Contact - 0704 Apr by pengxiuhui



                     Keeping Tradition Alive:
                       Flight Surgeon Reunion

APRIL 2007    VOL. 31    NO. 2
                                The Society of United States Naval Flight Surgeons
                                Post Office Box 33008
                                Naval Air Station Pensacola, Florida 32508-3008


                                                           The Society of United States Naval Flight Surgeons is a non-
 2006-2007 SOCIETY OFFICERS                                profit organization founded in 1976 by Capt. Frank H. Austin, Jr.
                                                           Its purpose is to advance the science, art, and practice of aerospace
 PRESIDENT                                                 medicine and the mission of the United States Navy and United
 Capt. Frank A. Chapman                                    States Marine Corps; to foster professional development of its                                members; to enhance the practice of aerospace medicine within the
 VICE PRESIDENT                                            Navy and the Marine Corps; to strengthen professional and frater-
 Capt. Richard A. Beane                                    nal ties; and to optimize the solidarity and professional standing of                                 Naval Flight Surgeons and other aerospace medicine professionals.

 SECRETARY                                                 Contact is published quarterly by the Society in January, April,
 Lieut. Daryl J. Sulit                                     July and October. Its original intent was information flow from the                                Naval Operational Medicine Institute to Flight Surgeons in the
                                                           fleet. It has evolved into a publication featuring articles on Avia-
 TREASURER                                                 tion Medicine, Aviation Safety, and news from around the fleet,
 Lieut. Trina M. Gates                                     including personal updates on members. The views expressed                                within this Journal are those of the individual authors and are not
 ASSISTANT SECRETARY                                       necessarily those of the Society of United States Naval Flight Sur-
 Lieut. Amanda D. Hagen                                    geons, the Department of the Navy, or the Department of Defense.
                                                           Membership in the Society is open to all Flight Surgeon graduates
 ASSISTANT TREASURER                                       of the Naval Operational Medicine Institute; Flight Surgeon mem-
 Lieut. Cmdr. Daniel J. Hohman                             bers have voting rights in the Society. Subscription memberships                            are available to those who are not Naval Flight Surgeons. Dues are
                                                           $25 per year, or $375 for a lifetime. Contact the Secretary or
 BOARD OF GOVERNORS                                        Treasurer for more information or a membership application form.
 Capt. James R. DeVoll (Emeritus 2005-2007)
 Capt. William B. Ferrara (Senior Member 2006-2008)        Article and photo submissions to the Journal are gladly accepted
 Capt. Mark Edwards (ex-President 2006-2007)               from any member or non-member at any time of the year. Expect
 Capt. Joseph P. Dervay (Reservist 2006-2008)              six weeks lead time for consideration for inclusion in the next is-
 Cmdr. Kris M. Belland (Senior Member 2005-2007)           sue. Articles should be related to Aviation Medicine, including
 Lt. Cmdr. Darian C. Rice (Junior Member 2006-2008)        case studies, grand rounds, or anecdotes of personal patient encoun-
 Lieut. Joel R. Metzger (Junior Member 2005-2007)          ters, or Aviation Safety, including ground and in-flight safety issues
                                                           or anecdotes of personal experiences. Other personal anecdotes,
                                                           news, promotions, retirements, marriages, births and obituaries will
 CONTACT EDITORS                                           also be considered. All text submissions should be sent via e-mail
                                                           attachment in standard text format. Digital photographs of military,
 CHIEF EDITOR                                              medical or artistic subjects while forward deployed should be sub-
 Capt. Nicholas A. Davenport                               mitted in jpeg format. It is imperative that submissions clearly                            indicate the author’s full name, rank, corps, current title and duty
 PUBLISHING EDITOR                                         assignment, e-mail, return mailing address and telephone number.
 Cmdr. Walter W. Dalitsch III                              Correspondence and all article submissions should be sent to the                           Chief Editor, and photos to the Publishing Editor, at the e-mail
                                                           addresses given to the left.

Dr. Alan Stormo, member of Flight Surgeon Class #85 from 1957, spins tall tales and sea stories for Lieut.
Nicolas B. Moya Del Pino, currently a Student Flight Surgeon in Class 0703. Fifty years of Wings of Gold
separate these two physicians, but the first ever flight surgeon reunion in January brought together multiple
generations to discuss topics from flying and doctoring to wars and deployments. For the story on the reun-
ion and information on future reunions—including how you can help—please see the story by Dr. William
Helvey beginning on page 16. Photo by flight surgeon Capt. Richard A. Beane.
April 2007
Volume 31, Number 2


2    Operational Considerations in Treating Community Acquired MRSA Skin Infections
     Lieut. Robert M. Marks, MC, USN
5    Headache: Evaluation and Aeromedical Considerations
     Cmdr. Michael B. McGinnis, MC, USN
     Dr. Henry O. Porter
7    Pseudofolliculitis Barbae in Naval Personnel
     Lt. Cmdr. Jonathan L. Bingham, MC, USN
9    Flight Surgery in the Middle East: Deployment Preparation and Resources (Part I)
     Lieut. Joshua A. Tuck, MC, USN
12   Aeromedical Considerations of a VIP Mission: Part I
     Lieut. Alexander B. Galifianakis, MC, USN
14   From the President: Thank You All
     Capt. Frank A. Chapman, MC, USN
15   From the Secretary: Meetings and Elections
     Lieut. Daryl J. Sulit, MC, USN
16   Pensacola Homecoming: The First Flight Surgeon Reunion
     Dr. William M. Helvey
6    Upcoming Events Calendar
18   Flight Surgeon Reunion Calendar
19   SUSNFS Officer Positions Closed: Time to Vote!
19   Join AsMA Today
20   Texas Needs a Flight Surgeon
20   Blue Angels Schedule
20   AsMA 2007 in New Orleans
21   SUSNFS Evening Social in New Orleans
21   Third Combined Operational and Aeromedical Problems (COAP) Course
21   Photo Contest Cancelled
22   Models of Cruiser to Carrier Conversion, 1922
                                     THE FLIGHT SURGEON’S OFFICE

Operational Considerations in Treating Community
Acquired MRSA Skin Infections
                                                                          LIEUTENANT ROBERT M. MARKS, MC, USN
                                                                            FLIGHT SURGEON, CARRIER AIRWING NINE
                                                               MARINE CORPS AIR STATION BEAUFORT, SOUTH CAROLINA

Introduction                                                     What I have found out is that most of these infections are
   As a fleet flight surgeon, how many times have you            caused by CA-MRSA and that these antibiotic choices
seen the following presentation? A nineteen-year-old             are not acceptable to successfully treat the patient.
sailor onboard a U.S. aircraft carrier presents to sick call        What is different about these MRSA cases, as op-
with a “spider bite” on his anterior leg below the knee          posed to those cases originating in healthcare facilities, is
with a small amount of surrounding erythema. He is               that this organism is being acquired in the community
afebrile and otherwise has no complaints. He comes to            and rarely is associated with severe and invasive infec-
you because he wants the bump to go away. A reason-              tions. As opposed to hospital-acquired MRSA, which is
able treatment plan used to entail draining the lesion and       usually resistant to multiple classes of antimicrobials,
treating the patient with cephalexin.                            CA-MRSA is resistant only to beta-lactams, macrolides,
   In recent years, despite this treatment plan, many pa-        and azalides. Outbreaks of CA-MRSA have been seen in
tients’ soft tissue infections would worsen, with some           heavily populated Navy regions such as Southern Cali-
developing major complications. This occurred because            fornia, as well as aboard surface ships in Norfolk, aircraft
these physicians were fighting a different organism than         carriers from San Diego, recruit training centers, and Na-
they had originally thought.                                     val advanced special warfare schools. The majority of
   This bacteria, known as community acquired methicil-          these infections presented as skin and soft tissue infec-
lin-resistant Staphylococcus aureus (CA-MRSA), is                tions such as cellulitis, impetigo, furuncles, and ab-
causing skin infections that have become a wide spread           scesses.
problem in the U.S. Navy and Marine Corps. These oth-
erwise healthy adults that make up our patient popula-           Transmission and Risk Factors
tion, who do not have the typical MRSA risk factors                  The primary mode of transmission of CA-MRSA is
(recent hospitalization, surgery, recent dialysis, or the        by direct contact with a person who is either actively in-
presence of invasive medical devices), are increasingly          fected or is a MRSA carrier. Carriers are most com-
reporting to military treatment facilities in CONUS,             monly colonized in their anterior nares. Other popula-
OCONUS, and when deployed, with MRSA-positive                    tions with high transmission rates of CA-MRSA include
skin infections.                                                 inmates in correctional facilities, competitive sports par-
   In my experience, both as a flight surgeon at Naval           ticipants, and day care attendees. The factors that lead
Air Station North Island as well as a flight surgeon treat-      these groups of people to become infected include
ing patients aboard the USS Carl Vinson (CVN 70) and             crowding, close quarters, warm weather, frequent skin-
the USS John C. Stennis (CVN 74), I have personally              to-skin contact, participation in activities that can lead to
seen many patients with abscesses that grew out MRSA-            compromised skin surfaces, sharing of personal items,
positive cultures. I have also seen multiple cases of mi-        and challenges in maintaining personal hygiene. All of
nor cellulitis that I had treated first with cephalosporins      these factors are prevalent on-board ships, in barracks, at
such as cephalexin or, if the symptoms were a little bit         recruit training facilities, and in the field. This is why we
more severe, with beta-lactams such as dicloxacillin.            see so many infections in military personnel and recruits

2                                                                                                Contact · Vol. 31, No. 2 · April 2007
                                          THE FLIGHT SURGEON’S OFFICE

in all settings. Thus, when any service member comes to         racyclines and trimethoprim/sulfamethoxazole (TMP-
you with a skin or soft tissue infection, treat them as if      SMX). Neither of these classes of agents are FDA-
they have CA-MRSA.                                              approved to treat serious soft tissue infections due to
                                                                MRSA, however both have been shown to be highly ef-
Treatment                                                       fective in clinical trials. If MRSA is suspected, the fol-
    The treatment regimen that should be employed when          lowing regimens are recommended: double-strength
treating patients for CA-MRSA suspected lesions de-             trimethoprim/sulfamethoxazole twice a day for ten to
pends on the type of presentation. First, as with all ab-       fourteen days, minocycline 100 mg twice a day for ten to
scesses and furuncles, treatment should always begin            fourteen days, or doxycycline 100 mg twice a day for ten
with a thorough incision and drainage of the lesion with        to fourteen days. Patients with severe infections requir-
subsequent culturing of any fluid. If you are unsure if         ing hospitalization should be treated with IV vancomycin
purulent fluid or pus is present, an attempt should be          as a first line therapy. These cases are not as common
made to aspirate fluid from the lesion. If the furuncle is      but can be treated in settings that have inpatient capabili-
too small for incision and drainage, moist heat should be       ties such as aircraft carriers and field hospitals.
applied to promote drainage. It is important to note that           Many guidelines recommend clindamycin 150 mg
every attempt to obtain a culture from any open lesion          four times daily for ten to fourteen days as an acceptable
must be made in order to determine sensitivities and for        first line empiric therapy for suspected CA-MRSA infec-
reporting culture-positive results to the responsible par-      tions. However, despite initial sensitivity profiles to
ties. As with all good wound care, a clean and adequate         clindamycin, inducible resistance to the antibiotic is
wound dressing should be applied and changed by medi-           common, especially in strains that are resistant to eryth-
cal staff on at least a daily basis.                            romycin. Thus, clindamycin is contraindicated unless D-
    Incision and drainage with adequate wound care will         testing is done on the strain in the laboratory to confirm
adequately treat a majority of skin and soft tissue infec-      that inducible resistance is not present prior to treatment.
tions whether or not they are due to CA-MRSA. Accord-           The better first line antibiotics remain trimethoprim/
ing to the Centers for Disease Control and Prevention           sulfamethoxazole, minocycline, and doxycycline.
(CDC), a recent placebo-controlled trial showed a greater           Rifampicin should never be used alone as a single
than 90% success rate in treating deep skin abscesses           agent for treatment of CA-MRSA because of MRSA’s
associated with cellulitis with incision and drainage           rapid ability to form resistant strains against the drug.
alone. However, there are some instances with military          Many reports indicate to add it to the above drug regi-
personnel where supplemental antibiotic coverage should         mens as dual therapy. Rifampicin aids in treatment by
be added. Factors that should cue you into supplement-          promoting eradication of MRSA carriage and decreasing
ing incision and drainage with antibiotics in the opera-        further drug resistance. However, there are disadvan-
tional setting include surrounding cellulitis, a rapidly        tages to using rifampicin as adjunctive therapy. It can
progressing or severe abscess or soft tissue infection, the     cause drug resistance in mycobacteria and other non-
presence of fever, chills, night sweats, nausea or emesis,      staphylococcal bacteria, can cause life-threatening emer-
immune suppression, inability to completely drain the           gencies such as Stevens-Johnson syndrome, hemolysis,
lesion, or lack of response to initial treatment with inci-     and hepatitis, and can have significant drug-drug interac-
sion and drainage alone.                                        tions such as with oral contraceptives in which it will
    As with all infections, antimicrobial therapy should be     decrease their efficacy. Thus, in the operational setting,
tailored to lab reported or local susceptibility data. In the   monotherapy with the previously stated outpatient treat-
general population, according to the CDC, beta-lactams          ment plans should be enough to successfully treat the
are still a reasonable option for first line therapy in pa-     patient.
tients with mild to moderate illnesses and no co-                   There are, however, instances where rifampicin
morbidities, if the local prevalence of CA-MRSA is low.         should be considered. Rifampicin should be considered
However, given the high prevalence of CA-MRSA in the            when the skin or soft tissue infection does not resolve
military population, especially those aboard ships or who       with monotherapy or the infection is very deep, but it
live in barracks, there should always be a high suspicion       should only be used after consulting with the responsible
for CA-MRSA. Thus, beta-lactams and fluoroqui-                  Navy Environmental and Preventive Medicine Unit
nolones should be avoided. Agents effective in treating         (NEPMU) or infectious disease specialists.
skin and soft tissue infections due to CA-MRSA are tet-             Many reports and guidelines recommend treating all

Contact · Vol. 31, No. 2 · April 2007                                                                                     3
                                         THE FLIGHT SURGEON’S OFFICE

MRSA-positive patients with nasal mupirocin and chlor-         members should be prohibited from sharing personal
hexidine body washes to eliminate the carriage of              hygiene items such as towels and razors. Barracks,
MRSA. The CDC Experts Meeting 2006 concluded that              berthing, and head facilities should be cleaned with a
there is no data to support this regimen in single isolated    1:10 bleach solution at least once weekly. Daily bathing
cases. However, in the setting of an outbreak or recur-        and proper laundering of uniforms, clothes, and linens
rent infections in one patient (three infections in a six-     should be encouraged. When patients with infections are
month period), each patient should apply mupirocin 2%          in the field, ensure that they have proper clean and dry
nasal ointment twice daily for ten days and should wash        wound care supplies and that they can maintain adequate
from neck to toe with chlorhexidine daily for five days.       hygiene in their specific environment. Medical staff
Consultation with NEPMU or an infectious disease spe-          should always use proper universal precautions when
cialist should be made prior to this starting this protocol.   treating infected patients and wear gowns and facemasks
   After incision and drainage and starting antibiotic         if splattering of body fluids is anticipated. Prior to de-
coverage, patients should be re-evaluated in twenty-four       ploying or early during the deployment, consider a medi-
to forty-eight hours to ensure that the lesions and the pa-    cal brief to your squadrons or commands detailing these
tient’s symptoms are resolving and are not getting worse.      items and encouraging early presentation to medical if
Also at this time, culture and sensitivity results should be   there are any questions about an evolving skin or soft
reviewed and antibiotic therapy should be tailored in ac-      tissue infection.
cordance with the results. Once antibiotic therapy is
completed, the patient should be re-evaluated again in         Conclusion
one to two weeks to ensure that the lesion has resolved            The military environment facilitates the spread of CA-
and no new lesions are present.                                MRSA, which can turn into a big problem if not properly
                                                               treated. It can cause lost workdays, decreased combat
Reporting                                                      readiness, an outbreak of skin and soft tissue infections
   Medical commands are encouraged to track all CA-            throughout a military unit, and in some cases, serious
MRSA culture positive cases and comply with local or           illness and disability. Using the above guidelines can
state regulations on reporting cases to the local health       help you, the operational physician, have a high index of
department. All outbreaks must be reported to the local        suspicion for CA-MRSA when presented with a soft tis-
Medical Treatment Facility preventive medicine office          sue infection and allow you to properly treat the infec-
and the responsible NEPMU in accordance with                   tion. So, the next time a patient presents to you in the
BUMEDINST 6220.12A. An outbreak is defined as two              field or aboard a ship with what he or she calls a “spider
culture positive cases that can be epidemiologically           bite,” how are you going to treat that patient?
linked together. The Naval Disease Reporting System
(NDRS) is the preferred method of reporting cases, how-
ever, phone or fax are adequate. The local laboratory or       References
preventive medicine department should be familiar with         1. Gorwitz RJ, Strategies for clinical manage-
NDRS and should be able to help you with the reporting.        ment of MRSA in the community: Summary of an ex-
                                                               pert’s meeting convened by the Centers for Disease Con-
Prevention                                                     trol and Prevention. March 2006.
   In the operational setting, preventing the spread of        2. Lamar JE. Sentinel cases of community-acquired
CA-MRSA is pivotal in maintaining medical readiness            methicillin-resistant Staphylococcus aureus onboard a
and decreasing the burden on the medical resources             Naval ship. Mil Med, 2003; 168(2):135-138.
available. As already stated, the operational setting is a     3. Naval Environmental Health Center. Guidelines for
ripe environment for the quick spread of CA-MRSA.              the Management of Community-Acquired Methicillin
Population education is critical in preventing big out-        Resistant Staphylococcus aureus (CA-MRSA) Infections
breaks of infections. You should highly encourage and          in the Navy and Marine Corps. August 2005.
demand proper hygiene from all service members and             4. Navy Environmental and Preventive Medicine Unit
especially those with skin and soft tissue infections. Ser-    Two (NEPMU-2). Methicillin-resistant Staphylococcus
vice members should be mandated to wash their hands            aureus infections: A public health update. www.geis.
with soap and water a minimum of five times daily,   
washing for at least fifteen seconds each time. Service        Resistance/MRSAInfections.asp.

4                                                                                             Contact · Vol. 31, No. 2 · April 2007
                                          THE FLIGHT SURGEON’S OFFICE

Headache: Evaluation and Aeromedical
                                                                      COMMANDER MICHAEL B. MCGINNIS, MC, USN
                                                                          NAVAL AIR STATION PENSACOLA, FLORIDA

                                                                                           DOCTOR HENRY O. PORTER
                                                              STAFF NEUROLOGIST, NAVAL AEROSPACE MEDICAL INSTITUTE
                                                                              NAVAL AIR STATION PENSACOLA, FLORIDA

    Headache is commonly seen in clinical practice.                   are episodic should be assumed to have mi-
Headache is the most common complaint referred to the                 graine.
Naval Aerospace Medical Institute (NAMI) Neurology
for evaluation. The flight surgeon must be adept in                      2. How often do you get other (milder) head-
evaluating headache in clinical practice and make the                 aches? Daily headaches should always be
appropriate diagnosis and aeromedical disposition.                    evaluated for “worrisome” features. Patients
Headaches, regardless of type, pose significant dangers               with daily headaches which at times are severe
in flight. Incapacitating cephalgia, confusion, visual                and migrainous may have “transformed mi-
auras and other transient neurological impairments are                graine,” often due to medication overuse.
examples of potential hazards to aviation safety. This
article reviews the approach to headache in the outpatient               3. How often do you take headache relievers
setting; a summary of headache syndromes considered                   or pain pills? Use of symptomatic medications
disqualifying for flight and NAMI waiver guidelines are               more than three days per week represents medi-
also presented.                                                       cation overuse. The label, “drug rebound head-
                                                                      ache,” should not be applied without a complete
Evaluation                                                            evaluation that has considered secondary and
   Headaches can be classified in to four general catego-             “worrisome” headaches.
ries: migraine, tension, cluster and other. The first three
categories constitute over 90% of all headache cases. A                  4. Has there been any recent change in your
detailed classification guideline was published by the                headaches? The best screening question for
International Headache Society in 2004. “Migraine in a                “worrisome” headaches. A patient with a stable
Minute” is a primary care validated four question screen-             pattern of headache for six months has the same
ing tool adopted by the American Academy of Neurol-                   likelihood of an underlying tumor as does a pa-
ogy ( This screen can assist in the                      tient without headache.
evaluation of a headache patient and includes the follow-
ing questions:                                                    Migraine
                                                                     Migraine is the most common headache presenting for
         1. How often do you get severe headaches                 evaluation. Migraine more commonly affects women
     (i.e., without treatment, they make it difficult to          than men (studies average incidence rates of 17% for
     function)? This question alone identifies mi-                women and 6% for men). Migraine can be broken in to
     graine. Any patient with severe headaches which              four phases: prodrome, aura, headache, postdrome. Not

Contact · Vol. 31, No. 2 · April 2007                                                                                   5
                                         THE FLIGHT SURGEON’S OFFICE

every migraneur experiences all four phases and each           quality, of moderate to severe intensity (inhibiting or
migraine episode may vary by number of phases experi-          prohibiting daily activities), and exacerbated by routine
enced.                                                         physical exertion.
    The prodrome may be experienced hours or days be-             Many describe the postdrome as feeling “hung-over.”
fore the onset of headache and is a warning to the migra-      The majority of migraneurs take hours to recover, and
neur that a headache is imminent. This is valuable to the      some take days. Symptoms of migraine postdrome in-
30-40% of migraneurs with prodrome because the symp-           clude: lowered mood levels, fatigue, poor concentration,
toms present an opportunity to abort the migraine before       lowered intellect levels, or feelings of well-being and
the onset of headache. Typical prodromic symptoms              euphoria. Many migraine patients attribute these symp-
include:     food craving, change in bowel habits              toms to the medications they have taken for the pain.
(constipation/diarrhea), increased frequency in urination,     Nevertheless, such symptoms, caused by medication or
mood changes, muscle stiffness (especially cervical), and      the migraine itself, must resolve before flight planning
fatigue.                                                       can begin.
    Migraine aura constitutes a wide range of symptoms
that can affect all five senses including: flashing lights,    Aeromedical Considerations
wavy lines, partial loss of sight, olfactory hallucinations,      Headache satisfying any of the following criteria is
tingling or numbness of face or extremities, difficulty        considered disqualifying and a waiver request must be
finding words, confusion, vertigo, partial paralysis, and      submitted:
auditory hallucinations.
    The headache phase is usually the most incapacitating         • Prohibits performance of required social, voca-
aspect of migraine and can last from four to seventy-two       tional or academic activities
hours. The headache is typically unilateral, pulsating in         • Member sought emergency, hospital, or acute care
                                                                  • Neurological dysfunction other than nausea/
                                                               vomiting or photophobia
                                                                  • Requires more than simple analgesics or non-
                                                               pharmacologic methods for control
     Aerospace Medical Association Meetings
        New Orleans, Louisiana — May 13-17, 2007                  As described in the Aeromedical Waiver Guide,
        Boston, Massachusetts — May 11-15, 2008                evaluate and detail the following factors when requesting
         Los Angeles, California — May 3-7, 2009               a waiver:
           Phoenix, Arizona — May 9-13, 2010
          Anchorage, Alaska — May 8-12, 2011                      •   Specific diagnosis and presentation
                                                                  •   Frequency
                                                                  •   Predictability
    Society of US Naval Flight Surgeons Socials                   •   Severity
          New Orleans, Louisiana — May 16, 2007                   •   History of incapacitation
          Boston, Massachusetts — May 14, 2008
                                                                  •   Treatment required
          Los Angeles, California — May 6, 2009
            Phoenix, Arizona — May 12, 2010                       •   Status of aviator
            Anchorage, Alaska — May 11, 2011                      •   Type of aircraft
                                                                  •   Flight hours and experience

     Combined Aeromedical Problems Courses                         All patients need neurology consultation prior to sub-
         Pensacola, Florida — January 14-17, 2008              mitting a waiver.
         Pensacola, Florida — January 12-15, 2009                  If there are any questions, Dr. Henry Porter (NAMI
         Pensacola, Florida — January 11-14, 2010              Neurology) is readily available to assist. You may con-
         Pensacola, Florida — January 10-13, 2011              tact him at or by dialing
                                                               NAMI Neurology at (850) 257-1022 (DSN 922). Email
                                                               is preferred.

6                                                                                             Contact · Vol. 31, No. 2 · April 2007
                                               THE FLIGHT SURGEON’S OFFICE

Pseudofolliculitis Barbae in Naval Personnel
                                                           LIEUTENANT COMMANDER JONATHAN L. BINGHAM, MC, USN
                                                                                              BETHESDA, MARYLAND

Introduction                                                          As stated above, PFB is an inflammatory skin condi-
   The Twenty-Second Law of the Navy states:                       tion. The inflammation results from tightly curled hairs
                                                                   growing back into the skin when shaved. The act of shav-
    Though Armour, the belt that protects her,                     ing creates a sharp tip to the hair that allows it to penetrate
           The ship bears the scar in her side                     the skin. Essentially, with penetration into the dermis, a
    It is well if the court acquit thee                            granulomatous, foreign body reaction ensues.
           It were best hadst thou never been tried (1).              In men, PFB presents as inflammatory papules or nod-
                                                                   ules on the anterolateral aspect of the neck but may also
   Pseudofolliculitis barbae (PFB), also known as shave            involve the chin and mandibular areas of the beard region.
bumps or razor bumps, is a dermatologic condition not              The moustache region is typically spared. Pustules and
unique to the military, but because of grooming standards          abscesses can even appear. The inflammatory lesions can
set forth in the Navy Uniform Regulations, it is very preva-       result in post-inflammatory hyperpigmentation, hypertro-
lent in the military population. It is not uncommon for the        phic scars and even keloids.
chief complaint at a sick call visit to simply be, “I need a
shave chit.” Great strides have been made in the treatment         Diagnosis
of PFB in an effort to prevent the disfiguring complica-              Although typically a straightforward diagnosis, the dif-
tions of PFB while maintaining the grooming and safety             ferential diagnosis of PFB includes acne vulgaris, sarcoi-
standards required of Navy sailors.                                dosis, flat warts, molloscum contagiosum and sycosis bar-
   PFB is curable—don’t shave. However, this is not nec-           bae. A similar, but distinct entity that can occur on the
essarily an option in military personnel, so as a result, PFB      occiput and posterior neck is acne keloidalis nuchae.
is a controllable condition. In general, two primary con-             The Manual of the Medical Department and the
cerns arise from the presence of facial hair in naval per-         Aeromedical Waiver Guide do not specifically address
sonnel. First, as addressed by U.S. Navy Uniform Regula-           PFB. Like with a respirator, the skin lesions of PFB or an
tions, is the requirement for military personnel to be clean       unshaven face can prevent the proper wearing and use of
shaven. Second, as discussed in OPNAVINST 5100.19D,                aviation equipment, specifically the oxygen mask and chin
which is the Navy Occupational Safety and Health Pro-              strap.
gram Manual, is the interference of proper wear and use of
a respirator with facial hair. PFB can also interfere with         Treatment
the proper wear and use of a respirator. Thus both the                 With regards to treatment, it is the fourth phase of the
medical condition and one form of its treatment pose a             Navy’s PFB Treatment Protocol, laser hair removal, which
safety concern.                                                    has revolutionized the treatment of PFB and has prevented
                                                                   the need for permanent “shave chits.” Most importantly,
Description                                                        laser therapy spares individuals from the terrible conse-
    PFB is a chronic inflammatory skin condition that com-         quences of post-inflammatory hyperpigmentation, hyper-
monly occurs in the beard area of men who shave. Men               trophic scars and keloids. Laser hair removal has been
mostly affected are of darker skin pigment with tight, curly       shown to effectively remove hair and treat PFB (2-6).
hair. However, the condition can affect fairer skinned men         However, like many forms of therapy in medicine, hair
and even women. It does tend to be milder in these popu-           laser removal is not without its risks. The treatment itself
lations. It can occur in any hair-bearing area that is shaved      can result in pain, burning, erythema, edema, hypopigmen-
but the beard area is most commonly affected.                      tation and hyperpigmentation, blistering, crusting, ero-

Contact · Vol. 31, No. 2 · April 2007                                                                                           7
                                          THE FLIGHT SURGEON’S OFFICE

                                                                        tion with a dermatologist will ensure that “It were best
                                                                        hadst thou never been tried”.
                                                                           Please consider a career in Navy Dermatology.
                                                                        Dermatology encompasses diseases of the skin, hair
                                                                        and nails of all skin types. Training focuses on those
                                                                        diseases as well as cutaneous oncology and derma-
                                                                        tologic surgery. If you are interested or have any
                                                                        questions, please contact Lt. Cmdr. Jonathan L. Bing-
                                                                        ham, Associate Program Director, National Capital
                                                                        Consortium Dermatology Residency, at JLBing

                                                                            1. Rear Admiral Ronald A. Hopwood, C.B., Royal
  Pseudofoliculitis barbae can interfere with the proper wear of respi-     Navy. The Laws of the Navy. USNA Reef Points,
    rators and aviation oxygen masks. Photo courtesy of the author.         Class of 1995.
                                                                            2. Kauvar, AN. Treatment of pseudofolliculitis with a
sions, purpura, scarring, folliculitis and infection (7, 8).           pulsed infrared laser. Arch Dermatol. 2000 Nov;136
The incidence of these side infects and complications are              (11):1343-6.
low (9), but nonetheless important for the patient to under-              3. Weaver SM, Sagaral EC. Treatment of pseudofol-
stand them. It is a therapy of which documented consent                liculitis barbae using the long-pulse Nd:YAG laser on skin
is required. As a result, members cannot be forced to un-              types V and VI. Dermatol Surg. 2003 Dec;29(12):1187-
dergo the therapy.                                                     91.
                                                                          4. Tanzi EL, Alster TS. Long-pulsed 1064-nm Nd:YAG
Disposition                                                            laser-assisted hair removal in all skin types. Dermatol
    The management and disposition of Navy personnel                   Surg. 2004 Jan;30(1):13-7.
with PFB is addressed in BUPERSINST 1000.22B (10).                        5. Ross EV, Cooke LM, Timko AL, Overstreet KA,
The instruction includes two enclosures: the PFB Treat-                Graham BS, Barnette DJ. Treatment of pseudofolliculitis
ment Protocol, and NAVPERS 1000/1 (Rev 12-02) the                      barbae in skin types IV, V, and VI with a long-pulsed neo-
PFB Shaving/Waiver/Evaluation/Disposition. If a member                 dymium:yttrium aluminum garnet laser. J Am Acad Der-
completes and fails the PFB treatment protocol or is un-               matol. 2002 Aug;47(2):263-70.
willing to do laser hair removal therapy, they will be rec-               6. Ross EV, Cooke LM, Overstreet KA, Buttolph GD,
ommended by the medical department for a permanent “no                 Blair MA. Treatment of pseudofolliculitis barbae in very
shave” status. Per BUPERSINST 1000.22B, if a com-                      dark skin with a long pulse Nd:YAG laser. J Natl Med
manding officer determines that a permanent “no shave”                 Assoc. 2002 Oct;94(10):888-93.
status is detrimental to good order and discipline or affects             7. Nanni CA, Alster TS. Laser-assisted hair removal:
the member’s ability to perform military duties, they may              side effects of Q-switched Nd:YAG, long-pulsed ruby, and
process the Administrative Separation under MILPERS-                   alexandrite lasers. J Am Acad Dermatol. 1999 Aug;41(2
MAN article 1910-120 for “Convenience of the Govern-                   Pt 1):165-71.
ment – Physical or Mental Conditions as evidenced by                      8. Lim SP, Lanigan SW. A review of the adverse ef-
Pseudofolliculitis Barbae.”                                            fects of laser hair removal. Lasers Med Sci. 2006 Sep;21
                                                                       (3):121-5. Epub 2006 Jul 1.
Conclusion                                                                9. Lanigan SW. Incidence of side effects after laser
    Back to the Twenty-Second Law of the Navy. With the                hair removal. J Am Acad Dermatol. 2003 Nov;49(5):882-
availability of laser hair removal, no sailor should bear the          6.
disfiguring scars that can be a consequence of PFB. A                     10. BUPERS Instruction 1000.22B: Management and
proactive approach to education of sailors, adherence to               Disposition of Navy Personnel with Pseudofolliculitis Bar-
the Navy’s PFB Treatment Protocol and prompt consulta-                 bae (PFB). 27 Dec 2004.

8                                                                                                   Contact · Vol. 31, No. 2 · April 2007
                                              ZERO TO MACH TWO

Flight Surgery in the Middle East: Deployment
Preparation and Resources (Part I)
                                                                          LIEUTENANT JOSHUA A. TUCK, MC, USN
                                                              SQUADRON FLIGHT SURGEON, PATROL SQUADRON EIGHT
                                                                          NAVAL AIR STATION BRUNSWICK, MAINE

   The following is part one of a two-part article com-       ported in three columns denoted as “Fully Medically
piled from our experiences in preparing for a six month       Ready,” “Partially Medically Ready,” and the less im-
deployment to the Middle East. This article is intended       pressive “Not Medically Ready.” The race to obtain
to share with the community those resources that our          “fighter grades” on your medical readiness is enough to
department found most useful.                                 put even the most experienced flight surgeon into a tail
                                                              spin. Fortunately, there is good news to report.
Introduction                                                      This number crunching has traditionally been accom-
   In late November of 2006, the proud and historic           plished utilizing the Shipboard Automated Medical Sys-
Fighting Tigers of Patrol Squadron Eight embarked upon        tem (SAMS) electronic medical record. Although an
their deployment to the Fifth Fleet Area of Responsibil-      effective and viable tool for the shipboard community, a
ity (AOR), in support of Operations Iraqi Freedom, En-        more modern and versatile program is taking center stage
during Freedom, and Joint Task Force Horn of Africa.          in the land-based arena. Welcome Medical Readiness
This six-month deployment required every member to be         Reporting System (MRRS) to the active fleet. This user-
medically prepared for the unique force health threats of     friendly internet-based program requires no single cum-
the region and the challenges of the sustained Global         bersome hard drive for storage, and can be accessed from
War on Terrorism.                                             practically any computer on the net from virtually any-
   I had only arrived four months prior to the pre-           where in the world. Although it has seen action for sev-
deployment surge, and had little time to learn the intrica-   eral years in the reserve component of the Navy, it has
cies of such an evolution. Fortunately, with the help of      only recently begun to replace SAMS as the preferred
several crucial resources, our medical department was         method of electronic medical data storage and reporting
able to successfully prepare a squadron of approximately      for land-based units such as the P-3 community.
400 people in a little over a two-month period. By the            Transitioning from SAMS to MRRS is a fairly pain-
time we pulled chocks, our squadron enjoyed a medical         free, hands-off evolution. Once your unit is enrolled in
readiness of over 99%, as noted in the Medical Readi-         the program, most of your squadron’s medical informa-
ness Reporting System. The following article is a com-        tion will be automatically transferred from the SAMS to
pilation of web-based resources that we found most help-      the MRRS database. The only information that did not
ful in preparation for our deployment.                        transfer was blood type, G6PD status, and sickle cell
                                                              status. These components had to be individually re-
Medical Readiness and Deployability                           entered into the new system.
   Few of the deploying flight surgeon’s responsibilities         The overall medical readiness of the squadron is re-
will garnish more attention from his Skipper than his         ported as a percentage of the total unit, and is of course a
squadron’s overall medical readiness. In an environ-          compilation of each individual’s medical readiness. The
ment that stresses numbers and percentages, the medical       desired status of “Fully Medically Ready” means just
readiness report is an accurate and concise statement that    what it states: this member is up to date on all of his or
can be used by the non-medical community to quickly           her annual physical requirements and immunizations.
assess a unit’s medical deployability. This overall per-      “Partially Medically Ready” could be reported with as
centage is based on several factors, and is typically re-     little as one vaccination missing in a member’s record.

Contact · Vol. 31, No. 2 · April 2007                                                                                   9
                                                  ZERO    TO    MACH TWO

Members in this status bring down the squadron’s medi-            the member. Those in flight status are authorized to use
cal readiness. However, those members who are “Not                doxycycline or chloroquine for primary prophylaxis, but
Medically Ready” cause the greatest drop in percentage            must first undergo an initial forty-eight hour grounding
for their squadron. Dental class III and IV members               period. Primaquine may be used for terminal prophy-
typically made up the largest group of this fortunately           laxis, (or primary prophylaxis in special cases), and also
small percentage of our squadron.                                 requires an initial forty-eight hour ground test. It is im-
   Annual physicals, dental exams, audiograms, optome-            portant to remember that those receiving primaquine
try exams, flight waivers, HIV status, and immunizations          must first have a documented G6PD status on file in their
are all recorded and easily accessed in a tabulated for-          medical record, as a deficiency in this enzyme may prove
mat. This integrated program also supports such features          fatal with use of the drug. Atovaquone/proguanil can be
as an auto-population function for reporting of annual            used in special circumstances when the above medica-
HIV results directly from the testing source. Soon, it is         tions are contraindicated or unavailable. This is cur-
planned that the program will also track waiver results           rently under review through the Naval Aerospace Medi-
and annual flight physicals directly through NAMI. In             cal Institute (NAMI) and requires a written approval
our experience, MRRS has proved to be a truly complete            from the commanding officer. For further guidance refer
and easily accessible electronic medical record, and has          to the Aeromedical Waiver Guide.
served as an indispensable tool for the medical prepara-              Besides malaria, many other arthropod-borne diseases
tion and continued tracking of our deploying(ed) squad-           are endemic to this region of the world as well: leishma-
ron.                                                              niasis, dengue, Chikungunya, typhus, sandfly fever and
   While it is not the scope of this article to review all of     West Nile Fever to name a few. While these diseases
the unique features of the MRRS application, it is recom-         currently have no vaccines, with the appropriate planning
mended that the reader preparing for deployment spend             and personal protective measures they can certainly be
time familiarizing himself with this program. More in-            avoided.
formation about the application, including a very useful              Ideally, each member should be issued his or her own
Computer Based Training (CBT) module, can be found                DEET (N, N-diethyl-meta-toluamide) containing bug
at Members can apply            repellent for the deployment. Although many options
for access by completing a System Authorization Access            exist, the standard DoD-approved preparation is a poly-
Request (SAAR/DD Form 2875), found as a link on the               mer-based, sustained-release product with a DEET con-
MRRS homepage. This form should be submitted to                   centration of 33%. This can be ordered through your
their unit security officer for review and submission.            command’s supply office, (NSN 6840-01-284-3982).
                                                                  Permethrin treated garments may also be a requirement
Vaccinations and Regional Heath Risks                             as part of the complete DoD Insect Repellent System.
   Another area of great concern for the new flight sur-          Region-specific vector threats will determine the re-
geon going on deployment is the issue of vaccinations             quired extent of these personal protective measures.
and chemoprophylaxis. It is obvious that members                  More information on the appropriate use of DEET and
should be up to date on their standard vaccinations prior         permethrin, as well as the DoD Insect Repellent System,
to deployment. However, the Fifth Fleet/CENTCOM                   can be found at http://deploymenthealthlibrary.fhp.osd.
AOR covers many regions with varying health threats               mil/home.jsp.
and additional immunization requirements. It is impera-               Other more commonly encountered infectious dis-
tive that the flight surgeon take an active role in the plan-     eases which should not be overlooked include hepatitis,
ning and coordination of his/her upcoming deployment.             typhoid, and various strains of bacterial and parasitic
Early knowledge of the specific region is required to ef-         diarrhea. A thorough pre-deployment medical brief will
fectively protect the squadron prior to arrival in theater.       help to educate your squadron about these risks and steps
Many variables, such as seasonal weather changes and              to avoid these agents. Careful surveillance of living con-
regional elevations, can greatly affect the local arthropod       ditions, food preparation and storage, water quality, and
threat level. With such variation, it can be a challenging        sanitation can help to limit the rate of infection and im-
process to stay abreast of the constantly changing health         pact of these entities.
recommendations within the Middle East.                               Although many websites offer useful information on
   For malaria, there are many chemoprophylaxis op-               traveler’s health, they can often conflict and may leave
tions, depending on local sensitivities and the status of         the reader with more questions than answers. The

10                                                                                               Contact · Vol. 31, No. 2 · April 2007
                                                ZERO    TO    MACH TWO

Armed Forces Medical Intelligence Center (AFMIC), has           to familiarize himself with such policies as appropri-
been an excellent resource for detachment and deploy-           ate to maintain compliance with current regulations.
ment preparation. The site contains practically every
country of any military significance, with full assess-
ments of the region’s health threats, arthropod risks, en-      References
demic diseases, sanitation, and medical facilities and re-         1. Armed Forces Medical Intelligence Center Home
sources. The site even goes into detail in recommending         Page. 19 Jan 2007. Defense Intelligence Agency / Offi-
the appropriate chemoprophylaxis for the regional dis-          cial U.S. DoD Website.
eases noted. Access to the site is obtained through an             2. “DEET Insect Repellent, Information for Service-
online application that usually takes twenty-four to forty-     members and their Families”, 25 Sep 2006. Deployment
eight hours for approval. This informative website can          Health and Family Readiness Library Home Page. 19
be found at                 Jan 2007. Official U.S. DoD Force Health Protection
                                                                and Readiness website. http://deploymenthealthlibrary.
   Part 2 of this article will focus on smallpox and an-
thrax vaccinations, as well as Deployment Health As-               3. Medical Readiness Reporting System Home Page.
sessments and pre-deployment flight physicals.                  19 Jan 2007. SSC NOLA, Department of Navy, Official
                                                                U.S. Navy / DoD Computer System. https://mrrs.cnrf.
    Note: This article is intended only as a supplement
to assist the inexperienced flight surgeon to prepare              4. Naval Aerospace Medical Institute Home Page:
for deployment to the Fifth Fleet/CENTCOM AOR.                  Aeromedical Waiver Guide. 14 Nov 2006. Medica-
It is not an all-inclusive list of requirements; nor is it      tions / Antimicrobials / Antimalarials. 19 Jan 2007. De-
intended to supersede or replace any current U.S.               partment of Navy, Official U.S. Navy Website.
Navy or DoD policies or directives in regards to spe- 
cific deployment requirements. The reader is advised            pdfs/Waiver%20Guide%20-%20Medications.pdf

   Thinking ahead and
 being fully prepared for
   deployment will help
  the flight surgeon and
    his or her team feel
 more comfortable in the
  austere environments
 that are so prevalent in
 today’s Navy. This is a
     photograph of the
  Flight Line Aid Station
  (FAS) at Al Asad Air-
   base in Iraq. Photo-
 graph by flight surgeon
  Lieut. Tara M. Walker
   of the Marine Attack
 Squadron 223 Bulldogs.

Contact · Vol. 31, No. 2 · April 2007                                                                                11
                                                ZERO    TO    MACH TWO

Aeromedical Considerations of a VIP Mission (Part I)
                                                              LIEUTENANT ALEXANDER B. GALIFIANAKIS, MC, USN
                                             SQUADRON FLIGHT SURGEON, MARINE HEAVY HELICOPTER SQUADRON 466
                                                               MARINE CORPS AIR STATION MIRAMAR, CALIFORNIA

   During a recent deployment to Iraq, Marine Heavy             until only minutes before the flight. The only advanced
Helicopter Squadron 466 was tasked with providing in-           information available was the name of one or two of the
theater transportation for Secretary of Defense Donald          dignitaries and an estimation of the total passengers.
Rumsfeld. Stationed at Marine Corps Air Station Al                  At that point, I decided to focus my efforts on contin-
Asad, we traveled to Amman, Jordan to pick up the Sec-          gency planning. Should the need to elevate medical care
retary and his staff. As the squadron flight surgeon, I         to a higher echelon arise, we would have two options.
had the pleasure of being tasked with the provision of          We would have the choice of employing our own re-
medical support for this VIP mission. Although the              sources to transport patients to the closest DoD facility
prospect of having to provide medical coverage for the          versus utilizing the closest local hospital. Given that we
seventy-six-year-old Secretary was slightly intimidating,       would be over three hours from the closest Level II treat-
this was easily overcome by my desire to explore a lo-          ment facility, the obvious choice would be to use local
cale other that the Al Anbar Province of Western Iraq.          resources. In exploring the available medical resources,
Task in hand, I set out to plan what this mission would         it was important to retain operational security. The flight
require and how it would be different from other combat         surgeon who, in an attempt to be conscientious and pro-
missions we had flown thus far.                                 active, notified an Arab hospital that the United States
                                                                Secretary of Defense would be passing through town
      “The flight surgeon who...notified                        would not be a hero. So, research of available medical
                                                                resources and evacuation routes was limited to obtaining
     an Arab hospital that the...Secretary
                                                                contact information for local authorities.
        of Defense would be passing                                   The final consideration was taking into account
     through town would not be a hero.”                         what aspects of this evolution would be different for the
                                                                pilots and aircrew. Our crew had been stationed in West-
   From a medical standpoint, much about this mission           ern Iraq for the past three months, working seven days a
would be business as usual. It is always prudent to be          week and between twelve to fourteen hours a day. Our
prepared for a medical emergency. Apart from brushing           operational tempo was high. In the month prior, the
up on Basic Life Support (BLS) topics and ensuring that         squadron flew 867 combat hours while its maintainers
adequate medical supplies were on hand, there were a            logged 24,706 maintenance man-hours. Our missions
few additional preparations that needed to be considered.       consisted mainly of heavy hauling of troops and sup-
One important question was who was being transported?           plies. The occasional tactical low-light insert kept things
In this case, I would get no say in a passenger’s suitabil-     interesting. Still, we were constantly battling issues of
ity for flight. As DoD personnel, there was no require-         monotony and fatigue. Having conducted numerous
ment for a special-passenger screening. Furthermore, a          evaluations for crew chiefs approaching and exceeding
full passenger list would not be presented to the crew          monthly flight hour limits, we now threw an additional

12                                                                                             Contact · Vol. 31, No. 2 · April 2007
SUSNFS MEMBERSHIP RENEWAL / ADDRESS CHANGE / GEEDUNK ORDER FORM                                                             JULY 2006

   #       ITEM                                                                                   PRICE               SUB-TOTAL
           (Indicate Size and Color Where Appropriate)                             Non-Member             Member
   ____    Polo shirt: FS Wings (M, L, XL) (Navy Blue, White)                           38.00              33.00      ___________
   ____    NAMI Flight Surgeon Belt Buckle                                              28.00              26.00      ___________
   ____    T-shirt: SUSNFS “Keep ‘em Flying” (M, L, XL, XXL)                            24.00              19.00      ___________

   ____    FS Wings of Gold Tie                                                         22.00              20.00      ___________
   ____    FS Wings of Gold Women’s Bow Tie                                                5.00              5.00     ___________
   ____    Sweat Shirt: FS Wings (check by e-mail on availability)                      20.00              20.00      ___________
   ____    Sweat Pants: SUSNFS Logo (check by e-mail on availability)                   10.00              10.00      ___________
   ____    Sweat Pants: FS Wings (check by e-mail on availability)                      10.00              10.00      ___________
   ____    SUSNFS Patch (only a dollar a patch for shipping)                               6.00              5.00     ___________
   ____    Full Size 14K Gold Flight Surgeon Wings                                     260.00             240.00      ___________
   ____    Mess Dress 14K Gold Flight Surgeon Wings                                    160.00             140.00      ___________
   ____    Sweetheart FS Wings Necklace, 14K Gold/Diamond Chip                         225.00             195.00      ___________
   ____    Petite Sweetheart FS Wings Necklace, 14K Gold/Diamond Chip                  150.00             120.00      ___________
   ____    Naval FS Pocket Reference to Mishap Investigation                            30.00              25.00      ___________
   ____    Travel Mug: SUSNFS Logo                                                         6.00              5.00     ___________
   ____    Refrigerator Magnet: FS Wings (price includes shipping)                         2.00              1.50     ___________
   ____    FS Wings of Gold License Plate (blue with gold border)                        8.00                8.00     ___________

   SUBTOTAL                                                                                                           ___________

          For all items (just a dollar a patch or refrigerator magnet)           $4.00 for 1st item
                                                                                 $2.00 for each additional item       ___________
           For jewelry items: postal insurance                                   $2.00 for first jewelry item only    ___________

        Annual renewal                                                           ____ years at $25.00/year            ___________
           Life membership                                                       $375.00                              ___________

   VISA/MC _________________________________________________                     TOTAL AMOUNT ENCLOSED                ___________
   EXPIRATION ___________________                                                (Checks payable to SUSNFS)

                For faster service go to for ONLINE ordering

Address change? Y / N Naval Flight Surgeon? Y / N Aerospace Medicine Graduate? Y / N Current AsMA Member? Y / N

  Name          _________________________________________________________________                         Rank
  Circle all that apply: MC / MSC / MD / DO / PhD / USN / USNR / Active / Reserve / Retired / Other ____________
  Street        ______________________________________________________________________________________
  City          ______________________________                 State __________________________           Zip ______________
  Home          Phone ____________________________                E-mail ___________________________________________
  Work          Phone ____________________________                E-mail ___________________________________________
  Command       _______________________________________________                 FS Class ________            RAM Class ______

The Society of U.S. Naval Flight Surgeons
P.O. Box 33008
Naval Air Station Pensacola, FL 32508-3008
                                                   ZERO     TO   MACH TWO

                                                                                         tack in a tourist hotel in Amman only
                                                                                         three weeks earlier prompted us to re-
                                                                                         strict our movement to the confines of
                                                                                         our hotel. This allowed us to emphasize
                                                                                         rest and focus amongst our crew mem-
                                                                                         bers on the day before the mission.
                                                                                            On the day of the mission, we arrived
                                                                                         early for the usual pre-flight inspections
                                                                                         and aircrew briefs. The Secretary’s party
                                                                                         arrived in the zone, loaded onto our heli-
                                                                                         copters, and left for home all in about
                                                                                         forty-five minutes. In that time, he spent
                                                                                         about twenty minutes in the air and an-
                                                                                         other twenty in the forward outlying base
                                                                                         responding to Army Private First Classes
                                                                                         requesting personal Humvees. This was
                                                                                         supposed to be followed by a stop at the
                                                                                         King’s palace for tea, but Mr. Rumsfeld
                                                                                         decided to call it a day early. In the end,
                                                                                         the mission was amazingly short, the
                                                                                         crew members were focused and profes-
  Sea Stallions of Marine Heavy Helicopter Squadron 466 ready on the flight line         sional and my involvement was reassur-
   for their assignment to transport the United States Secretary of Defense. Photo
                                                                                         ingly minimal. Looking back on the ex-
        courtesy of the author, flight surgeon Lieut. Alexander B. Galifianakis.
                                                                                         perience, conducting a VIP transport
                                                                                         while in theater was far from the anxiety-
element in the mix. We would be performing a new mis-                    provoking challenge I expected. Instead, it turned out to
sion in an unfamiliar location. Still, it was essential that             be a much-needed escape for a group of hard working
this team of twenty individuals, who have not had a day-                 and dedicated Marines.
off in over ninety days, remain abso-
lutely on top of their game. In addition
to questions of fatigue, another poten-
tial concern was distraction. The tran-
sition from such an intense operational
tempo to a relatively low-key three day
mission could invite complacency.
        In order to execute this hop, we
brought four birds, four complete
crews, and a team of maintainers. We
would have a section of two aircraft,
with only one carrying passengers. A
third helicopter would be a turning
back-up and a fourth would be on
standby. The mission actually required
three days to complete. On the first
day, we traveled to Jordan, familiarized
the crew with the specifics of the air-
field and then settled into a comfortable
hotel. Although known to be a U.S.- Members of the transport team pose with U.S. Secretary of Defense, the Honorable
friendly country, a recent terrorist at-               Donald Rumsfeld (center) on the flight line. Photo courtesy of the author.

Contact · Vol. 31, No. 2 · April 2007                                                                                            13
                              SEA STORIES AND NEWS FROM THE FRONT

From the President: Thank You All
                                                                                    CAPTAIN FRANK A. CHAPMAN, MC, USN
                                                                      FORCE MEDICAL OFFICER PACIFIC, NAVAL AIR FORCES
                                                                 NAVAL AIR STATION NORTH ISLAND, SAN DIEGO, CALIFORNIA

    Greetings all. This year as your                                                          couple of amendments to our bylaws
president has gone very quickly. Next                                                         that will allow us to qualify as a Tax
month at the Aerospace Medical Asso-                                                          Exempt Organization. Excerpts are
ciation (AsMA) at our annual SUSNFS                                                           included at the end of my column.
business meeting I will pass the lead                                                             Our membership is up among new
on to Capt. Rick Beane. The business                                                          Flight Surgeons. We welcome you to
of your society has continued to move                                                         our membership. We look forward to
forward and I would like to thank those                                                       serving the aerospace medicine com-
that have served with me and made it                                                          munity in the Navy. As we are a con-
happen. The Treasurer duties have                                                             stituent organization of AsMA, I
been carried forward by Danny                                                                 would encourage you all to join and
Homan. We are in a positive position                                                          help us maintain this status.
for our finances, recovering from the                                                             I trust you will again enjoy this
effects of the Hurricanes and being                                                           issue of Contact. Walt and Nick have
frugal with the expenses for our Com-                                                         assembled a fine set of articles. Sub-
bined Operational and Aeromedical                                                             mitted by first tour flight surgeons,
Problems (COAP) Social. Danny gra-                                                            faculty at the Uniformed Services
ciously offered his home for the eve-                                                         University of the Health Sciences
ning. It was a wonderful venue and                                                            (USUHS), and the Navy Operational
attendance was great. Our Secretary, Daryl Sulit, was in-             Medicine Institute (NOMI) Staff, the articles cover subjects
strumental in organizing the event and procuring of the food          involving forward deployed forces in combat to providing
and refreshments for the evening. I would like to thank our           primary care for those we serve. Again, the quality of these
President Elect Rick Beane for coordinating the first Flight          articles is impressive.
Surgeon Reunion on Friday following COAP (see page six-                   I closed my last column with a reminder about the many
teen). It was a treat to spend some time with these flight            of our ranks that are forward deployed in support of Opera-
surgeons that served following the Korean War in the late             tion Enduring Freedom, Operation Iraqi Freedom and the
50s. It would be great to continue to grow this event and             other hot spots around the world. Please keep them in your
include it as part of our planning for COAP each year.                thoughts. To you all: thank you for your service. It has
    And of course Contact. Walt Dalitsch has continued to             been an honor to serve you.
publish our journal with the help of Nick Davenport. Walt,
                                                                      Article I. Title and Purpose
we are privileged to have your leadership for our fine jour-          2. The mission of the Society is to promote the enhancement of the
nal. Please join me in thanking Walt for his outstanding              effectiveness of naval aviation through an increased understanding
service.                                                              of the physical, physiological, pathological or psychological factors
    Our SUSNFS elections ballot will be sent out again this           associated with the flight environment. The Association affirms that
year electronically. To vote please go to our website and             this is best accomplished through research, analysis, teaching and the
download the ballot and email it by May 1st.                          provision of informed operational guidance. The organization is
                                                                      organized exclusively for educational, and scientific purposes under
    I hope many of you will be able to join us at AsMA (see           section 501(c)(3) of the Internal Revenue Code, or corresponding
page twenty). Our Business Meeting will be Sunday after-              section of any future federal tax code.
noon at 4:00 pm. The location will be in the AsMA regis-
                                                                      Article XI Tax Exempt Status/Distribution of Assets UPON DIS-
tration Materials. We are sponsoring the Navy Luncheon
this year and Lieut. Hagen, our secretary elect, will be coor-         1. Upon the dissolution of this organization, assets shall be distrib-
dinating the event for us. Walt Dalitsch has great plans for          uted for one or more exempt purposes within the meaning of section
our Social on Wednesday Night (page twenty-one). It will              501(c)(3) of the Internal Revenue Code, or corresponding section of
be a real treat to see you all there.                                 any future federal tax code, or shall be distributed to the federal gov-
    At the annual business meeting we will be voting on a             ernment, for a public purpose.

14                                                                                                          Contact · Vol. 31, No. 2 · April 2007
                                        SEA STORIES   AND   NEWS   FROM THE     FRONT

From the Secretary: Meetings and Elections
                                                                            LIEUTENANT DARYL J. SULIT, MC, USN
                                                               FIRST YEAR RESIDENT, DEPARTMENT OF DERMATOLOGY
                                                                    NAVAL MEDICAL CENTER SAN DIEGO, CALIFORNIA

    I hope all the flight surgeons that                                              billet and your command cannot af-
attended the Combined Operational                                                    ford to pay for your CME course,
and Aeromedical Problems (COAP)                                                      there still is hope that BUMED can
Course at NAS Pensacola this past                                                    pay for you. However, you would
January found the courses educa-                                                     have to put in a request early with all
tional, useful, and fun. I attended the                                              the proper paperwork. For more in-
event and it was a pleasure to meet so                                               formation and instructions on Navy
many of the Navy’s hardworking                                                       CME funding, please go to their web-
flight surgeons face-to-face. It was                                                 site: mil/gme/
great to see old and new friends and                                                 CME1.htm.
trade “sea stories.” I would like to                                                    Springtime is also that time of year
thank the people who helped make                                                     when our organization SUSNFS un-
this annual event a success. I also                                                  dergoes change. Officer elections are
would like to thank our SUSNFS As-                                                   held and other officers are promoted.
sistant Treasurer, Cmdr. Daniel Hoh-                                                 I encourage you to send your ballots
man, who graciously hosted the                                                       in and vote. SUSNFS is your society
SUSNFS Social at his beautiful Pen-                                                  and you have a voice. Current offi-
sacola home.                                                                         cers start to step down from their cur-
    As this column hits the presses                                                  rent positions and new people are
with the April 2007 issue of Contact,                                                given the opportunity to participate in
it will be springtime. Springtime is a beautiful time of       the enhancement and preservation of our naval flight sur-
year when the sun starts to shine brighter and longer, days    geon society and its rich traditions. I will be one of the
get warmer, flowers bloom, and the trees become green          officers stepping down and this will be my last column as
and colorful once again. During this time of year, there       SUSNFS Secretary. It was a pleasure to serve you all.
are many exciting events occurring in our flight surgeon       The new incoming secretary will be Lieut. Amanda
community, such as the annual Aerospace Medical Asso-          Hagen, who is currently serving as SUSNFS Assistant
ciation (AsMA) meeting and SUSNFS officer elections.           Secretary. Amanda is a positive, energetic person who
The 78th Annual Scientific Meeting of the AsMA meeting         will truly be an asset to our organization. I have the ut-
will be held May 13-17, 2007 at the Sheraton and Marriott      most confidence in her abilities.
hotels in New Orleans, Louisiana. If you didn’t know,              Before I go, I would like to thank all the flight surgeons
SUSNFS is a constituent organization of AsMA. All              who submitted articles, photos, and other written materials
SUSNFS members are encouraged to come to the annual            to Contact. Thank you for sharing your knowledge and
AsMA meetings, which are always educational and enjoy-         past experiences. Thank you for helping other flight sur-
able. For more information on the annual AsMA meeting          geons learn, develop professionally, and become better and
in New Orleans, please see their website at                    more efficient at their jobs. I invite all flight surgeons to                                                  continue to submit articles (case reports, review articles,
    If you have not used your Navy CME funding this year,      lessons learned, etc) to our journal Contact. Good topics
the annual AsMA meeting would be a perfect opportunity         include aviation medicine, safety, deployment tips, and
to use it. Just in case you did not know, as a Navy medical    other useful “gouge.” By taking the time to collect your
officer, you are typically entitled to 1 CME course funded     thoughts, write them down, and submitting it to Contact,
by the Navy per year (which includes the cost of the CME       you are helping to connect, strengthen, and educate our
course, travel, and lodging). This is especially true if you   flight surgeon community.
are currently serving in a claimancy 18 billet. However,           It’s great to be a Naval Flight Surgeon. Enjoy every
even if you are currently serving in a non-claimancy 18        moment and keep ’em flying safely!

Contact · Vol. 31, No. 2 · April 2007                                                                                     15
                                   SEA STORIES       AND   NEWS   FROM THE   FRONT

Pensacola Homecoming: The First Flight Surgeon
                                                                                     DOCTOR WILLIAM M. HELVEY
                                                                                FLIGHT SURGEON, CLASS #85 OF 1957
                                                                                           LOS ALTOS, CALIFORNIA

Introduction                                                  13, First Marine Brigade) at Marine Corps Air Station
   In January of this year, three former Naval Flight Sur-    Kaneohe. Alan Stormo was departing to Naha, Okinawa
geons and their wives returned to Naval Air Station Pen-      as flight surgeon with Navy Patrol Squadron VP-4. Un-
sacola after an absence of fifty years. As graduates of       fortunately, Marty could not join him for six months due
the Class # 85 on December 20, 1957, we had just com-         to a lack of housing availability. So as the rest of us
pleted our six months of training – culminating in flight     boarded a bus at the federal building and then boarded
training in the T-34 at Saufley Field, and were en route      ships at Fort Mason, we wished Marty a tearful goodbye
to duty stations in the Pacific.                              as she returned to Minnesota. Ironically, a year later,
   George Albright and his wife, Dolly, were still on         when MAG 13 was temporarily deployed to Japan (some
their honeymoon when we all arrived at Pensacola in           dispute with China over the Quemoy and Matsu Islands),
July. Alan and Marty Stormo had entered the Navy from         Alan and Marty stopped to visit George and me at Naval
their home state of Minnesota, and Bill and Grace             Air Station Atsugi.
Helvey, with a three month old son, arrived from Saint
Louis, Missouri. While at Pensacola, as a part of a class     Civilian Life
of thirty-five physicians, we had become good friends.            In 1961, as civilians again, George and I were in-
Al and Marty had a place on Santa Rosa Island – with a        volved in medical research for the National Aeronautics
boat – where we all learned to water ski (more or less).      and Space Administration (NASA) on Long Island, New
                                                              York, and Alan was at Saint Albans Naval Hospital and
First Duty Station                                            Floyd Bennett Field in New York; so we all renewed our
   In January of 1958, after visiting families for Christ-    friendship there. Subsequently, Alan spent a total of
mas, the six of us rendezvoused in San Francisco. The         eleven years in uniform and then spent thirty-five years
Albrights and Helveys were en route to Hawaii, both at-       as a plastic surgeon in Boulder, Colorado. The Helveys
tached to the Marine squadrons (Marne Aircraft Group          and Albrights worked together for ten years in the space
                                                              program and then George became an anesthesiologist at
     Editor’s Note: The Naval Aerospace Medical In-           Stanford Hospital. Both families are retired in northern
     stitute was honored to host Doctors Helvey, Al-          California. The six of us have spent many vacations to-
     bright, and Stormo and their wives as part of the        gether over the years and so when the idea of a trip to
     first Retired Naval Flight Surgeons’ Reunion dur-        Pensacola came up – we all decided to return together.
     ing this January’s Combined Operational
     Aeromedical Problems (COAP) Course.            Dr.       Return to Pensacola
     Helvey has worked over the past two years to pro-           Little did we envision the fine welcome and extended
     mote this, and we hope we can encourage other            hospitality of Captain Rick Beane, Officer-in-Charge at
     retired flight surgeons to attend in the future, to      the Naval Aerospace Medical Institute (NAMI), and
     establish this as an annual event at the COAP.           many others at Pensacola. It is difficult to know which,
                                                              of many highlights, was the most pleasurable. Perhaps it

16                                                                                          Contact · Vol. 31, No. 2 · April 2007
                                        SEA STORIES    AND    NEWS     FROM THE       FRONT

    Members of the Student Flight Surgeon Class #85 (July to December 1957) pose in front of academic building 664 at the Na-
    val Aerospace Medical Institute (NAMI). From left to right: Alan and Marty Stormo (retired plastic surgeon), from Boulder,
     Colorado; Bill and Grace Helvey (retired physician), from Los Altos, California; Dolly and George Albright (retired anes-
     thesiologist), from Carmel, California. Doctors Helvey and Albright served together as flight surgeons with MAG 13 (VMA
    232; VMA 214; VMA 212; HMR 161) as part of the First Marine Brigade in Kaneohe, Oahu, Hawaii and Atsugi, Japan, from
      Jan 1958-May 1960. Doctor Stormo served as flight surgeon with a Navy patrol squadron (VP4) at Naha, Okinawa from
      1958 to 1960. He was trained as a surgeon in the U.S. Navy and left active duty after eleven years. The former flight sur-
      geons and their wives enjoyed touring NAMI, the National Museum of Naval Aviation, and the rest of the base, as well as
     sharing lunch and swapping sea stories with current flight surgeons of all ages. Photo courtesy of Capt. Richard A. Beane.

was the tour of the National Museum of Naval Aviation,               everybody else is young!). Some are soon to become
where we discovered one of “our” planes from MAG 13                  Senior Medical Officers aboard nuclear carriers.
days, or having lunch with current young flight surgeons                Still smiling, as we review photographs of our trip,
in training (when you are seventy-five years old—                    two final important and sincere thoughts occur to us.

Contact · Vol. 31, No. 2 · April 2007                                                                                              17
                                  SEA STORIES         AND   NEWS     FROM THE       FRONT

Current student flight surgeons (Class #0703) Lieuts. Nicolas B. Moya Del Pino and Benjamin Walrath listen to sea stories spun by
 former flight surgeon Dr. Alan Stormo (Class #85 of 1957). Fifty years worth of flight surgeons have earned their Wings of Gold
between these physicians! Also pictured are Dr. Stormo’s wife Marty, and in the background, NAMI neurologist, retired flight sur-
    geon Dr. Henry O. Porter. Photo courtesy of NAMI Officer-in-Charge and current flight surgeon, Capt. Richard A. Beane.

First: when Americans are threatened by events in to-
day’s world, as in decades past, we know that the U.S.                     Naval Flight Surgeon Reunions
Navy and Marine Corps will be the forefront of our de-
fense—and the duties of naval flight surgeons are very                         Pensacola, Florida — January 18-20, 2008
important ones; second—although we were not career                             Pensacola, Florida — January 16-18, 2009
military folks, we never forgot those days as flight sur-                      Pensacola, Florida — January 15-17, 2010
geons, and those people—pilots, doctors, corpsmen—                             Pensacola, Florida — January 14-16, 2011
and their families! The Marines like to say there are no
ex-marines; once a marine, always a marine. We know                      If you would like to help organize the next
what they mean. As the six of us visited Pensacola—we                     reunion, please contact Dr. Bill Helvey at
knew that, once again, we were with “our people.” It                    
was a real Pensacola Homecoming.

18                                                                                                   Contact · Vol. 31, No. 2 · April 2007
                                        FLIGHTS AND GROUND EVENTS

                                                              cine. AsMA was founded in 1929 and has grown to its
SUSNFS Officer Posi-                                          present strength of more than 3,200 members from over
                                                              seventy countries. AsMA is an organization made up of
tions Closed: Time to                                         those individuals who work in or have an interest in all
                                                              aspects of aviation and space medicine. It provides a fo-
Vote!                                                         rum for many different disciplines to come together and
   Voting will again be done electronically this year.        share their expertise. AsMA’s membership includes
The ballot will be posted by April 1 on the SUSNFS            aerospace medicine specialists, flight nurses, aviation
website at We are hoping any            medicine technicians, physiologists, psychologists, hu-
“kinks” from last year have been worked out!                  man factors specialists, researchers, and even pilots inter-
   Instructions will be included on the website. Accord-      ested in this field. Most are with industry, civil aviation
ing to the society by-laws, the Vice President is the elec-   regulatory agencies, departments of defense and military
tions officer; members will email their completed ballots     services, the airlines, space programs, and universities.
as an attachment to the SUSNFS Vice President, Capt.          Approximately 25% of the membership is international.
Rick Beane, at Member-                 Through the efforts of the AsMA members, safety in
ship (and right to vote) will be verified from the email      flight and man’s overall adaptation to adverse environ-
reply. Once received, the ballots will be printed so that     ments have been more nearly achieved. The Mission of
there is no identification and your votes will remain         AsMA is to apply and advance scientific knowledge to
anonymous. Positions include Vice President, Assistant        promote and enhance the health, safety and performance
Secretary, Assistant Treasurer, and Senior, Junior and        of those involved in aerospace and related activities.
Emeritus members of the SUSNFS Board of Governors.            AsMA objectives include advancing the frontiers of
   The deadline for voting electronically is May 1.           Aerospace Medicine and ensuring the highest levels of
   Capt. Frank Chapman will be departing after his year       safety and health in aviation and aerospace operations.
as SUSNFS President and Capt. Rick Beane will ramp            Additionally an objective of the organization is to estab-
up from the Vice President position to take his place for     lish and maintain cooperation between the medical, bio-
the coming year. Lieut. Amanda Hagen will be moving           logical, engineering, and other sciences concerned with
up as the Secretary and Lt. Cmdr. Danny Hohman will           aviation, space, and environmental research and pro-
be moving up as the Treasurer. They will be replaced          grams, as well as to promote the exchange of information
the following year by the Assistant Secretary and Assis-      on Aerospace Medicine to industry and the general pub-
tant Treasurer, respectively.                                 lic.
   We thank the current Secretary, Lieut. Daryl Sulit,            AsMA achieves their objectives by having the largest,
and current Treasurer, Lieut. Trina Gates for their hard      best and most comprehensive single annual meeting in
work over the past two years. We also thank departing         the aerospace medical sciences.
Board of Governor members Capt. (retired) James De-               It also publishes Aviation, Space, and Environmental
Voll (Emeritus Member), Cmdr. Kris Belland (Senior            Medicine (formerly the Journal of Aviation Medicine), a
Member) and Lieut. Joel Metzger (Junior Member).              monthly journal of the aerospace medical sciences, in-
Capt. Mark Edwards will also depart as the ex-President       cluding abstracts from the annual scientific meeting.
member of the Board of Governors, and Capt. Chapman           Other regular features include letters to the editor, aero-
will take his place.                                          space medicine reviews, editorials, book reviews, news
                                                              items, meetings calendar and news of members.
                                                                  AsMA membership for me has become a life-long
                                                              organization of friends, fun and a community that contin-
Join AsMA Today                                               ues to make a difference in this high-speed, high energy,
   The following was submitted by Cmdr. Kris Belland,         cutting edge technological environment. Please feel free
Senior Member of the Board of Governors, Society of           to contact me if you have any questions, and consider
U.S. Naval Flight Surgeons:                                   joining or re-joining our AsMA community today.
   The Aerospace Medical Association (AsMA) is the                For more information, please see the AsMA website
largest, most-representative professional organization in     at, or contact Cmdr. Kris Belland at
the fields of aviation, space, and environmental medi-

Contact · Vol. 31, No. 2 · April 2007                                                                                  19
                                          FLIGHTS      AND   GROUND EVENTS

                                                                        The job provides a wide variety of opportunities to
Texas Needs a Flight                                                 share and compare policies and strategies between the
                                                                     USN and the USAF on how aeromedical evaluations and
Surgeon                                                              recommendations are conducted. There is also regular
   The following was submitted by flight surgeon Capt.               contact with USAF Residents in Aerospace Medicine
Jim Longstaff:                                                                          (RAMs) as they rotate through the
   Here is a chance for some lucky                                                      ACS as part of their residency rotation
(and qualified) senior Navy flight doc
to finally fulfill their life-long desire
                                              Blue Angels Schedule                      schedule.
                                                                                           San Antonio is a very large and
to live and work deep in the heart of         April                                     dynamic metropolitan area that has a
                                              1        MacDill AFB, FL
the Great Republic of Texas! A job,           14-15    NAS corpus Christi, TX           lot to offer in the way of arts, enter-
that has gone relatively unknown over         21-22    MCAS Beaufort, SC                tainment, education and life style and
the years by most Navy flight docs,           28-29    Vidalia, GA                      has a cost of living that is compara-
will be coming open during the sum-           5-6      MacDill AFB, FL
                                                                                        tively much lower than many other
mer of 2007 in San Antonio, Texas.            12       Seymour Johnson AFB, NC          large metropolitan areas in the coun-
The billet is the one-person Naval            19-20    La Crosse, WI                    try.
                                              23       U.S. Naval Academy, MD
Operational Medicine Institute De-            26-27    Millville, NJ                       The position is currently filled by
tachment located at Brooks City-Base          June                                      Capt. Jim Longstaff who will be rotat-
in San Antonio.                               2-3      Rockford, IL                     ing out of the position in September
                                              9-10     Tinker AFB, OK
   This detachment technically falls          16-17    Fargo, ND
                                                                                        2007. If you are a senior flight doc
under the Naval Aerospace Medical             23-24    North Kingstown, RI              looking for a new job to rotate into
Institute (NAMI) and Capt. Rick               30       Battle Creek, MI                 this summer this may be just the deal
Beane in Pensacola. The job is part           1        Battle Creek, MI
                                                                                        for you.
of a joint exchange program between           7-8      Ypsilanti, MI                       If you are interested in the position
the Navy and Air Force and the posi-          14-15    McConnell AFB, KS                and have questions you can give Capt.
                                              21       Pensacola Beach, FL
tion is part of the USAF School of            28-29    Bozeman, MT                      Longstaff a call at 210-536-6913
Aerospace Medicine (USAFSAM).                 August                                    (DSN 240-6913) to learn more about
The position historically created for         4-5      Seattle, WA                      the job.
                                              11-12    Hillsboro, OR
the Navy doc assigned there is titled         25-26    Indianapolis, IN
“Chief of Professional Services” and          September
encompasses a broad range of duties           1-3      St. Louis, MO                  AsMA 2007 in
and responsibilities within the               8-9      NAS Oceana, VA

Aeromedical Consultation Branch
                                                       NAS Brunswick, ME
                                                       Millington, TN
                                                                                      New Orleans
(ACS) of USAFSAM.                             29-30    Salinas, CA                         The 78th Annual Scientific Meeting
   Although there are many differ-            October                                   of the Aerospace Medical Association,
                                              6-7      San Francisco, CA
ences, the ACS can best be described          13-14    MCAS Kaneohe Bay, HI             “Les Bon Temps Rouler,” will be held
as the USAF equivalent of NAMI.               20-21    Fort Worth, TX                   at the Sheraton and Marriott Hotels in
The ACS is staffed by a variety of            27-28    Muskogee, OK                     New Orleans, Louisiana May 13
medical specialists and is the organi-        3-4      Jacksonville Beach, FL
                                                                                        through 17, 2007. Programs and
zation within the USAF where                  9-10     NAS Pensacola, FL                events include scientific sessions on
aeromedical evaluations are con-                                                        aviation medicine, physiology and
ducted and flight duty waiver recom-                                                    history, aviation safety and mishap
mendations made on flight duty personnel who have                    investigations, and the aeromedical aspects of a manned
medical conditions that are of a more complicated, politi-           mission to Mars.
cally sensitive or precedent setting nature, or belongs to              Evening events include socials as well as the annual
specifically identified longitudinal study groups.                   Honors Night Banquet. A Spouses Program, sponsored

20                                                                                                 Contact · Vol. 31, No. 2 · April 2007
                                        FLIGHTS     AND      GROUND EVENTS

by the Wing of AsMA, is available for daytime activities
in and around the New Orleans area.                             Third Combined Opera-
   For more information on registration, accommoda-
tions and flight and car rentals, see the Aerospace Medi-       tional Aeromedical Prob-
cal Association’s official website at:
   Future Scientific Meetings will be held in Boston            lems (COAP) Course
May 11-15, 2008, in Los Angeles May 3-7, 2009, in                   No it ain’t too early to start planning! Be sure to mark
Phoenix May 9-13, 2010, and in Anchorage May 8-12,              it on your calendar now! If you missed the educational
2011.                                                           and exciting COAP this year, then you also missed the
                                                                Flight Surgeon Reunion! Bummer! So be sure not to
                                                                miss it this next time around!
SUSNFS Evening Social                                               The third annual Combined Operational Aeromedical
                                                                Problems (COAP) Course is scheduled for January 14-
in New Orleans                                                  17, 2008 at the Naval Aerospace Medical Institute at Na-
   The Fourth Annual Society of United States Naval             val Air Station Pensacola, Florida. Watch for more in-
Flight Surgeons Evening Social will be held at Michaul’s        formation on the website at or
in New Orleans beginning at 6:00 p.m. the evening of            the Naval Operational Medicine Institute website at
Wednesday May 16, 2007.                                (check the Naval Aerospace
   Last year’s evening social at the Fantasy of Flight in       Medical Institute (NAMI) tab).
Polk City, Florida, featuring one of the world’s largest            The conference now incorporates sessions for Avia-
private collections of antique aircraft and an interactive      tion Medicine Technicians as well as for flight surgeons
walk-through timeline of aviation history, met with re-         and carrier Senior Medical Officers and leadership staff.
sounding reviews, carrying on in the tradition started in       The courses will include aviation medicine topics for
Anchorage and continued in Kansas City.                         first and second tour flight surgeons, as well as flight
   This year’s event will take place only about a fifteen       surgeons in leadership positions, and those serving as or
minute walk from the conference. The event will high-           hoping to serve as Marine Aircraft Group Surgeons and
light New Orleans-style cooking along with a locally            aircraft carrier Senior Medical Officers. Additionally,
brewed beer, and live Cajun music! Unfortunately, ar-           part of the conference includes the Carrier Medical Lead-
ranging for a reasonably priced aviation venue this year        ership conference, which is open to senior carrier medi-
did not come to fruition. This year will instead feature        cal staffs, including Medical Administrative Officers,
the unbreakable fraternal ties between flight surgeons,         Nurses and Senior Enlisted Leaders.
and promises to once again be one of the most popular               There will also be another evening social event during
events at AsMA.                                                 the week, and of course, the Reunion. For future plan-
   In order to keep this event revenue-neutral for              ning, COAP will always fall during the week before
SUSNFS, ticket prices had to be raised slightly this year.      Martin Luther King, Jr. Day, with the Reunion falling
But they are still a bargain for all the food, beverage,        during the end of the week and into the weekend. For
entertainment, and most importantly, the camaraderie of         specific dates in future years, see the information boxes
your fellow flight surgeons!                                    on pages six and eighteen of this issue.
   Tickets will be sold for only $30 per person for
SUSNFS members and spouses, and $35 for non-
members. Tickets will be available only at the SUSNFS           Photo Contest Cancelled
table at AsMA. We are again limited to only 100 per-              Due to lack of interest and paucity of submissions, the
sons, and due to the increasing popularity of this event,       Third Annual Photo Contest was cancelled. Even the
we recommend buying your tickets early during the con-          promise of free SUSNFS geedunk did not bring enough
ference. For more information on this annual event, see         entries to warrant continuation. The possibility of a
your society’s website at                 photo contest will be explored again next year.

Contact · Vol. 31, No. 2 · April 2007                                                                                    21
                                               THE EARLY DAYS

          Models of Cruiser to Carrier Conversion, 1922
The advent of aircraft use in the Navy sparked an interest in launching them not only directly from the water as
they had done since the early days, but also from floating airfields: the first aircraft carriers. After the collier USS
Jupiter (Collier #3) was converted into the first carrier, USS Langley (CV 1), the Navy began exploring the possi-
bility of converting battle cruisers already under construction into future carriers.
This photograph shows a presentation on March 8, 1922 of the battle cruiser (CC 1 Class) and its proposed con-
version into the Lexington class carrier. The ultimate result was the Navy’s second carrier: USS Lexington (CV
2), laid down January 8, 1921, launched October 3, 1925, and commissioned December 14, 1927. She eventu-
ally met her demise secondary to torpedoes and bombs launched from Japanese carrier-based aircraft on May 8,
1942 during the Battle of Coral Sea. She was ultimately scuttled by the USS Phelps (DD 360).
Pictured at the Navy Department from left to right are Rear Admiral David W. Taylor, Chief of the Bureau of Con-
struction and Repair; Rear Admiral William A. Moffett, Chief of the Bureau of Aeronautics; Congressman Freder-
ick C. Hicks (New York); Congressman Clark Burdick (Rhode Island); Congressman Philip D. Swing (California);
and Rear Admiral John K. Robison, Chief of the Bureau of Engineering. Photograph by Harris & Ewing.
U.S. National Archives photo #80-CF-395b. Information from and

22                                                                                            Contact · Vol. 31, No. 2 · April 2007
                           The Society of United States Naval Flight Surgeons
                           Post Office Box 33008
                           Naval Air Station Pensacola, Florida 32508-3008


E-mail Information for Authors                      CONTACT EDITORIAL STAFF
                                                    CHIEF EDITOR
Lt. Cmdr. Jonathan L. Bingham, MC, USN              Capt. Nicholas A. Davenport          
Capt. Frank A. Chapman, MC, USN                         PUBLISHING EDITOR
                                                    Cmdr. Walter W. Dalitsch III
Lieut. Alexander B. Galifianakis, MC, USN 
Dr. William M. Helvey                               EDITORIAL BOARD MEMBERS                           Capt. Charles A. Ciccone
                                                    Capt. Nils S. Erikson
Lieut. Robert M. Marks, MC, USN                     Capt. W. Anthony McDonald                       Capt. Steven O’Connell
Cmdr. Michael B. McGinnis, MC, USN                  Capt. Charles A. Reese                       Capt. Felix R. Tormes
                                                    Cmdr. Ward Reed
Dr. Henry O. Porter, MC, USN                        Cmdr. Eric P. Smith                         Cmdr. (ret.) Henry O. Porter
Lieut. Daryl J. Sulit, MC, USN                      Lieut. Cmdr. Carolyn C. Rice
Lieut. Joshua A. Tuck, MC, USN                      Article and photo submissions to the Journal are gladly accepted
                                                    from any member or non-member at any time of the year. Expect                     six weeks lead time for consideration for inclusion in the next
                                                    issue. Articles should be related to Aviation Medicine, including
                                                    case studies, grand rounds, or anecdotes of personal patient en-
                                                    counters, or Aviation Safety, including ground and in-flight safety
                                                    issues or anecdotes of personal experiences. Other personal anec-
                                                    dotes, news, promotions, retirements, marriages, births and obitu-
                                                    aries will also be considered. All text submissions should be sent
                                                    via e-mail attachment in standard text format. Digital photo-
                                                    graphs of military, medical or artistic subjects while forward de-
                                                    ployed should be submitted in jpeg format. It is imperative that
                                                    submissions clearly indicate the author’s full name, rank, corps,
                                                    current title and duty assignment, e-mail, return mailing address
                                                    and telephone number. Correspondence and all article submis-
                                                    sions should be sent to the Chief Editor, and photos to the Publish-
                                                    ing Editor, at the e-mail addresses given above.

SUSNFS Publishing Guidelines: Submit articles to
                                                                             Typewritten, 12-point, single-space,
Type                  Characters (incl spaces)      Words
                                                                                        1” margins
Feature Article            9,000 – 12,000        1,500 – 2,000                         2 ¼ – 3 pages
News/Anecdote               3,000 – 6,000         500 – 1,000                             ¾ – 1 ½ pages
Upcoming events             1,500 – 3,000         250 – 500                                ¼ – ¾ pages
Personal update             600 – 1,500           100 – 250                           1 – 2 short paragraphs
Single column                     3,000              500                                      ¾ page
The Society of U.S. Naval Flight Surgeons         ORGANIZATION
                                                   U.S. POSTAGE
Post Office Box 33008                                   PAID
Naval Air Station Pensacola, Florida 32508-3008   PERMIT NO. 459

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