The
following was a letter that I wrote to a soldier. I have changed the name to maintain his
anonymity. The letter should be self
explanatory. The soldier is currently
being sent home to be medically boarded out of the Army. He was very upset about this. He had been looking forward to a long and
prosperous career with the military. Now
he is not certain what he will do with his life.
Dear Joe,
You had the unfortunate opportunity today, to add a
new chapter to the journals of my career.
It is a sad entry, for I fear that I have failed you.
I have delivered bad news to patients before. I have diagnosed tumors, leukemia, AIDS,
Multiple Sclerosis, and many other fatal illnesses. I have sat holding the hand of a woman with
whom I had progressed so far with in her treatments, only to be interrupted by
a failure of the most final nature.
During her last minutes of life, I felt frustrated that I couldn’t have
done more.
Your plight, your pain, is a new experience for
me. You are not dying. You have no physically limiting impairment
(with medications). You will go on to
live a long life. And, I do believe, a
great life. I know this, just by
watching your pain in this situation.
Only men of your caliber do great things, but it is that same commitment
to a cause and the men around you, that make this so hard.
I probably went too far already with your case. I should have just been some ass-hole doctor
that wouldn’t let you deploy in the first place. You would have been left behind, angry
(cursing my name), but without the additional pain that this situation brought
about.
Please believe me when I say that I can feel your
pain. Now that you have been here and
started the mission with your fellow soldiers, I know it is exponentially hard to
leave. That’s why I should not have let
you come in the first place. I know this
now, and I apologize. Again, this is the
first time I have ever experienced such a unique situation.
I truly believed that I could control your
asthma. There is medical literature that
suggests, after a short course of oral steroids for treatment of your initial
exacerbation, you may have been adequately controlled on the right combination
of inhaled steroids, beta agonists, and leukotriene inhibitors. All of these would have been acceptable by
military regulations, but not the oral steroids
Alas, this was not the case. The treatment goals did not come to fruition,
and now you are suffering for it. Your
situation reminds me of a rephrasing, done of the great Hemingway quote: “For
those the blind, who once could see, the bell tolls for thee.”
By bringing you here I gave you a sight of our
mission, and now I must send you home, thus blinding you.
I still think it was worth a try. Maybe someday you will see that as well.
I expect that you are having difficulty
understanding the nature of our decision.
I know that you would have been willing to sacrifice your health, to
support the men around you. The ARMY
cannot let you do that.
How ironic, that a soldier can not volunteer to
sacrifice himself, yet the Army asks all soldiers to do so.
If something had happened to you, as in an acute
asthma exacerbation, we would not have been able to save you. Particularly, when you are
already taking the maximum dosage of the only available asthma medications. Perhaps you would have been comfortable with
this fact, but the command (and myself) are not.
My guess is that, after time, you will appreciate
our decision despite your difficulty now.
Joe, you’re a good man. That statement echoes throughout your command
and above. It is obvious that your squad
and platoon believe so as well. No one
will think less of you as a soldier for this situation.
I wish you the best.
Be well.
Cpt. Daniel J. Green MD, TF 4-64 Battalion
Surgeon