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Rear Adm. Timberlake: No. It is up to the COCOM, the combatantcommanders, and their planning staff to determine what themissions are going to be and what forces they are going to require.However our staff is involved in the training that supportsthese missions.The Joint Medical Planner’s Course is sponsored by the JointStaff and is targeted for personnel going to a job as a medicalplanner. The Joint Operational Medical Managers Course, sponsoredby the Defense Medical Readiness Training Institute, andthe annual Joint Task Force Senior Medical Leader Seminar (JTFSMLS), sponsored by USJFCOM, are geared towards medical departmentofficers in the ranks of 06s and senior 05s.The services nominate their attendees with the expectationthat the attendees will be in leadership roles, preferably as ajoint task force surgeon or a COCOM surgeon.Currently, there are no medical personnel in the billet structureof USJFCOM’s Standing Joint Force Headquarters element.So they contacted us and I assigned one of my medical plannersto them for this mission. Cmdr. Michele Hancock went over toCJTF HOA for five months, serving as the medical subject matterexpert in the J5 shop helping with planning future medicalmissions.We are now working with U.S. Africa Command (AFRICOM) tohelp their surgeon set up his cell and identify what his tasks androles should be. We are also helping in some of USJFCOM’s J9experiments. For example, USJFCOM has an experiment calledHealthy Africa Scenario Exercise where we are working withWest African nations (both military and civilian components),AFRICOM and U.S. European Command, U.S. government agencies,NGOs (nongovernmental organizations) and IOs (interagencyorganizations) to decide how we can leverage medicalcapability as a tool to reduce future conflict in African nations.CHIPS: What does medical experimentation entail?Rear Adm. Timberlake: We take many concepts, ideas and getpeople together, like we are doing in West Africa, under the leadof J9, to identify problems and potential answers. We have someplay in the Noble Resolve and Urban Resolve experiments, aswell as Multinational Experiment 4 and 5.Our office works with [JFCOM's] Joint Warfighting Center(JWFC), who is responsible for the Unified Endeavor mission rehearsalexercises that train personnel to assume missions in JTFheadquarters in the USCENTCOM area of responsibility.Additionally, they conduct COCOM Priority 1 and 2 Exercises.One of our staff is assigned to the JWFC full time to be my medicalrepresentative. We were involved with Second Fleet’s certificationas a JTF and some of our reservists came in and playedthe roles of members of the medical cell as if they were part ofthe JTF.CHIPS: Is that part of their certification to be a JTF?Rear Adm. Timberlake: Yes, they have to prove that they canwork in that joint environment. They have to coordinate all theservice elements assigned to them.We have also been involved with USJFCOM’s Standing JointForce Headquarters’ response for assistance at CDAC-PAK (CombinedDisaster Assistance Center Pakistan), our military responseRear Adm. Gregory Timberlake (seated) with staff members, Air Force Lt. Col.Debra Timm, Army Maj. Patrick Lukes, Navy Capt. Tammy Nathan and Army Col.Sandra Evans in the admiral’s office at USJFCOM headquarters in Norfolk, Va.to the Pakistan earthquake. Also, when they set up JTF-Lebanon,they asked again for medical planning expertise.CHIPS: How do you determine the kinds of medical support neededfor a relief effort?Rear Adm. Timberlake: If the COCOM does not have organicservice elements that can respond, then through the requestfor forces process, a request would come to USJFCOM, and wewould work with the services to identify who has got the capability,for example, a CSH, an air transportable hospital, to meetthe mission requirement.With the COCOM, a set of parameters would be determinedfor the specific mission. This requires discussion with my planningstaff. Maybe we need obstetricians, pediatricians or familypractitioners because there are going to be a lot of pregnantwomen in need of medical attention, and surgeons would havea reduced footprint.The timeline in a relief effort is also important. Medical needswill change as the situation on the ground changes. We havebeen proactive in influencing the commanders to take a seniormedical planner because the planner will have an idea of thisdynamic timeline. The medical planner will also be able to interfacewith the locals, the IOs and the NGOs to be sure that duplicationis minimized.CHIPS: Is the civilian medical community looking at what’s beendone in military medicine for wider application?Rear Adm. Timberlake: As with all conflicts, lessons learned inmilitary medicine find their way into civilian practice. In Vietnama lung problem was described initially out of Da Nang. It wascalled 'Da Nang lung,' and now it is called post-traumatic pulmonaryinsufficiency or adult respiratory distress syndrome.The current conflict has allowed us to begin to explore theplatinum 10 minutes and work on training and education thatwill transfer into the civilian community as it matures.CHIPS October – December 2008 13