G.M.O. General Medical Officer

G.M.O.

General Medical

Officer

Stephen Schreiber

Published by Prominent Books, LLC at Smashwords

Copyright 2012 by Stephen Schreiber.

All rights reserved.

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Table of Contents

Prologue

Chapter I - The First Mistake

Chapter II - Arrival and Introduction

Chapter III - My First Job

Chapter IV - The Good Guys Alias the Short-Timers

Chapter V - The Bad Guys Alias the Lifers

Chapter VI - The Corps Men and the Corps Waves

Chapter VII - Corps Waves and Nurses

Chapter VIII - Rets alias Retirees

Chapter IX - The Out Patient Department

Chapter X - The Emergency Room

Chapter XI - Hair and Other Military Bullshit

Chapter XII - The Bitch Book

Chapter XIII - My Second Job

Chapter XIV - The Recruit Dispensary

Chapter XV - The Exchange and the Commissary

Chapter XVI - Moonlighting, My Real Job

Epilogue

About the Author

PROLOGUE

When I first mentioned the idea of writing a book about my experiences in the navy, the first reaction from my wife was the expected one, of course: You're crazy, she said. (I will have to admit that.) The idea first occurred to me after approximately three months in the navy. As time went on the idea did not seem quite as crazy as it had been initially. After all, other doctors had had successes writing books about their experiences, particularly Dr. William Nolen. So I thought to myself maybe I could write something. At least, it would be a release from frustration.

With this kind of ambiguity, the idea bounced back and forth in my mind for a number of months. One day when something particularly funny occurred, or I was incensed over a particular incident, I would come home raging that all these experiences had to be put down on paper. However, as I cooled down, had a beer, or played with my child I felt the need to write gradually dissipate.

After smoldering for a number of months, however, the idea surfaced again in November of 1974. At this time, as the holiday season was approaching, my wife approached me with the thought of what she could buy me for Chanukah. After thinking awhile, I jokingly said, A tape-recorder so I can write my book.

Once again, I got the usual stare and no further action was taken. However, on the first night of Chanukah, my wife Judy presented me with a brand new tape recorder.

Why did you do this? I asked.

Well, you've been saying you were going to write a book, she said. I thought I would give you the tape recorder and let you either put up or shut up.

That settles it, I said, I'm going to write the best damned book you ever saw. And it'll blow the top off of the Navy Medical Corps.

Laughing hysterically, she left, and I could hear giggles from the back of the house saying, Well, at least now maybe he'll shut up. Maybe the investment was worth it.

I decided then to take the opposite tack. I would write a book. Maybe nobody would publish it. Maybe nobody would be around to read it but me. At any rate, it might be fun and, who knows, maybe somebody would like it.

The next few days I spent thinking about how to organize my book. I finally decided on the idea of telling it in semi-chronological order with different anecdotes and experiences thrown in whenever appropriate. I did not know how other people wrote books, but I thought this was the best way I could tell the story in the most humorous and accurate way and still keep the general idea intact.

With these facts in mind, I set around to organize my thoughts the way I had done in high school. This was the last writing I had done with the exception of a few themes in English 101 my freshman year in college. Of course, I had written a few scientific papers but they were not quite the same thing.

With the idea finally set down, I mentioned to a few of my colleagues that I was writing a book on my navy medical experience. I got the same response from them that I had initially gotten from Judy. He must be crazy. He had to be out of it. Working over there at the recruit dispensary has gotten to him. Maybe he should be trying to get a psychiatric discharge and disability said one of my colleagues. I told them all that I was not crazy, and I really intended to do this. The rest of them said, Uh huh, we believe you, and left it at that. I think they all thought I was a little crazy, and did not want to tip me over into the abyss of insanity.

Therefore, I set out to write the great American non-fiction book. The result is what you see before you. In order to understand what has been written, certain terms need to be defined and ideas need to be explained so that the over-all big picture can be seen.

To any physician that has been in the service, this book probably contains a number of the experiences which he suffered or experienced during his tenure in the military, no matter what branch he was in. In addition, any other individual who has spent his time in the military could have a great deal of empathy or at least be aware of what I was speaking about. However the average individual who may not have been in the service, whether too old to have undergone that great experience or of the female sex and not desirous of enlisting, might be quite unfamiliar with many of the terms and the ideas which pervaded through the military as a whole.

For those of you who are aware and especially for those of you who are not, most military physicians are, or were prior to 1972, of the two-year variety. That is to say, most of them were serving, their military obligation of two years, and then going on either to resume private practice, residency, training, or academic careers. Prior to 1972, all medical students upon completion of their medical school training were required to send in a form to the Selective Service Bureau in order to help the Bureau determine when the physicians wanted to complete their military obligation. This was part of a law and was known to most medical students and house officers as The Barry Plan.

This plan enabled medical students to attempt to select when they wanted to complete their obligation. Actually three choices were set up. These three were:

1. The young physician could go onto active military duty on the completion of his internship.

2. The young physician could begin active duty at the completion of one year residency training, or

3. The young physician could obtain a full deferral for the completion of his entire residency training.

Through means usually unknown to all medical students and house officers, the military determined the number of physicians they needed by anticipating projected needs. Then, on a supposedly completely random basis, they selected those physicians during the early portion of their internship who were to receive full deferrals, who would go in after one year of residency or who would go in after their internship. All graduating physicians were required to sign up for this plan.

Prior to 1972, during the days of the Vietnam conflict and previous to this era, the military was fat with physicians. This was because all physicians had a military obligation and were required to serve at some time or other unless the military decided that they would not require their services. Only those with a great deal of long, arduous training usually got away from a tour of active duty. Many young physicians felt it was because they were lost on an endless maze of computer tapes and were still bouncing from electrode to electrode in some Department of Defense computer. However, the vast majority of physicians with only an internship, those partly trained in a specialty, and those with advanced specialty training did serve two years of active duty.

The physician draft, however, ended with the Class of 1971. Following this and with the inception of the all-volunteer service including the physicians, there was no further draft and the Barry Plan was abandoned. Accordingly, no medical students were required to sign up and the military lost its endless supply of physicians. As one could easily project, the all-volunteer military medical corps was a complete flop. Physicians were not willing to volunteer for the service when no draft was hanging over their heads.

The point of the entire discussion was that without the draft I would not have been in the service in the first place. However, let us begin at the beginning as they say and start this story so that hopefully it will make some sense. I hope most of you will enjoy my stories and anecdotes, and perhaps learn something from them. I know many of you, especially those who have a great fondness for the military, will not enjoy it and will perhaps be screaming for my head even prior to completing it. However, if you will accept it in the spirit in which it was written, there are numerous points to be made as well as lessons to be learned.

With the exception of the first chapter in this account, all of the action took place in and around the Central Florida town of Orlando and the Orlando Naval Training Center. This was a recruit training center similar to the ones at Great Lakes and San Diego. The navy took over what was formerly the Air Force Base and turned it into the Recruit Center sometime around 1966 or 1967. Since that time, the Training Center has experienced a phenomenal growth with the resultant gradual growth and enlargement of the recruit population.

All the physicians served in the navy with me during this time. Some you may recognize as former friends and associates. However, they were all there and they were all serving.

I hope I have not offended anyone by either admission or omission. If I have, you will just have to remain offended. I only wanted to tell it like it was. And that was what I tried to do.

***

CHAPTER I

THE FIRST MISTAKE

It was really difficult to tell where the first mistake was made because so many were made during this period of my life. However, I suppose you might say that the first real mistake was made in the fall of 1970 during the first part of my senior year in medical School at the University of Florida in Gainesville, Florida. During this time, I, like most of my fellow students, was very concerned about what to do with the Barry Plan. Should we ask for a full deferral or perhaps request to go in after our internship. On the other hand, maybe we should request to go in after one year of residency in case we did not know what we wanted to do with our lives in the first place.

It was also during this time that most of my classmates were taking long trips around the country to try to decide where they wanted to do their internship, what kind of internship they wanted to do, or maybe if they wanted to do an internship in the first place.

I decided one of the best ways to make the decision would be to ask the opinion of many of the esteemed professors of surgery whom I visited in my travels. So wherever I went to check on facilities, I asked whoever would listen and whoever had an answer, and almost everyone knew what I should do and which choice I should make. Go in after internship, go in after one year of residency, or finish my training completely; I suppose as many times as I asked the question, I got that many different answers.

The most consistent opinion was based on what happened in Vietnam. The conflict was still going on at this time and it was a generally accepted fact that if the conflict ended, the draft was going to end. However as long as there was a conflict in Vietnam a great many doctors would be going in after their first year of residency.

It was generally conceded that the best thing to do would be to sign up for a full deferral, hope the specialty you chose was what you wanted to complete your training in,' and also to hope that you got the full deferral. Therefore, if you had decided correctly and you completed your training, perhaps the Vietnam conflict would be over and you would not have to spend time dodging bullets in a rice paddy as a GMO.

Not only did I discuss my alternatives with learned professors of surgery, I also discussed it with my wife, my in-laws, and my own parents. Being a newly-wed at the time, my wife was of the definite opinion that I should do everything possible to avoid leaving her side. My parents and in-laws were also of the opinion that any way I could postpone my military obligation as long as possible would be to my advantage. Other sources of potential aid included my classmates. Most of them were in the same quandary as I. And any aid they had to give was also subject to the same thoughts and considerations that I had.

Several of my classmates had another alternative, which I considered and rejected. Retrospectively, and one always sees things more clearly retrospectively, they were the only smart ones in the whole bunch. They rejected the idea of the Barry Plan completely. They threw the information in the circular file and did not worry about it any further. Those few who did this were looked on in awe by some, disgust by others, and quizzically by the great majority.

When you stop to think about it, what were the alternatives should they do this: I suppose I really did not think about it very clearly then. About the only possible alternative was that you were drafted after your internship, one of the alternatives of the fabulous Barry Plan anyway. Should you not be drafted, the other alternative was that they forgot you completely. This, though not likely, was a distinct possibility.

When you stopped and thought about it, what was the Barry Plan anyway? It was merely a way to enter the service -- a way to be drafted. The only advantage or supposed advantage it gave you was to enable you to pick the time you were drafted. I suppose in a way this did give us a certain advantage. However suppose you did not want to be drafted. Suppose you did not want to go in at all. At that time, you had no choice. You had to go because the all-volunteer military was not a reality at that time.

After a careful evaluation of my choices, I decided that for me the best thing to do would be to request a full deferral in general surgery as that was what I had decided I wished to do as my life's work. The second choice was to request induction after one year of residency. At the time, it really made no difference to me which of these two that I got. I was to learn later that it would make a great deal of difference. Accordingly these were my requests and I sent in the card, happy to be rid of it and almost completely forgetting it.

During the remainder of the course of my fourth year of medical education, I talked to many house officers who had previously served in the military. Most of them had gone in after completing their internship or one year of residency.

Those who had gone in after one year of surgical residency had had an enjoyable experience in the military. Most had been assigned to general surgery or surgical sub-specialties while completing their military obligation. They functioned as working members of the surgical team, got to perform many surgical procedures under the supervision of fully trained surgeons all of whom had completed their residencies and who were more than willing to teach these young, partially trained physicians.

After I thought about it for a while, I decided it probably would not be too bad no matter which alternative of the Barry Plan I got. If I went in after one year of residency, most likely I could obtain some duty station, such as I described, and learn a great deal. It would be a time like additional residency I thought.

Many of my fellow classmates thought this also. And most of them turned in the same request that I did. Then several of the residents told us that not all was quite as rosy as we anticipated and there were tremendous drawbacks to being in the service, namely serving as a GMO and not being allowed to work in the specialty of your choice. I disregarded this, thinking it could not possibly happen to me, and that this must occur to the minority rather than the majority of partially trained doctors. I thought it would mean that I would not get to do as much, but I certainly would be allowed to function in my chosen specialty in the service in some capacity.

It was not until approximately one year later in the fall of my internship that I heard from the Barry Plan again. At that time, I was serving a straight surgery internship at the University of Kentucky Medical Center in Lexington, Kentucky. Although there was talk among all of the interns as to what they wished to hear from the Barry Plan, no one had actually received anything until around October. Then the news began to arrive. In a few days, everyone had heard and my choice had arrived. Much to my disappointment, I had not been given a full deferral in general surgery. I had received my second choice, which consisted of going in after one year of general surgery residency. A poll of the other interns and residents quickly showed that approximately forty percent of the surgery interns had received full deferrals. This was in keeping with what we had been told before: Forty percent of those graduating or requesting full deferrals in general surgery were granted them.

At the time, I did not realize what a big change this would eventually make in my life. I was more concerned with removing my first gallbladder the next day, and I quickly filed the reference in my pocket to discover it three days later.

I sat down with Judy that night and we talked about what we would do. We reached a decision and decided that if that was the choice I had, it might probably be best to go ahead and go in following completion of my first year of residency. Accordingly, I sent the post-card that accompanied the letter, saying I would accept a commission in the navy at the completion of my first year of residency. Little did I know what I had let myself in for.

Approximately a month later, I received another message from the esteemed Barry Plan administrators, one of many that I would receive in the next eighteen months. This one directed me to go to Louisville approximately two weeks hence to receive a pre-induction physical examination. I was to report to the Armed Forces Entrance Examination Station, later to be known to me as AFEES. I was to be there at 8:00 A.M. This necessitated my leaving Lexington at approximately 6:00 A.M., or else going to Louisville the night before and spending the night.

After obtaining permission from various sources, including the chief resident, the attending surgeon, and my fellow intern on the service, I set out on the morning as directed for my physical examination. I really did not know what to expect. I arrived at approximately 7:45 A.M. with a various amount of paperwork and reported to the gentleman at the door who glanced perfunctorily at the paper work and proceeded to give me a list of instructions on where I was to go. Through his mumbling, I heard two lefts and a right and the rest was lost in blur of unintelligible gobbledy-gook.

As I stood there looking confused, a sergeant came over and looked at my papers. He inquired if I was a doctor to which I replied that I was. I was then told I would be taken through more rapidly so that I would not have to wait. Of course, I was more than happy to follow him and I proceeded to do so. We went past a multitude of young men