I sat in the huge rotunda of the US Naval Academy Chapel and looked up at the soaring height of the dome and the giant stained glass depiction of Christ walking on the water. As the Naval Academy choir braced and sang the Navy Hymn, Eternal Father, to end the Sunday service, I witnessed a time-honored tradition. Two midshipmen flag bearers slowly removed from their stands the flags of the United States and the Naval Academy. They then dipped the flags, one by one, in symbolic thanks to God, the One “who bids the mighty ocean deep, its own appointed limits keep.” Then, as they marched crisply past our pew, tossing the flags behind their head to fly free, my mind went back to the fluttering of the flag I hung outside our Shock Trauma Platoon in Iraq, just one year ago.

Christmas was approaching and I wanted to send a flag back to some first graders who had written me faithfully during the deployment. I wanted to send them a flag that had flown over our unit, but I had been warned that we could not fly our national flag every day. In fact, I could only fly it long enough to take a picture. It would be too “American” I was told, when I asked why. What’s so wrong with being “American,” I asked. There was no answer.

I had heard this line of political correctness before, and I’d never understood it. Hadn’t we given thousands of lives and untold national treasure to allow these people the right to determine their own future, even if we didn’t agree with it? I thought that was pretty noble. All the talk about us being in Iraq for the oil was just silly. Though when we heard what the price of gas was back home, we wished we had come here for oil. No, just one visit to one of the killing fields had reminded me why we were there.

Our ‘field trip’ was back in 2003. As soon as the initial fighting had settled down, local residents showed the troops where they said that some of their loved ones had been taken and killed. Eyewitnesses reported people being trucked to an open field where a backhoe waited at the end of a large pit. Without warning those in the trucks were hosed down with machine gun fire and pushed off the trucks into the pit. The dead and dying were quickly covered up by the backhoe, returning the field to its previous state. The whole operation was said to take only minutes.

Despite the witnesses, it seemed a rather outlandish story. But when our troops began to dig, they found thousands of bodies. In order to identify the dead they had stripped the dead of their clothing and anything that would identify them, put the items into garbage bags, and reburied the rotting corpses. And yet, even after hearing this and seeing the field with bag upon bag of clothing, I still found it hard to comprehend. I even wondered whether we were being manipulated for political purposes. So I began examining some of the bags for myself. As I peaked into the first few, I felt as if I was gawking at a coffin. Solemnly I examined the contents of bag after bag. Rotted clothing, a wallet with an Iraqi ID. A pair of small, cheap tennis shoes that had no laces, tied together with rags. “Now that’s some poverty when you can’t afford shoe laces,” I thought. Then I noticed that both shoes still had filthy socks in them. I reached into the socks and found that they both contained the remains of small feet.

“There have been many of these fields discovered,” our guide from the civil affairs battalion said later. “All told, there may have been upward to 350,000 slaughtered like this by the regime. Whatever this war brings, whatever you have done, you can be proud that you helped put a stop to this.”

I was proud of what we had done. And a few Iraqis were thankful for our sacrifice. While at a medical staff meeting at a local Iraqi hospital a few weeks prior our commander had thanked the Iraqis for their hospitality. “No, no, you cannot thank us,” a small wiry doctor had said rising to his feet to address the group. His suit was dirty and wrinkled, his eyes dark, ringed and sunken with fatigue. “Please do not thank us. We have shared with you our cake. But you have shared with us your blood.”

But the thankful ones were few and far between. As we convoyed back to our base we still encountered resentful looks and haughty eyes. As time wore on, we wondered whether the sacrifice had been worth it all.

When we arrived home that self doubt was initially drowned out by the cheers and flag waving. I was proud to be an American soldier. We were far from perfect, but we had given our all trying to do the right thing – for the world at large as well as ourselves. But then it started to creep back. All the partisan bickering over who knew what when developed into a full-fledged national crisis of confidence. And in the time between my first and second deployments, the counterinsurgency and the troop surge sapped a lot of our will and most of our pride in what we had accomplished.

So there I stood outside of our Shock Trauma Unit last year, sneaking our flag up a pole, snapping a picture, and then quickly taking it back down.

Now I’m seeing the same confusion creep into my beloved profession. Politicians and pundits alike point their fingers at medicine and claim that profiteering is bringing the American industrial giant to its knees. And we, knowing the flaws that are there indeed, begin to question the fundamentals of who we are and why we are here. I don’t know about you, but I suspect that most of us were called to this profession out of a desire to serve. We did not come here to exploit the poor and ignorant. Rather we have dedicated our lives to rescuing the sick and injured. The fact that we are proud of that, indeed make our livelihoods from it, does not diminish our sacrifices nor our accomplishments. As Congress takes up the task of “reforming” our profession, we must not knuckle to the assumption, perpetuated by some who stand to benefit, that we are the culprits for the current problems. We are not perfect, not by a long shot. But we have done well and have the right to be proud of it. I will dip the flag of my profession to the Great Physician who healed ten lepers and had only one return to give thanks. But then I will fly it proudly.

Reform? We must. Improve? We will. But we are the only ones who know both the unique needs of our patients and the remedies that they require. If we become paralyzed by the criticism of our profession that is so evident in the current debate then we abdicate the leadership of reform to those who know nothing of health or caring. Our patients will suffer and we will be robbed of the joy of a job well done. Fly the flag, my friends. Work hard and be proud of what you have done.

by Mark Plaster, MD  


# Who is profiteering?K.S. 2009-12-16 16:55
Thank you again for a most moving essay. Your heart and your words are truly inspiring.

I don't think doctors, in general, are the profiteers. The insurance companies have increased profits year by year, whilst decreasing benefits year by year until the system is broken. Financially, that is by and large the most profound problem. In this healthcare debate, they have somehow managed to take an attempt to provide a funding alternative to limit their profits and turned it into a mandate for coverage with little accountability. Now how did THAT happen?

Our president was just "stood up" by 3 top bankers for an important meeting. If that doesn't tell you who is running the country, then you just aren't looking.

We, the people, and that means doctors, too, must take back our country, one word at a time. Yes, doctors should stand proud for what we do right, improve what we must and return healthcare to doctors and patients.

Thanks again,
# Thank Youthe Muse,RN 2010-01-12 13:28
"...We did not come here to exploit the poor and ignorant. Rather we have dedicated our lives to rescuing the sick and injured."

Beautifully said.

And, thank you for your service.
# Well said!Nancy 2010-01-14 05:19
Thank you Mark, for another excellent article! We are proud of your service to our country and to our patients! Bless you!
# I am a WW11 Veteran and I know that you and others face lots of dangerLawrence Plaster 2010-02-04 02:21
Mark we are proud of You and your friends that work so hard to help others that cannot provide for themself.
We have too many people that just want to complain
and have no idea what goes on, and never try to help anyone.

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