The President of the United States didn't really bestow the nickname, "Tank," on the young Marine, although that made a good story. POTUS did meet Tank at the National Naval Medical Center, and he took an immediate liking to the charming young man. But he didn't coin the nickname. In typical Marine camaraderie, Tank's fellow wounded combatants bestowed the moniker.
Tank arrived at NNMC Bethesda in that first wave of injured Marines. He was a victim not of enemy fire, but an equally dangerous threat called "DNBI," for "Disease/Non-Battle Injury." Simply defined, DNBI is death or disability that we inflict on ourselves. Looking at any conflict in our history you will find that DNBI usually exacts a larger toll on battle effectiveness than does any enemy action.*
A U.S. Abrams tank caused the non-battle injury to its namesake Marine. In the heat of sustained combat operations, Marines rest when and where they can. Tank dozed with his back warmed by the Iraqi sand. By design, his desert camoflague uniform blended right into the terrain, and the driver of the maneuvering vehicle never saw him. One track of the Abrams ran over Tank's body at pelvic level. If laying on asphalt or concrete, he would have been killed almost instantly. But the soft sand absorbed enough crushing pressure that he sustained reparable injuries, a fractured pelvis and ruptured bowel.
He came to Bethesda with a repaired bowel, temporary colostomy, and still bedridden from the fractured pelvis...physically and emotionally still in combat. His indomitable spirit rapidly overcame the restriction to bed. No wallowing in the rack for this Marine! Before we knew it, he was up on crutches. Every day he made his own rounds on the ward where about 30 wounded Marines recovered from a variety of injuries. He exhorted them, cajoled them, encouraged them. "Oo-rah, Marine," he would say. "Look at me. If I can do this, so can you!"
Most of those wounded Marines did survive and got on with their post-traumatic lives, in or out of the Marine Corps. But in truth, our advanced trauma care and sophisticated technology were merely adjuncts to the primary healing force on that ward: Tank and other Marines like him who simply refused to quit, refused to consider themselves disabled, and rallied each other to health.
I recall another recovering young Marine's immediate response when asked where he wanted to go for convalescent leave upon discharge from acute care in the late spring of 2003.
"Bagdad," he said.
Semper Fi, Marines!
*In my early flight surgery days I did a little study demonstrating how injuries sustained in hangar bay basketball games and other recreational sports negatively impacted the medical readiness of an aircraft carrier's crew. The conclusion asked for improved safety measures, not cessation of these important recreational outlets for deployed sailors.
Saturday, October 30, 2010
Thursday, October 28, 2010
...Fi!
The two Latino-Americans grew up in the Texas Hill Country, not far from each other. Roughly the same age, they both entered military service soon after high school. Staff Sargeant Alameda, USMC, and Hospitalman Alvarez, USN (not their real names) met and became good friends when both were assigned to a Marine Corps Logistics unit shortly before Operation Iraqi Freedom (OIF). Staff Sargeant Alameda was a regular Marine. Hospitalman (HN) Alvarez was a Navy hospital corpsman assigned as medical support to that Marine unit.
Navy Medicine provides health care to the Marine Corps, which owns no intrinsic medical assets. Many Navy doctors, dentists, nurses, medical service corps officers, and hospital corpsmen are assigned to the Marines over the course of a career. They wear Marine Corps uniforms, drill and exercise with their Marines, adhere to the same physical standards, and otherwise become an integral part of the units they support. Above all, the relationship of a hospital corpsman to his Marines is the most important and revered. Every Marine depends on his "Doc" for his life, and he knows that the Doc is prepared to make heroic efforts to save the life or limb of a Marine.
So there they were, in the early days of OIF traversing southern Iraq, miles behind the initial assault. The unit had stopped for rest and chow. Diving into his MRE, Staff Sargeant Alameda strolled around near his vehicle. A sudden, deafening explosion disrupted the tranquility of the place, quickly followed by a primal scream. The young Marine had stepped on a concealed Iraqi land mine. He lay in agony on the sand, bleeding profusely from the remant stump of a leg blown off.
"CORPSMAN UP!" came the immediate call. Hospitalman Alvarez, as any corpsman would do, rushed to the aid of his fallen friend and comrade, mindless of his own personal safety. As he knelt beside the victim, another explosion unexpectedly scrambled the scene. The ensuing primal scream came from HN Alvarez himself. He had knelt onto another concealed mine, whereupon he suddenly became not the rescuer, but the second casualty. And he too had lost a leg in the detonation.
Thanks to the most sophisticated and capable field trauma care in history, both amigos were rapidly medevaced to a nearby emergency resuscitative surgery site, where they underwent immediate life-saving operations to control bleeding from their traumatic amputations. They were then air lifted out of Iraq to the Landstuhl Regional Medical Center in Germany where they received their secondary definitive surgery. Within three days of the initial explosions, the two comrades in arms arrived at the National Naval Medical Center (NNMC) in Bethesda, MD. They were two of the first four OIF casualties received there.
Even though they were now safely ensconced in a hospital room thousands of miles from the war, emotionally and physiologically they were both still in combat. The support they gave to each other in those first few days, and that given and received from fellow Marines, made a huge difference. Both survived their initial wounds and ultimately wore state of the art prostheses. If you passed either of them on the street six months after their injuries, you would not recognize either one as an amputee.
Once he recovered from his injuries, newly promoted HM3 Alvarez elected to stay in the Navy and requested orders to NNMC Bethesda. He wanted to continue caring for wounded Marines.
The year after his knee hit that land mine he and his spouse were honorees at the annual Hospital Corpsmen Ball. They seemed ill at ease sitting at a head table with a Navy Medical Corps Captain and his equally uncomfortable spouse.
The HM3 didn't feel particularly worthy of all the honor and attention. He never considered himself a hero. He was just the Doc taking care of a wounded Marine.
Similar scenes have occurred thousands of times since OIF began in early 2003, and will recur as long as this or any conflict involves Marines going into harm's way. It's what Hospital Corpsmen do. It's what all of us in Navy Medicine do when called the serve the Marines.
We remain supremely honored to do so.
Semper Fi, Marines!
Navy Medicine provides health care to the Marine Corps, which owns no intrinsic medical assets. Many Navy doctors, dentists, nurses, medical service corps officers, and hospital corpsmen are assigned to the Marines over the course of a career. They wear Marine Corps uniforms, drill and exercise with their Marines, adhere to the same physical standards, and otherwise become an integral part of the units they support. Above all, the relationship of a hospital corpsman to his Marines is the most important and revered. Every Marine depends on his "Doc" for his life, and he knows that the Doc is prepared to make heroic efforts to save the life or limb of a Marine.
So there they were, in the early days of OIF traversing southern Iraq, miles behind the initial assault. The unit had stopped for rest and chow. Diving into his MRE, Staff Sargeant Alameda strolled around near his vehicle. A sudden, deafening explosion disrupted the tranquility of the place, quickly followed by a primal scream. The young Marine had stepped on a concealed Iraqi land mine. He lay in agony on the sand, bleeding profusely from the remant stump of a leg blown off.
"CORPSMAN UP!" came the immediate call. Hospitalman Alvarez, as any corpsman would do, rushed to the aid of his fallen friend and comrade, mindless of his own personal safety. As he knelt beside the victim, another explosion unexpectedly scrambled the scene. The ensuing primal scream came from HN Alvarez himself. He had knelt onto another concealed mine, whereupon he suddenly became not the rescuer, but the second casualty. And he too had lost a leg in the detonation.
Thanks to the most sophisticated and capable field trauma care in history, both amigos were rapidly medevaced to a nearby emergency resuscitative surgery site, where they underwent immediate life-saving operations to control bleeding from their traumatic amputations. They were then air lifted out of Iraq to the Landstuhl Regional Medical Center in Germany where they received their secondary definitive surgery. Within three days of the initial explosions, the two comrades in arms arrived at the National Naval Medical Center (NNMC) in Bethesda, MD. They were two of the first four OIF casualties received there.
Even though they were now safely ensconced in a hospital room thousands of miles from the war, emotionally and physiologically they were both still in combat. The support they gave to each other in those first few days, and that given and received from fellow Marines, made a huge difference. Both survived their initial wounds and ultimately wore state of the art prostheses. If you passed either of them on the street six months after their injuries, you would not recognize either one as an amputee.
Once he recovered from his injuries, newly promoted HM3 Alvarez elected to stay in the Navy and requested orders to NNMC Bethesda. He wanted to continue caring for wounded Marines.
The year after his knee hit that land mine he and his spouse were honorees at the annual Hospital Corpsmen Ball. They seemed ill at ease sitting at a head table with a Navy Medical Corps Captain and his equally uncomfortable spouse.
The HM3 didn't feel particularly worthy of all the honor and attention. He never considered himself a hero. He was just the Doc taking care of a wounded Marine.
Similar scenes have occurred thousands of times since OIF began in early 2003, and will recur as long as this or any conflict involves Marines going into harm's way. It's what Hospital Corpsmen do. It's what all of us in Navy Medicine do when called the serve the Marines.
We remain supremely honored to do so.
Semper Fi, Marines!
Tuesday, October 26, 2010
Semper...
The first three grabbed my attention as I approached the US Airways ticket counter in San Diego. I had just arrived TAD via San Francisco from Tokyo for a Navy medical meeting. I was now checking in for my leave flight to Arizona for a reunion with many extended family members.
Even in my jet lagged state the three U.S. Marines enthralled me. Only one was in uniform, the semi-dress version with the blue trousers and khaki shirt. I could tell from their high and tight haircuts and ultrafit habitus that his companions were also Marines. None of them appeared a day older than my own son who is now a college freshman.
With boarding pass in hand I proceeded to the assigned gate, along the way encountering similar knots of very young Marines either in groups or with family. They were young recruits, clear not only from their tender ages and youthful vigor, but also from the single National Defense Ribbon that each sported over the left pocket of his khakis. Most also proudly wore brightly polished new silver marksmanship medals.
These Marines became a sizeable portion of the passengers who boarding my flight to Phoenix. From snippets of overheard conversation I gleaned that these were all brand new graduates of the San Diego Marine Corps Academy, aka boot camp. Our nation's newest U.S. Marines now headed home or elsewhere for a couple of weeks of liberty before moving on their next assignment. Most would go to specialty training in the various warfighting skills for which Marines are famous. Beyond that? Some would surely see action in Afghanistan.
Youthful exuberance and justifiable pride pervaded the ranks on this particular day. In the dusk of my military career, I could not help but envy them a bit as they relished the dawn of their own.
On the plane I sat next to the mom of one Marine. She sat next to her ten year old son, and proudly told me that her Marine son was up in first class because a generous passenger, honoring the uniform, had traded boarding passes with him. Engaging in conversation with two other newly minted Marines sitting ahead of us, she gushed on about how wonderful was the graduation ceremony, and how proud (and relieved) she had been to spot her son among the ranks, the first time she had seen him or heard from him in five weeks.
Across the aisle another young Marine entertained a youth of about 10 - 11 years old, with descriptions of what it means to be a Marine, what training he had, and his aspirations for his future career. They young listener, who wore a camoflague jacket of his own, hung on every word, himself probably a future Marine.
Just before landing, the flight attendant announced that on board were some very special people, a group of United States Marines who had just graduated their basic training. The plane erupted in genuine applause and cheers.
A sexagenarian veteran Navy doctor somewhere in the middle let out a loud OOO-RAH, even as a tear formed in the corner of one eye.
Marines occupy a special place in my heart as my personal heroes, along with EMTs and Hospital Corpsmen. Sharing the pride and patriotism of these young warriors and their beaming parents and siblings was a peak moment for me. Tonight I pray that wherever they go next, each and every one eventually returns home to those same parents and siblings, safe and healthy.
Semper Fi, Marines!
Even in my jet lagged state the three U.S. Marines enthralled me. Only one was in uniform, the semi-dress version with the blue trousers and khaki shirt. I could tell from their high and tight haircuts and ultrafit habitus that his companions were also Marines. None of them appeared a day older than my own son who is now a college freshman.
With boarding pass in hand I proceeded to the assigned gate, along the way encountering similar knots of very young Marines either in groups or with family. They were young recruits, clear not only from their tender ages and youthful vigor, but also from the single National Defense Ribbon that each sported over the left pocket of his khakis. Most also proudly wore brightly polished new silver marksmanship medals.
These Marines became a sizeable portion of the passengers who boarding my flight to Phoenix. From snippets of overheard conversation I gleaned that these were all brand new graduates of the San Diego Marine Corps Academy, aka boot camp. Our nation's newest U.S. Marines now headed home or elsewhere for a couple of weeks of liberty before moving on their next assignment. Most would go to specialty training in the various warfighting skills for which Marines are famous. Beyond that? Some would surely see action in Afghanistan.
Youthful exuberance and justifiable pride pervaded the ranks on this particular day. In the dusk of my military career, I could not help but envy them a bit as they relished the dawn of their own.
On the plane I sat next to the mom of one Marine. She sat next to her ten year old son, and proudly told me that her Marine son was up in first class because a generous passenger, honoring the uniform, had traded boarding passes with him. Engaging in conversation with two other newly minted Marines sitting ahead of us, she gushed on about how wonderful was the graduation ceremony, and how proud (and relieved) she had been to spot her son among the ranks, the first time she had seen him or heard from him in five weeks.
Across the aisle another young Marine entertained a youth of about 10 - 11 years old, with descriptions of what it means to be a Marine, what training he had, and his aspirations for his future career. They young listener, who wore a camoflague jacket of his own, hung on every word, himself probably a future Marine.
Just before landing, the flight attendant announced that on board were some very special people, a group of United States Marines who had just graduated their basic training. The plane erupted in genuine applause and cheers.
A sexagenarian veteran Navy doctor somewhere in the middle let out a loud OOO-RAH, even as a tear formed in the corner of one eye.
Marines occupy a special place in my heart as my personal heroes, along with EMTs and Hospital Corpsmen. Sharing the pride and patriotism of these young warriors and their beaming parents and siblings was a peak moment for me. Tonight I pray that wherever they go next, each and every one eventually returns home to those same parents and siblings, safe and healthy.
Semper Fi, Marines!
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