Operation Uphold Democracy

Operation Uphold Democracy.  Field hospitals accomplish the same things as convential civilian hospitals. They stop the bleeding, help make pee, oxygenate blood.  The main difference is that the patient population is in dire need of immediate medical care, to no fault of their own.  The locals didn't ask to be in the cross fire, soldiers are accomplishing their missions dictated by the officers and President above. 

They are very flexible, if they don't have the right equipement, they make do.  No bassinet, no problem, impact case is just the right size. No arm board for a small infant, tongue depressor at your service.

This poor lad was a victim of witchcraft in Haiti. Pardon my pinky.  He had injuries to his legs and the local witch doctor concocted a a salve using vegetation from a local tree.  The combination of the infection and the poisionous vegetation rotted is legs.  Our surgeons had to amputate.  He was the honored guest at the 10th Mtn. Division picnic in Port Au Prince. Sorry fella...

Field hospitals have ambulances with great views.  I was lucky to have evacuated 3 ventilator patients back to the states.  Thanks Air Force, that was fun ;p

There is quite a difference between the medical career I started and the medical career I ended up with.  Sigh......

The Sergeant Major

One morning I sped to work with rock/heavy metal blaring, not because I was late but because the adrenaline adds a nice kick to my two cups of coffee, kinda like chicory in Louisiana coffee.  At 5:30 AM I  take all the help I can. I received my report from my night-shift counter part.  She gave the name and diagnosis, Guillan Barre, and..... "I don't know who he is but he has a bunch of visitors in Army uniforms that came to visit him...." WHAT? This is a liberal, non-military town.  Whatever.  Moving on.

Grabbed my third cup of coffee, before 7AM.  Move on down the lane.  One ventilator patient, then another...

Then, the Sergeant Major.  He sure didn't look like my usual patient profile, then his mom came from nowhere and doted on him, that was so sweet.  Then she pointed out he was a Sergeant Major in the US Army. What did you say? Holy Cow! I don't know what to say, I don't remember what I said but that was "The Spark".

I instantly felt bad about my entire enabling career that started after I was discharged from the Army.  They paid me well, they treated me well but truthfully I was a part of the big machine enabling the low functioning part of our society to continue doing what they do best, killing themselves.  All the while real American heroes are separted from their families and putting their asses on the line so the average, lazy American can continue to be a cancer on our country.  I was instantly disgusted during that brief intereaction and my midlife crisis began...

The Spark*

"The Spark" happened about 6 week ago when I first met Sergeant Major B****** from an Armored Cavalry Regiment at a nearby Army base.  It was a day like any other, clock in at 6AM, take report from the exhausted night shift, prioritize tasks, decide, act (after my morning snack of cereal, of course).  Mentally prepared to throw Albuterol darts at our health systems' gaping wounds.

My usual patient population consists of:

1) Overweight diabetics that will do NOTHING to reverse their disease (yes, it's reversible in its early stages)
2) Overweight heart disease patients recovering from their heart bypass operations.  This is where your arteries supplying life sustaining, oxygen-rich blood to your heart, are clogged with plaque from untreated hypertension, smoking, overeating, inactivity.  But this is not their first parade through my hospital. They have been coming in to have Angioplasties and stents for up to 10 years before they need this bypass.  You know you are one of these when you know your ENTIRE health care team by their first names!! "Welcome back you SOB:)"  This means:

  A) They have no interest in taking responsibility for their own health.
  B) They want to stay disabled to continue collecting their disability payments and Medicaid/Medicare.
  C) They want to really say "Fuck You" and pay up April 15th, tax day, whip out your wallets so I can pimp my ride.

3) Smokers**  I have a special bond with smokers.  I smoked heavily for 10 years.  I started in high school, not because i wanted to but because my friend wanted to but didn't want to smoke alone.  My parents both smoked and I really didn't want to go down that road, oh well....  I had a really hard time quitting,  it took about a dozen tries.  You know you are hard core when you develop bronchitis and cough up tar, thanks Marlboro Reds!  Anyways, by the time the smokers meet me, they are in dire need of relief and most of them can't kick the habit.  I try to educated them on my own personal experience knowing their doctors have already given them the tsk tsk speech.  I don't even go there.  For the die hard smokers i just tell them "Light em up, job security for me".  Ironically, smokers are my favority patient population.  Now, to my least favorite...ARGGGG!!!

4) Drug Addicts!  They are a unique breed.  They are usually between the ages of 20-40, led underproductive lives, sometimes collect disability and Medicaid for their "disability", ruin my Saturday mornings.  Apparently the big 'party night' is Friday so when the sun comes up, the bodies are found, half-way dead.  EMS called, fire department dispatched, arrive at my hospital and a team of 20 medical professionals swoop in to save them, just so they can be discharged 3 days later in time for the next RAVE! This is my highly esteemed professional life.  ENABLER: > (

Because of my usual population, my professional feelings of self worth are in the toilet.  It's not like the beginning of my medical career at all.  In the beginning, all was well.  I felt like I was a part of something great, important, non-enabling.  In fact, whining was not allowed, drugs were not aloud, incompetence was not tolerated, ambition was rewarded, leadership was exemplified and pride was pervasive.

In the beginning, I was a soldier.........

Maslow's Hierarchy Of Needs

I lifted this too from Wikipedia.... I am partially lazy but also this is good background information for establishing my midlife crisis, it's all about me!

Maslow's hierarchy of needs is a theory in psychology, proposed by Abraham Maslow in his 1943 paper A Theory of Human Motivation.^[2] Maslow subsequently extended the idea to include his observations of humans' innate curiosity. His theories parallel many other theories of human developmental psychology, all of which focus on describing the stages of growth in human.
Maslow studied what he called exemplary people such as Albert Einstein, Jane Addams, Eleanor Roosevelt, and Frederick Douglass rather than mentally ill or neurotic people, writing that "the study of crippled, stunted, immature, and unhealthy specimens can yield only a cripple psychology and a cripple philosophy."^[3] Maslow studied the healthiest 1% of the college student population.^[4]

Maslow's theory was fully expressed in his 1954 book Motivation and Personality.^[5]
1. Self-actualization
^{“What a man can be, he must be.”[7] This forms the basis of the perceived need for self-actualization. This level of need pertains to what a person's full potential is and realizing that potential. Maslow describes this desire as the desire to become more and more what one is, to become everything that one is capable of becoming.[8] This is a broad definition of the need for self-actualization, but when applied to individuals the need is specific. For example one individual may have the strong desire to become an ideal parent, in another it may be expressed athletically, and in another it may be expressed in painting, pictures, or inventions.[9] As mentioned before, in order to reach a clear understanding of this level of need one must first not only achieve the previous needs, physiological, safety, love, and esteem, but master these needs. Below are Maslow’s descriptions of a self-actualized person’s different needs and personality traits.
Maslow also states that even though these are examples of how the quest for knowledge is separate from basic needs he warns that these “two hierarchies are interrelated rather than sharply separated” (Maslow 97). This means that this level of need, as well as the next and highest level, are not strict, separate levels but closely related to others, and this is possibly the reason that these two levels of need are left out of most textbooks.}

^{[edit] 2. Esteem}

^{All humans have a need to be respected and to have self-esteem and self-respect. Also known as the belonging need, esteem presents the normal human desire to be accepted and valued by others. People need to engage themselves to gain recognition and have an activity or activities that give the person a sense of contribution, to feel accepted and self-valued, be it in a profession or hobby. Imbalances at this level can result in low self-esteem or an inferiority complex. People with low self-esteem need respect from others. They may seek fame or glory, which again depends on others. Note, however, that many people with low self-esteem will not be able to improve their view of themselves simply by receiving fame, respect, and glory externally, but must first accept themselves internally. Psychological imbalances such as depression can also prevent one from obtaining self-esteem on both levels.
Most people have a need for a stable self-respect and self-esteem. Maslow noted two versions of esteem needs, a lower one and a higher one. The lower one is the need for the respect of others, the need for status, recognition, fame, prestige, and attention. The higher one is the need for self-respect, the need for strength, competence, mastery, self-confidence, independence and freedom. The latter one ranks higher because it rests more on inner competence won through experience. Deprivation of these needs can lead to an inferiority complex, weakness and helplessness. IN SHORT :- People need both self esteem, a high evaluation of self and the esteem of others in our society. Fulfillment of these needs provides a feeling of self-confidence and a usefulness and their non-fulfillment/ produces feelings like inferirority, unhelpfulness.}

^{[edit] 3. Love and belonging}

^{After physiological and safety needs are fulfilled, the third layer of human needs are social and involve feelings of belongingness. This aspect of Maslow's hierarchy involves emotionally based relationships in general, such as:}

• ^Friendship
• ^Intimacy
• ^Family

^{Humans need to feel a sense of belonging and acceptance, whether it comes from a large social group, such as clubs, office culture, religious groups, professional organizations, sports teams, gangs, or small social connections (family members, intimate partners, mentors, close colleagues, confidants). They need to love and be loved (sexually and non-sexually) by others. In the absence of these elements, many people become susceptible to loneliness, social anxiety, and clinical depression. This need for belonging can often overcome the physiological and security needs, depending on the strength of the peer pressure; an anorexic, for example, may ignore the need to eat and the security of health for a feeling of control and belonging.[citation needed]}

^{[edit] 4. Safety needs}

^{With their physical needs relatively satisfied, the individual's safety needs take precedence and dominate behavior. These needs have to do with people's yearning for a predictable orderly world in which perceived unfairness and inconsistency are under control, the familiar frequent and the unfamiliar rare. In the world of work, these safety needs manifest themselves in such things as a preference for job security, grievance procedures for protecting the individual from unilateral authority, savings accounts, insurance policies, reasonable disability accommodations, and the like.
Safety and Security needs include:}

• ^{Personal security}
• ^{Financial security}
• ^{Health and well-being}
• ^{Safety net against accidents/illness and their adverse impacts}

^{[edit] 5. Physiological needs}

^{For the most part, physiological needs are obvious — they are the literal requirements for human survival. If these requirements are not met, the human body simply cannot continue to function.
Physiological needs include:[1]}

• ^Breathing
• ^Nutrition
• ^Homeostasis

^{Air, water, and food are metabolic requirements for survival in all animals, including humans. Clothing and shelter provide necessary protection from the elements. The intensity of the human sexual instinct is shaped more by sexual competition than maintaining a birth rate adequate to survival of the species.}

^{[edit] Criticisms}

^{In their extensive review of research based on Maslow's theory, Wahba and Bridgewell found little evidence for the ranking of needs Maslow described, or even for the existence of a definite hierarchy at all.[10] Chilean economist and philosopher Manfred Max-Neef has also argued fundamental human needs are non-hierarchical, and are ontologically universal and invariant in nature—part of the condition of being human; poverty, he argues, may result from any one of these needs being frustrated, denied or unfulfilled.[citation needed]
The order in which the hierarchy is arranged (with self-actualization as the highest order need) has been criticised as being ethnocentric by Geert Hofstede.[11] Hofstede's criticism of Maslow's pyramid as ethnocentric may stem from the fact that Maslow’s hierarchy of needs neglects to illustrate and expand upon the difference between the social and intellectual needs of those raised in individualistic societies and those raised in collectivist societies. Maslow created his hierarchy of needs from an individualistic perspective, being that he was from the United States, a highly individualistic nation. The needs and drives of those in individualistic societies tend to be more self centered than those in collectivist societies, focusing on improvement of the self, with self actualization being the apex of self improvement. Since the hierarchy was written from the perspective of an individualist, the order of needs in the hierarchy with self actualization at the top is not representative of the needs of those in collectivist cultures. In collectivist societies, the needs of acceptance and community will outweigh the needs for freedom and individuality. [12]
Maslow’s hierarchy has also been criticized as being individualistic because of the position and value of sex on the pyramid. Maslow’s pyramid puts sex on the bottom rung of physiological needs, along with breathing and food. It views sex from an individualistic and not collectivist perspective: i.e., as an individualistic physiological need that must be satisfied before one moves on to higher pursuits. This view of sex neglects the emotional, familial and evolutionary implications of sex within the community.[13][14]}

^{[edit] Business}

Marketing

This section does not cite any references or sources. Please help improve this article by adding citations to reliable sources. Unsourced material may be challenged and removed. (May 2010)

Courses in marketing teach Maslow's hierarchy as one of the first theories as a basis for understanding consumers' motives for action. Marketers have historically looked towards consumers' needs to define their actions in the market. If producers design products meeting consumer needs, consumers will more often choose those products over those of competitors. Whichever product better fills the void created by the need will be chosen more frequently, thus increasing sales. This makes the model relevant to transpersonal business studies.

[edit] International Business

Understanding the strengths and weakness of Maslow’s hierarchy of needs is important in the field of international business. Evaluating the different needs, values, drives and priorities of people from different countries - individualistic or collectivist - is incredibly valuable in cross-cultural communications, and especially within the workplace. It also illustrates how differences in values can greatly affect work atmosphere and work ethic between cultures: “ For example, societal cultures in many individualistic countries, such as the United States, may lead to an advantage in technological research and development. Many collectivistic societal cultures, such as that in Japan, may result in an advantage in workforce organization, quality control of products and service, and establishment of good relationships among contractees, suppliers and customers”. ^[15]

Midlife Crisis

I  completely lifted this from Wikipedia, the lazy person's source for research:

Midlife crisis is a term coined in 1965 by Elliott Jaques and used in Western societies to describe a period of dramatic self-doubt that is felt by some individuals in the "middle years" or middle age of life, as a result of sensing the passing of their own youth and the imminence of their old age. Sometimes, a crisis can be triggered by transitions experienced in these years, such as extramarital affairs, andropause or menopause, the death of parents or other causes of grief, unemployment or underemployment, realizing that a job or career is hated but not knowing how else to earn an equivalent living, or children leaving home. The result may be a desire to make significant changes in core aspects of day-to-day life or situation, such as in career, work-life balance, marriage, romantic relationships, big-ticket expenditures, or physical appearance.
Academic research since the 1980s rejects the notion of midlife crisis as a phase that most adults go through. In one study, fewer than 10% of people in the United States had psychological crises due to their age or aging.^[1] Personality type and a history of psychological crisis are believed to predispose some people to this "traditional" midlife crisis.^[2] People going through this suffer a variety of symptoms and exhibit a disparate range of behaviors.
Many middle aged adults experience major life events that can cause a period of psychological stress or depression, such as the death of a loved one, or a career setback. However, those events could have happened earlier or later in life, making them a "crisis," but not necessarily a midlife one. In the same study, 15% of middle-aged adults experienced this type of midlife turmoil.
Some studies indicate that some cultures may be more sensitive to this phenomenon than others, one study found that there is little evidence that people undergo midlife crises in Japanese and Indian cultures, raising the question of whether a midlife crises is mainly a cultural construct. The authors hypothesized that the "culture of youth" in Western societies accounts for the popularity of the midlife crisis concept there.^[3]
Researchers have found that midlife is often a time for reflection and reassessment, but this is not always accompanied by the psychological upheaval popularly associated with "midlife crisis."^[4]

For the approximately 10% of middle aged adults who go through an age-related midlife crisis, the condition is most common ranging from the ages of 40-60 (a large study in the 1990s^[5] found that the average age at onset of a self-described midlife crisis was 46). Midlife crises last about 3–10 years in men and 2–5 years in women.
A midlife crisis could be caused by aging itself, or aging in combination with changes, problems, or regrets over:

• work or career
• spousal relationships
• maturation of children
• aging or death of parents
• physical changes associated with aging

Midlife crises seem to affect men and women differently. Researchers^[6] have proposed that the triggers for midlife crisis differ between men and women, with male midlife crisis more likely to be caused by work issues.
Some have hypothesized that another cause of the male midlife crisis is the imminent menopause of the female partner and end of her reproductive career.^[7]

Characteristics

Sports cars as a form of conspicuous consumption.

Individuals experiencing a midlife crisis have some of these feelings:

• search of an undefined dream or goal
• a deep sense of remorse for goals not accomplished
• desire to achieve a feeling of youthfulness
• need to spend more time alone or with certain peers

They exhibit some of these behaviors:

• abuse of alcohol
• acquisition of unusual or expensive items such as motorbikes, boats, clothing, sports cars, jewelry, gadgets, tattoos, piercings, etc.
• depression
• blaming themselves for their failures
• paying special attention to physical appearance such as covering baldness, wearing "younger" designer clothes etc.
• entering relationships with younger people (either/or sexual, professional, parental, etc.)
• placing overimportance (and possibly a psychologically damaging amount) on their children to excel in areas such as sports, arts or academics

Theoretical basis
"The notion of the midlife crisis began with followers of Sigmund Freud, who thought that during middle age everyone’s thoughts were driven by the fear of impending death".^[8] Although midlife crisis has lately received more attention in popular culture than serious research, there are some theoretical constructs supporting the notion. Jungian theory holds that midlife is key to individuation, a process of self-actualization and self-awareness that contains many potential paradoxes.^[9] Although Carl Jung did not describe midlife crisis per se, the midlife integration of thinking, sensation, feeling, and intuition that he describes could, it seems, lead to confusion about one's life to date and one's goals.
Erik Erikson held^[10] that in life's seventh stage, middle adulthood, people struggle to find new meaning and purpose to their lives; their questioning, he believed, could lead to what we now call a midlife crisis.
Some psychologists believe men's midlife crisis is a psychological reaction to the imminent menopause and end of reproductive career of their spouses. Their genes may be influencing men to be more attracted to reproductive women, and less attached to their non-reproductive spouses.

That's a good beginning.