To Merck…or not to Merck

The Army’s medical training of enlisted personnel has changed over the years; I think largely due both to the successes and failures experienced on the battlegrounds of Vietnam. The Army’s successes heavily influenced civilian medicine. Our present day emergency medical technician and physician assistant programs flowed from the military’s positive experiences in time of great need.

The military produces medics in a matter of weeks. It relies heavily upon OJT (on the job training) to flesh out the training through supervised experience. OJT is sink or swim. There is a system to cull medics who repeatedly fail to use good judgment. In the Army’s eyes, our backup military specialty was infantry…but I am not sure the culled would make good 11Bravos.

How much medical training is needed? I think the correct answer is all you can get.  My daughter is a nurse practitioner.  I listen to her as she strives continuously to be the best in her field. Concepts and practices change with every research breakthrough. Professional stagnation is down right sinful for those called to the field of medicine.

Both Mark Jones and I worked briefly in civilian hospitals after our tour. We had far richer experiences in one military tour than many medical staff  personnel serving in hospitals for years. This has dramatically changed in the course of fifty years.  However, we both decided that the gap was too great between our experience and the opportunities presented.

My time with the 2/501st and Ft. Campbell afforded a solid seasoning amongst a full team of medics. We rarely worked alone (although we were assigned to platoons for field maneuvers). I didn’t want anyone to get sick or injured, but I wanted to glean everything I could out of the situations presented.  We shared what we knew between ourselves. I felt quite comfortable and almost complacent.

Orders for the 3/5o6th changed my mindset. Bullets and mortars would  take our experience to a whole new level. Within the sixth months of training, I sought every avenue to prepare myself. However, I (and most honest medics) felt some self doubt. The only cure that I knew was more preparation. I was relieved when Dr. Lovy answered that call to increase both confidence and preparation.

Dr. Lovy recommended a civilian medical book, more comprehensive than our military manuals. The book was entitled the Merck Manuel. It was the Reader’s Digest of the practice of medicine. [The book has been through a multitude of editions since 1899. “It was meant as an aid to physicians and pharmacists, reminding doctors that ‘memory is treacherous.”” Albert Schweitzer carried a copy to Africa in 1913, and Admiral Byrd carried a copy to the South Pole in 1913.” It’s currently available online. http://www.merckmanuals.com] On my next payday I asked Dr. Lovy to purchase one on my behalf. It was  a sacrificial investment for a PFC.

A few weeks later, I received my prized possession. Doc Lovy had procured the latest edition. I could bet you that no more than a half dozen medics had that reference on the whole base…and I would win. I had about four months to read that tome before we shoved off. My self confidence returned because I was going to be state of the art, practicing our skills with a whole new level of knowledge.

I was attached to an infantry unit and returned to my barracks. During our off duty time I poured through my new reference. All was well until an infantryman approached me asking, “What are you reading Doc?”  I proudly replied, “Some advanced medical procedures.” He replied, “What are you reading that for Doc? Don’t you know your stuff? Have you ever fixed somebody with a bullet wound?”

I had scared my man. There was no recovery in gaining his confidence. However, it tapped me into an awareness of the growing tension…we were all going live combat. As I expected, the platoon sergeant later asked me, “What are you reading Doc?” I informed him honestly, in the most confident manner that I could muster. He strongly advised me, “Don’t spook the men.”   I replied, “They won’t see it again Sarge.”

There is very little privacy in the army; there was absolutely no privacy in the 3/506th. I hid my Merck deeply into my spare gear. I hauled it with me to Vietnam in the bottom of my duffle bag. Once we landed, I never saw that duffle bag again. I suspect my duffle bag and my Merck somehow landed on the black market…somewhere in Vietnam.

Currahees…medicine is both art and science. People have to have confidence in your abilities…that is the art. The science is your training. I would like to have mastered the 11th edition of the Merck. The Merck was just…not meant to be.