Page 92 - JSOM Spring 2024

An Ongoing Series

Social Determinant of Unconventional Resilience

Tactical Engagement with Bonding Patterns

Erika “Ann” Jeschke, PhD *; Jared Wyma-Bradley, MDiv ;
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Jay Baker, MD ; John Dorsch, DO ; Sarah L. Huffman, PhD 5
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ABSTRACT
Building upon our strategic framework and operational model, performance as tactical engagement with social determinants
we will discuss findings from our ethnographic study, entitled: will illustrate how culture influences unconventional resil-
“The Impact of Catastrophic Injury Exposure on Resilience ience across the deployment cycle and allow us to specifically
in Special Operations Surgical Teams (SOSTs),” to explain the explore each social determinate. This fourth paper will use
tactical nature and importance of social determinants within qualitative quotes to exegete the social determinant of bond-
our new characterization of unconventional resilience. Our ing patterns. To achieve our goals, we will: 1) provide an in-
fourth paper in this series, will explain how bonding patterns troduction to social determinants as tactical engagement with
establish the quality of intra- and interpersonal connections unconventional resilience; 2) define the social determinant of
that create a tensive conduit for the pressure of performance bonding patterns as extrapolated from qualitative data as well
within our operational model, allowing for dynamic freedom as use qualitative data to thematize various types of bonding
of maneuver to take place in ambiguity. We will use qualita- patterns; and 3) relate tactical engagement with bonding pat-
tive quotes to illustrate various ways SOST medics relate to terns to our metaphor of bag sets. We conclude by gesturing to
themselves, other people, and the Special Operations Forces how bonding patterns create semi-permeable boundaries that
(SOF) culture. To achieve our goals, we will: 1) provide an in- allow SOF medics to engage and adapt to new information,
troduction to social determinants as tactical engagement with experiences, and people.
unconventional resilience; 2) define the social determinant of
bonding patterns as extrapolated from qualitative data as well The findings in this paper are taken from the study “The Im-
as use qualitative data to thematize various types of bonding pact of Catastrophic Injury Exposure on Resilience in Special
patterns; and 3) relate tactical engagement with bonding pat- Operations Surgical Teams.” The Air Force Research Labora-
terns to our metaphor of bag sets. We conclude by gesturing to tory’s Institutional Review Board approved the study as an ex-
the importance of bonding patterns in orienting SOF medics’ empt protocol. To capture intricacies within the cultural ethos
proprioception and kinesthesia in the SOF performance space. of SOST, data was collected through individual, open-ended
interviews with six participants from each of the four clinical
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Keywords: unconventional resilience; social determinant; specialties represented in SOST. Additionally, focus groups
bonding patterns; practical performance; SOF medic and field observations were organized across the two SOST de-
tachments to capture team and organizational dynamics. The
standard practice of removing all identifying names, genders,
locations, medical specialties, and military ranks has taken
Introduction
place. To further protect the privacy and confidentiality of all
In this paper, we build upon our strategic framework and op- participants, themes described herein do not reflect individual
erational model to explain tactical engagement with our new commentaries. All quotes are constructed from various SOST
characterization of unconventional resilience. Findings from medic narratives that code under the theme discussed. As such,
our ethnographic study, entitled: “The Impact of Catastrophic quotes are an aggregate analysis, which not only draws a holis-
Injury Exposure on Resilience in Special Operations Surgical tic blueprint of the entire data set, but also represents the co-ed
Teams,” establish culture as an integral aspect of SOF med- composition of the organization.
ics’ practical performance. Specifically, social symbols, values,
norms, and attitudes coalesce into five social determinants While data in this and subsequent papers focus specially on
that orient SOF medics’ proprioception and kinesthesia in the SOST, we believe our findings will have strong resonance and
SOF performance space. Exploring SOST medics’ practical applicability to all SOF medics because our study focused on
*Correspondence to stlamazonia@gmail.com
1 Dr. Erika “Ann” Jeschke is affiliated with SURVICE Engineering, Belcamp, MD. Jared Wyma-Bradley is Director of Spiritual care at Northern
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Virginia Mental Health Institute, Washington, DC. COL Jay Baker is the Joint Trauma System Operations Branch Chief, San Antonio, TX.
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4 Col (Ret) John Dorsch is affiliated with the University of North Carolina Southeastern, Lumberton, NC. Lt Col Sarah L. Huffman is affiliated
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with the 60th Medical Group, Travis Air Force Base, CA.
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