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May join in following the course of least resistance and shipping the unhurt but stunned and sobbing troops off-base to a less harassed 2-E facility. This impulse must be resisted, or there will be an intolerable loss of unwounded troops to off-base locations from which it may prove very difficult to reclaim them. An on-base holding facility must be provided to the DBMS by a wing commander who understands the principles involved, explains them to the commanders of the various squadrons, and supports the DBMS in their application. Reflecting upon Richardson's Tranquility House described above, 45 this author recommends that such an on-base facility be established in a reasonably secure location, away from primary targets, and run by the available mental health personnel. Flexibility in assigning mental health nurses and occupational therapists to this facility may also prove useful. In the personal communication previously noted, 51 Levy commented that the Israeli medical service organizes its combat stress casualties along military lines, with unit names rather than medical names. Under this model, each U.S. Air Force psychiatric technician might direct a "flight" of 10 or more casualties. Three or more flights would comprise a "squadron, " with the squadron command element consisting of the psychiatric social worker, an NCO-in-charge NCOIC ; , and, if available, an occupational or physical therapist. This latter function might even be filled by a knowledgeable physical training technician from the base gymnasium. The structure of this local treatment team would thus emphasize the military aspects of the situation and minimize the medical aspects. At this level, treatment essentially consists of acknowledging a temporary inability to work, without falling into the medical model taking a history, writing up a chart, making a formal diagnosis ; , that reinforces the patient role. Such troops--do not call them "patients"!--should not be formally admitted to the facility. "You're not a coward, you're not sick, you're just worn out, and you'll be all right in a day or two" must be the constant theme. A chance to rest, a hot meal the U.S. Army's "3 hots and a cot" ; , a physical examination, however perfunctory, to reassure that there is no physical problem, and an appeal to honor, group loyalty, and the mission may be all that is necessary. In fact, at his first contact with the medics, all that a scared kid may need is for someone in authority to tell him that he's all right, and that he must get back to work, do his part, and not let his buddies down and sinemet.
23. Mittelman M. The psychological aspects of MCI. Paper presented at: Gerontological Society of America. Conference Proceedings; November 2003. 24. Whitehouse P. Losing My Mind: An Intimate Look at Life with Alzheimer's by Thomas DeBaggio [Book review]. N Engl J Med. 2002; 347: 861. Whitehouse P, Karlawish J, Ballenger J. Conflict of interest in the development of drugs for dementia: a historical perspective. In: Tomossy W, Campbell, eds. Symposium on Medicine and Industry. Sydney, Australia: Kluwer Series; 2004. 26. Whittington C, Fonagy P, Cottrell D, Cotgrove A, Boddington E. Selective serotonin reuptake inhibitors in childhood depression: systematic review of published versus unpublished data. Lancet. 2004; 363: 1341-1345. Karlawish J, Schneider L, Hermans D, Whitehouse P. Silence science: the problem of not reporting negative trials. Alzheimer Dis Assoc Disord. 2005. In press. 28. Auchus A, Chen C, Orgogozo JM, Sawada T, Senanarong V, Whitehouse PJ. 2nd Asia Pacific Regional Meeting of the International Working Group on Harmonization of Dementia Drug Guidelines: Meeting Report. Alzheimer Dis Assoc Disord. 2003; 17: 129-131. Auchus A, Chen C. Asia regional meeting of the International Working Group for the Harmonization of Dementia Drug Guidelines: Meeting Report. Alzheimer Dis Assoc Disord. 2001; 15: 66-68. Whitehouse P, Maurer K, Ballenger J. Concepts of Alzheimer Disease: Biological, Clinical, and Cultural perspectives. Baltimore, Md: Johns Hopkins Press; 2000. 31. Whitehouse PJ. Classifications of the dementias. Lancet. 2003; 361: 1227. Whitehouse P. Conclusion: the future of successful intergenerational health. In: Successful Aging Through the Life Span: Intergenerational Issues in Health. New York, NY: Springer Publishers; 2004, for instance, coumadin.

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