Commentary
Reflections: Service to Our Nation
Joseph Goodman, MD1
No sponsorships or competing interests have been disclosed for this article.
Abstract Service to others is something that physicians understand and undertake on a daily basis. Military physicians are in a unique role of serving both our patients and our nation. Millions of Americans have answered the call to military service since the attacks of September 11, 2001. As otolaryngologists, we will increasingly care for veterans of the Global War on Terror. Service to our nation is a mutual goal that brings together people from very different walks of life.
Keywords service, military, Global War on Terror, Operation Iraqi Freedom, Operation Enduring Freedom, traumatic brain injury, veteran Received April 13, 2015; accepted April 15, 2015.
F
ifty-four years ago, President John F. Kennedy gave his inaugural address on the steps of the US Capitol1: ‘‘And so, my fellow Americans: ask not what your country can do for you—ask what you can do for your country.’’ As distant now as that day may seem, it is noteworthy that we have spent nearly a quarter of that time engaged in a Global War on Terror. Despite nearly 7000 dead and hundreds of thousands wounded, our military continues to be engaged in the fight that was brought to our soil on September 11, 2001. The 2.6 million men and women who have served in the military in the post– September 11 period have answered our nation’s call to service. They chose to serve their country and their communities. They have sought to preserve and advance the freedoms upon which America was founded—freedom of religion, freedom of the press, freedom to assemble— fundamental human rights that are unimaginable in many parts of the world. For that, we are grateful to have fellow Americans, men and women, willing to go and do what we ask of them in defense of our nation’s interests. Many of the veterans who have served since September 11 are reservists and National Guard troops representing a microcosm of America, cutting across all 50 states. Unlike in previous wars, there has been
Otolaryngology– Head and Neck Surgery 2015, Vol. 153(4) 491–492 Ó American Academy of Otolaryngology—Head and Neck Surgery Foundation 2015 Reprints and permission: sagepub.com/journalsPermissions.nav DOI: 10.1177/0194599815585498 http://otojournal.org
no compulsory service or draft. All who have joined the armed forces have volunteered to do so, and most Americans are grateful for that service. Much of our nation has been insulated from the pain and suffering of war over the past 13 years, whereas the majority of recent veterans deployed at least once into harm’s way; about half deployed multiple times.2 This is not to say that military experience is an idealized form of national solidarity. Rather, it is one example of the way that some Americans internalize service as a core value. National service represents investment in the future of our country and participation in shaping our collective destiny. Many of the same reservists who answered the call to military service have now returned to their communities in other capacities, still committed to building and defending this nation. They are teachers, police, firefighters, health care workers, and other municipal employees who continue to serve their communities and the greater good of the nation. As physicians, we recognize this motivation to serve our communities, and we understand the personal sacrifices that are often made in that pursuit. A great way to try to better understand the sacrifices that veterans have made in service to our nation is to read one of the many true accounts of the war recently published.3 Books such as Redeployment, by Phil Klay, and For Love of Country, by Howard Schultz, capture both the grime and the glory of military service through a series of short stories. We owe it to our veterans to spend a moment with them in that experience. Signature war-related injuries from Iraq and Afghanistan include amputations, posttraumatic stress disorder, and traumatic brain injury.4 Our soldiers are increasingly surviving devastating wounds but are left with severe disabilities. Most of these service-connected injuries carry a significant disability rating, allowing wounded veterans to seek care at military hospitals initially and ultimately within the Veterans Affairs (VA) system. Through partnerships 1
Walter Reed National Military Medical Center, Bethesda, Maryland, USA
The author is an Army physician at the Walter Reed National Military Medical Center (WRNMMC). The views expressed in this document are those of the author alone and do not claim to represent the position of the Department of Defense, the US Army, or WRNMMC. Corresponding Author: Joseph Goodman, MD, Walter Reed National Military Medical Center, 8901 Wisconsin Ave, Bethesda, MD 20889, USA. Email: [email protected]
Downloaded from oto.sagepub.com by guest on November 14, 2015
492
Otolaryngology–Head and Neck Surgery 153(4)
with academic institutions, the VA system has become the largest educator of physician trainees in the country.5 Care for veterans is increasingly becoming an integral part of residency training, which provides meaningful interactions between veterans and civilian doctors. Otolaryngology residents often gain extensive head and neck cancer experience within the VA system. Oral cancer in particular has been found to have a higher prevalence in Vietnam-era veterans, relative to the general population.6 Other injuries, such as tympanic membrane perforations and noise-induced hearing loss, are routinely evaluated by ENT specialists. Military otolaryngologists make up a small but highly specialized and necessary resource for military medicine, both on and off the battlefield. Several senior military head and neck surgeons have published extensively on their experiences at the height of the recent conflict—from the ENT role of managing penetrating neck wounds7 to a series of microvascular free flaps for reconstruction of host nation civilians.8 Facial reconstruction continues to be a particular multidisciplinary challenge, of which microvascular-trained reconstructive surgeons have played an important role. We are all familiar with images of returning soldiers as amputees and burn victims, as those now paralyzed, and as those recovering from the psychological toll of war. What may not be apparent, however, is the extent to which recent veterans of the Global War on Terror have reintegrated into society in the past 14 years. A recent Washington Post/ Kaiser Family Foundation2 poll found that many veterans are doing well—enrolled in college on the GI Bill, reintegrating into the business world, and starting second careers in government or teaching. Most of these veterans shy away from being called out for recognition. They have done what they expect any American would do in service to our country. We honor their service when we care for our own families, neighbors, communities, and, by extension, the rest of America. When each of us walks out the door in the morning determined to help our neighbor and to build our community, then we will no longer fear that our way of life is
threatened; the only thing that we will have to fear is fear itself. Author Contributions Joseph Goodman, sole author (all content).
Disclosures Competing interests: None. Sponsorships: None. Funding source: None.
References 1. Kennedy JF. Inaugural address (January 20, 1961). http://www.jfkli brary.org/Asset-Viewer/BqXIEM9F4024ntFl7SVAjA.aspx. Accessed April 7, 2015. 2. Chandrasekaran R. After the wars: a legacy of pain and pride. http://www.washingtonpost.com/sf/national/2014/03/29/a-legacyof-pride-and-pain/. Accessed March 29, 2014. 3. Kakutani M. A reading list of modern war stories. http://www .nytimes .com/2014/12/26/books/a-reading-list-of-modern-warstories.html. Published December 25, 2014. 4. Hoge CW, McGurk D, Thomas JL, Cox AL, Engel CC, Castro CA. Mild traumatic brain injury in US soldiers returning from Iraq. N Engl J Med. 2008;358:453-463. 5. US Department of Veterans Affairs. Medical and dental education program. http://www.va.gov/oaa/gme_default.asp. Accessed April 7, 2015. 6. Fox EE. Cancer in Vietnam veterans [dissertation]. http://digitalcom mons.library.tmc.edu/dissertations/AAI3346407. Published 2007. 7. Brennan J, Lopez M, Gibbons MD, et al. Penetrating neck trauma in Operation Iraqi Freedom. Otolaryngol Head Neck Surg. 2011;144:180-185. 8. Klem C, Sniezek JC, Moore B, Davis MR, Coppit G, Schmalbach C. Microvascular reconstructive surgery in Operations Iraqi and Enduring Freedom: the US military experience performing free flaps in a combat zone. J Trauma Acute Care Surg. 2013;75:S228S232.
Downloaded from oto.sagepub.com by guest on November 14, 2015
Reflections: Service to Our Nation
Joseph Goodman, MD1
No sponsorships or competing interests have been disclosed for this article.
Abstract Service to others is something that physicians understand and undertake on a daily basis. Military physicians are in a unique role of serving both our patients and our nation. Millions of Americans have answered the call to military service since the attacks of September 11, 2001. As otolaryngologists, we will increasingly care for veterans of the Global War on Terror. Service to our nation is a mutual goal that brings together people from very different walks of life.
Keywords service, military, Global War on Terror, Operation Iraqi Freedom, Operation Enduring Freedom, traumatic brain injury, veteran Received April 13, 2015; accepted April 15, 2015.
F
ifty-four years ago, President John F. Kennedy gave his inaugural address on the steps of the US Capitol1: ‘‘And so, my fellow Americans: ask not what your country can do for you—ask what you can do for your country.’’ As distant now as that day may seem, it is noteworthy that we have spent nearly a quarter of that time engaged in a Global War on Terror. Despite nearly 7000 dead and hundreds of thousands wounded, our military continues to be engaged in the fight that was brought to our soil on September 11, 2001. The 2.6 million men and women who have served in the military in the post– September 11 period have answered our nation’s call to service. They chose to serve their country and their communities. They have sought to preserve and advance the freedoms upon which America was founded—freedom of religion, freedom of the press, freedom to assemble— fundamental human rights that are unimaginable in many parts of the world. For that, we are grateful to have fellow Americans, men and women, willing to go and do what we ask of them in defense of our nation’s interests. Many of the veterans who have served since September 11 are reservists and National Guard troops representing a microcosm of America, cutting across all 50 states. Unlike in previous wars, there has been
Otolaryngology– Head and Neck Surgery 2015, Vol. 153(4) 491–492 Ó American Academy of Otolaryngology—Head and Neck Surgery Foundation 2015 Reprints and permission: sagepub.com/journalsPermissions.nav DOI: 10.1177/0194599815585498 http://otojournal.org
no compulsory service or draft. All who have joined the armed forces have volunteered to do so, and most Americans are grateful for that service. Much of our nation has been insulated from the pain and suffering of war over the past 13 years, whereas the majority of recent veterans deployed at least once into harm’s way; about half deployed multiple times.2 This is not to say that military experience is an idealized form of national solidarity. Rather, it is one example of the way that some Americans internalize service as a core value. National service represents investment in the future of our country and participation in shaping our collective destiny. Many of the same reservists who answered the call to military service have now returned to their communities in other capacities, still committed to building and defending this nation. They are teachers, police, firefighters, health care workers, and other municipal employees who continue to serve their communities and the greater good of the nation. As physicians, we recognize this motivation to serve our communities, and we understand the personal sacrifices that are often made in that pursuit. A great way to try to better understand the sacrifices that veterans have made in service to our nation is to read one of the many true accounts of the war recently published.3 Books such as Redeployment, by Phil Klay, and For Love of Country, by Howard Schultz, capture both the grime and the glory of military service through a series of short stories. We owe it to our veterans to spend a moment with them in that experience. Signature war-related injuries from Iraq and Afghanistan include amputations, posttraumatic stress disorder, and traumatic brain injury.4 Our soldiers are increasingly surviving devastating wounds but are left with severe disabilities. Most of these service-connected injuries carry a significant disability rating, allowing wounded veterans to seek care at military hospitals initially and ultimately within the Veterans Affairs (VA) system. Through partnerships 1
Walter Reed National Military Medical Center, Bethesda, Maryland, USA
The author is an Army physician at the Walter Reed National Military Medical Center (WRNMMC). The views expressed in this document are those of the author alone and do not claim to represent the position of the Department of Defense, the US Army, or WRNMMC. Corresponding Author: Joseph Goodman, MD, Walter Reed National Military Medical Center, 8901 Wisconsin Ave, Bethesda, MD 20889, USA. Email: [email protected]
Downloaded from oto.sagepub.com by guest on November 14, 2015
492
Otolaryngology–Head and Neck Surgery 153(4)
with academic institutions, the VA system has become the largest educator of physician trainees in the country.5 Care for veterans is increasingly becoming an integral part of residency training, which provides meaningful interactions between veterans and civilian doctors. Otolaryngology residents often gain extensive head and neck cancer experience within the VA system. Oral cancer in particular has been found to have a higher prevalence in Vietnam-era veterans, relative to the general population.6 Other injuries, such as tympanic membrane perforations and noise-induced hearing loss, are routinely evaluated by ENT specialists. Military otolaryngologists make up a small but highly specialized and necessary resource for military medicine, both on and off the battlefield. Several senior military head and neck surgeons have published extensively on their experiences at the height of the recent conflict—from the ENT role of managing penetrating neck wounds7 to a series of microvascular free flaps for reconstruction of host nation civilians.8 Facial reconstruction continues to be a particular multidisciplinary challenge, of which microvascular-trained reconstructive surgeons have played an important role. We are all familiar with images of returning soldiers as amputees and burn victims, as those now paralyzed, and as those recovering from the psychological toll of war. What may not be apparent, however, is the extent to which recent veterans of the Global War on Terror have reintegrated into society in the past 14 years. A recent Washington Post/ Kaiser Family Foundation2 poll found that many veterans are doing well—enrolled in college on the GI Bill, reintegrating into the business world, and starting second careers in government or teaching. Most of these veterans shy away from being called out for recognition. They have done what they expect any American would do in service to our country. We honor their service when we care for our own families, neighbors, communities, and, by extension, the rest of America. When each of us walks out the door in the morning determined to help our neighbor and to build our community, then we will no longer fear that our way of life is
threatened; the only thing that we will have to fear is fear itself. Author Contributions Joseph Goodman, sole author (all content).
Disclosures Competing interests: None. Sponsorships: None. Funding source: None.
References 1. Kennedy JF. Inaugural address (January 20, 1961). http://www.jfkli brary.org/Asset-Viewer/BqXIEM9F4024ntFl7SVAjA.aspx. Accessed April 7, 2015. 2. Chandrasekaran R. After the wars: a legacy of pain and pride. http://www.washingtonpost.com/sf/national/2014/03/29/a-legacyof-pride-and-pain/. Accessed March 29, 2014. 3. Kakutani M. A reading list of modern war stories. http://www .nytimes .com/2014/12/26/books/a-reading-list-of-modern-warstories.html. Published December 25, 2014. 4. Hoge CW, McGurk D, Thomas JL, Cox AL, Engel CC, Castro CA. Mild traumatic brain injury in US soldiers returning from Iraq. N Engl J Med. 2008;358:453-463. 5. US Department of Veterans Affairs. Medical and dental education program. http://www.va.gov/oaa/gme_default.asp. Accessed April 7, 2015. 6. Fox EE. Cancer in Vietnam veterans [dissertation]. http://digitalcom mons.library.tmc.edu/dissertations/AAI3346407. Published 2007. 7. Brennan J, Lopez M, Gibbons MD, et al. Penetrating neck trauma in Operation Iraqi Freedom. Otolaryngol Head Neck Surg. 2011;144:180-185. 8. Klem C, Sniezek JC, Moore B, Davis MR, Coppit G, Schmalbach C. Microvascular reconstructive surgery in Operations Iraqi and Enduring Freedom: the US military experience performing free flaps in a combat zone. J Trauma Acute Care Surg. 2013;75:S228S232.
Downloaded from oto.sagepub.com by guest on November 14, 2015
