If you Think Adventure is Dangerous

“If you think adventure is dangerous, try routine; it is lethal” ―Paulo Coelho

My wife, Pam, and I recently returned from a fantastic sailing adventure in the Bahamas aboard the Liberty Clipper, part of the Boston Harbor Liberty Fleet of Tall Ships. The 125-foot gaff-rigged schooner is a modern replica of the small merchant vessels that plied the American coast in the 18th and 19th centuries. While the steel-hulled ship caters to tourism in Boston during the summer, taking guests on short sails around Boston Harbor, it overwinters in the Bahamas out of Nassau, providing weeklong cruises throughout the islands for those looking for something different in cruising.

This cruise is more of an adventure tour. The food was outstanding—my glass was never empty—and the scenery was incredible (we sailed the isolated Bahama Exuma islands), although the cabins were consistent with a working sailboat. While we did have a private bathroom, we slept in bunks, and Pam and I could not pass each other in the cabin without one leaving the room.

If you want to clean up the world, first clean up your room

“My mother used to say to me if you want to clean up the world, first clean up your room.”—S.E. Cupp, CNN interview aired Jan. 4, 2020, 1800 ET.

CNN reporter Sarah Elizabeth Cupp was interviewing Rabbi Joseph Potasnik concerning recent anti-Semitic attacks on members of the Jewish faith. My spouse, Pam, viewed the CNN interview and made me aware of Cupp’s quote used above from the broadcast. My wife and I have been discussing the ongoing challenges to the world’s environment due to the consequences of climate change, the horrifying ongoing bush fire disaster in Australia being the most current and poignant example. Unpleasant changes in our global environment from extremes in weather, animal species extinction or rising sea level seem to be routine on the nightly news.

The Two most Frightening Words in Washington: “Bipartisan Consensus”

“The two most frightening words in Washington are ‘bipartisan consensus.’ Bipartisan consensus is when my doctor and my lawyer agree with my wife that I need help.” —P.J. O’Rourke

I have been struggling with the idea of consensus-building for some time in my machinations within the Defense Health Agency to mold effective pain management policy for military beneficiaries. P.J. O’Rourke, one of my favorite modern authors and satirists, cuts to the heart of the issue with brevity and humor. I can easily identify with the feeling that O’Rourke’s comment on consensus evokes in my efforts to move forward on any front within pain medicine by forging agreement among military medical leaders.

As I have noted many times in this column, decisions for medical change are far easier to achieve during a hot war, when the necessity for action is made clear through the clarifying lens of servicemembers’ blood, injury and suffering.

“Not Part of the Ordinary Medical School Curricula”

“Treating mass casualties or performing emergency procedures in the middle of a firefight or while under chemical attack are not part of the ordinary medical school curricula.”

Rep. Constance A. Morella (R-MD) Constance “Connie” Morella was a Republican representative for Maryland’s 8th Congressional District from 1987-2003 during the Bill Clinton presidency and made the above comment in 1994.

At that time, Vice President Al Gore and a team of congressional leaders were working to reduce the nation’s deficit. They were planning the demise of the Uniformed Services University, suggesting that military physicians and nurses could be procured from civilian medical institutions through health professions scholarship programs at significantly less cost than graduates from America’s only military medical school. Clinton’s spending plan for the 1994 fiscal year called for the first significant steps to close the institution.

Embrace the Suck

As I write this editorial, I am fully engaged in the Uniformed Services University’s Operation Bushmaster1 as a platoon team leader instructor. I have mentioned this activity numerous times on this editorial forum. The Bushmaster experience is perhaps the best example of why USU is clearly a unique medical university producing medical leaders for our military and our country. For the USU School of Medicine, Bushmaster is the culminating final exam where students exercise four years of military-specific training in leadership and battlefield trauma management provided through the USU Department of Military and Emergency Medicine, where I currently serve as a professor of anesthesiology.

I told you so

I told you so

“The four most beautiful words in our common language: I told you so.”—Gore Vidal (1925-2012)
I wrote an editorial in U.S. Medicine on June 10, 2018, entitled “If you tell a big enough lie and tell it frequently enough, it will be believed.”

In an Age of Incompetence

In an Age of Incompetence

“I am, as I’ve said, merely competent. But in an age of incompetence, that makes me extraordinary.” ~Billy Joel

Like many others who pursue a career in medicine, I invested my early years as a 20-something in a seemingly endless effort to obtain the necessary education and training requirements to place an MD at the end of my name. Yes, I would find part-time work in the summer for extra beer money but did not need to work while in school. I was fortunate to have parents willing to financially support my educational efforts and “Uncle Sugar” (the U.S. Government) was willing to pay for my collegiate and medical school expenses in exchange for Army services in defense of the Constitution.

Do as much nothing as possible

Do as much nothing as possible

“13. The delivery of good medical care is to do as much nothing as possible.” “Laws of the House of God,” ~Samuel Shem

I have been a part of U.S. Medicine and this column for several years now. I am occasionally asked where my ideas come from for the editorials I produce. Many ideas, of course, are pulled right out of the headlines or the nightly news. Others are derived from my experiences, both medical and otherwise, that have a link (no matter how tenuous) to our collective experience as federal medicine providers.

“God help us, if, the first time something fails—and something will fail—we crush whoever it was … whoever’s responsible,” —Gen. John “Mike” Murray

Gen. Mike Murray made this comment as he became the first commander of the Army Futures Command. The command’s website describes the mission of the organization with the following statement: “Army Futures Command leads a continuous transformation of Army modernization...

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