Macklin Symposium: Autism and HADR

RADM Martin Macklin

This past week, I've been able to attend Naval Medical Center Portsmouth's Macklin Lecture Symposium. The Macklin Symposium is named after RADM Martin Macklin who was the Commanding Officer of Naval Medical Center Portsmouth in the 1960's. It's a yearly conference addressing medical topics, trends, and technologies relevant to the military. The symposium has gone on every year since 1966 with what appears to be one topic each year. This year, however, there were two topics - Autism and the Military Child and Humanitarian Assistance. Both topics were relevant and fascinating.

We need more

The two days of autism were perhaps the most interesting but likely less related to the brand new nurse. It seems that the specific techniques we discussed are gears to parents of children with autism spectrum disorders (ASD) and providers who work exclusively with that population. Everything about it was eye-opening though. I learned that the prevalence of ASD is much higher than it was in the 1980's. Today, the prevalence is roughly 1 out of 100 where it used to be 1 out of 150. Part of the reason for this is the change in the criteria for diagnosis. It used to be that you had to have all six of the defining criteria to be diagnosed. In the DSM IV, one must have six of twelve. Having more criteria to choose from essentially makes it easier to diagnose thus increasing the prevalence. Also, out of a mindset of helping the child and having military insurance, it's very easy for military medical professionals to diagnose autism simply because the resources are there.

For military families with autistic children, the stress is magnified by constant deployments, varying daily schedules, inconsistent school environments, and moving to new locations every few years. I can't imagine the stresses these families are faced with, and it was extremely eye-opening to hear their stories during the discussion panels.

The last two days of the symposium were focused on Humanitarian Assistance and Disaster Response (HADR). There were some very high ranking people from Washington there to discuss disasters like Haiti, Hurricane Katrina, and the tsunami in Japan.

USNS Comfort

One of the major topics regarding the humanitarian aid was the hospital ship. Disaster response usually called for our haze gray Navy ships to get someone rapidly. Sometimes, those same ships will be used for humanitarian reasons. They have fully functioning hospitals built into them, so why not make used of them to help other countries if we can get them there quickly? But something I've never thought of is the perception of seeing a huge US Navy fighting ship pull up with its massive guns pointed at the country in need. It causes some confusion as to why we're their. But when countries see the clean, calming look of the USNS Comfort and the USNS Mercy, both weaponless vessels bearing huge red crosses on both sides, it sends a definite message that we're here to help. Or does it?

The hospital ships definitely send a comforting message that we're here to help more so than the haze gray ships, but an interesting was brought up during the conference. What happens to the countries after we leave, and what goes through their minds? What are the real reasons these strangers came from so far away to help us? Why doesn't our government take care of us the way that America takes care of it's own country during its disasters? How do we transition from them taking care of us after this disasters to us taking care of ourselves? These were all tough topics with no definite answers, but what I took away from it is that it's not over once we go in, help as best we can, and then leave. These situations last for a long time.

One team, one fight.

We also learned about the potential creation of a new "warfare device" specifically for people trained in HADR. But the cool thing about it is that it would somewhat transcend services. Members of the Navy Army, and Air Force would all be trained the same way in a basic curriculum for HADR. From that basically trained pool of people, one would be pulled based on their specialty. This would eliminate the current selection process of, "We need bodies and you're on the list. Go home and pack and report to the ship." It would make the use of people's specialties more beneficial to the mission and it would also increase the amount of people in the pool since there would be three services involved. The Navy, Army, and Air Force all have their strengths and weaknesses when it comes to deploying. Combining the medical services of all three would allow us to bring the best of what each service has to offer to the mission. I liked this concept and hope that it comes to fruition during my time. I also hope that it spreads to other aspects of the different branches so that overall, we can be a more unified team.