Page 155 - Journal of Special Operations Medicine - Spring 2017

An Ongoing Series

Admiral’s Log

Surgeon General VADM Michael Cowan’s Insights on Military Medicine

Interviewed by COL (Ret) Andre Pennardt, MD

Please provide our readers a brief summary treatment and patient movement for the injured and,
of the highlights of your military career. equally important, at the same time providing effective
I entered the military courtesy of the Selective Service care for that Warrior’s family—finally, for the Warrior
(“doctor’s draft”) in 1971 in the closing years of the Viet- and his/her family on departure from the service.
nam Conflict. I didn’t want to be in • The “brass ring” for American military medical systems
uniform any more than did many of is that the first casualty of the next war has the same
the young Marines I cared for at Camp chance of survival as any casualty who follows, because
Lejeune, NC. But I quickly realized we deploy a highly capable team with the first Warrior
that treating those who were serving on the first day. That is the promise military medicine
their country added another layer of makes to the nation and the reason the system exists.
purpose to my professional life—that
I enjoyed practicing medicine without How do you see those lessons learned
having to worry about someone’s in- applying to the civilian community?
VADM Michael Cowan
surance status. All I had to do was de- Two principles have marked military medicine during the
liver the best care I could, and I liked that. past two decades: the first is science-based casualty care
based on the trauma registry established back in the later
Fast forward a third of a century, and that’s pretty much stages of the Vietnam Conflict. The use of tourniquets,
the story. I entered the military at the close of our last the value of stabilization and rapid evacuation, and a
war and became Surgeon General number of surgical innovations have
of the Navy on August 10, 2001, a “I am proud that I got all flowed from that experience.
mere month before the start of our
next. drafted and had the good The second—and, in my opinion,
sense to ditch my antimilitary even more valuable—principle has
During that time, I both watched attitude and spend my entire been the concept of family-based
and participated in the transforma- care. During the Vietnam era, we
tion of three “Cold War” military professional career caring for treated the amputee’s wound, and
medical departments into a modern those who care for America.” when the wound was healed, the
“post–Cold War” unified and ef- patient was separated from service,
fective healthcare system implementing the concepts of given a disability rating, and generally expected by both
“Force Health Protection” to a level never before seen in society and the individual to spend the rest of his life as a
any health system. “cripple.” That sounds harsh, but it’s true.

Our nation has been at war continuously for longer Today, the first face a wounded Warrior sees when he/
than 15 years. What do you view as the most she wakens is often a spouse or mother. The entire family
important lessons learned by those practicing military is the focus of treatment and rehabilitation from day 2,
medicine during that time? and the stated expectation is that that valuable Warrior
• Battlefield and deployment medicine depends on and family will achieve a “new normal” of productive and
the full spectrum of Force Health Protection: fielding happy life. We’ve come a long way, baby.
a healthy and fit Warrior who is resilient psychologi-
cally and physically. Protecting that Warrior from both Any medical system caring for any population will do
environmental and warfare dangers and rapid mobile well to emulate both of these contributions to American

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