Tuesday, October 14, 2014

The method behind the machine: Surgeon, shooter, Soldier

SALEM, Ohio (Oct. 14, 2014) -- Rifle marksmanship is like performing surgery. There's a method used to accomplish both. The only difference is, when surgery is performed correctly, the person at the other end lives.

That's the world that Lt. Col. J. Cletus Paumier sees as a command surgeon in the U.S. Army Reserve -- a world full of methods.

From the way he holds his coffee cup, full to the brim with hot liquid, while roaming the hospital hallways without spilling a drop, to the way he inserts surgical screws into a hip joint. Even shooting a rifle has a method, down to the last detail.

Between surgeries, his Army obligations, and shooting rifle competitions, it's hard to tell where one role begins and another ends. Even when cleaning his rifle, Paumier uses a surgical cystoscope to inspect the barrel and gas ports.

The scope is worth several thousand dollars, but to him it's just a tool, just an idea. When people blame tools for their lack of success, they fail to unlock their true potential, he says.

"Every time I hear someone say they don't have the right equipment, I want to take them down an abandoned road and beat them to death with their own words," he said.

When he talks to convey a specific idea, his blue eyes blaze with such intensity he looks like he's about perform surgery or shoot down a target. He is so determined, some friends teasingly refer to him as a machine.

He projects that intensity even when he's listening.

"I just listen intently, and I figure out sort of what goes on, but I'm intense. There's no hiding that. It's always been that way," he said. "You have to be ready to listen at all times. You can learn so much from every sense that God gave you."

"Every answer is right here," he said, extending his hand out in front of his face, pivoting around the room. Everything is solvable. Everything is within reach, he said.

That's the philosophy driving everything he does, whether in uniform, at the range, or in surgical scrubs.

SURGEON - A PATH TO MEDICINE THAT BEGAN IN HIGH SCHOOL

As an orthopedic surgeon, Paumier has treated 25,000 patients in 20 years. The population of Salem, Ohio, where he lives, is 12,000, but his hospital's service area reaches 70,000 in a 50-mile radius.

Growing up, he wanted to go in the military, not medicine. His father was in the U.S. Coast Guard and made him do his bunk with a four-inch seam so tight you couldn't crawl into it. Every vacation was at a Coast Guard base.

His path toward military changed when sudden tragedy hit the family.

He came home from school one day in 11th grade, and his father was there, waiting for him. Waiting to deliver the news.

"I grew up in 10 seconds. 'Your brother has cancer.' My life was over. It was never the same," said Paumier.

That news derailed Paumier's plans completely toward medicine. His parents took his brother to St. Jude Hospital in Tennessee, and stayed there for several months. He was stuck running the house, taking care of his sister, paying the bills. He got up at four in the morning to run traps that caught foxes and ferrets by a nearby pond, before getting himself and his sister ready for school. Then football practice into the late hours of the evening. Only to do it all over again the next day, for months, until his parents and brother returned.

That's the only time Paumier appeared vulnerable. He paused a few times to compose his words while telling that story. He was too young to be forced into that, he said.

Thankfully, his brother survived Non-Hodgkin Lymphoma, but by then, Paumier's path new was already set.

He was accepted into medical school at the age of 17. He lived on five dollars a week, and his studies went from 17 credit hours a semester to 30 by the end. He finished his undergrad at Youngstown State University, in two years. Then, he graduated medical school at Mount Carmel Medical Center, by 23.

There was no room for the military then. No room for anything else during his studies.

School consumed him so completely he compared the experience to Rip Van Winkle's slumber. When he returned to society, he felt totally disconnected from the world around him. It was like he'd been asleep from it all. People had grown older and the world had changed without him.

Yet, he made an impression on medical professionals everywhere he went. Paumier received offers to join prestigious practices around the country.

"But I wanted to be a Hill Jack," he said, using a term he prefers over "Hill Billy."

He wanted to rebuild the hospital in Salem, Ohio, the town where he'd grown up his whole life. At the Salem Regional Medical Center, he saw design flaws in how the operating rooms were constructed. Those flaws resulted in increased contamination rates he knew could be prevented.

"Sterile technique is a method and that method has rules. If you break the rules, you have contamination," he said while giving a tour of the area.

He came up with a plan to totally redesign the operating area. Almost everyone was against him when he proposed the plan. He let no one stop him. He used a method called "center-out engineering," which he invented.

"I engineered the thing -- all the parameters in the room, to the inch, with an engineering method that I've made up -- using a tape measure. And I taught the architects how to engineer the operating room using (my system)," he said.

Having large surgery rooms was vital to prevent accidental contact with sterile equipment. The Salem hospital has seven rooms now, each 30 to 50 percent larger than the average size around the country. The orthopedic rooms, in particular, are 670 square feet. That's larger than a studio apartment. All to reduce infection rates and improve efficiency.

He wanted patients to receive the care they deserved. He pours so much energy into them.

One particular Monday morning, Paumier treated 30 patients before lunchtime. That same day, he came home to catch up on Army obligations, had dinner with his family, and went back to the hospital to perform a hip surgery. He didn't go to bed until almost midnight. Nonstop. Even when he dictates patient notes, he talks so fast he might as well be an auctioneer.

Yet, Paumier is never thrown into a hurry by circumstances. On any given day, he treats everything from a mangled hand to a herniated disk. His medical realm covers every joint and bone from the neck down. In the ER wing, he jumps between four or five rooms as patients cycle through constantly. The amount of information load he deals with would overwhelm most people, he said. He's seen people snap because of what hospitals demand.

"I don't get rushed. I stopped feeling rushed when I started taking charge of everything," he said.

He likened it to a combat stress environment. A new problem, a new trauma, every few minutes. On a repeated cycle.

"You have to adapt and overcome," he says, a typical Army mantra, but he makes it true.

He remains in control the whole time. Flipping out would equal panic. Panic means loss of control. Loss of control means poor decision-making. Once the pattern begins, it goes on, all the way to the bottom.

When fellow doctors or nurses complain about the struggles of work, he hands them a single straw as a joke.

"What's this for?" one nurse asked the first time he ever gave her one.

"To suck it up."

Yet, unlike actual machines, he's not emotionless. He doesn't lack empathy. In fact, he uses emotion as a tool. He channels other people's emotions to drive them toward positive actions, instead of negative ones.

"If you learn how to marshal emotions, then it's an incredible thing. What role does emotion play? What role does logic play? Emotion is the engine that propels organisms ... Emotions drive everything you do. All logic does is guide you. It steers that force."

SHOOTER - ACCOMPLISHING PEACE OF MIND

The emotion that drives Paumier is peace of mind.

"Peace of mind takes care of all (other) emotions," he said.

He found that peace in the surgical precision of rifle marksmanship. It's about more than just defeating the enemy, he said. It's a discipline that instills self-control. It's what helped Paumier focus his life. He was already a surgeon when he started shooting matches, but picking up a rifle transformed him in new ways.

"I did it to clean up my thinking method ... I realized I was succeeding in all these things, but I had no idea why ... I had to look into it and figure out how it works," he said.

He used the metaphor of a car. People work on their cars all the time, but every person has only one mind. For the longest time he was hesitant to work on his mind because he didn't want to break something.

"Marksmanship launched me into the center of my mind," he said.

He performed surgery on himself, in a way. Through rifle drills and training, he cut his mind open put it back together in a logical fashion.

He became so driven he sought out anyone who could answer his questions: how to aim, how to stand, how to grip. A mentor, who served in Vietnam and Korea, told him about a Marine Corps marksmanship video, and Paumier transcribed the whole tape into written word. He practiced it thousands of times. He would do standing rifle drills in his basement to see how long he could stand there. He started at five minutes and worked himself up to an hour.

"I sort of developed a new educational method for teaching marksmanship ... It's an amazing process. I've completely figured that thing out based on how people think and function," he said.

He mastered the rifle. Or rather, he mastered his body and mind to control that rifle perfectly.

"In marksmanship, everything you do has an impact on the target," he said.

Every minor movement "here" causes a drastic change in the shot group "there," hundreds of yards down the line. He sees it as a metaphor for everything else in life. The smallest idea might propel a person either into great error or great success.

"You have to learn to throw away ideas. Sometimes your ideas lead you back to things you thought were truths but were not."

When he began his marksmanship journey, he scored dead last in his first match. He applied everything he learned into his method. He refined his skills. Since then, he's achieved the Distinguished Rifleman Badge at Camp Perry, accomplished in three qualifying leg matches once he made the cut. He's earned the President's Hundred Tab twice. Plus he's won trophies and medals both in civilian national matches and at inter-service competitions against other military branches.

"A lot of these guys, they said it's kind of impossible to do this stuff. I mean, every time I hear impossible, I love it because it's a tremendous challenge that can be overcome," he said.

He build his own private range just to spend more time shooting. The range took three years to complete. He cleared 14 acres of brush and hawthorn trees just to get started.

"I cleared every square inch with a brush hog and a 14-inch chain saw. I remember suffering," said Paumier.

That, alone, took him three months. Then, with the help of some friends and constant communication with Camp Perry and the headquarters of the National Rifle Association, he built a 600-yard beauty. The range has four lanes, four shooting mounds, three "live fire" flags and a pit complete with professionally-framed targets that move up and down on a counter-weight system. The whole thing exceeds NRA standards. All in his backyard.

"I had to hire a bulldozer because I had to remove two hills. In Ohio, there's a hill every 200 yards. So if you want a 600-yard range, you've got to remove two hills," said Paumier, who casually refers to himself as both the unstoppable force and the immovable object.

Not even hills could stop his determination, his vision. He's not shy about his stubbornness. He said every Paumier in his family lineage was stubborn in some way.

When neighbors complain about the gunfire blasts, he responds, "Never mind the noise. That's the sound of freedom."

Up the hill from the range, Paumier's house is a beautiful 4,000-square-foot home. Its design is a fusion between an eastern river tycoon in the front, and a southern plantation style in the back. Like the surgery wing, Paumier designed it using a measuring tape from the inside out.

At dinner time, Paumier and his wife, Amy, and their two kids, can see the whole landscape through the kitchen windows. They eat dinner at home together most nights despite the mad hours Paumier grinds through.

The name of the road where they live might as well have been destined for Paumier: Perry Grange Road. The four lanes in his back yard are exact replica of those found at Camp Perry, where national matches take place.

It takes 14 hours just to mow the range, but he shoots year round. Even in the winter, in negative-ten-degree temperatures, he shoots in complete peace.

Yet, rifle marksmanship brought Paumier more than peace of mind. It's what brought him into the Army Reserve.

SOLDIER - POURING HIS WHOLE LIFE INTO THE UNIFORM

Paumier shot his first rifle at the age of eight. He shot his first deer at 13 (a 10-point buck). He shot at national championships in his 30s.

Yet, he joined the Army at 48. He's been wearing the uniform less than two years.

He became so renowned as a rifleman and surgeon that Army officials noticed. He met an Army Reserve officer at a shooting match who ended up recruiting him. Paumier was commissioned as a lieutenant colonel. Typically, it takes 15 years or more for officers to reach that rank.

"When I decide I want to do something, I make it happen. I mean I have a complete life's history of deciding to do things and making it happen ... You will never see such determination ever. I decided I wanted to be distinguished. I am distinguished. I decided I wanted to be in the Army. I'm in the Army. I decided I wanted to be a lieutenant colonel. I'm a lieutenant colonel. They said major. But I said I wanted lieutenant colonel ... based on my credentials," he said.

He recalls his recruiter saying, "I don't know who this guy is, or who he knows, but in my whole life, I've never seen the Army operate this way."

He said he loves the Army because of the discipline it requires out of Soldiers, who are capable of a huge range of missions.

"I think the Army is the best overall organization, ever. The Army is a giant machine. It has all the functions to sustain a society. It's its own complete mechanism. We can fight. We can govern. We can lead. We can build. We can heal people. We can establish security. It's a complete governmental organization."

In the Army Reserve, he drives six hours - 415 miles, one way - to report to the 416th Theater Engineer Command, each month. As the command's chief surgeon, he oversees the medical readiness of approximately 13,000 troops, spread across 27 states. His goal is to eventually improve medical stats throughout the entire Army.

Additionally, he took charge of the Army Reserve's Mobile Training Team. The team is part of the Army Reserve Marksmanship Program, which has approximately 60 pistol, rifle and combat experts who compete at various championships. In turn, the training team travels the country to help Soldiers improve their weapon skills.

"How Soldiers are instructed in marksmanship spills over the combat environment," Paumier said.

Now he's on a mission to completely revamp the Army's marksmanship methodology. He coaches every person he ever comes into contact with: topics range from shooting to general life lessons. He wants to transpose his knowledge, coaching skills, and sheer determination to improve the Army's institution as a whole.

He won't stop until he does so, he said.

If he can redesign an entire surgery wing and a three-story home using a measuring tape, imagine what he can do with a surgical scope or a rifle.

"If you go through your life and don't use the talents you were given, then you've wasted these talents," he said.

 http://www.army.mil/article/135958/The_method_behind_the_machine__Surgeon__shooter__Soldier/

 By Sgt. 1st Class Michel Sauret

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