The Two Sides of Modern-Day American Combat: From Camp Austerity to Camp Chocolate Cake

  • Jeffrey MilleganEmail author


My military medical career has been defined by the global war on terror. Upon completion of a psychiatry internship, I became a Marine battalion surgeon and was deployed to Camp Austerity in Iraq with Marine infantry in 2004. Camp Austerity was remote with few creature comforts. On top of the separation from my wife, it was a challenge to overcome the isolation as the only Navy medical officer on the base. Camp Austerity was routinely under attack and my unit took several casualties. Although I was fortunate to have skilled and experience corpsmen, a number of our Marines died. Although Camp Austerity was full of hardship and adversity, a strong sense of comradery developed among the Marines there providing tremendous emotional resilience for all of us. After I returned from this deployment, I returned to my psychiatry training. Immediately upon completion of my training, I was sent back to Iraq as a psychiatrist. My second deployment was to a large air base with relatively extravagant amenities that I referred to as Camp Chocolate Cake. Whereas at Camp Austerity my time was spent either in boredom or complete terror, at Camp Chocolate Cake I had a regular psychiatric practice and routine including swimming and regular communication with my family. A central difference with psychiatry in Iraq and at home was the presence of a gun rack in the waiting room. Therapeutic rapport is critical when your patients are armed. My second deployment was during a period of a pause in the violence and most mental health visits revolved around unit morale and stress back at home. My two deployments are a fairly good representation of the vast range of experiences that one has when deployed to a combat zone. Each comes with unique opportunities and challenges that are worth examining.


Marines Combat psychiatry Psychiatry in war Iraq war psychiatry Battle psychiatry 

Copyright information

© Springer International Publishing Switzerland 2017

Authors and Affiliations

  1. 1.Naval Medical Center San DiegoSan DiegoUSA

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