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Physician assistant helps to put New York Guard Soldiers first

By Col. Richard Goldenberg | New York National Guard | Oct. 10, 2018

WATERVLIET ARSENAL, N.Y. – For New York Army National Guard Physician Assistant Maj. Stephen Carson, service to his community was part of his life before graduating high school.

Now, 12 years after volunteering to serve in the New York National Guard's Medical Command, his service extends to his Soldiers, communities across New York State and the Army's overseas contingencies.

Carson, with two overseas deployments, one in Afghanistan in 2009-10 and then to Kuwait in 2013-14, is one of 30 Physician Assistants authorized to New York Army National Guard units.

The week of Oct. 6-12 marks the nation's Physician Assistants (PA) Week, focusing on the contributions of the PA profession to the nation's health.

For Carson, those contributions are an everyday occurrence and help the Army Guard maintain individual Soldier readiness, according to Lt. Col. Luis Garcia, the New York Army National Guard's deputy state surgeon.

"PA's play a key role in the medical readiness of the New York Army National Guard," Garcia said ."PA's are assigned in battalions and above across the command."

"I primarily assist Soldiers in maintaining their medical readiness," Carson said."This ranges from interviews during Periodic Health Assessments to reviewing labs and electrocardiograms (EKGs). I also conduct Physical exams both for accessions and Aviation personnel."

The Army's employment of PAs was ideally suited to Carson and his vision as a PA in uniform.

Approximately half of the PA assignments in the New York National Guard are within battalion formations, Garcia said.

"The Army loves PAs," Carson said."I know of no other environment where a Physician Assistant enjoys such latitude in practice or respect by colleagues. The Army utilizes PAs like physicians and it extends the Army Medical Department's ability to provide excellent care to Soldiers."

What Carson liked most in his assignments was serving alongside junior Soldiers.

"Typically PAs are the first-line provider that Soldiers interact with and as they are assigned at battalion level, they have the ability to influence Soldiers every drill," he said.

Before joining the Army National Guard, Carson had extensive experience in public safety but wanted more.

"I spent many years prior to Physician Assistant school working in Emergency Medical Services (EMS) as a paramedic and continued to do so after graduating," Carson said."I practiced as a PA in Emergency Medicine and as a member of a Federal Emergency Management Agency (FEMA response) team and deployed to multiple disasters and special security events."

With all these commitments, Carson knew he could do more, he said.

"As corny as it sounds to many outside of (our) military families, I'm a patriot and the sense of obligation to serve my country never lessened," Carson said."So ultimately I knew I had to join if I could."

His familiarity with disaster response at FEMA helped shape his decision for which military service to seek out. Carson wanted to continue serving communities at home, and the National Guard was, for him, the premiere force for defending the homeland, he said.

"During my FEMA days, prior to the Guard, one of my responses was to New Orleans for Hurricane Katrina. At the time I met an active duty PA from the 82nd Airborne Division who brought one of his Soldiers to our aid station," Carson said."This event was a key to triggering my seeking to join the Guard."

"I chose the Guard as I truly feel that the Minuteman tradition - the civilian that sets aside their other responsibilities at a moment's notice when their fellow citizens are in need- is one of the noblest creations of the American "experiment." I am very proud to be a part of that legacy."

"I actually recruited myself," Carson joked."As a civilian, it took a great deal of effort at the time to find information on Guard Medical recruitment."

As a qualified PA with an undergraduate degree from the State University of New York at Oneonta, Physician Assistant training from the Albany Medical College and a graduate degree with specialization in Emergency Medicine from the University of Nebraska Medical Center, Carson was able to secure a direct commission in 2006.

Carson said he sees his role as helping Soldiers, building medical fitness, readiness and confidence in accomplishing the mission with the medical support to prepare for any eventuality.

Carson serves not only as the first medical provider that Soldiers see, but as the commander's medical advisor, Garcia said. Their unique qualifications bring added capability to the Army National Guard's medical services.

"Due to a PA's education and training, they play a key role in preventive medicine, trauma care, surgical care, health maintenance and behavioral health," Garcia said.

"One of the greatest parts of being a medical provider in the Army is the unique relationship you have with Soldiers," Carson said."You of course have their respect given your rank, but more important is the bond of trust that comes from knowing you are there solely for the purpose of supporting them in the completion of their mission."

Service in the New York Army National Guard has also helped make him a better medical provider, he said, even beyond his emergency medicine, disaster response or EMT duties.

"My Army service has exposed me to situations and conditions that I would never have experienced in the civilian world," Carson explained.

"Those experiences have given me a collection of responses to challenges that would likely have caused me significant distress without the resilience gained from my service."

Carson went on to deploy within New York State between overseas contingency missions, first in Buffalo for the snow emergency in 2007 and again in the Capital Region of New York for the severe flooding from Hurricane Irene in 2011.

Carson served as a battalion PA for engineers providing support to local first responders, providing medical care to Soldiers while providing liaison and interaction with public health personnel for their relief efforts.

His service as a medical provider both overseas and during civil support operations has also made him a better Soldier, he said.

"As an Army Medical provider you witness firsthand how the lack of attention to medical readiness and preventive medicine can impact the outcome of missions. This understanding inspires me to pay closer attention to those factors."

Ultimately, Carson said that it comes down to helping Soldiers get medically ready to deploy and providing them with responsive care no matter the mission, the location or the circumstances.

"I'm not sure exactly how Soldiers see me," Carson said."Maybe as some sort of mystical creature that with a wave of my pen makes their Medical Readiness Code 4 (signifying non-deployable) go away?"

And serving Soldiers is the most important of his job, he said.

"In an age of a World where seemingly a "what's in it for me" prevails, I get to help those people that not only didn't ask what was in it for them, but offered everything they had for others."

"They know that when they need medical care, it is right there when and where they need it," Carson said, highlighting his deployed medical care experience."You are not some abstract concept across town in a hospital, but in the tent next to them. Standing in the rain with them. It's an awesome responsibility."

Carson lives with his wife Jodi in New York's Catskill Mountains in the town of Andes, not far from the region he served taking care of Soldiers following the flooding after Hurricane Irene.

"For me, the best part of being a PA in uniform is the honor of knowing that my job is, (in the words of former Army Gen. Maxwell Thurman) "to provide world class combat casualty care to America's most precious resource - It's sons and daughters - in Peace and War!""