Medical Monday: Preparing our Corpsmen for Combat-Related Stress

By Dr. Jerry Larson, Ph.D., Chief Scientist for Behavioral Health, Behavioral Science and Epidemiology Department, Naval Health Research Center, San Diego.

Most of us have preconceptions of service members in various military occupations. A Marine infantryman, much like the emblematic “devil dog”, fights with courage and ferocity. Navy medical staff are perceived to have all the tools at their disposal to treat wounded Marines and sailors and keep them in the fight while remaining stoic.

While there is truth is these views, it’s not that simple.

In Iraq and Afghanistan, where traditional battle lines no longer exist, Navy medical staff increasingly find themselves in harm’s way and must be prepared at a moment’s notice switch from being a “Doc” to being a rifleman. Casualty figures bear this out – numerous corpsmen have been killed in action during the current wars. Moreover, surveys of sailors deployed in Iraq indicate that at the height of Operation Iraqi Freedom in 2007, corpsman were exposed to more intense combat than any other Navy component.

Cover of "The Docs," a graphic novel produced by the Navy Health Research Center. Photo courtesy of Navy Health Research Center

At the Naval Health Research Center, I and my colleagues have worked to develop training and educational materials that mitigate combat stress in warfighters. As we came to realize that “warfighter” is an increasingly common role for expeditionary corpsmen, we saw the need to deliver information that would help psychologically prepare this community for active combat and the many other stressors encountered during war. But how to best deliver this information to corpsmen who, like many of us, may feel that training is already excessive and burdensome?

Where and when the “A-ha!” moment occurred is a faded memory. But our breakthrough was the realization that a graphic novel could effectively deliver our message. Graphic novels tell stories through use of sequential art in a traditional comic format, but have a “beginning, middle, and end” like traditional text novels. This format was chosen specifically for its appeal to the targeted age group and its value in providing thought-provoking content for discussion in training scenarios.

With my colleague Dr. Heidi Kraft and excellent contract support for artwork and additional writing, I embarked on what seemed like an odd journey for a career scientist – creating fictional characters that train, fight, are injured, heal, and ultimately find ways to remain resilient. In retrospect, what an endeavor it is to write a novel! It helped that from the beginning, my co-authors and I knew of specific topics we had to address if were to succeed in portraying the battle-front challenges of Corpsmen.

Delivering medical assistance was an obvious scenario. But performing triage, and second guessing one’s life-and-death triage decisions, was an example of an added stressor that can haunt a Corpsman if not placed in proper psychological context. Battle-front emergencies require decisions, and the failure to decide can be the worst of all outcomes. Also, our fictional Corpsmen are, by design, constantly vigilant regarding the psychological health of their Marines. Because of the trust and respect that Marines have for “Devil Docs”, we felt that Corpsmen should be explicitly aware of their roles as potential psychological first responders in times of crisis, or as sympathetic listeners during down time.

“The Docs” is a graphic novel produced by the Navy Health Research Center that follows four expeditionary Navy Corpsmen, Petty Officers from both active duty and reserve components, who are deployed with Marine and Seabee combat units.  The story watches them manage emotionally impactful events and combat stress emergencies, home front issues, and even boredom.  In addition, they face the stigma of seeking mental health care in their patients and in themselves, and learn of their need to care for one another.

It was a privilege to work on the graphic novel, and to be afforded an opportunity to help our corpsman during a time of war.

Click here to download or read “The Docs” online. Plans are underway to animate the story for viewing on portable phones and computers. Navy and Marine Corps personnel can order a free copy by visiting the Marine Corps Combat and Operational Stress Control site.

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