 You have to pay attention to detail and you have to give it your maximum effort. Navigate! Let's play! Let's play! Welcome to the Only Easy Day was Yesterday, the official Navy SEAL podcast. Mental and physical health is essential to a successful trip through Navy Boot Camp. Even more so for NSW candidates. I'm Daniel Fletcher. As we continue our Boot Camp series from Great Lakes, Illinois, we sit down with medical liaison for Crew Training Command, Chief Hospital corpsman, Jeff Ramirez. We answer some common questions about recruit medical history, mental health, medications, and preventative care. Listen up. Thanks for sitting down with us for one and if you could just briefly talk about what you do here, that would be a great start. So I deal with all medical related issues in terms of recruit appointments, any injuries that we have here going to network hospitals, to the federal health care center, outsourced down to Chicago, any questionable areas that the doctors have that they need to liaison with the RDCs here in terms of missed appointments or recruits not eating enough, or even if they feel like they're getting too much exercise, because there's instances where we start breaking some recruits down that are couch potatoes and then they get over here and they're learning right away that it's a little bit different here. What types of tests or any type of screening do you administer or is that not part of your position? So that's not part of my position here. So I deal with the docs and it's going to range from mental health to your physical therapy, your preventive meds, and then general sick call. But it's every illness or injury or anything medical related between RTC and the providers. Okay. Are there any ailments or injuries that you see specifically for the 800 guys that are coming through the pipeline here? 800 guys, I would say the biggest injuries that I see would be shin splints, stress fractures, and not getting enough nutrients. Really? Rabdo, rhabdomyolysis. We'll see that. They didn't train for the pipeline before they got here. Okay. And so when they're doing the DiMO PT, their body's breaking down. Pretty severe. The muscles are breaking down pretty severe, yes. I guess that's a kind of form of a failed test, so to speak, if someone's put in position physically where their body's not holding up. Are there any other specific medical tests that are given periodically or on a routine basis that you see NSW candidates having issues with? Special physicals. What are special physicals? They'll answer the questionnaires there, go through the overall history, see if there's anything that raises any red flags. In terms of anything periodic, that doesn't happen unless they choose to go to sick call. If they're having some issues with RTC, they see any 800, any recruit really walking around with limbs or looking distressed or sick, we're going to send them to sick call regardless. You get your labs drawn over there, or if you've got to go to bone density scan or X-rays, a lot of 800s, they really want to be here most of them, so it's kind of hard to get them to go to medical sometimes. So it's our responsibility, and I get a lot of phone calls about that, that I have a recruit that's been limping around, he says he's okay, but however, most body sensors telling me he probably needs to get seen, then we'll go ahead and send them in there and usually find out something, something else. If there's somebody who gets to this point in the process and then a medical screening turns up not not good enough or a fail, whatever you want to call it, are there chances for a candidate to kind of retake a test? Can you tell me a little bit about that landscape of that kind of situation? So if we're going to use vision for an example, so if you came here and your MEP says, you know, the MEP's doctor says your vision's a certain score and you come here and it's not or you're colorblind, they're going to reissue the actual test again. So you're going to do one MEP's, you're going to do one here. If you fail that, you're going to do it again. And if, you know, if all the scores end up just the same here, then they're going to either request a waiver if you're eligible. The special phys docs, well, they're going to determine who's waiverable for the Bumet instruction. So they'll go in there and make sure it is a waiverable condition, whether it's vision hearing. If it is waiverable, we'll keep them in the pipeline here, and then the waivers usually come back by the time they get out of here. If it's not, since most of them are contracted, then they can opt to either pick a different rate or pretty much get separated in their contract. So your basic recruits, they're coming in, they're not contracted like the A-hundreds. If they don't meet specific requirements for a certain job, then they'll get put in another job before the A-hundreds. If they don't want to fulfill their contract, because they can't do something medically related, then they can either opt to go or stay with another rate. Our primary audience is, I guess I could say the layman or layperson or civilian, so I'll do a little bit of interpreting for them. So someone who comes into the special warfare pipeline is kind of quasi hired by the Navy and they can then choose to choose a different direction to take their career. Is that accurate? Yes, that's exactly what I'm saying. And if they got their heart set on being a seal and you don't meet the medical qualifications to fulfill that contract, then yes, you can drop on request and get separated from the Navy altogether. So you decide to make a different decision. How often do you see that misalignment of MEPs decision versus something onsite here? There's those that do fall through the cracks. There's always human error. It's not as much as we think. Most of our drops are usually drop on request, really, after a dive mo. In terms of medical, it's not as much as we actually think. Okay, well, that's good to hear. What types of tests can a recruit fail to have them say, you're not going to be able to be in the Navy at all? Hearing's on a bigger scale right now than vision is. Why is that? Any kind of permanent hearing loss, the deeper decibels, it's an automatic disqualifier and some of them are even waverable. So you're saying that it's starting to become a bigger issue than it used to be or it's more noticeable? I think it's probably more noticeable. All the loud music. I think it, I would say that the earbuds and the working out, I'll be hypocritified and say I do it myself. I would imagine they have something to do with it. So if you listen to something loud right away, you'll have the minimum hearing loss, the temporary, the lower frequencies, but the higher frequencies and that would be, you can consecutively listen to your earphones really loud while you're in the gym 24-7 or in your cars nowadays. No good. I'm guessing that there's sometimes injuries that happen during basic training that can kind of put someone in that same situation. Is that something that people should be concerned with or is that pretty rare in terms of shin splints that are so severe or whatever it may be that they're not able to continue? Do they have a chance to maybe have a few weeks to kind of heal up? So we have the recoup convalescent unit that's actually here in chip four. The reason for that is if you do get shin splints or stress fractures, you actually get a rehab time. So when you go to the hospital, you go see one of our docs and they say, hey, you got shin splints, you're gonna be like limited duty for 21 days. So that's 21 days of rehab. So doing that 21 days, they're gonna go to a chip four and their job is to get better. They'll be putting a hold status until they are fit for full duty. Once they're fit for full duty, they'll incorporate with another 800, to keep the training going. Does it happen often enough that you think that's a successful way to deal with that? I don't think it happens as much for the 800s. For the regular recruit divisions, yes. For the 800s, no. And that's the same process for both of them in terms of the time that they're given. Yes, if you look at the recoup convalescent unit, you'll have for every 30, 40 recruits, you might have one 800 in there. Usually the one 800s get injured is because that individual didn't prep. Right, right. So he came over here and did a little more running than what he or she was doing at the time. Right, right, right. From your perspective, what type of advice would you give to someone coming into the pipeline to avoid types of medical issues that we're speaking of? The biggest thing is prep. So don't do the bare minimum before you actually get here. Going over to Dymo PT, they're gonna give you a workout. Right. So if you weren't prep before you got over here, it's gonna show and it's gonna show quick. Dymo is really where they start falling out. It's not regular PT. That's not the PT that all the other recruits get here because you're contracted. You're gonna do something more strenuous. So it's definitely prep is huge. Is there part of the process that you think people should be maybe more aware of? You have to prep. Prep's the biggest thing. If you're taking a lot of protein powders and all this stuff that you can get from GNC or bodybuilding.com, whatever you're taking, just remember you're not gonna have it here. Okay. You know, the stuff that gets you over a good workout because sometimes you're pushing your body so much that you need the extra protein or you need a little bit extra. Or whether it's pre-workout. You're not gonna have it here. That's gonna be cut straight out of your whole diet. Now you need to know how to eat correctly. And we do our classes here and teach you how to eat. However, it's a lot better if you have the history of doing it and you know your greens, you know your fruits, you know what you're doing. Cause you can't just take that simple protein powder and call it a day. It's not gonna happen. Right. If there's anything that you see on a common basis that you think that people should be more aware of, it'll be great if you kind of cover some of that as well. One big thing is the psych issue. And when I say that would be more geared towards the mental health part of it. Mental health's a big part here and it's a great, great tool for recruit training command. Some of these, the 800 guys that we have will get them and they are watching videos and everything since they were young, they're real motivated, can't wait to do it, which is outstanding. However, they come to boot camp and they figure out maybe this is not what I wanted to do. So it's a general hype that they get theirself going through for however long that they get theirself hyped up for, but they get here and they kind of shut down a little bit. And once they shut down, it's kind of hard to pick them back up. So then they end up going to mental health and talking to them. Sometimes they can say things that may disqualify them. Does it happen? Yes, and it's not on a huge scale, but however it does happen. Almost like they pretty much psych themselves out. The first couple of dive mode days they kind of psych themselves out and they're like, okay, maybe this is not what I want to do. Cause it's strenuous, it hurts. At the end of the day, this is what you wanted and they're getting trained by the best people we have over there. But sometimes they can psych themselves out and they put themselves in a bad position. I think you brought up a good point. So much focus on the prep and even further along in the buds process and then throughout there's a huge emphasis on physical preparedness, physical capabilities, but the mental aspects seem to be coming to the forefront a lot more than it used to be in the past. And even awareness of mental health issues speak to that a little bit. Are there underlying issues that people should be aware of? If they want to come through basic training or maybe in the past, they had issues with depression or anxiety, what's the Navy's kind of opinion on that in NSW and the big Navy? How does that kind of fit into your job? I work with mental health really, really closely here. And the reason being is because it is a different kind of day and age. We have kids getting prescribed meds from early age. However, that's not all disqualifying factors. Yes, there's certain diagnosis where it's going to be a disqualifying factor and that's just kind of what it is if you bipolar type two or something like that. It's going to be a disqualifying factor. However, if you struggle a little bit through school or even your first year of college and you show progression and you have those notes by a doc saying that you're good to go, you've been on meds for a little bit or something bad happened in the family, these are all things that they are waiverable. You just got to show the actual documentation. So in terms of someone prepping to come here, it's good to know that if you're going to get your civilian medical records and it's going to say that you were put on a certain medication, don't just stop. Don't just stop and say, okay, well, I'm going to stop taking this because I plan to go to boot camp in a year. So if you stop when your doctor tells you to stop and then you show the progression for the one or two years, preferably two, the doc can sign off on that and say, hey, this person fell into a kind of a slump, did what he had to do, she had to do and recovered fully, we're good. Where we have the issue is when someone goes to a hard part in their life, gets prescribed some medications and then decides this is what they want to do, they want to go to boot camp and then just stops it. So when you get some civilian medical records, it shows that you were getting treated and then there's a blink. So there's really nothing to go off of and now you got to get reevaluated here and then there's a huge, it's huge. So there's nothing wrong with mental health, it's a part of all of us, whether we like it or not. However, it's the way we go about it. Well, I think that's a good thing to point out. I think a lot of people might say, whatever this existing condition, whether it's physical, mental or whatever, disqualifies me. I think reading between the lines is, talk to your doctor and you guys want to see as long of a spread between whether it's a prescription or a diagnosis and have some evidence to say, like, hey, this is where I am now. I think that would be helpful for a lot of people to hear because a lot of people might just say, well, I can't do that now. And I mean, you know what I'm wrong, in mental health there's a lot of different areas, a lot of different diagnoses and this doesn't speak for every single one of them. But there's a big chunk out there that you can still be in the Navy, not wrong with it. They just need to see the full treatment plan. They can't just cut it off in the middle because you never went through treatment then. There seems to be maybe some confusion in the aspect of medical records and how that's integrated into the Navy from civilian into integrating into the sailor life. What's that process look like? Or does the Navy get all, does they scoop up everyone's medical records when you come in? Well, any diagnosis, anything that you, legally, that you have to put on your medical history form and that's a medical history form that's legally used by the whole Department of Defense. You do have to provide that documentation if you put a diagnosis on there. So if you put a diagnosis on there, you have to provide that actual information because the doc's gonna know what the treatment plan was for and how that's gonna affect you. In terms of receiving all the civilian medical records, what we'll get with you put in there. Do we get them all? Probably not. With that being said, we probably don't get it because they still got the human error or you got humans lying as well. Right, you see that as an issue normally or I guess not normally, but. I think it is an issue. Otherwise, we wouldn't have recruit separating every day because they'll go to mental health or they'll get seen because past injury's gonna act up. Past injury acts up here and we find out that it's something that was pre-existing. So now if they wanna stay in, we're gonna request those civilian medical records so we can see if you can actually stay in. But in terms of the Navy just reaching out to civilian hospitals and get medical records, that's not even legal. Well, obviously it seems like being honest on your forms is probably not only legal but the better thing to do for your own success. Yes, absolutely. So like I said, any medical history form you get in the Navy, you have to list legally. That's why they're asking you. We gotta know what's wrong with you. And if you don't provide that actual information and you can get in trouble for that. But in terms of if you don't provide it and even if we think something, it's not like we could reach out to where you got seen as a kid and say, hey, I need those records. It probably doesn't work like that. Are there any kind of medical issues that can develop here that can disqualify someone completely from the Navy? Recurring stress fractures or reoccurring shin splints. You're contracted to be here. However, you can't get past dive mode because you just keep on breaking unfortunately. That's not your fault. Right. However, that's something that would definitely, you want to make it much further than that because you're pretty fragile. And after this pipeline, you're going on to something even more aggressive. Right, more aggressive. I appreciate you taking the time to sit down and talk with us. I know this might not be the most glamorous topic, but it's just as important as every other part of this pipeline. You know, crawl, walk, run, medical is a big part of that. Thank you for your service and thank you for the time today. Absolutely. Find out more at Sealswick.com and join us again for the next NSW podcast.