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NEWS | June 25, 2015

Can you make the notional, emotional?

By Story by Sgt. 1st Class Adam Stone 807th Medical Command (Deployed Support)

FORT MCCOY, Wis. - Most training exercises are conducted notionally. This means made-up country names, invented civil unrest, or fictional injuries where a soldier is told by an exercise referee that he has a wound, but displays no visual symptoms. But for citizen soldiers leaving their civilian medical worlds to conduct annual training at the Army Reserve’s Global Medic 2015 exercise — how do you get them to really buy in?

Most training exercises are conducted notionally. This means made-up country names, invented civil unrest, or fictional injuries where a soldier is told by an exercise referee that he has a wound, but displays no visual symptoms. But for citizen soldiers leaving their civilian medical worlds to conduct annual training at the Army Reserve’s Global Medic 2015 exercise — how do you get them to really buy in?

Moulage artists from the 807th Medical Command’s 94th and 228th Combat Support Hospitals help create that buy-in when other soldiers experience their creations – staged, bloody, messy broken limbs; slimy eye balls dangling from empty sockets; burned and charred skin; and sucking chest wounds that suck a little too well. By the time the 2015 Global Medic Exercise is over they'll have supported more than 700 scenarios that involve mannequins, robots, and real-life role players.

Fort McCoy has a warehouse full of mannequins and work benches dedicated to the moulage details. The units participating in the exercise provide Soldiers to the detail who dress up mannequins or act as role players, so the range of experience for soldiers coming into moulage runs the gambit from combat medic, to licensed vocational nurse, to physical therapy techs. Each one of these Soldiers comes in with very little experience actually creating wounds. They are used to seeing the wound after it’s made.

“When I was with First Army, back in 2008, we were pushing Army Reserve and National Guard medics through a 21-day refresher course and we'd just slam them,” said Sgt. 1st Class Kristina Boetner, the sergeant in charge of the moulage detail. “It’s where I got into the moulage and make-up, the whole nine-yards to make it more realistic and build that part up so the medics would really feel stressed.”

The mannequin shop operates 24-hours-a-day in order to prepare enough casualties to properly exercise the capabilities of the 807th's combat support hospitals.

“It's a great experience,” said U.S. Army Pfc. Muguel Rodriguez-Estrada Jr., a native of Dallas and a generator mechanic for the 94th Combat Support Hospital. “I think I could put this thing in a movie and say, 'here you go.'”

“I do enjoy working with the junior enlisted because a lot of times we get these augmentees from sections that don't have a role in the exercise. And this is brand new to them and they never knew it existed. The units they are in, like the CSHs [combat support hospital] and area support medical companies, they've never seen this side of the house, they never know the work and planning that's involved to kick this off. It's an eye opener to them.” said Boetner.

The detail does not just dress up department store mannequins. These are realistic mannequins that weigh over 150 pounds, cost anywhere from $3,000 to $19,000, and can be made to look like they have from one to a couple hundred different injuries. They also have mannequins that move and squirt blood.

The epitome of animated mannequins is one called a SIMMAN -- an approximately $140,000 dummy that can simulate breathing, blink his eyes, replicate a heartbeat and showcase dozens of problems while being controlled by a soldier at a computer.

“This exercise is for the nurses and the medics-- it's not to teach the doctors how to practice medicine. Look how much everyone is engaged! That’s what I like about it,” said Lt. Col. Foster Kordach an emergency room doctor with the 94th. “The hardest thing about the mannequin is knowing what you get from the mannequin or the observer controller. No one is standing around just looking at the patient, and they are all engaged.”

Allied military forces who send their soldiers to Global Medic also benefit from the specialized training with SIMMAN.

“They have a good role in training. They get all the information, lets you intubate, practice your skills on them. It gives you a bit more feedback than as far as the vital signs. It helps you improve your clinical direction and practical skills,” said British army reserve Capt. Beth Squire, 207th Field Hospital, Manchester, British army reserve.

One way the moulage artists approach their task is to dwell upon and internalize the backstories. Spc. Bill Koehler, a resident of San Antonio and a licensed vocational nurse of the 228th Combat Support Hospital, gets creative in order to make the training even more personal. Koehler invents backstories for each mannequin, like characters in a novel.

“If I believe it's real, then I do a better job on the mannequin and maybe that makes the difference so that those guys out there training will think it's real,” Koehler said.

“My favorite is Charlie. He's dug himself into a pretty deep hole, credit-wise, but acting as a casualty is one way he can build back his credit. It's a heart-warming American dream story,” said Kohler.

Most of the role-playing scenarios are planned, but sometimes the exercise heads in a different direction.

“The biggest challenge is just being flexible. Sometimes we get an order for an injury an hour before an inject,” said U.S. Army Pfc. Alex Campbell, a resident of Midlothian, Texas and a medic in the 228th. “Because waking up early isn't really much of a challenge.”

“We can make cool stuff like blast burns, lacerations, broken bones and occasionally we get to act crazy,” said Campbell.

“The best part about this detail,” said Sgt. Nicole Rodriguez of the 228th and a resident of San Antonio, “is that we get to create death on a daily basis.”

The 2015 Global Medic Exercises are hosted annually by the Medical Readiness and Training Command at Fort McCoy, Wisconsin; Fort Hunter-Liggett, California; and Joint Base McGuire-Dix-Lakehurst, New Jersey. Personnel from these locations collaborate to create the Army's premiere training events for military medical professionals. Global Medic events are the only Army Reserve-led exercises accredited by the Pentagon for participation by all branches and both active-duty and reserve components.