I spent 20 years of my life practicing military medicine in the Air Force. I started my career as a pediatrician, thus my primary focus was on peacetime medicine. However, the last 11 of my years were spent as an Air Force Hospital administrator. Nine of those years were as a commanding officer.
As a commanding officer, you have a different vantage point. You quickly realize that military medicine means wartime medicine. The rest of the time you spend preparing for that possibility.
Here is an example. I arrived at Langley AFB as the commanding officer in August 1989. In early 1990, my readiness department came to me and told me it was time for the annual inventory on our Air Transportable Hospital (ATH).
The ATH was a 50 bed hospital with 25 inpatient medical beds, 25 inpatient surgical beds, an OR, a full lab and an X-ray suite. All of it could fit on two Air Force C-5’s and be flown anywhere in the world.
I asked the readiness people how we did the inventory. They told me they would send 25 people out to the field for six weeks. These 25 people would set up the hospital, inventory the equipment and then pack it back up.
I asked how many of the 25 people were actually assigned to the ATH. They told me 11 of them. I expressed concern about that. There were 128 people assigned to the ATH and only 11 would have a clue of what was in the ATH.
I told them that we would need to have all 128 people do the inventory. They told me that could not be done. We could not run the hospital with 128 people missing.
My response was to do some research. On any given day, we had some people on leave. We had some people away attending courses and others were attending on base enlisted schools. Some were doing base detail work like picking up garbage.
When the research was completed, we found that on any given day 110 people were missing from the hospital staff. That meant we only needed 18 more people to get to 128.
Now all I needed to do was find a two week period to do the inventory. No one could take leave, attend courses or base schools, or do base detail work.
So we planned an inventory over two weeks with the full 128 people, which occurred in April 1990.
For many of them it was their first chance at even laying hands on what they would use in a wartime scenario. The hospital found it could run fine with all those people missing so we were ready to go to war on both fronts. Our primary mission could be fulfilled.
Four months later Saddam Hussein invaded Kuwait. Six days after the invasion, the ATH with its 128 people climbed onto two C-5’s. They set up the first ATH in Desert Shield in record time.
They had the training. Back home the hospital never missed a beat. They knew they could get the job done with 128 people missing.
The hospital was able to practice military medicine the way it had originally been conceived. Wartime and peacetime medicine both thrived because of the way it had been practiced.