Autumn 2006 AANGFS AFRFSA 1

Alliance of Air National Guard Flight Surgeons &

Air Force Reserve Flight Surgeons’ Association

Volume 18, Issue 2 Published by the AANGFS/AFRFSA and on website: www.aangfs.com Autumn 2006

In this issue

AFRFSA AMSUS Publisher Information

2

AANGFS President Col William Pond Flight Doc Qual Exam

3

Space, the Final Frontier Maj J.D. Polk

4

Headquarters Update Col Jim Collier

5

4th Air Force News Col Bruce Nelson Historical Pilot Attributes Col(ret) Phil Steeves

6

AFSO 21 Col G.L. Bondor 10th Air Force Col Thomas Walker

7

Deployments Col Jim Balserak

8

Ballistic Eyewear 9

22nd Air Force News Maj J.D. Polk Weaver Society LtCol John Kirk AFRFSA President LtCol Leah Brockway

10

Why We Fight Col Reid Muller Flight Surgeon Survey Maj Lisa Snyder

11

AMSUS AFRFSA Social Event Weapons Council State Air Surgeons

12

Sixty Years

This year the Air Force will celebrate 60 years as a separate armed service. It is likely that in 2007 my time in the uniform will end after almost 35 years, so I will have been around for over half of the USAF’s existence.

Change—transformation—abounds. AFSO 21, Lean Six Sigma, recapitalizing, you name it. The CSAF wants every airman to be AEF participa-tory and deploy-able—not the 85 % that are presently so qualified. Air Force personnel strength decreased over 16,000 this year and is projected to re-duce by another 40,000 by 2009! The USAF medical service is looking at a reduction of over 20,000 positions, and both the AFRC and ANG medics are experiencing losses of personnel.

Despite force reductions, our missions have increased. The ANG is the primary pro-vider for an EMEDS in the OIF AOR beginning January 2007, and as we know ANG medics are the sole provider of CERFP and HLS medical response at this point. Furthermore, the USAF medics and the ANG medics are looked upon as leaders in “lean” operations and Expeditionary force structure. I have been in briefings in front of the Air Force Council and proudly watched as the 4-stars and civilian leadership were briefed on our successes. I don’t know how much better we can get, but I am confident that we will. Just as I think we have become as lean and as capable as we can possibly be, something happens to fur-ther impress me and other leaders with our ex-traordinary talent. How we do this is exactly that—the talent of our amazing professionals! This nation is blessed with an exceptional array of superbly qualified and dedicated military medical specialists, and it is my great honor to be viewed as one of them. You can bet that I will tell that story at every opportunity; you deserve nothing less.

Gerry Harmon Major General

September 2006

From the pen, ANG Assistant to ACC Surgeon General BrigGen Ray Webster

Fall is on the horizon and most of the summer Active Duty PCS/Retirements are in the books. Brigadier General Russ Kilpatrick retired as the ACC/SG on Septem-ber 7th in a memorable ceremony at Lang-ley AFB. On September 8th, Brigadier Gen-eral Tom Travis was in place as the new

ACC/SG. In addition, Colonel Ken Knight is now on board as the new ACC/SGP. Ken will be looking for ANG Flight Surgeons to help with accident investigations and de-ployments. Let me know if you are inter-ested and I can arrange to get you in con-tact with Ken. Readiness Frontiers the first two weeks in August at Snowbird Resort, Utah were ab-solutely outstanding. From the EMEDS set up with a mass casualty exercise, Harvard trauma training, and RSV training for Flight

The photo was from Baghdad earlier this year. The officer with the mustache is an Iraqi military general who wel-comed me to Iraq as the senior ANG physician. He presented me with a souvenir that I accepted on behalf of the ANG. Those Iraqi military folks are true heroes. They risk their lives daily to do the right thing, and they do not live behind the Coalition barbed wire...they live in the community. They de-serve our every support.

Continued on page 2

***Lost wingman procedures are designed to ensure safe separation between aircraft in a flight when a wingman loses sight of Lead. Lost wingman procedures are not designed to recover a wingman with severe spatial disorientation

Autumn 2006 AANGFS AFRFSA 2

• Articles and announcements for the next newsletter should be submitted by 1 May 2007 (but I will be happy to accept them anytime before then.)

• Avoid the last minute rush; submit your article today. • Once again, authors, thanks for the great contributions—WWP, editor)

Alliance Officers

President: Col Kirk Martin, FLANG 8489 Stables Road Jacksonville, FL 32256

Email: eagledoc@bellsouth.net Vice-President: LtCol David Ashley 145 Gilbert Stuart Road Sanderstown, RI 02874 E mail: dashely@cox.net Treasurer: LtCol Brett Wyrick, HIANG 1155 Waialeale Place Hilo, HI 96720 Email Fightrsurg@aol.com Secretary: Col Reid Muller 5200 Ridge Road Cazenovia, NY 13035 E mail: mullerr@alltel.net Newsletter Editor: Col William Pond, INANG 5730 Autumn Woods Trail Fort Wayne, IN 46835

Email: wwpond@aol.com Program Committee: LtCol Mark Snyder & Col Dana Rawl Bylaws Committee: Col Buck Dodson Historian: LtCol Brett Wyrick Web site: Col Reid Muller

Alliance of ANG Flight Surgeons Air Force Reserve Flight Surgeons

The newsletter is published two or three times annually. Articles for inclusion are solic-ited from members and guest authors. Material for publication can be sent to: AANGFS Editor Col Reid Muller (incoming) Email: mullerr@alltel.net Col William W. Pond (outgoing) 5730 Autumn Woods Trail Fort Wayne, IN 46835 Email: wwpond@aol.com Viewpoints expressed in this publication do not necessarily represent official positions of the Alli-ance, the Air National Guard, the United States Air Force, or the Department of Defense. Letters may be edited for grammar, spelling or length, but not content. William W. Pond (WWP) Editor and Publisher

AFRFSA Editor Col George Bondor (incoming) Email: Dondoor@aolcom BGen Chuck O’Toole (outgoing) 1102 Holiday Court Granbury, Texas 76048 Email: chuck@itexas.net

Docs, BEE's, Public Health, and MSC's; it was a joy to watch happen. A job well done by all the Air Surgeon Staff with special recognition to Colo-nel Nye. Having Lt. General McKinley as the keynote speaker outlining his vision was a highlight. It was apparent everyone in the ANG Medical Service was ready to take on the EMED's mis-sion at Baghdad International Airport based on feedback to General Harmon. As this unfolds in early 2007, everyone should have the opportunity to make this a regular part of their 5 year training program. General Harmon is to be commended on his work with the AF/SG to bring this about. Recently, there is a call for a Joint Medical Command that the AF Medical Service opposes. This, coupled with the AD downsizing and search for relevant ANG line mis-sions, will require diligence on our part as we keep busy in 2007 training, de-

ploying and having fun as a Guard family. .

TUESDAY, 9 November 2006

Autumn 2006 AANGFS AFRFSA 3

From the pen of the AANGFS President: The flight surgeons of the Air Reserve Components—Guard and Reserve continue to demon-

strate their indispensability to the mis-sion of the Air Force in these exciting times. Deployments in support of the War on Terrorism, humanitarian assis-tance at home and abroad as well as keep-ing our war-fighters fit to fight—all on-going efforts that would not be possible without you. The AANGFS and AFRFSA con-tinue to give excellent value for the mem-bers by providing timely, thorough deploy-ment required RSV training. The associa-

tions also are a forum for exchange of in-formation and feedback for leadership. Kudos to the office of the USAF Surgeon General for developing a stan-dardized Flight Surgeon Aircrew Quali-fication Examination (see below) rather

than relying on numerous local units to develop their own. The flight doc exper-tise in flight physiology and human per-formance span the breath of aircraft, yet the principles are the same. Completing this examination will allow portability of the flight surgeon examination. This is a review of important in-formation of which flight docs should be ever cognizant. Throughout this issue, there are pearls of wisdom in red. Membership in the AANGFS is robust, finances are sound, and the educa-tional program is excellent. Thanks for the opportunity to be your President!

Bill Pond

Doc Pond examining child on Domini-can Republic Humanitarian Mission

Flight Surgeon Aircrew Qualification Exam Type: Self-paced Format: SCORM Cost: $0.00 Provider: Air Force Surgeon General Office , Background: This course consists of a Master Question File (MQF) of approximately 70 ques-tions developed to reinforce and evaluate Flight Surgeon knowledge of aircrew requirements and core aeromedical competencies directly related to aircrew performance. Completion of this test is required every 17 months to meet criteria for Flight Surgeon aircrew qualification written test-ing as outlined in AFI 11-202V1, Aircrew Train-ing, and AFI 11-202V2, Aircrew Standardization/Evaluation Program, and replaces previously man-dated, unit-developed, MDS-specific Flight Sur-geon tests. Overview: This is a self-paced, web-delivered test. Text and hyperlink references support the ena-

bling objective of demonstrated knowledge profi-ciency in the following areas.

• In-flight Safety and Crew Coordination

• Ejection/Egress

• Basic Aircrew Requirements

• Crew Rest

• Flight line Safety and Rules

• Oxygen Equipment and Hypoxia

• Core Aeromedical Physiology

• Night Vision Goggles

• Flight Surgeon Flying Currency Require-ments

Assessment: There is no pretest for the course. Test subjects will be presented with 30 randomly generated questions from the MQF that are repre-

sentative of all major knowledge areas listed above. Test subjects must achieve a score of 85% to pass this test. Failure to achieve a passing score of at least 85% will require the test subject to re-take the test. Each new attempt to take the test will result in a new set of 30 randomly generated ques-tions from the MQF. Upon scoring, correct an-swers for all incorrect responses will be presented to the test subject. Upon successful completion of the test members must print out a Certificate of Completion and present a copy to their local STAN EVAL office to document compliance with AFI 11-202 requirements. STAN EVAL is re-sponsible for ensuring that this documentation is provided to the local HARMS office for inclusion in the test subjects Flight Record Folder. If you have any comments about this course or sugges-tions on how to improve it please send us an email at afmsa/sgpa@pentagon.af.mil.

Roadmap to Access/Navigate Online Flight Surgeon Aircrew

Qualification Test

1. Go to AFIADL website:

https://afiadl.mont.disa.mil/ 1. First time users click on Register to fol-

low instructions to establish login and password.

2. Enter login/password and click Submit. 3. Click on Learning Center. 4. Click on Course Information and En-

rollment. 5. From pull-down menu in the top right

corner labeled Topic, scroll down and select Medical then click on Search.

6. Click on Flight Surgeon Aircrew Quali-fication Exam.

7. Read Course Description: Background, Overview, and Assessment.

8. To take the qualification test, click on Take Course (**NOTE: Ensure box is

checked next to Take Course for Credit), and then Flight Surgeon Aircrew Quali-fication Exam. The program will gener-ate 30 questions

9. from the MQF that will cover all major subject areas. 10. Answer all 30 questions. The majority of

references are hyperlinks to the 11. appropriate documents. Upon comple-tion click Submit. 12. Upon course completion, click on Per-

sonal KC on the left side of the screen.

13. Within the Personal KC window, click on the Transcript tab along the top.

14. If you have successfully completed the course a Certificate hyperlink will appear next to the course name. Click on this hyperlink to go to a printable version of the certificate.

15. Provide a copy of the certificate to STAN/EVAL who are responsible for providing this documentation of test completion to

your local HARMS office for inclusion in your Flight Record.

16. For any questions, or suggestions for addi-tional test content, please contact AF-MSA/SGPA, Operational Medicine at DSN 297-4200, or the AFIADL Support Desk via the link on the left side of the AFIADL webpage.

(This is a great idea, a little bit tricky to navigate, but definitely worth the effort—WWP, editor.)

****Crewmembers will not be scheduled to perform crew duties within 72 hours after loss of 200cc (standard blood donation) or more of blood. For aircrew on mobility status, or subject to on-call alert duties within the above timeframe, they must first get their flying unit commander’s approval before donating blood.

Autumn 2006 AANGFS AFRFSA 4

The Final Frontier Maj J. D. Polk You would have to have been living in a cave for the last decade to not notice the sudden interest in Space Tourism. A quick web search of the term “Space Tourism” will tell you how many new start-up companies are vying for pole position since the X prize was won. Space planes are being de-signed left and right, and some even “borrow” from the old Air Force X-20 design. Russia and China have both been working on space plane designs. Both have their space programs intricately tied to their military. The future of mankind, business entrepre-neurship, and old fashioned capitalism are definitely tied to space.

But the United States military was re-cently hammered for not doing enough in space, with threats of splitting space off into a separate service or space force if change did not occur. The Air Force and the other military services set about to develop their space cadre in response to the scathing report by the Commission on Space.

Most of you who know me, know that I am indeed a space cadet, both literally and figura-tively. As the Chief of Medical Operations at NASA, I lead one of the most highly educated and highly trained flight surgeon cadre. There are 12 reserve flight surgeons and 2 active duty flight surgeons at NASA under my Medical Operations branch. Unfor-tunately, most of the military has no idea we even exist, or that our expertise in space is beyond the “turn your head and cough” examination of the astro-nauts. But there is much more to it.

It is Saturday, the 9th of September 2006. I am in the Launch Control Center (LCC) at the Cape representing the medical community in the Mission Management Team. The space shuttle sits directly behind me, and in 2 hours the crew will arrive at the pad. Dr. Smith Johnston is with the crew as they suit up. Dr. Rick Senter is at the console in the LCC. Dr. Joe Schmid (Col, USAFR) is on console in Houston awaiting the vehicle to launch and clear the tower. We have trained with this crew for nearly two years, have been flying in T-38’s with them, and diving in the Neutral Buoyancy Lab with them, lifting weights in the gym with them, running their medical tests, and taking care of their families. We have been work-ing on the hardware for the medical suite for the mission, writing procedures, evaluating new hard-ware, and testing it on the Vomit Comet aircraft in microgravity. Our goal is to see them safely to orbit, take care of them on orbit via console in mission control and recover them by crawling into the vehicle upon landing. We bring our medical or surgical board certification, aviation medicine expertise, aus-tere environment experience, degrees in space studies and aerospace medicine, to the table in an effort to ensure mission success. We will work through a new campout procedure on-orbit for a space walk, hoping that we have done the right calculations and that the crew will not get the bends. It is an all Navy crew on the shuttle on this flight, so we Air Force officers feel we are at least doing our purple duty taking care of these squids. They are good people, and we know every single part of them. Dr. Gary Beven (LTC, Ohio ANG) is the flight surgeon/psychiatrist on duty today in the Mission Control Center as well, and he knows the crew’s fears, their passions, and their families. He knows what motivates them, and what scares the hell out of them.

I have had a hard week of scrubbed launches, late nights, and enough Mission Manage-ment Team meetings to require a tub of Tuck’s medi-cated pads. The bulk of my time this week has been

spent laboring on the calculations for crew rescue if the shuttle takes a hit to the reinforced carbon-carbon and is stranded on orbit. They would have to dock with the space station and it may take as long as 84 days to get the next shuttle launched to rescue them. I have been looking at hardware failures on the Inter-national Space Station. I have been calculating how long they can survive based on certain hardware failures, …things like the Vozduhk (Russian carbon dioxide scrubber), Elektron (Russian oxygen genera-tor), CDRA (US Carbon Dioxide Removal Assem-bly), food, water, etc. If the Vozduhk fails, how long can CDRA operate on one out of two beds before the CO2 for 10 people on the space station exceeds the flight rule limits? How long before it becomes inca-pacitating? How long before it becomes lethal? If I change their RQ (respiratory quotient) by having the crew revert to an all fat diet, 1,000 calories per day, and no exercise, how much CO2 production will I save? How long before the metabolism ramps down so that the oxygen consumption is not so high? Can I get to an RQ of .75? I have the advanced projects team working on thousands on different variables and doing a Monte Carlo analysis on them so that I will have some confidence in my numbers and calcula-tions. It could literally be their lives if I am wrong. My hours on the calculations last night were inter-rupted only by a trip to Taco Bell and four hours of editing 75 different Human Systems Integration Requirements, which we have been writing for the new Orion vehicle. The President and the Department of Defense have called for the training and development of a cadre of space professionals. The expected specialty codes of systems procurement, space weap-ons operators, and satellite drivers are already in-cluded. What has been forgotten is the identification of a cadre of medical professionals that will take care of these professionals, the military Astronauts who fly currently in the civilian space program, those that will fly in the next generation of military aerospace vehicles, and those who can best utilize the orbital technologies and capabilities that only space medi-cine can provide. But medicine is never considered in the space cadre, or at least it hasn’t been yet. Sure, it is a small segment of folks right now. But will it stay that way? We believe we already have both an experienced cadre of military space medicine profes-sionals and the training programs to continue to pro-duce more. I sincerely doubt that Virgin Galactic will be sending folks to space in a space plane and the Air Force will sit on its laurels. I also sincerely doubt we will allow hostile countries to lob missiles at us for a day while we attempt to intercept them. The days of “we are going to come over there and 5 days from now we will kick your behind” are long gone. They have to be. Prompt Global Strike means we will have to deliver a payload in a matter or a few hours. That may be all the time we have to prevent our home territory from getting hit with missiles, or Israel or other allies from being destroyed. Hours,.. not days. There is only one platform that can do that, and that platform is space. If the Air Force suddenly has a change of heart and realizes the value of having medical offi-cers as space cadre, they will then have to come to grips with the fact that an enormous amount of train-ing goes into it. It isn’t something you can pick up as you go along. We fly, we dive, we know space physi-ology, we know engineering subsystems, we know human systems integration, we have to learn Russian, we have a plethora of things to learn in order to be-come space surgeons. To turn out flight surgeon space cadre, the Air Force will have to train more folks or take avail of the fact that NASA already

trains it’s folks. For example, to qualify to sit con-sole as a surgeon supporting the International Space Station, you will need at least 204 hours of class and practical training on radiation, space physiology, vehicle systems, toxicology, environmental systems and crew procedures. Throw in another 220 hours for space shuttle systems. Add to this an extensive re-view of mission flight rules, rationale, medical sup-port systems, contingency plans, communications and medical procedures. Then there are the sims. Some-where in the bowels of Johnson Space Center is the Simulation Supervisor’s Team. They are satanic, evil people who make your life a living hell during space-flight simulations. You’ll have to have a belly full of 100 hours of simulation before the mission as well. They’ll throw problems of decompression sickness, toxicology emergencies, and fire and inhalation expo-sures at you and you’ll handle the problems with the human physiology that few of the other engineers in the room can understand. It is now 8:10am and the crew is getting ready to head for the launch pad. Because the mission has slipped nearly a week, I am on the phone with my Russian flight surgeon counterpart talking about the sleep shift for the space station crew, and how bunched up the schedule is about to become with one shuttle going to the ISS, a Soyuz launching on the 18th, and a Progress resupply ship docking to the ISS in between. The space station will look like Grand Central Station. The conversation is taxing my lan-guage skills and I have difficulty remembering all the Russian words, but I think he got the jist of it. In between talking to the Air Force rescue forces that are stationed near the pad and talking to Houston on the loops, I have been working on the plan for crew recovery in Kazakhstan. The space station crew will land in a Soyuz in Kazakhstan at the end of the month, unlike their shuttle counterparts, and I am working on the schedule to see what sur-geons will go and recover the crew there. I also have to negotiate a contract with a hospital in Astana, Kazakhstan in the near-term, which means yet an-other trip to Russia and then to Kazakhstan for me in October. Two hours to launch. I am polling my surgeons. “Houston Surgeon…Go”. “Crew Sur-geon….Go”. “DoD Surgeon….Go”. “ISS Sur-geon….Go”. The Mission Management Team launch director then calls me over the loops, “Surgeon?” “We are Go!”. A lot has gone into that tiny statement; two years of training, several crew physicals and medical procedures, calculations, hardware design, flight hours, scuba hours, flight rule validation, meet-ings galore, etc, etc, etc. It all comes down to those three words “we are GO!” I hope the Air Force will be “Go!” I don’t want the medical community to get left behind when the proverbial space cadre train leaves the station. We have been pushing for that recognition through multi-ple channels, and we will see if we are successful. To be honest, I think much of the greater force forgets that we have a host of active duty astronauts, and does not realize we as flight surgeons play a vital and very sophisticated role in human spaceflight or in taking care of space operators. I am often asked by flight surgeons how to get into this line of work. If you are a reserve or guard flight surgeon, there are several ways to get space knowledge. First, there is the Space Operations Medical Support Training Course at Patrick Air Force Base. After completing this course and the helo-dunker, you can support space shuttle missions as a flight surgeon aboard the MH-60’s that serve as rescue aircraft for the crew for a contingency at the pad, upon landing, or if the crew had to bail out over the Atlantic due to engine malfunctions. Second,

Autumn 2006 AANGFS AFRFSA 5

there is the Aerospace Medicine in Space Operations course. This course was held every other year at Brooks City Base, but I am not sure of the fate of the course at this time. There is also the Space 100 course from the National Security Space Institute.

Much as some flight surgeons sport jump wings in addition to their flight surgeon wings, I hope in the future we will have flight surgeons sporting space wings. It will take a changed mindset. But space is here to stay, and as flight surgeons, we will always have an important part to play in the final frontier. T minus 9 minutes and counting…

Air Force Certification Criteria to be Space Cadre and Wear the Space Badge

Level 1 (Basic): Education: Space 100 Training: Current in position; CDC(5-

level) complete Experience: 1 year in a space billet Certification Brief

Level 2 (Senior):

Education: Space 200; Continuing Education

Training: Current in position Experience: 6 yrs in space billets

Level 3 (Command):

Education: Space 300; CCAF; Continu-ing Education

Training: Current in position

Experience: 9 yrs in space billets NASA Flight Surgeon Requirements to be Certi-fied Education: MD or DO degree, Master’s Degree in

Aerospace Medicine, Space Studies, or Aerospace Engineering

Training: 540 hours for shuttle and space station Experience: Board certification, ACLS, ATLS, 50

hours CME in aerospace per year, prac-tice experience, 2 years OJT

Dive certification Flight qualification in T-38N United Space Alliance Academy training Comparison of Air Force criteria for wear of the

space badge by space cadre with require-ments and training received by Active Duty and Reserve flight surgeons at NASA

Update from Headquarters

First of all, I’d like to thank each and every one of you for what you do for the Air Force and for this country. In these hectic and fast-paced times, it may not feel like you are getting the recognition you deserve for your hard work and dedication but, believe me, we notice and we really are thankful that you are doing such great things! Sec-ondly, I’d like to thank General O’Toole for this opportunity to commu-nicate with all of you via this newsletter. Thirdly, and before I get into the real gist of my information to you, I want to remind you that no one here at HQ AFRC/SG is any smarter that any of you. We’d like to think that what comes from our office is derived of an informed stance on the various issues, but it certainly is not perfect and should never be con-strued to be holy writ. If you see something that doesn’t make sense to you or if you have a good idea and wonder why no one at HQ is figuring it out, don’t hesitate to give us a call or send us an email. Ask questions of us and share ideas with us. We look forward to a collaborative effort to “keep ‘em flying”!

There are lots of new developments at the HQ staff that we hope will make you more effective as ARC flight surgeons. First, we are continuing to work our transformation that will enable us to support the new enroute care mission of the Air Force Medical Service but will see us divest ourselves of our pure EMEDS mission. Even though this will eliminate some flight surgeon slots that currently support EMEDS, it is countered by new base operating support UTCs, so the overall effect on flight surgeon billets is negligible. The actual tasks that flight sur-geons perform while deployed will not change so all of you will still be doing outpatient medicine, human performance preservation, preventive medicine and aeromedical evacuation support.

Secondly, there are a lot of new policies that have come out recently so make sure you are up on all the changes. As you may remember, the new AFI 48-101 came out in August of 2005. Hopefully you have had a chance to implement those requirements that were missing. The IG has unfrozen the operational support items so you will now be graded on those operational support activities that are at the heart of what we do as flight surgeons. Flying, shop visits, safety briefings, and occupational medicine are now “officially” as important as all the PHAs and other tasks you are required to ac-complish. Your chief of aerospace medicine should be working with you to help prioritize your tasks if you are in one of those common situations of having more work

to do than you have time. We added a new section to the SGP policy memorandum that went out in September of this year that helps clarify the requirements in 48-101 for AFRC which we hope will make it easier for you to comply with 101. Speaking of the new policy memorandum, it also has supplemental guidance on the new AFI 48-123 which just came out. The biggest change is in mental health standards. As a re-minder, AFRC no longer uses medications as the determinant on qualifi-cation for world wide duty. If someone has one of the few mental health conditions listed in the AFI they will need a world wide duty (WWD) evaluation. Any other axis one diagnosis requires an assessment by a military mental health provider for deployment suitability. If they are cleared to deploy, no WWD evaluation is required. Modafanil is now approved for all aircrew that are allowed to use go pills. This is a significant expansion of our armamentarium to help maintain aircrew performance. Those of you who support CAF units need to be well versed on the side effect profiles and other advan-tages of Modafanil over Dexedrine so that aircrew can make an in-formed decision about which, if any, go pill they wish to use. As you know, commanders must now approve all 4T profiles before they are loaded into MilPDS. We have purposely left the me-chanics vague initially so that each base could implement a system that made sense for them until such time as we are able to put a system wide solution in place. If you need advice or help figuring out how to imple-ment the CSAF’s new profiling policy, please call our SGP office. They are more than willing to help you work through this important process. Finally, let me commend all of you for helping clear up the backlog of line of duty (LOD) cases on our Reserve members. The

medical units have been doing a great job processing the cases and the new LOD module in RCPHA show us that your turnaround time is usually the shortest of those players involved at the wing level. We are hop-ing to shorten the process by several steps with the new LOD AFI. In the mean time, do what you can to help your commanders and JA folks get the LODs com-pleted in a timely fashion. Again, thanks for all you do and my staff and I are looking forwarded to continued opportunities to work with and for you! Jim Collier

Autumn 2006 AANGFS AFRFSA 6

GREETINGS from Fourth Air Force/SG

I don’t have to tell you that you flight surgeons are the backbone of our units that provide base operating support (BOS). I know the work never seems to end and getting it right is tedious but with-out you our flyers wouldn’t be able to deploy and carry on the

flying missions. You’re all volunteers and I’m proud of the dedication and sacrifice you make. Many of our civilian colleagues can’t comprehend why we do this because it costs us in terms of lost revenue from our civilian practices, time away from family and friends, and we place our lives at risk when we deploy. That’s preaching to the choir to make you feel good because I need a little more from you. As you know, our numbers are small and some of us are getting along in years. We have some units that have been struggling to get flight surgeons. When we go out on our visits to the units, we see how some units are struggling and have to rely on the active duty to get their physicals done and watch over our flyers and support shops. I need you to become our spokesmen and recruiters for new flight surgeons. I need you to think globally about how we can help each other in the NAF to get the job done. In other words, I would like to see you guys start thinking beyond just your units. Meet the other NAF flight surgeons in your region. Share your ideas about how to work your programs more smartly. If you know a unit is short or doesn’t have a flight surgeon and you have some time you can give them, let them know. If you are reading this, I know you are a member of the Reserve Flight Surgeon Asso-

ciation but get the word out to those who are not. Get them to join. Send all your flight surgeons to the annual AFRC Flight Surgeon Sustainment Course. The return is immense when we can pool our ideas, energy and resources. In line with these thoughts, I have to confess that I don’t know all of you as well as I would like. You would think that being at the NAF that we have all the information that need at our fingertips but while that may sound true; I have to tell you that it is not. I think that it is time that we remedy that so I am proposing a NAF flight surgeon data base that I’m asking the new SGP at the NAF to build. I would like you all to send me an e-mail. You can put down anything you like but include both civilian and mili-tary e-mail addresses. If you like, you could include your civilian specialty, position in the unit, what you feel are your strengths (and weaknesses), what you have enjoyed the most, what you would like to do, and what can we at the NAF do for you. If you send that e-mail then we have a contact. That way we can start to share almost anything. Our new SGP is Lt Col(s) Art Nuval from the 452 AMDS, March ARB, CA. He is excited to have joined us and we are glad to have him on board. A lot of you already know who he is, so don’t be shy about congratulating him on the move, and then hit him with your tough issues. He’s had a lot of experi-ence. He was mobilized for 1 year for BOS at the 452 AMDS, has been an SGP for 4 years, and has worked at the active duty flight surgeon office at the LA Air Force Base. What he doesn’t know, he’ll research for you. I expect that you’ll keep him busy and that’s how he wants it. Since I have your eyes, there are 2 pressing issues that I would like to bring to your attention. I have my reasons but I’ll keep it short. First, if you look at the HSI Guide you will see under the Flight Medi-cine Operational Responsibilities the section that

states “Overall Aerospace Medicine Council docu-mentation indicated ongoing flight surgeon partici-pation in mission essential tasks/activities for line support (METALS)…” One of the biggest findings for reserve flight surgeons during our SAVs and echoed by the analysis of AFIA is that flight sur-geons are not accomplishing shop visits and need to verify METALS for their Wing. Take a look at this and let us know if you have any questions, but I’d like to see these findings go away. Second, we have had an incident that involved a pregnant copilot who was properly profiled for pregnancy but did not have a waiver to fly during the second trimester. This was discovered during an SIB for a Class E mishap. Obviously, this wasn’t the cause of the mishap but because of the finding we have to look at why she was flying without a waiver. Her response was that she was not aware of the need to ask for the waiver. If you look at AFI 48-123V3, 5 June 2206, A4.23.1.1, you will find that “flight surgeons shall educate female pilots during annual PHAs that preg-nancy is disqualifying. Pregnancy waivers for trained flying personnel may be requested under the following guidelines:” So it looks like we need to work out a system to make sure this is accomplished and documented. I’ll leave it to you to come up with solutions, but for those of you who will be facing an upcoming HSI don’t be surprised if this comes up along with the question about how your are docu-menting that you are making an aeromedical disposi-tion every time you make an entry on the SF 600 for a flyer. Call us if this doesn’t make sense to you. Lastly, again, thanks for all you do. I look forward to seeing all of you in future travel. Bruce L. Nelson, Col, USAFR, MC, FS, Chief Medical Division, 4 AF/604 RSG/SG 895 Baucom Ave, S.E. March ARB, CA 92518-2266 Voice (951) 655-4234 Fax (951) 655-4239 Cell (949) 939-9189bruce.nelson@march.af.mil bnelson4@hotmail.com

Letter to the Editor from Col(ret) Phil Steeves Interesting excerpts from two early articles related to the first opinions of what we would call flight surgeons, and their impressions of (fighter) pilots. 1) Rippon & Manuel, September 1918, The Lancet, Report on the essential characteristics of successful and unsuccessful aviators: Hands. - One of the most important characteristics we have noticed in successful aviators is "hands." This characteristic is difficult to define, but may be described as follows. The horse-rider with good hands is able to sense the mentality of a horse by the feel of the reins and also to convey his desires accurately to his mount. We have never known of a man who has consistently been in the first flight in the hunting field making anything but a good pilot. "Hands" appear to be congenital and cannot be acquired, although they may be improved and vice versa. 2) G A Sutherland, December 1918, The Lancet, Observations on the medical examination of aviation candidates: Among other things Drs Sutherland and Rippon, and LT Manuel, also noted that:

- The successful aviator possesses resolution, initiative, presence of mind, sense of humour, judgment; is alert, cheerful, optimistic, happy-go-lucky, generally a good fellow, and frequently lacking in imagination; - Their favourite amusements include "music (chiefly ragtime); - It appears necessary for the average pilot that he should indulge in a really riotous evening at least once or twice a month; - They possess in a very high degree a fund of animal spirits and excessive vitality; - It is not necessary to legislate on the subject of alcohol for pilots; - The majority of successful pilots are unmarried; - A persistent dilatation of the pupils with an excitable manner is regarded as suspicious of undue nervous excitability; - If, for instance, we take the public-school boy who has been captain of his football team and has held his own in the class-room, we require no elaborate examination with special tests to estimate his physical fitness for flying; - The rest is guess work; - Instead of endeavouring to standardise the tests I think that an attempt might be made to standardise the examiners; - (of being an aviation medical examiner) ... we had no guiding principles and the problems set were entirely new; - It may be said that the candidate will conceal important facts in his eagerness to be passed, and many do. (Phil, great to hear from you. This is one article to post in the flying squad-ron break room—WWP, editor)

Autumn 2006 AANGFS AFRFSA 7

AFSO 21……“Lean Across the Air Force”

In a November 2005 memorandum, the Chief of Staff and Secretary of the Air Force im-plored the Total Force, top to bottom, to insti-tute a comprehensive strategy to improve work processes. This predominate strategy will rely on the “Lean ” concept , which in-cludes “ the two pre-dominate process attrib-utes of doing it right the first time, as well as to stop doing non-mission critical tasks, and the more material related

reduction of desk, stock room, and warehouse related inventory”. This fundamental change in Air Force culture requires that all Airmen understand their individual role in improving their daily

processes and eliminating things that don’t add value to the mis-sion. The “Lean” concept based on the book Lean Thinking by James Womack and Daniel Jones, began as a way to identify and re-move production waste to gain competitive advantage. But, man-agers accustomed to thinking Lean noticed that other areas of the enterprise could benefit from Lean initiatives. They realized that cross- functional information flows were far more complex than they had to be. Too many steps were needed to manage and con-trol processes and, ultimately, the organization as a whole. By applying Lean principles, routine business operations could be simplified, more rational procedures established , and repetition reduced (if not eliminated), thereby accelerating core business processes and responding more quickly to customer needs. The Lean process has been proven in our Air Logistics Centers and some Maintenance areas over the last 4-5 years. Ergo, the entire organization can also benefit. AFSO 21-Air Force Smart Operations for the 21st Century, embracing the Lean concept, is the overarching program guiding continuous process improve-ment in the Air Force. It can be successfully applied to any proc-ess in the Air Force including the provision of in-garrison and operational flight medicine services.

I encourage all of you to become familiar with Lean and AFSO 21 by securing a copy Lean Thinking and reading about AFSO 21 on the web at http://www.afso21.hq.af.mil. It appears that this process is more of a permanent cultural change in the Air Force way of doing business than TQM was. G.L.Bondar Col, USAFR,MC,CFS Chief, Medical Division 622 RSG/SG, 22AF

10AF's submission. Hello from 610RSG/SG. Those AEF’s keep rolling around and the volunteer’s continue placing AFRC out front setting the stan-dard for others. It is an honor to be associated with the people who repeatedly perform at such a high level and do so willingly. All continue while sacrificing at home. My hat is off to them. Since transferring from the Army in 1992, the F-16 has been the primary airframe and airmen I have served. Like all of us, I been afforded opportunities to ride in a ride a large variety of other airframes and experience some part of the day to day life of airmen in other units. For the past two weeks, I have been experi-encing some of what is the day to day life a CCATT team mem-ber. They are also a special people. As I train to become qualified as a team member and serve with them on AEF’s, I know it gives me further insight to be better qualified to serve them as a flight surgeon. For those of you like me who have not previously been

with them on an flying mission, even a training mission, I would encourage you to look for an opportunity to go on one their flights as a flight surgeon. If you were wondering, I will still be at the 610RSG as the Medical Director while doing some CCATT missions. In that regard, a heads up on some recent memos and AFIs. AFRC has updated the approved medication list this past spring. There is a new AFI for incentive, fam or the like flights. I encourage each of you to read it and then get with the line side to give input on your local unit’s operating order. It is an opportunity to have included additional required processes for screening people medically on whom you may otherwise have limited information before you see them shortly prior to their flight. If you would like to discuss this further, shoot me an email at thomas.walker@charter.net. Col Thomas Walker

AFRFSA OFFICERS AIR FORCE RESERVE FLIGHT SURGEON’S ASSOCIATION

OFFICERS ABND BOARD

President – Col Mike Torres- Commander/ 459th Aerospace Medicine Squadron President Elect/ Education Chair– LtCol Leah Brockway- 604th Aerospace Medi-cine Squadron Secretary- Col Mike Jones- Commander /446th AMDS Treasurer/Social Chair- BG Lance Chu- MA/ Air Force/ SGO Editor/ Membership Chair- BG Chuck O’Toole- MA/ DSG Air Force Bylaws Chairman- Col Andy Burkins- IMA- ARPC/SG Education Committee Co- Chair- Col William Hurd- Commander/ 445th ASTS

***Crew Resource Management (CRM) as outlined in AFI 11-290 is intended to maximize operational effectiveness and combat capa-bility while preserving resources. As such, the CRM Core Curriculum includes Situational Awareness, Crew Coordination/Flight Integ-rity, Communication, Risk Management/Decision Making, Task Management & Mission Planning/Debrief. **Crew duty time period starts when the crew reports for a mission, briefing, or other official duty

Autumn 2006 AANGFS AFRFSA 8

Deployments When my Chief of Aerospace Medicine, LTC Eric Kendle suggested that he and I volunteer for the surgeon’s UTC in the Baghdad EMEDS a few years ago, I was certain he had a yet-to-be-diagnosed brain tumor and offered to drive him to the hospital for a CT scan. The more we talked about, the more I realized that volunteering to support the operation in Iraq was the right action to take, for many reasons. My ANG colleagues such as Col Bill Pond, Col Sal Lombardi, Col Brett Wyrick, Col Pat Aiello, LTC Kendle, Maj Duncan and a host of unmentioned others have before and since accomplished remarkable achievements. I wanted to share my thoughts on deployments during a time when the ANG Medical Groups maybe asked to support AEF contingencies as our active duty forces, Guard and Reserve wear thin and weary. I asked myself, “How do you want your ANG career remembered?” Did I want to be remembered for an Excellent on a HSI, or to have traveled to Alpena Michigan more than any other Flight Surgeon in the Guard? Obviously not. We have an opportunity to directly impact and support the security of our country and our families, to do something truly patriotic that will be remembered. Do you want to have a 20 year Guard career pass you by and have nothing remarkable to account for it, to validate it? So Eric and I pressed on, jumped through the many hoops it took to get permission and thereafter experience the most rewarding time of our professional lives in a dusty tent city at the Baghdad Airport. Most of our Active Duty contingents were from Travis AFB, and a few other guardsmen. We blended right in and became a family quickly. Tent city was primitive and we shared our tents with rats, mice, scorpion and the infamous camel spiders. It was hot, dusty, and the food was marginal when it was good. The showers were a large Petri dish enclosed within an Alaska Shelter and after a while I realized that staying on Camp Sather made much more sense than traveling into the Green Zone during Ramadan and the push for Fallujah in the fall of 2004. These 64 days were without a doubt the most memorable days of my surgical and professional career. I miss my 447th EMEDS family daily and in many ways long to be back there. With that voluntary departure from my practice came a cost, and this is the primary purpose of my writing: to summarize the financial and emotional cost on a flight surgeon contemplating a lengthy deployment. I sent a note to my referring physicians to let them know I would be away, for how long and for what reason. I requested a leave of absence from my local hospitals where I performed surgeries and asked to have my medical liability insurance pro-rated for the time I was gone. My local medical society paid my dues for that year. A nice suppor-tive gesture. My friends, my partners and my family were, for the most part, supportive. One of my partners commented that would require he take more call, and I recall that I was somewhat incensed when I heard that, but let it go. My wife wasn’t thrilled and in many ways scared for my safety. I remember doing the attack Intel on BIAP and while it wasn’t like Balad Air Base, they still had their share of IED and rocket attacks in the area. You can die crossing the street in Tucson as easily I thought and tried not to think about that too much. My friends had a huge party for me and the day I left I wanted only my wife and 2 sons to go with me to the airport. It was personal and private then and I didn’t want to share that time with anybody else. When I got there it was almost a movie-like environment. It was live-fire and real. The guns were loaded and the bad guys not actors. We suffered a 122mm Soviet-made rocket attack the morning I got the Baghdad, which impacted coinci-dentally 30 meters from the northwest corner of the EMEDS. I estimate that the for the time I was gone I sacrificed over $100,000 of billings per month, which equated to about $30,000 of earnings a month. I still had my practice bills to pay, employee’s salaries, etc. My overheard continued and I had no type of insur-ance for that. My practice did have an extended absence clause that stated after 30 days, that some overhead costs would be forgiven, in case you suffered a prolonged illness or injury for example and could not work. That was very helpful to me for the 2nd month away. When I was getting ready to come back I had my office manger send all of my referring doctors a note, telling them I would be back in 3-4 weeks and it was okay for them to start referring patients, if they chose to do so. I was saddened and had my eyes opened when I came to find that many of my regular referring docs forever changed their referral practices, not because of me personally, but because habit patterns are hard to break. I am not the type of person that will cold call a doctor to ask or beg for a return of their surgical referrals. Many of my regulars were glad to see me back and I had a good start when I got back. I would say my practice never fully recovered from it, but it did recover to an ap-proximate 80% office patient appointment rate. For some reason, when I got back, money wasn’t as important to me as it used to be, and I also found it had to motivate myself to kick into afterburner and work so hard. Many of my colleagues saw that too. Finishing first in the billings category at the end of the month just wasn’t high on priority list like it used to be. I found myself spending more time with my wife and with my boys. I started coaching my son’s baseball team and playing in a league myself. I paid my partners to take my E.R. call. I became focused on the Medical Group and asked to be transferred from State Head-quarters back to the 162nd MDG commander’s office, because I missed my people and wanted to be the one to take them to the AOR if we were ever tasked for it. The military became an even greater part of my life, to the chagrin of my family, and to some of the MDG members who saw that I had changed from a laid back, get-along-with-everyone type of guy, to a much more serious commander who insisted that everyone follow the rules and play fair or pack up your duffle and be on way type of guy. Some say it was good, and others said I was off my rocker and a changed man. I now take every Friday off from my practice to come out to the 162nd Fighter Wing and engage weekly on the activities of the Wing and the Medical Group, sometimes for free, sometimes I get a half day or an AFTP out of it. But I do know this. You cannot be an effective commander and keep up with

everything a commander needs to know in only 1 weekend a month. It is impossible and you commanders out there know that to be true. We are a dedicated group of citizen sol-diers and we do this most of the time, because we like it and we know it serves our patriotic duty, not because of fame or fortune, nor any expectation of career advancement. As there are more and more discussions of the ANG MDGs supporting the EMEDS at BIAP, one of major issues to be discussed is for deployment length. Personally, I think if the ANG took a 120 day AEF and supported it in 3 by 40-45 day cycles that it would solve problems immediately. Many argue we cannot be effective in a shorter period of time. I say, I was effective within hours of boots on the tarmac at BIAP, was in-processed in a matter of hours and working within 12 hours of arrival. It took my 36 hours to get there from Tucson. But dividing the 120 AEF into 2 by 60 day rotations seems to be what the higher-ups want and to that I would concede. But, I think a physician would secretly say that 30-45 days would be much easier on their practices than 60-120 days, and that point I personally understand and respect. So when I sat in on MG Harmon’s address to the State Air Surgeons at Readiness Frontiers and heard the numerous concerns about not being able to support the BIAP EMEDS mission, I both agreed and disagreed with the arguments at the same time. It is in no way an easy situation for traditional ANG Medical Groups, but I do think if we are tasked, we need to find creative ways to support that effort and even more creative ways to motivate our colleagues who may be understandable concerned and fearful of the consequences of leaving practices they worked so hard to build and maintain. If you are reading this and thinking, “Still, I know I cannot personally do this. It is too much,” I would tell you I felt the same way initially, but you can and you will be a better person in many intangible ways for doing so. I asked my Medical Group personnel about their primary concerns of such a deployment and there responses in order were:

Fear Family Financial

I tried to reinforce the fact that no U.S. servicemen have been injured at Camp Sather for quite sometime and that if they stayed on the Camp and elected not to take tours of downtown that they had very little to be truly concerned about. Some of my folks are single parents and have child-care issues to attend to, but we are already supposed to be prepared for such possibilities. The financial concerns I have already mentioned and they, in my opinion, are the most genuine of concerns. Each of us will have to deal with and justify those costs in our own way. I am certain that your combat pay won’t make up the difference so you will need to be prepared. Personally, I think it was well worth the cost/sacrifice…whatever you want to call it. And I would do it again, knowing it would hurt a little financially within my household and that my practice may take another direct hit to the referral magazine. In summary, if your country calls on you, how will you respond? Those like Lombardi, Kendle, Wyrick, Pond, Duncan and many others met that call and I am certain will tell all that the experience was one of the most memorable in their careers and one they secretly miss and aspire to enjoy once again. I personally would feel my Guard career was complete if I could take my well-trained medical group personnel to Baghdad and have them participate in something for real, something other than an Alpena exercise or Code Silver (not that those training vehicles are not important mind you), and have them take home with them something that they will be proud of for a lifetime, something that will validate their careers. So if you think you cannot do this, I say you can. But realize those of us who support this possible mission also remember that it is not as easy as it may sound, and that there exists real family, financial and practice aspects to consider. I can leave my Guard career at this point and be whole. I made the almost 20 years of what seemed to be the most monotonous training, become immediately the most valuable. So if we are tasked, let’s do with enthusiasm and do it right. We can work together and make it a survivable request on many levels. The last time I submitted an article to this newsletter was many years ago and the topic I addressed was PME and how I thought AWC and PME for the drill status guardsman was excessive and unnecessary. How times have changed. I completed AWC 5 years ago, and appreciate the experience and what I learned and the credibility it now gives

me with my wing leadership….so I was wrong about that too. We do work hard and do we get all of the credit that we deserve for what we do in our private practices? Proba-bly not. Jim Jim Balserak, Col, MC, CFS Commander 162nd MDG Tucson AZANG (Jim, thanks for an insightful article that puts the deployment issue in perspective—WWP, editor)

Col James Balserak and wife Kristi with the President Bush

Autumn 2006 AANGFS AFRFSA 9

As body armor has become more readily available, survivability in the desert has increased. How-ever, the incidence of devastating head and neck wounds has also increased. The majority of the head and neck injuries involve injury to the eyes.

Impro-vised Ex-plosive Device (IED)-type weapons used in unconven-tional war-fare by terrorists create serious

threats. Fragmented, small ballis-tic projectiles are common with these weapons and pose great danger to our troops. Our Airmen were deploying with eye protec-tion, but in retrospect, we have realized that a vast percentage of the protective eye protection was inappropriate. Air Staff recognized the need to establish an Air Force-wide policy to ensure Airmen deploy with eye protection and that the eye pro-tection can meet our wartime threats. The Air Force Protec-tive Eyewear List (AFPEL) is the list of allowable eye protection devices. There is no “best” product for all units. Units must determine if their members require spectacles, goggles or both dependent upon:

Environment and risk of ex-posure

Normal duties of the individ-ual / unit

Financial resources available Becoming familiar with the prod-uct characteristics about each

AFPEL item will assist you and the Unit Deployment Managers in choosing the product that will be unit appropriate. 1. ESS ICE 2/NARO

This is the system of choice for Airmen requiring vision correction and includes frame, clear and sun shield, neck leash and case. Pre-scription insert is ordered through the optometry clinic. The ICE 2 is designed for Airmen with medium to large faces while the NARO is for Airmen with very small faces. 2. Revision Sawfly

This eyewear is appropriate for all Airmen, and the kit includes frame, clear and sun shield, neck leash & case. The prescription insert is ordered through the optometry clinic and is available in two sizes: • Regular for Airmen with

small/med faces • Large for Airmen with very

large faces 3. UVEX XC

This device is appropriate for all Airmen and the kit includes frame, clear and sun shield, and case. The prescription insert is ordered through the optometry clinic and the product is “One size

fits all”. It is the least expensive BEP product on AFPEL. It provides exceptional facial coverage, but the assembly with insert carrier can be chal-lenging. 4. OAKLEY SI M FRAME

This eyewear is appropriate only for Airmen NOT requiring vision correction. The kit includes frame, clear and sun shield, and case. The product is “One size fits all”. Note that this is the most expensive BEP product on AFPEL. It is also very important that care is used when ordering. ONLY the military version of this frame that has the clip on the center of the bridge should be purchased. . Other versions do not pass military ballistic testing. The National Stock Numbers should be checked very carefully. 5. WILEY X PT-1

This eyewear is appropriate only for Airmen NOT requiring vision correction. The kit includes frame, clear and sun shield, and case. The product is “One size fits all”. 6. ESS PROFILE NVG GOGGLE

This device is appropriate for all Airmen. The prescription insert is ordered through the optometry clinic and the product is available

in two colors: Foliage Green and Black (not recommended in hot environments, the black color absorbs a lot of heat). 7. ESS LAND OPS GOGGLE

This device is appropriate for all Airmen. It may be worn over Frame of Choice spectacles. The product is available in Olive Green. 8. ESS VEHICLE OPS

This device is appropriate for all Airmen. It may be worn over Frame of Choice spectacles. The product is available in Black. 9. ARENA FLAKJAK

This device is appropriate for all Airmen. It may be worn over Frame of Choice spectacles. The product is available in Tan. NOTE: Fogging problems noted in field with this product. Due to quality issues, this product may be re-moved from future updates of the AFPEL.

Look for

Col Brent Klein

***Be part of the solution: when evacuating the aircraft in the event of an emergency, look out for responding emergency vehicles, assemble all persons safely away from the aircraft, assemble all persons safely away from access lanes used by emergency vehicles. *** You only have 1-2 minutes of Useful Consciousness in the event of a sudden loss of at a cabin altitude of 30,000 ft. ***The cabin altitudes of isobaric-differential pressurized military transport aircraft flying at 30,000 feet MSL are typically less than 8,000 MSL.

***FYI: the use of contact lenses by aircrew is prohibited while wearing aircrew chemical defense equip-ment IAW AFI 11-301V1 and AFJI

Autumn 2006 AANGFS AFRFSA 10

NEWS FROM 22ND AIR FORCE Service Before Self…for 36 years.

It is hard to pick which event to talk about for the 22nd Air Force this quar-ter. Each unit has had something sig-nificant going on. This has been a quarter of recognition for the units that make up the 22nd Air Force. Recently, the Association of Military Surgeons of the United States selected seven units and 17 reservists as

winners of Air Force Reserve Com-mand's 2006 AMSUS awards. We have also been neck deep in train-ing. Somehow, between a visit from the President this month, Dobbins was engaged in some serious training for disaster medical support. They partici-pated in a National Disaster Medical Service exercise. A practice of deplan-ing, triaging and tracking as many as 100 patients, agencies from the Georgia State Defense Force, Cobb County Public Health, Douglas County Public Health, Centers for Disease Control, American Red Cross, Metro Atlanta Regional Transit Authority, Federal Emergency Management Agency, Georgia Emergency Management Agency, local hospitals and units from around Dobbins received knowledge and training on what it was like to hand le a hur r icane d i sas te r . The 302nd ASTS also participated in an Air Medical Staging Exercise. This was on top of the constant stream of de-ployed personnel they have been taking care of. The 403rd ASTS at Keesler has been in the midst of rebuilding and recovering from last years devastating hurricane season, but has been open for business

and fully functional. Congratulations to our fellow association member Col Maria Pons and the 403rd for the excel-lent rating on their recent HSI. Members of the 439th ASTS at West-over were deployed to Balad, and Kirkuk, where the action has not seemed to cease. The 440th ASTS has supported a steady stream of C-130’s to Iraq. Meanwhile the 512th AW at Do-ver has taken possession of new C-17’s. One of the most important happenings was the retirement of Chief Master Sergeant Dennis Kirkland from the U.S. Air Force, and the 910th Airlift Wing. Dennis spent 36 years in the service, with all but 2 of those years served solely with the 910th Airlift Wing. A 36 year career in the Air Force reserve. That deserves more recognition, more award, and more notoriety than any plaque or medal can give. This struck a cord with me when I was reviewing all the happenings within the 22nd Air Force because I know Dennis person-ally. Dennis had an impact on many officers and noncoms alike. He is a very personable and professional air-men, and epitomizes the role of the Air Force reservist. He knew everyone, and I mean everyone in the unit by name, and I dare say he knew almost everyone

on the entire base. He also performed nearly every job on that base over his career. But he made the medical unit his home. He is a self-made man, and Air Force blue to the bone. Unlike many active duty bases, where people move about every 2 to 4 years whether they need to or not, reservists tend to stay at one base, and they tend to bond with their fellow reservists a great deal. It becomes more than just a unit, it becomes a second family. The 22nd Air Force has a lot going on right now, with support of wars in two areas of responsibility, defense of the homeland, and training exercises going on incessantly. Somehow the 22nd Air Force will seem just a little smaller without Dennis Kirkland in it. Thanks for your 36 years of service Denny. May all of us in the 22nd have a career even half as fulfilling. J.D. Polk, Major, USAFR, MC, FS Chief, Aerospace Medicine 22nd AF/622nd RSG SGP Chief, Medical Operations NASA Johnson Space Center

As we prepare for our Annual Chapter Meeting during AMSUS (5 Novem-ber 2006 in San Antonio, Texas), I recognize that many of you will not be in attendance to hear the an-nual report. Therefore, I wanted to share some infor-mation and gather your feedback......which I will then share with those in attendance. I will also send out a follow-up e-mail after our meeting. There are currently, three major areas of focus for the Society. First, thanks to the hard work of retired Major General (Dr.) Dennis Higdon, our guest lecturer for this year's meeting will be retired Lt General (Dr.) PK Carlton (former USAF/SG and current Director of the Texas A and M Center for Homeland Secu-rity). He will cast a vision that will inspire the Weaver Society regarding our capability to shape the current environment regarding the Global War on Terrorism. Our current membership serves as a wealth of knowl-edge on preparedness and planning. We need to leverage that influence into partner-ships that will increase our nation's overall readiness posture. Second, we will spend some time at AM-SUS discussing a new and revitalized strat-egy to have Dr. Weaver posthumously promoted to the rank of Brigadier Gen-eral. We have had great frustration over the last year and feel the process has "stalled". We will overcome the resistance and will ask AMSUS to join the cam-paign. We have complete faith that this process will eventually be successful!

Third, the Weaver Society Board of Directors have had great discussions and agonized over what to do to increase the visibil-ity of the Weaver Library. Fi-nally, after great discussions, we accepted an offer from the Na-tional Guard Museum in Wash-ington, DC to house and display the exhibits. The entire Library (that many of you saw in Alpena in the Summer of 2005) has been

transferred and will be available for your viewing in the near future. Currently, they are resourced for the mission and report over 5,000 visitors and viewers per month. This significantly increases the number of people who will enjoy and learn from the archives you have pro-vided. Fortunately, the Curator will con-tinue to seek the Weaver Society involve-ment in procuring more memorabilia from the history of the Air National Guard Medi-cal Service! Last, I want to say thank you to CMSgt Graham, Col Bickel and Peggy Wolf for their outstanding and tireless work for the Society over the last six years and especially during the summer while I was in Afghani-stan. They always do a tremendous job and prefer to stay "behind the scenes" but de-serve the great appreciation of our Society! Please stay in touch and let me know if you have any questions or would like to gather more information about the Weaver Society ac t iv i t ies over the las t year!

Lt Col John Kirk Weaver Society Co-Chair

The Air Force Reserve (AFR) Flight Surgeon Section at AMSUS has been expanded to one and a half days,

including Tuesday afternoon and all day Wednesday. With the additional time, we are able to offer the full complement of RSV training for Reserve and Guard Flight Surgeons, except for ATLS. While not as comprehensive as the annual Flight Surgeon Sustainment Training Course held every March, this offers ARC Flight Surgeons an alternative for their busy schedules.

The program this year is packed with information about the changes coming in the Air Force Reserve Medical Service and a compre-hensive review of our core training material. Lt Gen James G. Roudebush, Brig Gen Charles O’Toole, Col James D. Collier, and Col Andrew Tice will address the group. There have been changes in the schedule since the printed program submission, so be sure to pick the revised schedule at noon on Tuesday, 7 Nov 2006.

There will be a special offering on Tuesday evening from 1730 to 1830; Col (Ret) Rodger Vanderbeek will give a presentation on Gap Analysis. Col Vanderbeek’s session is only open to Senior Flight Surgeons and SGPs. Sign-up for Col Vanderbeek’s presentation will be held at noon on Tuesday, 7 Nov. The overall AFR Flight Surgeons program will begin on Tues-day, 7 Nov, from noon until 1730. The program will resume on Wednes-day, 8 Nov, from 0730 to 1800. The schedule allows everyone to attend both the AFR Awards Luncheon and the Annual General Membership Meeting of the Association of AFR Flight Surgeons. CME will be offered as usual through AMSUS. Attendees will also be given letters of verifica-tion for the RSV training that they receive.

Leah W Brockway, Lt Col, USAFR, MC, FS 604 MDS/attached 92 ARS for flying Fairchild AFB, WA Mobile: (509) 995-3307 Unit: DSN 657-2994, Fax: DSN 657-2245 Home: (509) 747-4156, Fax: (509) 747-4234

Autumn 2006 AANGFS AFRFSA 11

WHY WE FIGHT

The title for this column comes from Band of Brothers, the episode when men of Easy Company come upon their first concentra-tion camp at the end of World War Two. I had occasion to think of that phrase, when recently I was in New York for a confer-ence. I had planned to attend advanced

training for a new procedure, and had scheduled it so far in advance that I never even noticed that the first day of the pro-gram was 9/11. As I went through the day, memorial services abounded, and there were reminders of that day five years ago everywhere. I have to admit that as the day wore on I was having a tough time, until I looked up at a passing jet, and saw that it was a Viper – a Guard Viper on combat air

patrol over New York. Many people don’t know I’m origi-nally from New York City – I grew up within walking distance of the World Trade Center and asked my wife to marry me at Windows on the World. Since 9/11 I’ve had the opportunity to deploy on several occasions, including to Ground Zero. Every time I need to be clear why I put on my uniform and take time away from my job and my family, I just have to remember walking through a 10 story high

pile of smoking rubble that used to be part of my neighborhood, or the wounded troops on the airevac flights I’ve been privileged to fly on. We do this because we are taking care of our friends, our neighbors, our fellow countrymen. Our soldiers, airmen, sailors, and marines de-serve the best care possible, and we are the ones who can provide it. What’s more, if ever there were a perfect opportunity to recruit new physicians, it’s the chance to provide state of the art care, to people who both need and deserve the best, and to work with some of the most talented and dedicated professionals on the planet. Where do I sign up? Col Reid Muller

AsMA Future Annual Meetings: New Orleans, LA - May 13-17, 2007

Boston, MA - May 11-15, 2008 Los Angeles, CA - May 3-7, 2009

ASSOCIATION OF AIR FORCE RESERVE FLIGHT SURGEONS MEMBERSHIP APPLICATION (PLEASE PRINT AND CHECK APPROPRIATE ANSWERS)

NAME/RANK:__________________________________ MAILNG ADDRESS:_____________________________________________________________ DUTY ADDRESS: (unit)______________________________ PHONE NUMBER: (civilian)___________________________ (military)___________________________ e-mail (civilian)____________________________________ (military)_________________________________ APPLICATION: NEW___ RENEWAL___ Data Change___ MEMBER STATUS: ___MEMBER ___ASSOCIATE (non flight surgeon) __FELLOW (must be member of Aerospace Medical Association and Society of USAF Flight Surgeons) MEDICAL SERVICE: ____ MC ____FLIGHT SURGEON

______ DC ____NC _____MSC ____BSC DUTY CATEGORY: ___ CAT A ____IMA ____AD ___RET DUES: $25.00/YEAR____ $60.00/THREE YEARS____ $250.00/LIFE MEMBER____ MAKE PAYABLE:Association of USAF Reserve Flight Surgeons MAIL TO: Membership Chairman, AFRC FS Association 1102 Holiday Court Granbury, Texas 76048

Attention Flight Surgeons. A current RAM (and Guardsman) will be conducting a survey of Air Reserve Component Flight Surgeons looking at satisfaction, deployments, training and ops tempo. This is similar to, but separate from the FS Survey commissioned by the USAF/SG several years ago. The survey will be web-based and anonymous and should go "online" toward the end of October. Look for an e-mail and other announcements later this month for the web address. Colonel Riggins (NGB/SG) fully supports Guard Flight Surgeon participation and will be receiving the results when they become available. The POC is Major Lisa Snyder (lisa.snyder@brooks.af.mil) (This is really important information for policy makers; please take a moment for your input, thanks—WWP, editor)

Autumn 2006 AANGFS AFRFSA 12

BGen Chuck O’Toole AFRC FS Association 1102 Holiday Court Granbury, Texas 76048

When: Tues, 7 Nov 06 Where: Rivercenter Comedy Club 849 E Commerce; Ste 893 San Antonio, TX 78205 (short walk from all convention hotels) Time: 1915-2200 Cost: Members = free; Guests = $5

Reservations: email Robert.Chu@pentagon.af.mil (pick up tickets @ Member Desk during Reserve AMSUS events)

RESERVE FLIGHT SURGEONS ASSOCIATION ANNUAL AMSUS SOCIAL

05 NOV @ AMSUS for the Society of SAS • 0800-1200 SAS's meet with Assistants. Advisors, and

ANG/SG with additional attendance from EUCOM/SG and SOUTHCOM/SG

• 1300-1700 SAS's meet with EUCOM/SG, SOUTHCOM/SG and Army Guard Surgeons

• 1800-1930 Reception sponsored by Society of SAS The room assignment has been changed due to the fluctua-tion of attendee numbers—Please check upon arrival. Col Jim C. Chow President, Society of State Air Surgeons

WSC meetings are on Tuesday, November 7. We have time & rooms blocked for regions to meet among their own groups from 8-10, then an at-large meeting for regional leaders (and interested others) from 10-12. Hope to see you there! MICHAEL PALETTA, Colonel, MC, CFS Medical Weapons System Council