Battle Ready: Memoir of a SEAL Warrior Medic (16 page)

Navy PAs follow the same general path, unless there are extenuating circumstances. They cement their newly acquired skills at a primary care clinic and eventually receive orders to an expeditionary command. I looked at it as navy medicine’s way of ensuring each of us completed a workup before pushing forward to practice medicine in some of the more challenging environments.

My assignment was to the Branch Medical Clinic at Naval Amphibious Base Coronado, my old home as a BUD/S candidate. At Coronado, I worked under two of the best PAs in our community, one being a frogman like me.

Dave Holder was a straight shooter who served as a corpsman for several years before becoming a physician assistant. He excelled in the job and eventually took over as officer in charge of a clinic that served the Navy’s amphibian forces inhabiting Southern California. His cohort in crime was another ambitious PA named Jessie Gross, a former SEAL corpsman who served with the West Coast SEAL Teams. His early career took him all across the South Pacific, and it was several years before he decided on making medicine his primary occupation. As a medical officer assigned to BUD/S, he spent countless hours with the orthopedic department at Balboa and eventually became one of the navy’s top experts in sports medicine before moving on to be Dave’s right-hand man.

I checked aboard the clinic early one Monday morning, anxious to get started. My first stop of the day was a meeting with Dave and Jessie in Dave’s office.

After a few minutes of small talk, Dave dove right in. “Mark, you’ve accomplished a great deal with the SEAL Teams, but unfortunately none of that matters too much with navy medicine.” I had a feeling this was going to be the tone of the conversation.

“Don’t take it wrong, Mark,” Jessie continued. “As a new PA, you need to continually build your medical knowledge, and to be competitive that means completing a specialty, and that means an advanced degree.” Both men smiled as I absorbed the news.

Great, more school, just what I needed. I knew they were right, though. If I was going to succeed as a Medical Service Corps officer, I needed to complete a master’s degree in a specialty that was useful to the navy. “I’m tracking; the best PAs have graduate degrees, but am I going to have the time to pursue one?” I asked.

“We’ll work that out for you. Do you have any preferences for a specialty?” Dave asked.

“I think I would like to try something new. I’ve had plenty of trauma and emergency medicine in my career, but nothing really jumps out at me right now.”

“Fair enough. We’ll get you some face time with the different departments and see what lights your fire,” said Jessie.

The mentoring session went on for over an hour as they laid out the plans for my new job and educational pursuits. Both Dave and Jessie would pick up some of my patient caseload, allowing me to split time between the clinic and the hospital. This would ensure I had an opportunity to obtain a specialty. We talked about everything from ENT to orthopedics and eventually wrapped the meeting around lunchtime, allowing me to finish the check-in process. The following day, they sent me off to the hospital to meet with the different departments, to see if a particular specialty would spark my passion and interest.

Navy physicians are generally very supportive of medical providers furthering their academic and professional development, especially those with years of experience. Early in my career I worked with Dr. Larry Garsha at the SEAL compound in Virginia. Dr. Garsha was one of the most encouraging doctors I ever met. In addition to being a Navy Undersea Medicine doctor trained in nuclear and diving medicine, he held board certifications in internal medicine, neurology, and psychiatry. His real specialties, however, were humility and inspiration. Unlike the occasional doctor who’d spend his time at an expeditionary command trying to convince himself and those around him that he was a steely-eyed warfighter, Larry embraced his role as a supporting cast member and mentor to young corpsmen. From the moment I met him he had the “what can I do for you” attitude, and it was his influence and mentorship that steered me exactly where I needed to go.

*   *   *

Frank Carlson ran the medicine department at Balboa Hospital. He was a senior provider who enjoyed fine dining, wine, and complex medicine. We had met years before, when I was a young student rotating through his department. Back then we would talk about overseas deployments and two areas in operational medicine that intrigued me the most: infectious disease and chemical warfare. I was still fascinated by both, and in order to master those particular areas, I needed to build a strong foundation. That morning, I sat with Frank and pleaded my case to specialize in internal medicine. The consummate teacher, he arranged for me to join the staff on alternating days between the Medicine Clinic and the Branch Clinic with Dave and Jessie. Once again, I was encouraged to succeed by a caring expert who simply wanted to help a young medical provider master his craft. Four hours into the second day, I had chosen my specialty.

Later that day, I returned to Coronado and met with Jessie and Dave.

“You’ve got to be kidding me, Mark! A flea!” Jessie said. “You’re going to be a flea.” The term is jokingly used around hospitals to describe internists. The idea is that fleas travel in packs and are always the last ones to leave the body, but I only found the first part to be true. Internal medicine is a humbling practice due to the complexities of the patients these doctors manage day in and day out. The constant consultation with their colleagues only reinforces their devotion to providing the best care possible, so the term “flea” never bothered me. In fact, I kind of embraced it.

“Yep, I’m going to work toward being a flea. At least for the interim. Who knows what could happen next?”

I plowed into my studies at the same pace at which I attacked PA school and completed a majority of my academic requirements in six months, leaving just under a year on the wards to finish my clinical time. I was really looking forward to a break and promised myself no academics for at least two years—but I’ve never done very well living within the confines of absolutes.

PA INSTRUCTOR

One morning I was packing my gear and heading out to spend the second half of the day at the hospital. Jessie knocked and stuck his head in the door. “Mark, can I see you for a second?”

“Sure, come on in. What’s up?”

Jessie entered and closed the door behind him. “As you know, Dave’s leaving, and as it turns out, I’ll be taking over the clinic.” I interrupted him with well-deserved congratulations and a few humorous comments about the great crew we had working there, but he held up a hand, stifling a laugh.

“Yes, I know, the crew is awesome and you’re the king of awesomeness. Now let me continue so you can get out of here. I need a primary preceptor for the PA students rotating through family medicine here at the clinic, and you’re my number-one choice. It shouldn’t be too much of a workload since you already help teach at the clinic and the internal medicine department. I simply won’t have time with all of my new duties.” Jessie crossed his arms and leaned back on the door frame while I absorbed the request.

My gut reaction was to stick with my promise: no academics. However, I always learned a great deal about a subject when I taught it to others, and I really enjoyed teaching medicine; it gave me a chance to give back in a way that would make Mom proud. Besides, I owed it to both Jessie and Dave, two committed medical officers who worked hard to build the program and took special efforts to ensure my success.

“If I say yes, can I have Fridays off?” I smiled.

“Hell no, but I’ll give you one Friday a month so you can attend the student presentations at the schoolhouse.”

“Well, that’s better than nothing. I’ll do it.” We shook hands roughly, the team guy way.

“I knew you would. Thanks, Mark. Now get out of here.” He slapped my back as I headed off to the hospital, a newly minted instructor.

I had no idea how profoundly the teaching position would change my life.

KORRINA

Six months into the teaching assignment, my instructor duties had been expanded and I’d been reassigned to a brand-new medical clinic at Marine Corps Air Station Miramar. Despite my new location, I continued to divide my time between the clinic and the hospital and greatly enjoyed the duty. Each student had his or her own personality, and I marveled at how each one’s passion for medicine and personal character would positively impact navy medicine. It was also the time I met my future wife.

Korrina was a beautiful and incredibly smart woman and single parent who was juggling the pressures of PA school while dealing with the stress of being separated from her child. She had split amicably with her husband years before and felt it best that her son stay with him while she focused on PA school. It seemed reasonable at the time, but the guilt was a major distraction and added to the difficulty of an already brutal academic course. Her only consolation was that her ex-husband was a good father and empathetic to her struggles. Following the divorce, she found herself in an abusive relationship, and the breakup that ensued only further complicated her already stressful life, but no one would have been the wiser. Korrina’s grades were always at the top of the class, and her ability to reach her patients was remarkable. She was a survivor in every sense of the word, yet she still couldn’t shake the weight she carried upon her shoulders; instead she reverted to doing what she knew best, and that was how to shield others. Over the weeks that we worked together we’d share stories about the difficulties of being a parent away from your child and began building a bond based on mutual empathy. Months later she graduated PA school, and while her class awaited orders to their first command, we began to date.

I read somewhere that “true love comes quietly, without banners or flashing lights,” and that was certainly the case for Korrina and me. What started out as a simple friendship quickly grew into a trusting relationship that had us spending countless hours talking about the struggles we shared being military parents separated from our children. I learned how devoted she was as a parent, which in turn made me a better one, too. I also learned how to listen to what she was really trying to say, and I began to realize how much I adored this woman.

For the first time in my life, I felt truly complete. My career was on the fast track; I had recovered from my financial difficulties and had found someone who loved and wanted me as much as I did her. Yet she had pending orders to Virginia, and we knew our lives would once again change. Rather than break up, we believed we could survive the distance if for no other reason than because neither one needed anything from the other. Our relationship was based on our desire to be together as friends, then lovers, so a mutual trust existed like never before. Years later, I would ask Korrina to marry me, and when I told my mother of our engagement she answered with her typical words of wisdom. “Marky, I am glad you are marrying someone you like. Fondness is much stronger than passion. You’ll find as you go through your lives together, love, like memories, will continually fade and resurface, but your friendship will be the one constant that will hold the marriage together.”

9/11

I have always been an early riser due to the military lifestyle. I’d rise at 0500 in order to get a run in by the navy’s 0700 start. In September 2001, I lived a short six blocks from Balboa Park and had access to some of the best running trails in the city. I took full advantage of all of them, including on the Tuesday that changed the world as we knew it.

I returned from my morning run and opened the living room curtains and gazed out toward the San Diego airport and the bay just south of it. I followed my morning routine of calisthenics and postrun stretch while watching the morning shows, primarily for traffic and news. I was scheduled at the hospital and planned to take a leisurely bike ride through the park to get there. It was the first day for a new PA student at the internal medicine clinic, and I looked forward to introducing him or her to the staff. I’d been away from the teams for several years and had become fully immersed in the medical community and nearly forgotten about the life I’d left behind.

Just as the television glowed to life, the phone rang, indicating something was wrong. No one called that early unless it was a wrong number or bad news. Caller ID indicated the cell phone number of my close friend and fellow Medical Service Corps officer Jeff Oman. Odd, I thought. Maybe there’d been a change in my schedule and I was needed at Miramar?

“Morning, Jeff. What’s up?”

“Are you watching the news? If not, I think you need to turn it on,” he said in his typical low mumble. Jeff was the administration officer for the clinic; he didn’t particularly like the job, but there were a lot worse places to be stationed while he waited for a medical planner billet to open up with the marines.

“I just turned it on. What should I be looking for?” I asked, walking back into the living room to see what I was supposed to be looking for.

“A plane hit the World Trade Center.”

He kept talking, but my eyes were fixated on CNN’s special report. I turned up the volume to learn more. Just then the second plane hit the South Tower. “OK, that’s not a coincidence,” I said.

“Damn right,” Jeff replied. “I don’t think this will change too much for us, but your buddies across the bay are going to be real busy. I’ve got to get to work. If I find out anything I’ll page you.” I continued staring at the TV as I hung up the phone, trying to put it all together. Jeff was right; the SEALs on Coronado would soon be very busy.

Like everyone else on 9/11 I had a thousand thoughts going through my mind. I mentally went over the steps that I knew were going on in the military headquarters in Tampa. I sat and listened for several minutes, fully convinced we knew who was behind the attacks. They had tried to destroy the Twin Towers in 1993 and were known terrorists to the intelligence agencies. It was just a matter of time before we identified them and took action to prevent further attacks. It was inevitable that my life would once again abruptly change; it was just a matter of when.