ADM. MICHAEL MULLEN: As I listen to that, it is more a discussion about age than it is – (laughter) – about where I’ve been and what I’ve done. But there are a couple things that – and I very much appreciate, Dr. Laughlin, your kind comments, and also your leadership.
I care a lot about the university here, actually, and what you’ve done and your predecessors have done, and what you do to, quite frankly, provide incredible doctors and nurses throughout our military over the years has really been extraordinary. And we would not be in any kind of shape in terms of how we’d be able to handle these two conflicts without that. And you’ve provided sort of life-sustaining blood, if you will, to the health side, the medical side of our force, which has really been extraordinary.
And, actually, I talk frequently – I’ll get to the total fitness thing here shortly – but I talk frequently about areas that have changed since 9/11. And there are two that I identify that are moving so fast I don’t know where they end up. We always like to have something we’re shooting for, you know; sort of a target out there that says, here’s where I’m going.
And one of them is the guard and reserves and the other is, quite frankly, medicine – medicine on the battlefield and medicine as a result of the battlefield, if you will, that has put us out on the leading-edge in so many areas. And I’m just not sure where it ends up. I’m still struck by being in Al Taqaddum 3 years ago with a young pediatric physician who asked me if she had a future in the military. And this is at a time where we’re dramatically reducing that particular skill and outsourcing it, et cetera. And it’s a question that haunts me literally to this day not just for that skill but, do we have it right for the future?
That isn’t why I came here today, but it speaks to another thought that comes up with Dr. Laughlin’s introduction, is I didn’t know anything about military medicine – anything about military medicine – except how it took care of me. And unfortunately, I had enough opportunities as I was coming up through the ranks, but I really didn’t know anything until I was the vice chief – the first time I even met the surgeon general of the Navy. And I’m an insatiably curious fellow about lots of things, not least of which is career paths, because I’m drawn to how are they sustained, who comes, why they come, who goes, who stays, how do we incentivize it, what’s the attraction.
And this was in 2003 for me, so we were at war at that point in time, and I now I’m losing people and I want to know a lot more about that from the line standpoint – doesn’t mean I didn’t have my bouts with my foremen or my battles with various people in the medical world when it came to my people, because I did. But in terms of it being a mainstream area for me – I’m the number two guy in the Navy at that point – it just wasn’t.
And to me, that is a fundamental that is very real in this room today because we’re talking about something that is, I think, as I looked at the curricula – and I really would like to get to your views and some questions in the latter part of this period I’m with you to see where you are and how you think about it. But the reason I want to draft and write this instruction is for guidance for the military.
We have another area that’s changed, and I don’t think we understand it well enough yet. I think we’re reacting to it well and making the changes, but I don’t think we understand it well enough yet, is the impact of families. And this is not meant to be an academic drill – you write it down; yes, families are important – or a theoretical drill. We all know that. But our readiness to be able to carry out our mission as United States military is directly impacted, fully integrated, by how our families are taken care of, paid attention to, and that is a fundamental readiness issue.
So I’m at Fort Campbell two days ago – some of you may have seen that – and one of the young – I think it was a lieutenant colonel – stood up and said, we just got our family programs cut by – and it was a resilience program, I think, or, it doesn’t make any difference what it was; it was either resilience or reintegration – we took a cut from 65 million (dollars) in ’10, which is what we’d planned on, to 22 million.
And that really got my attention because a year ago, I sat with the chiefs, including Gen. Casey, and I said, if – and I’m a budget guy – so I can tell you that the budget types will drop family programs as soon as the pressure lands on the budget because we want to buy widgets; it’s what we do. We’d rather buy helicopters than do that. But what has changed in the last several years has been the fullness of the family requirement in terms of our readiness – literally, our readiness – to carry out a mission.
And it will be thus for the foreseeable future. That’s a different construct in how family programs do – it is fundamental to us as is this issue, which is total fitness. And hopefully, you can, after a couple days, come to a better understanding of what it is. And then secondly, I don’t want the perfect instruction; I don’t want the perfect metrics. I want something I can go with. You are – not all of you, but generally – you are purists here. And I’ll go to – and I’m living in a world of integration. And there are a lot of people who don’t understand that yet.
And I’m the integrator. You can’t integrate medicine; you can’t integrate the individual skills we too often talk about in the stovepipes. And we do it in a critical way. Actually, it’s pretty natural stuff. I am the line leader. And in these areas that I didn’t pay much attention to until I’m a four-star with 30-plus years in the Navy – in medicine – and oh, by the way, medicine didn’t mind a lot that I didn’t pay attention to it because medicine sort of liked being out here in its own little world, funded, taking care of itself – didn’t want intervention from someone else that might have a different idea, very often.
And those days are gone, from my perspective. That doesn’t mean there aren’t really important areas that are very pure and clean, and that we need to sustain that, but they’ve got to be integrated. And I’ll give you – I went – in fact, Chris Macedonia (ph) put me onto this many months ago – and we went up to the Boston VA, looked at TBI and MTBI, and they’re doing some incredible work up there in a real hub of medical brilliance and potential and study and research.
And the organization that I spoke to that evening was the International Brain Mapping and Imaging Society annual convention – blah, blah, blah, it goes on longer than that. But it is a bunch of brilliant people who essentially are looking at integrating bioscience, neuroscience. And there’s a gal there who’s very famous in NASA who’s from JPL – Jet Propulsion Lab in Pasadena. Why is she there? Because she’s a systems engineer. So we are now looking at how to integrate these different requirements.
So in this total fitness, total health, how do you get at the integration of the spiritual, the mental, the social, the physical? What does it mean, or what does it mean to us? And as I said it is – for families, it is a readiness issue for us because if we aren’t successful in that, you’re not ready to carry out your mission individually, as a unit, et cetera.
And too often, these have been challenges that we’d rather have somebody else take care of. Line leaders would just as soon – some would; I would be careful here – but this is an area, as a line leader, I don’t know much about. So turn it over to specialists and bring them back to me when it’s okay. I can’t afford to do that anymore.
How many chaplains here? (Pause.) Drive me crazy. (Laughter.) Absolutely crazy, and I’ll pick on you because I’ve actually been dealing with chaplains for a long time. And I’m talking my own service here more than anything else. I don’t think there’s – as a group, in total, nobody knows more about my force than the chaplains – the problems, the breadth, the depth, the you-name-it. And I have been completely unsuccessful at extracting that as a line leader, writ large.
I tried it as a vice chief; I tried as a CNO; I’m working Steiner and others right now to do the same thing; to say, these are the major issues. And I haven’t figured it out if it just breaks down on confidentiality because I’m not asking for individual eaches (ph). It doesn’t have anything to do with it, from my perspective. But admiral or chairman, these are the areas that we see that are failing. And I am unable to broadly extract that from the group that I think know more than anybody else about what’s really going on. And I need to break that. So I’m critical but I want to tap that – that are we working on the right areas? I pick on that area because it’s one that’s very near and dear to me, but that’s just a piece of it.
I am desperate for understanding what I need to do to lead in mental health. I am desperate because I think we’re on – I actually believe that we are at a time that we are holding in, in these fights to get through at so many problems that we can’t even imagine are going to explode here once the pace comes down.
And I just fundamentally believe that because I’ve seen – and where I get this from, quite frankly, are not the troops because they won’t talk to me, but the spouses. (Laughter.) You know, I just give the spouses an inch – and my wife, Deborah, is with them all the time – they explode with need. And that says how much they’re holding in. And so that’s why the timeliness of this, the totality of it, is so critical because we’re going to have to have something in place that addresses, in my view, this explosion that’s coming at some point down the road.
And one of the questions I’m asking – and this goes to the totality of the fitness – is what’s next? What are we going to do after these wars? Have you seen – I’m not advertising for this movie; it just had a big impact on me – have you seen “The Hurt Locker?” Anybody seen that movie? Not enough of you. And I like movies. I don’t get to go very often – but it’s a great flick. And “The Hurt Locker” is about an EOD group that is essentially on an adrenaline rush and cannot leave the fight. They lose their best friend – doesn’t make a difference; they cannot leave it.
And I was sitting alongside – I had about nine Marines at lunch a couple days ago down at Lejeune and this one Marine said to me – sergeants, only sergeants in the room. And I was asking them about deployed time and optempo and time at home, et cetera. And this one guy goes, listen, I’m on my fourth or fifth cycle of seven out and five back. That machine’s running; we are ready; you know, don’t change it. And I said, well, how’s it working at home? He said, well, that’s another problem. (Laughter.)
But the point is, this is going to slow down here in the next four or five, 6 years, and what does that mean for us? How do we think about that and what do we need to be ready to handle? And when I look at him, this Marine that’s sitting two seats over from me, and he says that – and I said, so how are you going to do at 1-and-2, or how are you going to do at 1-and-3? And he just shakes his head.
This is not a new phenomenon, because we’ve been at war before. But when it slows down – and these are 20-somethings, as you know, and it’s what they live for. And it’s not just the Marine Corps and the Army, quite frankly, because I run into a lot of airmen and a lot of sailors that want to be in the fight and that have gone to the fight. But what does all that mean down the road?
And so back to this, the components of this and the fullness of their linkage, if you will, I think offer great potential for us to meet the challenges. There’s not a post we go to these days, or a base, where spouses don’t talk to my wife about the mental health of their kids. And it’s declining rapidly. We have not very much capacity to handle that. And there’s a real basic principle here for all of us in the military – been that way a long time. If it’s not going well at home, it’s not going well wherever I am. I cannot focus; I can’t stay focused on what’s going on.
And I’m also struck – there was a young specialist that asked me a question out in Vilseck, Germany, about 18 months ago. She stood up – and this was a group that had deployed a number of times – and she stood up – it was also dependents, so spouses were there, as well. And she said, are you going to get me benefits for my best friend, who is my family? And she – and this gal she was living with was there – but young; I mean, she’s a very junior – she’s an E2 or an E3 and she’s not making much money.
And the audience kind of snickered when she asked the question. I didn’t because I think the definition of family is changing. And we are amongst the most resistant to that – first of all, because of our rules, and secondly, in broad – I’ll broad-brush here – because of our background. But it’s changing, and these 20-somethings – they are our lifeblood in our service whether they’re married or not. And we have a tendency in our family programs to focus on, are you married, and do you have a spouse? So who are the other people?
We had a Christmas party last weekend for the wounded and the families of the fallen. This is the second year where we’ve done it. And not to speak to that, but there was a parent – a mom and a dad whose son got killed in April, from New York City. And they drove down just for the party to drive back. And this father is in touch with a half a dozen of his son’s buddies, who are wiped slick by this, and who cannot bring themselves to ask for help because they are – it is a very powerful reason, this whole stigma issue, but it’s very powerful.
How do we get in touch with them? How, in our total fitness, do we reach out to that group which, on the face of it, are – it makes all the sense in the world – and who’s doing that? How do we prepare – you and I will pay taxes for the rest of our lives to pay orders of magnitude more than we had to, to treat veterans that we didn’t pay any attention to before they left because they wanted to go.
So part of total fitness for me is, quite frankly, readiness to move out into society and be a productive citizen. And there is a wonderful characteristic that we have in the military, when I make a decision I’m not staying in, whenever that is – and I don’t care whether it’s officer or enlisted – and I get to you-pick-the-day – 180 days out or 200 days out or 365. But from that moment on, I focus on one thing – that date – whether I’m ready to get out or not.
And I’m very struck by the rules in Special Forces that don’t allow that to happen. Special Force docs here? (Pause.) What’s up with that? Huh? Oh, you can just barely raise your hand? (Laughter.) (Inaudible, background noise.) So what I found in Special Forces is that essentially you cannot – you will not be released until you’re ready to go.
So they have an integration – reintegration plan – transitional – whatever it’s called – to make sure that you are physically, mentally, socially, spiritually, all those things, ready to go. And it’s been enormously successful. I didn’t think you could do that, but it turns out it’s a conscious decision between an individual – do you want to be in Special Forces? And if the answer is yes, these are the requirements.
So they are into this transition while on the active duty side in the regular services, it’s what’s my EAOS or my ETS. And I focus on that day and I don’t prepare to leave; I go through transition. I’m stunned at the number I – we try to visit VA hospitals and there are active and vets – active-duty vets – in these PTS programs and things like that. I’m stunned at the number who didn’t have – I guess I’m not stunned – that didn’t have a clue what the VA provides.
What do I know? If I’m injured, I know a lot more. If I’m not – which, most of these were not because they haven’t acknowledged they had PTS – I don’t know, except maybe the VA has something to do with education and sick people. Well, I’m neither, so I don’t know much about it, yet I’ve signed all the forms. And that’s just this – I want to get out. What do I have to sign? See you later.
And then they show up on the other side of that bridge, having walked over it alone – alone. There’s a guy that I’ve befriended who runs a great organization called Soldier On putting vets to work, giving them a place to work and giving them a future. Really, really severe cases – (inaudible, audio interference) – individual failure, if you will, on many levels that he’s brought back to life.
And he said 90 percent of his constituents come from single-parent families. And they had no structure. They come into the military; they’ve got this structure. They cross that bridge; they have no structure. They’ve seen hell or worse, and then they just dive into you-pick-it – drugs, booze, a combination, self-medication, legal, illegal, whatever it is. That’s who we are right now – and we are – always have been and it’s a great strength, but we also bring weaknesses, you know, with who we are as a society.
Who’s here? Who’s here? And what are the demographics that we need to pay attention to down the road? And it goes back to the – and I’ll wrap up, and I’d really love to take your questions of what you’ve learned and what’s on your mind and what’s hard, what do you think I’m absolutely off-base on, on this. But I’ll go back to where I started: This is a line issue. It is a line issue. And it is – as I look at different services, different services handle reaching outside the line world differently. So when I go to Walter Reed and I look at the commander of Walter Reed, of the – what is it – W-T –
MR. : WTU.
ADM. MULLEN: WTU – and this has happened to me more than once – I have someone who will not mess – and I mean big terms, big letters – will not mess with medicine. Okay, well I was just – and it maybe because I was just brought up differently. I understand the bright line between – I am not the doc, and I have never prescribed, nor would I want to, but I’ve got a pretty good sense of when my people are being treated well or not, whether I know anything about what they’re being treated for, as a line officer.
And I’ve injected myself into that situation my whole life. Maybe it’s being on a ship; we all live together. You know, we know each other pretty well. I’m not sure. Maybe it’s small units. But I do that – have done it regularly. And as I have watched Walter Reed, the WTU, that line is incredibly bright, and I worry sometimes that line isn’t pushing hard enough about what is going on here, doc, with patient A, B or C. But we all do it differently, and all that is to say that I feel incredible line responsibility in this area and in the integration piece.
So I use the brain mapping group because that’s an integration requirement. What you’re doing is you’re talking about a bunch of areas, quite frankly, that must be integrated and obviously, for an individual, properly balanced. Some need a lot of X and a little of Y and vice versa. Some might need a dose of it all. And I can’t outsource it. I can’t say, okay, over to you, doc. Just fix it; call me later, you know, when he or she or the family is in good shape. I can’t do that.
One, it’s not in my DNA and two, it’s not going to work in the world we’re living in right now. So those are at least some thoughts as I look at – and I mean, I think individuals here from OSD as well – from health affairs? This is a uniform responsibility for my people. Health affairs, SECDEF, right up through the civilian leadership, notwithstanding – and they all care a lot – this is a uniform responsibility, which is why I’m here, for the men and women who wear the uniform and their families.
So fundamentally, those are some thoughts on this. I hope you’ve been able to do some good work and learn how to bring this together and at least not be too harsh on – I’m a big output guy. I think we, actually, are – we are drowning in input stuff. It’s what we do. We make lists; we talk about activities. I am anxious to see – which is why the metric piece is so important – is how are we doing? I don’t need – and I’ve beat the chief up and he’s been very patient with me – Gen. Casey – I don’t need another program in the Army. I’ve got programs – Colleen, you know that – to a fare-thee-well.
I need to see is the program working. I want to sit there are the output side – and the output side of this are people. I look – Deb and I – many were – but Deb and I sat with about 14 or 15 engineers out of 20th Engineering Battalion that were in the room – four of whom they lost and 10 of whom are wounded at Fort Hood. I was terribly struck by our conversation with them over a period of 45, 50 minutes. And a couple of things – one, they were all guilty. They felt guilty because they didn’t do enough and yet, they were all heroic in saving lives. That’s the human side of it. Someone’s got to reach in and let them off the hook and say, pretty normal, you did great; you’ve got to move on.
I sat yesterday with someone that has been at Fort Hood a couple times since. And the word that I hear is betrayal. And I’ve listened to that for the last – I mean, since Fort Hood. And yes, it was. And in this case, it was someone who worked on the base – a civilian who worked on the base for many, many years. And this individual was – just felt completely betrayed and did not know what to do about it because it was on the base, it was one of our – it was all those things.
And my reaction – and Chris and I were talking about this driving up this morning – my reaction was, okay, I get that. I’ve been betrayed. I’ve had some of my best people be exposed and commit heinous acts that completely surprised me. And it has been hugely disappointing. But you’ve got to move on. We’ve got to move on, here. Not just, we have the mission. I mean, I’m not saying just flip a switch and do that. But leaders have to find paths where people who are affected by this have to move on.
And these dozen or 15 or 16 engineers have spent – this was Tuesday, I think. So this is, what, five or six days into it when we were down there. And they had spent no time with their families. And six or seven or eight or nine of them were married – I can’t remember. And they were about to deploy. And I grabbed the battalion commander and I said, first of all, I’m going to come and see you in Afghanistan. You know, I know where you will be, and the first question I’m going to ask you is, did you get these young soldiers time with their families so they could resolve this before they deployed? Otherwise, it’s going to explode on deployment.
And this is different – and it is different at Hood; it is different than anything you or I have ever experienced, including the most intense combat your or I could imagine. Because it was safe; it was home; it was one of ours. One mother said, you know, I just wasn’t – first deployment – I wasn’t ready to be scared yet. He wasn’t going until February. So it was that betrayal, which is human. How do we move forward from that? And that’s what the totality of this has to come to grips with. Okay. What’s on your minds? (Pause.) Special Force doc – (inaudible, laughter).
Q: Sir, you talked about the adrenaline high from the movie. That’s what I see across the Army, is that so many people are in this hyper-vigilant hyper-alert state that they have when they’re in theater that keeps them alive, and then they come back and they can’t adapt back to that garrison environment. And they can’t cycle into a state of relaxation. And I think that’s causing a lot of substance abuse problems that we’re seeing. What is being looked at from a leadership standpoint to kind of help people get into healthier patterns of relaxation?
ADM. MULLEN: That’s a great question. At least, my own experience with this was this characteristic – this hyper-vigilance became visible most immediately with the wounded that could not – and the PTS piece. They just couldn’t come down. And then obviously, beyond that, I mean, without just saying it’s broad-blanket PTS. Although Mike Hagee, who was the commandant of the Marine Corps – classmate of mine – said when this started, and I was the vice chief and he was the commandant – and we’ve been good friends our whole life – he said to me there was nobody in Vietnam in combat that didn’t have PTS – zero, period.
Now, the point is, it can be dealt with. It’s an exponential or inverse exponential equation, if you will; the sooner you deal with it, the less significant it’s going to be, no matter how significant it is. The same is apparently true – or being proven to be true – with the whole issue of TBI. Where we are going – the big to-do with this is time. And we’re seeing an awful lot of evidence that you need to be back twice as long as you were deployed in order to calm down, get trained, get away from it and get ready for the next one. And this is coming, most recently, reconfirmed in this MHAT-6, which is this – which is, if you haven’t seen it, it’s worth just – did you go over that here?
MS. : No, sir.
ADM. MULLEN: I mean, you just need to look at the data from this mental health assessment team, which Gen. Casey – and actually, the Marine Corps has been on and off of this as well, but they’re now going to do it very consistently with the Army. And what we’re seeing is the level of – what’s the term that you use? I don’t want to say discord, chaos, disturbance – after 2 years, kind of – in an unit, gets down to what it was before all these deployments – so the norm, if you will. So that’s why getting to 2-to-1 and 3-to-1 is pretty important and that’s what we’re shooting for right now. And it allows people to handle these issues.
I should give you a better answer on what are we doing with the hyper-vigilant – you know, with the individuals, as far as treatment is concerned – still badly constrained by the stigma issue. I mean, I talked about this father and this half-a-dozen of his son’s buddies who won’t ask. And I know that’s very much the norm. And I have argued for and tried to be very encouraging – from a leadership standpoint – to get leaders to do it. Because I believe that the master chiefs and the sergeants do it solely – (inaudible, background noise). And if they don’t, they won’t – same thing with the battalion commanders and the brigade commanders, et cetera. Because there is this fear of, you know, my career is over.
And they’re not willing to jeopardize that. In fact, we’re seeing PTS – I’m sorry, families – spouses are stigmatized, now. They will not either force – unless it’s a crisis – force their husband or wife into treatment, plus they need it themselves. I’m not sure what the right medical term is, but they’re under so much stress and pressure over time that they are showing the symptoms of – they’re PTS-like symptoms as well, because – you know, and our families have just been unbelievable in terms of what they’ve done here.
I don’t think many of us really, really understand it. The way I tell that story right now, though, is, this is our ninth year at war. So if I were a 10-year-old boy or girl when the war started and my father or mother deployed on these major deployments out of 10th Mountain or 101st or 82nd or you-pick-it. And we’re now coming up on, sort of, ending our fourth cycle; we’re starting our fifth major deployment.
First one was six (months); second one was eight; next one was 15 or 12; and then the next one is going to be 12. So I just went off to college. And I don’t have a clue who my father or mother is through – anybody that’s got kids knows – through some pretty precious years – 10 to 18. And that’s a reality. Well, we’ve got to, okay, recognize that and you get at some of that, clearly, by slowing down the pace.
But for the next 2 years, it’s not going to slow down. It’s not going to slow down a lot in the Army. It is slowing down in the Marine Corps. And it’s going to – it’s getting better for the major units. There are a lot of forces that it’s not better for yet – smaller units, if you will. Special Forces are awful, absolutely awful. When I go to Campbell and I talk to the 1-6 – (inaudible) – how many deployments?
Seventeen. How about you? Twenty-three. This was last February. They’re not – I mean, they’re 45 or 90 or 120 deployments, but how’s your family? Terrific, Adm.. No, really, tell me – no, sir, they’re really good, until you talk to them. (Laughter.) Eric Olson said 2 years ago – who is the head of the Special Operations Command – 2 years ago, he was starting to sense that the SEALs – he is a SEAL – but SEALs and Special Forces – because I think the statistics on the divorce rates are bogus.
You give me that every month, Colleen, and I think they’re completely bogus. (Laughter.) They’re just doing okay – higher for enlisted females – I’ve got all that. Because we – I’ve just got – I cannot get a group of spouses to tell me that it is – and actually, members to tell me it is exploding. And what Olson told me 2 years ago was, there was so little time between deployments, they didn’t have time to get divorced – (laughter) – didn’t have time to process the paperwork.
That was 2 years ago from the Special Forces. Sheila Casey testified to that on the Hill this year in the Army. She said the same thing. So that gets to the – those are some of the antidotes, symptoms of this, I think, explosion that’s coming for all of us down the road. So I wish I could give you a long – a big laundry list of things we are doing to address this. Probably fundamental there is the whole PTS piece.
We’ve put mental health – put a lot more docs in theater. I would assume you know that. We are trying to treat there, as opposed to here, where we can. I haven’t gotten to it, yet, but you know, I’ve told the chiefs – I’ve said three explosions and you’re out. And I don’t know if that’s not too many. Obviously, we could debate – obviously, one bad enough and you ought to be out. But there’s got to be a judgment call made on the part of the line leaders that are there to say, you’re out, period. These aren’t medical types and everybody wants to get back in. I talk to them all the time. They don’t want to leave their units; they don’t want to be pulled out of the fight.
Yet, I’m looking at data at this conference here a few months ago – there was one piece that’s pretty significant data that they did surgery on a 30-year-old and he had a 67-year-old brain. And that’s just – that’s what happens to us naturally – we all start pitching over at about late 40s – I guess I didn’t know that. (Laughter.) But this young man had pitched over because of the number of explosions.
And it’s interesting to me – I took Goodell on a USO tour – he’s the commissioner for the National Football League – I took him two Julys ago. And we talked about this; we talked about head injuries and what he was going through. And it’s kind of interesting watching the NFL here the last few weeks about recognizing that they’ve got some problems they’re going to have to deal with.
So I know there’s a lot going on; what I don’t have a good enough handle on is the effectiveness of it. Because the – (inaudible) – goes far beyond the wounded, as you know. This same guy up in the VA told me they – that runs this program in the VA said on average, those veterans show up and they are at the bottom. They’ve just survived living – and you’ve all – whether it’s booze or drugs or whatever it is, you get on that dive and sometimes you pull out and sometimes you don’t.
So these are the bottom of the barrel – their lives have all hit the bottom of the barrel. They show up with him – to him, on average, with seven scripts from the VA. So there’s also a doc, why am I writing so many prescriptions? That’s the (line in me ?) tell me here – piece of this.
Q: Well, sir, we talk about total fitness as a unit, as a group, but there’s another aspect which you’re familiar with, and that’s the individual augmentee. And what’s happening when the IA goes to the field, he isn’t really going as a unit or a group; he goes in as the, you know, individual.
And total fitness is really not encompassing that person in the battlefield environment. I’m a person who just came back from Afghanistan as an IA, and I think the issue I saw – the result is the younger IAs, who were recently deployed or have never been deployed are getting out. And these other professionals – doctors, nurses, et cetera –
ADM. MULLEN: It would be worth tracking that statistic, to see –
Q: So I just want you to just –
ADM. MULLEN: You’re talking about in the medical field?
Q: I’m just focusing on the medical field right now, as those who are mentors or those who are out there trying to make a difference for the country.
ADM. MULLEN: So who just went to Italy? Did you go to Italy, Mark?
Q: No, sir, Matt did.
MR. : Woodbury (sp) did.
ADM. MULLEN: Matt? Okay. So in – and this is really a critical question. And I mean, I was the CNO that said okay, sailors, we’re going into the fight. We’re going to displace as many ground forces as we can because I’m a Vietnam baby and the ground forces are going to absorb the brunt of this. And this is going to be a tough fight for a long time. How much pressure can we take off?
So today, I think the number is like 14,000 sailors on the ground in CENTCOM, specifically. And there are some skills that have really helped and other ones that have just been in support, all of which have helped the fight. So I’m a big believer in that. So we went to this individual augmentee program, and I think in the Air Force, I think it was in lieu of – and I think there are 10 or 11,000 airmen doing the same thing today.
But it’s a foreign land. Imagine growing up as a sailor – and actually, I used to go around – back to, I used to do all-hands and the 20-somethings would say how do I get to Iraq? And they’re on the deck of a carrier halfway around the world. This is their war. This is their time. It’s why they joined the military. They want to be in the fight and they want to know how to get there – not every one, but it was a lot. So we did an awful lot of that. And then they attach themselves to an Army unit.
They go through – no, they’re trained down at – is it Sullivan? Jackson. They go through Jackson. And they’re out there with packs and guns and, you know, marching around. I can’t even imagine what’s going through their head. Yet, every single one of them said it was the best – and I’ve talked to dozens – said it was the best tour they ever had. They don’t want to go back. They don’t want to become a Marine; they don’t want to become a soldier. But because it was the fight and they made a difference and they know that.
But they – and they had a great time – but their spouses, their families didn’t have a clue. How do I – who’s the CO? Who’s the ombudsman? Who do you get in touch with? How do you even know that? And when your unit – your ship or your hospital or where you left – they’re not deployed. That group isn’t going through the same thing that you’re going through because you’re an individual augmentee. So that – and this gets to the fundamental requirement that we have brought – and I’ll get to Italy; it actually is related to this.
For, how do we create a support structure for the people who are going through the same thing, because that’s part – that is heart and soul, in terms of the requirement to take care of each other. So when a whole unit deploys, all the families, all the spouses – they’re all going through that, so they’re working with each other on how to do that. But when you have individuals that do that – I was very struck several months ago by – Deb visits with spouses of the fallen wherever we go. We go to Bragg; we go to Hood; we go and she’ll sit down with a dozen of them or so – and Pendleton and Lejeune as well.
And I was very struck by what she brought back, which is, they feel as though the lifeline has been lifted and they’re adrift. They are unable to connect, in too many cases, with their service. Obviously, that lifeline was the member. I understand that. But these are 22 with three kids, got married 4 years ago – all I know as an adult is the Marine Corps. And then one day, it disappears. And I want to keep that connection.
So how do we – what’s the support group, what’s the support mechanism that allows that? And spouses on base, who may even have been friends of – they don’t want to associate with them, because what’s the disease – there’s a name for it – but it’s the, you know, “I don’t want to talk to you because I don’t want to deal with even thinking about my husband might be next, or I might have to go through this.”
So again, a very tough connection to make, but these are very special people who, if they want to stay connected, we should connect them. And we’ve made – and in particular, the chief has – actually, both the commandant and the chief have taken this on and it’s better than it was. So how do I extend – and these are – so they gave everything – lost their lives, et cetera – I mean, you understand all that. So what do I do with the 173rd in Aviano with an – I lived in Italy – with an Italian spouse? How am I connected to her? She married an American. He lost his life. They’ve got kids.
How am I doing in, you know, Idaho Falls, Idaho with the guard or the reserve or the – and this is an integration piece – it’s a reintegration piece where I fly back on a flight coming out after a year. I get home on Friday. You know, I might get a week off and then Monday, I’m back at whatever my job was and I’m look – look at what – I mean, I’m thinking, look at what I’ve been through, and there’s nobody in that place that has a clue what I’ve been through. And I can’t tell them. I mean, I can explain it to them, but there’s no common understanding.
So what are the support structures in the world that we’re living in right now that must be there – and I really believe that the common experience is the basis for this – the question is, how do you do that? We’ve got the technology to do that these days. I mean, we’ve got the ability to do it, but we don’t think it through as we should to take care of these people who’ve lost – who’ve sacrificed so much. And the individual augmentees are a great example.
I mean, that question gets to a lot of things, obviously, for me that we have got to make sure we’ve got mechanisms to recognize that. And these things keep happening. They keep spinning off. There’s another one that I hadn’t anticipated – whatever it is – and it’s going to be different in Afghanistan than it was in Iraq. I don’t know how, but it’s going to be different than it was there. Maybe it’s the mission; maybe it’s the land; maybe it’s the length of time. I’m not sure. But I don’t immediately – there’s been too much change for me to think it’s going to be the same, though there will certainly be great similarities as well. Yes, ma’am?
Q: I’m just curious, the Army has something called family readiness – (inaudible, off mike) – similar.
ADM. MULLEN: Yes. And quite frankly, they’re as good as the leaders. And oftentimes, they’re as good as the unit leaders. We sat down with SECDEF a month ago. He wanted to talk about family issues – the vice chiefs, myself, Gen. Casey. And I thought the ACMC, who is Gen. Amos – the assistant commandant of the Marine Corps – said it very well. They’re struggling at the very junior level. Got the programs, the leaders at the senior level get it. How do you – back to, how is it really working for the bulk of our people?
So as you look at measurements, that’s the measurement I need. How are my leaders doing? Okay, that’s interesting to me. I mean, it’s important; I don’t want to dis my leaders. But I mean, for the people who it really impacts on, how are we doing with them – the ones that have seen the most effects of these? And we do have very active programs.
My standard, quite frankly – and I did a lot of this and I was very engaged in this – one, I have a passion for it, but two, because I live with a woman who, you know, will not let me sleep without getting at these issues on a regular basis – been that way my whole life – with respect to are we – she’s the one that said to me 10 years ago, this is a readiness issue. I said okay, all right, next conversation. (Laughter.) No, we’re going to talk about this until you get this. (Laughter.) And she was right, in that regard.
And quite frankly, the gold standard is the Air Force, because the Air Force had it in best shape when all this started. And we all – you know, us hard guys out there that, you know, eat dirt and live in hard places and we talk about – we kid each other about the various services – but I’ll tell you, there wasn’t anybody, from a family perspective, more ready for these wars than the Air Force. And it’s going to get tougher on them because their deployments – you know, four-month deployments was the norm for them. And I’ve listened to the Army talk about this now.
But I remember, you know, 10 years ago when the Army didn’t deploy – when soldiers looked at me and said you go overseas for six months at a crack or seven or eight months? Are you nuts? How are you living? (Laughter.) That was a common conversation. So on family programs side – and that’s one of the things I try to do. As you look at metrics for this – how to measure, what to compare to – just get some benchmarks, get some gold standards, say this is the best we’ve got right now, and let’s just do that until we find something better. Let’s not go search for the Holy Grail because it hasn’t been found yet and I don’t have time.
Q: Sir, multiple deployments are also hard on the physical body, as you’re well aware. And currently, the evaluation system for physical fitness in some of the services includes, you know, push-ups and pull-ups and sit-ups and runs, which we don’t think prepares people for a combat mission. So we were wondering if there’s any discussion or movement towards evaluating physical fitness with a combat fitness test to help people prepare – to train for and prepare for combat missions.
ADM. MULLEN: Do you read Army, Navy, Marine Corps, Air Force Times?
Q: Yes, sir.
ADM. MULLEN: Okay, so I don’t know what the percentage is – I do; I actually get the versions Sunday before they come out every week. When I was a chief, I never read it. But I find out the they’re – and I’ve known this for a long time – that it’s what the troops read. Many families read it. And so it’s where the news is and so you have to respond to it. I get asked about it all the time.
I think I’m – this may be an exaggeration – but half of the covers are either uniforms or PT tests. (Laughter.) No, it’s not pay. Pay is sort of annual, you know. I mean, it’s always there – the benefits thing is always talked about as well. I literally try – I have a bad back. I have actually, it isn’t just combat that gets – that’s bad for your body; it’s age, also. (Laughter.) And I encourage – I talk to a lot of new flag and general officers and spouses about health and taking care of themselves, because it’s absolutely critical.
So I don’t know the answer to that, quite frankly, in terms of whether the services are considering that kind of a functional, if you will, mission-focused PT test. When you say that, though, I just know – I tried – I have a bad back. I don’t like to do sit-ups. I can’t do very many. Because it actually physically hurts me. I mean, it doesn’t hurt – I can get through it – it’s not – it further erodes my health, and I’ll just leave it at that. (Laughter.)
So as the CNO, I tried to get rid of sit-ups in the PT test. (Laughter.) I’m the CNO! I’m in charge of that! Certain things, you just think more wisely of later on. And so I didn’t take that on. But it’s a good question and, you know, this many years in the war, there’s some common sense associated with that, that I’ll go back and at least ask the question. And I’m in a pretty delicate position here, quite frankly, because I’m either in charge of everything or I’m in charge of nothing. (Laughter.)
And having been a service chief, you know, I’m very responsive to the Title X requirements that service chiefs have. Fortunately, we get along pretty well as a group and we’re able to exchange ideas in a very healthy way to try to help each other, because it’s bigger than all of us – individually, it’s bigger than all of us.
Q: Sir, I want to, first, thank you for giving us all this opportunity to do what we’re doing here to identify domains and provide a framework that commanders in the field can use if they really want to look at measuring readiness or what their unit looks like. And what we’ve done is, you know, of course, try to come up with means for them to measure particular aspects of health.
The next step is – and it’s going to be a difficult one; and this is the frustration that you’re going to see from the field – is okay, I’ve identified, now, within nutritional or within spirit or within physical, I have some shortcomings. Where do I go, then, for that good program that has some level of efficacy that has measures of effectiveness that are proven and true? That’s going to be the hard part.
ADM. MULLEN: Well, I hope in that – and first of all, you’ve got to do the first part before you have the hard part. And so do that work now. You know, I welcome the hard problem. And then, when I talk about what are the gold standards – and I don’t know what they are – but certainly, don’t just look at each other. I would hope we would be looking nationally and internationally for who does this better than anybody else, for whatever reason, and then is there a way to tap that, to put that in place – or a version of that in place – which makes sense?
Because that will get at solving – starting to solve some of those problems. It’s not going to solve them overnight, but in the long run, it will change. If you’ve been overseas, you go to these DFACs – I mean, if you lose weight on a deployment, I don’t care who you are, I mean, you’re one of the most disciplined people in the world. (Laughter.) Because you walk into these places and the first place – I mean, it’s at the front door, is the ice cream station. (Laughter.)
And it’s all there. You know, we want to make – it’s like okay, this is comfort food, in totality. (Laughter.) And you’ve never seen more of it and you can have as much of it as you want. So – and there is – I’ve seen lettuce over there somewhere. (Laughter.) It’s true. It is – and so – but again, these are 20-somethings that have grown up on junk. And when I think about this – and I’ve got to – I’ve got the hook. (Laughter.)
So the other thing – because a lot of you are seniors – where are we going on this? And when you look at that series of slides that talks about the obesity in America – I don’t know if you’ve seen those. I mean, I saw them a year or two ago. But essentially, it takes it from the ’50s, ’60s, ’70s, ’80s, ’90s, and it goes from blue – this is not a political statement – (laughter) – goes from blue across the country to red, which is really bad.
And it’s in the heart of the country, but it is, by no means, only located there. So where are we going? And given that we know who our input is here, what should we do from day one? And that’s another question. In all these areas, what should we do – I don’t want to just treat problems; I’d like to get to a point where I can do some preventative work.
So from day one, including do I have it right in my testing for, you’re okay to come in – you know, can I be – because I can be more selective. In the middle of this financial crisis, believe me, I can be more selective than I could a couple of years ago. And that will be sustained for a while and that will go up and down over time as welcome out of this – and I’m sure we will.
But can I be preventative even – and selfish about it – by the decisions I make about who comes in, which I know I could be. And at the same time, now that I have you in, from day one, you know, sending that message of, in the totality of your health, we include these things and this is where you are. They’re hooking me out of here. One last question.
Q: Sir, Jeff Rhodes (sp). I work at the Defense Center for Excellence. I’m a retired Navy chaplain. When I first came in, I was at 3-9 – (inaudible, background noise) – also was on the USS Arkansas – (inaudible, background noise). (Inaudible, background noise) – what we call spiritual and ethically driven engagement for our leaders. That is a spiritual issue – leadership. It has to do with trust, with unit cohesiveness, confidence up and down the chain of command. And I was just wondering if you could make a comment on that.
ADM. MULLEN: I’ll only comment here. I’ve just done a review of what my guidance will be and kind of looking at the next couple of years, what my goals are, how I should engage the force, what my priorities are. And in addition to the broader Middle East, health of the force in terms of things that – there are three big priorities which have – stability in the broader Middle East, health of the force and then the risk throughout the globe, because I’ve got so many eggs in one basket in CENTCOM right now.
But inside that, in the health of the force piece, in terms of big chunks of what do you do, my staff came to me and said you really need to actively state and seek and generate a discussion about ethics and morals, period. And that really struck me. I just hadn’t been thinking about that. And their reasoning was the easy one and very, very – I mean, easy in terms of identification – catastrophic in terms of us as a military – was Abu Ghraib, and then others.
But their contention is that this is something you need to get a lead on – ahead of – not wait for the next really bad incident and go, what happened; how have you missed this, at a time when I am still seeing, quite frankly, abuses from our people along those lines – certainly not to the level of back then. But we still – despite leadership focus and direction and lots of other things, it’s still going on.
The other thing – and this goes back to – it’s worth looking at how the Army – you know, Gen. Casey is looking at how – in the Navy, I used to call it tone of the force. Gen. Casey gets a report this thick every month – or a notebook this thick – of many indicators. And I’m not sure I believe all of them – I talked about the divorce piece of it, which I don’t believe in the Navy – or in any of the services, quite frankly.
This unbelievably tough problem of suicides, which is a horrendous problem before any of this started, much less where we are right now, and unraveling that. And the third – and I was disappointed to find out yesterday that this study hasn’t started yet, which I sat with a bunch of smart people telling me the first spinoff is October and I woke up the other day and I said, geez, October is past and I haven’t seen – first outlook was that. That’s just direct from me to the chief, Colleen. (Laughter.)
And Chiarelli already knows that, but if you look at what we’re looking at, which is sexual assaults, child abuses – what’s the family abuse program – domestic violence, but what’s the program?
(Cross talk.)
ADM. MULLEN: Family advocacy. You know, all of those things. This goes back to, in many ways, the chaplain’s life – or lives. But these statistics – what is important in that book, obviously, are the trends, but also just what they’re measuring, just what they’re looking at. Because it’s a thick book that, in totality, gives you a feel for where the force is. And we’re all – I think we’re okay. We’re not great. We’re not going to break it. And I do not want to – I really don’t want to break it because I think that is fundamentally catastrophic for our national security. So anyway, god bless you and thanks.