Preparation for Greenside

Dad never mentioned that Navy doctors take care of the Marines. I learned during Officer Indoctrination School (OIS) that the US Marine Corps does not have its own medical officers. They have their own lawyers, but Chaplains and “Docs” are Navy.

During my internship and residency at National Naval Medical Center (NNMC), Bethesda, Maryland, I treated Marines and Sailors, performed disability and limited duty assessments, rotated to The Basic School (TBS), Quantico, Virginia, to gain “Greenside” exposure, and taught at the Uniformed Services University of Health Sciences (USUHS), as a field instructor for the combat stress prevention course.

As chief resident during Desert Storm/Desert Shield (DS/DS) when exposed to all the resulting chaos and emotions exhibited by those chosen and not chosen to deploy, I had started a paper entitled “To Not Be Chosen,” exploring parallels with those emotions of not being picked for the first string team on the playground. Those of us left behind could only support those in preparing and returning as well as the others not chosen. The paper was never published.

I saw some staff crying in the hallway when they were notified of impending deployment, upset that they “didn’t sign on to go to war.” It was now an all-volunteer force, and many recruiters focused on the low possibility of another conventional war. After all, the Cold War had reinforced the concept of the military being used as a deterrent to a shooting war. If we fired the first shot, we had failed our primary mission. Even though DS/DS would not last long, it marked the return of large-scale deployments and the need to prepare for such.

Most troops had redeployed by the end of my residency. I felt I had missed something. I was looking forward to my first assignment after Graduate Medical Education (GME). I hoped for a clinic in Hawaii, but I was called into the office of my Specialty Leader shortly before the list announcing orders was released. He told me that I was needed as the Division Psychiatrist in Okinawa, Japan. There was not an option to decline.

The Navy and Marine Corps are in the same Department of the Navy. Both are expeditionary, but their cultures, like their uniforms, are profoundly different. Navy personnel have the option of adopting Marine uniform regulations when they are assigned to a Marine unit, but they will never be a Marine, even if the Navy Doc learns to look and talk like one. Translating between Blue and Green can be very difficult.

While the “Division Psych,” I provided the clinical services for the Marines and Sailors assigned to the Third Marine Division (3d MARDIV). Since I was the only “operational” psychiatrist for Third Marine Expeditionary Force (III MEF), I became the first choice for the other Marine units in the area. Marines like to take care of their own, but if I could not manage them as outpatients, US Naval Hospital, Okinawa, was available for referral. Pride and pressure resulted in them rarely being used.

After my first year, I complained to my Division Surgeon that I was getting too little operational exposure “baby sitting” the Division in garrison. He was more than happy to accommodate me. Over the next 2 years, I then deployed throughout Asia for battle staff and field exercises. I served as a medical planner on field exercises and performed humanitarian aid on Medical Civic Action/Dental Civic Action (MEDCAP/DENCAP) missions.

I returned for the Military Forensic Psychiatry Fellowship sponsored by Walter Reed Army Medical Center. The first Navy graduate of the program, I was subsequently assigned as the first billeted forensic psychiatrist at NNMC, until I went to the Naval Hospital, Charleston, South Carolina.

When it was time for my next assignment, one of my mentors, who knew I had done well as the Division Psychiatrist, urged me to “put my name in the hat” for the Division Surgeon at 1st MARDIV. I thought it would be a chance to return to the operational arena in a more senior assignment. Besides, I had missed the Marines and their leadership style.

Many criticized my possible return to Division. “Why would you want to go back to the Marines? You are going to be bored. All you’re going to do is get ready for exercises. We’re not going to do anything. Do you think we are going back to the Middle East? That isn’t going to happen. We just got out of there.” I applied anyway.

After a series of interviews and waiting several months, I received the congratulatory call from the office of the Medical Officer of the Marine Corps notifying me of my selection. I asked, “How long do I have to decide if I want to accept?” The voice on the other end went silent. Then I heard, “No one tells the General ‘No’ after he has made a decision.”

I was to detach from Charleston on 11 September 2001. The furniture was gone. Our home of 3 years had been sold. I awoke on an air mattress. Most of the suitcases had been packed into the van for our trip to California. The air mattresses, coffee machine and portable TV were all that remained to be loaded.

Getting up to make one last pot of coffee, I turned on the news to see the planes crashing into the Twin Towers and Pentagon. I knew that the nature of my assignment had instantly changed.

As a result of the attacks on 9/11, all military personnel were frozen in place. Security was increased on all bases. A few days later, as the shock wore off, movement was again authorized. My family and I started our cross-country drive.

I attended Advanced Officer Leadership Training at San Diego, California, prior to reporting to 1st MARDIV in Camp Pendleton, California. Most in the class were headed to new duty stations. All wondered what was next.

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