Nothing makes an Army drill sargent (prounounced something like ‘Sar-Ughnt’) more testy than when a good number of his/her unit skips morning physical training.

I take that back…there’s a veritable Olympics of things competing to be the thing a drill sargent hates the most.  But showing up late for PT is definitely on the list.

One of my jobs is to set up patients with this Army thing called a Profile.  THE profile.  After a few months here, I can say in all certainty that the profile is my own personal battlefield.  Everything I do seems to revolve around this paean to administrative oversight.

Simply put, the profile defines what an injured soldier can and can’t do.  They get very specific: Soldier may mix cocktails, but d/t a herniated C-4 disk, he may not tip his head back to drink them.

Oh MAN...we can't come in 'till 9. Super tired...

One of the big reasons I see patients is to “review the profile.”  Read between the lines, and typically, the visit is really about the patient trying to get some other restriction put on their profile.  Restrictions that will make most soldiers ecstatic and drive a drill sargent nuts.

The most ubiquitous profile restriction is the “0900 work call”.  Prounounced “Oh-9 call”.

Droopy-eyed private: “Uh, man, sir, uh.  Need an Oh-9 profile.  TONS of sleep meds. Can’t get up for 0630 PT.  Help.  Desperate and all that.”

Me, Dr. Naive:  “Ok.”  Fill out form.

Private: “THANKS, man.  Can I get Oh-9 profiles for the rest of my X-Box buddies.  Now that I can stay up all night playing Soldier of Fortune, I need my buddies cuz we compete against each other.”

“Soldier of Fortune…isn’t that pretty bloody.”

Evil smile, “YEAH, totally.  We just run around shooting everybody.”

“K.  Why are you on meds again?”

“Can’t sleep.  PTSD.  Keep seeing people get shot when I close my eyes.”

Embellished only slightly, I’m coming to the point where I can’t see a SINGLE medical reason to approve someone for 0900 work call.  Sleep meds don’t last forever.  If you take them at 7pm and are in bed by 0800, you should be able to get up in time for PT.

I’m asking around to doctors I know:  Any medical reason you can think of to allow someone to come in at 0900 rather than 0630?

Get On the Plane!

Jerry reluctantly entered the WTU, the unit I oversee as a doctor, just recently.  This soldier has achieved about as much as anyone in the non-officer ranks can achieve.  He’s been in the Army for 24 years.  After 20, you can retire with full military benefits, but this guy hung on by voluntary extension for another 4.

He entered my unit because of a health problem list that runs to 6 or seven issues.  The primary ones being kidney disease and hypertension.  He’s had both for years.  All untreated.

“Why haven’t you taken care of this stuff?” I ask, ready to get all righteous on the Army.

“Well, you can only do what you can do, sir.”  He says, politely pretending that I would outrank him if actually a soldier myself.

“Um, do you know how long you’ve had hypertension, and how bad it’s been?” I say, trying a different angle.

“Listen son, I know exactly what my blood pressure was averaging before my last deployment downrange.”

“How many times have you been deployed?”


Making no effort to hide my surprise, I reply, “You’re peeing out half a bicep in protein every 24 hours, your blood pressure is 190-101 today, and you’ve been deployed 3 times?  Each time for over a year?”

“Son, when the time comes, you gotta get on the plane.”

“So, you knew about all of this prior to deployment?”

“Which time?”

“ANY time!”

“Well, sir, yes I did.  But I told my men, ‘When it’s time, I’ll be getting on that plan.  If I don’t, I’ll be dead.  If YOU don’t get on that plane after me…I personally hunt you down, I will find you, and then YOU’LL be dead.”

“There’s doctors downrange, though, right?  Couldn’t you be seen by one of them?”

“Look, I cain’t treat myself too well with the boul-ets whistling over my head.  And I’m not gonna tell nobody that I got problems at a time like that.  They’ll send me back home and leave all my boys there to fend for themselves.”

“Right.  What was your blood pressure prior to your last deployment?”

The thin, muscular man thumbs through a huge stack of medical papers, “Hmmm.  I remember that day.  Headache, bad.  Seeing spots and stuff.  Hmmm.  Oh, here it is:  224/112.”

“That was your blood pressure before you left for a war zone!!??

“Son, you won’t understand because you ain’t never worn no uniform.  But when the plane is for you…you get on that plane.  It’s pretty simple, really.”

“Do you think, just maybe, I can get you to take some blood pressure pills now?”

“Oh sure, doc!  You bet.  Army brought me back safe and sound, see?  Doing fine now.  I’ll take them pills.  Hooah, boy!”

Never Offer To Cut Off Your Own Leg

At least, not in the Army.  They might just take you up on your offer.

Joe (do I really have to tell you that this isn’t even close to the guy’s real name?) had problems with his left leg after 2 deployments to Iraq and multiple exposures to high-velocity trauma.  Lots of problems, shall we say.  The leg often doesn’t work much at all.  Sometimes, this overwhelming feeling of burning pain spreads from his mid shin up to his knee and then pulses up into his thigh for hours.

But what’s debilitating leg pain got to do with being in the Army?  At least, that’s how Joe sees it.  Unlike most soldiers in the WTU, Joe is determined to stay in the military.  He wants to be sent “down range” (deployed) again.  Tomorrow, if possible.  He loves his unit and enjoys the excitement of his job. 

Joe does not understand that a soldier who can’t walk probably isn’t going to do well in a war zone.

Actually, Joe is quite smart.  He understands perfectly well that a debilitated soldier can’t perform a required in a combat situation.  But he doesn’t care.  He loves the Army.  Lives for the Army.  So he has worked with a lawyer for over a year now to keep himself in the Army.  The WTU doc before me has worked to this end – admittedly with some bemusement – for the past few months as well.

Recently, Joe met with a special review board comprised of high-ranking commanders.  They evaluated his chart, looked over the reports of his injuries, and then interviewed him personally.  I think this occurred at Walter Reed Hospital, in Washington D.C. in – the Mecca of Army Medicine.  As you might imagine, this was a big deal.

I don’t know the exact specifics of that interview, but here’s my reenactment:

“Soldier, you’ve served your country well.  We thank you for your sacrifice and heroism.  After thorough review of your file, we have determined that you are no longer qualified for active duty and will therefore be separated from the military with full medical coverage and benefits.  You will be given an honorable discharge and should have no problems entering civilian life.”

“Sir, it’s the leg, right?  That’s the problem?” Says Joe.

“Correct, Sargent.”

“What if the leg wasn’t a problem?  What then, sir?”

“Why, you’d stay in the military, Son!  Send you down range week after next.  Get you back in the fiiigght, boy!”

“Then cut it off!  Just cut the damn thing off!  I can run on a prosthetic.  There’s less to clean up if I get crosswise of an IED (roadside bomb) again, right?  Just send me down there with a couple of extra legs in my pack and I’m all good.”

This – honest to God – is a relatively faithful reenactment of this soldier’s conversation with his Army superiors.  Admiring his courage and commitment, I was more surprised to find that, following this meeting, our doctors in the WTU received this order from on high:

****de, de, d, d, deeeee —Official communication from High Command:  SGT Joe to be referred to surgery for evaluation of chronic leg dysfunction and pain.  Consider surgical correction.  Amputation a viable option.——-de, d, d, deeee,

***** Stop.