he President told the Army to fight in Iraq. He told everyone else to go shopping.

“Hey soldier, I’m doctor …” I started to say in the preoperative area. “I AIN’T NO SOLDIER! I’M A MUH-REEEEN!” he screamed at the top of his lungs, along with a string of expletives. I nearly wet myself. Minutes into my first mobilization with the Army Reserves, I made my first military faux pas, and everyone around me knew it. Julie (the anesthesiology resident assigned to me) simply rolled her eyes, sighed and said, “You can call anyone here ‘soldier’ except the Marines. Call them ‘Marines.’ Sorry, doc.” She then went on to explain that most of the injured military personnel exposed to improvised explosive devices (IEDs) had some element of closed-head injury and tended to show some disinhibition. I was about to get the education of my life as a mobilized Army Reservist at Walter Reed Army Medical Center (WRAMC).

My military career began 13 years before my first mobilization. Like many of my current Reserve component colleagues, I joined the military after the first Gulf War near the beginning of my medical career, before I had a career or family. Our reasons for joining are multiple, but patriotism, not financial windfall, is the common thread we all share. The service obligations for a weekend a month and two weeks a year provided a small stipend during residency but afforded a reason not to moonlight. In later years, drill weekends became opportunities for teaching medical students and nonanesthesiology residents about anesthesia as well as maintaining nonanesthesia clinical skills. After September 11, 2001, the seriousness of drill weekends changed. War had become a reality. Sooner or later, we’d be mobilized. Until then the war was happening on the other side of the world. I worked, shopped and vacationed as usual.

I was mobilized to WRAMC in May 2005. I met capable and well-trained anesthesiologists from Johns Hopkins, Yale, Emory and Duke as well as military anesthesiology residents. There were West Point graduates who smoked cigars with generals we see on television. Most of the regular Army anesthesiologists had spent some time in Afghanistan and/or Iraq. Some of them had been the recipients of enemy attacks, nearly becoming casualties of war themselves. One had a Bronze Star for bravery. The quality of care was impressive. I resisted beginning my sentences with “At Mayo we…” No one needed that advice.

War wounds are horrific, particularly the IED-related. Blast waves impart massive energy on the human body, tossing and smashing it like a rag doll. At times I marveled at how being young and thoroughly physically fit allowed survival from what should be lethal wounds. At times I was equally dismayed. We watched the families struggle with their loved one’s injuries. Death was infrequent at WRAMC but always a possibility. When a soldier died, the outpouring of sympathy from the physicians and nurses for the soldier’s family was quite touching and demonstrated that the war had not exterminated compassion from the caregivers.

Although I had a seemingly easy assignment, the continuous stream of war-wounded young men and women flown back to WRAMC imparted an emotional toll. I was at WRAMC (not Iraq) for 90 days (not a year) more than a year ago. Only in the past few months can I now speak of the experience without my heart getting lodged in my throat and my eyes welling up with tears. To my surprise, while I was comparing stories with my friend who also was mobilized to WRAMC, he abruptly excused himself when tears began streaming from his eyes. Until then I thought I alone had these feelings.

The emotional consequences of war are important, but the economic consequences are often far more tangible. Military pay is well below the national income average for anesthesiologists. For some, repeated prolonged mobilizations have been financially devastating. As the war in Iraq persists, reserve component physicians will likely have shorter intervals between mobilizations that extend beyond the end of combat actions. The economics of repeated mobilizations is a major reason why even some of the most patriotic physicians can no longer justify continued participation in the reserves.

ASA is sensitive to both the financial and emotional aspects of military service. The ASA House of Delegates adopted a resolution at the 2005 Annual Meeting waiving ASA dues for members mobilized to military service since September 11, 2001. This resolution recognizes that the economic impact of military service may make maintenance of ASA membership difficult. Also, to better understand the emotional and professional perspective of members serving in the military, the Wood Library-Museum of Anesthesiology’s Living History Series is seeking writings, photos and other memorabilia from those ASA members serving our wounded military personnel around the world. In time, this collection will provide exciting insight into anesthesiology’s contributions to military personnel care as well as healing for others.

In the end, my decision for remaining in the Army Reserve was solidified by accident when I traveled to an Air Force base to retrieve my nephew, Tim, who was on leave. As Tim and I walked from the airport terminal, immediately on the other side of a fence was a large military aircraft flanked by uniformed airmen standing at attention between the rear of the plane and awaiting trucks. A flag-draped coffin was ceremoniously lowered from the aircraft into the awaiting hands of the soldiers who, with great precision, carried the coffin into the awaiting van, saluted, then returned in formation to the rear of the aircraft, accepted another coffin and repeated the sequence. We watched more than 10 coffins removed, saluting in unison with the uniformed personnel. “I hope someone tried to save these people,” I thought to myself. From the corner of my eye, I looked at Tim. I considered Tim being injured or worse. I pondered the implications of resigning my commission and withdrawing my skills from the shrinking physician pool caring for wounded soldiers.

Although fraught with inconveniences, remaining in the Army Reserve, offering my skills in support of the wounded when requested by the Army, is an honor. I pray that my family, my employer and my friends afford me this indulgence. It means everything to me.

Brian P. McGlinch, M.D., Lt. Col., Medical Corps, 452nd CSH, Fort Snelling, Minnesota, is an Assistant Professor, Department of Anesthesiology, Mayo Clinic College of Medicine, Rochester, Minnesota.  He is ASA Director for Minnesota.