ANNOTATED GLOSSARY as it appears in Doctor in Blue

Selected words and phrases

from a Cold War military medical career

by Martin I. Victor, M.D

APGAR SCORE: A rating system to quickly assess the health of babies at the time of birth, named after its inventor anesthesiologist Dr. Virginia Apgar. Babies are rated at one minute after birth, and again four minutes later, based on Appearance, Pulse, Grimace, Activity, and Respiration. While ten is the theoretical perfect score, most completely healthy babies receive nines. Dr. Apgar introduced her scoring system in New York City in 1953. It caught on quickly, and was well known by the time I entered medical school in 1958. It is still widely used today to expedite the identification of newborn babies needing urgent medical intervention.

BERRY PLAN: Physicians had been drafted into the U.S. military since World War II, and historically could be forced to postpone whatever medical training they were in if called to serve. Frank Berry, M.D., an Assistant Secretary of Defense from 1954 until 1963, came up with a way to try and balance the competing needs of the civilian medical community and the military as to drafted physicians. His plan, named after him because it was his idea, was to give drafted U.S. trained physicians an option. Beginning in the mid-1950’s, drafted physicians who were planning to enter residencies could apply to defer entry into the military until they completed their residency training. Even if their Berry Plan applications were approved, the government could still pull draftees out of a residency if there was an urgent need for their services. During the 1960’s and early 1970’s, many young U.S. trained physicians who were drafted took advantage of this option and most, but by no means all, were able to complete their residencies before serving in the military. The end of the draft in the mid-1970’s also meant the end of the Berry Plan, although by that time the Air Force had begun a scholarship-for-commitment program for medical school students and residents.

BX: Base Exchange: The equivalent of a department store, selling everything from clothes and shoes (civilian for all ages, as well as military uniforms and accessories) to electronic equipment to sheets and towels, furniture, sports equipment, and children’s toys and gear, usually at discounts compared to civilian shops. These stores are called BX on Air Force and Navy bases and PX (Post Exchange) on Army bases. Their selection varies with the size of the population they serve, which includes retirees and reservists as well as active duty military.

COMMISSARY: The equivalent of a modern grocery store – selling all manner of fresh and packaged food, sundries, and household cleaning supplies on or near military bases. Like the BX, prices are normally lower than in civilian stores, and retirees, reservists, and active duty military may all use any Commissary.

DINING IN & DINING OUT: Military social functions, usually held in the evening. The ‘dining in’ was an old tradition started at least several centuries ago, and imported to the U.S. from England. It was attended only by active duty personnel and often became a raucous affair. The ‘dining out’ originated in the United States, includes the spouses of active duty members, and is much more sedate than the ‘dining in.’ Both typically feature one or more invited guest speakers and lots of toasts.

IVP: Intravenous Pyelogram: A way to visualize the urinary tract on x-ray, aided by dye injected into the patient’s vein. The IVP has since been largely replaced by other, newer, tests.

PCS: Permanent Change of Station. An official military transfer from one home base to another, as opposed to TDY which is temporary and does not change one’s home base. I had thirteen PCS moves in my thirty-year military career.

RAM: Resident in Aerospace Medicine. While a Resident in Aerospace Medicine officially becomes a RAM on his or her first day of the first year of the residency, most of us did not identify ourselves or each other as RAM’s until after we had begun the Master’s Degree in Public Health. Then, as now, it is a three year program (after medical school and internship), but the specific course requirements have changed. Also, as a prerequisite to the current Air Force RAM program, the physician must have a minimum of two full years experience as a flight surgeon before he or she can be considered for the residency.

ROTC: Reserve Officer Training Corps. When I attended college in the mid 1950’s, MIT, along with many other schools, required all male students to take some military training for two of their four years. This typically amounted to about eight hours a week of a combination of classroom instruction and learning how to march. At the time I enrolled at MIT, one could choose between Army and Air Force ROTC. (Naval ROTC wasn’t available at MIT until 1957.) MIT had a long tradition of military training going back to the 1860’s. The Massachusetts legislature had required the school to offer instruction in military science in return for having been given land, and formal ROTC had begun there by 1917. Around the time I graduated, MIT made Officer Training voluntary instead of compulsory, but ROTC was never abolished at MIT, even at the height of the anti-Vietnam-war protests and even as (by the early 1970’s) some Boston schools completely outlawed ROTC on their campuses. By the mid-1970’s, however, almost all colleges and universities which had outlawed ROTC had re-started their on-campus programs.

TDY: Temporary Duty. Trips, lasting anywhere from one overnight to just under a year, that are for military/work purposes but from which one expects to return to a home base, as opposed to a PCS transfer where one’s home base changes. On occasion, people went TDY en route during a PCS move, but the TDY itself did not change their home base. I would estimate I had well over a hundred TDY trips during my thirty years’ active duty in the Air Force. Military personnel receive additional pay while on TDY assignments to help compensate for out of pocket costs of being away from home. TDY written orders specify exactly where one may go, and any deviation from that order is not generally a career-advancing move. See page 64 of Doctor in Blue for an example of how strictly TDY orders are interpreted, and what happened when I misinterpreted one set of my own TDY orders and exceeded its limits while in Viet Nam.