tv [untitled] November 24, 2012 2:00am-2:30am PST
i found absolutely fascinating as a way to bring a real life experience to that individual. for me that was a fantastic tool that you have and i thought that was wonderful. >> we're going to be -- little advertisement -- we're going to be demonstrating that capability at our display at the marina green so if you'd like to come see that, that's available. >> any final questions? i'd like to thank our panelists very much. as rob mentioned earlier, the exercise series we have put on and started 3 years ago has really become, for the department of emergency management and we hope for the military, this foundational piece of the fleet week humanitarian exchange. it's been a wonderful way for us to work together on some of these common issues and figure out how our agencies are all going to integrate. i think the time and effort
that has been expended by both the military planners and also the civilian planners is definitely going to be bearing fruit in years to come when something happens. i know we are quite a bit ahead of time, you are going to have a 20-minute break from now and then our next speaker will come up at that point. thank you again.
he heads the baur row of medicine for the navy. i lacked at his bay oh in the program, educated in georgia and he's had a great career in the navy commanding several hospitals, winning several awards and his most recent command was as the commander of walter reed, and i was so glad that he was here to hear the panel that we had with our medical peer to peer exercise. and he's going to talk to us now about navy medicine. with that, please help me welcome vice admiral matthew nathan. (applause).
>> thank you, general, very much. well, it's a pleasure here and i'm honored to be able to speak in front of such a distinguished audience. secretary schultz, mrs. schultz, pleasure it see you and you lend tremendous gaffe tas to this program. general spees, distinguished flag officers, general officers and mostly everybody here who is in the readiness business, i am honored to be speaking to a group of people and that would include i think everybody in this hanger deck who is part of that cadre of individuals who when bad things happen and everybody runs out, your job is to run in. it doesn't get better than this coming out here. the a's are in, the giants are in. back in dc's the national's had the best -- who would have
thunk it. and being on this ship, skipper pringle, congratulations on a great ship and a superb crew. as you get higher up in the navy you get less and less opportunity to be on a ship as i head back to the bureaucracy, my only request to you is for god's sake take me with you. i'll work in the engine room, i'll chip paint, i'll do anything to be hayes-white gray and underway. i'm responsible to them primarily for our wartime mission. my job is the readiness mission, as is yours. i have to be ready for the next big thing whatever it is.
it may be somebody that's blown up, it may be a unit taking fire, it may be a mass casualty, it may be mass relief or to those of our neighbors and allies, it may be somebody getting ready to deliver a baby. imagine we are sitting in this venue oopbd all of a sudden your pager goes off, your associate comes up and taps you on the shoulder and says, you need to see this. there has been a bomb that's gone off in our nation's capital or los angeles, a nuclear device. there has been an earthquake. there has been a hurricane where we thought the good news was the winds blew and it did some damage but all is well, oh, my god, the levies just broke. oh, by the way, there's an earthquake or a tsunami or a
nuclear critical accident that's occurred somewhere overseas. how will we respond to that? and then let's bring it closer to home, how did we marry up the capabilities that exist because there is no greater tragedy than to have robust capabilities, mellow medical, logistical or otherwise. you are better prepared with every one of these meetings, you are better prepared with every networking that happens in the hallways and exchanging business cards but you will never be absolutely prepared. what we're doing here today and in future events is a journey, it is not a destination. we will never be able it high five ourselves and say we have everything figured out and we'll be able to solve it the minute it happens. ask
anyone who has been in the throes of a complex medical emergency. i congratulate you on leaning forward and recognizing the next nightmare scenario may be around the corner and our job, the american people have come to rely on us to be able to stand between them and trouble, to be able to jump out in front of them and say, get behind me, i will lead you through this, i will get us out of this. i will build the relationship, i will build the networks, i will build the competence and professionalism that will change lives and save lives and make a difference. i will learn from the lessons of the past as difficult and as gruesome as some of them are. i will learn from the lessons that have occurred on our shores and on other shores. as i said, i'm in the readiness business. here's some of the capability we bring to the plate. if i were to tell you that if you were walking out somewhere and you were to step on a bomb, an
improvised explosive device, and its detonation capacity was such it would take off all four of your limbs and cave in your skull, what are the opportunities you would survive that? today that happens. my prior job, as was mentioned, is to be the commander of the national naval medical center and oversee the integration of that with walter reed army medical center to what's now known as the walter reed national medical center at bethesda. pretty challenging the cultures that exist there, you have cultures that exist here, you are speaking about cultural differences between the military and its hierarchy of command and control and the civilian command and control and figuring out the two greatest things you need in the chaos of disaster. no. 1, communications. no. 2, who's in charge. i dealt with a lot of cultural
issues when i was combining the army and the navy medical forces between walter reed and bethesda. america's army is an amazingly heroic army. they have occupied valley forge , tokyo, berlin, danang and now it occupies bethesda, maryland, but we're working through that. how do we break those cultural barriers, how do we figure out supporting supporters, how do we do that before the next capacity goes on? so what have we done, what capabilities do we bring, where do we use them and how will they be playing a role here in the event of the most likely nightmare scenarios for this area? i grew up in the bay area, i have tremendous affection for it. i did train on the east coast but i grew up in santa clara and in napa,
i used to come down and watch candlestick park, my dad would bring me down, i would watch the 49ers play and i have great pride in the amount of collaboration and cooperation you are showing to figure out what the next nightmare scenario might be and be ready for it. it's probably going to be either an earthquake, it may be a man-made catastrophe such as an heinous terrorist act that could range anywhere from a mass casualty with chem-bio, be it small pox, be it chemical gasses, be it tactical nuclear effect, to a pandemic. avian influenza.
how prepared will we be? let's get back to that marine or sailor that's blown up? in previous conflicts from the time you were grievously injured to the time you were eventually immediate vaked back to the states to a tertiary care facility such as a tertiary care medical facility such as walter re d or bethesda or san diego or brooke army in texas or a va medical center, that time of injury to time of immediate vak was 45 to 60 days. ladies and gentlemen, today if you are a warrior and you are blown up or griefously injured, on average from the time you are grievously injured to the time you arrive in my icu in bethesda is 3 days. that capability is provided to us by on screen care with
unparalleled first responder action that can save the live, tourniquet therapy, clotting agents, understanding, robust immediatevac capibility, and then a continuing continuum to germany and back to the states in the c130's, the flying icu's which the air force has, which you are safer in the air at 30,000 feet than you are in 90 percent of the icu's in this country. they do not lose patients over the atlantic. they do not lose patients over the pacific and, remember, they transport them within days, days, of them being critically injured. the patient will wake up for the first time in a hospital in the states. that is often the first time they wake up. that's how fast the
medevac system goes. wouldn't it be a shame to waste that compartment of skills on a mass casualty event that occurs here. well, we have hospitals and they're going to be okay and we have a robust provider system, and you do, one that the cities and counties and states should be proud of. because they get it. they get it out here. but the hospitals, they will have to figure it out. but what if you are a country and all of a sudden you have an earthquake and by the way the one thing you need most because of that earthquake, the hospital infrastructure, is gone. can we describe a scenario that could be like that? i remember when i was in college a popular thing was the national lampoon and they did a parody of the political science final. please write a scenario
where world events and powers provide and results in total thermonuclear warfare results and the next question was, please create a lab practical to test your theory. is there a lab practical to test this theory? haiti. as you know, a few years ago the haitian people suffered an earthquake and the initial problem was crush injuries. yes, infection and dysentery and water supply and all those things would follow fairly soon, but the initial catastrophe was crush injuries, trauma, and the hospitals were gone. so what did we do? the world responded as best it could. what we did, the naval maritime forces, we sent our balts group down there which was patroling the area, we sent the hospital
ship comfort down. so you have the comfort on the east coast, you have the mercy on the west coast. the mercy is parked down in san diego. it just got back from its asian humanitarian assistance from guam, indonesia, vietnam, an amazing number of nations we're partnering with. those hospital ships with 1,000 beds, 12 operating rooms, they produce their own medical oxygen, they have ct scanners and they can do almost anything a hospital on the west coast can do and we can park them offshore as we did in haiti and in haiti they spent the first 72 hours once they got on scene doing nothing but repairing crush injuries and restoring life.
that's the capacity we have. i like to think in our partnership with the maritime services and the coast guard and our reserve forces, i like to think of us as america's or the world's 911 when something bad, either man-made or natural happens, some catastrophe happens in the world, often times the ambassador will pick up the phone and dial 911 and the navy marine corps team answers the phone. it is our those, it is our dna it is our ability to be there. if you look at the communicate dapbt's 3 central tenets of what he believes it importance, readiness is in there. the ability to move and go now. where do you want us, when do you want us, like fedex, we are absolutely guaranteed to be there overnight. it's what we do. it's what we are trained for. and the more we understand and can operate with
civic forces, the more we understand what already exists in our life line, the more we can break down political barriers and culture barriers that exist within our own country, the more we can partner and stabilize and support civic operations, because as someone said earlier in the panel, if we need to come in, things are pretty bad. but here's the good news. we bring a tremendous arsenal of capability and talent and technology and command and control and mostly we bring a how can i help you, how can i work to support your mission, how can i make a difference? is your hospital structure so overloaded and so overburdened and so overcrowded and so crushed that we need to off load patients to other counties, to other states, to other areas in the country? do your roads work? do you have a transportation infrastructure, do you have a communications net up? no? we can bring
that. we come as we are. we constantly prepare for the next major conflict. in the navy our motto is -- this is big navy's motto -- a global force for good. we believe that we operate on a continuum of bringing heat and light. you are sitting on one of those platforms right now. you are sitting on this amazing lhd, the uss macon island, it can bring the heat or it can bring the light. do you want to get a little twitchy around the world and you want to sort of rattle the cage a little bit and test our will and show bravado? you don't want an amphibious group showing up off your shore. that can be a bad day for you. on the other hand, we'd like to bring the light. we'd like to bring the medical prowess, its ability to generate
electricity for you, we'd like to bring its cadre of people to rebuild your churches, your clinics, your homes, we'd like to be able to bring its operating rooms and 40,000 tons of icu's and hospital beds and transports and medical evac, whether we fly you in or float you in. that's what we'd like to bring. and like everybody else in the medical business, i wake up every morning and hope the next day i'm out of a job. i hope the next day that world peace has been declared and disease has been stamped out and nobody will be ill, nobody will be harmed or injured. until that day comes, it's my responsibility to be able to speak to the communicate dapblt and the chief of naval operations and tell them we are ready to go when you need us. and so i'm very proud to be here and witness and to somewhat extent participate in the collaborative efforts that are being made. i had a chance to be up close
and personal tlau probably the worst hurricanes in the gulf coast in the last 40 years: ivan, dennis, katrina. and katrina i was the commander of the medical forces in pensacola, florida, and i owned the branch clinics that existed in new orleans, pascagula and gulf port, mississippi. we thought we had dodged the bullet and then the levies broke and who would have predicted that there was a sea of humanity in the super dome that basically was in extreme miss? who would have predicted in this day and age we would lose many, many people based on the fact they couldn't be medevacked, that the hospitals themselves had been flooded and the hospital staff was having to carry critically ill patients up to the top floors to avoid the water that was filling in the rooms. who would have predicted that? and were we set up to handle that? and who would have
predicted in the early goings there would be civic disorder and civic disobedience and lack of command and control and then the military came there and provided that stability for a while until the civic authorities took over and eventually got things moving in a fairly organized continuum. we learned a tremendous amount of lessons from that, lessons that i hope no other city will ever have to repeat again. but the bottom line is it is so critical at this point to talk about the amazing things and capabilities you have both within the internal system of the federal management emergency response systems here that exist in the city and the state and the federal level and what the military can bring. our chain of care will only be as strong as its weakest link and my job is to make sure that if you call us or if you need us in the maritime services that our links will be as strong as yours and your job in
the civic and again, i applaud the amazing men and women of our law enforcement agencies and our emergency response teams, you are my heroes. you are the ones that run in when everybody else is supposed to run out. and we see the drama all the way from 9-11 through katrina to whatever the next catastrophe is going to be. we live in a nuclear age. who would have predicted the united states would be fully invested in a response in japan? who would have predicted several years ago when a tsunami hit a country in indonesia which was predominately anti-american in its sentiment, mostly because of disinformation, mostly because as people grew up there they were given propaganda and told stories about the american those and what we do and how we do it, and they learned to feel we were the enemy. then they saw through that
catastrophe, they saw the response of the lincoln battle group, they saw american military men and women in uniform as well as partnering with non-governmental organizations like project hope, operation smile, doctors without borders, they saw all those people coming off the ships and taking care of their loved ones, taking care of those who were hopeless and helpless. they saw that and it turned them around. it made the world a better place. it certainly made indonesia a better place, but it made the world a better place. it made it a little less dangerous than it is today simply because we took a country that was predominately anti-american sentiment and through that past tragedy and catastrophe and our response to it, we flipped the sentiment and it was ultimately pro-american in sentiment and we decided to create sustainment missions to sustain that goodwill and that's where the mercy taking off as it does out of san diego and goes around the asian pacific rim.
that is why the comfort takes off and heads down to south america, to show goodwill, not to be the american country that comes down there and shows people how it's done, to be the united states' ambassador of medical care that wants to partner with these nations, learn about them, learn about their illnesses, learn about their afflictions and learn from the people in the area how we can better support and partner with them. build bridges before they have to. if we have had twice the number of aircraft carers in 9-11, if we had twice the number of marine battalions in 9-11, would that have stopped it? it would not have. but maybe, maybe through humanitarian assistance, disaster relief, global engagement, the ability for us it reach across borders and change minds, maybe the intelligence might have been
forthcoming. maybe there was one individual who might have seen something happening and recognizing we can't let bad things happen. that is why we do this. one, we globally engage because it's the right thing to do. we are citizens of the world and we deserve to take care of those less fortunate than us. and we do it because we wapt to increase communications, we want to foster communication because if somebody says i know of something bad that's going to happen in america, i just don't think they deserve that, i've seen them in action. we're trying to intensify and heighten those communications and we narrow that apure tour down from its global engagement from the japanese nuclear reactor, be it haiti, turkey, be it mexico, be it honduras, new orleans, and hopefully we prepare for something that will never happen in the bay area.
and that's what you do today. again, the great tragedy to me, the great tragedy would be if we have capabilities each of us can offer and we don't bring them to bear on the game. so i thank you and congratulate you on the difference you are making, the partners, learning the communications, learning how to be where you have to be. our responsibilities, every one of you out there, what will you do when that tap on the shoulder comes? what will you do when your pager goes off? what will you do if you hear all of a sudden los angeles has been hit by a 6.7. what will los angeles do if they hear san francisco has been hit by a 7.2? what will we do, where will you be, all those people who work for you, do they know their azuped place, do they know where to go? do we in the military understand your roles and responsibilities? do we understand how to integrate into your chain of command? do we understand how to communicate with you? do we understand what we have and how we can bring it to bear with
you? do we not want the after action report after the next nightmare scenario it read, we failed to utilize some of the capabilities we had inside and outside our life line. the american people are expecting us to get it right. they are not expecting perfection, they are not expecting huge gaps. they are not expecting some of the missed cues and gaffes that occurs in the gulf port area during katrina. they expected us to learn from that and indeed we have. i caution you again, we are not prepared, we are not prepared for the next nightmare scenario, but we can better prepare ourselves every day with the activities you are taking on now. i thank you in advance for the family, the child, the son, the daughter, who has no idea that their life is going to be uprooted by
catastrophe within the confines of the san francisco bay area or perhaps in a western pacific nation or in africa or south america. i thank you in advance for the good work you are going to do. because there's going to come a point, be it an ert quake, be it a tsunami, be it a man-made heinous terrorist catastrophe, that makes a large group of people feel helpless and feel hopeless. your efforts today, your passion, your commitment, your desire to make a difference, will give help and give hope to those people. it may be your family or it may be a family across the world. it is what we do, it is what you do and i'm proud to count myself among you. so i thank you in advance for the difference you will make. i thank you in advance for putting personification and putting action into the those of ou