In addition to teaching at the residency program and seeing patients, I serve on the Army medical evaluation board for the Pacific. I determine if Soldiers' medical problems prevent them continued service and make recommendations on whether or not Soldiers should be discharged from the military and transitioned to Veterans' Affairs.
  1. I should also point out that most Soldiers whose cases I handle are happy to end their military service.
  2. They've served honorably and made immeasurable sacrifices. They just physically, or mentally, can't do it anymore and still have too much time on their contracts to realistically serve out.
  3. The medical evaluation board process ensures that Soldiers are getting taken care of physically and mentally, have gotten the treatment they deserve, and then pushes the case to the next level, where compensation and pay get determined.
  4. The military and/or the VA continue to care for these issues for the remainder of these Soldiers' lives. It's the least we can do.
  5. Here are the most common career ending diagnoses:
  6. Low back pain; accounts for probably half of the cases I see. Caused by a variety of things: bulging discs, pinched nerves, muscular pain, and more.
    Back pain almost always gets better with physical therapy, but tends to not work if the patient is convinced they're not going to get better (true of most back pain, even in the civilian world). Most try physical therapy, acupuncture, massage, injections, chiropractic, OMT, surgery, and more. If the Soldier's pain doesn't improve enough to to allow them to do their job, I recommend separation from the Army.
  7. Knee problems
    The Army asks people to run, jump (sometimes out of airplanes), carry 80 pounds of body armor, gear and equipment on their back, and carry heavy rifles too. Eliminate that aspect and you still have a job that tells people to be gym rats to keep their job, makes them learn hand to hand combatives, dig trenches, etc (yes, I've dug trenches as a doc). Example: I injured my knee carrying a 180 lb casualty to safety. Luckily I'm okay, but I did tear my cartilage and it aches quite a bit.
  8. Neck pain
    Along the same lines as low back pain. Imagine spending an entire year in a war zone with a heavy armored helmet on, hunched slightly forward because you're carrying 80 lbs of gear on your back, sitting in a packed tight in a HMMWV ("Humvee" in English), sleeping in strange semi upright contorted positions for days on end. Not to mention getting thrown from an IED blast, even when you're 50 feet away. This happens A LOT.
  9. Shoulder issues
    I see a lot of shoulder injuries too, mostly rotator cuff tendonitis and labral tears. Most occur at the gym while weightlifting, but they also occur from wearing body armor on multiple deployments for about 12 months each time (some of the Soldiers I see have been to Iraq and/or Afghanistan three or more times, not to mention other smaller missions to other countries).
  10. PTSD
    Though PTSD is fairly prevalent (we have been at war for nearly 15 years), it is pretty uncommon to have it so severely that it isn't manageable with therapy or medications. I see a lot of Soldiers who have PTSD and are doing incredibly well. Still, there are those that have been unable to heal enough from their invisible wounds such that a career in the military no longer remains a safe or healthy option for them.