Monthly Archives: January 2019

Surgical Suite Aboard a Small Ship

Around mid-January, there was a flutter of news that the Spanish frigate ESPS Méndez Núñez (F-104) was in Norfolk and will be integrated into the USS Abraham Lincoln (CVN-72) Carrier Strike Group until November of this year. A review of the ship’s history on Wikipedia shows that since her commissioning in 2006, she has been quite active in international anti-terrorism and anti-piratical activities.

What’s medically interesting about the ship (which, according to an article in USNI News, is being showcased by Spanish shipbuider Navantia to the U.S. Navy, presumably as a possible candidate for its FF(X) future frigate program) is that it has what looks to be a basic surgical suite instead of a simple sick bay.

Sickbay / Operating Suite Aboard ESPS Méndez Núñez (F-104). (USNI News photo)

The ship also has a separate space to accommodate four sick or injured sailors. She typically carries a physician and a nurse when deployed, according to the USNI News article.

This kind of medical space is pretty unusual in a small unit like a Frigate. I recall that the sickbay in my Adams Class guided missile destroyer – I was the staff medical officer for Destroyer Squadron 15 – was no larger than a large closet. Sure, one could evaluate sick sailors there (physical diagnosis only; no Xray or lab) and perhaps do minor surgical procedures such as suturing wounds or draining abscesses, but there was no room to do something as basic as an appendectomy (the crew’s mess deck, a much larger space,  could be fitted out for surgery, but this was intended for combat casualty care, and doing even simple appendectomies was officially discouraged). Most U.S. small units don’t rate medical officers unless they are squadron flagships (and I’m not sure even these ships rate a physician these days). Independent duty corpsmen, specially trained to be the sole “Medical Department Representative” serve on these smaller ships, and have proven to be most capable for tending to the minor surgical and medical needs of the crew. Sailors with more serious problems are typically medically evacuated to an amphibious ship, aircraft carrier, hospital ship (all of which carry qualified surgeons, or would in a potential combat situation) or a facility ashore.

So I’m not sure the operating room in Méndez Núñez would be all that useful. Surely, for instance, there is no way laparoscopic work (the clear trend in abdominal and chest surgery not related to trauma) could be performed in that space. It would be interesting to learn what the Spanish experience has been.

©2019 Thomas L Snyder

A Medical Hero Celebrated

It’s not so often that we see a military medico publicly recognized for life sustaining work in combat. “It’s our job, after all” would be a common rejoinder. It was good, therefore, to read about Royal Navy Surgeon Captain Rick Jolly, who was named OBE for his surgical and leadership exertions in the Falkland War. Jolly recently passed over the bar at age 71. At the time, he was the senior medical officer of 3 Commando Brigade. He and his crew set up a field hospital in an abandoned slaughterhouse at Ajax Bay. There, Jolly and his colleagues treated more than 500 British wounded soldiers and Marines, and about 200 Argentine troops. Only 3 of those wounded died, none while under his care. The Argentine government awarded him the Orden de Mayo for his work.

I remember reading that Argentine surgeons often mismanaged soldiers’ wounds, which, under typically filthy combat situations, were grossly contaminated with dirt, clothing fragments and shrapnel. Already loaded with bacteria, these wounds became terribly infected, so when the Brit surgeons “inherited” the patients, their work was often that of managing these serious infections – truly life-saving work.

Jolly was an outspoken guy. See his interesting comments (and facial expressions) in a two-segment (~4 mins each) interview for Sky News here. I like this quote: “We had only one motto in War – that the wounded MUST survive”. Military medicine at its simple best.

(Hat tip: Cdr Salamander)

(C)2019 Thomas L Snyder