August 16th, 2013
FOB Freedom, Fort McCoy, WI

[Note:  All patients mentioned here turned out to have no suicidal intent.  All are now safe and have had appropriate counseling.]

About 2200 I had updated my briefing slides for the next day’s command brief in the CP tent and headed back to the Aid Station, thinking I would shower and hit the rack.  Might even get 6.5 hours of sleep which would be nice.  One of my medics told me LTC T (Deputy Brigade Commander or DCO) was looking for me, so I went to his office in the TOC. He was there with COL S (Brigade Commander) and asked me to shut the door.

A soldier in the brigade had expressed possible suicidal intent and they wanted me to look into it. Roger.  That’s part of my job.  I met with a 2LT from S1 who gave me the soldier’s name and I was surprised that it was someone I know.  Back at the Aid Station, my NCOIC tells me that the BH (behavioral health) patient is being transported from another FOB, which confused me, as the one I know is on my FOB.  The exercise has a dwindling number of medical providers and I am now covering several FOBs.  It turned out that I had two patients who where potentially suicidal.  Fun stuff.

Then there was an explosion.  And gunfire. And a wailing siren. The FOB was under attack.  Oh boy! I ignore the attack and continue doing my job.  I can get away with that as I am providing real world medical support for the exercise, which takes precedence over exercise play.

So I find out the first BH patient doesn’t want to talk to me, but will talk to a female BH tech, so that process starts.  In the interim the other BH patient arrives and it turns out that he has chest pain for a week (!), starting when he received disturbing news from home about the health of a child.  He is devastated, but not suicidal. About thirty minutes dealing with that and making the difficult call that the chest pain is likely not cardiac and he can wait until morning before getting an EKG and seeing a counselor.

Back to the TOC to update the Cdr and DCO and while I’m talking to them I get a call that a soldier on another FOB is having an allergic reaction and his throat is swelling shut. Badness.  I tell them to hit the kid with an EpiPen and transport to the ER.

Back to the aid station with gunfire and explosions still going off to deal with BH patient #1 and I find that another of my soldiers is there being treated for nausea and vomiting.  I speak with the BH tech, the Cdr, the Chaplain, and the Staff Judge Advocate and we come up with a plan for BH #1 that keeps her on the FOB, but we have a close watch on her and a follow up plan for the morning.

It’s now about 0100, and I’m told that we have another patient inbound from another FOB who has severe abdominal pain.  She arrives as we get the All Clear for the attack on the FOB.  We’ve now finished treating Nausea and Vomiting and she is on her way out the door to her tent.  I quickly find that Abdominal Pain is a suspected appendicitis and we call 911 for transport to local ER.  My second ER evac of the night.

I get to my bunk about 0200 and I need to be up at 0515 so I can start Sick Call at 0600.

I desperately need coffee this morning.