Q&A: Captain Jay Sourbeer
Force Doc
Continuously Adapting to Provide Improved Medical Support
Captain Jay Sourbeer
Force Medical Officer
Naval Special Warfare Command
Captain Jay Sourbeer obtained bachelor degrees in chemistry and economics in 1981 from Duke University and joined the Navy in 1981 via the Armed Forces Health Professions Scholarship Program. He completed his Medical Doctorate in June 1985 at Jefferson Medical College in Philadelphia.
Following a family practice internship year at Naval Hospital Charleston, S.C., Sourbeer served two years as a general medical officer attached to the Third Marine Division, with assignment to the emergency department of the Naval Hospital Okinawa. After completing the third year of a family practice residency at Camp Pendleton,Calif., he served as emergency department head of Branch Naval Hospital Sigonella for two years. He then served as family practice staff at Naval Hospital Rota, Spain before attending the Naval Undersea Medical Institute in Groton, Conn., and Panama City, Fla.
Upon graduating as an undersea medicine officer, Sourbeer served as senior medical officer on the USS McKee (AS-41). His following tour at COMSUBDEVGRU ONE allowed him to qualify as saturation diving medical officer, fleeting up to senior medical officer of COMSUBDEVRON- 5. Sourbeer then served as exchange officer to the Royal Navy at the Institute of Naval Medicine in Alverstoke, the United Kingdom. In this capacity, he represented the United States in the 2003 Royal Navy/Royal Marine Everest Expedition on the 50th anniversary of the original ascent. Prior to the current assignment at Naval Special Warfare Command, he served three years in Washington, D.C., as White House physician.
Interviewed by MMT Editor Jeff McKaughan
Q: Good morning, Captain Sourbeer. Force medical officer for Naval Special Warfare Command—what does that job entail?
A: As special advisor to Commander, Naval Special Warfare, I work with my staff to provide vision, policy guidance and oversight on all NSW-related medical issues. These issues range from medical readiness and addressing and tracking the general health care of NSW military personnel; to providing medical services, researching emerging medical techniques and technologies to support our operational requirements; and the very serious business of medical treatment for injured operators on the battlefield.
We ensure quality care by engaging with the medical teams at our six Echelon III commands, providing credentialing and performing assist visits and assessments. We issue guidance and make recommendations to higher authorities regarding individuals seeking waivers for special duty. As special operations forces adapt to a different kind of enemy in a different type of war, we are continuously adapting how we in the medical community do business and looking for news ways to provide improved medical support to meet the emerging warfighting requirements.
Q: From the medical perspective, what do you see as the biggest challenge facing Naval Special Warfare Command warriors?
A: In the broad sense, Navy SEALs and Special Warfare Combatant-craft Crewmen are a very small band of very determined warriors standing against a large threat that is always changing. We need to be more forward thinking and adaptable than our opponents.
Specific medical issues that concern me most are support for NSW families and combat casualty care. NSW has a robust, on-going effort to provide support to the families of its deployed operators, but we are always looking for ways to help families during those long deployments.
Regarding combat casualty care, currently large numbers of conventional medical forces in Iraq support SOF with a robust forward surgical resuscitation capability. With the future size of that conventional force uncertain, and the fact that SOF often operate independently far from the support of large conventional forces, we must be prepared to provide that critical capability regardless of where our forces deploy. U.S. Special Operations Command is working with its components to develop that capability.
Q: Is there a need for a common training curriculum among all U.S. special operations forces? How much of the training is handled in-house and how much is handled by the big Navy or outside contract services?
A: SOF operators share a common medical training curriculum. SEALs and SWCCs receive first aid training during their basic course of instruction at the NSW Center. More advanced medical training to handle combat casualties is taught at the John F. Kennedy Special Warfare Center and School in Fort Bragg, N.C.
Commander, Special Warfare Medical Training Group [A] manages the 27-week curriculum. The 90,000 square foot facility hosts an estimated 400 SOF students per year and its instructors include Army, Navy, Marine Corps and Air Force special operations personnel in addition to federal civil servants and civilian contractors. It is truly a joint training facility when it comes to curriculum.
Within the Naval Special Warfare community, we employ predominantly corpsmen and medical officers from big Navy to provide training and staff support. A limited number of field medical training services are supported by contract.
Q: SEALs by their nature are expertly trained to conduct water-borne missions, but it is not uncommon for them to be found in high elevation locations in operational areas. What can you do for those warriors to prepare their bodies for those kinds of extremes? Are there conditioning routines as well as technology applications that can help?
A: There are definitely ways to assist the body in adapting to altitude. Physical conditioning helps as does staged ascent and the use of acetazolamide to prevent altitude sickness; however the best preparation is for operators to train the way they fight.
Since 2002, SEAL training has included a month-long course of instruction at Kodiak Island, Alaska. There SEALs learn how to conduct operations under extreme stress, in extreme weather conditions and in harsh, challenging environments.
Q: Since many of the missions that special operators—naval and others—are faced with are unique, how much medical research capability do you have direct access to and can direct in specific areas of need to SOF?
A: We have input on and access to a great deal of research being conducted through SOCOM and its Biomedical Initiatives Steering Committee, various Navy technology review boards and research by our sister services. If a particular research proposal has merit, the SOF medical community labors hard to make it happen. It is especially rewarding when we learn of advances in new areas that may ultimately benefit the warriors on the battlefield.
Q: What are some key areas or technologies in the medical field that industry can help bring better solutions to the warfighter, especially in the combat casualty care capacity?
A: Combat care is an exciting area, and while there are continual advances in hemostasis, pain and respiratory management, forward surgical stabilization and medical communications, more can always be done.
Q: How far along are you on digitizing health records for Naval Special Warfare? What have been or still are the obstacles to the program?
A: We are advancing, albeit slowly, in our ability to use AHLTA, the Armed Forces Health Longitudinal Technology Application This database is DoD’s enterprisewide, Web-based health information system designed to generate and maintain comprehensive, life-long, electronic patient records for active duty military, their family members and others entitled to DoD health care in fixed medical/dental facilities, on board ships and in theaters of operations.
Currently, most of our fixed medical care facilities have intermittent connectivity, and we do not have portable or remote networked digital health records yet. And while AHLTA generated records can be very large, difficult to read and prone to errors, we continue to press ahead because we believe having digital health records clearly has great merit.
Q: Are the pre-deployment, deployment and post-deployment health issues relatively the same among the active duty forces and the reserve components?
A: In the sense that the health threats are common, yes. Continuity of care and follow up are a special challenge for personnel who do not deploy as a permanent member of an active duty unit. The good news is that leadership across the spectrum is very aware of the issue and is working hard to prevent problems for these personnel.
Q: Can you talk somewhat about the systems you have in place to help reduce the personal stress of your warriors, especially those returning from long and/or hard deployments?
A: The stress on NSW personnel is exceptionally high due to their operational tempo and the high exposure rate to intense combat at close personal range. And while NSW personnel have a cultural bias to underreport stress, they also have traits that may mitigate stress effects.
In general, NSW personnel are resilient, self-motivated and determined. They tend to be career-oriented, experienced, more mature. They are expertly trained operators guided by a warrior ethos. They build very strong professional bonds and they support one another as brothers. Their partners and families tend to reflect these kinds of characteristics as well.
Active duty members including individual augmentees receive periodic psychological screenings in addition to regularly scheduled Navy health screenings. Secondary indicators of stress are tracked for trends, and at specific points in the deployment cycle, personnel and their families receive resilience training conducted by group psychologists, medical teams and chaplains in combination with contract counselors. Recent initiatives include the development of neuropsychological baselines and one-on-one postdeployment health visits for active duty personnel.
The NSW leadership has long recognized that supporting the families at home is crucial to supporting the operator on the battlefield. If a SEAL knows his family’s needs are being met and they are handling the day-to-day tasks while he’s gone, he can remain combat focused. To that end, NSW has initiated several new, cutting-edge programs to help its military personnel and their families mitigate the stress of long or difficult deployments and to aid them in adjusting to life after the deployed servicemember comes home.
NSW is working tirelessly to strengthen the role of family readiness groups, developing family support resilience training retreats, conducting communication workshops for the operators and their families, and educating them on post-deployment decompression methods and the importance of making of homecoming plans. ♦