Through a constellation of circumstances, I left the active-duty Navy last year. I was sad to leave but it was the best decision for my family at that time. I did not want to cut ties with the Navy and so I transitioned to the Reserves while taking on life as a civilian surgeon. This summer I completed my Reserve ‘2 weeks a year’ and I found myself back in 29 Palms California. I was stationed here years ago as my first duty station out of residency. Back then we had 2 surgeons, still tiny surgical volumes and all of the challenges of being a small military hospital- zero risk tolerance, young sailors and limited to no backup. The 2 weeks simply focused on allowing the lone surgeon stationed there to take a well-earned break from 365 days a year of call.
It is easy sometimes to see only the negatives of the military surgeon life, the struggles with case volume, salary, confused readiness metrics, etc. But I felt different being back after living on the civilian side, however briefly. There are so many positives- things I really just didn’t always recognize as important, as valuable, or formative for me as a surgeon- things I have to give total credit to the Navy for giving me.
First, training. I came straight from training to being a young surgeon, alone in the desert and realizing that I, perhaps despite some quiet internal doubt, was a totally competent surgeon. Not everyone I operated on had a terrible outcome! My training was good, on par with any others I’ve come across since. Those who trained me signed off on me of course, but I only really internalized this while at my first MTF. Regardless of the volume and acuity, the complete independence only works if we have excellent training. I have the military to thank for that.
Second, leadership. Leadership and administrative skills are highly coveted, maybe as important as clinical excellence. Its perhaps most accurate to say that I feel these are exceedingly rare things in the civilian world. Exposure to excellent leaders, understanding of ‘chain of command’, delegation of responsibility, mentoring- these are skills that we live daily in the military from day one. Screaming or throwing things in the OR, unprofessional intimidation of a bedside nurse, a leader failing to commit to a hard personnel decision- I see these happen commonly in civilian practice. I never saw them in the Line community nor at a Military Treatment Facility (MTF). There IS value in maintaining ‘military bearing’ and professionalism, and I am proud to carry that with me.
Last, a comment on perspective. I have spent my career pushing, filling empty days on a calendar, publishing or perishing, missing holidays and birthdays and kids growing up as I ran the rat race. My personality dictates that I continue to run it, and I have been successful by being this way, so it is unrealistic to say that Ill stop anytime soon. But in the time I spent as a general surgeon at 29 Palms- I never missed a birthday, took my kids to school, slept every night in my own bed, and did all the things ‘normal people’ do. I appreciate now how good those times were, simpler times I guess, and I certainly didn’t appreciate it then. Reserve duty was full of happy memories- memories of the day-to-day MTF struggles do not persist.
There is something about the military and the sense of purpose and mission that appeals to me, probably many of you. The Marine mission here at 29 palms hasn’t changed at all since I was here, like a desert time capsule. We may ‘draw down’ or ‘plus up’ all over the world but the core mission of the military remains unchanged, and medical support stays committed to it. Think about anyone you know who has served, especially the old timers- their nostalgia is nearly always positive! This is a rare and special thing and I am proud that I was a part of it, and maybe still get to be a little bit as a reservist.
So, I am encouraged. I will still argue and fight for what I believe will and will not make our military medical service better, through research, support, publications- however I can. But in reality, military surgery is alive and well. Despite many hardships, I have the Navy to thank for the surgeon I have become.