"War is Hell." Union General William Tecumseh Sherman's famous quote was inspired by his extensive experience in the field of battle, and he didn't want to gloss over its horrific nature in favor of vague platitudes of glory and honor. Instead, he wanted to warn a new class of military officers to avoid the suffering that comes from war if possible.
During wartime, the U.S. Army Medical Corps' field units face that human suffering on a regular basis. The dark television comedy "M.A.S.H." treated the experience of frontline Army field medics in a way people could relate to, and to be sure, the experience has a tremendous good side, as well. But what kind of challenges do real Army field medics face on the front line?
Military campaigns have always required armies to be far from home for months or years at a time. While advances in communication and transportation technology -- like air travel and video phones -- allow a certain level of connection to take place more frequently, it can never replace being with your loved ones in the same room.
Army field medics are no more immune to this than any other military personnel. In fact, as deployments around the world have grown longer and more frequent, the need to care for the mental well-being of caregivers has risen too. To help with this, Congress funds the Center for Deployment Psychology (CDP) in Bethesda, Md. [source: Center for Deployment Psychology]. Founded in 2006, the CDP's purpose is to provide the strong psychological support needed by today's soldiers.
While being deployed away from home for long stretches isn't unique to the Medical Corps, it deservedly ranks among the top challenges. But what are some of the more unique challenges Army Field Medics face?
All the training in the world doesn't prepare someone for real combat. Even in live-fire exercises, part of your mind always knows those bullets aren't really aimed at you. As a medic, your job is to find people who are in a dangerous area, get them to safety and try to save their lives. Focusing on this while knowing someone on the other side is aiming at you is no easy feat, but is critical to accomplish when the wounded soldier's life is in immediate risk.
Hemorrhaging and the resultant loss of blood is the leading cause of battlefield death, and it can happen in a matter of seconds or minutes, depending on the severity of the wound. It's estimated that more than 2,500 lives could've been saved had proper treatment reached them in time to stop the bleeding. That's why the first objective is to provide any tourniquets needed even before pulling a wounded soldier to safety. Being able to concentrate on performing this kind of lifesaving service while being shot at is a huge psychological challenge for any medic [source: U.S. Army].
Even with the wounded soldier pulled to relative safety, the challenges are just beginning.
Back in the 1980s, the television character MacGyver earned a reputation for making complex devices out of everyday things he found lying around. Because field medics can't carry an entire hospital with them all the time, they need to be extremely resourceful. On one level, it could be as straightforward as making a tourniquet out of a piece of clothing, a simple but critical life-saving device.
Not all resources are physical, though. Sometimes being able to relate to a patient in a completely nonmedical way can be enough to stabilize a situation. For example, speaking softly to a child, even if the child doesn't understand your language, can do amazing things. This kind of resource relies on the emotional care a medic is able to provide [source: Seehusen].
Physical or emotional, a medic's resourcefulness in some measure has to come from within. On the other hand, the hazards medics face can come from literally anywhere.
Every area of the world has its own set of threats. In the United States, we're familiar with the flu and colds, with some regions host to poisonous snakes and spiders, and areas of extreme heat and cold. American military units face deployment in almost every corner of the world at one time or another, so field medics are trained in how to treat problems. For example, the tropics are notorious for myriad exotic diseases, while winter in the mountains can bring frostbite in seconds.
Likewise, combat often takes place in the most remote of locations, far from any kind of permanent medical facilities. Getting the wounded soldier away from the line of fire is just the first step. Finding transportation for casualties to a medical care facility, and getting them there quickly, can dictate whether the patient lives or dies.
In both cases, the challenges for the field medic are to be aware of the local threats to soldiers in the way of diseases and knowing how to get patients to the care they need.
From what we've seen so far, being an Army field medic is no walk in the park. How do they deal with all of this psychologically?
In addition to their medical duties, field medics receive combat training to help their units in the field fight enemy forces. Unlike a purely combat soldier, though, the medic's duties don't end there. Exposure to both direct combat as well as its effects in the medical facilities day after day affects most people in a very fundamental way, causing them to react defensively. When things become overwhelming, it's human nature to turn off that part of your psychology that produces compassion and empathy, two of the most critical aspects of being an effective medic.
Added to that is the fact that Army medical personnel are often deployed without a permanent unit, so they lack the natural bonding and psychological support that goes with it [source: Schoomaker]. Having access to a solid support network to enable frontline medics to cope with this challenge is what makes the difference between a medical team capable of amazing resilience and one on the edge of burnout.
For centuries, the standard approach to meeting the field medic's challenges were more or less the same, and more patients died than needed to. In 1996, a workshop dealing with Tactical Combat Casualty Care (TCCC) produced a paper that changed a lot [source: Butler]. Working from that new beginning, the tools Army field medics have at their disposal are getting better and better. The challenges they face won't get any easier, but through improved tools, techniques and psychological care, they can approach their task better prepared than ever before.
Preventive medicine in the U.S. Army is similar to civilian medicine. Test your knowledge with the preventive medicine in the U.S. Army quiz.
- Butler, Frank K., Jr. et al. "Tactical Combat Casualty Care in Special Operations." Military Medicine. 1996.http://www.tacmed.dk/pdf/TCCC_Special_Operations.pdf
- Center for Deployment Psychology. "About CDP." (April 1, 2011)http://deploymentpsych.org/about-cdp
- Schoomaker, Eric B. "Army Family must help members deal with stress." The Mercury. December 2010. (April 1, 2011)http://www.armymedicine.army.mil/news/mercury/10-12/Mercury-Dec2010.pdf
- Mabry, Robert L. "Use of a Hemorrhage Simulator to Train Military Medics." Military Medicine. November 2005.
- Seehusen, Dean A. "Giving Care in Iraq." Military Medicine. November 2007.
- U.S. Army. "Perform Tactical Combat Casualty Care." (April 1, 2011)https://www.cs.amedd.army.mil/clsp/TCCC%20Lessons%201-3/TCCC.ppt