Not everyone welcomed the elongated P-day interval. The recruits were still in sweat suits at the beginning of their formal training cycle.
From Seaman Recruit Megan Wirsch’s first letter home Mom! All I can say is that those who are sick in bed are actually the lucky ones, because we all stink! I can’t even explain, Mom, how bad we all smell. We all know what the problem is, and where the nasty odor is coming from. Imagine, Mom, eighty or ninety new recruits, all scared, tired, and really confused, and marching all over the base. All of us, dirty and sweaty and stinky.
Now, Mom, even worse, imagine our clothes. Remember that these aren’t just ordinary clothes, these are Navy blue sweat suits with the Navy logo on the front and sides of the pants. Half the time we wear sweatshirts, and the rest of the time we wear tee-shirts. We call them our Smurf suits, and they soak up anything and everything. Of course, it gets better. Since we only get one set, there hasn’t been an opportunity to wash them yet, and we’ve had them on for nearly a week now. Marching all over and practicing on the grinder really works up a sweat, and since our showers are three minutes long, you can just guess how many layers of dirt have been building up since we got here. I think this will be a memory I will never forget.
Petty Officer Kent says that when you drive through the gate here, there is a real difference in the smell. That would be us, the “Stinky Smurfs.”
I do have to defend those who just smell bad because they haven’t had a chance to wash their Smurfs yet. But there are extra-stinky Smurfs, who might want to wash out their socks and stuff a little more often. Some of them can clean out the room when they take off their Navy boots.
Well, Mama, it’s a good thing my nose is all clogged up, or boot camp would be worse than it is. Even after yesterday, when we got to take showers as long as we liked, it was pretty bad. Now we just notice when we don’t smell, and not when we do!
Seaman Recruit Wirsch was not the only recruit with a stuffed-up nose. By the end of their first week at Great Lakes, most recruits suffered from an upper respiratory infection, intestinal discomfort, or, for the truly unlucky, both. Each compartment—usually empty during training hours—housed a half-dozen or more recruits who had been declared “sick in quarters” (SIQ). And some were even less fortunate.
Stephanie Bruce, 18, Social Circle, Georgia
If there is one thing in boot camp that is certain, it is that everybody has the Ricky Crud. You’ve got people coughing, sneezing, throwing up, and passing out almost every day. At night, you can hear sirens as ambulances go to the different barracks. I got really, really sick right after I got here. I made a trip three days in a row to Building 1007 [USS Tranquility, the branch dispensary, located across Illinois St. from Ship Eight]. I was coughing badly, running a fever, and just felt bad in general. Those three days I was SIQ, but the fourth day they said I was FFD [fit for full duty]. Two or three days later I was still feeling bad, maybe a little worse. So, I went back to Tranquility, and they said my temperature was 105 degrees and my pulse was 137 beats per minute. Right then, the doctors called for an ambulance, and I was driven to the Naval Hospital. Over there, they gave me a private room with a TV, telephone, and real bathroom. A female doctor came and said I had pneumonia. She was really nice; she went and bought me lunch from the McDonalds they have downstairs. She knew I was a recruit, so she bought it with her own money. I called my mom, like, a thousand times while I was there. She wanted to get on a plane to come up and take care of me, but I told her things were great in the hospital. I got to watch TV, talk on the phone, sleep and eat all the time. It was like a mini Ricky-vacation. Too bad I got ASMOed for it. That was the only drawback to it, that and being sick, but at least I got ASMOed into Division 005, and that was really nice.
In her short time at Great Lakes, Seaman Recruit Bruce had experienced the full spectrum of medical care available to recruits. She had received her basic physical examination and immunizations at Building 1523. Upon becoming ill, her division’s medical yeoman escorted her to Building 1007, a recently constructed clinic and dispensary, centrally located just south of the recruit chapel. Ten-oh-seven, as it’s called (the formal name USS Tranquility is rarely used) provides triage, urgent care, medication, and follow-up for recruits and staff. The U.S. Naval Hospital, Great Lakes, is the focus for military medicine in the north-central states. The nine-story general hospital is located at Camp Barry, on Mainside, just east of Recruit Training Command.
Wirsch Every body calls us “recruits,” right? They ought to call us “acutes.” Everybody around here now has, or had, or is in the process of getting, the Ricky Crud. Everybody started feeling rundown right after we got our shots, and nobody has really felt good since. I think I must be the host carrier, because I’ve been sick so many times. I’ve been hugging the throne in the head ever since I got here. And with eighty females in one compartment, and everybody sick, you just hope there’s one open when you need it most. I’ve always been healthy, but during the short time I’ve been here I’ve had pink eye in both eyes at the same time. I had it so bad that I woke up in the morning with my eyes glued and crusted shut. Then I got the flu. When I went to the doctor, I got some Sudafed. Everyone in the division had the Ricky Crud at the same time, with swollen throat, earpain, headaches, and painful sinuses. Body aches you don’t count, because they never stop, even when you are healthy.
Mary Smith Chief Zeller made me the medical yeoman. Sometimes I don’t know if that is good or bad. One of the things that I do is to set up everyone’s appointments at medical. There are days when I’ve filled out twenty chits for sick call. I hate it when I have to go over there myself for anything. The waiting room is full of people coughing, sneezing, people with fevers, whatever. If something serious happens to you, they will see you right away, but with a million recruits on base, and everyone sick, if you just show up running a fever, you wind up in this big waiting area right inside the door till someone can look at you.
Gildersleeve Well, I hurt my knee the first days we were here. I was on crutches for a couple days, then on LLD [light limited duty]. I went over to medical every other day, and they were pretty good. They knew what they were doing. Everyone complains about the long wait but if you are a “Rick on a Stick” [a recruit on crutches], it’s good to sit down and not be marching and drilling and stuff.
Because of the crushing workload, the recruits had little time to chat with the medical officers and enlisted corpsmen who provide medical care on base. Every category of provider is in short supply: dentists, nurses, physician’s assistants, pharmacists, psychologists, physical therapists, and, most critically, physicians.
Lt. Robert J. Houser, MSC (Physician’s Assistant)
Our job here is to take care of recruits. We see some staff, but mostly recruits. The volume here can be anywhere between fifty and a hundred patients, per provider, per day. It’s overwhelming. They stack up like cordwood on the weekends. All the way down the hall.
Lt. Rowland J. Rivero, MD
We can’t do much triage using corpsmen. With the number of patients every day, there’s always the chance that someone will triage incorrectly. So most recruits who make sick call will see either a nurse, a physician’s assistant, or a physician. We had 177,000 sick-call patients last year. With 53,000 different recruits here in a typical year, the average recruit lands here three or four times. Now, those are just averages. Some recruits we never see, others seem to be here every day.
Lieutenant Houser We see everything from out-and-out malingering to life-threatening conditions. We’ve got a bad one right now—he presented with pneumonia, and now he’s over in the hospital with acute respiratory failure. But when you consider that we have a total population larger than a lot of cities, and most of the people are involved in physical activities all day long, it’s really not all that unusual, I suppose.
The last fatality we saw had Marfan syndrome, and experienced sudden cardiac arrest. The MEPS station does a fair job of screening, but the mo
tto of the physicians here is “We’re like the little scrubbing bubbles—we work harder so they won’t have to.” The MEPS stations do a fair job at best. They are under a lot of stress to get recruits here. The Navy is shorthanded. The recruiters pressure the MEPS stations, and they pressure the contract physicians. We had a kid arrive with a glass eye last year. We’ve had a dwarf (achondroplastic presentation). He had to jump to get up on the examination table. He had some kind of unofficial waiver for his height, from the XO of his recruiting district. We see kids with multiple retained hardware, pins in their joints, plates in their skulls. We’ve seen a hermaphrodite, full-fledged Cushing’s syndrome—you name it, we get it. Some are so blatant, so obvious, it’s just a waste of taxpayers dollars sending them here.
Dr. Rivera Those are just the physical conditions we see. From a psychiatric perspective, we are one of two entry points for the Recruit Evaluation Unit upstairs. Either the RDCs or we refer recruits to the psychiatrists and psychologists on a daily basis. The RDC can fill out a preliminary form to get them upstairs; they generally don’t need us here in the clinic to look at them before they go topside. But just last night, I had one. I had a young lady come in here, who said she fell down the stairs in the barracks. I looked at her back, and she had bruises up and down her spine. It wasn’t a fall pattern, she didn’t have bruises to her extremities, and she didn’t try to catch herself falling, no bump on the head—just a banged-up back. She was in hysterics when she came in; she was having a psychiatric episode right then. Personally, my hunch is that she was being abused at home, and when she came here to escape that, the first thing she ran into was a bunch of guys screaming in her face, and she broke down.
This might surprise some people, but I’d say that 98 percent, maybe 99 percent of the kids we see in here have legitimate medical problems. Malingering happens, but not nearly as much as you might expect. Now, that doesn’t mean that they’d all have wound up in the ER at their local hospital. It might not be all that serious, but you have to remember that this is a controlled environment. These kids can’t run down to the drugstore for a bottle of aspirin. So we have standard cold packs, analgesics, decongestants, all in small enough packages that there’s really no danger of abuse. But still, on any given day you’ll see a couple that are malingering. Maybe 10 percent of the ones we see have no visible pathology, but they do have pain, and it’s fairly easy to tell when it’s real.
Lieutenant Houser Well, you have to understand, too, that the ones that stick out in our minds are the ones that are exceptions to the norm. When you are seeing fifty, sixty, maybe even a hundred patients on a duty day, you only remember the really unusual ones.
Dr. Rivero There’s a protocol that we follow as to whom we treat here and who goes over to 200H [Building 200H, Naval Hospital, Great Lakes]. If a kid is decompensating over a seventy-two-hour period, if he’s getting worse and not better, then it’s time to get them over to a specialist. We really can’t treat a recruit as an outpatient; it’s not like when you’re out in private practice and you say, okay, take this medication and come back tomorrow and see me. When we don’t feel comfortable with how things are going, they head over to Mainside. If we suspect meningitis, if we even suspect that we suspect meningitis, they’re across the street, stat. We don’t have the facilities for spinal taps here, nor are we set up for isolation. And we’ve pretty much decided that anything that requires intubation, other than an out-and-out emergency, should go across the street. Naval Hospital, Great Lakes is, in every sense of the word, a teaching general hospital.* There’s no place better to send them, at least in this region, if things are heading downhill.
Lieutenant Houser I know everyone talks about contagion, but I really don’t think it’s worse than any other place where you have large age cohorts together. The one big difference, though, is proximity. In a college dorm, you’d usually have people in separate rooms, with separate toilet facilities, whatever. These recruits are with each other all day, every day. You pull kids from every corner of the country, and from whatever foreign countries, you expect people to be exposed to viruses they’ve never seen before. Couple that with the fact that all these kids are sleep-deprived, and their immune system heads south. I can’t tell you how many times I’ve heard a kid say, “I’ve never been sick like this before,” and the answer is, hey, you’ve never been in boot camp before, either.
Dr. Rivero Well, this place is a stress factory. You come here, your cortozol levels get all screwed up, and cortozol is vital to fighting infection. Add that to sleep deprivation, strange bugs, incipient malnutrition because you’re stressed out and have zero appetite, and you wind up with infection.
Lieutenant Houser A lot of the recruits have been programmed or influenced by other recruits that their shots are going to make them sick. We have very few cases of allergic reaction to immunizations, either immediately over at 1523 or over here. All the immunizations we do here are common; in fact, most are required before you can enter public schools or college. The only immunization that the Navy gives that is a little unusual is yellow fever, and we don’t do that one here. They’ll get that at their first active-duty station. But, hey, you go through the tunnel, you get your shots, you come back to the barracks, somebody coughs or whatever, twenty-four hours later you have a headache, sniffles, your joints ache, and, ah! it must have been the shots. But it really isn’t.
Dr. Rivero It’s really amazing that, for many of these recruits, we’re the first providers they’ve ever seen. Well, maybe the MEPS station is the very first doctor, but we know that they only see them for a couple minutes. We see thousand of recruits who have never, ever seen a dentist; their teeth are already rotting out of their heads. We see lots of female recruits who have never seen a gynecologist. They usually claim that they couldn’t afford medical care, but, hey, the way things work in this country, you can always get adequate medical care. You may wind up waiting for awhile down at your local county general, but you’ll get seen eventually.
Lieutenant Houser I’ll tell you one thing that is interesting. About 15 percent of our recruits are female. At last count, 57 percent of all sick-call visits in this building were female. We’re taking more than half of our resources—and we’re shorthanded in every category you can think of—and dedicating them to 15 percent of our population.
Dr. Rivero We see recruits at two extremes. There are those who come over here every chance they get, and always have an excuse why they are here. And then there are those who keep on plugging, tough it out, walk around with fractures and keep going till they just physically can’t, and then they drop. There are recruits whom I truly admire. There was one recruit who came in here after Battle Stations, he was hurting so bad he couldn’t even limp right, and I took x-rays, and what do you know? Three fractures, two in one foot and one in the other. One broken metarsal on one foot, two on the other. When did it start hurting? Second event. He ran Battle Stations all night on two broken feet. There are kids like that out there, and you really have to admire their dedication. Their judgment might be questionable, though.
Lieutenant Houser But, you know, a lot of those that keep on plug-gin’ are female, too. Recruits with pelvic stress fractures or stress fractures to the humus, and they keep on going. Amazing. It’s been my experience that female recruits—at least a portion of them—have more ability to grin and bear it through pain than the average male recruit does.
Dr. Rivero I think a lot of problems could be corrected with wellness education, I really do. These kids smoked, most lived sedentary lifestyles until they hit here, some abused alcohol, and few had any idea of balanced nutrition. So if they don’t get anything else out of this place, I hope that they leave with healthier lifestyles than when we got them.
One area of interest to both Dr. Rivero and the recruits was nutrition. Navy food has a well-deserved reputation among the military services as a notch above the rest. While the thought of balanced meals may not have resonated with the younger recruits,
the meals at Galley 928 were always hot, nutritious, and usually quite tasty.
Leitner My college degree is in nutrition, so I was very interested when I first got here to see what the Navy would serve, and how they would prepare it. By and large, I thought it was okay. It’s certainly not terrific, but it’s acceptable. It’s can be bland at times, but it’s wholesome and filling.
Parker Navy food is no different than any other cafeteria food, I guess. The food tastes similar to lunchroom food when I was in school. And, just like in junior high, there are people going up and down the line, making sure that everyone behaves.
Leitner For me, the best meal of the day is breakfast. I’m usually pretty famished by the time we get over to the galley. I’d really like the opportunity to sit and chat while eating, to have some time to relax, but with all the recruits lined up, we don’t get much time at all. And I haven’t had a chance to talk at a meal since we got here.
Wirsch Well, the food is okay, I guess. I have a problem with finding something to drink, though. I observe my church’s ordinances about not taking caffeine, so I skip the soda pop and coffee and tea. I usually just have water, or “Ricky bug juice,” which is what everyone calls the red, Koolaid-like stuff that they have in the machines. The milk can be good at breakfast, but it’s never very cold.
Honor, Courage, Commitment Page 6