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TEAMMATE, MENTOR, FRIEND
There is nothing like returning to a place that remains unchanged to find the ways in which you yourself have altered.
—NELSON MANDELA
Once I finished up the classroom requirements at Fort Sam Houston, we packed up our belongings and headed for my next stop, Naval Medical Center San Diego. Surprisingly, I found myself checking in at the exact building where I’d reported as an undesignated sailor for Hospital Corpsman School. Only this time no one was questioning my warfare qualifications. For the next year I would undergo all the same clinical rotations a general practitioner serving the fleet would require, not to mention monthly exams and presentations to my colleagues and journal club. I was becoming a regular academic and hoped I would feel equally as comfortable as a midlevel medical provider. In fact, that was the easy part.
No matter how successful I was in medicine, I had already failed in my mission to salvage my marriage. Soon after arriving in San Diego, we filed for divorce. It didn’t matter that I knew it was coming or that it was something we both agreed upon. It didn’t matter that we still cared for one another as individuals and tried to be understanding of each other’s circumstances. It’s still extremely painful when two people realize the dreams they once shared will never materialize.
All that would pale in comparison to being separated from my daughter. Going from holding my flesh and blood each day to not having her anywhere near me was the most painful experience in my life. I might have only had a few moments with her each day, but they were the most valuable moments in my life. Often when I would come in late from the library, study group, or hospital wards, I would go to her room just to sit and watch her sleep. Now I would have to make a twenty-six-hour round-trip to a small town outside of Albuquerque to see my little girl. I would have much rather flown than make that drive, but every penny we had was spent on bills we accumulated by either trying to save our marriage, relocating Tamara back home, or paying lawyers’ fees—leaving both of us penniless. By the time it was all over, Tamara had to move in with her mother, and I barely had enough money for gas and food.
I lived close to work at Balboa in sunny San Diego and rode my bike in each day. The money saved paid the bills and covered the gas I would use traveling back and forth to New Mexico. The drives were brutal, after spending a forty-to-sixty-hour week on the hospital wards or clinics, depending on the rotation I was on. I would jump into my car and drive thirteen hours to Tamara’s mother’s home. Time was limited, so if traffic allowed me to get there earlier than expected, I would pull over and catch a thirty-minute catnap in the car before washing up at a local gas station. Then I would pick Tabetha up by 8:00 A.M. From there it was a drive into the city to stay with Diana or Mom, depending on how Cassandra’s mental condition was at the time. It really didn’t matter where we stayed. All I knew was that for the next thirty-two hours, I was going to be with my little girl.
Returning to San Diego was always even harder due to the anxiety that generally accompanies morning traffic on the California freeways. Yet somehow I always seemed to make it back to the hospital with enough time to shave and throw on my lab coat before morning rounds. This chaotic routine took a lot out of me, and it was starting to show in my grades, but that didn’t matter as much to me as the idea of having my daughter grow up without knowing her father. Every time I’d hit that long stretch through the Arizona desert, I’d tell myself that any man can be a father, but you have to work hard to be a dad.
Still, all my time in the teams, from BUD/S to Central America, couldn’t change the fact that there were only so many hours in a day. Whether I liked it or not, I had to limit my trips to twice a month and every three-day holiday when I wasn’t on call. I’d like to say that it was solely my love and devotion for my daughter that enabled me to keep this tempo up for more than half a year while I recovered from financial ruin, but truth be told, there’s no way I could have accomplished any of this without some very close friends. Although our jobs never really allowed us to spend time together as a group, I would refer to them as my “fire team.”
Derrick Van Orden was a young tadpole when I first met him coming out of BUD/S; I had the honor of mentoring his work, and that of other young SEALs, which would eventually dwarf anything I ever accomplished. Out of all the things he and the others were able to achieve, there was only one thing that I envied—Derrick’s role as a husband and father. From the first day I met Derrick and Sara, I knew they had everything prioritized. After arriving in San Diego, I would escape to their home at every possible opportunity. Sara would feed me while Derrick and I caught up on everything going on in the teams. She’d then send me home with meals and groceries I couldn’t afford. What I enjoyed the most was spending time with their kids. That family taught me what I needed to do in order to be Dad, and it made me never want to leave. Eventually, though, I had to get back to the time-intensive world of medicine, and with Derrick’s operational tempo in the teams, and Sara managing four kids ranging from high school to elementary, anything more than a weekly visit was impractical. That’s where Jim, Jerry, and Pat took over.
Jim Elliott was a reserved, fit, and clean-cut doctor who was going through his intern year at Balboa. We first met during one of my first hospital rotations and immediately hit it off. Even though I tried to hide how precarious my situation was, he was able to figure it out by piecing together my activities.
“Hey, let’s go to lunch while we have the chance. You know things here can get crazy quick,” Jim said one afternoon, making a joke about our current rotation on the psychiatric ward.
“Go ahead, brother. I’m not hungry. Besides, I could use the time to study.”
“Nah, come on, it’ll be quick, and I’ll treat. I’m not going without you, and I’m starving,” he said in a friendly but persistent tone.
As we walked to the sandwich shop on the hospital grounds, we casually talked about his alma mater’s loss in the Sugar Bowl. We grabbed a couple of hoagies and went outside to eat under the California sun.
“Mark, we’ve talked about my divorce, so you know I have some understanding of what it’s like to be separated from your kids,” Jim said, alluding to being apart from his son and daughter. “But I also know you’re broke. I see how you make the drug rep’s coffee and bagels every morning, and how you try to attend each of the sponsored luncheons, too.”
I kept listening despite my throat going dry as he went through a litany of circumstantial evidence. “Look, you don’t have to go at this alone. No matter what you say, you’re taking this,” he said as he inconspicuously slid a folded stack of bills under my hand.
I wasn’t sure how to respond until I remembered what my mom told me years earlier. People want to help, mijo. You just have to let them know how. Suddenly my eyes were tearing up as I stared off into the distance. “OK, but what I really need is help getting my mind off all of this. I can’t seem to concentrate right now, and if I fall too far behind I’ll never catch up.”
“Keep it, we’ll do both.”
The rest of the year, Jim never left my side, and a couple of rotations later we picked up an ENT (ear, nose, and throat) resident named Jerry Castro and a classmate of mine named Pat Hare. Between all of them, I always had a place to stay, food in my belly, and my mind focused on school and my baby girl. None of them ever asked for anything or gave anyone even a hint about what was going on. I might have been away from Special Warfare, but with my family and friends, I was never without a team.
* * *
Following graduation from PA school, my classmates and I shipped to Officer Candidate School in Newport, Rhode Island, the final step to becoming commissioned medical officers. After twelve weeks of instruction, we were commissioned as ensigns in the United States Navy. Prior to that, we were merely officer candidates, which meant we wore the uniform but had no authority whatsoever. I always marveled at the strange looks I would receive when seasoned sailors stared at the r
ank on our collars, trying to figure out whether they needed to salute or not. Those days were over. As newly minted ensigns in the Medical Service Corps, we were excited to report to our very first medical clinic for duty.
Navy PAs follow the same general path, unless there are extenuating circumstances. They cement their newly acquired skills at a primary care clinic and eventually receive orders to an expeditionary command. I looked at it as navy medicine’s way of ensuring each of us completed a workup before pushing forward to practice medicine in some of the more challenging environments.
My assignment was to the Branch Medical Clinic at Naval Amphibious Base Coronado, my old home as a BUD/S candidate. At Coronado, I worked under two of the best PAs in our community, one being a frogman like me.
Dave Holder was a straight shooter who served as a corpsman for several years before becoming a physician assistant. He excelled in the job and eventually took over as officer in charge of a clinic that served the Navy’s amphibian forces inhabiting Southern California. His cohort in crime was another ambitious PA named Jessie Gross, a former SEAL corpsman who served with the West Coast SEAL Teams. His early career took him all across the South Pacific, and it was several years before he decided on making medicine his primary occupation. As a medical officer assigned to BUD/S, he spent countless hours with the orthopedic department at Balboa and eventually became one of the navy’s top experts in sports medicine before moving on to be Dave’s right-hand man.
I checked aboard the clinic early one Monday morning, anxious to get started. My first stop of the day was a meeting with Dave and Jessie in Dave’s office.
After a few minutes of small talk, Dave dove right in. “Mark, you’ve accomplished a great deal with the SEAL Teams, but unfortunately none of that matters too much with navy medicine.” I had a feeling this was going to be the tone of the conversation.
“Don’t take it wrong, Mark,” Jessie continued. “As a new PA, you need to continually build your medical knowledge, and to be competitive that means completing a specialty, and that means an advanced degree.” Both men smiled as I absorbed the news.
Great, more school, just what I needed. I knew they were right, though. If I was going to succeed as a Medical Service Corps officer, I needed to complete a master’s degree in a specialty that was useful to the navy. “I’m tracking; the best PAs have graduate degrees, but am I going to have the time to pursue one?” I asked.
“We’ll work that out for you. Do you have any preferences for a specialty?” Dave asked.
“I think I would like to try something new. I’ve had plenty of trauma and emergency medicine in my career, but nothing really jumps out at me right now.”
“Fair enough. We’ll get you some face time with the different departments and see what lights your fire,” said Jessie.
The mentoring session went on for over an hour as they laid out the plans for my new job and educational pursuits. Both Dave and Jessie would pick up some of my patient caseload, allowing me to split time between the clinic and the hospital. This would ensure I had an opportunity to obtain a specialty. We talked about everything from ENT to orthopedics and eventually wrapped the meeting around lunchtime, allowing me to finish the check-in process. The following day, they sent me off to the hospital to meet with the different departments, to see if a particular specialty would spark my passion and interest.
Navy physicians are generally very supportive of medical providers furthering their academic and professional development, especially those with years of experience. Early in my career I worked with Dr. Larry Garsha at the SEAL compound in Virginia. Dr. Garsha was one of the most encouraging doctors I ever met. In addition to being a Navy Undersea Medicine doctor trained in nuclear and diving medicine, he held board certifications in internal medicine, neurology, and psychiatry. His real specialties, however, were humility and inspiration. Unlike the occasional doctor who’d spend his time at an expeditionary command trying to convince himself and those around him that he was a steely-eyed warfighter, Larry embraced his role as a supporting cast member and mentor to young corpsmen. From the moment I met him he had the “what can I do for you” attitude, and it was his influence and mentorship that steered me exactly where I needed to go.
* * *
Frank Carlson ran the medicine department at Balboa Hospital. He was a senior provider who enjoyed fine dining, wine, and complex medicine. We had met years before, when I was a young student rotating through his department. Back then we would talk about overseas deployments and two areas in operational medicine that intrigued me the most: infectious disease and chemical warfare. I was still fascinated by both, and in order to master those particular areas, I needed to build a strong foundation. That morning, I sat with Frank and pleaded my case to specialize in internal medicine. The consummate teacher, he arranged for me to join the staff on alternating days between the Medicine Clinic and the Branch Clinic with Dave and Jessie. Once again, I was encouraged to succeed by a caring expert who simply wanted to help a young medical provider master his craft. Four hours into the second day, I had chosen my specialty.
Later that day, I returned to Coronado and met with Jessie and Dave.
“You’ve got to be kidding me, Mark! A flea!” Jessie said. “You’re going to be a flea.” The term is jokingly used around hospitals to describe internists. The idea is that fleas travel in packs and are always the last ones to leave the body, but I only found the first part to be true. Internal medicine is a humbling practice due to the complexities of the patients these doctors manage day in and day out. The constant consultation with their colleagues only reinforces their devotion to providing the best care possible, so the term “flea” never bothered me. In fact, I kind of embraced it.
“Yep, I’m going to work toward being a flea. At least for the interim. Who knows what could happen next?”
I plowed into my studies at the same pace at which I attacked PA school and completed a majority of my academic requirements in six months, leaving just under a year on the wards to finish my clinical time. I was really looking forward to a break and promised myself no academics for at least two years—but I’ve never done very well living within the confines of absolutes.
PA INSTRUCTOR
One morning I was packing my gear and heading out to spend the second half of the day at the hospital. Jessie knocked and stuck his head in the door. “Mark, can I see you for a second?”
“Sure, come on in. What’s up?”
Jessie entered and closed the door behind him. “As you know, Dave’s leaving, and as it turns out, I’ll be taking over the clinic.” I interrupted him with well-deserved congratulations and a few humorous comments about the great crew we had working there, but he held up a hand, stifling a laugh.
“Yes, I know, the crew is awesome and you’re the king of awesomeness. Now let me continue so you can get out of here. I need a primary preceptor for the PA students rotating through family medicine here at the clinic, and you’re my number-one choice. It shouldn’t be too much of a workload since you already help teach at the clinic and the internal medicine department. I simply won’t have time with all of my new duties.” Jessie crossed his arms and leaned back on the door frame while I absorbed the request.
My gut reaction was to stick with my promise: no academics. However, I always learned a great deal about a subject when I taught it to others, and I really enjoyed teaching medicine; it gave me a chance to give back in a way that would make Mom proud. Besides, I owed it to both Jessie and Dave, two committed medical officers who worked hard to build the program and took special efforts to ensure my success.
“If I say yes, can I have Fridays off?” I smiled.
“Hell no, but I’ll give you one Friday a month so you can attend the student presentations at the schoolhouse.”
“Well, that’s better than nothing. I’ll do it.” We shook hands roughly, the team guy way.
“I knew you would. Thanks, Mark. Now get out of here.” He slapped my ba
ck as I headed off to the hospital, a newly minted instructor.
I had no idea how profoundly the teaching position would change my life.
KORRINA
Six months into the teaching assignment, my instructor duties had been expanded and I’d been reassigned to a brand-new medical clinic at Marine Corps Air Station Miramar. Despite my new location, I continued to divide my time between the clinic and the hospital and greatly enjoyed the duty. Each student had his or her own personality, and I marveled at how each one’s passion for medicine and personal character would positively impact navy medicine. It was also the time I met my future wife.
Korrina was a beautiful and incredibly smart woman and single parent who was juggling the pressures of PA school while dealing with the stress of being separated from her child. She had split amicably with her husband years before and felt it best that her son stay with him while she focused on PA school. It seemed reasonable at the time, but the guilt was a major distraction and added to the difficulty of an already brutal academic course. Her only consolation was that her ex-husband was a good father and empathetic to her struggles. Following the divorce, she found herself in an abusive relationship, and the breakup that ensued only further complicated her already stressful life, but no one would have been the wiser. Korrina’s grades were always at the top of the class, and her ability to reach her patients was remarkable. She was a survivor in every sense of the word, yet she still couldn’t shake the weight she carried upon her shoulders; instead she reverted to doing what she knew best, and that was how to shield others. Over the weeks that we worked together we’d share stories about the difficulties of being a parent away from your child and began building a bond based on mutual empathy. Months later she graduated PA school, and while her class awaited orders to their first command, we began to date.
Battle Ready: Memoir of a SEAL Warrior Medic Page 12