Page 108 - JSOM Summer 2024

The second impression management style that degrades un- without offering a means to release performance pressure.
conventional resilience is sterilizing medical power in SOF Qualitative data suggest that, when inadequately functioning,
(i.e., demonization of kindness as effeminate), as illustrated by this social determinant eliminates authentic social support and
the following quote: increases, instead of releases, performance pressures in SOF
culture.
Caring about our patients all too often seems like this
weird anomaly in SOF. People start to wonder, “Am I crazy Bag Sets as Meaningful Metaphor:
to want to take care of people and show kindness in de- Impression Management
ployment?” When I think about the medical mission to
support SOF, I know it’s necessary. I know I am capable. I’ve Tactical Function of Social Determinant:
done a good job and successfully provided medical care. Impression Management
People need to be comforted in times of darkness. That’s The social determinant of impression management carries
the power medicine brings, but other people in the military the weight of the circulation component of bag sets. Bio-
3-5
don’t feel that way, especially in SOF—sometimes even in logically, the lungs only have capacity for a certain volume
SOST. I roll my eyes every time they bring up selection and of air. Functional breathing causes the intercostal muscles to
act like all I need is a selection to be credible. What the Op- expand, regulating the volume and rate of oxygen influx and
erators really want is for us to be good at medicine. They carbon dioxide outflux from the lungs. Dysfunctional breath-
want us to be able to save the person who’s wounded. It’s ing causes too much or too little volume of air at a too high
about the medicine, not the “cool guy killing shit.” People or too low rate of influx and outflow. Therefore, breathing
start to think their medical skills are insufficient because orchestrates the proper exchange of oxygen and carbon di-
caring makes us soft. SOST tries to pretend they are cool oxide between the external and internal environment of the
and sell it, but I don’t understand why they’re so insecure human body. Breathing is an essential component of the bag
about their medical capabilities because people in SOST sets because airways alone cannot regulate the exchange of
are very smart. They’ve gotten through med school, resi- gases; they only allow them to move in and out. Catastrophic
dencies, nursing, training, etc. For some reason, they don’t injury generally compromises breathing and demands medical
believe medicine is as valuable as killing the “bad guys.” respiratory assistance. In other words, ventilatory devices give
Medicine is important because it brings compassion, gen- SOF medics a measure of control over oxygenation during
tleness, a reserved kind of intelligence, accepting of oth- life-saving surgery or resuscitation.
ers, but those qualities are quickly dismissed in SOF.
The function of impression management relates to the meta-
Military attitudes that trivialize compassion tend to eschew phor of assisted breathing during catastrophic injury. Func-
the act of caring by seeing it as detrimental to SOF charac- tioning impression management acts like an external dial for
ter, thus invalidating medical prowess. Vilifying human at- unconventional resilience by modulating the intensity (vol-
tentiveness involved in showing concern for one another and ume, pressure, and rate) of the authenticity of the image (oxy-
responding to human fragility with kind presence privileges gen) according to the needs and demands of the SOF mission
an idolatrous social-political imagination of war. The result (bodily system). Like assisted breathing, impression manage-
of shunting care to the side is the creation of a cultural norm ment regulates performance pressure across the ecosystem
wherein Operators and medics ought to be invulnerable to the of unconventional resilience by synchronizing the appropri-
impact of catastrophic injury. Accordingly, SOF medics should ate balance of professionalism across interdisciplinary teams.
mechanically respond to the human carnage of war. Reduc- When impression management is functioning in support of the
ing the SOF medic’s technical skills to the mechanics of life- dynamic freedom of maneuver in ambiguity, it conducts the
saving medicine not only demonizes the professional essence influx of external tension toward the appropriate application
of medicine on the battlefield but also exacerbates tension by of torque, enabling the right balance of professional skills to
denying the interrelationship of palliation to morale- and con- be flexed in support of the SOF mission.
fidence-building in SOF teams. When a high level of torque is
constantly maintained to uphold a distorted image of virility, As such, artificial breathing has to be adjustable to support the
practical performance eventually collapses. conduct of professional interactions (gas-exchange) across the
technical skills (alveoli) necessary to animate energy across an
The everyday practice of denying kindness suppresses the nat- SOF mission. When this happens, teams work together within
ural fear associated with the ambiguity of a SOF mission caus- the SOF culture to transform the pressure of performing into
ing the pressure of performance to be bottled-up. This style of interoperability that ensures the recognition of professional
managing social impressions causes short-term degradation of value for all components of the SOF mission and effectively
unconventional resilience by denouncing commonplace human distributes intensity where it is needed to achieve mission
needs, making it virtually impossible to cope with the actual success.
human stress of an SOF mission. It causes long-term degra-
dation of unconventional resilience by devaluing the contri- Dysfunctional impression management acts like impaired ar-
bution of medical professionalism in achieving SOF mission tificial breathing assistance that is at risk for systems failure
objectives. Ultimately, demonizing SOF medics’ technical skills because there is no means of regulating inflow of new energy
(caring) not only decreases the Operators’ desire to risk-take and outflux of expended energy into and out of the ecosystem
during SOF missions but also discourages SOF medics from of relationships. Toxicity in the form of dysregulated tension
authentically admitting their professional value in SOF culture. causes over- or under-functioning professional skills in the
ecosystem with no means of integrating practical performance
The previous quotes highlight how insincere impression man- across interdisciplinary teams. When this happens, SOF medi-
agement aggravates performance pressure and increases torque cal teams create internal social competition during deployment

106 | JSOM Volume 24, Edition 2 / Summer 2024