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“Sir, there was a little situation last night that you might want to be aware of.” The voice on the phone was that of a corpsman. His voice was high pitched, barely post pubertal, very nervous and grovelingly apologetic. “It’s pretty much been taken care of, sir, but you might still get a call about it.” It was early in the morning, well before time that I needed to be up. But we were on standby to fly out of the US to our final destination overseas. So any problem that put a kink in those plans could create a huge headache for everyone. Even though I wasn’t in charge of the unit, I was the ranking medical officer, so all medical problems that couldn’t be handled at the corpsman level eventually made their way into my lap.

“OK,” I said slowly. “Do you want to tell me about it?”

“Uh, well, sir, uh, I think HM3 (hospital corpsman third class) Woods should tell you about it himself. He was there.”

“OK, then,” I said, preparing myself for something worse than a ‘little situation.’ Alvin “Bubba” Woods was a big, muscular Mississippi boy who loved to hunt and fish. He had gone through field medical school, the required training for all Navy corpsmen, before being assigned to a Marine Corps unit. He ‘knew the book’, as they say of anyone who scored well on the exams. But he was not one to think much outside of the box, medically that is. He could talk endlessly about novel ways to catch fish, but when it came to medicine, he pretty much stuck to the ABCs. But he was a great shot with an M16 and could take about anyone in martial arts, so the Marines felt he was a real asset to the unit.

“Would you like to put Petty Officer Woods on the phone?” I said.

“Uh, yes sir,” he squeaked. I heard a loud crash as he fumbled the receiver in the pass to Woods.

“This is HM3 Woods,” the voice was slow, deep, and had a thick, backwoods accent.

“Petty Officer Woods,” I started slowly as if speaking to one of my children. “Would you like to tell me what happened last night?”

“We-ell sir, it was like this,” he began. “I was in my rack on the first deck, just minding my own business, when I heard a big ‘thunk’ follered by a bunch a hollerin’ up on the second deck.” I knew this was going to be one of those tall tales, because no one, and I mean no one, minded their own business in those barracks.

“And?”

“We-ell, Ah ran up to the second deck.”

“OK, Woods, you ran up to the second deck. What did you find?” I was getting impatient.

“We-ell, Whiney was just layin’ there on the floor.” Lance Corporal Billy White had such a bad reputation for complaining that he had been nicknamed ‘Whiney’. “It looked to me like he had fallen out of the rack.”

“Was he unconscious?” I asked.

“No, he was just real drunk.”

I was dumbfounded. Was I getting a call about a drunk Marine who fell out of bed? “So what happened?” I asked getting more impatient by the minute.

“We-ell, he wanted to get back in bed, but I told ‘em to keep him real still while I went and got the back board.”

“Did you see if he had any injuries? Did he hit his head? Was he bleeding?”

“Naw, I didn’t see anythang, at least not at first, but I wasn’t gonna to take eeny chances.”

“What do you mean ‘not at first’?”

“We-ell, by the time ah got back with the back board, C-collar and first aid kit, he was kinda bloody from the fight they had holdin’ him down…so he wouldn’t hurt his neck or back or anythang.”

“So they beat him up trying to keep him from being injured. That makes a lot of sense.”

“Sir, he was pretty pissed off by the time I got him taped to the board and started two Ah-Vees.”

“You boarded, collared, and started two IVs on someone who fell out of bed?”

“Yes, sir, and we gave him oxygen too,” he said proudly. “But then it kinda got out-a-hand.”

It sounded to me like it had already gotten out of hand. “What do you mean?” I asked cautiously.

“When I was startin’ the second ah-vee, Whiney bit me on the arm.” I let out a loud exhalation. “He wouldn’t let go,” he protested. “He was like a pit bull.”

“So what happened then?”

“Corporal Gonzalez kicked him in the head until he let go. And then Corporal Jones threw Corporal Gonzalez through the window.”

 “What?” I almost yelled. “He threw him through a second floor window?”

“Naw, he didn’t go all the way through. When the MPs arrived they put us all in cuffs until the helicopter arrived.”

“Don’t tell me you called a helo for this?”

“I jest told Private Witherspoon to call an amblance for a trauma case. He came back and said that they were sending a helicopter because we had to go to a trauma center.” How I had slept through this night I’ll never know.

“Where is Lance Corporal White now?” I wanted to get to the bottom of this.
 
“We-ell, when he got to the hospital he was yelling that he was gonna kill somebody.” That’s understandable, I thought. “The ER said he might be an overdose, so they gave him some medicine to paralyze him and put a tube in his lungs and stomach. Then they did a CT scan of his head, chest, and abdomen. They did a drug screen too and a whole bunch of blood tests. He looked like he was givin’ blood.“They said all the tests were negative, so they took all the tubes out. But now he’s waiting to talk to a psychiatrist.” “Why is he being evaluated by psych?” I was stumped with this consult.

“They said he might be a ‘danger to others’,” he said, apparently quoting the doctor.

“But Woods, all Marines are a ‘danger to others.’ We train them to be.”

“I talked to Whiney after he got his tubes out and he was real sorry for bitin’ me. Are they gonna to keep him from goin’ over with us?” he said sympathetically.

I was absentmindedly rubbing my newly buzzed head as I pondered how many zillions of dollars just got wasted on this case.


I related the whole story to my wife by phone later in the day, ranting that this was a perfect example of medical overkill. She knew better than to try to reason with me. Finally, after a silence that I understood to mean ‘move on’, I said, “You wouldn’t believe all the cool gear that I’ve been issued.”

“Really,” she said blandly.

“Yeah, they even issued a bayonet with my M16.”

“You’ve got to be kidding,” she said. “They issued you a rifle?”

“Yeah, and a bayonet,” I said proudly. “And a pistol.”

“Oh my gosh, talk about overkill.” She was incredulous. “Do they really expect you to shoot a rifle at someone. I knew we were stretched thin, but…Are you going to get poked with your own bayonet?” I could tell she was making fun of me.

“Very funny. You don’t ‘poke’ somebody with a bayonet. I also have this very cool body armor. It looks like I could diffuse a bomb.”

“Do me a favor, will you? Don’t.”

“It weighs over 30 pounds,” I continued, ignoring her jab. “With plates in front and back that will stop an AK47 round.”

“What do you need that for? You are a 56-year-old doctor. I hope they don’t think…”

“It even has this little apron like thing that hangs down to protect my privates.”

“Like I said what do you need that for? I thought your privates were supposed to protect you.”

“Very cute.” I smiled into the phone and felt the first pangs of homesickness. This was going to be a long deployment.

**************
"Overkill" is a work of fiction. Dr. Plaster is deployed to Iraq with a unit of marines who never drink or get into fights.
**************

Mark Plaster, MD is the founder of Emergency Physicians Monthly and is currently deployed with the United States Navy serving in Iraq.
 

Comments   

# adapjr 2008-09-03 19:15
dont forget adap.. everybody gets adap referral.. and the event was surely traumatic to the patient, and well any traumatic event can scar a person.. and head injuries.. can't say enough about all the follow-up and years of re-evaluation this will surely generate =-)
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# Line Of Duty/VA DisabilityMichael A. Torres MD Colonel, NY Air National Guard 2008-09-05 19:19
Don't forget to mark the Line of Duty (LOD) form with "not in the line of duty" or he'll be able to get a VA disability for the traumatic brain injury he suffered when kicked in the head! THAT would be adding insult to the piling on injury it has already cost us!
Reply
# Oh Lord.Jack 2008-09-09 18:13
They would never stand for this sort of thing in the ARMY!
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# Army Medical Corp 1974-1983Dale Long, DO 2008-09-14 13:41
"NIght Shift" is always a HIT even if I only have time to scan the rest of the paper, I pause to read your latest "insight." Thank you very much.
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# Hmmmm Navy guys!Brad S. Goldman, MD FACEP, LT Col USAFR, MC FS 2008-09-17 00:42
Actually this story isn't so far fetched. When I was active duty USAF on Andrews AFB, MD when my ER techs said we have a combative intoxicated pt coming from the enlisted club I always had my money on either a member of the Navy or Marines (& I was right!).

Too bad you didn't call of us CCATT folks (Critical Care Air Transport Team). We love to take folks like these out of theater to Germany and parts further from AOR.

Keep the hit's a comin' and be safe, be well and come home soon. Don't hurt yourself with that M16, nasty wounds......

Doc BG
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# Of course it's 'fiction'CDR Mark L Plaster MC, USN 2008-09-18 07:11
A recent private email from a Navy friend begged me to tell him that this was fiction. Of course, I said, I learned long ago that I can be sued when I tell the truth. So, yes, the stories are 'fiction'. Nobody could be 'that' boneheaded. Not my Marines. Or Army either for that matter. And the Air Force, I'm not sure the Air Force has any teeth to bite anybody. So not to worry. Now I've got to go to chow with 'HM2 Woods'.
Semper fi
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# RNRay 2008-09-20 15:23
This tale is not so far from the truth. As an ER Nurse and retired Navy Chief the only medical treatment I would have added to a shipmate in this condition is a foley!
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# "danger to others"Marianne Haughey 2008-11-05 23:00
Dr. Plaster- It is always an extreme pleasure to read about your insights into medicine. As I was laughing out loud my eight y.o. was asking what was so funny. It was a little tough to explain the line "all marines are a 'danger to others.' We train them to be." Stay safe, you bring pleasure to many you haven't even met- thanks.
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