RETRIBUTION

BLOG POST         RETRIBUTION

When the Secretary of the Navy starts out by saying “ This is not about retribution,” you can be SURE that is EXACTLY what it is about : retribution.

The captain has the responsibility to lead the sailors under his command; but he is also responsible for each man’s life and for making the choices that protect his sailors’ lives. That is a grave and serious responsibility.

When the ACTING Secretary of the Navy FAILED to respond to the immediate and deadly threat of coronavirus ravaging the sailors on his ship, the captain HAD TO ACT. If your chain of command does not respond, you have to become a whistleblower.

And, you see, what he revealed to the press got action: those sailors are now being taken off the ship. Their  captain saved their LIVES.

He may have saved the entire crew. When you have a “break the glass moment”, you must exercise courage-- and BREAK THE DAMN GLASS!

I had a situation like this when I was a third-year medical student working in the ER.  I encountered a patient, an elderly African American man, who was complaining of the worst abdominal pain of his life. He was sweating,  and short of breath. He was obviously in distress and he was frightened.

I cut to the chase . I quickly did an essential examination of him while I was taking his history, listening to his story. On physical examination, I found a huge, tense, pulsating mass in his belly.

Initially he had palpable pulses in his feet; but within a few minutes  on checking again, those pulses had disappeared. The diagnosis? Dissecting Aortic Aneurysm.

This was an extreme emergency. Without immediate lifesaving surgery, he would die within minutes. Period.

Like the captain of that ship, I had choices. The usual procedure for a third-year student on a medical service who encountered a patient with a surgical problem would be to do the following:

Medical student on a medicine service consult your counterpart, the medical student on the surgery service. After that student had responded to your call, arrived at the ER,  examined the patient himself/herself, hopefully agreed with your diagnosis, he or she would then consult the intern.

The intern would arrive, listen to the presentation , do his own exam, and then he would consult the resident. The resident would do the same. 

Then he would call the  who would call the chief resident.  You see what kind of time would have been involved in following the usual protocol of consultation for surgery.

The other choice --the one that I took --was to cut to the chase, cut out all the middlemen. I called the chief resident of surgery, Robert Sally M.D.—an unheard-of thing for a third-year student to do.

 I told him I had a patient with a dissecting aneurysm who was rapidly decompensating—getting worse as the dissection, which was happening in real time, continued to progress.

He came at once, but with the idea that he was going to tear me a new one for daring to violate chain of command , or rules of consultation. But instead, he found exactly what I told him was the case. He agreed with my diagnosis.

Bob Sally, Chief Resident himself raced my patient on a stretcher to the OR, where he would begin the live-saving emergency operation, with everything happening at once.  The nurse anesthetist would proceed with intubation and induction of anesthesia, while the scrub nurse prepped the patient’s chest and belly  with betadine.

The circulating nurse would be opening and setting out the surgical instruments. Another nurse would be starting an IV, while drawing blood for type and cross match, while someone else ran to the Blood Bank for O negative blood for initial transfusion.  There is more that would be taking place SIMULTANEOUSLY,  but you get the idea.

My decision to call the Chief Resident directly and immediately saved my patient’s life.   

My judgement that the life of the man was vastly more important that the chewing out  and reprimand I was risking for violating procedure and protocol. I did not hesitate.

The Captain of the ship did exactly the same thing. He took immediate action to save the lives of his crew. 

He reached out to the ACTING Secretary of the Navy who hesitated. There is not time to hesitate when there is a gun pointed at your head. You have to ACT.

Covid 19 is highly contagious. It is transmissible for perhaps two weeks when carriers are asymptomatic.

It spreads in close quarters. You don’t get any closer quarters than on an aircraft carrier, three men to a bunk wall,  inches apart, using all the same facilities, breathing the same air, coughing, sneezing, wiping  their hands; touching their eyes and faces…there could not be a more hospitable environment for the virus.

 There could not be a more dangerous environment for our  courageous young sailors who took oaths to defend this nation with their lives. If combat were threatening their lives, that would be one thing.

But as the captain said, to leave them on the battlefield completely defenseless against an unseen enemy even more deadly that bullets? That would be unconscionable.

To leave them on that ship, while Command took their own sweet time to try to figure out what to do, that would be comparable to the Captain taking a gun and shooting each sailor in the head.  The captain did the right thing. 

He did the only thing left to him to do, when following protocol got no response.  He acted to save the lives of his sailors. I am sure he would do it again.

The fact that he has been relieved of his command for saving his sailors’ lives and saving his ship is despicable-- and,  yes, it is definitely retribution.