Overcoming Medical Substandardness

Medical aid is an essential part of combat. In the Second World War it has been proved conclusively that it was the excellent work and sacrifices made by many line medics who contributed to saving lives. There were many brave line medics who even sacrificed their lives in the line of duty. This tradition has been rigorously followed by line medics in America’s subsequent wars be it in Korea, Vietnam, Operation Enduring and Iraq Freedom.

Thus we have the sterling example of Private First Class Charles Thomas Moore who on 5 January 1970 was killed in action while providing medical aid to members of his platoon despite grave danger to his life and limb. Some more facts about this sterling example of great sacrifice, devotion to duty and above all maintenance of high standards of medical ethics and discipline will be covered later. I need to draw inspiration from the stories of Private Moore and others who have made history through their high standards of professional and medical competence in serving their platoon.

It is through these measures along with my own efforts to develop high level of competence and discipline that I can improve the health and welfare of my platoon and maintain it at all times. For the consequences of being sub standard will tell on the level of medical fitness of my platoon, in turn affecting their health, morale and combat readiness. Thus its penalty will be certainly grave, endangering the lives of many people comparable to the incompetence of the platoon leader. Thus the first thing is that I should improve my professional standards.

To examine the level to be obtained as a line medic, it is essential to see a few examples of the same from my own genre, the platoon medic. Role of a Line Medic The line medic is frequently referred to as the first line of medical defense in combat. (Wenger. Pozos, 2001). He is a person who is trained and fully capable as well duly certified for the appraisal of casualties, providing them emergency treatment as well as care till they are evacuated. Thus if he is substandard, it will not compensate for having even the best of specialists, means of evacuation as well as hospital facilities.

A medic has to be extremely competent to be able to save lives. The line medic performs a number of challenging tasks. At the outset on the front line he provides first aid to the injured and wounded, thus he is their first contact with the medical fraternity. In case a person is sub standard, he is likely to affect initial treatment as well as subsequent evacuation which would result in reducing the scope of survival. Thus the line medic is the first medical attendant even when a person in a platoon is sick. If I am substandard I cannot possibly fulfill this role.

The second aspect is the ability to treat minor injuries, stop bleeding from major injuries such as shell and splinter, apply emergency bone splits, treating patients with shock and also applying tourniquet at pressure points. These are some of the other areas of duty performed by the line medic. Evacuation is another important role that he performs. Evacuation is not just lifting a person on to a stretcher and then carrying him to the hospital; it is also to ensure that he is transported in a manner which enables him to survive the evacuation and also supports the follow up treatment that would be given to him.

This requires knowledge of various types of injuries and diseases and the, “golden hour” prevention measures that need to be taken. This cannot come without high levels of competence. Managing these when I am substandard would be disastrous to the lives of many of my comrades who are having implicit faith in me. The role of the line medic does not end in providing physical assistance to the platoon personnel. He is also a friend, guide and confidant to whom they would open their heart. They would have developed faith in him and unless they are confident of his abilities, they would not be able to repose faith in him.

Thus maintaining standards becomes highly important from the point of view of morale of the platoon. To understand the consequences of being sub standard, let me first relate to the heroes of the U S Army Medical who have virtually sacrificed their lives in the line of duty for their platoon, who will enable understanding requirements and constraints of maintenance of standards. PFC Charles Thomas Moore – Establishing Standards for Line Medics PFC Charles Moore has provided an excellent example of high standards of performance of line medics at the platoon level.

The Platoon is the cutting edge for a medic, where high standards are required the most. This valiant soldier was posted to the Headquarters Company, 2nd Battalion 5th Cavalry, and 1st Cavalry Division in Vietnam. Private Moore was a line medic with the First Platoon of D Company. His platoon was engaged in a fierce encounter with the enemy on that fateful day when he sacrificed his life. It was a brutal engagement in which the Platoon displayed a very high degree of valor. The enemy was very well entrenched in a highly fortified bunker.

A charge was launched to evict him. The casualties were inevitable and hence Private Moore had placed himself close to the front line troops. As one of the soldiers in the attack was wounded, PFC Moore went up in the line to treat him and arrange for his evacuation. However there was a hail of bullets flying all around and Moore was injured in the wrist. Unmindful of his own injuries, in the true tradition of a line medic, he moved up to treat his fellow soldier. As he moved up a rocket was fired at the platoon leading to injury to the First Platoon leader.

Private Moore close by was also injured in this encounter but he remained unmindful of his own injuries and moved up to the Platoon leader to evacuate him. He succeeded in doing so to safety. However by that time the first patient to whose aid he had rushed had become critical and was showing signs of loss of breath and appeared to be in life threatening danger. Moore by now was extremely tired but had to ensure that the patient in his charge survived. So he went on to first resuscitate his patient through mouth to mouth breathing. Through his extensive efforts, the patient was revived.

Moore now took upon himself to construct a stretcher to carry the critically wounded individual to the rear for further medical aid and assistance. It was at this time that he was wounded critically as a hail of bullets went through his hips. This was to be a grievous injury which rendered Moore unconscious. As he continued to struggle for his life, Moore recovered consciousness for a brief time. Here again he displayed the highest degree of concern for his patient and started giving directions to others to provide him medical treatment.

By now Moore was rapidly sinking due to his injuries himself; however he continued to pass instructions, which resulted in successfully evacuating the patient to safety and further medical treatment. Unfortunately Moore succumbed to his injuries despite personally having contributed to saving many lives. For this high level of gallantry he was awarded the Distinguished Service Cross, the Bronze Star Medal and the Air Medal, a rare distinction indeed for the services by a soldier at the platoon level.

The medic did not have to make this supreme sacrifice as after his own injury he could have well retreated to the rear. But knowing that he was needed in the front line he continued to stay there and more importantly guided individuals of the platoon in providing correct aid and evacuating the platoon leader and one more soldier to safety. His are the true values of the American Army, concern for your fellow beings, regardless of your own safety. Fortunately for America there are many such competent line medics as Moore who provide a role model for maintenance of high standards in the Army Medical fraternity.

What were the lessons in maintaining high standards that we gain from this saga of Moore? Apart from his high level of motivation and personal courage, there are many other standards which need to be emulated. The first and fore most is the intense involvement of the line medic with the first platoon. There is an emotional bond which is evident between the medic and the soldier. It is a bond of confidence which is unique. This is the first standard that the line medic needs to establish with his platoon mates. They must develop implicit trust and faith in him.

This trust and faith however does not come without a high level of commitment which is built on the foundation of intense emotional involvement. The professional standards of a line medic displayed by Moore indicate that he had very high level of skills for life saving, resuscitation, aid and assistance which could revive his patients with ease. The attendance to the wounds of the Platoon leader also denoted that he had very high degree of wound management ability. Evacuation of two patients undertaken by Moore was the ultimate demonstration of his skills in patient management.

He could very effectively first stabilize them for evacuation and then succeeded in sending them to safety. His true competence was denoted in his ability to give appropriate instructions to other soldiers in the platoon as being injured he could not undertake the task himself. The high standards displayed by Moore were evident when both his patients were saved though unfortunately he himself lost his life as he was wounded more than once and due to his insistence on remaining on the front line. By prioritizing his comrades before himself he set new standards of medical ethics.

The US Army Tradition – Line Medics The story of Moore narrated above is not an isolated instance of a soldier giving up his own life while attempting to save that of his comrades. The US Army is full of such examples which span many wars. The sacrifices made by these men however some how never get noticed and their competence remains unrecognized. In the Second World War it is said that the line medic totally involved himself with his platoon. The attachment of the line medic with his platoon is thus the first issue which needs to be considered in attaining higher standards.

This involvement is not peripheral but is based on an emotional and professional bond. This is built up not just as a result of the formal relationship which is denoted by being part of the same sub unit, a platoon, but is nurtured over a period through a feeling of togetherness both in war and peace. Thus as the Second World War line medic veterans have indicated, they were not strangers to the platoon they served but there was a high level of camaraderie which was build within. A good part of building solidarity lies in emotional bondage.

Thus once the line medic and the soldier eat, live, sleep and drink together a bond similar to that in a family is created. While some times soldiers avoid being too close to their comrades for the fear of losing him which can be traumatic, the line medic is perhaps the only person with whom they take this liberty. This trend is confirmed by veterans of many long wars, who have faced the trauma of losing their comrades in successive campaigns. The need to retain this confidence would imply that the line medic should have very high professional competence.

For at no time he can give an impression that the loss of life after injury could not be controlled rather it should create an impact that he did his best to save but circumstances were beyond his control as the injury was too severe and thus the person could not survive evacuation to the battalion casualty post. Thus standards are an important part of this emotional bondage. Delivering the buddy to the battalion aid station in a state for early revival is the ultimate aim of a line medic in a platoon and which can only come with high level of professional, personal and ethical standards.

At the same time a line medic has to remain sufficiently detached to ensure that while carrying out his professional duty emotions do not overtake him. As it has been said many times that when a medic treats one who is close to him emotionally, his hands tend to tremble, voice softens and eyes grow moist. A hard professional medic will however not succumb to these failings despite being close to his platoon mates. The ability to create confidence thus also implies that when a private has placed his life in your hands you should be able to provide for his safety and security in an impeccable manner without losing your head.

This camaraderie is also due to the soldier’s assurance that in case he is injured he would be looked after well and thus could be considered as a motherly bond between the soldier and the medic. But a substandard line medic will not be able to build up this connection. For he would not be competent enough to give confidence to his comrades that they would be safe in his hands. This confidence building is the most significant part of high standards of a line medic. The position of a line medic in a platoon is unique.

He is the only person who can come to the aid of the wounded and the sick. There is none who can really replace him, for others are neither trained nor are competent to render the required aid when a person needs it. Thus there can be no compromise of standards in this sphere, as any medic who is not well trained will be playing with the life of his buddy in a platoon. This is so as the next level of medical aid is far behind the lines and if not handled competently, the person may succumb to his injuries during the stage of evacuation.

Medical evacuation is by itself an important part of duties of a line medic. It requires knowledge of how and in what manner a particular casualty is to be evacuated. An injury on the lower limb and a wound in the stomach are two very different types of casualties. Each will require a different method of evacuation. In case a person with a splinter injury in the stomach is evacuated on a stretcher without ensuring that his wound has no scope for being exposed it is more than likely that he would die en route.

Thus it is essential that wound control is attained before evacuating a person and this is one issue where a substandard medic can cause havoc. Lessons from the Traditions of Line Medics The key lessons that emerge from the traditions of line medics would denote that I need to ensure that I am able to spearhead and supervise the health of my first platoon by first improving my own professional competence in all fields of my line of duty. These are firstly my ability to provide first aid to my soldiers on injury or being wounded in battle.

I need to master these skills to perfection. On the other hand it is essential for me to ensure that I am able to deal with all possible types of medical contingencies that would arise on the battlefield. In case I am not able to do so, my platoon mates will not be able to survive the first gun shot wounds. The next aspect is the ability to safely evacuate my comrades to the battalion aid station, for which I need to develop skills in techniques of evacuation. Emergency resuscitation is also an important facet of my combat medicine skills.

On the other hand, it is also important that I develop the capability to look after health needs of my platoon in normal times. This should ensure that the standards of wellbeing and hygiene are maintained by the personnel as well as in the barracks and cooking areas, that the rations received are of a high quality and are able to sustain the extremes of weather. That arrangements for drinking water, bathing, heating and washing are adequate is also one of the parts of my responsibility. I need to have good knowledge of all these aspects and in case I fail to do so my platoon will suffer from diseases.

Finally I must develop that unique bond of professional and personal friendship which will give confidence to the soldier to be my mate and buddy and confide in me in times of personal and professional crisis. Thus I should be able to provide him the moral support required in such situations. Conclusion The American line medic has an enviable reputation amongst troops. At the platoon level he has been providing a very effective first line of medical support to the wounded, the injured and the needy in battle.

During times of peace he is the person who ensures that troops remain free of diseases and also healthy. Unless a person can maintain high standards he would not be able to perform these tasks that have been assigned to him. A sub standard line medic will only lead to his comrades losing their lives and even in normal circumstances they would suffer by being bed ridden when they could be healthy and being despondent when they could be cheerful all because some of us are not able to emulate Moore in doing our duties.

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