From Battalion Surgeon to Combat Psychiatrist: Three Tours in Iraq and Afghanistan

Kenneth Richter Jr.

It was the seventeenth of July, 2009. I graduated from residency a month prior, and was due to take my first week of call as a Staff Psychiatrist at the Naval Medical Center San Diego (NMCSD) the very next week. I stood on a stage with many of my colleagues from our large Mental Health Directorate awaiting the honor of having my shoulder boards replaced, reflecting my promotion to Lieutenant Commander.

My wife, Nicole, and dear friend Reese stood in the shadows ready to participate in the ceremony. It was a great moment of joy to stand there and be acknowledged for progressing with my military career. But, as this moment moved along and my shoulder boards were replaced, my Director, after making a few kind remarks, declared that I would be going to Kandahar, Afghanistan, in less than 1 month.

I could feel the celebratory nature sucked out of the room. My colleagues wondered if they should congratulate me or express their regrets. They also wondered how to console my wife: she didn’t look to be in that much distress, but she couldn’t have been too happy about her husband having to go away.

The announcement of my deployment to Afghanistan was not actually a surprise that day. A few days prior, I had received a call from my Director, who had offered the deployment to me. It felt like he was asking me, “Do you want to take what you know is behind door number one, or do you want to roll the dice on door number two, whenever it comes along?” He let me know whose name was next on the list if I were to decline, but I still went with my first reaction, which was to say, “I’m not ready to get back out there yet.”

This chapter covers Kenneth Richter’s time as a GMO from 2004 to 2006, residency from 2006 and 2009, and finally deployment as a psychiatrist from 2009 to 2010

K. Richter Jr., D.O. (*)

US Navy Bureau of Medicine and Surgery, 7700 Arlington Blvd #5113,

Falls Church, VA 22042, USA e-mail: This email address is being protected from spam bots, you need Javascript enabled to view it © Springer International Publishing Switzerland 2017 E.C. Ritchie et al. (eds.), Psychiatrists in Combat, DOI 10.1007/978-3-319-44118-4_12

He understood my hesitation and told me he would call another Navy Psychiatrist.

As the minutes passed following the call, I thought about that colleague who was next on the list. I knew him, and I knew his life. I thought about the fact that he already had one child and that his wife was pregnant with their second, and I thought of him missing the birth-while my wife and I hadn’t yet started our family. These thoughts gnawed at me.

After a few minutes, I picked up the phone, and in a conspicuously unemotional way, apprised my wife of the options: I could deploy for 7-8 months to a newly built hospital on a big base and get another deployment behind us, or, I could decline. We discussed this incredibly consequential decision for about 4 or 5 min.

The brevity of our discussion remains truly remarkable to anyone who knows us. Typically, we are known to be quite loquacious: our pastor who delivered our premarital counseling noted that we were “hyper verbal,” and the reading nook in our bedroom has been renamed the “talking nook” to reflect our fondness for conversation. Indeed, five minutes of discussing a potential deployment to a war zone does seem brief, but in this particular moment, it was a simple conversation that we clearly had both thought about a lot before the moment of decision.

I hung up the phone and called my Director back. “Sir, have you called Troy yet?”

“No. Not just yet.”

I will always wonder if he was waiting for my return call, or if he had just become distracted by another matter.

“I’ll do it,” I said.

He paused and probed, “This is an important thing for you to discuss with Nicole.”

I assured him that I had, but I’m positive he wondered how such a consequential decision could have been discussed in such short a period of time. We spoke more, and he again gave me an out, letting me know that with my history of two prior combat deployments and having been wounded, I could reasonably expect not to be compelled back into such circumstances. Ultimately, he accepted that I had reasoned through the decision, and I was slated to deploy for a third time into a combat zone.

Being slated for my first psychiatry specialty deployment to Kandahar in the fall of 2009 might seem then to be the logical place for my story to begin. But, it can’t properly begin at that time. The story doesn’t begin there because my experience in Afghanistan was hugely shaped by my two prior deployments to Iraq as the Battalion Surgeon for Marine Infantry Battalion-1st Battalion, 7th Marines (1/7) out of the Marine Corps Air Ground Combat Center Twentynine Palms.

Those two deployments were both full of totally intense and foreign situations, especially for an only child raised in upper middle class suburbs who had just completed his internship weeks prior. The two deployments would expose me to some of the grizzliest battlefield trauma that people would never wish to imagine, let alone actually see. I would be shot at, blown up, and thrust into a myriad of utterly unfamiliar situations. The situations ranged widely from being a tactical medical planner for large operations and doing grim cause-of-death investigations, to living and working without power or a shower for prolonged periods of time.

Thus, as I relate my story about being a Combat Psychiatrist, I begin with my being a Medical Officer/Battalion Surgeon from mid-2004 through mid-2006. This time frame shaped who I am today and has shaded every clinical encounter that I have had with the active duty population, as they do their distinctive work.

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