or going on market-walks, it's normally for talking to the local docs or some outreach programs.

Your last deployment: what was the "routine" day in the life?

Could you describe in terms of:
-how many guys you treated in a given day at the medical base?
-what you usually treated if not combat wound related?
-how you guys approached the traumas that came in -- you stabilize, then medevac to a CSH?
-anyone go on patrols?
-avg #hrs sleep / night?

Thanks.

i was at a level 1 (battalion aid station).

-0730: wake up
-0800-1100: sick call
1100: work out, lunch
1400-1700: sick call
1700: work out, dinner
2000: train medics
2000-0730: await incoming sirens, sleep

we typically had 20 per sick call, give or take, depending on op tempo. mainly musculoskeletal and colds/allergies. good number of derm. when patrols came back in we'd get a little spike as well.

traumas we stabilized and shipped. we were colocated with a medevac unit, and they would drop in unexpectedly on their way to the CSH if they needed some help. we'd run out to the blackhawks and do what we could, or they'd bring them into us. they'd also use us as a pitstop for tail-to-tail transfers or to hold a patient for awhile unil the next crew picked them up.

we'd also do some VIP care for some local nationals as a favor to our command, and worked with a colocated ODA team when they needed assistance with spooky secret stuff.

we had some rocket casualties (one KIA)), EFP/IED injuries (one KIA), and some suicidal patients. the vast majority of musculoskeletal "trauma" was due to combatives and people screwing around. miscellaneous accidents as well, but if i could have eliminated combatives training/tournaments and flag football we'd have saved ourselves a significant amount of work, lol.

we went on some "patrols" to the local national hospital and to check on the guys out at the small bases. our battalion covered down on what was covered previously by a brigade, so we were spread to the 4 winds. my PA was at his own little FOB, and was on 24/7 but had me via radio for consults and had medevac 20 min away or so.

i had a lot of opportunity for "sleep" but the damn mortars and rockets make sleeping a bit difficult sometimes.

it really varies from place to place. everyone's experiences differ, but the underlying themes are definitely similar.

--your friendly neighborhood TF 1-2 caveman

 

[Mace1370]

Thanks for all of the replies, everyone. They were very informative.

 

[Fabio001]

So, if one is applying as a GMO, would one just plan on being deployed for the same amount of time as the unit (12-18 months), regardless of specialty?

 

[pgg]

yes and no. our BDE surgeon was an O-3. to get to our "medical" O-5 or O-6 would require going to Division, and they could give two sh*ts about the battalion surgeons. the best tactic is to develop a good relationship with your battalion commander, and discuss these things. we were also against them, but there are times when as docs you do have to step into these situations where no, it's not safe, but it could pay dividends for the line-- even if it is some social leverage or negotiating room for the line commanders.

Agree the best option is to have a solid mutually respectful relationship with your line commander. Mine was superb; I hope he makes flag rank someday. There were times I wished I was a Marine so I could have followed my CO out in the field. Other COs don't quite have either the leadership ability or grip on medical reality mine did.

I also agree that civil affairs missions, medcaps, etc are reasonable things for battalion docs to take part in. Professional knowledge, rank, and even the simple prestige of 'an American doctor' all help when dealing with local leaders. I spent a lot of time riding humvees around Afghanistan in the pre-uparmor days doing that kind of work, and I have no gripes or complaints about my role there. But this is wholly different than pulling 'glorified medic' duty on patrols or operations.


It's a sad state of affairs when certain segments of milmed leadership don't care about the battalion level docs to the point that getting inappropriate patrol duty nixed is a problem. When I was a GMO our Division Surgeon (O6) was very personally involved and a strong advocate and ally of the O3 docs at the battalion level. Just one more instance in which I've been lucky in my military time.

it's not like we are on patrol shooting at stuff or going on market-walks, it's normally for talking to the local docs or some outreach programs.

That's the problem though. Some (few) line commanders DO think it's a neat idea to have a "surgeon" hoofing it through the marketplace or riding out on for a raid.