The Coast Guard Needs Designated Instructor Pilotsan unusually high number of Class-A mishaps, resulting in the loss of not only aircraft, but also the lives of 18 aviators and air crew. This has shaken the community to its core. Perhaps most alarming is the lack of a single causative factor attributed to this unprecedented series of mishaps. The service has thoroughly investigated each incident, and the aviation community immediately responded, but additional steps are warranted to ensure that Coast Guard aviators and air crew can safely and effectively execute their challenging, diverse missions.
Unraveling the Conundrum
A cadre of Coast Guard pilots should be attached to a program similar to those of aeronautical engineers and flight-safety officers, where applicants apply through their commands to a selection panel of experts who thoroughly review records and command endorsements. In theory, this process selects high-caliber aviators to serve in specific billets with significant responsibility, and to develop as professionals in their respective fields. Engineers and safety officers also have peer support and access to additional job-specific continuing education in their formalized programs. Fleet-wide management lies at the headquarters level.
Once they are designated at the unit level, Coast Guard instructor pilots now take on the added responsibility for standardizing aviation operations, wardroom proficiency, and managing dozens of upgrades every year. This role is assumed in addition to their tasks as duty-standing pilots and collateral assignments. In many cases, instructor pilots are aeronautical engineers and safety officers. This places an enormous strain on their ability to focus on the critical task of ensuring that each wardroom member is properly trained and ready to respond at a moment’s notice, piloting an aircraft far from home, low over the water, and often in unpleasant weather.
In addition to a formalized instructor-pilot program, the Coast Guard should manage this cadre as separate and distinct from the regular officer corps. Once selected, these aviators should remain at the service’s aviation units for the remainder of their careers, serving in designated standardization billets at operational units and training commands. They must be free from the organizational pressure to leave aviation for out-of-specialty assignments or joint tours. Rather than focusing on future commands or competing for sought-after big-ticket assignments, this cadre would permanently serve as the unparalleled experts in aviation operations and training.
The most practical way to manage such a group is to create an instructor-pilot corps in which those selected are designated as warrant officers, and their assignments are centrally managed at the headquarters level. This will provide a pool of permanent instructor pilots with the unique opportunity to focus exclusively on standardization, operations, and training throughout Coast Guard aviation.
A Permanent Pilot Corps
Extensive and continuing experience as duty-standing pilots and instructors will help to steady wardrooms that often struggle to fill the void created by losing the most experienced pilots every transfer season. This does not preclude commanding officers from designating regularly commissioned aviators as instructor pilots at their units, as is the current practice. With regular and warrant-officer instructors working side by side, their different perspectives will undoubtedly enhance standardization and training.
The tradeoff for those entering this permanent corps will be their removal from consideration for future command, joint tours, postgraduate school, and out-of-specialty assignments. As regular aviators nearing the mid-career point, they are often forced to leave the cockpit to broaden their knowledge of service operations beyond aviation. For those officers who will one day command major units and serve on district, area, or headquarters staffs, this is a critical step as they assume more senior positions of responsibility.
But in aviation, it is a double-edged sword. It robs Coast Guard aviation of some of its most talented, experienced, and proficient pilots. After completion of naval flight training (normally two years), it takes the average aviator the better part of three years to qualify as aircraft commander. This means the first four-year tour is spent in large part developing skills as an operational pilot and reaching full qualification. During the second tour, aviators further refine their airmanship and become experts in their fields. Sadly, the timing (often almost ten years invested in aviation) coincides with the organization’s needs for diversification as an officer and not just a pilot.
Aviation is a perishable skill, and many of the Coast Guard’s most talented pilots are lost to the service’s needs at critical moments in their flying careers. While some first-tour aviators become instructor pilots, most are second-tour with thousands of hours under their belts. Designation as an instructor presents a host of new challenges, as aviators must develop teaching and mentorship skills to best serve their units. At this point in their careers, veteran duty-standing pilots have a wealth of experience that is partially lost when taken out of the cockpit. By retaining a small percentage of these seasoned service members, the Coast Guard will fill a dangerous void created by the necessary structure of its promotion system.
Additionally, a prospective aviation-unit operations officer must no longer be required to have been selected as instructor pilot in the past. The foresight, leadership, and vision necessary for a prospective operations officer do not go hand in hand with the skills of an instructor pilot. Demanding both simultaneously pulls in often opposing directions. A better solution is to allow those seeking command the opportunity to focus on collateral duties more aligned with the political, fiscal, and operational challenges of running a Coast Guard air station. The current requirement means commands must designate any aviator as an instructor pilot if that officer is to have a chance at future command. Instead, commands should be free to recognize differing talents among their ascendant officers, assigning duties accordingly. It is a disservice to aviation to obligate someone to act as an instructor pilot if that is not necessarily the person’s desire or strength.
Meet the Need Efficiently
The creation and central management of a cadre of warrant-officer instructor pilots will maintain a pool of seasoned operational pilots at each unit. Junior aviators will benefit tremendously from their presence through the increased availability, improved continuity, and structured training. Senior pilots who do not desire an instructor designation can focus their energies on collateral assignments as they follow the traditional route for commissioned officers.
Each Coast Guard aviation unit has a standardization division that handles training, upgrades, records, and proficiency. This division should comprise a mix of coded billets specific to warrant-officer instructor pilots and rotating assignments for regular officers serving as instructors, to foster open dialogue and cross-communication. To broaden their collective knowledge base, additional assignments for warrant-officer instructor pilots could include instruction billets at naval flight training, the Coast Guard Aviation Training Center for airframe-transition and proficiency courses, and exchange tours with other services. These billets would also remain open for all pilots.
Training was not a causal factor in all of the service’s mishaps over the past four years, but proficiency, standardization, and experience are of course key elements of a solid foundation for excellence. In the current system, many of the service’s most talented pilots are lost just as they are establishing themselves. By retaining a small portion of them and dedicating their professional efforts exclusively to aviation, the Coast Guard will take a bold step to better establish continuity throughout its flying community.
Lieutenant Boland, a C-130J Hercules pilot at Coast Guard Air Station Elizabeth City, North Carolina, is a 2003 graduate of the U.S. Coast Guard Academy. In addition to aviation assignments, he has served afloat and at Coast Guard Headquarters, and holds a master’s in military history from Norwich University.
Reducing Costs for the Virginia Class
To plot a successful course for a defense-acquisition program in today’s fiscal environment necessitates more than sound budgeting. Programs must actively work to deliver platforms with the right capabilities for the current complex battle space and tomorrow’s unforeseen challenges, while simultaneously driving excessive expenses out of the equation. Few programs have met those requirements as successfully and consistently as the Virginia-class submarine program.
Since 2005, the Virginia-class program office (PMS 450) has implemented three cost-reduction efforts that are at the core of its success: design for affordability, with its now-ubiquitous slogan “2 for $4 in ’12” (explained later); reduction of total ownership costs (RTOC); and will-cost/should-cost management. Each of these initiatives addresses different drivers of the price tag, and each is vital to the program.
Squeeze More Out of Funding
Following the cancellation of the Seawolf class due to its high acquisition costs, the Navy turned to its engineers and shipbuilding partners to design and build a new breed of attack submarine. The Virginia was designed from the outset to be both the dominant global undersea combatant and cost-effective.
The class’s warfighting attributes were evident from the inception of the program. But its reputation for acquisition success involved a more arduous process. Like many new programs, the class incurred early overruns in cost and schedule. By the time the lead ship, SSN-774, was delivered in 2004, construction had taken 86 months—almost 4 months later than the contract delivery date—and cost $2.85 billion in Fiscal Year 2005 dollars. The USS Texas (SSN-775) delivered a year late, taking 94 months to build. Because of these schedule and cost overruns, the Navy delayed by nearly a decade reaching its stated goal of building two Virginia-class submarines a year.
In fall 2005, then–Chief of Naval Operations Admiral Mike Mullen issued a challenge to the Navy: reduce the per-ship cost by 20 percent, and the program would be permitted to increase production to two boats per year in FY12. Thus were born two Virginia-class submarines for $4 billion (in FY05 dollars) in 2012: 2 for $4 in ’12. The 20 percent reduction mandate required reducing the acquisition cost by $400 million per submarine. To accomplish this, the Navy enlisted its shipbuilding partners General Dynamics Electric Boat and Huntington Ingalls Industries–Newport News Shipbuilding, as well as firms such as Booz Allen Hamilton and the RAND Corporation, to examine the issues at hand, identify inherent cost drivers, and find ways to intelligently reduce them.
The Navy accomplished its 2-for-$4-in-’12 goal by following three cost-reduction principles: improved construction performance, design for affordability, and increased procurement rate in a multi-year procurement contract with economic order-quantity savings. In the process of this achievement, the Virginia-class program also established a set of guiding principles for the next cost-reduction effort.
Reducing acquisition costs involved lessons that were then applied to reduce the operations and support (O&S) price tag. These O&S costs are incurred by a ship after its delivery to the Fleet and it accounts for about 50 percent of a ship or submarine’s total life-cycle costs. The program’s RTOC is an ongoing initiative to systematically eliminate certain lifecycle costs while maximizing value to the warfighter. The Navy formed teams to examine submarine acquisition, integrated logistics support, maintenance, manning, and support, with the goals of improved reliability, increased operating-cycle duration, and reduced maintenance without decreasing capability or service life. The Block IV construction contract for FY14–FY18 hulls was set as the target for achieving significant O&S savings.
Bear Down on the Details
RTOC teams determined that decreasing the number of major shipyard availabilities would result in the most significant O&S savings over the life of a ship. Decreased depot maintenance periods from 4 to 3, along with increased deployments from 14 to 15 (referred to as “3:15”) will take effect as of Block IV. As with the 2 for $4 in ’12 efforts, the Navy will make investments in system redesigns and and life cycle maintenance processes to reach 3:15. In addition to large-scale efforts such as this, the program is investigating ways to save money at the system and component levels. Since its inception, the Virginia-class program has evaluated more than 700 cost-saving proposals and validated 149 concepts that are now being executed.
While RTOC goals are refined and implemented, the class is pursuing will-cost/should-cost efforts. Dr. Ashton Carter, Deputy Secretary of Defense and former Under Secretary of Defense for Acquisition, Technology, and Logistics (USD AT&L), introduced the fundamentals of this initiative in September 2010 as part of his “Better Buying Power Guidance Roadmap for Obtaining Greater Efficiency and Productivity in Defense Spending” memo, covering affordability and cost-control measures in the acquisition process. USD AT&L Frank Kendall refined this directive in November 2012, with Better Buying Power 2.0, in accordance with which the Virginia-class program office worked to improve contracting practices by increasing competition and reducing the pre-post shakedown availability sequence and duration. The will-cost/should-cost initiative continues to expand throughout the program.
Reducing costs has been of paramount importance for the past eight years, but that does not mean the Navy or its industry partners have been cutting corners or reducing capability. It is, in fact, the opposite: at a lower price tag, capabilities and first-time quality have improved. With 2-for-$4-in-’12, the Navy redesigned the ship’s bow, and in doing so introduced a new large-aperture bow array that provides enhanced passive capabilities, as well as replacing the 12 vertical-launch tubes with two Virginia payload tubes (VPTs). The two VPTs nearly doubled payload volume while reducing the parts and maintenance associated with 12 vertical-launch tubes. All this was done for $40 million less per ship. Further, the past five ships have been delivered earlier than their contract date. Their quality is consistently improving, as evidenced by the USS Mississippi (SSN-782), the most recent Virginia-class boat to join the Fleet. Delivered nearly one year early, she received the highest marks to date from the Navy’s independent assessor, the Board of Inspection and Survey.
The Virginia class demonstrates that with clear goals and a motivated team, programs can spend less without sacrificing capability or quality. As we continue to work through what will likely be several more years of budget pressure, affordability coupled with delivering warfighting capability on time and on budget will be increasingly important. Such constant improvement is a hallmark of the submarine force.
Captain Goggins is the Virginia-Class Submarine Program Manager (PMS 450) at Program Executive Office for Submarines.
Hormone Treatment for PTSD
To date, easy solutions to the post-traumatic stress disorder (PTSD) problem have largely eluded medical specialists and related researchers. With many healthcare personnel focused on resolving this challenge, why has so little substantive progress been made? Perhaps the answer lies in a blind spot.
Diagnosis is the first (and most obvious) step toward developing a solution. Treating the condition is more challenging, perhaps because at least one key element is being ignored. A model known as the Johari Window, developed by Joseph Luft and Harrington Ingram and originally used as a tool to improve interpersonal communications, may shed light on this situation.1 In the adaptation shown here, three of the four quadrants may represent places that hold the PTSD solution.
Community knowledge lies in the upper-left quadrant. This is the space in which doctors agree on treatment options for PTSD and when they should be applied. The area is not well-defined at present. The Department of Veterans Affairs (VA) reports that the guidelines established for PTSD treatment focus on behavioral therapies and a second technique known as Eye Movement Desensitization and Reprocessing. Beyond these two, the VA notes that other treatments might be effective, but sufficient data do not exist to support their use.2
Successful approaches could be classified as “unknown” in the Johari model. The other two windows, labeled here as “hidden” and “blind,” present interesting challenges and might well accelerate the development of effective treatment protocols. In these two categories, information is known by the doctor but not shared (hidden), or known to others but not by the doctor or treating specialist (blind).
Search for Consistency
A pharmaceutical approach would rely on medications to treat the physical component of the body to complement the cognitive aspects. This has been tried without consistent success. In 2010, the Journal of the American Medical Association reported that antidepressant medications had little impact beyond a placebo on the patient when the depression was at a minimal level. More positive results were obtained as the significance of the condition increased.3 This could prove of value for those most severely injured. But it cannot be a guideline for the basic treatment of all PTSD-diagnosed patients.
The human body has two key internal communication systems. One, the nervous system, is fairly well understood by physicians and researchers alike. The other, the hormone system, receives less attention, although it may hold the key to treating at least one aspect of PTSD. The absence of the inclusion of hormones in treating the disorder means that information is hidden from healthcare professionals, or they are blind to the evidence that exists.
Pharmaceutical firms are not likely to commit hundreds of millions of dollars to the Food and Drug Administration approval process for drugs if the final product will not have some market protection. Patents provide this, but bio-identical hormones, the same at the molecular level as those produced by the human body, cannot be patented.
This impacts the education of medical professionals, as drug companies do not pursue studies of bio-identical hormones. Thus the results of such studies are not submitted to medical journals, nor is related information shared with medical schools. The evidence of their bio-identical hormone treatment value and safety is scattered and not readily available to healthcare practitioners, thereby creating a medical blind spot.
A Possible Answer
Hormones are carried by the blood stream to all cells in the human body, where they interact with target cells to produce a biological response. The body recognizes bio-identical hormones as if it had produced them, and these can be expected to have the same results as those produced naturally, if properly administered. At levels common to the human body, these hormone products are very safe.4 As an example, progesterone levels are highest in brain tissue as compared with other physical locations.5 Establishing a proper level of that hormone alone could well address the brain’s physical ability to function properly. But what could bring on this out-of-balance situation in the first place?
In Adrenal Fatigue: The 21st Century Stress Syndrome, James Wilson describes four causes of adrenal fatigue, any of which could have direct links to PTSD.
• A long period in which the individual resists the impact of stress, eventually leading to adrenal fatigue. For example, a given soldier may seem to do well but deploys multiple times to repeat a stressful routine.
• A single significant period of stress followed by an immediate loss of adrenal activity. This could be the soldier faced with the death of a close comrade or an IED attack.
• Repeated instances of high stress followed by a recovery, such as that of a soldier who deploys into a situation where he or she is exposed to stressful events.
• Repeated exposure to stress from which the individual never fully recovers and has a gradually decreasing level of resistance. A soldier exposed to multiple stressful events without time to recover fully could experience this.6
The process that leads to adrenal fatigue starts when a stressor is identified and the body initiates the fight-or-flight response. Adrenaline increases both heart rate and blood pressure to improve blood flow to the muscles. Digestion shuts down, making more blood available for muscular action, and cortisol levels rise to make more stored glycogen available as blood sugar to handle increased work. Other hormone-activated responses are added so that a peaked human body can resist the stressor.
When the situation is under control, the body begins a recovery phase, which normally takes 24 to 48 hours. Constantly repeating this sequence can lead to high blood pressure, cancer, and diabetes. Individual responses to single or repeated stresses vary, as does the recovery time. A final phase may be exhaustion, in which major body functions are affected and in extreme situations can result in death.7
Because of the number of hormones involved from onset to recovery, the impact may have effects elsewhere in the body. Improper hormone levels are known to cause a number of illnesses, and the brain’s main neurochemicals may also be affected. Treatment must be monitored on an individual basis.
An Alternative Course of Treatment
The unusual stresses encountered by those in combat zones appear to have a direct link to an increased incidence of PTSD; addressing hormonal changes should be a regular part of any treatment process. The physiology of stress response should be treated either before or in parallel with psychiatric or psychological treatments.
Treatment should become a regular part of any unit or individual deployment to high-stress environments. Initial steps should include blood work before deployment, to determine healthy hormone levels and establish a baseline for recovery; and, following deployment, hormone tests should be repeated to be compared with pre-deployment levels. All those identified with significant changes should be immediately referred for further testing and treatment.
The records of this testing should be anonymously recorded for research purposes in a study that would provide value not only for future generations of military personnel, but also for non-military applications to the civilian population. PTSD, although currently associated with stressful service, is not unique to the military.
Adequate information is available regarding the treatment of hormone variations, but it has limited distribution among healthcare professionals. Therefore, in the Johari Window, for current treatment specialists this type of knowledge would be in the “blind” category. Bio-identical hormones are largely unknown to most doctors, and treatment protocols that establish levels of various hormones are known only to a limited number of practitioners. Pharmaceutical companies should make the final products for treatment while not relying on compounding pharmacies to meet individual prescription requirements. Treatment for hormone irregularities must be integrated with psychological aspects so that both physical and cognitive aspects are treated.
The cognitive aspects likely can’t be cured, but the patient can learn to manage them. The physical impact, on the other hand, may well be treated directly and completely. The result should be less depression, declining suicides, and much less violence outside the combat environment.
2. Department of Veterans Affairs; National Center for PTSD, Overview of Psychotherapy for PTSD, January 2012, www.ptsd.va.gov/professional/pages/overview-treatment-research.asp.
3. Journal of the American Medical Association 303, no. 1 (6 January 2010): 47–53.
4. K. Holtorf, “The Bio-Identical Hormone Debate: Are Bio-Identical Hormones (Estradiol, Estriol and Progesterone) Safer or More Efficacious Than Commonly Used Synthetic Versions in Hormone Replacement Therapy,” Post Graduate Medicine 121, no. 1 (January 2009): 73–85.
5. M. Platt, The Miracle of Bio-Identical Hormones (Rancho Mirage, CA: Clancy Lane Publishing, 2007), 22.
6. J. Wilson, Adrenal Fatigue: The 21st Century Stress Syndrome (Petaluma, CA: Smart Publications, 2001), 293–9.
7. Ibid., 287–92.