 We're excited about the fact that we're wrapping up our final preparations to get underway here at about one o'clock this afternoon and have the opportunity to deliver a pretty unique medical capability that no Navy in the world has the capability to do. And that's where a guy like Captain Buckley behind me brings that medical capability and any of the questions with specific medical capabilities I'll let Captain Buckley answer those. My function will be to go down and help with the command and control coordination between the maritime component commander and the land component commander there. Basically think of my role and the role of my staff is to keep everybody out of the way so that the medical professionals can do their jobs. And so I'm pretty good at that and they're really good at what they do. And then subject to your questions I would just turn it over to Captain Buckley to talk about capability. So the conditions are pretty good right now. The seas started laying down yesterday. We think that the transit we should be on station by three October. If we have to slow down a little bit for October at the latest but I'm pretty confident we'll be there by the third. So we don't know where we're going yet. Those final mission analysis and coordination with the national level agencies is ongoing. We'll get our orders in route and wherever we go the great part about what comfort brings to the fight is the ability to move anywhere that they ask us to go. So again that's part of the mission analysis that's still going on. As you can imagine with the level of destruction that occurs from a CAT 5 hurricane or CAT 4 whatever it was when it made shore. We're very cautious about how we bring a large ship in and so those surveys are still ongoing. We're working with our Coast Guard counterparts that are down in the area to get that assessment. And so we are flexible. The medical capability that the ship can deliver can be done underway. It can be done in port or it can be done at anchor and so between the helicopter capability that we have, the boats that we have, all of those things together give us the ability to be flexible in our mission and still contribute with very little interruptions in that process. So I mean the part about that for us is if we go pure side then there's that challenge of things are going to have to move by truck. The assessments that are coming out of there are mostly what I hear on the news as well and that is there are some areas that we're starting to do it. There are issues with or challenges with fuel distribution and things like that. We're flexible enough to do that and one of the capabilities that we have is should we have to go out and restock or something like that, we could leave port for a very short period of time, go out there and meet underway replenishment with our other combat logistics force ships and be able to do those resupplies. So again that goes to the flexibility and the uniqueness of comfort going into an area like that. So I know that my orders are a minimum of 30 days. You know and again those are decisions that are made much above our level. What we'll do is we'll go out there and hit the ground running or hit the deck plates running as we say in the Navy and we'll keep moving until somebody tells us that we're no longer needed. So I don't know enough about that to be honest with you. I think with when you look at the U.S. response that's going in now that things are starting to get mobilized and we're able to make the assessments that we make you know my initial cut is 30 days seems to be about right for this mission. So you didn't promise 2015? So two years ago they went to I think 13 countries approximately and saw 122,000 people. So you know those are decisions that are national level decisions. You know decisions made well above my pay grade. I can only say that we've received the order to go and it's time to go. What decisions were made at the national level I'm not privy to that and I wouldn't feel comfortable trying to answer you know why decision makers made those decisions. You know again I'm a simple sailor from Chicago. You know my job is to when somebody tells me to go I go. All of the rest of it is frankly irrelevant to me. We have a mission to go deliver a capability and get involved in an operation to reduce human suffering in an area that has been devastated by weather over the last five to six weeks. That's all I'm focused on and that's all that my medical professionals that I'm going with are focused on. So you know that's a great question. So to understand that you have to understand how the ship is designed in a non-operational status. Right so this ship is normally maintained in what we call a reserve operating status five which means they can get the order and be ready to go in five days. Now that's from the civilian mariner standpoint and then the uniqueness about comfort is that we can tailor those medical packages that Captain Buckley can talk about a little bit more in depth here and typically that's a five day or plus process depending on the size of that package. You know we started posturing as we saw weather coming in. We were leaning forward in the event that we were asked to go especially as ARMA was approaching the United States. So we made some of those preparations, decisions that were made within the Navy to do that. Here's what's really unique. Forty-eight hours ago there were less than a hundred people on board this ship. That's civilian mariners and medical treatment facility personnel at the same time. Over the last 36 hours we have flown medical professionals in for that tailored medical package along with their support personnel from all over the country and the number of people that are on board right now are over 800. Think of the logistics that's required and the capability that's required to move over 700 young men and women and good Americans to come on board and drop what they're doing to go and deliver that capability. I couldn't be more proud of how Military Seal of Command and how the medical community have responded and to walk aboard the ship or talk to those sailors who are all ready to go. That's what keeps you coming back to work every day. Y'all probably want to talk to the other guy so I can get out of the way unless there's any more specific questions for me. Yes, my name is Captain Kevin Robinson. I'm the Commodore of Military Seal of Command Atlantic and the Task Force Commander and on board here I am the forward command element for comfort to fall in on the other military commanders that are in the area. Good morning. I'm Captain Kevin Buckley. I'm an emergency medicine physician with a sub-specialty in pediatric emergency medicine. I am the commanding officer of the hospital or they call the MTF military treatment facility on the Comfort. Captain did a good job of giving you some of the overviews. I can give you a general feel of what we can do or you can ask me questions. What would you prefer? Well, I can't speak to what's available currently in Puerto Rico but I can tell you what we can do and that's okay. So we have the capabilities of any hospital that you have in this country. So we have a bunch of specialists. I have a CAT scanner, angiosuite and I have dialysis capabilities. The only thing we don't have on board is an MRI because if you know MRIs, they don't do very well with metal and you can see there's a lot of metal there that would probably interfere with that. So we don't have an MRI but we do have a new capable CT scanner ultrasound. We can run up to 11 ORs but we're only going to be loaded for six. The ship that's built, the primary mission is for combat, combat support. So the combat support mission is a little different package than humanitarian. In combat, we don't bring OBGYN doctors and pediatricians and neonatologists and this tailored package, we have more community health, more primary care. I have a 50-bed ER capability on board the ship. I have the ability to store about 250 people and we'll have up to 50 ICU beds. The potential of the hospital ship, actually, if it's made for combat would probably be one of the largest trauma centers in the United States. If you Google it, it'll be number seven because it has up to 1,000 beds capability. We're not packed on a 1,000 bed because, again, our mission is not trauma for combat. It's more for humanitarian assistance. We have the capability to, the MSC command who runs the hull part of the ship has been a great partnership with them and Logistics League, we can run for six months for combat without being resupplied for medical supplies. Food, we would need that for humanitarian because of the nature of the short notice and the flexibility we don't know what we're going to face yet. We load for about 30 days of supplies. I actually have Navy sailors from Puerto Rico, including my adminship, who was supposed to go on vacation next week to see his family in Puerto Rico. And they're fine, by the way. They're in the eastern part of the island, but they're okay. It took them a week to get a hold of them, but they're okay. There are also a number of sailors that have come on my crew. So it's like a nest egg. So I usually have about 58 sailors that sit here and maintain the shop. It's not in mothballs. If you don't think about equipment, you have to keep things running. All my lab equipment capabilities, CT scanners, radiology machines require to be used or at least turned on. You can't leave them off for a month and come back expecting to work. You guys own no technology. It's a bit fickle. So I had that crew. Then I have a critical corps that comes on board, which is sourced from different 18MTFs around the country. Majority comes from Portsmouth, which is local. That's 241 more people. That doesn't bring you a capability for medical support, but the framework, our bone structure, for the hospital to get ready to take patients. And then the Foss-Taylor package, which we bought on board, over 529 people were tasked with the mission less than 36 hours ago, some as late as last night, and they're here this morning to help support us. So as a dock, coming on board the ship and seeing the capability, it's really impactful and emotional what we can deliver. And thanks to the partnership with MSC Command in the hull and Navy Medicine East and Navy Medicine and General Bueman leading forward, I don't think you guys understand. No civilian agency can bring this capability in 24 hours to be able to go on a ship, to go anywhere in the world, anytime, anywhere. And because of our capabilities, any deep port, we have two transports that you may see on a regular cruise line that can bring patients up as well, up to 40 patients at a time. Most cruise lines just bring things down, but the load up to do that is a great capability as well. So we can bring them from the pier side, from small boats, if we can't get further up into an area, or by the large deck can actually move in closer. Pier side does have some limitations, but we can be flexible and do almost anything. So when we're fully full-debore, we can process about 200 people per day, depending on our supply list. Our combat would be six months indefinitely for that period of time. We don't know what we're going to be tasked with. We don't know what the medical ask is. That's from higher up national authorities. We'll work with FEMA to decide where the base use of us, because we don't have the... I'm just a captain on this level. My job is to be ready to go with our team and get what we can to be as flexible, or as simple as you want to be to be on the site. But those areas will have to be determined where our best impact will be. There is a great already a Navy asset, a military medicine asset on land. So we're going to plus up with them, and the captain, the Commodore, will actually give us, or he's over there now, will give us the guidance where we're going to go. So wherever he says we're going, my team is ready to support and provide care. What types of aid might be in demand? For instance, like in an earthquake, you basically have hundreds of percent of the military. In hurricanes, is there generally something that you're expecting to see more of? Well, we use a computer model base that actually can tell you what kind of problem you're dealing with, emergency economy, a well-developed nation type thing, and timelines, so depending on when you get and what kind of disasters. So whether it is a local disaster, an earthquake knocks the building down, or you may have a wider spread so that you can then put these questions or input into the data and get an input. Normally the first few days of an incident like this would be more trauma related incidents, things falling down, things being blown over, or hit by debris that are hitting. As we further move out, there's more medical things. So as you lose some of the civilization type things, running water, proper sanitation, things like dysentery or cholera can also be on. So usually around day 14 through on, you start getting more medical issues. Or medical patients who haven't seen their doctor or haven't got their medications refilled may have problems that may do their immediate disease. So again, trauma up front, and then as you go furth out, it's more medical based. I'm sorry, she had a question next? Nearly, yes. Well there are certain surgeries we just wouldn't want to do. We wouldn't want to do a joint replacement because that's a long follow on. Someone has a broken bone or needs a wash out, yes. So one of the differences between this ship and some of the other medical capabilities, the L8DH, they can do damage control surgery and major surgeries to stop them, but they don't have the follow on holding capability. So we have a patient that has a contaminated wound and may have to go back to the OR five or six times over a week, or a person on board and do that and do all of that definitive surgery. We have a pharmacy based on, we have what we call AMALS, which are packages that are pre-based packages based on what we think. We don't keep anything on the ship for the most part until we get an order to where to go because we want to tailor a mission what we need and we get support from MSC, from our civilian contractors, from Portsmouth, and we've actually called commands up and down the eastern coast if we don't have something we can get to pull and that's been loaded on. I mean, 98 pallets of food by my guys during a storm wins the last couple days here because the hurricane had been in there and they did very challenging. So it's been a heroic effort, a teamwork effort to provide a capability like it, as the commander said, very few in the world can do. We have them on board now. So we loaded them over the last two days. That's why we have the Roth five status. You have to get your mission and then task what you need and it does take a few hours to do that. I have enough for 30 days. Well, so one of the things as we get more information from higher authorities, as I said, we don't know what the full ask is. We have to be very broad. If we need to do more, say dialysis or more so-and-so, we have the ability to say order up from the ship and order ahead and have redelivery so we can do the underway replenishment so we have those already scheduled for food but we can add other things on there or we also have a Hebrew debt on board that if we know where we can preposition supplies then fly them out to the ship. Well, I have over 300 of our finest Navy corpsmen and those break down into specialists and texts so we have lab techs, x-ray techs, pharmacy techs, physical therapy techs and I have approximately 140 medical type officers so that's doctors, nurses MSC officers which is not different than MSC line command that does the support medical service corps so those include your pharmacist your physical therapist you may have also, we have nurse practitioners in PAs and I have a number of I have at least I have 45 doctors and they don't count me anymore unfortunately on that list but I have, and my executive officer is also in internal medicine so we actually have two additional doctors that don't count on the list because we're in a position that we're set for for CO and XO Well, I have a number of people on board ship that speak Spanish if we have that issue you know, I've been doing this for a while and I've had a lot of my doctors have always told me if you get to do a humanitarian mission it's usually the highlight of your career and one of the joys is being a skipper and an admiral swap who's an admin at East Admiral and the source for most of our actually all of our medical capability was on board last night and this morning and walking around normally you get deployment there's always people like I can't go for this reason or that reason the energy, the smiles the enthusiasm to help is really rewarding to see as a commanding officer it's really heart touching to see that and I'm very proud of our sailors and I couldn't be more proud I mean it's almost like put me in coach I can help, I'm ready to play and they really had that enthusiasm getting on board last night it just takes time to process that many people across that little brow fighting and birthing and not one person was complaining everyone's smiling happy and just happy to be aboard so it's really an infectious type thing so I'm they're really eager to help and we'll do our best for the commanding officer as us do and the higher authorities to do what we're standing by to assist September 11th as well well each crisis is different you know September 11th had a focal point where it's gone the natural disasters and it's always a little more challenging work with the states because you also have to work with states those different states governments and the female actually will drive a lot of that and a lot of the stuff way above that so we're just more of tell us what you want and we'll support what you need many of the states though actually have inland resources so sometimes easier to move inland than to have to go out to sea so depending on what kind of nation it is or nature of the event we have to we're more in tell us what you need and we'll support well the supplies for 30 days is what we need to do medical care so when we start medical care we will need food resupply we have enough food for about 21 days for 900 people you mentioned the morale are there any challenges in terms of growing all these people together at once like procedures maybe someone does something different than someone else and they kind of have to work things out actually it's amazing the teamwork approach is really a pretty good most of it we're all active duty so we all worked in different we were all plug and play if you will I've been deployed down range to Iraq or as an ERSS team lead to different areas and there are general training pipelines that people have so a lot of it is consistent people always have their certain preferences like I like this type of retractor if I'm a surgeon and surgeons always have their own little personal things they like but on the ER docs there's always a little battle between ER doc and surgeons so so there are at least 71 mariners may have a little more plus up for that that actually run the hall and on the medical side I have over 800 right now well that includes my support staff so not just medical I have a large non-medical component so somebody has to feed people so we have a galley that can provide up to 8500 meals a day if properly stored we don't need that much right now because we only have 900 people on board times 3 so at least 3,000 meals a day we'll be cooking so I need staff to do that and then we have logistics supply orders so I have barns of warehouses on here I can put stuff in and a whole bunch of people civilians and military that work together to make sure we have what we need so it's over right now over 800 military staff and then the 71 civilian mariners yes correct so the ship has capability for dialysis like I said it can provide them nearly anything any medical hospital tertiary care facility in the states can provide except MRI and usually some of the neurosurgical procedures if you staff it right so we are always have dialysis machines we've actually plused up from Portsmouth with two other ones and we've actually have nephrology on board for dialysis texas support so the beds are you have to look at that it's 250 beds is a breakdown because you have of that 50 beds are in the ICU so those 250 beds are varying level of care I can ask everybody obviously they have to go on the way in 90 minutes so we're going to go last question whoever can get it in in terms of what you've written victims on board and they're saying in ICU how does that handoff work depends on what the condition is and there's also people that have come from other islands from the previous storms that are maybe there too so if they're a foreign national we would work with the embassy in state department to get them back to their host country Puerto Rico is actually US territory so a lot of it depends on do they have other assets or resources anywhere else or is Puerto Rico ready to take care