Undersea Medical Officer Course


Well, I spoke too soon. Monday of week five started early with a “Death March,” with the terminology having now evolved to “Death Run” for a more accurate representation. We were running with another class due to instructor manning issues and one of the other students committed a serious infraction during the sprint. So we were led to a remote concrete pad behind an old Navy building and subjected to calisthenics torture including eight-count bodybuilders and flutter kicks. Our lead instructor whose pace we are required to match in these Death Sprints did every rep with us though, and also led us in 100 four-count flutter kicks unbroken to prove the point that he will never require something of us that he himself cannot do. Again, another huge WIN for our training team. The rest of the week we performed more “Crossfitesque” workouts which most of us are loving.

Friday, after the typical morning workout, we were led by the instructor staff on a run to the “Back Forty” of the Navy base to “Thor’s Playground.” Thor’s Playground is a small patch of sand nestled in a small jungle of palm trees and underbrush with various objects for torture/exercise available for those so inclined. At Thor’s Playground, we organized into different groups and were instructed to somersault to one end of the playground, bear-crawl back, then sprint to the other end. We did the same thing again racing, except this time we were instructed to retrieve our class shirts from the back of the instructor’s truck that none of us had noticed until that moment, then perform the same evolution again with our new shirts before finishing. It was humorous watching our fellow classmates roll around in the sand clumsily like drunks after the somersaulting, and then awesome to see each other in the blue and gold having graduated from the white stenciled T-shirts. With the new blue and gold T-shirts also came a heightened level of responsibility and respect. Hooyah!


Week six and seven continued with more Crossfit and running workouts with the addition of new swimming workouts in the pool. On Friday of week seven, nearly the entire command performed the Training Officer Challenge, a nearly monthly event when warmer weather allowed. We divided into groups of four and pushed through the approximately five mile run while carrying one sandbag per team and performing various calisthenics at stations along the way. The fastest team finished with a time of 49 minutes, and most teams were done by 70 minutes. This was a blast because of the Hooyah! team aspect, but it was also brutal with nearly no rest during the entire high intensity hour long workout.

After morning PT, week five was spent in the classroom learning about decompression dives and all the various nuances involved. Previously when learning SCUBA, we planned every dive to be a no-decompression dive. No-decompression dives are shorter dives after which the diver can ascend straight to the surface at the established ascent rate of thirty feet per minute without stopping for decompression. Decompression dives are longer in duration and due to surpassing the “no-decompression” time limits, the diver must make decompression stops at various depths during the ascent to allow the dissolved inert gases to “off-gas.” Because water is much more dense than air, the pressure exerted on a diver increases rapidly as he descends in the water column, with as much pressure being exerted by every 33 feet of sea water as is exerted by the entire atmosphere. Due to this elevated ambient pressure underwater, gases (nitrogen, oxygen, etc.) dissolve into a diver’s tissues at much higher levels than seen on surface, and the deeper the diver goes the worse it gets – the more he “on-gases.” Also, the longer he is at depth, the more he on-gases until his tissues reach equilibrium. If that same diver were to ascend straight to the surface like a no-decompression dive, his tissues would become supersaturated due to the decreasing pressure and the dissolved inert gases would come out of solution and form bubbles in various tissues causing some variant of decompression illness – more commonly known as “The Bends.” But if that same diver ascends slowly making decompression stops along the way, his tissues would off-gas in a much more controlled fashion – thus avoiding the Bends, and all of the subsequent associated medical problems. Learning to perform decompression dives safely by following the Navy Dive Tables and the Dive Manual is vitally important for all Navy Divers since many missions require extended periods spent at depth.


Thursday and Friday of week five were spent orienting to the Mark 20, Mark 21, and KM-37 surface supplied diving systems. Surface supplied diving is much different from SCUBA in that your air is supplied by a hose from the surface, rather than from a tank on your back. This has enormous advantages for Navy Diving including a practically unlimited air supply and communications with the surface, but it does sacrifice the portability, maneuverability, and low maintenance of SCUBA. Surface Supplied diving, also referred to as “hard-hat diving,” is considered by most Navy Divers to be true Navy Diving.


On Monday of week six, adhering to the tried and true Navy “crawl, walk, run” method, we started surface supplied diving in the pool. After a few days of becoming accustomed to the new gear, operating the communications and console, and learning to perform in-water emergency procedures we moved to the Pier Side Support Building (PSSB) to begin diving in the bayou. We spent the rest of the week searching the murky bottom of Alligator Bayou for a “lost rifle” and performing “hose stretches” – their term for just diving the rig, walking it out, and returning.


On Monday and Tuesday of week seven, we headed out on the YDT for open water diving. A few miles offshore, the Captain found a flat spot of sand in about sixty feet of sea water for us to dive. Surface supplied diving off the YDT is similar to diving off the poolside or pier, except now with the addition of a stage – a large metal framed “elevator” operated by a crane that transports the divers up and down in the water column. Each dive team had a chance to dive, with the other classmates following the “Dive Bill” and performing all the other operations that are necessary for a successful surface supplied dive – comms, logs, console, tenders, wire man, etc.


We all dove the KM-37, a hard yellow helmet made of fiberglass, metal, and other materials weighing 28 pounds. The air hose and comms connect directly into the hat which has a built in regulator similar to a second stage SCUBA regulator. Each diver wore a single SCUBA tank on his back as an Emergency Gas Supply (EGS) in case the air supply from topside malfunctioned. We also wore wetsuits for thermal protection, and weighted boots that allowed us to walk on the ocean floor. After riding the stage down, setting on bottom, and exiting the stage, it was a phenomenal experience to move out onto the ocean floor – it looked and felt as if we were moonwalking in near zero-gravity. So our playful, experimental, and youthful traits emerged and gave way to handstands, cartwheels, ocean floor eight-count bodybuilders, and any other shenanigans that we could imagine. Walking on the ocean floor wearing the KM-37 was literally one of the coolest things I have ever done in my life, and unfortunately it had to end as we returned to the YDT. These dives concluded the actual diving portion of the nine week course, but it was a beautiful, sunny, and very fitting closing day as we basked in the warmth on the deck of the YDT during the return to NDSTC.


Wednesday and Thursday of week seven were spent in the classroom orienting to the Mark 25 and Mark 16 – rebreather rigs used by Naval Special Warfare and the Explosive Ordnance Disposal guys. Unfortunately, we only were able to familiarize ourselves with these rigs on the surface and did not have the chance to dive them – something that should change in future classes. On Friday, we started the hardcore medical portion of the course, the time that we as medical providers learn to operate as true DMOs and fill our niche in the dive community. Hooyah 14-10-DMO!



Weeks eight and nine continued with the same morning PT routine including running, swimming, and Crossfit style workouts. Our lead instructor had mentioned earlier in the course about potentially performing outside the box “fun” PTs, something that sounded interesting, but also mildly intimidating. On Thursday we showed up early and began PMSing our UDT vests (life preservers) and organizing our wetsuits, booties, fins, and goggles. When the instructor team arrived, we piled our gear into two Zodiacs and lined up in formation in our UDT shorts, blue and golds, and running shoes and then we headed off on a mile mile interval sprint into the “back forty” past Thor’s Playground and onto Ammo Pier. The support small boats were arriving at the pier via the water as we arrived by land. After retrieving and donning our gear, we all entered the water and began the one mile open water swim following our lead instructor back to NDSTC. As one of the mediocre to slower swimmer’s in the group, it was quite a bit of work to keep up with my dive buddy and the class. But if you are ever having difficulty smoothing out certain swim strokes in the pool, just go and swim a mile or two, you will figure it out.

On Monday of week nine, we did our typical show up at 0530, march to NDSTC, change out into our PT gear, line up on the grinder, and stretch in formation as we waited for the instructors. By this point, we had developed a method educatedly guessing the morning workout by watching for the number of instructors and what clothes they were wearing. When the entire instructor cadre emerged wearing running shorts and instructed us to load our med gear/backboard into the bed of a truck, we began suspecting bad things. When we noticed our lead instructor carrying a tube of lube that is generally used for checking rectal temperatures in hyperthermia, we feared the worse. Then we were off on a run that took us outside the front gate of the base and over the Hathaway Bridge connecting Panama City Beach to Panama City. Thankfully, it was only a six mile run at a not too strenuous pace that ended back at NDSTC. The last workout of Dive School was another two mile run and one mile swim evolution, which was a pretty cool way to go out.


Intellectually, weeks eight and nine included the training that would truly make us Dive Medical Officers. In the classroom, we sat through many more dive medicine lectures that really dove deep (pun intended) into the background, theory, diagnosis, and management of dive related illnesses. As doctors, we were back in our comfort zone, but unfortunately, we were finished with the diving of dive school. We became Navy Divers first, and then were molded into Dive Medical Officers. During these two weeks, the most informative and helpful training evolutions were the chamber shams. These were scenario based evolutions where one student enact a script and specific dive related injury, the other student would be the dive doc and attempt to diagnose and treat the illness appropriately. Often these resulted in the injured diver being taken into the chamber and pressed to depth on a specific dive table and for a specific time as prescribed by the dive doc. Since many of the dive diagnoses are tied intimately to the dive profiles and conditions experienced undersea, having trained as divers immersed in that environment assisted phenomenally in our competence as physicians. After more training, we all completed a final exam and the class passed in flying colors.

Having completed all of the dive and medical training, we graduated as a class, packed our gear and began the trek back to Groton, Connecticut for phase three of the UMO course. Hooyah 109! Hooyah 14-10-DMO!

%d bloggers like this: