How do doctors perceive life

"I carry my gun to protect my life or the life of my patients"

In addition to the Hippocratic oath, medical officers of the Bundeswehr swear with their oath to serve the Federal Republic of Germany faithfully. How does this affect the self-image of the “doctors in uniform”? How does your daily medical routine differ from that of your colleagues in civil practices and hospitals? And how is “service at the weapon” compatible with the medical ethos? These are the questions asked by the Rheinisches Ärzteblatt Senior Medical Officer Hendrik Meendermann from the Cologne-Wahn medical supply center.

RÄ: There are two titles in your rank: staff officer and doctor. Which of the two do you identify with more?
Meendermann: I am an officer and a doctor and it is difficult to separate them. I try to reconcile the two. My patient is my patient with his worries, fears, needs and illnesses - whether he is a private or a general does not matter. In my daily work as a troop doctor, I am primarily a doctor. In addition to caring for my patients, I also have official duties as a supervisor.

RÄ: Why did you decide to study medicine with the armed forces?
Meendermann: When I realized that I wanted to study medicine, I looked around to see where my grade point average could do that. Since I originally wanted to become a trauma surgeon, the Bundeswehr was an obvious choice for me. In a three-day assessment center, the Bundeswehr first checks the suitability to become an officer. This is followed by a selection interview. In addition to the NC, the applicant's character suitability, motivation and experience also play a role here. In my opinion, prospective soldiers are very motivated to study medicine. You have already dealt intensively with the profession. They want to be doctors.

"Every medical officer is deployed in the field of general medicine."

RÄ: How are medical studies and specialist training in the armed forces organized?
Meendermann: We're studying medicine at a civil university. Before that, we have a three-month basic training. One advantage of studying with the German Armed Forces is that we already receive training money as officer candidates. We have support officers who make sure everything goes according to plan. If you have any problems, you are our point of contact and the liaison between studies and the office.

We complete the first two years of further training in the Bundeswehr hospital. Afterwards, every medical officer is assigned to the general medical field, regardless of his or her specialist training, just like I am now as a troop doctor in the company. Then it's back to the hospital. I will probably continue my training as a specialist in anesthesia at the Bundeswehr Central Hospital in Koblenz. For some wards I will also go to a civil hospital.

RÄ: You are a troop doctor. Translated, this means that you are the soldiers' family doctor. How does your medical activity differ from that of a resident doctor?
Meendermann: The so-called "new sick registration time" is between seven and nine o'clock. This means that all soldiers who feel acutely ill and unfit for duty report to us here. Then the appointment consultation begins. Here we differ little from a civilian general practitioner. A lot of things simply mean differently: We don't issue AU, but our comrades are “kzH”, meaning sick at home. We are seven troop doctors here in Cologne-Wahn. We are supported by medical assistants and trainees.

Unlike a civilian general practitioner, we as military doctors always see our comrades before a specialist consultation. In the vast majority of cases, we then refer to specialists in the Bundeswehr. Only when this is not possible, for example because there are no specialists in gynecology nearby, do we fall back on civilian doctors.

RÄ: What are the advantages or disadvantages of working as a doctor in the armed forces?
Meendermann: In addition to my normal medical work, as a doctor in the armed forces, I get insights into areas that are closed to civilian colleagues. For example, I can be used as a firing doctor at the military training area or as a doctor at the paratrooper dropping point. In my opinion, the Bundeswehr is very generous with basic, advanced and advanced training. Most of the medical officers are trained as emergency doctors.

At the same time, as a doctor in the armed forces, you are also a recipient of orders. I am deployed where there is a need. That demands a lot of flexibility. It takes time to understand the extent of what this flexibility means.

"A safety anchor for the comrades"

RÄ: How do you see your role as a doctor on missions abroad?
Meendermann: As a doctor, I can go on foreign assignments in various functions. For example, I can accompany the soldiers as a family doctor on the mission. There, too, the comrades have a cough, runny nose or back pain. As in Germany, my job is to take care of the patients. Medical officers report that they are even more of a kind of safety anchor for comrades on missions abroad. It is nice for them to have someone around whom they can turn to.

RÄ: Although the Bundeswehr describes the medical service as an “unarmed service”, soldiers in the medical service also carry weapons and, according to the Bundeswehr's job description, can use them. The professional code of conduct for doctors in North Rhine-Westphalia says: “The task of a doctor is to preserve life.” How do you combine these two professional profiles?
Meendermann: International law says we are so-called "non combatants". That means we don't attack, we defend. I carry my weapon abroad for two reasons: to protect my life or that of my patients. When I am deployed abroad, I have a special duty of care towards my patients. As a doctor whose job it is to save life, I have few ethical and moral concerns about carrying a weapon. I will save my comrade's life and my own. If I have to use gun violence to do this, because I am met with gun violence, I think that's bad. But I can't change it.

It took time to realize what it means to be a doctor and a soldier at the same time. We discuss such ethical issues, for example, at courses and can exchange our concerns with comrades here.

RÄ: In your opinion, does the doctor-patient relationship in the military sector differ from a doctor-patient relationship in civilian life?
Meendermann: As a doctor in the Bundeswehr, we have two hats on: We are practitioners and assessors. I have an official interest in my comrades recovering quickly. When I put someone on sick leave, I find myself in a conflict. On the one hand, I have to ask myself whether the comrade is fit for duty and could relieve the comrades of work. On the other hand, I have to protect my patient.

The trust in us as a medical service is extremely high. I have the feeling that in patients' lives we are confidants on medical and non-medical issues. The advantage for our patients is, of course, that we know the troops. The comrade does not have to explain what a colonel is, for example.

The interview was conducted by Jocelyne Naujoks.