Author Topic: Injured recruits misdiagnosed then dropped by military  (Read 35403 times)

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Offline Greymatters

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Re: Injured recruits misdiagnosed then dropped by military
« Reply #75 on: February 14, 2008, 17:20:52 »
What caught my eye is that twenty-five percent do not successfully complete recruit training.  It has spawned more questions for me and which hopefully should also be of concern to the CF. 
Is that 25% failure rate historically consistent with 2, 5, 10, 20 years ago.?
Has the failure rate increased or decreased since the cessation of EXPRES testing during the recuiting process? 
What percentage of failures are due:
 - Medical reasons (breakdown by Musculo-skeletal injuries vice other medical causes)
 - Disciplinary problems or inability to adapt to military life
 - PO failures
 - On request
What percentage of recruits who had been given medical restrictions complete basic training with their original serial or what is the average timeframe for completion with another serial?
Are there clinical practice guidelines (protocols) that the medical authorities use for screening and treatment of recruits?  If so, have these been validated and are they reviewed on a regular basis by the doctors/PAs who may use them? 

My memory of those times is distant, but I think I would have remembered if 25% of my course, or any other paralllel course at the time, had a 25% failure rate... and clarifying why they are failing/releasing/getting hurt at so high a level would answer a lot of questions...

Offline Wookilar

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Re: Injured recruits misdiagnosed then dropped by military
« Reply #76 on: February 14, 2008, 17:46:38 »
My concern with all of this comes straight from personal experience while at CFLRS on BOTP. I injured myself (not intentionally mind you  :P) while out in Farnham. It was an obvious incident, very visible, everyone saw me crumple into a little pile on the ground (I thought I would bounce more  ;D). My staff were excellent, got me on the truck, went to see the medic, excellent again, put me in the van back to St.Jean.

The Dr's there (2 of them, civy's) were freaking deplorable. In 13 years in, I've seen a few crazy things in MIR's, but these two clowns took the cake. I also  had "a sprain." They took x-rays, looked at them, sent me to the shacks for the night. I went back the next morning because of the pain, they were not listening to me at all. Between the x-ray tech and the MCpl there, I finally got sent down town to the hospital with the same x-rays in hand. 12 hours later I'm in surgery getting 4 screws put in my leg to fix 3 breaks. How did they miss that and call it a sprain?

There is a possibility here that we may have a larger problem here than out-of-shape recruits, and it comes down to whether some of the support people we have hired really give a darn about us or just the fact that it's almost 4 pm and it's time for them to book off. At CFLRS, I never had one problem with any of the medical staff in uniform and I never had a good experience with any civilian med staff. That's just me of course, but I wonder if ti was the same civy Dr's that looked at the recruit that looked at me.

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Offline Bigrex

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Re: Injured recruits misdiagnosed then dropped by military
« Reply #77 on: February 14, 2008, 18:19:38 »
well the only real negative experience I've had with any uniformed med techs was in 97, after breaking a finger playing basketball in Norfolk VA. The staff down there placed the finger in traction and casted it with the pinky extended, but after getting back to Halifax they cut the cast off and put it in a removable splint in a position of function (bent, holding onto a roll of gause) and after a few days i told a Sgt that I had to go see for a recheck that it looked like the finger was shorter, And he said it was due to the swelling, and when i pressed it, he looked at me and "oh really, and where did you get your medical degree?", it was my frikin finger! But i was vindicated because the next time I saw him he apologized because x-rays showed that the bone had splintered and was floating around, and the actual finger was now 4mm shorter due to losing that bone. I realize these guys are trained and all, but they are still human, and they need to learn that we know our own bodies better than they know physiology, so when we point out something that is wrong, they shouldn't brush it off because it may not be a symptom of what has been diagnosed but it could be from some underlying condition that was previously missed.

Offline TCBF

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Re: Injured recruits misdiagnosed then dropped by military
« Reply #78 on: February 14, 2008, 19:15:50 »
... What caught my eye is that twenty-five percent do not successfully complete recruit training.  It has spawned more questions for me and which hopefully should also be of concern to the CF. 
Is that 25% failure rate historically consistent with 2, 5, 10, 20 years ago.?
Has the failure rate increased or decreased since the cessation of EXPRES testing during the recuiting process? 
What percentage of failures are due:
 - Medical reasons (breakdown by Musculo-skeletal injuries vice other medical causes)
 - Disciplinary problems or inability to adapt to military life
 - PO failures
 - On request
What percentage of recruits who had been given medical restrictions complete basic training with their original serial or what is the average timeframe for completion with another serial?
Are there clinical practice guidelines (protocols) that the medical authorities use for screening and treatment of recruits?  If so, have these been validated and are they reviewed on a regular basis by the doctors/PAs who may use them?

- I was a recruit platoon instructor in Cornwallis, and put through a little over 500 recruits there.  Wastage occurred for the fol reasons:
1.  Shoddy medicals not catching previously existing medical conditions (metal bracket holding spine together, etc.).
2.  Injuries during training - many recruits had never worn real leather footwear (or even shoes with laces before) and ten weeks was too quick to bring them up to the level of fitness without hurting their knees.
3. Failure to adapt to military life for psycho-social reasons - shoddy CFRC procedures (stop sending me "3"s!!).
All in all, the final success rate was about 85%, but that included pers gradding after three re-courses.  Obviously, the platoon succes rate was somewhat lower.

I then had the pleasure of teaching recruits at St-Jean.  Wastage occurred for the fol reasons:
1. Shoddy medicals not catching pre-existing medical issues.
2. Injuries during training.  An even less active generation now had only 80% of the time to get up to physical standard - with predictable results.
3.  Failure to adapt to military life.  This ratio was much higher in St-Jean.  My first platoon, I developed Cornwallis style, which was 'give the slow ones a chance to catch up if you can'.  When the RSM saw a frontage of twenty (a platoon of 58, if I recall) on the Sixth Week Drill Test he was shocked. "You have too many people!" he said.  It appears that the climate of command there merited their instructors on the perfection of the final product, not the overall success of the platoon.  Remember, on an eight week course, you had to have started to assess your recruits on Week One and have started to have failed those you perceived as discards on Week Two, or you would never be rid of them by Week Six and they would sewer your 6th Week Drill Test (and your PER).

You can imagine what happened next:  Platoons would commence with sixty and grad 28 to 36, sometimes INCLUDING recourses in.  A sixty man platoon might cycle through 84 people and grad 46.

A very expensive, inefficient and wasteful way to do business.

My suggestions: 
1. Enrol as "full time part-time" on a six month contract. sort of like the RCMP do.
2. Immediately release previously existing medical conditions that were not picked up on the initial Part 2. Release authority to be the Recruit School, NOT Ottawa.
3. MMPI 2 EVERY recruit - no excuse not to.
4. Anyone who has not passed BRT after six months for any reason does not get to sign a regular contract. Release on new release item: "Not Economically Trainable."
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Re: Injured recruits misdiagnosed then dropped by military
« Reply #79 on: February 14, 2008, 20:54:45 »
My suggestions: 
1. Enrol as "full time part-time" on a six month contract. sort of like the RCMP do.
2. Immediately release previously existing medical conditions that were not picked up on the initial Part 2. Release authority to be the Recruit School, NOT Ottawa.
3. MMPI 2 EVERY recruit - no excuse not to.
4. Anyone who has not passed BRT after six months for any reason does not get to sign a regular contract. Release on new release item: "Not Economically Trainable."

Good ideas all around. My comments on each item:

1. Can be achieved by enrolling them on an FPS of six months. Upon graduation, TOS are converted to BE/VIE/IE as appropriate.
2. Agree. Release item should be 1D (Fraudulent Enrolment). We need to be certain that we focus solely on undisclosed pre-enrolment medical conditions. Exacerbations of disclosed pre-enrolment conditions require a different approach.
3. Absolutely! Good due diligence.
4. Could probably be rolled into the existing 5D by creating another paragraph: Unable to complete Recruit Training.
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Re: Injured recruits misdiagnosed then dropped by military
« Reply #80 on: February 15, 2008, 19:28:24 »
- I was a recruit platoon instructor in Cornwallis, and put through a little over 500 recruits there.  Wastage occurred for the fol reasons:
1.  Shoddy medicals not catching previously existing medical conditions (metal bracket holding spine together, etc.).
2.  Injuries during training - many recruits had never worn real leather footwear (or even shoes with laces before) and ten weeks was too quick to bring them up to the level of fitness without hurting their knees.
3. Failure to adapt to military life for psycho-social reasons - shoddy CFRC procedures (stop sending me "3"s!!).
All in all, the final success rate was about 85%, but that included pers gradding after three re-courses.  Obviously, the platoon succes rate was somewhat lower.

I then had the pleasure of teaching recruits at St-Jean.  Wastage occurred for the fol reasons:
1. Shoddy medicals not catching pre-existing medical issues.
2. Injuries during training.  An even less active generation now had only 80% of the time to get up to physical standard - with predictable results.
3.  Failure to adapt to military life.  This ratio was much higher in St-Jean.  My first platoon, I developed Cornwallis style, which was 'give the slow ones a chance to catch up if you can'.  When the RSM saw a frontage of twenty (a platoon of 58, if I recall) on the Sixth Week Drill Test he was shocked. "You have too many people!" he said.  It appears that the climate of command there merited their instructors on the perfection of the final product, not the overall success of the platoon.  Remember, on an eight week course, you had to have started to assess your recruits on Week One and have started to have failed those you perceived as discards on Week Two, or you would never be rid of them by Week Six and they would sewer your 6th Week Drill Test (and your PER).

You can imagine what happened next:  Platoons would commence with sixty and grad 28 to 36, sometimes INCLUDING recourses in.  A sixty man platoon might cycle through 84 people and grad 46.

A very expensive, inefficient and wasteful way to do business.

My suggestions: 
1. Enrol as "full time part-time" on a six month contract. sort of like the RCMP do.
2. Immediately release previously existing medical conditions that were not picked up on the initial Part 2. Release authority to be the Recruit School, NOT Ottawa.
3. MMPI 2 EVERY recruit - no excuse not to.
4. Anyone who has not passed BRT after six months for any reason does not get to sign a regular contract. Release on new release item: "Not Economically Trainable."

Excellent post - I agree with the full-time part-time idea.  Where I was working, it would take about 3 months to release a recruit who wanted to VR - longer if you wanted to kick him out.  The file can be put together and signed off by the CO in a day, but then the BPSO has to see it and then it gets sent to DMCARM, then we have to wait for the release message.  We complain about the lack of instructors when we have to dedicate staff to look after these kids who just want to leave.
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Offline MediPea

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Re: Injured recruits misdiagnosed then dropped by military
« Reply #81 on: February 15, 2008, 21:36:39 »
I just had time to watch a video of the news broadcast about these two ladies that were released. I thought one of the stories seemed quite familiar. One of them was on RFT when I first got there, and lets just say I couldn't watch that broadcast with a straight face. I find it pretty funny when someone is now basically saying their life is "over" because of a disabling injury, when the whole time in St.Jean on weekends off they were able to shop around the mall all day, and hit up the dance clubs at night. Come Monday morning they would be back to limping and complaining of pain.... until Friday evening came of course.

This type of stuff drives me crazy, and it's rampant in St.Jean. There were tons of people on PAT platoon when I was there who had "horrible injuries" all week, but come the weekend they were at the dance clubs in Stiletto's dancing the night away. It kills me that these people wear the same uniform as we do, and get paid the same salary, to do absolutely nothing because they "have restrictions".

To know that a person could get away with so much while in St.Jean, and make a living doing nothing and now finally be released and going public and saying all these things, peeves me a bit. It's quite frustrating really.

Offline TCBF

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Re: Injured recruits misdiagnosed then dropped by military
« Reply #82 on: February 15, 2008, 23:42:02 »
I wonder: does DVA have a mechanism to accept 'minority report' witness statements?  CF-98s always have a space for witness's remarks, do we need another form for people who can attest to actions congruant with malingering or fraud?
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Offline Blackadder1916

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Re: Injured recruits misdiagnosed then dropped by military
« Reply #83 on: February 16, 2008, 00:38:35 »
I wonder: does DVA have a mechanism to accept 'minority report' witness statements?  CF-98s always have a space for witness's remarks, do we need another form for people who can attest to actions congruant with malingering or fraud?

While a CF 98 is usually initiated following an injury and often is the sole investigation into the circumstances of the injury, a summary investigation can be ordered (and often should be but is not).  I once had the bad luck to work for a CO who closely read the CFAO and ordered a ****load of SI's instead of the completion of CF 98s.  Guess who had to do most of them.

A properly conducted SI (or even an abbreviated investigation for a CF 98) should look at all factors, but unless someone offers such allegations (and proof of same) at the time of the investigation, the only course would be to so inform competent authority at a later date.

CFAO 24-6 -- INVESTIGATION OF INJURIES OR DEATH
Quote
SUMMARY INVESTIGATION
12. When a death occurs a summary investigation must be ordered if a board of inquiry is not convened.
13. When an injury occurs and a board of inquiry is not convened, a summary investigation:
     a.   shall be ordered if the injury
          (1)  is serious,
          (2)  is likely to cause permanent disability, or
          (3)  is suspected to be the result of a wilful act of the injured person; and
     b.   should be considered if the injury is considered attributable to military service or if there is any doubt about the permanency  of the injury.


USE OF FORM CF 98, REPORT ON INJURIES
14.    In the case of an injury for which a military investigation has not been ordered, the CO shall ensure that para S of form CF 98 is completed fully and in accordance with 24-2. This abbreviated form of investigation is suitable in certain circumstances such as where the officer or man is not on duty or the injury is clearly not attributable to military service. In making the determinations required by form CF 98, reference should be made to paras 15, and 27 to 31 be low .

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Offline Nemo888

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Re: Injured recruits misdiagnosed then dropped by military
« Reply #84 on: February 16, 2008, 00:54:16 »
Due to CF medical incompetence/lack of resources/training we will never know what happened. Medics are paramedics, not physiotherapists. They don't have training in how to diagnose or treat musculoskeletal injuries other than broken bones and sprained ankles. The CF's lack of medical imaging promptly after injuries is almost criminal in my opinion. A CAT scan or MRI could separate the truly injured from the malingerers in 30 minutes. It could also prevent the stoic hard asses from pushing themselves to the point of medical discharge because of their abnormally high pain thresholds.

With the level of fitness we need now for deployment recruits are going to get hurt. Period. Good training makes you push yourself beyond your limits.  Our medical infrastructure can't  deal with the concommittant injuries. It can't do what it wasn't designed for.
« Last Edit: February 16, 2008, 01:04:52 by Nemo888 »

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Re: Injured recruits misdiagnosed then dropped by military
« Reply #85 on: February 16, 2008, 01:01:41 »
Due to CF medical incompetence/lack of resources/training we will never know what happened. Medics are paramedics, not physiotherapists. They don't have training in how to diagnose or treat musculoskeletal injuries other than broken bones and sprained ankles.

And you base this on your intimate knowledge of the MedTech CTP/CTS? Or perhaps your years spent at the school? Perhaps your superior clinical judgement and training?

It's bad form to denigrate someone else's occupation when you leave your profile blank.
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Re: Injured recruits misdiagnosed then dropped by military
« Reply #86 on: February 16, 2008, 01:05:15 »
I'm a medic. The only medics who have that knowledge have learned it on their own time. I didn't even have to learn my cranial nerves or spinal dermatomes, but I did on my own time. On my own time I bugged the physiotherapists with annoying questions about taping, anatomy, etc. I just think things could be done better. It's medicine. There is no "good enough".
« Last Edit: February 16, 2008, 01:14:00 by Nemo888 »

Offline TCBF

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Re: Injured recruits misdiagnosed then dropped by military
« Reply #87 on: February 16, 2008, 01:26:02 »
...There is no "good enough".

- Sure there is.  This is Canada, after all.

 :D
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Offline xo31@711ret

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Re: Injured recruits misdiagnosed then dropped by military
« Reply #88 on: February 16, 2008, 02:01:36 »

As Mike said, but I'm old school, an old dinosaur, but I remember having to learn to learn the CNS / PNS;.... 'Oh. Oh, To touch And Feel A V....'




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Re: Injured recruits misdiagnosed then dropped by military
« Reply #89 on: February 16, 2008, 02:03:33 »
I'm a medic. The only medics who have that knowledge have learned it on their own time. I didn't even have to learn my cranial nerves or spinal dermatomes, but I did on my own time. On my own time I bugged the physiotherapists with annoying questions about taping, anatomy, etc. I just think things could be done better. It's medicine. There is no "good enough".
Then you must be a QL3, because it's in the QL5 material.
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Offline the 48th regulator

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Re: Injured recruits misdiagnosed then dropped by military
« Reply #90 on: February 16, 2008, 02:30:14 »
I just had time to watch a video of the news broadcast about these two ladies that were released. I thought one of the stories seemed quite familiar. One of them was on RFT when I first got there, and lets just say I couldn't watch that broadcast with a straight face. I find it pretty funny when someone is now basically saying their life is "over" because of a disabling injury, when the whole time in St.Jean on weekends off they were able to shop around the mall all day, and hit up the dance clubs at night. Come Monday morning they would be back to limping and complaining of pain.... until Friday evening came of course.

This type of stuff drives me crazy, and it's rampant in St.Jean. There were tons of people on PAT platoon when I was there who had "horrible injuries" all week, but come the weekend they were at the dance clubs in Stiletto's dancing the night away. It kills me that these people wear the same uniform as we do, and get paid the same salary, to do absolutely nothing because they "have restrictions".

To know that a person could get away with so much while in St.Jean, and make a living doing nothing and now finally be released and going public and saying all these things, peeves me a bit. It's quite frustrating really.


Oh what it would take to have someone with a camera phone, and a good usb connection.

I think once these videos were sent to CBC, alot of the whinning by these life devestated, ex-soldiers, would be exposed as being the true charlatans they are.

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Offline Nemo888

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Re: Injured recruits misdiagnosed then dropped by military
« Reply #91 on: February 16, 2008, 03:03:32 »
I should have known that. In shame I will now go study my surgical instumentation.

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Re: Injured recruits misdiagnosed then dropped by military
« Reply #92 on: February 16, 2008, 03:07:28 »
I should have known that. In shame I will now go study my surgical instumentation.

huh?

dileas

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Re: Injured recruits misdiagnosed then dropped by military
« Reply #93 on: February 16, 2008, 03:09:10 »
Then you must be a QL3, because it's in the QL5 material.

He was answering a post from the last page...
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Re: Injured recruits misdiagnosed then dropped by military
« Reply #94 on: February 16, 2008, 17:28:07 »
Due to CF medical incompetence/lack of resources/training we will never know what happened. Medics are paramedics, not physiotherapists. They don't have training in how to diagnose or treat musculoskeletal injuries other than broken bones and sprained ankles.

Well, at a QL3 level, I'd have to agree.  But a QL3 shouldn't be kicking patients to the door without either a senior Med Tech, PA or MO or even PT having AT LEAST discussed the patient with them.

What I find rather amusing is the fact that our Sports Med instructor basically told my class that we get more time in MSK Physcial Exam than an average medical student does - certainly alot more than he did in school - and it's reflected from what my classmates are telling me working out in the civvy hospitals on rotations (other than on orthopedic services).  If you're so concerned about how little you were formally taught, guess what, you'll find that most medical learning is in fact self directed, and I doubt that there is any of us older school guys that will refute that we had to learn alot for ourselves by ourselves and or on the job to ensure that we could do our jobs right. 

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Re: Injured recruits misdiagnosed then dropped by military
« Reply #95 on: February 16, 2008, 18:21:58 »
We had a good team at the med cetre at Depot PARA.

The Med NCOs would size up the 'sick parade' each morning. Prior to this, they were warned of by the recruit Pl 2ICs as to who would be going sick, and why. Those with real injuries were seen first, as you do with a good triage type approach. Those who claimed to be injured - but were obviously faking - were invited by the doctor to have their temperature taken, rectally, as the first step in the diagnostic process.

Needless to say, the sick parade numbers dropped dramatically in the first month.
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Offline TCBF

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Re: Injured recruits misdiagnosed then dropped by military
« Reply #96 on: February 16, 2008, 21:06:53 »
Q: Know the difference between an oral thermometer and a rectal thermometer?

 8)

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Offline Kirsten Luomala

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Re: Injured recruits misdiagnosed then dropped by military
« Reply #97 on: February 17, 2008, 11:25:08 »
Q: Know the difference between an oral thermometer and a rectal thermometer?

 8)


The taste. LOL

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Re: Injured recruits misdiagnosed then dropped by military
« Reply #98 on: February 17, 2008, 14:20:29 »
The taste. LOL

- I figured you'd get it!
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Re: Injured recruits misdiagnosed then dropped by military
« Reply #99 on: February 17, 2008, 16:10:59 »
While it always seems that the ones that make for the press can be discounted fairly easily, I understand the situation from my own firsthand experience.  Now, that said, I'm not about to blame the CF entirely for the situation, because there were other factors at play.  Essentially, I went off to the Infantry School for the first time - and I wasn't entirely physically or mentally prepared for everything I was undertaking.  However, I carried on until running the obstacle course one sunny Friday afternoon I went over on my ankle, hard.  I don't remember a lot of that summer in detail, but I do remember how much that hurt.  I got carted off to the MIR who taped up my ankle, gave me some ice, some Motrin, and a chit for a week of light duties or something like that.  I went on trying to complete the course, but I had done so much both to my ankle and to muscles (compensating for the ankle apparently) that I was just euchred.  Being that I wanted to finish the course I just tried to keep going, and eventually my attitude hanged me before the medics could kick me off the course.

So the following year, I had trained up a lot harder and I was very motivated to get things done, had sorted out the attitude issue etc, and I went to Gagetown again.  It took almost no time in the field before I had somehow aggravated something and I was gone in a week, medical RTU.  This time, however, I got lucky and managed to get seen by a phsyiotherapist in Trenton who realized that there really was something seriously wrong.  Over time between his assessment and consulting with my civilian doctors, there's a hypothesis that I most likely actually broke my foot that first summer (no x-rays were ever taken) rather than merely spraining an ankle.  Now I've got a really screwed up good the requires orthotics and go faster boots (I actually get blisters on the tops of my feet from Mk IIIs with my orthotics in!) and it still gives me grief from time to time, but fortunately once that was all figured out I was able to head back to Charm School with comparatively more success, and since then things have been much better.

Was there deliberate negligence from the CFMS?  I'm not prepared to say so - because it may well have been what some suggested - that I didn't volunteer enough information because I was too interested in trying to push through the course rather than really paying attention to my own health at the time.  It strikes me that there's a bit of a conflict - we can't accept MIR Commandos trying to get out of doing any work (and believe me, I got accused of that, and malingering, and the whole nine yards) with no real reason - the ones who get off PT all week but can still make it to Sweetwaters Friday night... but it seems that at the same time by being so aggressive against them we lead legitimately injured pers to make decisions that will ultimately cause them more problems down the road...  Tough situation to reconcile.
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