Navy Beginnings (Part 2)
It was time for his first patient of the day. A Lieutenant in khakis was seated in the waiting room. Steve beckoned for him to come into the office. They sat down as Steve glanced at the medical records. “Good morning, LT Spooner. Can you tell me why you are here?”
Spooner slouched in his chair, his elbows resting on his thighs, his head bowed. “I’m having trouble on the boat.”
“Trouble? What sort of trouble?”
“I’m not sure I can handle it anymore.”
“Can you be more specific? What do you do on the boat?”
“I’m the nuclear officer on the Gar. We got back from a deployment a few weeks ago. I’m having difficulty facing the prospect of going back out. I’m having difficulty sleeping and when I do fall asleep I dream about being confined in the sub and being unable to get out.”
The gar was one of the SSNs attached to the base. LT Spooner appeared downcast, depressed, morose, and withdrawn. He had been assigned to the sub for two years and was between deployments. Unlike the SSBNs which had two crews that rotated every three months, the schedules of the SSN’s was unpredictable. They could be out for a few weeks or months. Nuclear subs have the capacity to make their own water and oxygen. The old saying was that they only had to surface every six years so that the crew could reenlist. The lieutenant was psychologically at the end of his tether. Unlike the ring knockers, his ardor for the Navy was less robust. He did not appear to have the stamina to deal with the rigors and long hours required to be running the nuclear power plant of a sub. He came with a diary he had been keeping chronicling his depression and despair over the preceding months. Poor sleep, difficulty concentrating, ruminations about and preoccupation about death, loss of appetite, and a flat affect rounded out the picture. To Steve, LT Spooner appeared to be a classic case of major depression. As such, Steve removed him from his command, started him on anti-depressants, and instituted a Medical Board.
The powers that be at Sub Group Two would have no part of it. To Admiral Benson in command, the man was malingering. Within a few days Steve received a call from his Commanding Officer (CO) CAPT Sanders informing him that he had been invited to meet the admiral in his office. As Steve’s command was separate from the Sub Group, he was accompanied by his own CO.
“Admiral Benson is not happy that you removed the nuclear officer from one of his subs,” Sanders said as he drove down the hill from the hospital to Subgroup Two headquarters.
“Sorry, sir. I think the man has a pretty severe clinical depression.”
“I hope you’re right.”
Sanders parked the car and they walked into Subgroup Two headquarters. A civilian clerk received them and escorted them to Admiral Benson’s office. The office was spacious with wood paneling covered with numerous command plaques, photographs of submarines and the members of the chain of command including Rickover, the Chief of Naval Operations, the Secretary of the Navy, the Secretary of Defense, and President Nixon. Furnishings included a large mahogany desk and some older leather chairs and a couch. Admiral Benson was seated behind the desk. His aide with gold braid over his left shoulder was standing nearby.
As Steve and Captain Sanders entered, the admiral stood and came from around the desk. “Captain Sanders, nice to see you. I suppose this is the doctor who has commenced a medical board on LT. Spooner.”
“Yes sir, it is. This is Dr. Steve Marcus.”
“Have a seat gentleman.” The admiral gestured towards the couch, while he took a seat in one of the leather chairs. The aide remained standing.
Admiral Benson scrutinized Steve, trying to take his measure. “How old are you, doctor?”
Admiral Benson, turned toward CAPT Sanders, “You’re letting them in rather young, aren’t you?” The tone was clearly disparaging.
“It’s standard rank for someone three years out of medical school, sir,” Sanders replied
“How long have you been in the Navy, Dr. Marcus.”
“About a month, sir. I got here two weeks ago.”
“A month. Not very long. Do you know much about the Navy, lieutenant?”
“No sir. I can’t say that I really do.”
“Why are you here?”
“I’m here to fulfill my two-year military obligation, sir. I am in the Berry plan.”
“So, I assume you wouldn’t be here if it hadn’t been for the draft. Do you know the difference between a cruiser and a destroyer?”
“Not really, sir.”
“How about a submarine?”
“Enough to know they can submerge and resurface.”
“Well, sir, I know that most of them are nuclear powered, and since I’ve been here, I’ve learned the difference between a boomer and a fast attack.”
“You’ve never been on one?”
“No sir, I haven’t.”
“Have you been on any ship?”
“What were you doing before you came on active duty.”
“I was in my residency training, sir. It was three years for psychiatry.”
“And you just finished that. So can I assume, your psychiatry experience has not been very long either?”
“I suppose you could say that. This is my first experience in psychiatry without some level of supervision, but I believe that my training was adequate.” Steve could feel a knot forming in his stomach.
“The Navy has certain needs, doctor. Removing a crew member from a submarine, especially an officer is not taken lightly. Although submarine service is voluntary, there are lots of sailors who suddenly decide after the Navy has spent thousands of dollars training them that they don’t want to be on the boats. If we had the doctors removing all of them, we wouldn’t be able to crew one vessel.”
“I understand, sir. I’ve already seen a few sailors asking to get off sub duty, claiming psychiatric problems.”
“Did you take them off?”
“No sir. It was evident that their dissatisfaction was not due to psychiatric issues, but personal problems.”
“What makes you so sure that LT Spooner isn’t just making things up, that he’s not really depressed, that he just wants to get off the sub?”
“He does want to be off the submarine, sir, but his level of depression makes me concerned about his welfare.”
“The needs of the Navy are greater than the needs of the individual.”
“I understand, sir, but as he is the nuclear officer on the boat, I also had to consider the risk he could present not only to himself, but the entire crew. This could have been a recipe for disaster. I asked myself, ‘Would I want to be on a submarine with this man in charge of the nuclear power plant?’ The answer was no.”
Several minutes followed with the admiral berating the Medical Corps, civilian doctors on two year active duty due to the draft, and psychiatry. Steve and Captain Sanders sat quietly while the admiral spoke. “Captain. You are career Navy and a Submarine Medical Officer. Of course you have made the Navy a career, but I am not happy with some young pup fresh out of training, coming in here and disrupting the normal flow of things. I am going to ask you to investigate this Spooner mess. You are dismissed.”
“I’m sorry you had to experience that, son.” CAPT Sanders said as they drove back to the hospital. “Admiral Benson can be pretty outspoken.”
“I’m sorry sir, if I have created a problem. I’m new at this. All I have to go on is my clinical judgment. Psychiatry isn’t like ophthalmology or gastroenterology. We are limited by what the patient tells us and our observation of their demeanor. I don’t think LT. Spooner is faking, and I was as concerned about the boat and crew as much as I was about him.”
Two days later at the request of CAPT Sanders, the chief of Navy psychiatry was flown up to Groton to evaluate the patient. He was a source of cognitive dissonance as he arrived in his dress blues with the four stripes of a Captain on his sleeve, but with a thick Viennese accent. It felt as if Sigmund Freud had joined the Navy. Steve sat in while CAPT Steinert interviewed LT Spooner. After concluding the interview, Steinert asked Spooner to wait outside while he spoke with Steve.
“Well, I would say that your assessment was accurate and that this man should not be serving on a submarine.” As Steinert spoke, Steve could feel a sense of relief. “You haven’t been on active duty very long and I can tell you the Line is always suspicious about the Medical Corps, especially since most of the doctors are only here to fill their two-year military obligation. I suppose now the draft has been abolished, things may change. I’m not sure how the armed services are going to fill the medical billets without a draft. I understand they are now offering substantial recruiting bonuses, but you really have to want to be in the military to accept this incentive.”
“I don’t know the answer. All I wanted to do was to serve my two years without making any waves. Looks like that plan has already been ruined.”