A week of legal briefs (5 straight hours), cultural sensitivity training, hospital tours, sexual harassment and assault prevention training, suicide prevention training, more suicide prevention training, surveys, outbriefs, surveys. Nothing too exciting to report.
Wednesday, July 24, 2013
Sunday, July 21, 2013
Last week in the field
Last week we spent in the field again, at our glorious TTB (tactical training base) up at Camp Bollis.
Monday: due to some unfortunate scheduling of buses, we had to leave at 2AM Monday morning to head back out to the field. That's....two hours into the day. It was a very very long day as a result. Last week was focused on the tactical levels of care in combat medicine, so we rotated through the three "roles of care" in our platoon and ran through scenarios of taking on casualties. Super fun. On Monday we did "Role 3" which is the CSH, or combat support hospital. I was...the hospital commander. Not scary at all. The platoon did really well and honestly I didn't really have to make any tough decisions. I did get to have basically a one-on-one training session with a previous second in command at a CSH in Iraq, so it was incredible to get to hear her experiences and pick her brain.
Tuesday: Our platoon did "Role 1", which is the most forward level of medical care aside from buddy care. This is a place very close to the battlefield where patients are stabilized and evacuated to higher levels of care. I was the doctor in this scenario, so had to make a lot of treatment decisions. They also had simulated gunfire that we had to react to and return fire (with rifle blanks). This was a little more stressful as a lot of casualties (members of other platoons who were employed as actors for our scenario) were coming in and fast. We also got to evacuate people via helicopter which was pretty awesome.
Wednesday: Our platoon did "Role 2," which is an intermediate level of care. I got to be on the Forward Surgical Team (FST), so we triaged patients to go or not go to the operating room. The head of the FST was an actual trauma surgeon in my platoon, so it was a great experience in that he led us through what a surgery on each of our patients would actually look like. I was the recorder for the FST, so in addition to providing treatment, I took notes on the patient's condition and what treatments we gave them, writing it on a piece of tape and sticking it to the patients' chest when we evacuated them.
Earlier in the day, I got to be a patient (multiple facial fractures because of a blast injury) for another platoon's scenario, which was another great way to see how the scenarios play out. It was actually extremely educational because you got to see the patient flow through the various roles of care. The different levels are all being played out simultaneously each day by different platoons, so although I was injured at a Role 2 facility, I got evacuated (by truck, unfortunately, didn't get to ride the helo) to the platoon at another end of the TTB who was acting through the Role 3 care.
Thursday: We packed up and went home on Thursday, but not before we had testing of our "warrior tasks." We had to assemble and disassemble a radio, call in a nine-line medevac order, and clear/assemble/disassemble and do a functions test on our M16. Not gonna lie, I kinda killed it. I was the first one done with the medevac order out of our testing group of about 40 people and the person to disassemble the M16 the fastest. A far cry from a week ago when I was struggling A TON with the steps of rifle disassembly. When we got back to Ft Sam Houston, we got to turn in our M16's. Although I really enjoyed learning to shoot and being a "real soldier," I couldn't be happier to turn that thing in. Having to carry it around at all times (and always at "the low ready" position), was not the most fun part of the last two weeks.
Friday: we were back at Ft Sam and we split into our different tracks for the day (e.g. vets vs dentists vs med corps vs HPSP). The HPSP among us did physical training with our company commander, a former special forces guy. Needless to say I was quite sore the next day. However, we only had one more talk to go to, so we had the rest of the day off. The family went to lunch at a brewery, then walked the Riverwalk, and met up with a bunch of other students at San Antonio's Howl at the Moon. Good times were had by all.
Saturday: we had a charity golf tournament for the Center for the Intrepid. Four person teams, best ball play, 9 holes. We had a great time golfing, driving around in carts and potentially enjoying some beverages. Being out in the sun really wiped us out, so we took it easy last night and just hit up some delicious Mexican food and a movie ("This is the End" -- funny, but strange. Very strange).
One more week until I head back to Baltimore! A little conflicted about leaving: I've really enjoyed my time here and am definitely going to miss all the great friends I've made. They keep telling us that the Army is a small small place and that Army medicine is even smaller; we are virtually guaranteed to run into each other again. I hope that's true!
Monday: due to some unfortunate scheduling of buses, we had to leave at 2AM Monday morning to head back out to the field. That's....two hours into the day. It was a very very long day as a result. Last week was focused on the tactical levels of care in combat medicine, so we rotated through the three "roles of care" in our platoon and ran through scenarios of taking on casualties. Super fun. On Monday we did "Role 3" which is the CSH, or combat support hospital. I was...the hospital commander. Not scary at all. The platoon did really well and honestly I didn't really have to make any tough decisions. I did get to have basically a one-on-one training session with a previous second in command at a CSH in Iraq, so it was incredible to get to hear her experiences and pick her brain.
 |
| I may look aloof, but that's just my calming command presence |
 |
| Triaging patients |
Tuesday: Our platoon did "Role 1", which is the most forward level of medical care aside from buddy care. This is a place very close to the battlefield where patients are stabilized and evacuated to higher levels of care. I was the doctor in this scenario, so had to make a lot of treatment decisions. They also had simulated gunfire that we had to react to and return fire (with rifle blanks). This was a little more stressful as a lot of casualties (members of other platoons who were employed as actors for our scenario) were coming in and fast. We also got to evacuate people via helicopter which was pretty awesome.
 |
| Our rides for the week |
 |
| Evacuating patients by air! |
 |
| M16 at work |
 |
| establishing a security perimeter |
Wednesday: Our platoon did "Role 2," which is an intermediate level of care. I got to be on the Forward Surgical Team (FST), so we triaged patients to go or not go to the operating room. The head of the FST was an actual trauma surgeon in my platoon, so it was a great experience in that he led us through what a surgery on each of our patients would actually look like. I was the recorder for the FST, so in addition to providing treatment, I took notes on the patient's condition and what treatments we gave them, writing it on a piece of tape and sticking it to the patients' chest when we evacuated them.
 |
| Responsibilities of the FST |
 |
| Trauma bag for the FST |
Thursday: We packed up and went home on Thursday, but not before we had testing of our "warrior tasks." We had to assemble and disassemble a radio, call in a nine-line medevac order, and clear/assemble/disassemble and do a functions test on our M16. Not gonna lie, I kinda killed it. I was the first one done with the medevac order out of our testing group of about 40 people and the person to disassemble the M16 the fastest. A far cry from a week ago when I was struggling A TON with the steps of rifle disassembly. When we got back to Ft Sam Houston, we got to turn in our M16's. Although I really enjoyed learning to shoot and being a "real soldier," I couldn't be happier to turn that thing in. Having to carry it around at all times (and always at "the low ready" position), was not the most fun part of the last two weeks.
 |
| Disassembled M16 |
 |
| Some of the fam! |
 |
| Battle buddy! |
 |
| Battle buddies lookin fly |
 |
| Golfing + beers = too aggressive for my blood, so I volunteered to photograph |
Sunday, July 14, 2013
Army life
2. "Too easy" is another favorite Army saying. It can be used in many contexts, but most often after explaining something. Often combined with HOOAH for a real Army phrase. E.g. "to clear your rifle, place the weapon in the safe position, lock the barrel back, visually inspect the barrel, close the barrel, switch to semi, pull and hold the trigger, charge the weapon once, release the trigger, switch to burst, pull and hold the trigger, charge the weapon three times, release the trigger, charge the weapon again, switch back to safe. Too easy, hooah."
 |
| How to properly stack rifles in the rare instance you're allowed to put it down. Too easy, hooah. |
3. The TTB, tactical training base, or FOB, forward operating base, is where we stay when we're out in the field. It's located at Camp Bollis, which is a training base some distance away from Fort Sam Houston. I can't tell you exactly how far because I always fall asleep on the bus. It has a bunch of tents for sleeping and classrooms, a tent for a gym (obviously can't live without that), port-a-potties for bathrooms (referred to as a latrine in Army parlance), and three trailers of semi-functional showers.
 |
| Loading up duffel bags at the TTB |
 |
| Our luxurious lodging at the TTB |
 |
| 4th squad is the best squad |
 |
| Women of 6th Platoon |
5. Everywhere we go in the TTB we have to carry our rifle (M16) in the low ready position (as illustrated in the picture above). We also have to wear our Molle vests at all times when in ACUs and our two canteens must always be full. We frequently have to carry our assault packs and Kevlar helmets as well. Those days are not my favorite days -- that's a lot to carry in the heat!
 |
| Kevlar and assault packs. Sometimes we're allowed to put them down. Sometimes |
6. Vocabulary. Our guns (M16s) are rifles, not guns. It's a latrine, not a bathroom. It's 1400, not 2pm. A WARNO is a warning order, to let you know that something is about to come down the pipeline. FRAGO is a noun or verb that means "fragmentary order," or -- what I just told you is wrong, e.g. "FRAGO that, we're going at 1400." Your kevlar helmet is an ACH.
7. Battle buddy = someone in your squad who you're assigned to for accountability. You're supposed to always know where they are and are as responsible for them being squared away as you are for yourself. If your battle buddy jacks something up, you're responsible/guilty as well. My battle is a really nice gal from Ohio who just finished her first year of medical school. I also have a different battle buddy for land navigation, a really fun dental student from California who has a 6 month old daughter at home (me: "how much does your wife hate you right now?" him: "so much"). Heather and I also call each other "life battle buddy" or BBF (battle buddy forever) since we're roommates and best buds. You can also address your battle buddy as battle, e.g. "hey battle, what's up?"
 |
| Land nav battle showing regular battle the finer points of the M16 |
8. Yelling things. Every time we come to attention as a company, we have to yell the battalion motto -- "train to save." Every time we come to attention as a platoon, we yell our battle cry: the platoon sergeant yells "SONIC" and we all respond with "BOOM." Sonic the hedgehog might be (=is) our mascot.
 |
| Sonic helps Julian clean his M16 |
9. We usually eat MREs (meals ready to eat). Not as bad as one might think. They contain a ton of food and include beverages as well (dehydrated -- just add water!). The entrees are meant to be heated and each MRE comes with a magical heater pack -- just add water and somehow it heats up (really hot). Throw your entree in there and within a minute, it's all heated up and ready for consumption. I've had chicken fajitas, beef chilli, pork rib, chicken with vegetables. Haven't had one yet that I didn't like. The sides can be hit or miss, but there's usually several sides in each MRE, so you don't need to like them all! A full MRE is usually 1200 calories, so I definitely don't need all that food at every meal. I often save some of the sides and have them later as snacks, or give them out to people who need more food. We have a shelter on the TTB that we eat under. Standing up. Always a little weird in the Army.
.JPG) |
| Amber shows off her sweet MRE |
 |
| Some good-looking soldiers enjoying MRE's |
WEEKEND / photo dump
We got to sleep in a little bit Saturday morning, but had to be at formation up by the schoolhouse at 0710. We had about a 90 minute class and some briefings and were out by 1000 to enjoy the weekend. We also received the incredible news that the drinking ban had been lifted. Praise.
Obviously we went to Big Lou's and ordered a 42 inch pizza. As one does when in San Antonio.
We rounded out the day with drinking and dancing at the Riverwalk. Incredible time with incredible people.
When we're out in the field, we're not allowed to have our cell phones with us during the day and aren't allowed to take pictures. Luckily, one member of the platoon is permitted to take pics and she posted the first batch when we got back from the field on Friday.
Unluckily, we have formation at 0210 tomorrow morning to head out to the field again. I plan on not moving the rest of the day in order to mentally and physically conserve strength.
Obviously we went to Big Lou's and ordered a 42 inch pizza. As one does when in San Antonio.
 |
| This pizza was not a joke, but ultimately no match for 11 hungry soldiers |
When we're out in the field, we're not allowed to have our cell phones with us during the day and aren't allowed to take pictures. Luckily, one member of the platoon is permitted to take pics and she posted the first batch when we got back from the field on Friday.
Unluckily, we have formation at 0210 tomorrow morning to head out to the field again. I plan on not moving the rest of the day in order to mentally and physically conserve strength.
 |
| voluntary morning PT |
 |
| pre-combat inspection before heading to the field |
 |
| early morning physical fitness test |
 |
| taking a break on the land nav course with my battle buddy |
 |
| some of our platoon during land nav training |
 |
| Heather disassembling her M16 |
 |
| learning positioning for shooting |
 |
| disassembly of the M9 |
 |
| Our mascot Sonic is fully proficient in the M9 |
 |
| looking stoic? / playing attention? |
 |
| loading patient litters into helicopters |
 |
| On the land nav course at one of the points |
Friday, July 12, 2013
Look out for the rattlesnakes and feral hogs!
This morning we got up at 0215 so that we could start land navigation by 0300. We had to be dressed in full ACU's with bags packed and put in a certain area by 0235, formation at 0250 and the beginning of the land nav briefing at 0300. They weren't messing around.
The land navigation course works like this: spread out over a few square kilometers, there are various targets (basically orange triangular cones atop metal poles). Each pair of officers is given a set of coordinates of 8 of these points. You use a topographical protractor to plot your points on a map of the area, create a strategy to get to all the points as quickly and accurately as possible, and then figure out what the distances and directions are between your successive points. We had five hours to complete the course, which included planning time, and had to get at least 5 of 8 points to pass. Once you find a point, you confirm that it is correct (the targets have grid coordinates on them), and then write down an alphanumeric code of the target on your scoresheet. There are also punches of specific designs at each target with which you have to punch your scoresheet. You are disqualified if you lose your scoresheet, communicate with another pair of officers, do not follow noise and light discipline (flashlights are only permitted to look at your map for short periods of time and you can only use the red lens), or are found out of uniform (e.g. don't have your hat on).
My land nav battle buddy and I had done the practice course together earlier in the week, so felt like we had a pretty good system down. One person led the way and kept us on the correct azimuth (=magnetic direction) using the compass and the second person followed behind, keeping a pace count to determine how much ground we covered. We had a plan to each point, e.g. from point #3 to #4, it's 550 m at 273 degrees. We did an incredible job early on, and were within 10 meters of our first point, so that established some confidence early on. We banged out the first 5 points in the first two hours, so knew we were going to pass early enough to take the pressure off for the rest of the course. We had a really tough time finding the 6th point; it turned out to be tucked away in an area of thick brush, so was extremely difficult to spot on the dark. Luckily, the course is "self-correcting": since all the targets have grid coordinates on them, if you happen upon one that isn't yours, you can plot the point you're at on your map and determine a new distance and direction to your next point. We ended up abandoning the search for the 6th point and went on to the 7th and 8th. The sun was rising as we found the 8th; it was a great way to start the day.
The 6th point (the one we skipped) was on the way back to the FOB, so we decided to give it another go at finding it. In the daylight, it was much much easier and we found it without any trouble. We got back to the FOB with more than an hour to spare and were one of the first 15 or so pairs to finish (out of about 150), so felt pretty good about that.
The rest of the day we spent learning about the various medical "roles" (= levels of care) in combat zones. We're doing scenarios next week where we have to respond to mass casualties at the various levels (complete with ambulance and helicopter medevacs!), so that should be pretty interesting. I'm the commander of the combat support hospital (!), so am already a little nervous about managing 60 people and coordinating with the other levels of care. Should be an exciting challenge.
We came back to post for the weekend after cleaning up the FOB. Everyone was exhausted and SO hot, and kinda losing their patience and courtesies (I know I was!). From a morale perspective, it was definitely time to come back.
Took a long long hot shower and we'll probably go to bed super early today. We have class tomorrow from 0715 - noon, so.....fun. But we've decided to go out to get 42" pizzas afterwards, so we'll have that to look forward to ;)
Bonus pic of the day: Texas sunset from our "snacks and stogies" sessions.
Bonus bonus: one of the members of our little "family," as the roommate and I have named the little group we hang out with, mentioned how impressed he was with how thoughtful, generous and genuine the people we've surrounded ourselves with have been. I couldn't agree more. One of the huge reasons I went into military medicine was because of the high quality of people and it's awesome to have that confirmed. There's a few bad apples, as in any organization, but my platoon is largely incredibly thoughtful, intelligent, generous, kind, self-deprecating, and team players. And my selected "family," even more so. People are always helping each other out, encouraging each other to keep up with hydration, helping each other remember what they need to bring (both functionally and to avoid getting in trouble), etc etc. It's basically impossible to pay anyone back for anything. Maybe it's because we're all still in the honeymoon phase of knowing each other, but it's a welcome change from the grind of medical school, which sometimes feels a little "every man for himself" (which is a function of the structure of medical school and clinical rotations, not just the people).
The land navigation course works like this: spread out over a few square kilometers, there are various targets (basically orange triangular cones atop metal poles). Each pair of officers is given a set of coordinates of 8 of these points. You use a topographical protractor to plot your points on a map of the area, create a strategy to get to all the points as quickly and accurately as possible, and then figure out what the distances and directions are between your successive points. We had five hours to complete the course, which included planning time, and had to get at least 5 of 8 points to pass. Once you find a point, you confirm that it is correct (the targets have grid coordinates on them), and then write down an alphanumeric code of the target on your scoresheet. There are also punches of specific designs at each target with which you have to punch your scoresheet. You are disqualified if you lose your scoresheet, communicate with another pair of officers, do not follow noise and light discipline (flashlights are only permitted to look at your map for short periods of time and you can only use the red lens), or are found out of uniform (e.g. don't have your hat on).
My land nav battle buddy and I had done the practice course together earlier in the week, so felt like we had a pretty good system down. One person led the way and kept us on the correct azimuth (=magnetic direction) using the compass and the second person followed behind, keeping a pace count to determine how much ground we covered. We had a plan to each point, e.g. from point #3 to #4, it's 550 m at 273 degrees. We did an incredible job early on, and were within 10 meters of our first point, so that established some confidence early on. We banged out the first 5 points in the first two hours, so knew we were going to pass early enough to take the pressure off for the rest of the course. We had a really tough time finding the 6th point; it turned out to be tucked away in an area of thick brush, so was extremely difficult to spot on the dark. Luckily, the course is "self-correcting": since all the targets have grid coordinates on them, if you happen upon one that isn't yours, you can plot the point you're at on your map and determine a new distance and direction to your next point. We ended up abandoning the search for the 6th point and went on to the 7th and 8th. The sun was rising as we found the 8th; it was a great way to start the day.
 |
| Sunrise on the land nav course; a beautiful Army day! |
The rest of the day we spent learning about the various medical "roles" (= levels of care) in combat zones. We're doing scenarios next week where we have to respond to mass casualties at the various levels (complete with ambulance and helicopter medevacs!), so that should be pretty interesting. I'm the commander of the combat support hospital (!), so am already a little nervous about managing 60 people and coordinating with the other levels of care. Should be an exciting challenge.
We came back to post for the weekend after cleaning up the FOB. Everyone was exhausted and SO hot, and kinda losing their patience and courtesies (I know I was!). From a morale perspective, it was definitely time to come back.
Took a long long hot shower and we'll probably go to bed super early today. We have class tomorrow from 0715 - noon, so.....fun. But we've decided to go out to get 42" pizzas afterwards, so we'll have that to look forward to ;)
Bonus pic of the day: Texas sunset from our "snacks and stogies" sessions.
Bonus bonus: one of the members of our little "family," as the roommate and I have named the little group we hang out with, mentioned how impressed he was with how thoughtful, generous and genuine the people we've surrounded ourselves with have been. I couldn't agree more. One of the huge reasons I went into military medicine was because of the high quality of people and it's awesome to have that confirmed. There's a few bad apples, as in any organization, but my platoon is largely incredibly thoughtful, intelligent, generous, kind, self-deprecating, and team players. And my selected "family," even more so. People are always helping each other out, encouraging each other to keep up with hydration, helping each other remember what they need to bring (both functionally and to avoid getting in trouble), etc etc. It's basically impossible to pay anyone back for anything. Maybe it's because we're all still in the honeymoon phase of knowing each other, but it's a welcome change from the grind of medical school, which sometimes feels a little "every man for himself" (which is a function of the structure of medical school and clinical rotations, not just the people).
Thursday, July 11, 2013
Rapid fire
Title for the form and content of this blog post.
-went to the firing range today with the M16, shooting from the prone supported, prone unsupported and kneeling positions at various popup targets ranging in distance from 50-300 yards. Did a respectable, if not great job, which i think is ok for my second say of shooting ever.
-learned to load litters into various vehicles and a helicopter
-learned what to do if we're attacked in a convoy. Basically: get the f out the kill zone
Tomorrow: land navigation starting at 0300. Wake up at 0215.
Goodnight
Wednesday, July 10, 2013
Marksmanship
Exhausted. These 4am wakeups are catching up with me. But a very Army day to report. Today I:
1. Learned how to assemble and disassemble an M9 (9mm handgun) as well as clear and fire it. "if you're going to shoot someone, kill him. Don't waste your time wounding him because he's definitely trying to kill you." Bonus points: learned how to shoot and reload a M9 if your shooting arm is broken.
2. "zeroed in" my M16 in what i think is a respectable 4 magazines (a magazine is 5 shots and to zero in, you have to hit the target with 3 of those 5.) Our target was a person cutout that simulates a person at 300 yards away. Not going to lie, shooting is pretty fun. I can see how people get into it.
3. Cleaned my M16 like the good soldier I am.
4. Smoked a cigar with the boys like the good soldier I am. The Texas nights are really nice around here - humidity almost disappears, it definitely cools down, the breeze is generous, and the sunsets are phenomenal. Not the healthiest of habits, and not one that i plan on picking up, but a great way to wind down the night with new but good friends.
Had kinda a come to Jesus moment today. The cadre (staff) are mix of Army officers (most of whom are prior enlisted as well) as well a a bunch of retired prior service enlisted guys who teach the weapons and tactical stuff. As our M9 instructor pointed out today, many of them have sons in infantry or artillery and part of the reason they come teach is to ensure that the men and women taking care of their kids should they get injured are the best possible officers they can be. Was definitely a call to arms to take our training seriously and do the best we can do to learn as much add possible in the short time we're here. For me at least.
Subscribe to:
Posts (Atom)