Page 137 - Journal of Special Operations Medicine - Fall 2015

must always go back and refresh the mastery of the basics. key difference from the conventional force. Normally, med-
As I see it, we have to constantly ensure that the foundation ics are adjuncts to the provider in the clinical environment
of a task or skill is reinforced. TCCC has become a prime or even in the evacuation chain. In SOF, it is the other way
example of this for the SOF medic. It is a skill set we must around; the providers must be adjuncts to the medics, who
always maintain even as we shift to an operational spec- are operating independently and widely dispersed. New
trum that is less direct action combat. I personally believe in docs need to find ways to be enablers and assets to the
teaching and maintaining the most basic of field craft skills medics and not the other way around. I mentioned trust
such navigation with a compass, simple water disinfection, and empowerment of the medics. The only way to trust and
and iron sights marksmanship. We have a generation that empower the medics is to train with them and interact with
has mostly known GPS watches, bottled water, and high- them. Being a SOF unit medical director is mostly about
tech lasers and scopes on our weapons. In my experience, providing oversight, guidance, and top cover. Sometimes it
the batteries always fail and you run out of stuff at the most is about going out on a limb from the clinical everyday nor-
inopportune moments. Always having the backup basic mal and thinking how best to manage something in austere
skills can save lives. You can’t teach or learn most of those scenarios with limited resources. You must be a doc who
skills by PowerPoint; you have to do them hands-on. can think outside of the box and then allow your medics to
practice outside of that box as well. That said, the medics
Advice for the medics? must understand their limits and what can and cannot be
First, you are part of a global SOF medical network, regard- attempted in the SOF environment. For both to navigate
less of whether your role is a team medic, an instructor, in this quagmire, the medics must embrace and train the doc
R&D, a surgeon, or at policy level. Make your role as part to understand their environment.
of the network. Take the role and run with it, make it your
own as an individual, and be part of the network. When you What’s helped you along the way?
step out of your role or your job, leave no vacuum. Don’t Always living the Ranger Creed as a standard to measure
leave a gap for others to fill. Build the system better so it every day and action. Aside from the creed, I’ve kind of
handles turnover and transition and remains connected to lived by a basic principle. When you are right and you know
the network. One of the principles guiding SOCOM is that you are right, then you have a moral obligation to force
to defeat a terrorist network, we have to build a better net- your will on others. I see this as a basic test of any agenda,
work. Make your individual network part of the global SOF project, endeavor, or cause I have ever pushed along. If it’s
network. the right thing to do, then do it regardless of the obstacles.
Policies can be changed; equipment can be changed; tech-
Second, never rest on your laurels; be better today than niques can be changed; whatever can be changed. What
you were yesterday. Our community’s magic is that it’s self- matters is whether people will ram through the resistance
critical. Learn from the past for a better future. Evaluate all and push the change to make things right. I’d like to think
the time; identify and fix failures; validate requirements; that this principle applies to everything I’ve been talking
and find the right resources. In 1993, Somalia showed us we about today.
can do better—some things worked and some things went
wrong. Things that were wrong led to the emergence of
TCCC. Reinvigorate; challenge yourself and your team to
always be better. SOF units and individuals have incredible MSG Montgomery served in the 75th Ranger Regiment for
histories and valorous actions. But we must be better than 22 years, most significantly as the Regimental Senior Medic.
we were yesterday. CSM Greg Birch often said that you’re Throughout his career, he worked with all SOF elements
only as good as last night’s mission. But that was last night. through multiple combat deployments and exercises. His fi-
You’re really only as good as the mission you’re prepared nal assignment was as the Senior Enlisted Medical Advisor
to do tonight! (SEMA) for United States Special Operations Command (US-
SOCOM). MSG Montgomery retired from active duty on 1
Advice for the docs? June 2015.
Young docs new to SOF must understand medics better,
and vice versa. There is so much that can be learned from E-mail exchanges, including documents, have been condensed
one another. You’re in our environment now, but learn and edited.
how to bring your clinical skills to the environment and
empower the medics. Medical officers MUST TRUST AND The opinions or assertions contained herein are the private
EMPOWER THE MEDICS! The overwhelming vast major- views of the author and are not to be construed as official or
ity of SOF medicine is SOF medics at the team level. SOF as reflecting the views of the Department of the Army or the
medics are the ones actually out there practicing medicine, Department of Defense.
and the docs have to find ways to assist them. That is the

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