Brad Kinney MD. UMOC 109. 14-10-DMO. January-June 2014.
NUMI WEEK ONE
Today is Monday, the beginning of the second week of the Undersea Medical Officer Candidate Course, Class 109. This course is designed to train US Navy Medical Corp Officers (Medical Doctors) to treat USN Divers and Submariners and is divided into three phases. The first phase is held in Groton, CT at Submarine Base New London in the Naval Undersea Medical Institute (NUMI) and consists of daily brutal physical training (PT) sessions and various didactics. Day one was the typical military check in with the students running around to different locations having their check in sheets initialed and listening to multiple briefs from different groups on base. After a day of introductions, the class headed to the Grinder (gym) to have an afternoon break-in PT session which left everyone pretty wiped from sprints, suicides, lunges, squats, pushups, situps, crunches, flutter kicks, sun-gods, etc. We were informed that this was an “easy day,” which the class quickly adopted as a “hooyah! easy day!” for brutal PT sessions to follow.
Day two started promptly at 0500 with the Diver Physical Screening Test (PST), a screening test that must be passed to attend Dive School in Phase 2. It consists of a 500yd swim, max pushups, max situps, max pullups, and a 1.5 mile run all for times or reps with strict form and a regimented timeline. Having just PT’d hard twelve hours previously was likely an ingenious design to lower our PST scores so that there would be a significant improvement by the end of the six weeks, kudos to the instructors. All but five of the fourteen candidates met the requirements with most of those who failed only slightly missing the standards. Hooyah! Thinking we were awesome, none of us imagined a lengthy celebratory PT session directly following the PST in honor of our success. After morning PT, we marched back to NUMI in the sub-freezing weather developing ear frostnip and frozen sweat pants. It just so happened that our very first week of marching around base in early January in our UDT shorts and T-shirts with USN PT sweats over top was also the week that a frigid arctic storm descended upon the US plunging the temperatures to 10 degrees and below with a wind chill of 10-15 degrees. Anyways, a lot of mental roadblocks were obliterated that first week, and marching in sweats in sub-freezing weather really is not that bad.
Day three was “pool day” starting with a 1000 yard bay-fin, followed by more physical torture and creative water instruction. On day four, we found ourselves on the grinder with an upper body workout devised by some PT fiend. By Day five, another pool day, nothing brutal was really surprising us anymore until halfway through the pool workout when we did 200 4-count air squats without stopping, talk about another mental barrier again obliterated. So for the next six weeks, Monday/Wednesday/Friday will be pool days and Tuesday/Thursday will be on the grinder.
Morning PT was followed by multiple lectures in radiation basics and radiation health that will assist us in understanding the unique medical issues surrounding submariners in case we are assigned to a submarine billet. So week one is done, and week two has begun. More to come. Hooyah 109!
NUMI WEEK TWO
Ah yes, a three day weekend. My body needed this. Week two upped the ante on everything. Flutter kicks were with fins, sun gods (twirling your arms above your head, at your side, and in front of you) were while holding our fins, the reps were higher, and much more was required of us. On Wednesday, I felt like my body hit a wall, a feeling that was mirrored by most of the class and sensed by the instructors. Our motivation was not up to par, so the instructors went to work on us and quickly remedied our motivation. Whoever invented frog-hop burpees was a sadist, and two football fields later I was smoked, just in time for multiple 100 meter lunges spaced apart by backpedaling and jogging. Thursday started with a jog in formation down to the PT field. When one of the students messed up the running cadence we were ordered into road ranks (pushup position) while reciting Boyle’s law and singing the three stanzas of Anchors Aweigh as a class. Good thing we practiced together earlier that morning or we would have been there a lot longer. Then it was time for “Angie,” a Crossfit workout, that is typically 100 pullups, 100 pushups, 100 situps, and 100 air squats for time. But since we are UMOC 109, we each had the privilege of doing 109 reps of everything. Anecdotally, developing blood blisters underneath my calluses from the pullups was a first. Friday was pool day again starting with 1000 yard bay fin followed by lots of pool fun. An interesting addition to the routine was treading water as a class for extended periods varied by the instructors by having us hold our hands, elbows, and arms above the water. As much as it hurts during the morning workouts though, most of us later laugh and relish in the fact that we are getting paid to have an entire team of personal trainers dedicated to the honing of our physical conditioning. The more days go by, the more the instructors reveal that the workouts are designed for specific activities in dive school at which we must excel to succeed.
Friday was our Radiation Health test over the material that we had been learning for the last two weeks. Yes, we are all doctors, so the educational stuff should be a breeze, but not having thought of physics, algebra, logs and natural logs in many years, it took a little dusting off the cobwebs before we got into a groove. But thankfully, we all passed on Friday and avoided the Academic Review Board. We also learned a lot of cool information about submarines, nuclear propulsion and weapons, and general Navy saltiness that will help us in our future assignments.
Earlier today, I headed to the local theater to watch Lone Survivor. Years ago I began reading war biographies and descriptions of current conflicts as an attempt to understand what our deployed servicemembers are experiencing. It was my way of contributing while being stuck here in the states for endless medical training. When it was first published, I wept while reading Lone Survivor and learning about the single largest loss of life in the Naval Special Warfare (NSW) community up to that point. More recently, I read Marcus Luttrell’s second book Service: A Navy Seal at War that described his return to the teams and subsequent deployment. It just blew my mind that he returned to operating as a SEAL after sustaining a broken back and femur and multiple other injuries in addition to the psychological trauma of having suddenly lost so many of his close friends. He is and will always be one of my few heroes, so out of duty to Marcus and to the fallen of Operation Red Wings, I wanted to see this depiction of those events. Other than shocking asystole, altering a few events, and adding details for cinematic effect Hollywood seems to have nailed it. Again, I cried a few times knowing that the horror on the screen was reality.
In August 2011, this horrible event repeated itself when another helicopter full of NSW operators responding as a Quick Reaction Force was shot down. I had just finished my first week of a four week rotation in the Basic Underwater Demolition / SEAL (BUDS) Medical Department, which also happened to be “Hell Week” for one of the SEAL candidate classes there. We had been treating that class daily and ensuring they were medically able to continue training until they finished Hell Week on Friday. Over the weekend, we learned the horrible news. That experience intimately revealed the reality these men face, and the gravity of my job as a medical provider to them. I am so thankful that my family can “sleep safely in our beds because rough men stand ready in the night to visit violence on those who would harm us.” Amazingly, via this unique training I may have the opportunity to medically support these men. There’s a little glimpse into the “WHY” of Undersea Medicine. Hooyah 109!
NUMI WEEK THREE
It’s hard to believe we are halfway done with Phase One already. This week was a short week with the MLK holiday and then a “snow day” on Wednesday. Logistically, our class needs the gym, pool, and classrooms open with staff and instructors, so when the base shuts down or opens late, we get a snow day, something most of us have not experienced in years. On Friday, 109 passed another exam covering Radiation Control despite the shortened week. After the exam, a British exchange officer gave a very interesting lecture concerning submarine escape, a subject of renewed concern in the USN after the disaster with the Russian submarine Kursk in 2000. The week previous we toured the “Escape Trainer” on base, a 40 foot tower filled with water built in 2007 for training submariners to escape from a disabled submarine lying on the ocean floor. Submarines are equipped with “Steinke Hoods” and more recently with inflatable suits for the crew members to exit the sub through an escape hatch and shoot to the surface from depths greater than 600 feet. The newer suits offer thermal protection, buoyancy, air to reach the surface, a life raft, and the ability to reach the surface in less than a minute from incredible depths in a worse case scenario. Ideally, there would be enough time to rescue the crew with submersibles that dock with the submarine and then transport the crew to surface ships and decompression chambers if needed, but with a deteriorating and dangerous submarine environment the crew now has the ability and training to escape on their own.
Training is going as beautifully as ever. Thursday, due to the ridiculously low temperatures, the instructor staff elected to let us PT in the NUMI building instead of marching outside to the gym. To quote one of the chiefs, “It was a great day for Stairway to Heaven.” The “Stairway to Heaven” involves running to the top of three flights of stairs, performing one burpee, then running down a floor and performing one pushup, then running down a floor and performing one squat, then down to the ground floor for ten four-count flutter kicks. Then back up and increasing the reps to two, two, two, and twenty. We were to perform ten sets total, and halfway through we felt awesome, until we got up into the sixty four-count flutter kick range. Our last set was ten burpees, ten pushups, ten squats, and 100 four-count flutter kicks. The workout was not that bad except for the flutter kicks, which after 550 four-count flutters, our hip flexors were officially smoked. Friday was another pool day with a 1250 yard bay fin, sprints utilizing different strokes, various calisthenics, more water treading, and occasional instruction. In addition to improving our different swim strokes and fin, the instructors are preparing us for dive school by teaching us how to enter the water, surface correctly, perform underwater checks, and perform multiple other diver specific tasks.
One diver tradition is the “buddy system,” something that is practiced in many other professions as well. In the dive world though, things can go very badly very quickly, and the buddy system is a huge asset for mitigating these risks. During our training time, we are required to do everything together as a buddy team including entering the water, surfacing, swimming laps, calisthenics after our laps, filling our water bottles, and even going to the bathroom. Early in our training, the class was penalized steeply when two guys ran to the bathroom and another followed instead of grabbing his own buddy. We have not made that mistake again.
Another tradition that is as old as the military is the strict adherence to uniformity, especially in the training environment. From day one, we were required to do everything uniformly as a class. We are required to always have uniform sources of hydration with uniform labeling, which resulted in everyone carrying around twenty ounce Gatorade bottles with our last names written with a Sharpie in a semi-circle around the top of the G on the cap. We also wrapped athletic tape around our gear (fins, masks, snorkels, dive bags) in the same location and direction and initialed the tape uniformly. We wear the same uniform daily, and when PTing we wear the same ankle high white socks, black spandex, UDT shorts, white t-shirt with our names sharpie stenciled on the front and back. In the cold we wear the same Navy PT sweatshirt and sweatpants, watchcap, and black gloves. When we march we carry our gear in the same hand. When we take our sweats off to PT, we fold everything uniformly and place it all stacked in a line at the edge of the wall. At the pool we fold our booties in half and insert them into our fins, then stack our fins upright with the heel straps toward the wall, the mask wrapped around the top fin with the snorkel pinned to the fin under the mask with the J hook facing to the left, and our water bottle to the left of the stack of gear. One pool day, our gear wasn’t perfectly lined up against the wall, so while we stood at attention dripping wet after the previous evolution, the instructor staff began separating our gear and tossing all the individual pieces into the pool. We were then instructed to retrieve all the pieces as a class and have it all assembled and organized perfectly at the edge of the pool within sixty seconds, an impossible task. We went over our time by ninety seconds and paid dearly. Again, lesson learned. Despite the inconvenience to the individual, uniformity in the military is one of the military’s great strengths. In our class when squared away, everyone is on the same page, doing the same thing, at the same time, and not much has to be said to get something done.
Tomorrow is another PST, and all our scores should improve significantly compared to the first week. Hooyah 109! Week four, here we come.
NUMI WEEK FOUR
Most servicemen will understand the expression “Embrace the Suck,” especially those who have deployed or seen combat. Well, that expression could have been the motto for this week. Monday started with a PST, most passed, but curiously, some actually did worse. This may be due to the largely catabolic state that our bodies have been subjected to for the last month. Afterward, we again paid dearly for a variety of infractions. Tuesday and Wednesday were somewhat normal days, but Thursday we were once again in the suck. We started the morning with a brief pull-up pyramid of 5-4-3-2-1-2-3-4-5, and then for the workout of the day, we performed the “Murph” – a workout named after LT Michael Murphy, the Medal of Honor recipient and leader of the four man unit involved in the Operation Red Wings tragedy. The workout is performed for time and starts with a one mile run, 100 pullups (the instructor staff shortened to forty due to the previous pyramid), 200 pushups, 300 squats, and finishes with a mile run. This used to be one of LT Murphy’s favorite workouts which he performed while wearing his body armor, so we substituted a ten pound weight plate to carry with us throughout the workout. We then separated into dive buddies and began Murph. I was pretty motivated to honor one of my heroes, so my dive buddy and I pushed each other hard throughout the workout whenever the other was lagging behind. Then as a class, those who finished early all joined the last dive team to finish as a team. Hooyah 109! But then again, it was judgment time. The instructor staff “sensed” a lack of motivation in the class and felt we were not “putting out,” which mind-boggled me somewhat. So we again paid our dues. Friday was another pool day, and it was the general consensus that we were all physically smoked, which I believe the instructors realized near the end of the workout when they lightened up and allowed us to play an underwater version of rugby to finish out. At the end of pool day, one of the instructor’s stated that we are now done “building,” and will be switching gears into maintaining and preparing for dive school for the next two weeks.
Academically, we learned more about USN radiation administration issues including protocols, forms, etc. We then spent two days in the Navy Pride and Professionalism course that everyone completes at a new command. On Friday, after the workout, we each presented a medical case scenario to the class for critique that we had prepared for use in the Independent Duty Corpsman (IDC) curriculum. IDCs play a unique and crucial role in the USN, working on subs, surface ships, and with NSW as nearly independent medical practitioners. They are senior enlisted Corpsman who undergo an intense year long school that prepares them to practice under the medical supervision of a UMO. So as UMO candidates, helping develop and expand the IDC curriculum is actually beneficial to our future as well since we will be overseeing and working closely with the IDCs. It was also refreshing to see everyone in their element again expounding upon medical things, since we are really medical doctors.
Each blog I try to relate something unique about our little world that others might find interesting, so this week it is the “mustache.” As 1970s and ugly as mustaches are, they are the “in” thing in the dive world and dive school. So, through intense peer pressure, all of the “UMOCers” are now sporting mustaches except for the one female candidate, we are still working on her. When I first broached the subject to my wife, I was threatened with all sorts of barbaric deeds and briberies, but she finally submitted, and commented the other day that it was actually growing on her slightly. We still have to keep it groomed and within USN standards, but it is the one patch of facial hair that we are allowed, so we are maximizing it.
Another tradition is watching submarine and dive movies together as a class. We finished Das Boot over the course of several sittings during the week when we had spare time, next is The Hunt for Red October. One of our classmates is a former sub officer and a talker, so we also got to listen to his running commentary which was almost as interesting as the script. He has also provided incredible insight into the submarine world over the last month as he contributes bytes of information to the lectures and shares sea stories during our breaks. Here we come week five. Hooyah 109!
NUMI WEEK FIVE
True to their word, the UMOC instructors were a little kinder during PT this week, though they did reveal a new standard that none of us knew about – a three mile run in 24 minutes. An eight minute mile is not a fast pace by any stretch of imagination, but holding that pace for three miles does require some training and preparation. Because of the cold weather and nearly constant blanket of snow, 109 has not run much at all other than a few warmup laps on the indoor track and the 1.5 miles for our PSTs. On Tuesday, the class gazelles crushed the 24 minute benchmark but some did not, so an interval session was on the menu for Thursday to help the slower runners improve. One of the negatives of the winter UMO class is that we do not get to do much running compared to the summer class, but we get snow days, haha.
Once accepted to the the UMOC program around Christmas halfway through internship, we request either the summer class that starts the following July, or the winter class that starts in January a year later. When internship ends in June, the July class has a few weeks to move their household before reporting, but the January class begins a six month “stash” where each former intern is “stashed” at a nearby USN medical facility doing doctor things (usually primary care). Some in the winter class also get to attend a month long Military Tropical Medicine Course in July hosted at Walter Reed in Bethesda, MD, which was awesome. Then a portion of the class practiced a few weeks of true tropical medicine in areas of Africa and South America for a followup field session to the previous month of didactics. There are other differences between the classes mostly due to the weather including a different emphasis on running versus calisthenics as mentioned above, and a different ratio of outdoor versus indoor training. But otherwise, the classes are very similar, so the decision between the summer and winter class is usually made for logistical or family reasons.
On Friday, all but one of us passed the PST – a requirement to attend dive school in Panama City starting the next week. We followed this with 160 eight-count bodybuilders (a modified burpee), which was somewhat exhausting after maxing out on the PST. One of the tools of the instructor staff has been punitive eight-count bodybuilders. Whenever someone messes up or violates an established rule, the instructors assign an appropriate number of eight-counts, generally ranging from ten to forty at a time. We keep track of our accumulating eight-counts, and then we usually pay them off Friday afternoon before leaving for the weekend. Thankfully, we get to pay them off at our own pace as a class with an instructor proctor, so our breaks between sets are a generally longer than allowed during official PT. As painful as it was, it was nice to get our eight-count debt back to zero.
Well, tomorrow begins the last week of phase one. Crazy! Hooyah 109!
NUMI WEEK SIX
During week six, we finally started reaping the benefits of our hard work. Monday was the last pool day and also the first time that everyone beat the 22 minute requirement for the bay fin. The instructors also kindly ended the workout early enough for us to hang out on the pool deck as a class and take pictures while enjoying the respite. On Tuesday, surprisingly we smoked the three mile run as a class with the last man finishing a good twenty seconds before the 24 minute allotted time. This was probably the most Hooyah moment of phase one due to the vast improvement over the week previous, and it also meant that we did not have to repeat the run on Thursday. On Wednesday, we all passed the PST again for the last time except for one student, the final requirement to be cleared for dive school. Wednesday night, we all had a class party at a local house celebrating the end of phase one and the transition to Florida for dive school. Thursday was our last snow day as the Northeast got slammed again from the Polar Vortex that has been hovering over the US and wreaking havoc for the last few weeks.
Academically, during the last two weeks of phase one, we began learning the most important practical information for a UMO – physicals. As UMOs, it is vitally important that we screen personnel and only allow those who are physically, mentally, and medically fit for submarine or dive duty to get onto a submarine or dive. In the dive world, things can go very badly very quickly at depth, so there is an intensive screening process involved with multiple steps along the way to filter out those who may have problems in one of the most austere environments on earth. Likewise, submarines are also austere environments with limited resources and often delayed access to further medical intervention due to operational issues or remote locations. Often, IDCs have to “sit on” a patient (supportive management) in a submarine for days when the patient would usually get more advanced medical care immediately in any other environment. This consumes resources and occupies much of the IDC’s time when he has a plethora of other responsibilities. Also, a MEDEVAC could jeopardize an operation or the safety of the entire crew. So, generally only very healthy individuals are allowed into the undersea community to avoid these dangerous scenarios. Therefore, the UMO is responsible for safeguarding the medical readiness of the undersea community which ultimately advances the warfighting capabilities of the Navy.
On Wednesday, we had one of the coolest experiences of phase one, we toured the USS Missouri (SSN-780) – one of the Navy’s newest Virginia-class attack submarines. Without going into detail, it had some of the coolest and most technologically advanced systems I have ever seen. We were required to read Blind Man’s Bluff, a book detailing many incredible feats of USN submarines after World War Two during the Cold War. This book introduced me to the “Silent Service” and gave a me a profound respect for their heroism and amazing accomplishments. After reading this book, and then touring one of most quiet and lethal weapons of the deep, again, I was truly impressed by the dedication of some of our most under appreciated yet hardest working American servicemen.
On Friday, we officially finished phase one, and began meandering down to Panama City, Florida in caravans of cars and on airplanes, ready to begin dive school. Hooyah 109! Hooyah.