Saturday, October 3, 2009 Health assessments make us all crazy…
Before we deployed we all conducted a Pre-Deployment Health Assessment, this was to assess our state of health prior to deployment and to assist military healthcare providers in identifying any present or future health care we might need. I suppose it makes sense when used as a benchmark to gauge any changes in our physical or mental health as well. After we fill out the questionnaire we also have to talk to one of our Independent Duty Corpsmen or doctors and answer a bunch of questions especially in the event we answered something on the questionnaire that catches their attention like:
I sincerely desire to go on a five state killing spree and charge all expenses to my Government Travel Credit Card.
If you check Strongly Agree they may want to come back for a follow up.
Currently we are in the midst of the glorious Post Deployment Health Assessment. This is to asses our state of health after deployment in support of military operations and to assist military healthcare providers in identifying and providing present and future medical care we may need. The information we provide may result in a referral for additional healthcare that may include medical, dental or behavioral healthcare or diverse community support services (this is pretty much all plagiarized right off the questionnaire).
Some of the questions simply ask how you would rate your health, if you had been injured or sick during the deployment, and whether or not you have any emotional problems, etc.
As America’s 1stSgt filled out his assessment the building veritably shook with the deafening running commentary that accompanies nearly everything that goes on in the company office.
For any of the following symptoms, please indicate whether you went to see a healthcare provider, were given light/limited duty (Profile), and whether you are still bothered by the symptom now.
Fever- NO!
Cough lasting more than 3 weeks.- NO! I guess that two-week phlegm festival I had doesn’t rate!
Trouble breathing- NO!
Bad headaches- I’m having one right now!
Generally feeling weak- I’ve never been weak a day in my life!
Muscle aches- NO!
Swollen stiff or painful joints- Is this the geriatric test or what?
Back pain- NO!
Numbness in hands or feet- NO!
Trouble hearing- Can YOU hear me now!
Ringing in the ears- Why do you think I turn off the phone?
Watery, red eyes- Only after I watch Sands of Iwo Jima!
Dimming of vision- NO!
Dizzy, light headed- NO!
Diarrhea- Well I haven’t had a solid one in seven months!
Vomiting- I can taste it right now!
Frequent indigestion/heartburn- Have you eaten here?
Problems sleeping- Only when idiots knock on my door!
Trouble concentrating- What was the question?
Forgetful or trouble remembering things- If I didn’t write it down then it never happened!
Hard to make up your mind or make decisions- No, it’s hard to get anyone to listen!
Increased irritability- You’re kidding me!
After the entire battalion does this questionnaire on line they line up daily outside the Battalion Aid Station where they shuffle past the Battalion Surgeon’s desk like POWs answering a battery of questions the majority of which are answered with a sigh and resounding, No Sir or What! Why would I want to kill myself? I’ve been eating ice cream three meals a day for the past seven months.
The only thing that could possibly be more banal is being the poor guy that has to ask these questions to over 1200 Marines and Sailors. My sit down with the battalion surgeon went like this:
Swaggering into the office I found my doctor had begun to slump down the back of his chair in despondency and could barely be seen over his monitor.
“You ready to get this over with 1stSgt?”
“Is that one of the questions sir?”
Anything resembling humor had completely evaporated from his system 400 interviews ago. By now he had more or less degenerated into a bio-mechanical automaton whose fist had grown around the mouse on his desk forever chaining him to the demon possessed machine residing there.
“Do you have any medical or dental problems that have developed developed over the deployment?”
“I may have chipped a tooth while repeatedly head-butting the corner of my desk.” This comment completely missed his funny bone as the nerves surrounding it had turned necrotic and died.
“Over the past month have you been bothered by thoughts that you would be better off dead or hurting yourself?”
“That’s the stupidest thing I’ve ever heard of. You do realize who you’re talking to right?” At this point I was just another social security number the idea of America’s 1stSgt having been completely burned from his memory.
“Over the past month have you been bothered by thoughts that you would hurt someone else?” The sound of my breath hissing through clenched teeth finally got his attention. His head lolled in my direction.
“Uncontrollably?”
“Oh! No.”
“During this deployment have you sought or do you intend to seek counseling or care for your mental health?” Having had Marines in the past with PTSD and Traumatic Brain Injury this issue isn’t one I normally joke about as my feelings concerning it are rather passionate.
Considering how much violence we endured this deployment though (that is to say NONE), it was the question that made me roll my eyes.
“Do you have concerns about possible exposures or events during this deployment which you feel may affect your health?”
This is the question that my medical professionals just love to ask as there are always a few Jarheads that are worried about the effects of being exposed to the Electronic Counter Measures devices on their vehicles or concerned about how many metric tons of dust they may have inhaled over the last seven months. These are usually the same ones who have no issue with having a cell phone surgically attached to their face or smoking five packs of cancer sticks a day.
The conclusion of the Post Deployment Health Assessment is by no means the end of the story though. Much like sequels to bad horror films, health assessments rise again and again. Some months after we get back there will be the Post Deployment Health Re-Assessment where we will answer all the same questions again. This is ends with one or two of the medical Corpsmen being staked in the heart to ensure they don’t become one of the living dead.
Then of course there is the Periodic Health Assessment which the military does with or without a deployment. At the rate we deploy now days I could be asked as many as five times in a year by a medical professional if I’m OK without there ever being any sign that anything is wrong with me in the first place. A lot of times the deployment schedule is such that the Re-Assessment for the last deployment and Pre-Assessment for the next one are conducted at the same time. How’s that for mind bending?
The next time I hear an “expert” on some news network talk about how we’re not doing enough to identify troops with medical, dental, or mental health issues I will openly wonder if he has ever had to interview an entire battalion five times in a year.
Even now there are units experiencing fare more strenuous and combative deployments than we are this trip. With any luck the health assessments coupled with assertive leadership will be able to identify those who haven’t realized they need help or too stubborn to seek it themselves. If it were a simple matter of paperwork we’d all be inoculated by now.
Things 1stSgt’s deal with include…
Other people’s marriages:
Everyone just HAS to get married right before deployment. These individuals are always lined up outside my office with their marriage packages in hand; oblivious too everyone who is getting divorced right before deployment who are waiting in another line to see me. There is a mysterious phenomenon occurring here where these two groups of people are utterly blind to the existence of the other and will heed no one’s advice about waiting until after deployment or at least until he gets to know her better.
Then of course there is everyone who is getting married during post deployment leave (at least they waited for the deployment to be over). This is followed closely by all those getting a divorce immediately following the deployment. The classic example is the Marine who returns home to an empty house having had no idea his spouse had left him. His chain of command and all his buddies no doubt told him it wasn’t a good idea to marry a stripper he had only known for four weeks but did he listen?
Once I had a Marine get a divorce right before we deployed. When we came back seven months later, one the guys from his platoon ended up marrying the girl on post deployment leave. I think I broke at least three of my own teeth during this episode.
If you don’t trust her then maybe you shouldn’t have married a woman that was sleeping around with you behind her previous husband’s back when he was on deployment. Sometimes people just get what they deserve.
Other people’s parents:
Then there is the odd Marine who writes home to his mother that he doesn’t get to eat. She naturally writes her congressman in concern which starts a whole chain of e-mails with a subject line containing the letters W, T, and F. Now of course there is plenty of food for this Marine and his delicate palate to consume he just doesn’t like it. Here’s a news flash: NONE OF US LIKE IT!
There is no doubt in anyone’s mind that military food is just plain rancid. MREs, Tray Rations, and UGRs are only slightly less foul than what passed for chow back in the Old Corps. But guess what? There is plenty of it so there is no reason to complain about hunger. I remember once the little heathens ate everything in sight and my Company Commander and I were left eating peanut butter and jelly sandwiches made out of shelf bread. So Mom, check it out: your son is being fed plenty; he is just being a sissy because you are not cooking for him anymore. Tell him to man up. I already did, that is why he sent you that whiny e-mail.
Most mothers want their sons home from combat. I don’t blame them. I want their sons to come home from combat too; right now in fact. Here’s the problem, we all signed up to do a job. It’s called a contract. When you don’t live up to it then you are called a dirt bag. So Mom, please stop sending the command emergency Red Cross Messages requesting the presence of your son because you are having a bunion removed. No one in the entire theatre of operations is going to approve that emergency leave request. There’s like a war on.
Self inflicted wounds:
In the Marine Corps we have standards; standards of conduct; standards of dress; even height and weight standards. The weight standard is particularly amusing especially when the fat Marine in question is completely mystified by the fact that you want to break a park bench over his back. Of course it is never his fault; no one told him he looked like a beach ball with lips. Maybe when that gigantic orb of flesh called your gut began to affect the tides it should have given you a clue. Listen, when Japanese fishermen start licking their lips when you walk by it’s time to cover your blow hole and run.
Alcohol is the perennial villain in many a tale of liberty gone awry and is usually prominently featured in any and all of the above scenarios. Its uncanny ability to cripple what is already questionable judgment is legendary. Lessons like it is against the law to operate a motor vehicle under the influence are usually learned the hard way vice simply listening to your 1stSgt tell you it is EVERY WEEKEND. That fact that stumbling around Waikiki blind drunk at 0300 in the morning will make you a victim is another good one.
Even as you read this I am probably standing in front of a group of Marines getting ready to fly home from Iraq. I am more than likely trying to convince them that all the alcohol in America will still be there the day after they get back and that there is no need to attempt to drink it all in one night. Will they listen? That remains to be seen this trip.
Semper Fi
Michael Burke
America’s 1stSgt
HS/3/3 2009