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Master Warrant Officer Jean-Sébastien Morin: You’re really shooting for the one hundred percent success rate—but it’s not the case. Good people will die essentially, regardless of what you’re doing.

Captain Adam Orton: Hi! I’m Captain Adam Orton with the Canadian Army Podcast and this episode is going to be about medics. I can’t think of a support trade that’s better represented in TV and the movies than medics. But it’s more than just plugging bullet holes. And to unpack all this is Master Warrant Officer Jean-Sébastien Morin from the Canadian Forces Health Services Group. And we’re talking about medics. Welcome to the podcast.

MWO Morin: Well, thank you.

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Capt Orton: So, I think we might set the tone for this coming out of the gate. Tell us for you, a story or something that represents the ultimate medic experience from some point in your career.

MWO Morin: I think if I had to pick one, for sure it took place overseas, where really, you live and breathe this particular experience where you’re with the troops—you’re attached to a company, you kind of live that almost childhood dream where you see in the movie the medics accompanying the troops. And they’re really there to make sure everybody gets home safe and sound with, I guess, their entirety of their limbs and everything else. I was attached to a hotel company with a 2 RCR Battle Group. And, I think, just walking through this open field and when our first contact happened. We started placing ourselves and doing our thing and responding to the ongoing attack. And that was my first experience where just going around making sure everyone was good was the starting point where you really felt like you’re there—you’re the only resource. This is what you were trained for. You’ve put in a lot of hours through simulation, through training, through different career courses. And now it’s culminating to there, and it almost seems surreal because there’s nothing else out there; there’s no other ambulance parked at the corner of the street to get you out of trouble or come and get your casualties right away. So the adrenaline is going. You’re trying to make sure everybody’s safe and you’re really focused. And it’s impressive how the training and with the repetition and everything you’ve done and how the army has trained you and how you have gone through multiple scenarios to try to do it enough that you can’t even do it wrong anymore. Then you’re ready to go. And you’re always kind of second guessing yourself. But at that point, it’s where the, I guess, the rubber meets the road or the pavements. And that’s where it kind of took off. It was good enough at that time, at that particular time that no one got hurt. It was just mostly people falling off those walls or small mud walls and whatnot and getting stuck in here: “Doc come here.” And then they just probably roll an ankle or something like that. But nothing, I guess, at that moment, people are on the genuine high and they don’t necessarily know if sometimes they’re even hurt. So, that’s really where you felt like you were doing your thing. And so there’s not necessarily a far-fetched scenario that really encompassed everything. But I think that's the closest that I can think of how it represented us as medics.

Capt Orton: Yeah. And it’s interesting also that you’re talking about that sense of—until you’ve been there, you don’t know. And then, even if something serious didn’t happen at that particular time, you come away with a sense that you actually knew what you were doing.
Then it feels good that you’re just like, oh, yeah, we did all this stuff. And I didn’t feel confused or uncertain at any point. It made sense. And now I know I’m ready.

MWO Morin: No, absolutely.

Capt Orton: So, you’re coming out of recruit school. You know, it’s day one; it’s time to become a medic. What does that look like as a brand new soldier heading into this trade?

MWO Morin: I guess the existing model that’s been going on for a while now is essentially after BMQ or Basic Military Qualification, you get out and then you head out to Borden, Ontario where you’re welcome by the Canadian Forces Health Services Training Centre. And at that point you go through, I guess, a phase that’s more focused on the clinical aspects. So you start going over the different areas of clinical care where you learn how to do physical exams, and you go through a series of testing and just the basics of taking a blood pressure for the first time, examining a knee. You kind of go through all the different testing and exams you could be performing on someone and even how to question people. And it’s not something that comes naturally to people. So it’s your first point where you start learning how to interact with patients. And that’s a very important aspect because it'll serve you well later on in your training and in your career.

Once you’ve done all this clinical-focussed training, now you move on to the Primary Care Paramedic Training which, essentially, you travel now to Moncton where there’s the Paramedic Academy where they will train you on paramedicine. So you go through what the civilians will go through. When I did it, it was six months long. It was an accelerated program because you’re there every day; you just focus on the course itself. And essentially, you become a paramedic. And that’s, I guess, a very appealing side for a lot of people and for me, as well, where you do a lot of medicine in a context where it’s urgent. There’s a lot more action. Let’s just say, it’s less deliberate or slow paced in the clinical phase. Once that's done, you pass all the exams, and then you are officially a paramedic. And then you go back to Ontario, to Borden, where you conclude your training with the field portion of your training of your RQ3. So, you’re there and then you do a lot of what the Health Services will be doing in land operations for the most part. It’s impossible to cover everything. As you know that it’s a purple trade, there’s no time or opportunity at that point to make you a master at everything right out the gate. So, the intent is really to make you a soldier where you can now apply all the skills you've acquired in the past months prior to that as a paramedic and as a junior clinical type individual. And you apply them in the fields. So, you go through several scenarios. And then it’s graduation day and posting to your first unit.

Capt Orton: Off you go!

MWO Morin: So, off you go. We do have a large scope of practice which encompasses those two main areas: so the pre-hospital, which you do with your Paramedicine Course, and then the more clinical bedside care and nursing type skill set, which you do in Borden. And then you kind of fuse all of this together. And you become, officially, a Medical Technician.

Capt Orton: Let’s talk a little bit about the piece that comes afterwards. So we’ll focus on the Army aspect because that’s kind of what you’re here for. So you’ve emerged from training and you’re ready to do some business. How do you get streamed in whatever direction—because, I know for example, like my experience with medics, sometimes they’re attached either at a battalion level and then they’re coming out and doing training and exercises in the field. Or they wind up in a clinical setting and they kind of bounce around a little bit. How does that kind of work?

MWO Morin: So, essentially, when you get to your first posting, I think sometimes it’s luck of the draw or faith or there’s a plan. I know that, in the crew managers, I guess everything is taken into account. But as a young private or corporal fresh out of training, you’re just sent. And then for me, it was just you’re going to 5 Field Ambulance, and, okay. I just packed my bags, and off you go. So, when I landed at the 5 Field Ambulance, right off the bat you’re kind of pushed where the needs are. So the brigade and the units kind of look at where they need to distribute their people. It’s almost, again, another luck of the draw of where you end up starting your first gig. And I did, for myself, end up working in a UMS a Unit Medical Station with 5 Service Battalion—which, at first, being an old gunner and knowing that things were unfolding in Afghanistan and business was going to happen and medics and troops were going to be deploying, I was really anticipating being deployed. Although I was Junior, I was being told: “Hey, calm down, you’re still learning and we’ll see.” But I would constantly ask to go. Then again, to come back to where you can potentially go, for me, I went to a clinic. And it was just a short stint. And after I moved to the EVAC Platoon, where a lot of my peers ended up at the Care Delivery Unit, aka the Base Medical Clinic, where they worked and just saw people constantly. So, I guess at that time, the UMS was more of the base hospital type of people and, of course, more of the field type where I really wanted to go and I got my chance to be, I guess, moved to the field area where we focused a lot on training. And, as well, we did a lot of supporting activities where we supported the base unit. So, in the land or Army world and in a general context, this is where medics will go first— where they can be sometimes mentored, coached by more seasoned medics. And then you’re kind of developing your tradecraft from there.

Capt Orton: Yeah. And so, on that subject, people generally have this mental image and you kind of described it like I think it's more at the private-corporal level, is, you know, the soldier that’s like embedded with a platoon or maybe embedded with a company that’s running around and like doing, you know, medical stuff on people that are injured.
But, that’s just a very small slice of the whole medical structure that may exist even in a combat environment, like even on a deployment. So, maybe describe for people who don’t necessarily know, like, a buddy gets injured or maybe like, you know, in combat, something happens. And you got your tactical combat casualty care people that are embedded in the platoons working with the medics, and they’re doing immediate life saving aid. Well, there’s a whole other system behind that to get things moving. What does that look like?

MWO Morin: Initially, in that context, where you’re the senior medical authority on scene. So, and then it’s impossible to be attending to everyone at the same time. So a lot of rehearsing or rehearsal happens prior to that. A lot of work and time has gone in during training to have the members who are TCCC qualified to assist you. So depending on if there’s a lot of wounded soldiers, or there’s just one person the scenario will unfold quite differently. But, what the main focus is, you being, I guess, the leader, where you direct people. And so if you’re still under effective fire or under contact, of course, minimal care will be done. And your peers that are trained as well will know that you do the minimal things, get the people out of trouble, and, as well, win the fire fights. And then, once everything’s said and done, you’ve won that battle. And now you move on to more extensive medical work. So you prioritize everyone, or if you just have a patient, you start working and start assessing, you have help. And people, of course, are covering your six and actually all around you. So they provide security, you’re there you’re playing your skill set and trying to do whatever is required to make that person live—just to survive, essentially, the ride back home or the ride back to a more definitive care centre.

So, at that point, there’s a lot going on in your mind. You’re thinking, what’s my next move? Actually, you have to be two or three steps ahead, keeping situational awareness of what’s going on, looking at what the fellow soldiers are doing to help you as well—even if they’re not doing it right. You’re providing, as well, a lot of updates most of the time for an infantry platoon which I have experience with, and you’re sending reports up.

At that point, you have to think, what’s their exit plan? Because you won’t get the luxury sometimes of having a helicopter just land there. And then sometimes you’re gonna have to haul this individual inside of an armoured vehicle. Or you might be able to reach out and there might be an armoured amb. So there’s quite a bit of things you have to think about. And especially if you anticipate being there for a while. So, getting to more cover, keeping the patients warm, because people that are traumatized tend to cool off quite quickly, and there is lost a lot of blood, and that particular factor is a major contributor to people dying. So, even in the middle of Afghanistan, it’s forty degrees out, but people will start being a lot colder. You have to be very creative sometimes as well. Sometimes the stretcher, there’s an explosion that went off, so where the stretchers were the flash or thermal flash melted all those stretchers. So now, what do you do?

Capt Orton: What do you do?

MWO Morin: I’ve heard of colleagues using very creative ways from ripping a door off a building to using a donkey to move a casualty. So at that point, you need to have a plan. And I think it’s something your qualified experience, and especially back home, when you get posted to the first unit, those are things that you need to develop. Always have a plan. And I would probably end on saying as well as that someone told me one day, and this will sound probably cheesy, and people will remind me once they listen to this. Someone told me once that: “When you decide to become a medic, you decided to become a leader.” And that’s it, because people will turn to you and say: “What’s the plan, doc?”

Capt Orton: Well, like in the context of a deployment—and I think we’re gonna get personal here a little bit—I’ll tell a story of something that happened. And I think it’s probably worth talking about because especially in a combat arms environment—or you know, in an operational environment, bad days happen, and a bad day is a really bad day when something’s happening. And I think a bad day for an Infantry Unit is a bad day. But I think it’s probably even harder—and I like to hear your comments on this— is, for example, on my deployment, one of the platoons got hit, and you know, some guys got killed and it was a really rough—like, you know, it was bad. And at the end of it all, I remember seeing the medic master corporal. He was sitting in the bunker and you know, he was crying. He was really upset because we’d been training together for years. And he was really close to these guys. And he felt like he let the team down because he couldn’t do it all by himself. Right? And so when you’re doing infantry stuff as an example, you’re running around and you’re doing infantry stuff and sometimes you don't feel the responsibility to save people’s lives. But the embedded medic—it’s like everybody's looking at you. You’re talking about being a leader and stuff like that. How do you handle that? Like, what would you say, is a way to deal with that?

MWO Morin: I think there’s a lot of different ways that people deal with those types of situations. And it’s, I guess, an impossible task to be one-hundred percent prepared. Depending on your background and how you were raised and how you were brought up and your life experiences as well can influence that. However, there’s always where you’ve been through some hardship and whatnot and that kind of helps as well. So, there’s bits here in their past experiences, life experiences, and work experiences, where you kind of start putting this together. But nothing prepares you for—for really when things have gone wrong. And you’re always kind of tearing apart every single move, or every single thing you’ve said and done. And really, you’re reliving those moments, and then you’re like: “Oh, maybe I should have done this; maybe I should have done that.” And, I guess our measure of success for medics is always the outcome of what the patient, what happens, and you’re really shooting for the one-hundred percent, I guess, success rate. But it’s not the case. Good people will die essentially, regardless of what you’re doing. And I think you have to start accepting that. And I guess, with your training as well, you kind of understand the mechanics behind that or where people that suffer life threatening injuries, especially in the warfighting environments, there’s people that will not survive that initial injury. And that’s what happens. And for myself, it’s always kind of reflecting. You kind of go through, you beat yourself up. For me talking to other people, and kind of going over a few things always helps to kind of defuse the situation, because you can’t let it become some kind of weight on your shoulders, and you have to move on. And especially at the end of the day, if you’ve done everything in your power to make that person survive or that patient survive, you can, I guess, rest a bit better. So, I guess it’s a different experience for different people. Some people will take it more emotionally, and we’re all humans, and it’s not something you’re just processing and then delete, and then you move on. There’s a lot, I guess, of experience that goes into it. I guess, with time, you kind of build that perception where you’re better at processing those events. And then it’s that less of a defeat when something goes wrong. Some people won’t talk about it as well. And I guess there’s no right or wrong answer into that so everybody kind of processes those events differently.

I remember one of the 2 RCR infanteers I served with. And, at some point he turned around during the tour and he said: “Hey, Doc, how are you doing? You’re always asking how we’re doing, and I feel like we haven’t been like, really up to par on this—Yeah, so how are you doing?” And it was kind of the middle of the tour, and I was like: “Well, do you have a few hours?” To let me know, to get off my chest. Yeah. And I guess there’s no perfect answer to how the process days have gone not so well. But everybody kind of, like in life, kind of processes things differently.

Capt Orton: I like, also, that, you know, you said it twice already and it makes me laugh every time like I think of you know my time and it’s just like, you know: “Doc.” You’re calling the medics Doc. And they’re like, yeah, we’re not doctors—we’re medics, and it’s like: “No, no, you’re Doc” and everybody loves the Doc. You know, that’s the old joke is don’t make your cooks or your medic angry. It’s like that close relationship with that as a team. What are your thoughts on that?

MWO Morin: I think we’ve been called several different names through history, I guess. Having different jobs and kind of evolving through the ages. But I think this one, Doc, always is very movie-like, but I guess it’s something that people will actually use. And I guess it’s a lot easier to say than: “Hey, medical technician or medic, come here.” However, I did remind people as well, like, you know, I’m not a full blown medical doctor; I don't have a doctorate in medicine. But I guess you’re that maternal or paternal figure. And typically, it’s just using the Army environment word—the field, deployed areas, or when you run into some old friends as well, which you deployed with. They’ll call your Doc’ still. Yeah, or even like Doc that and last name, but it’s really an affectionate name.

Capt Orton : Yeah. Can you explain a quick difference between, like—you know, in one minute or less—the difference between med techs and medical assistants? Because I think that’s important.

MWO Morin: So for med techs, in general, are Regular Force individuals. They’ve gone through the training I’ve talked about before. Med aides or medical assistants are Primary Reserve counterparts where they do have a smaller scope of practice, given the fact that they don’t go through the exact same training. They can, which, eventually, if they do all the Reg Force training, people adopt the medtech nomenclature. However, for now, I guess to make a very easy delineation is that the med aides will have a smaller scope. They still support exercises and different operations. So they do have a bit of a different skill set, but still serve a very good purpose. But I think we want to refine that and actually maybe just kind of make it just the one skill set in the future. But that’s more to come on that. But the differences where they’re employed and how much they can do.

Capt Adam Orton: So, we talked a lot about, you know, the medics, but you have a very specific role. Talk to us a little bit about your role, and kind of like what the future of the medical trade holds right now. It’s a big question I know.

MWO Morin: Yeah. In the last few months, I’ve been added to the team that's located under the Director of Personnel Generation Requirements. That particular directorate looks after military employment structure. So, essentially, in a nutshell, we’re conducting a study and looking at how we can make the med tech trade and the medical system trade better. We’re talking full-scale review and study through a very deliberate process. We want to ensure that the medics do have all the tools, the abilities, and, I guess, even to kind of set that culture— even the personality or kind of having really, everything kind of fall into line that you get the best version of that person that day that will have to deal with a casualty. So you can’t just stay idle and warfare is advancing. There’s new things every day and nevermind what COVID did to the entire world. And as well, it’s no longer like symmetrical warfare. And I guess this is fear for me that they come irrelevant. I want to keep the medics on the battlefield, relevant and a lot more effective. So the more effort you pour in producing the best medic, the better the chances of success.

Capt Orton: So, why did you become a medic?

MWO Morin: Back in, I guess that was in 2002, I was a Reserve Artillery Gunner. And I was going to school in college or a CÉGEP and learning about politics, anthropology, and sociology, thinking I was going to change the world. And I guess it’s just when you’re young, and then you’re kind of gullible or you’re looking at like: “I'm going to make a difference,” and whatnot. And I guess, fate or destiny struck, and my buddy was knocking on the door and said: “Hey, J-S, do you want to go to Bosnia?” And I said: “Sure, let's do it.” So, I paused school and went to Bosnia. And that’s where, I guess this entire experience kind of transformed me and really gave me that realization of I wasn’t going to change the world
anytime soon. But I could definitely make a difference in someone’s life—one person at a time. And I think, looking at what the medics were doing, and they were with us and the appeal of them always learning new skill sets or just new knowledge. Because medicine is constantly evolving, and that was very appealing to me. It wouldn’t be something that you just learned and it just stays like that. That kind of culminated into me putting my paperwork for occupational transfer to medic while I was still serving in Bosnia. And really, I think it started from there. I would say that as being a gunner, and you’re like: “Oh, no, I don’t want to do too much of this field or living in trenches,” or whatever. But like the hardship or some kind of silly, silly thought like that. And you’re like: “Like, the medics have it good. Look at them, they have chairs, they have an ambulance.” And little I knew, it was actually, I think, I’ve done more Army-centric and gone through a lot more hardship being as a medic. But at the time, I was like: “You know, what? It seems like a pretty good deal.” And, from there, I knew this was the gig I’d be doing probably for us in my life.

Capt Adam Orton: And, and then you did.

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MWO Morin: Yeah, and here I am!

Capt Adam Orton: Well, hey, thanks so much for taking the time to, you know, unpack all this for us and explain what it all looks like. I really appreciate it. Thanks for coming on the podcast.

MWO Morin: Yo’'re welcome.

Capt Adam Orton: That was Master Warrant Officer Jean-Sébastien Morin from Canadian Forces Health Services Group. If you want to talk about something or have an idea for a show, shoot us an email, the email is in the show notes.

As usual, I’m Captain Adam Orton. Orton out.

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