The Navy is not a natural pick for service in Afghanistan because Afghanistan is a land-locked nation, one which would be lucky to have a lake much less an ocean.  But Afghanistan has been a very big job and for many years the Army has needed extra bodies to help with it, so over this time in both Iraq and Afg they have been graciously “inviting” us Navy swabbies to come in and assist.  Those people assisting are called “Individual Augmentees.” Have I ever heard of Army guys “augmenting” the Navy? Nooo….  Anyway, I digress.

Naval Individual Augmentee Combat Training exists for us Navy IA types to get familiarized with Army terms, protocols, weapons, tactics, and platforms.  The NIACT course is conducted at Camp McCrady, South Carolina, just adjacent to Fort Jackson, which is an enormous Army base where ~1,000  recruits are trained each week.  Below is a picture of a lo-ong line (large majority of it not included in photo) of recruits going on a ~10 mile march (or “hump”) with their #30 lb backpacks, in the rain, in 35 degree weather.  In short, that’s why we joined the Navy, right?

Privates on a March

The weather here has been cold-ish, from 15 degrees to mid 40’s, the facilities have been excellent and our accommodations have been a little spartan but actually just fine.  Personally I’ve been lucky –even though I’m only an “O-5” or “Commander” I was put into an “O-6’s” (“Captain’s”) berthing.  Almost all of the other guys and non-guys (the wo-men) are in barracks but lucky me I’ve a room to myself, a desk, a locker and a fridge: Sometimes you win, sometimes you don’t.  (Fiona and Maeve, you can see that my little travel buddies, Ming-ming and Skinny Bear, found the bed first.)


NIACT has been a fabulous course of training.  Whereas San Diego (NMPS: Naval Mobilization Processing Station) was all of the administrative and in-processing concerns we needed to deal with, and NEMTI (in Camp Pendleton) was focused exclusively on the medical preparation specific to our upcoming mission, these weeks here have been dedicated entirely toward weapons and tactics and components of Army combat training.

Every day we’ve had early mornings and late evenings, with specific and detailed instruction on pistols, rifles, radios, IED’s, convoy execution, urban assault tactics, Afghan cultural awareness, green-on-blue awareness, forward operating base security, machine gun familiarization… and every step of every one of those subjects has been monitored and directed by a cadre of  outstanding Army Drill Instructors. They have not been as hard on us as they would on recruits; they say they like having us medical companies because since we’re pretty rank-heavy we already know how to do basic things like tie our own shoes, sit politely in rows, and the like; in return they have not had to stomp and holler as they might do with the recruits.  Below is a picture of one of our favorite DI’s (we have a bunch of favorites):

Drill Sergeant

I can’t say enough great things about our DI’s:  These Drill Instructor men and women are up even before we are and they go home after we finish every day, they’ve been absolutely solidly professional and cordial, and they have been completely dedicated toward making our group –most of whom have had none or only limited training with weapons– safe enough to carry them and competent enough to use them, should the need ever arise. As a result of their training we all feel a lot less vulnerable and a lot more capable with respect to where we are headed, and we are most grateful for this training.

On arrival we got issued a shit-ton of gear in addition to a 9mm pistol and an M-4 semi-automatic rifle. The first efforts of the NIACT course were primarily dedicated toward things like muzzle awareness, safety procedures, and expunging any bad habits with respect to weapons handling.  Although if you intentionally or accidentally launch an M-4 rifle’s high velocity round it travels thousands of meters before it runs out of steam,  to me the pistol seems to be much more dangerous to carry about: the M-4 is big and it’s easy to keep track of, but the pistol is small and it is phenomenally easy to flex your wrist or elbow and point that muzzle somewhere it ought not to point.  It has taken concentrated practice underneath deliberate oversight in order to learn how maintain it safely at all times and every circumstance.

At first we just carried around blanks in our magazines, with stern admonitions that accidentally firing off a blank is still viewed in the gravest of terms, one for which the perp and the entire class as well as our instructors all suffer.  Once we got to the firing ranges we exchanged our blanks for real bullets:  It was a sickening feeling for me to have real bullets in real guns.  Having treated so many people after their gunshots, it was daunting potentially to be on the front end of such a process.  One regrettable mistake and… you can’t go get that bullet back after it leaves the muzzle.  Cannot reclaim it.  It’s long gone, off to put a hole into whatever it can find. Now multiply that times x100 because that’s how many of us were in the class.

Pistol Range

Range days have been awesome.  Up at 0430, home at 2030, and loading into busses wearing all #40 lbs of our “battle-rattle” (kevlar helmet; huge bullet-proof vests; elbow and knee pads; eye and ear protection; etc), and firing guns all day.  The weather was typically 35-40 degrees and rainy, but you cannot let that bother you. One must “soldier on.”

Rifle Range

I didn’t think it was going to be as exciting at the range as it was.  I was certainly anxious about being there: with 100 people firing in total several thousand rounds of ammo all day, chances for problems -serious problems-  exist. But with weeks of stern and serious preparation performed up front, simulations executed in advance of the real thing, hawk-like oversight by the many “Rizzos” (Range Safety Officers) and with an extremely well controlled series of instructions and movements, things proceeded very smoothly, and to date, no one has accidentally shot nobody.

We have had a lot of other training as well, such as on how to plan and execute a convoy; or the basic principles of engaging in urban combat.  That particular class has had me thinking and thinking of the Battles of Fallujah and Ramadi and the fights in Baghdad in Iraq, and of all the innumerable similar missions throughout Afghanistan all these years, and it has made me admire those who went through these events even more than I already did.

Urban Combat

We also went through the “rollover” simulators: massive setups where all dressed in our #40lbs of armor we climbed into the frames of the military vehicles and they simulated rollovers by spinning us around like in a washing machine.  We’d end up upside down or sideways and have to exit the vehicles and post for post-rollover security.  May sounds easy but wasn’t.  And the simulation could only be a fraction of the experience of the real thing.

MRAP Rollover

So far  as well we have also learned some infantry fundamentals, Improvised Explosive Device fundamentals, and a few other things. All of these combat lessons I hopefully won’t ever require to develop further or express in reality, us being posted into a hospital and without any intention of leaving it; but, although we are many leagues away from being a Ranger or a Sniper or any other Infantry profession, it has been extremely comforting to be getting exposed to these elements, it will help us work with our Army colleagues,  as well as help us better empathize with our patient population.

At the moment we are on a 24 hr liberty (rare), and so last night our Neurosurgeon, our Chaplain, and I went into town to a Brazilian BBQ restaurant.  (Unbelievable food and heart-smart.  Wait, not so much “heart-smart.”)  While we were talking over a steak, beef, salmon, chicken, and pork dinner, an interesting concept came up:  At what point does one stop being a physician or a chaplain first / a military officer second, and convert into being a military officer first who happens to be a physician or a chaplain?  Where, when, and how does that transformation occur?  We decided we didn’t know for certain, but agreed that the transformation absolutely does happen. I for one think it’s when either we move our families overseas, or when we deploy.  At such points the person and their family really understand that the one profession has overtaken the other.  Why does it happen?  Because you identify with the mission and with the troops who will be carrying it out.  Nothing helps you identify like walking a mile in their moccasins.

I suppose I am proud of the fact that of my entire medical school class only one other person was on a military scholarship, and I’m not sure but I don’t think she is still in the Navy.  There weren’t any military students in the year above or below me, either.  I guess it is proud of being crazy, right?  But nevertheless, as the the world’s most famous sailor “Popeye” used to say, “I yam what I yam.”