Page 90 - JSOM Fall 2024

an appropriate mix of circulation equipment for the bag sets environment of SOF performance space cannot be activated in
(tourniquets, IV kits, and blood products) without imposing support of perspective taking, which causes something akin to
how those products should be utilized in different scenarios. dissociation amid mass casualty. 13(p72)
To maximize medical-martial creativity, organizational sup-
port establishes the necessity and appropriate mix of realistic Conclusion: The Pragmatic Value of
hybrid training opportunities and extracurricular activities. At Impression Management in SOF Medicine
the tactical level, medical teams are given freedom of maneuver
to utilize and capitalize on their group and individual training The practical skill of allowing and investigating new social
and extracurricular experiences during SOF missions. At the symbols, values, norms, and attitudes trains SOF medics to
team level, the weight of tourniquets and IVs are equally dis- be imaginatively nimble. This agility trait fosters flexible mili-
tributed across bag sets implying that all medics are engaged tary medical decision-making by engaging diverse experiences
in military medical decision-making. It also implies that each both professional and personal in everyday experience and
clinical specialty brings a critical perspective to the assessment activity, such that a gestalt understanding of operational dy-
and interpretation of catastrophic injury amid a mass casualty. namics cultivates fluid movement toward its functional end
The weight of blood products is mission specific to the martial and helps support the weight of performance pressure. Being
context in which the SOF mission is being performed, which imaginatively nimble is essential to supporting change-agency
implies the centrality of collaboration. This particular distri- because it provides holistic discernment about battle patterns,
bution of weight allows the SOST and SOF teams to engage which enhances medical performance amid the dynamic and
in a fluid process of triage that balances mission requirements ambiguous complexity of the SOF performance space. In the
while managing the flow of catastrophic injuries. next paper, we will discuss the social determinant of grief
processing.
When the organization is functioning in support of unconven-
tional resilience it recognizes that, like the circulation compo- Author Contributions
nent of bag sets, the development of medical-martial creativity EAJ conceived of this study and wrote the protocol. SLH ob-
is essential to the practical performance of SOF medics in the tained funding and IRB approval. JD acted as liaison to the Air
martial performance space. Organizational leadership estab- Force Special Operations community in specific the 24 Special
lishes appropriate training requirements and encourages SOF Operations Wing and Special Operations Surgical Teams. JD
medics to engage in extracurricular activities outside of the also orchestrated all approvals for field observations. EAJ re-
medical and military profession. In mass casualty, performance cruited participants, collected and analyzed interview data and
pressure is modulated across the SOF teams (medical and mar- drafted the initial taxonomy of themes. JD served as AFSOC
tial) by allowing medical-martial creativity to direct the flow medical expert during data analysis process. EAJ, JA, and SLH
and volume of information into the appropriate form of prob- wrote the first draft of this paper. JW-B provided substantive
lem-solving in support of the SOF mission. SOF medical teams feedback to the second draft. JB served as military medical
achieve freedom of maneuver with SOF martial teams when expert in redacting all findings. All authors read and approved
individual medics are willing to insert and carry the weight of the final manuscript.
their professional and personal experiences into their individ-
ual bags. Disclosures
Jay Baker, Jared Wyma-Bradley, John Dorsch, and Sarah L.
Like the circulation component many of the medics will carry Huffman have no financial relationship to this study. Erika Ann
similar experiences (tourniquets and IVs), but the way a medic Jeschke served as the Senior Lead Research Scientist on this
packs an individual bag within the bag set is illustrative of the project and was paid through the following contracting com-
unique medical-martial creativity brought by that particular panies: Parsons Corporation, ABSS Solutions, Inc./1st Ameri-
medic. The distribution of weight across the circulation com- can Systems and Services, LLC, Innovative Employee Solutions
ponents of the bag set brings both repetition and contrast that (IES), SURVICE Engineering.
enhances the problem-solving capabilities at the individual and
team level. Essential to the circulation component of bag sets Disclaimer
are blood products; the weight represents the collaboration The Public Affairs Office, United States Air Force 60th Med-
and coordination with the SOF team. Since blood products are ical Group at Travis, AFB has approved this publication for
heavy, scarce, and essential in the face of major casualty, they universal distribution. The AFRL’s Institutional Review Board
have to be carefully transported and judicially used. As such, approved the study as an exempt protocol (# FWR20200104)
blood products represent the refinement of medical- martial in August 2020. The information, content and/or conclusions
creativity in a nuanced understanding of how to relate to the do not necessarily represent the official position or policy of
SOF team and work within the SOF performance space to AFRL-USAFSAM, the Department of Defense, or the U.S.
achieve the SOF mission objectives. Government.

When medical-martial creativity does not function in support Funding
of unconventional resilience at the tactical level, kinesthetic This research is sponsored by funding (# FU 20-042) from the
and proprioceptive understanding of the SOF performance Air Force Research Lab-U.S. Air Force School of Aerospace
space is thwarted. Metaphorically speaking, if bag sets lack Medicine (AFRL-USAFSAM) through the Studies and Analysis
tourniquets, then kinesthetic information floods and frag- Program.
ments the SOF medics focus in the stimuli rich environment
of the SOF performance space causing something akin to hy- References
per-vigilance amid mass casualty. Similarly, if bag sets lack IV 1. Jeschke EA, Baker JB, Wyma-Bradley J, Dorsch J, Huffman SL.
kits, then proprioceptive information from the stimuli rich Conventional resilience and the impact of catastrophic injury

88 | JSOM Volume 24, Edition 3 / Fall 2024