When I sat in Mahan Hall at the beginning of my final semester at the Naval Academy, one remark from a senior officer’s address struck me: “Remember, you are all training to be human weapons of mass destruction.”
I thought about how there will never be a replacement for the human element in warfighting, no matter how much weapons increase in destructive capacity or autonomy. The Academy’s four-year leadership curriculum makes this evident. Midshipmen learn about situations in which, over and over again, sailors and Marines must make split-second, life-or-death decisions, a role machines are not prepared to perform. For this reason, the U.S. military must support the personal needs of its human element to sustain its forces.
The Naval Academy’s primary mission is to develop line officers for the Navy and Marine Corps, but every year a handful of midshipmen commission into one of several restricted-line communities. As one of those midshipmen, I recognize that my mission will be different from that of most of my classmates. My job will be to support the warfighters. Mulling the analogy to weapons of mass destruction, I thought to myself, “I’m going to be Weps.” A ship’s weapons officer leads the team that maintains all the weapons, checking them regularly to ensure they are mission ready. Similarly, as a Navy Medical Corps officer, I will lead a team that is entrusted with the maintenance of our most valuable assets—our sailors and Marines.
When I had the opportunity to shadow pediatricians at Walter Reed National Military Medical Center and Portsmouth Naval Hospital, I began to recognize the limits of my “Weps” analogy. Navy medicine cares for more than just the men and women wearing uniforms; it also cares for the people they leave behind. When I asked one doctor why she chose pediatrics, she told me that she originally had not considered it. She joined the military because she wanted to take care of our nation’s service members. She soon realized, however, that pediatricians also fill that role.
“When the service member is deployed,” she told me, “we are the people back home taking care of the people they most love. They trust us, and we can give them peace of mind.”
In the short time I spent in military hospitals, I witnessed the Medical Corps support families through some of their most trying and most joyful moments. I witnessed the joy of a couple giving birth to their first child, and the terror when that child did not begin breathing until his care team resuscitated him. I saw the way one father leaned on the positivity of the orthopedic pediatricians to help his daughter endure the pain of scoliosis treatment, and the relief of a mother when a doctor told her that her son’s club feet could be corrected without surgery. One pediatrician I shadowed was paged several times to the emergency room to consult on some children with chronic illnesses. Each time, he greeted the families with familiar smiles and hugs as if part of their families.
The first military pediatric training program was officially approved nearly 70 years ago, in 1949.1 But the needs of the Navy change over time. The current focus on forward deployment and better mission readiness may lead to the elimination of a large number of medical billets, and pediatrics may take a hit.2 Retired Navy Captain Kathryn M. Beasley, director of government relations for health issues for the Military Officers Association of America, has noted that the staff cuts (up to 17,000 overall, with about 5,300 coming from the Navy) would reduce patient access to care, especially from pediatricians and obstetricians, whom young families frequent.3 According to a Military.com article, senior officials argue that the “current [medical] force is larger than needed to meet today’s operational missions and is overloaded with skill sets not useful for deployment and delivering of battlefield care.”4 Furthermore, they express concern that Medical Corps personnel lack sufficient patient volume to maintain skills.
Section 725 of the National Defense Authorization Act for Fiscal Year 2017 called for the implementation of measures to focus on two major areas: maintaining “critical wartime medical readiness skills and core competencies of health care providers” and ensuring medical readiness of the armed forces.5 I agree; these are Navy Medicine’s primary missions. I worry, however, that Navy families will suffer if they are not recognized as part of the armed forces.
In other areas, the Navy clearly recognizes the importance of supporting families, through improved maternity and paternity leave policies, for example, or recent efforts to harmonize location and synchronize deployment schedules, not to mention the many initiatives led by the Fleet and Family Support Program.6 These services allow sailors and Marines to stay on mission, trusting that their families will be taken care of by the Navy.
We cannot forget the key role the Medical Corps plays in this support network. There are few things scarier to any parent than a child who is suffering pain or illness. While it is crucial to continue to improve medical readiness and forward deployment, the Navy also must have care providers available at home, easing those fears for service members and their partners. When Dr. Joseph Lorpreiato, now associate dean for simulation education at the Uniformed Services University, was deployed with Marines in Panama, they would tell him how much they worried about their families back home. He would tell them, “Hey, look, your child or your spouse is in the hands of the military system,” and they felt “relief, knowing someone in uniform back home was taking care of them.”7
At the end of the day, the relief pediatric care provides these men and women enhances mission readiness. Navy Medical pediatric care should continue, or even be enhanced, because uniformed pediatricians can care for families in a way no other option can. Good pediatric care can increase time in service for the best sailors by showing them that they do not have to choose between Navy and family. Furthermore, uniformed pediatricians are deployable. According to the 2017 Department of Defense demographics report, about half the military is age 25 or younger. With the pediatric specialty comfortably encompassing patients up to age 21, many personnel fall within the specialty’s bounds.8 Those who fall just outside the expertise of pediatricians remain within these physicians’ capabilities.
Medical Corps pediatricians can support families in a way civilian contractors cannot. According to one Portsmouth physician, civilian doctors are unable or unwilling to serve abroad, but physicians in uniform are. The Navy cannot send sailors with families abroad without the medical assets to support them. If the Navy lacks sufficient pediatricians, it will have two options: Restrict the sailors stationed abroad to those without families, or send families abroad without appropriate medical support. The first option is unsatisfactory; many of the best, most experienced personnel have families. Diminishing the pool of sailors and Marines who can be sent abroad hurts readiness. The second is unacceptable, because the Navy and Marine Corps will not retain these families.
Uniformed pediatricians provide parents with an extra element of comfort—these doctors understand. Many military pediatricians have deployed, leaving their own family members behind. This allows them to empathize in a way that no other doctor could.
As precise plans for staff cuts and reallocation of medical forces roll out, I hope senior officials will consider Navy families in their decision-making. I will begin medical school this fall, committed to a minimum of nine years active duty, and I am excited about the years of training and service ahead. I look forward to serving as the “human weapons” officer for my future units, keeping warfighters healthy. I hope that I can serve sailors and Marines as a trusted ally, caring for their little loved ones at home.
1. Charles W. Callahan et al., “History of Military Pediatrics: Fifty Years of Training and Deploying Uniformed Pediatricians,” Pediatrics 103, no. 6 (June 1999), 1298.
2. Tom Philpott, “More Than 17,000 Uniformed Medical Jobs Eyed for Elimination,” Military.com, 10 January 2019.
3. Philpott, “Medical Jobs Eyed for Elimination.”
4. Philpott, “Medical Jobs Eyed for Elimination.”
5. Tom Philpott; John McCain, “Text—S.2943—114th Congress (2015–2016): National Defense Authorization Act for Fiscal Year 2017,” 23 December 2016.
6. “Fleet and Family Support Program (FFSP).” Noah Nash, “New Navy Parental Leave Policy Gives New Parents Additional Flexibility,” Navy Times, 22 June 2018.
7. Perri Klass M.D., “For Pediatricians in the Military, Duty Always Calls,” The New York Times, 12 April 2010.
8. Center for Devices and Radiological Health, “Medical Devices—Pediatric Expertise for Advisory Panel—Guidance for Industry and FDA Staff.”