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Semper Fi
The New England Journal of Medicine ^ | July 1, 2004 | Pamela Grim, M.D.

Posted on 07/02/2004 11:35:44 PM PDT by neverdem

A while ago, before more recent geopolitical disasters, I saw on the news that a "rapid response team" of Marines had landed in Port-au-Prince, Haiti, and I wondered whether any of "mine" were there — the recruits I see at the Parris Island Marine training facility in South Carolina. I realized my first morning here that the culture of the "Island" and the "grunts" is worlds away from my own. My first recruit-patient — an 18-year-old with pilonoidal abscess — shouted "Yes, Ma'am!" or "No, Ma'am!" whenever I asked him a question. When I was his age, I was out in the streets protesting against a war. Somehow, almost unnoticed, that war has become a long time ago. What did I know about war? About as much as these kids do, I guess.

I was quickly corrected when I called him by name: you call each patient "recruit," and he calls himself "this recruit" — no "I" allowed.

Marine basic training attempts to take a kid and turn him into a responsible, disciplined adult — in 70 training days. And it works; you can actually see the transformation from the doorway. On day 1, the recruit is lounging on the gurney as if it were a settee; on day 64, he is a taut and toned junior jarhead sitting bolt upright, a cupped hand on each knee. From the very first day, I marveled. How was this possible?

Within a few weeks, I started to get a sense of what I would see clinically. The first thing to ask a recruit is "What training day are you?" You can usually guess the final diagnosis on the basis of this information. Basic training includes 2 "intake days," 5 "forming days," and 70 "training days." The kids who come into the emergency room on an intake day are usually there with slapstick stuff: someone breaks his arm stepping off the bus, another knocks himself out by running into a wall. Not a good beginning.

During the forming days (also known as "disorientation"), the drill instructors (DIs) introduce themselves and make the first real demands on recruits. This is when the weeding-out process begins. The earliest to go are the kids who've hidden a significant medical history, anything from asthma to bad knees. These are "fraudulent enlistments." When they get into trouble, the DIs send them to us to sort out. One kid sent in for "weakness" told me he would be fine if he could just restart his medications.

"What medications?"

"Zyprexa, Prozac, Buspar, and Ambien for sleep."

"And they let you in here? Did your recruiter know about this?"

"My dad told me not to tell him."

I looked at him. "What does your father do?"

"He's career Navy."

"And he told you not to say anything?"

The kid looked sheepish. "He thought this might make a man of me."

That first week, the kids meet the Third Hat — usually the most junior of the DIs, who has been described as "a maniacal, sadistic, extremist psychopath whose name you, the recruit, will never forget." His job is to ensure that once a recruit becomes a Marine, he will not crack up, become insubordinate, or "go postal" at a critical moment. Obviously, the Third Hat doesn't accomplish this feat by being soft-spoken. And it's because of him, I presume, that I see the other common complaints of early training — chest pain, shortness of breath, dizziness, weakness. The diagnosis invariably is "panic attack," but these are ferocious panic attacks: heart rates of 180, respiratory rates of 50, carpopedal spasm, and — worst of all — tears. Seeing a 6-ft 4-in., 250-lb former high school football star hyperventilating, sobbing, and begging to be sent home is an unsettling experience. And what exactly should I do for him?

I have two roles here: doctor and member of the Marine training team. My usual remedies, benzodiazepines and reassurance, aren't really adequate for this situation. Six months from now, any one of these kids could be dying in a ditch somewhere in a country he first heard of 10 minutes before he got there. How do I help someone deal with that kind of stress?

I tell the recruit, "What you are feeling is normal fear. It's totally understandable." The recruit, say, has just come from a drill in which he's required to sit in a chamber filled with CS gas with his gas mask off for a certain period. A fair number can't handle it. They bolt out of the chamber, gasping and vomiting. We get the ones with worrisome symptoms — chest pain, severe dyspnea. Usually, it's just nerves. "It's normal to be scared," I tell the sobbing kid. "But your job now is to learn how to deal with these perfectly normal feelings. Your job as a recruit is to learn how to think even though you are frightened." Most, given time, manage to pull themselves together, but a few try to convince me that it is their constitutional right to quit basic training this very instant. (It's not.) The DI rolls his eyes. "This is the gnarliest set of recruits that has ever come through this hole," he mutters.

The DI is the catalyst that transforms recruits into Marines, and his job may have its own psychological sequelae. Recently, I saw a DI whose chief complaint was "I want to kill the recruits."

"We all want to kill the recruits," I said solicitously.

"No," he said, giving every word equally ponderous weight, "I. Want. To. Kill. The. Recruits." He buried his head in his hands. "Just send me back to Iraq. I didn't have any trouble with Iraq."

After the first few weeks, unsuitable recruits are sent home for "failure to adapt," and the long grind begins. From the endless hours of physical training, we get the traditional diseases of foot soldiers — shin splints, stress fractures, hernias, pneumonia. "Combat simulation" drills bring us shoulder dislocations, nasal fractures, and on one occasion, a mandibular fracture (LeFort type I).

The final stage of boot camp, the Crucible, is a 54-hour mental and physical gauntlet. It consists of combat exercises, forced marches, and "warrior stations." Each station is dedicated to a great Marine of the past, and as the recruits maneuver under barbed wire and over the mud flats of the Beaufort River, they are expected to relive these warriors' golden moments — Marines like Gunnery Sergeant Dan Daily, who in 1918 led the Marine charge into Belleau Woods with the cry, "Come on, you sons of bitches, do you want to live forever?"

Oddly enough, we don't get too many injuries at this stage; most of the kids are smarter about dodging blows. What we do see are kids who are end-stage sick, with double pneumonia, grapefruit-size abscesses, appendicitis. These guys will do anything now to see this thing through. By this time, a recruit has become invested — invested in making it with his fellow recruits, invested in proving the Third Hat wrong, invested in just getting the whole damn thing over with. One kid came in with fulminating Guillain–Barré and dropped out only when he became apneic.

The final stage of the Crucible, a nine-mile hike, is dedicated to the men of Easy Company who in 1944 fought their way to the top of Mount Suribachi on Iwo Jima and planted an American flag.

"Wear the Corps' emblem with pride and honor not only on your uniform but in your heart," these new Marines are told. "Remember once a Marine, always a Marine." Semper fi!

Clausewitz, the great strategist on war, says there is only one means to war: combat. And with combat come casualties. The wounded from Iraq have started to make their way back home. The first we see are those with head injuries; the scuttlebutt is that we are going to see a lot of these. Most of these injuries are from roadside bombs — "improvised explosive devices" — which differ from traditional antipersonnel devices in that they shoot shrapnel and dirt up rather than the more traditional out, making a Kevlar helmet merely a bucket that collects ordnance.

Last night, a middle-aged couple came in, the wife complaining of shortness of breath. They had gotten the news that afternoon that their only son had been killed in Iraq. The man was retired from the military, and he stood ramrod straight and expressionless. But the woman was a basket case, a bottomless pit of sorrow. Her son was supposed to have come home a month ago, she told me, but his tour had been extended because of the ongoing insecurity. I called the chaplain; I talked to her for a while; I gave her some lorazepam. What else could I do?

The Marines are in the news every morning now as I get ready for work, the anchor talking about "taking casualties" and "hearts and minds." When I go outside, I can hear the shouts floating across the water, the young recruits out there sounding off in unison as they go out for their morning run, flat-out gung-ho at 6 a.m. The shouting sounds as if it is coming not just across the marshes but across the decades, and I swear sometimes that I can hear what they are shouting — all that Marine tough-guy talk:

Lock and load!

Ready on the left!

Ready on the right!

Ready on the firing line!

Failure is not an option!

Good to go.

Source Information

From the Naval Hospital, Beaufort, Parris Island, South Carolina.


TOPICS: Extended News; Government; News/Current Events; US: South Carolina; War on Terror
KEYWORDS: atf; parrisisland; training; usmarinecorps; usmc
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To: tet68

31 years ago today, July 3, 1973 I finally graduated from PI.

Life is still good, but it sure hurts a lot more!

Semper Fi


41 posted on 07/03/2004 4:57:47 PM PDT by JoeSixPack1 (Freedom Stands Because Heroes Serve.)
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To: neverdem

This article brought back some memories. Army boot camp, Ft. Dix, NJ, where two guys attempted suicide in my company. You know, the DI's never even told us if they made it or not. Never found out. Memories, memories.


42 posted on 07/03/2004 6:03:20 PM PDT by doosee (Those who ignore history are bound to repeat it.)
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To: tet68; JoeSixPack1; Dubya; RaceBannon
I perhaps am the only Marine you can **hug** without getting into trouble..:))

LOL

Oops! Race Bannon's mother was a Marine in WWII, though!

43 posted on 07/03/2004 8:44:53 PM PDT by LadyX (((( To God be all praise and honor and glory -- ))))
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To: JoeSixPack1
31 years ago today, July 3, 1973 I finally graduated from PI.
 
31 years ago Monday (July 5th 1973) I got off the plane in San Diego, (with hair)  seems like yesterday, the bus ride to RTC what a hoot.

44 posted on 07/03/2004 10:16:18 PM PDT by TexasTransplant ("You know, I think the best possible social program is a job" Ronald W. Reagan)
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To: LadyX
I perhaps am the only Marine you can **hug** without getting into trouble..:))

Only if you're willing, otherwise, you're just like the rest of us! TROUBLE!!

Happy 4th, LadyX
X X X X

<|:-)~~

45 posted on 07/03/2004 10:47:54 PM PDT by JoeSixPack1 (Freedom Stands Because Heroes Serve.)
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To: LadyX; MudPuppy; fairfaxwatch

Well, Dont forget MudPuppy!!

And Fairfaxwatch, too, She is a WM! :)


46 posted on 07/04/2004 4:34:08 AM PDT by RaceBannon (God Bless Ronald Reagan, and may America Bless God!)
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To: tet68

My mask fell out of my carrier and I got caught picking it up.

The second time through was actually not so bad! :)

I was used to it by then, I was kind of amused at how much everyone was spitting and choking and I was able to just listen and watch and cry.

But I will never forget it! :)

I wondered if I and the rest of the guys I went through it with the first time looked like that, I dont know, Maybe I was too busy seeing the snot fly out my nose and throat and the geysers out of my eyes, but I SWEAR we didn't make all the noises as the squad who was there on my second attempt.


47 posted on 07/04/2004 4:45:08 AM PDT by RaceBannon (God Bless Ronald Reagan, and may America Bless God!)
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To: neverdem

bttt


48 posted on 07/04/2004 6:49:16 AM PDT by lainde (Heads up...We're coming and we've got tongue blades!!)
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To: TexasTransplant; tet68; JoeSixPack1; RaceBannon; MudPuppy; fairfaxwatch; Dubya; The Mayor; ...
"31 years ago Monday (July 5th 1973) I got off the plane in San Diego, (with hair) seems like yesterday, the bus ride to RTC what a hoot."

BUS RIDE?!!
Why, back in the Good Old Days of The Corps, during the Korean Conflict, we had something "a little different"..:))

Sworn in at Jacksonville Naval Air Station, the entry point for Florida Marines, on 25 June 1952, I was placed in charge of the 8 of us WM's going to Parris Island. We went the next day by train, me clutching all the meal tickets, to Yemassee, SC - that name made famous in a certain Cadence Call..:))

Nice smooth-riding BUS from there the 26 miles to Port Royal, near PI?
Oh, no - we transferred to an ancient (I swear it was from the 1800's and the Civil War!) coal-eating steam locomotive with four cars, complete with AIR CONDITIONING - - as in huge no-glass windows so the hot air could properly envelop us!
We chugged slowly past farmlands in an oven with wheels - - LOL

Debarking at the station at Port Royal, there was a bus there for the short hop to PI, and also hundreds of male new recruits.

It was at that moment we first heard that catchy name - shouted loudly and with enthusiasm - "Look, BAMS" !!

It took a while for me to figure out that really meant:
Beautiful American Marines..:))

Hey, Joe - we came to FR and the Whitewater Days around the same time. I lurked from the fall of 1997, and registered in April of 1998.
In those days, a reply stayed on the Front Page of the Latest Comments for most of the day!!

Be good to Florida - Land of my Birth and Childhood until 18, with return engagements 3 more times...have sons in the West Palm Beach and Ft. Lauderdale areas...

The Corps is doing us proud - as always will be - -

~ ~ ~ Parade Deck - Parris Island, SC ~ ~ ~

49 posted on 07/04/2004 9:05:43 AM PDT by LadyX (((( To God be all praise and honor and glory -- ))))
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To: RaceBannon
We WMs went through the gas chamber, but I did not have an extreme reaction.
It is probable we were not in as long a time as the men...
50 posted on 07/04/2004 9:07:44 AM PDT by LadyX (((( To God be all praise and honor and glory -- ))))
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To: neverdem
I was quickly corrected when I called him by name: you call each patient "recruit," and he calls himself "this recruit" — no "I" allowed.

(Actually, in 1st Battalion at PI it's "private" and "the private".)

Great article!
BUMP!!!

51 posted on 07/04/2004 9:13:36 AM PDT by Lancey Howard
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To: LadyX

Proud to know ya, BAM
Happy Fourth of July.
Happy Birthday America!!! Land that I love!


52 posted on 07/04/2004 9:13:46 AM PDT by Diver Dave (Stay Prayed Up)
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To: All; tet68; JoeSixPack1; RaceBannon; Dubya; The Mayor; MudPuppy; Diver Dave
Look at what I found on the same Google site as the Iwo Jima Monument at Parris Island !!
There were more photographs of past days of The Corps - - -

Arriving at the Yemassee Train Station:

Old Platoon Photo:


53 posted on 07/04/2004 9:17:15 AM PDT by LadyX (((( To God be all praise and honor and glory -- ))))
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To: LadyX

You sure don't look old enough to have been in the Corp during the Korean War.


54 posted on 07/04/2004 9:17:41 AM PDT by dixie sass ( Claws are sharp and ready for use!)
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To: JoeSixPack1
Love your tagline, Joe - -

(Freedom Stands Because Heroes Serve.)

55 posted on 07/04/2004 9:18:51 AM PDT by LadyX (((( To God be all praise and honor and glory -- ))))
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To: LadyX

Happy Independence Day BAM :-)


56 posted on 07/04/2004 9:20:35 AM PDT by deadhead (God Bless Our Troops and Veterans Bush-Cheney '04)
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To: dixie sass
Hey, cuzzin dixie!
You know what it was to be part of the Marine Corps....
can't be explained in mere words.....
57 posted on 07/04/2004 9:24:01 AM PDT by LadyX (((( To God be all praise and honor and glory -- ))))
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To: RaceBannon
Incredibly, my platoon never did the gas chamber. Something happened the day we were supposed to do it (I forget what) and the schedule was tight (I was the admin private - - every night I printed up the index cards with the next day's schedule that the DIs put into their campaign covers) so we had to skip the gas chamber.

I got plenty of tastes of CS gas during infantry training at Geiger, though.
Nine seconds, heck - - I got that mask on in less than six.

58 posted on 07/04/2004 9:24:41 AM PDT by Lancey Howard
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To: neverdem

God Bless them all. The DI's methods may not be politically correct, but they get results that are very good. I'm not a Marine, I am an Airman. My sergeants taught me so much and expected a lot out of me and when I became a sergeant I carried on in their tradition. My son who is twelve years U. S. Navy has told me that I was like a Gunnery Sergeant when he was growing up. I was only an E-5 but I accepted this as a compliment and was proud to be thought of like someone in such a great group of people. I can tell you this that it works be cause if my son would have only made me half as proud of him I would have gotten more than I deserved. God Bless all of these people in uniform because they are the Best of the Best.


59 posted on 07/04/2004 9:27:19 AM PDT by JOE43270 (JOE43270 My vote goes for President Bush because he is a great leader and a good man.)
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To: Shooter 2.5

60 posted on 07/04/2004 9:27:44 AM PDT by Shooter 2.5 (Vote a Straight Republican Ballot. Rid the country of dems.)
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