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Let the Games Begin

July 19, 1996

The opening ceremonies of the 1996 Olympic Summer Games this evening mark the beginning of an event that is predicted to bring millions of international visitors to Atlanta, and it's probably safe to say that we as the host nation share hopes and dreams not only with the competing athletes, but also with the guests who come to witness and support the games. Sure, we hope American athletes will do well and win medals--after all, this is a "home game." But just as importantly, we hope that all goes well, no matter who wins what--that athletes and visitors alike will acquit themselves with honor, and that the world will see Americans as gracious hosts and the United States as a pretty good place to be.

But good things don't usually come about by hopes and dreams alone; it also takes preparation and perspiration. So starting today, we will be sharing some behind-the-scenes work being done to ensure the physical and mental health and safety of all those attending and participating in the Games.

Psychiatrist L. James Grold, M.D. will share his experiences during in his tour of duty at the Games as a member of the California National Disaster Medical Assistance Team (DMAT) #8. The DMATs, which are under the auspices of Health and Human Services (HHS), are 35-member teams trained to administer medical care under austere conditions to victims of natural or manmade disasters. While on duty in Atlanta with hundreds of other volunteers, trained and ready to assist should any natural or manmade disaster befall the Games, Grold will keep a diary. These experiences will be published on MHI following the closing ceremonies. He begins below with his recruitment and training--Ed.

Mission Launch
by L. James Grold, M.D., F.A.P.A

In April I received a message from the administrator of California DMAT #8, asking if I would participate with my DMAT team at the Olympics. I gave him my commitment immediately although our mission was still a mystery. I later learned that I probably would be training at an air base 30 miles outside of Atlanta, and I received several documents to be notarized so that I could be reactivated by HHS. One of these was a "Declaration of Appointee," which asked many questions about waiving government life insurance (not too comforting and idea).

Next came the following information for "public disclosure":

"The Department of Health and Human Services has been requested to assist in the provision of medical care for the participants and visitors to the 1996 Summer Olympic Games in Atlanta, Ga. This effort will be provided though the Department's Offices of Emergency Preparedness/National Disaster Medical System. Among the resources available to the NDMS are over 60 National Disaster Medical Assistance Teams, comprising more than 5,000 volunteer medical personnel. These teams are most often deployed to address medical needs as part of a federal health and medical response to disasters, for example, hurricanes or earthquakes [we assisted victims of the Northridge, Calif. earthquake], when activated by the Federal Emergency Management Agency under the Federal Emergency Response Plan...

"During the Olympic Games, members of these teams will be prepositioned in the Atlanta and Athens, Ga., areas to assure that a timely response can be effected if a mass casualty incident need arises. In an effort to assure a more complete medical coverage of potential incidents which may occur, the NDMS will also deploy medical/hazmat (hazardous material) teams to augment local responders in their efforts."

The response concept was explained:

"On a mission launch, Medical Strike Teams consisting of five persons will be deployed to the incident site. Each team member will carry a backpack of supplies to respond to medical issues. Each team will have medical drugs and supplies to address chemical trauma, ALS (advanced life support), and anticipated general injuries and conditions that may be encountered. These teams, based upon the most reasonable means of transport, will be flown to a landing zone near the incident site in rotary wing airframes [helicopters?] or ground support provided through the MSU (medical support unit)."

It was reassuring to know that the hazmat team will be the initial entry team to incidents involving contaminated patients (chemical, biological). In such incidents the Medical Strike Team will provide triage, medical care and assist in patient evacuation of safe (decontaminated) persons. We were informed that we would be provided appropriate personal protective equipment.

While trying to digest the implications of all this, I decided to go to my friendly computer for more information. I logged onto a professional forum having to do with traumatic reactions to stress. During one of the electronic discussions when I mentioned that I was going to be in Georgia, I was told to call a woman who is involved at the state level with the mental health aspects of disaster work.

After I contacted her, she asked me how she could participate with the federal government in a coordinated plan. When I attempted to find out with whom she should speak (this required seven or eight phone calls to different agencies and transfers within the agencies), I discovered that some amazing turf wars are going on within our federal and state governments over which agency has control over disaster work. Apparently, there are four or five different governmental agencies trying to establish their authority over the mental health aspects of disaster work. This includes the Veteran's Administration, the Public Health Department and HHS. Everyone I spoke with was very cautious about being quoted.

That same week CNN produced a special program devoted exclusively to thediscussion of terrorism and the Olympics. They reported that the current mobilization of security forces is the greatest that has ever occurred at any Olympics. Several times the narrator referred to Munich 1972 and not wanting a repeat of that disaster. CNN then reported on an American "right-wing-extremist" who had purchased several vials of live bubonic plague organisms through the mail, purportedly to use in his research. When the FBI investigated, he told them that he was not doing anything illegal, and to the FBI's amazement and chagrin, they found out that he was correct. In fact, this man had had the vials of bacteria mailed right to his home.

CNN also devoted a segment to extremist religious groups whose members believe that dying for their cause will result in their achieving ultimate and eternal bliss. The narrator said that these individuals sometimes act as suicidal bombers carrying powerful explosives strapped on their bodies, and described the difficulty of defending against such religious fanatics. Then the following month came the horrible explosion on a U.S. air base in Saudi Arabia by terrorists, and the Arizona-based white-supremacist group thathad planned to bomb a number of federal buildings in Arizona. These very real events were sobering thoughts for me to ponder on the eve of my departure.

Two weeks before my deployment date, I received a letter from the International Relief Teams, the sponsoring agency of California 8 DMAT, providing me with the purpose of our "special mission deployment to US [sic] Olympic games in Atlanta, Ga." However, the "to US" part had been mistyped to read "tous." After reading this several times, I thought that "tous" must be some HHS jargon with which I was unfamiliar--perhaps a French word describing some covert action.

In a more practical vein, I learned I would receive a per diem meals and incidentals (M&IE) allotment and free lodging. I was also told I would be on eight-hour duty shifts and that I must wear my DMAT uniform consisting of khaki pants (no shorts despite the predicted 108 degree Heat Index) and a special polo shirt and hat with the International Medical Team's DMAT logo printed on them, which I was to buy for $15 each. But, I was advised to wear "civilian clothing" on my "civilian transport" airline flight to and from Georgia. I felt like I was back in the army again, especially with those obscure, unintelligible abbreviations and official documents with headings of "Department of Health and Human Services Travel Order." I learned that I would not be permitted at Dobbins AFB without my DMAT picture ID (which I had been given several years ago) and that I must provide my own stethoscope (that I would have to find and get out of storage).

The reality of my forthcoming trip was starting to hit me and I began to prepare my patients for my hiatus from my psychiatric practice. A few of my patients, familiar with my past travels to exotic locales, asked about this latest sortie. As has always been my policy with selected patients, so as to not be an anonymous figure, I explained briefly what I would be doing.

For the most part, their views were that this would be an exciting adventure. One patient who has lived most of her 50 years with a great deal of anxiety, asked me if I had plans to retire soon. I reassured her that with experiences like this one, I was still having "too much fun to just sit around."

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