Few people know this about me, but when I was a young boy, I slit my wrist in the bathtub. After watching Rocky in the theatre, I returned to the home of my mother's parents where I took a bath prior to bed - my parents were in the city to see Evita on broadway. After washing my hair (distant fond memory), I re-enacted spars between the fantasy Italian hero and his opponent and Billy Dee Williams' Apollo Creed. My poor choice was relegating the glass shampoo bottle (yup, they used to have those) as Apollo Creed. I lost. The slight scar on my medial wrist is hard to discern from the natural creases in the skin, and as my hand always seemed to work fine, this was a 30 year old injury without apparent consequence other than the anxiety caused to my grandmother when she walked in to see her only (then) grandson in a pool of bloody water. [For the record, my grandmother, mother of 6, grandmother of 15, and great-grandmother of 3 turns 90 this year - no worse for that wear].
Then I went to officer training about 10 years ago, and realized an otherwise unnoticeable defect: an ulnar palsy which prohibits me from adducting my 5th finger when my hand is extended flat, as might be necessary in, say, a salute. In fact, my first attempts at a salute in officer training were met with extreme derision as my pinky flared apart from my hand as if I were mockingly imitating Liberace, or the Scarlet Pimpernel, making a joke of the ancient military tradition. In fact, I had no such intent, I simply couldn't move my pinky. After a fine time inhaling the spittle and halitosis of a young diminutive Lieutenant with penis envy and anger management problems, a sympathetic Master Sargeant garnered the attention of the Major in charge who soon discovered the truth behind my disability. He taped my 4th and 5th fingers together, and typed a letter - signed by the he, the commander - for me to carry with me at all times, declaring my permission to use tape on my fingers. During the training, with or without the tape, I learned a few little tricks to hide this embarassing salute faux pas, and eventually, found a way to form a respectable salute, sans splint. I also learned during this time the rules of engagment when it came to saluting. You salute outside, not inside. You salute all high ranking officers, but not enlisted NCOs. You return salute, but not when in your presence is an individual of a higher rank; he or she has that honor. You salute when walking and approaching at 180 degrees, not if passing, on a bicycle, driving a car, or carrying large objects - all for obvious reasons. At my job in the states, I walk into the building before most are there, and leave after most are gone. There is no saluting inside, and when I go home and on weekends, I don't wear my uniform.
Here in theatre, you always wear your uniform, and the salute can become a little bit like a Monty Python skit mixed with "Who's on First" from Abbot and Costello. Sometimes, when I go to the cafeteria, if I time it wrong, I end up return saluting 50-60, or more, young troops, as if I were a marionette being jerked to order on a timer. I have to really be on my toes, as intermixed in these salute offerers is the occassional colonel. And for they the roles are reversed; this is the custom, and I am accepting of that.
The more interesting or difficult quandry comes when faced with the non-saluting troop. Though we are implored by the senior NCOs and officers to dress down approaching troops who fail to adhere to this tradition, I usually don't say too much. I rationalize that they didn't see me, weren't paying attention, or what have you. There is a rare particular impudence in a young airman as I come bee-bopping along with my medical insignia in clear view, and for integrity, and to avoid being observed ignoring this rudeness, I should speak up. Indeed, I did today. After eye contact, and what I thought was a smirk, with no salute, I called a yound staff sargeant to the carpet. For reasons not quite clear to me, I stopped, incredulous of my self, and called for him. I quoted Band of Brothers and told him how one "salutes the rank, not the man." (Lord knows where that came from!?!?!) As he curtly threw up a lackadasical salute, a senior master sargeant who apparently knew this individual appeared beside me, and proceeded to provide this poor bastard with a high tonal expression of his dissatisfaction in his military bearing. (Imagine getting the riot act from your Momma in front of all of your high school friends at the movie theatre. Now imagine you were naked. This is what I saw in his eyes).
Some military tradition and discipline is difficult to reckon for a physician; it can run counter to the way we think and are trained. Hawkeye Pierce didn't help with the sterotype, and this is nothing like M*A*S*H here. But as did Hawkeye, modern day military physicians tend to philosophize the absurdity of this war, and some of the things that we do in the military. As with caring for patients, we ultimately are concerned with "Why."