Army Basic Training for Doctors

Many of you may know that I am a member of the Iowa Army National Guard. On June 30th I flew down to Texas to begin medical officer basic training. Basic training for future army docs is done in Fort Sam Houston which is located in San Antonio, Texas.
Week 1
The first couple things you learn about the Army is that they like to start really early in the morning and that you stand around and wait a lot (often referred to as hurry up and wait). My first day started at 04:50. That is right! 4:50 am in the morning. That morning after roll call we proceeded to in-process, receive some paperwork, and get measured for height and weight. I came in at 208lb and 75.25 inches. After the weigh in, we began classes. Just like medical school, it was death by powerpoint. Occasionally we had good instructors who shared soldiering stories of deployments to Afghanistan or Iraq, but for the most part it was the is the Army and this is what we expect you to know and how to behave. There were several things that they emphasized over and over and over. I guess they have had a few problems in the past. Basically:

• Drink Water (it's hot)
  
• Don't fraternize with enlisted soldiers
• Don't drink and drive or do stupid things while drunk
  
• Don't speed on post or talk on a cell phone on post
• Don't commit adultery
• Drink Water!
  

That was my first couple days. For those of you who went to "real" basic training or have heard about how hard or how they break you down. What I went to was nothing like that, it was cake comparatively speaking. I was lodged with another student in a hotel on base with nice AC, full bath, mini refrigerator and microwave. We are done with classes around 5 or 6pm every night. After which we are allowed to use our cell phones, computers, etc. We are permitted off post whenever we would like. In fact after a couple days of classes. We had a three day weekend. We happened to start class just before July 4th and so as a government employee on a national holiday we had the time off.
A group of us found out that Seaworld was supporting the troops with free tickets so we spent Saturday riding the rides and watching Shamu. They also had a nice waterpark to escape the heat. The next day we spent some time watching fireworks and also spent a night out on the Riverwalk in San Antonio toured the Alamo and several of the squad went to get tanked. Unfortunately one of our class mates got in a fight after drinking a little too much and ending up getting sent home. See rules above.

After the three day weekend. Things changed drastically. We were no longer going to be in our air conditioned hotel on post. We were going to the "field". Tuesday was filled with more death by powerpoint until the evening. In the evening we loaded up on buses and made our way to the Camp Bullis. We put our gear in our tents and were then issued our brand new best friend: the M16. One fellow soldier put it this way: "From that point, your new buddy is your constant companion. You will eat together, sleep together, and take a s- together." Yes, we did have to take it to the port-a-potty with us.
Breakfast and dinner are generally hot meals served cafeteria line style in a mess tent. Lunch was always an MRE or if "Mama Snacks" showed up people could buy what they wanted. "Mama Snacks" is a gut track who always seemed to know where we would be training and when we'd have a break. She would pull up in her RV and a line would form. She had a tasty spread of tacos, burgers and cold drinks.

Camp Bullis' medical FOB (forward operating base) is about 1000 square feet surrounded by barbwire and filled with tents and convoy vehicles. Texas is HOT in the summer. Most days were around 95 degrees and around 60% humidity for a heat index of 110 degrees. The worst part about the field was the 110 degree weather and the attire. We were required to always be in our boots, long pants, long sleeve jacked, vest, canteens, pouches, and cap or helmet. I was constantly sweating. Relief was relaxing in the AC of the tent. Seen below:
Different people get tasked each night with various duties (fire watch, serving breakfast/dinner, trash, filling up the handwashing stations with water, etc) for the evening and the next day. Over the three weeks I did a fare share of those tasks.

The first FTX is basically weapons training and an intro to land navigation. The first full day in the field began with PT. Get up at 04:50 in the morning, do some stretching and some pushups and situps and then run a couple miles up a mountain. Not to bad, right? The only thing is the lack of showers. In the heat and without showers you can imagine how everyone and the tent smell after a couple of days. After breakfast, we spent the rest of the day getting an intro to the M16 rifle, dissassembly, assembly, and marksmanship. Finish around 2pm and then have nothing to do until supper. Just sit in the bleachers or walk around camp in the hot weather. We weren't allowed to go to the air conditioned tents till after 5pm.

Day two started with breakfast. We practiced land navigation. Basically we were given a set of coordinates, a map, and compass. Spend 20min or so plotting the points and using our trusty protractor and then run around the hills and find the little markers they placed at the points. This day we did it in large groups of about 20. Next week we will do it in groups of two for our test.
Day three was zeroing at the M16 range and how to assemble and use a radio. Nice! The picture above is me at the range. Dead give away, who else shoots south paw? It was a fun day, except for the fact that zeroing lasted about 20min and radio training was about 15 min. They just had around 250 people that needed to complete those tasks. So while I had a great 35 min of Army experience. The rest of the day was lounging in the sun or under the bleachers waiting for our turn to go or for everyone to finish to go back to base. Most days were like this a good 1-2 hours of training and 6+ hours of waiting around.
Day four is Saturday. Everyone's skin is sun abused and we all smell like balls. We spent the whole day doing mock qualification with the M16. They take you a range, and targets pop up and you shoot at them. They tell you how you did, but no score is recorded so it makes no difference whether you shoot 4 or 40. I was one of the few who qualified. Only about 15% of the class qualified with the M16, good thing doctors aren't the ones fighting our wars. The targets were at 50m, 100m, 150m, 200m, 250m, 300m. They would pop up for a few seconds and then go down. The closer they were the shorter time they would pop up. We shot 20 rounds prone with sand bags (supported), 10 rounds unsupported (on elbows), 10 rounds kneeling. It was a blast scanning and firing. Finally you head back to the FOB, wait for the buses to show up. Then they realize that they don't have enough buses for everyone. So I happen to be one of the 30 stuck in the field for a couple more hours waiting for the buses to drop people off and then send one back to get the leftovers. I wasn't really to surprised. I kind of expected it at that point.

Week 2
Getting back to Fort Sam for the weekend the first thing you do is shower. After that you go to a laundry mat and wash the stench out of your uniform. I slept, went to Church on Sunday, played a little afternoon basketball, then Monday it was back to the field.

Monday was a mock pistol qualification with the M9. We showed up in the morning and took the buses from Fort Sam straight to the pistol range. Same as the M16 mock qualification: go to a range, shoot at targets, and get a score. No official record is made. This time though I think our class averaged around 75% passing. Much better. The targets though were a lot closer. The furthest M9 (a 9mm handgun) target was 50m. Most were much closer.
We also had some concurrent didactic training going on about convoys, IEDs, and calling in MEDEVACS. The next three days were spent on convoy training, CBRN training, or a litter carrying obstacle course. The order you went through depended on your group.

8th platoon had CBRN (gas) training first. For CBRN training you covered things like how to set up a decontamination zone, how to use a gas mask, how to use the detector kits, etc. The crown jewel of the day was putting on your mask, walking into a room with CS gas (form of tear gas), and then removing your mask. The idea being that if you were fine with your mask but burning and writhing in pain without the mask: you would conclude that the mask works and have confidence in it. The pictures below show how much fun the gas chamber was.
We entered the room with our masks on and immediately you felt a sun burn feeling on any exposed skin. It was tolerable but rather irritating. They had us do jumping jacks in the room with our masks. Then they proceeded to have each of us take our mask off, state our name, rank, and social security number and take a breath. Depending on when you took your breath your you might not finish. Then we could exit. Without the mask it was quite painful. It took about 10min for my eyes to flush and for me to be able to see again. Many had snot just running out of their nose. That was training that I would rather NOT repeat.

The next day was an obstacle course consisted of a team of four carrying a litter with a mannequin patient through a path with some narrow passages, a few walls, and under some barbed wire. A few people with blanks are hiding out in the woods to add an extra element to the task.
The third day was convoy training and it was probably one of the coolest things you get to do. It consists of three events:
1) You practice exiting a HMMWV that's rolled over. Pretty much a fun little carnival ride. You hope into a HMMWV attached to a machine and the operator rotates the machine at a moderate pace and then stops it on it's side or roof. You're then tasked with getting out.

2) The coolest thing you do is hop into a convoy simulator. They have a set of HMMWV mocked up inside of a building. Each one is in a room surround by a wall they project your virtual surroundings onto. Everyone is assigned various roles in each truck and in the convoy chain of command and then you carry out a virtual mission. Your driver drives, your chain of command communicates with each other and virtual support services (CAS, EOD, MEDEVAC, etc), and your gunners fire at insurgents (complete with air compressor recoil in the rifles).3) The last is a convoy exercise where they load a group of you into trucks and give you a magazine of blanks, assign a few leadership positions, and then drive you through the FSM area where some fake IEDs are set up and a few cadre with weapons dressed like middle easterners and blanks are ready to ambush.At the end of the fourth day there was a night land navigation exercise. After dinner they sent us out into the woods in pairs to find an assigned list of points. Depending on how you do, you end up getting to bed around midnight to two in the morning.
On the last day (Friday) we woke up, grabbed breakfast, and then did a day land navigation exercise. Same as above, but without flashlights. I'm not sure if they normally do it in that order or if this was an anomaly. Finding things in the day is much much easier than at night. After land nav, we sat around for about four hours waiting for the buses to arrive (they'd been scheduled for much later, presumably to allow time to find any people who got lost). Go back to Fort Sam, shower, sleep some, have a few classes on Army Healthcare, go to Church, play some bball, then head back to the field for the third week.

Week 3

This third week covered Army Healthcare. Army Healthcare is divided into 5 levels. Level 1 is battlefield care it consists of combat medics (68W) and a doctor and PA within about 10min or closer to the front lines. Level 2 is a couple tents with some ancillaries like xray and lab. Level 3 is a combat support hospital and the first time you see surgery. This is the largest type of in theater care. Level 4 is outside of theater (Landstuhl Germany) and Level 5 is CONUS (Care in the Continental United States).
Day one is just driving to the FOB, checking out weapons, and then a set of three informal classes on levels 1-3 of medical care. You sit around and a cadre member explains what each level does, what care it can provide, and how it's generally set up.

Day two through four involve rotating through a mock-up of each level at one per day. You go to a mock up of a particularly level each day and practice running a mass casualty event through it.
It was a fun week and for the level 1 training we had air support. Yes, that means a Blackhawk helicopter for evacuating our fake casualties. We would call in our medevac on the radio, relay some GPS coordinates, throw a smoke grenade and BAM! - A blackhawk chopper shows up, picks up a couple people, and disappears back to the home base. It was a fun experience. Unfortunately I wasn't one of those randomly selected to ride the blackhawk and play casualties. I did however get to load a litter and a 230lb buddy onto the chopper. Fun stuff!

A fellow student (aka deadcactus) summed up the experience in a forum this way: "Overall, the course was an interesting experience. You learn some interesting stuff, but prepare to "hurry up and wait" for the three weeks you are there. The only real complain I have against the course is an overwhelming atmosphere of "we're all just here because there needs to be a check in the box".

It represents a lot of people's indoctrination into the military and I feel that rather than taking the chance to hold us to the standards any other officers would be held to, it just allowed a lot of people to begin there career with the same experience and attitude that leads the rest of the Army to view AMEDD as the Rain Man of the military.

Maybe it's just me, but I would expect that three weeks of Basic Officer training should produce an Officer proficient with a rifle, able to march in formation and lead a formation, knowledgeable on how to wear the uniform and how to act when wearing it, and in better shape afterwards than before. All that would require is a little more time on the range and cadre dedicated to holding students to the proper standards. I don't know if it's complacency on the part of the cadre or the results of the simple reality that they need medical officers so badly, though I tend to think it's more of the latter.

Still, it was a memorable experience with a lot of good people to meet. If you're going, the best advice is to bring some cards and a book or two and just be patient and try to learn whatever you can. The prior service folks among your peers will be a great asset and will help you learn more of what you need to know if you are willing. Over all, just enjoy. It'll be pretty fun if you go with the right attitude... "

I couldn't agree more. It was fun. Too bad I have to go back to real life and school as soon as I get back. In fact I have missed 4 days of class already and am behind around 20 lectures. Oh well.

One last fun story, so what happens when you have a lot of guys who have a lot of free time on their hands. You get an event that Don King himself would promote. It was "scorpion vs. spider". One squadmate captured a scorpion, another a spider and then announce it to the tent and you have a pretty fun 5 min of hooting and hollering. It was quite the contest. The spider initially ran out of the box and had to be recaptured. Upon reentering the ring he was stung by Joey the scorpion. But spidy recovered and wrapped Joey's stinger up with his web. Then started the ground game and we all thought the scorpion was done. But it wasn't that much fun to watch. So the promoter decided to use a knife to split the two and placed them back in their corners for round two. When round two began Joey the scorpion struck again with the stinger and spidy was finished. It was a knock out and he never woke up.

My time in Texas was fun. A little long for the amount we learned, we could have used a little more discipline and it could have been more organized. But with just under 500 students to split up into tasks I can understand their pain in scheduling. It was a good chance to meet a lot of future doctors from all over the country and make some new friends that I may someday see in a war zone 8 years from now. Who knows what the future will hold? I certainly don't, but I feel more prepared to greet it.

Other little notes more to myself since I gave up journaling:

1. I need to work on being a follower better. There were a few times we had women leadership and our women student leadership go fustrated they tended to yell at the top of their lungs in a very irritating tone. I lashed back a couple times. Not so good, I even apologized to a couple. It taught me that screaming is a horrible leadership method. It's better just to wait till people quiet down themselves and also to lead by example. Instead of yelling at someone to do something, just go do it yourself and your platoon may be likely to follow suit and not resent you.
2. I really miss having my wife around all the time. Being married is good stuff I can't wait to get back too.
3. Doing a physical fitness test at 04:35 in the morning with a stomach ache maybe hazardous to your health. The pushup went fine. I got 61 in two minutes. The sit ups were ok, I did 77 in two minutes (the lowest I've done on any PT test). After which, I walked off into the darkness and spewed my breakfast onto the field. After a 10min break, we began the two mile run. I ran it in 15:24 and as soon as I was done. I went back to the field and emitted any leftover contents of my stomach in two retching expulsions. I felt horrible, but I passed.
4. Floating the Guadalupe river is a great end point. We floated the horseshoe the day before graduation. A few coolers of drinks, a super slow river. I bet we only traveled two miles in like 3.5 hours. The water was cool, the sun was hot. Very relaxing!
   

One final picture and one quote that sum up much of the Officer Basic Training experience. The photo is my squadmates "waiting" for our next training.
The quote is from Mr. Jones, a retired combat medic and civilian instructor. He said this line about 5 or 6 times anytime he instructed. "That is bulls-! Hooah!"