Page 88 - JSOM Fall 2024

girl behind. So, the combination of medical and martial weapons systems. Engaging in dance teaches individuals
training prepares us for warlike conditions and both are to orient to the different occupational rhythms involved in
critical to our ability to effectively support SOF missions. a variety of performance spaces. Yoga helps individuals
center and ground their personal energy amidst chaotic
This quote highlights how hybrid training allows SOST med- situations. All of these activities enhance our ability to
ics to move beyond the fixed and formed practical skills nec- perform complex medical interventions in an unregulated
essary to optimize medical decision-making in the regulated SOF environment.
environment of a military training facility and develops nu-
anced problem-solving skills that support military medical This quote highlights how extracurricular activities allow
decision-making in SOF missions. SOST medics reclaim their SOST medics to expand skill development beyond the fixed
creative relationship to the energy of death by developing a and formed role of medical life saver. Engagement in avoca-
more sophisticated training repertoire that includes exposure tional activities refines the SOST medic’s proprioception by
in civilian trauma and military martial environments. These integrating a diversity of experiences. These activities expand
environments allow SOST medics to regularly encounter the SOST medics’ repertoire of patterns entailed in life energies
patterns entailed in death energies and begin to develop an and enhance their ability to integrate new perspectives into
understanding of how to interpret these patterns during SOF their global understanding of SOF missions. As such, extracur-
missions. ricular activities support SOST medics’ impromptu and fluid
movement with life amid the violence of the SOF performance
Hybrid training increases performance pressure, creating torque space, which is always saturated by the shadow of death.
for integration of life and death energies. Creative action man-
ifests through a nuanced interpretation of the catastrophic in- Extracurricular activities create torque that expands the per-
jury exposure that impels multi-dimensional problem- solving, formance space in which the martial and medical professions
which integrates medical and martial decision-making in real can optimally coexist. The everyday practice of engaging with
time. The everyday practice of engaging death energy in hybrid extracurricular activities enhances critical problem-solving in
training reduces ambiguity through prior exposure to perfor- stressful scenarios by expanding SOST medics’ awareness of
mance pressure that seeks to mimic and approximate austere life energy, which provides short-term optimization of uncon-
combat environments, providing short-term optimization of ventional resilience. Long-term unconventional resilience is
unconventional resilience. Long-term unconventional resilience optimized by constantly improving SOST medics’ apprecia-
is optimized by constantly improving appreciation of the nu- tion of their value within the SOF performance space.
anced real-time patterns of death, which not only allow SOST
medics to trust their interpretations of catastrophic injury Degradation of Unconventional Resilience
when performing military medical decision-making, but also
their value to the SOF mission. The first reduction of medical-martial creativity that degrades
unconventional resilience is disregard of specialized medical
The second enhancement of medical-martial creativity that op- training (i.e., lack of realistic austere mass casualty training),
timizes unconventional resilience is extracurricular experiences which is illustrated in the following quote:
(i.e., above and beyond duty requirements) which is illustrated
in the following quote: Honestly, we did not have enough training focused on
the injury patterns and type of austere medicine that
People in SOST really drive hard, focus on cultivating we experienced in deployment. There was not a lot of
their careers and expanding through experiences that realistic training that allowed us to gain exposure and
take us beyond hospital medicine. Usually, we spend hand’s-on repetition to the context of battlefield mass
about five years going to the hospital, working in an op- casualty There is somewhat of a misconception by lead-
erating room, and learning all the different surgery cases. ership that if you are at a level one trauma center, you’re
Once that starts going well, many of us move out to new getting all the experience you need. That is not the case.
opportunities. One person did four months of Honor It is necessary, but not sufficient. Those experiences don’t
Guard. Almost all of us played team sports growing up provide surgical or critical care problems that are unique
and spent an inordinate amount of time outside. A lot to war environments and the injury patterns we might see
of people continue to engage personal private hobbies on the battlefield. As a medical team, this lack of experi-
like competitive shooting, martial arts, yoga, dance, mu- ence puts us at a real disadvantage during SOF missions.
sic, photography, and woodworking. Many people finish We had a patient with shrapnel injuries. When we opened
degrees. These activities are like our playground in which the abdomen, the shrapnel had not actually entered the
we engage broader experiences that set us up to succeed bowel, but had created burns all over the surface of the
in SOST. Playing team sports provides an understanding bowel. My imagination of wounds had not gone to that
of team behavior, coordinated movement, and real-time point. Obviously, it’s great to be at a Trauma One. Again,
decision-making in high-stress competition. Being on it’s necessary, but it’s also important to find ways to train
Honor Guard teaches how to handle super emotional mo- for cases that look like what we might find in war; espe-
ments while still showing respect and reverence. This skill cially, when it comes to austere mass casualties. The sites,
allows us to engage the tragic dimension of war—people smells, and sounds can be gruesome, which complicates
die and grief is a necessary part of honoring that loss. our decision-making process in ways that cannot be repli-
Spending time in nature means people are more com- cated in a civilian trauma center.
fortable in austere environments. Being around competi-
tive shooting and martial arts cultivates a martial attitude This quote highlights how the lack of realistic mass casualty
that is displayed through respectful relationship to SOF training volume causes SOST medics to move with only the

86 | JSOM Volume 24, Edition 3 / Fall 2024