encore Failed Attempt

A senior medical offi cer who makes his fi rst visit to his ship’s brig to check on the health of the inmates realizes he might not be as observant as he thought he was.

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As senior medical officer on USS Nimitz (CVN-68), I headed up a 50-plus person medical department. We’d finished our last workup cycle at sea, and the air- craft carrier was heading home for a few days’ R & R. It had been a busy time for my medical department, and my general medical officer requested a well-deserved week’s leave before returning to sea for our planned six-month cruise. One of her duties was to visit the

ship’s brig on a regular basis and ensure the health of the prisoners, some of whom had been sentenced to the Navy’s traditional three days of bread and water as part of their punishment. She had even once restricted herself to a bread- and-water diet to personally experience the physical effects it might produce; my medical curiosity had never driven me that far. I’d never visited the brig before, so she advised that I review the inmates as they stood for inspection. “Ask if they’re being well treated and if they’re being well cared for,” she said. A full medical examination wasn’t required, unless a prisoner had complaints or was feeling ill. A skilled doctor can determine a lot about a patient just from observing his general demeanor, expression, and pos- ture. The level of alertness tells much about sleep deprivation or subtle changes in mentation, which might suggest incipi- ent illness. Sometimes a telltale whiff of ketones on the breath will alert the diag-

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nostician to starvation, or a subtle lack of skin turgor might signal dehydration. Much like the trained aviator who looks over his plane before launch, the experi- enced physician can gain critical infor- mation just by looking and listening. I climbed down the ladder leading to the brig. The quarters were im- maculate. The floors, brass, and fittings gleamed from the endless scrubbing and polishing the inmates were put to — they had little else to do as they passed their time in confinement. The prisoners were lined up, standing at rigid attention, as I approached the row. I stood before the first sailor. His eyes stared into the distance as I care- fully studied him, looking for any signs of ill-health or abuse. “Are you being well treated?

Are you being well cared for?” I asked. “Sir?” He seemed puzzled and turned his gaze to meet mine. “Are you being well

treated? Are you being well cared for?” I re- peated, surprised at his lack of comprehension. “Sir,” he replied, “I’m one of the guards!”

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— Dr. Nick Davenport is a retired Navy Medi- cal Corps captain. He lives in Mukilteo, Wash. For submission information, see page 6.

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