Episode 65
What Does Memorial Day Mean for Military Leaders?
with Lt. General R. Scott Dingle, Lt. General Ronald J. Place, Joseph Caravalho, Jr., M.D., MG, U.S. Army, (Ret.), and Elder Granger, M.D., MG, U.S. Army (Ret.)

May 26, 2022

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Lt. Gen. R. Scott Dingle​
Surgeon General, U.S. Army; Commanding General, U.S. Army Medical Command

Lieutenant General R. Scott Dingle is the 45th Surgeon General of the U.S. Army and Commanding General, U.S. Army Medical Command. Prior to his appointment, he served as the Deputy Surgeon General and Deputy Commanding General (Support), U.S. Army Medical Command.

His previous military assignments include: Commanding General, Regional Health Command – Atlantic; Deputy Chief of Staff, G-3/5/7, Office of The Surgeon General, Falls Church, Virginia; Commander, 30th Medical Brigade, Germany; Director, Health Care Operations/G-3, Office of The Surgeon General, Falls Church, Virginia; Commander, U.S. Army Medical Recruiting Brigade, Fort Knox, Kentucky; Commander, 261st Multifunctional Medical Battalion, Fort Bragg, North Carolina; Chief, Current Operations, Special Plans Officer, Healthcare Operations Executive Officer, Office of The Surgeon General, Falls Church, Virginia; Chief, Medical Plans and Operations Multinational Corps-Iraq Surgeon’s Office, OPERATION IRAQI FREEDOM, Baghdad, Iraq; Chief, Medical Plans and Operations, 18th Airborne Corps Surgeon’s Office, Fort Bragg, North Carolina; Executive Officer, 261st Area Support Medical Battalion (44th MEDCOM), Fort Bragg, North Carolina; Ground Combat Planner for Combined Joint Task Force -180, OPERATION IRAQI FREEDOM, Baghdad, Iraq; Assistant Chief of Staff, Plans and Exercises, 44th Medical Command and 18th Airborne Corps Plans Officer, Fort Bragg, North Carolina; Chief, Division Medical Operations Center, 1st Armored Division, Germany; Instructor, Officer Basic and Advanced Courses, Army Medical Department Center and School, Fort Sam Houston, Texas; Plans Officer, 3rd Infantry Division Medical Operations Center, Germany; Commander, Charlie Company, 3rd Forward Support Battalion, Germany; Commander, Medical Company and Medical Hold Detachment, Fort Eustis, Virginia; Chief of Plans, Operations, Training, and Security, Fort Eustis, Virginia; Adjutant, Fort Eustis, Virginia; Ambulance Platoon leader and Motor Officer, 75th Forward Support Battalion, 194th Separate Armored Brigade; Fort Knox, Kentucky.

Dingle is a Distinguished Military Graduate of Morgan State University. His degrees include Master of Science in Administration from Central Michigan University, Master of Military Arts and Science from the School of Advanced Military Studies and a Master of Science in National Security Strategy from the National War College.

His awards and decorations include the Distinguished Service Medal (Oak Leaf Cluster), Legion of Merit (two Oak Leaf Clusters), Bronze Star Medal, Meritorious Service Medal (seven Oak Leaf Clusters), Joint Service Commendation Medal, Joint Meritorious Unit Award, Army Commendation Medal (two Bronze Oak Leaf Clusters), Army Achievement Medal (one Bronze Oak Leaf Cluster), Humanitarian Service Medal, the Order of Military Medical Merit, Recruiters Medallion, the Order of Kentucky Colonels, the Army Surgeon General’s prestigious 9A Proficiency Designator, Expert Field Medical Badge, Parachutist Badge, and the Air Assault Badge.

 

Lt. Gen. Ronald J. Place
Director, Defense Health Agency (DHA)

Lieutenant General Ronald J. Place is the Director, Defense Health Agency (DHA), Defense Health Headquarters, Falls Church, Virginia. He leads a joint, integrated Combat Support Agency enabling the Army, Navy, and Air Force medical services to provide a medically ready force and ready medical force to Combatant Commands in both peacetime and wartime. In support of an integrated, affordable, and high quality military health service, the DHA directs the execution of ten joint shared services to include the TRICARE health plan, pharmacy, health information technology, research & acquisition, education & training, public health, medical logistics, facility management, budget resource management, and contracting. The DHA administers the TRICARE Health Program providing worldwide medical, dental and pharmacy programs to more than 9.6 million uniformed service members, retirees and their families.

Place hails from South Dakota, graduating from the University of South Dakota with a Chemistry Degree, a member of the Phi Beta Kappa Honor Society and ROTC commission. A member of Alpha Omega Alpha honor medical society, he then graduated from Creighton University School of Medicine. Place completed his General Surgery internship and residency training at Madigan Army Medical Center (MAMC), Washington and fellowship training in Colon and Rectal Surgery at the University of Texas Southwestern in Dallas.

Place’s staff surgical assignments include Martin Army Community Hospital, Fort Benning, Georgia and MAMC. His combat surgical experiences began in October 2001 when he deployed as a general surgeon with the 250th Forward Surgical Team (FST-Airborne) to Afghanistan. He subsequently deployed with the 67th FST during OIF I, Task Force Med Falcon IX to Kosovo, and “A Detach” 249th General Hospital (OPCON to the 173rd Support BN) for OEF VI.

Place’s medical leadership positions began with his assignment to Landstuhl Regional Medical Center, Germany as the Chief of Surgery in 2002 and then Deputy Commander for Outlying Clinics. He returned to MAMC as the Deputy Commander-Clinical Services, then gaining responsibility for the day-to-day operations of the Medical Center as the Principal Deputy Commander. He next served as Commander of USA MEDDAC Fort Knox/Ireland Army Community Hospital, Kentucky, then USA MEDDAC Fort Stewart/Winn Army Community Hospital, Georgia. His flag officer positions include Assistant Surgeon General (Force Projection) at the Office of The Surgeon General, transitioning to the MEDCOM Deputy Chief of Staff (Quality and Safety). After serving as the Commanding General of Regional Health Command-Atlantic, Place led the Military Health System NDAA 2017 Program Management Office. He most recently served as the Director of the National Capital Region Medical Directorate, the transitional Intermediate Management Organization, and the Interim Assistant Director for Health Care Administration, all within the Defense Health Agency. He currently serves as the Director, Defense Health Agency.

Place is a graduate of the AMEDD Officer Basic and Advance Courses, the Command and General Staff Officer Course, and the National War College. He is board certified in both General Surgery and Colorectal Surgery, the author of more than 40 peer reviewed articles and book chapters, and a Clinical Professor of Surgery at the Uniformed Services University of Health Sciences. His awards include the Distinguished Service Medal with oak leaf cluster, Defense Superior Service Medal, Legion of Merit with three oak leaf clusters, Bronze Star Medal with oak leaf cluster, Navy Presidential Unit Citation, Combat Action Badge, Combat Medic Badge, Flight Surgeon’s Badge, The Surgeon General’s “A” Designator for clinical excellence, the Order of Military Medical Merit, the Army Staff Identification Badge, and others.

 

Joseph Caravalho, Jr., M.D., MG, U.S. Army, (Ret.)
President and CEO, Henry M. Jackson Foundation for the Advancement of Military Medicine

Dr. Caravalho is responsible for the guidance and leadership of HJF. He sets strategic goals and guides HJF in advancing military and civilian medicine. 

Prior to joining HJF, Dr. Caravalho served as the Joint Staff Surgeon at the Pentagon in Washington, D.C. He was the Chief Medical Adviser to the Chairman of the Joint Chiefs of Staff, providing recommendations to the Chairman, the Joint Staff and Combatant Commanders on a wide range of medical and readiness issues.

Before becoming Joint Staff Surgeon, he was Army Deputy Surgeon General and Deputy Commanding General (Support) of the U.S. Army Medical Command. Clinically, Dr. Caravalho held positions as a staff internist, nuclear medicine physician and cardiologist.

Dr. Caravalho graduated with a M.D. from the Uniformed Services University of the Health Sciences School of Medicine in 1983. He also has a B.A. in math from Gonzaga University, and a master’s degree in Strategic Studies from the Army War College. In 2019 he received an honorary doctor of laws from Gonzaga University. 

For more than 30 years, he has served the U.S. Army in various leadership positions, including Commanding General of the Southern Regional Medical Command and Brooke Army Medical Center, the Northern Regional Medical Command, and the Army Medical Research and Materiel Command at Fort Detrick in Maryland.

 

Elder Granger, M.D., MG, U.S. Army (Ret.)
Founder and President, The 5P’s LLC

In July of 2009 after 37 years of Military service Major General Elder Granger, MD retired as the Deputy Director and Program Executive Officer of the TRICARE Management Activity, Office of the Assistant Secretary of Defense (Health Affairs), Washington, DC. In this role he served as the principal advisor to the Assistant Secretary of Defense (Health Affairs) on DoD health plan policy and performance. He oversaw the acquisition, operation and integration of DoD’s managed care program within the Military Health System. MG Granger led a staff of 1,800 in planning, budgeting and executing an $19 Billion Defense Health Program and in ensuring the effective and efficient provision of high-quality, accessible healthcare for 9.4 Million Uniformed Service members, their families, retirees and others located worldwide.

Prior to joining TRICARE Management Activity, MG Granger led the largest US and multi-national battlefield health system in our recent history while serving as Commander, Task Force 44th Medical Command and Command Surgeon for the Multinational Corps Iraq. He has led at every level of the Army Medical Department.

MG Granger began his career with the Army Medical Department in 1971 as a Combat Medic in the US Army National Guard. He earned a Bachelor of Science degree from Arkansas State University in 1976. A Distinguished Military Graduate, MG Granger was commissioned through the Reserve Officer Training Corps. Upon graduation from the University of Arkansas School of Medicine in 1980, he was awarded the Henry Kaiser Medical Fellowship for Medical Excellence and Leadership. MG Granger completed a residency in Internal Medicine in 1983 and a fellowship in Hematology-Oncology in 1986 at Fitzsimons Army Medical Center. His Military education includes the Army War College, the Army Command and General Staff College, the Army Medical Department Officer Advanced and Basic Courses, the Military Health System and Army CAPSTONE Courses, and the Combat Casualty Care Course.

MG Granger continues to advance his passion for patients and healthcare improvement through advising and supporting teams across the spectrum of healthcare. He and his wife Brenda now live in Colorado. Their son Elder II is a lawyer and their daughter Eldesia is a M.D.

 

I stand on the shoulders of those who have given their life for their country. I'm able to lead today and serve today because of those who have given their lives in battle.

Transcript

[00:00:06] Gary Bisbee, Ph.D.: On this Memorial Day, May 30th, 2022, we remember the men and women who made the ultimate sacrifice for freedom. It’s appropriate that our guests today are for current or retired military generals. We appreciate their service and are pleased that they’re with us today. We welcome Generals Scott Dingle, Ronald Place, Joseph Caravalho and Elder Granger. Leading off is Lieutenant General Scott Dingle, Surgeon General of the US Army and commanding general of the US Army Medical Command.

[00:00:40] Lt. Gen. R. Scott Dingle: What does Memorial Day mean to me? To me, Memorial Day is a very significant event in my life and in the life of every soldier, sailor, airman, and Marine. Why is that? Because, me as a soldier, I sit and I stand on the shoulders of those who have given their life for their country. I’m able to lead today and serve today because of those who have given their lives in battle. General Douglas MacArthur said this quote. He said that no one desires peace more than the soldier because it’s he, or she, I paraphrase, who must pay the greatest price when called upon. Memorial Day honors those service members who paid that ultimate price in battle. That means they have given their lives. They have died in combat. Memorial Day is not to be mixed with Veterans Day. Veterans Day honors those who have served previously. And then Armed Forces Day, the third Saturday, weekend in May, that honors those who are currently serving on active duty. But Memorial Day, very special. When we see the tombs, the gravestones, the red poppies that are handed out, it reminds us of those who died in combat. They paid the ultimate price. And so we have our freedoms today, I have my freedoms today, because of the soldiers, the sailors, the airmen and the Marines who died in combat. So I remembered them today. It’s a very special day and we pay homage to that ultimate sacrifice. And that’s what Memorial Day means to me.

[00:02:30] Dr. Gary Bisbee: Next up is Lieutenant General Ronald Place, a physician who is Director of the Defense Health Agency.

[00:02:37] Lt. Gen. Place: We’re aboard the USS Mesa Verde, LPD 19, an amphibious vessel used to support and transport Marines anywhere across the world that we as Americans, we as the Department of Defense, we need Marines. Memorial Day, an important day, an important concept. I think that I’ve really transitioned to how I thought about it over my lifetime. As a kid, start of summer. Or as a young adult, it was, do I have school today or do I even work today? But the way I thought about it, the way I continue to think about it, really changed the first time that I deployed to Afghanistan. I went in the fall of 2001 through the spring of 2002. Before that I saw myself as a physician. I saw myself as a surgeon who happened to be in the Army, but I identified as a surgeon. But with that deployment, with these incredible, these incredible soldiers and sailors that I happened to be stationed with and their ability to focus on each other and really live for each other and the comradery that came with it changed me such that I no longer thought about myself that way. I thought about myself as a soldier who happened to be a physician. Later in Afghanistan, I had another experience that I think is going to be germane to Memorial Day. The day was like many other days, trauma activations, casualties coming in. But in this particular case, it was a young soldier, young Lieutenant, whose vehicle that she’d been riding in was destroyed with an improvised explosive device, an IED. And shortly before arriving in our Ford resuscitative surgical team, she started to code. In fact, her heart stopped beating. And so getting her into the resuscitation bay and evaluating her for her traumatic blood loss, her above knee amputation on one side, and her below-the-knee amputation on the other side, and fragment injuries to other parts of her body. And what could we do and stop the bleeding and coding her in chest compressions. And that’s not working. Opening your chest, doing intrathoracic cardiac massage, trying to save her life. Everything that we could possibly do. Blood transfusions. Everything. And sadly, we’re unsuccessful. And at that point we don’t know who she is. And so my responsibility then was to go through her clothing, to find her wallet, to find her ID, to find her name. And it’s at that point, she stopped being the bilateral leg amputee coming in coding. She became this young woman who volunteered to go anywhere, to do anything, to keep America free. That’s who we think about on Memorial Day. Now, my job as the Director of the Defense Health Agency is to make sure our healthcare team is trained, equipped. They’re ready for anything, no matter what any soldier, sailor, airman, Marine, or guardian have happened to them or disease process, that we’re there to take care of them, to optimize their healthcare, to make sure that really, really long list of those people we honor on Memorial Day stops adding new names to it. Memorial Day is the gift of one American to another, so that we can be free. I hope that everyone listening to your show has a peaceful and reflective Memorial Day as we think about those service members who are deployed in harm’s way across the world to maintain that safety and security for the rest of us. So, God bless everyone listening to your show, God bless our service members deployed in harm’s way, and God bless America.

[00:06:42] Dr. Gary Bisbee: Next is Major General Joseph Caravalho, retired, a physician who is currently President and CEO of the Henry M. Jackson Foundation for the Advancement of Military Medicine.

[00:06:54] MG Joseph Caravalho, Jr., M.D. (Ret.): Well, it’s a federal holiday. Unlike other holidays, there’s not happiness with it. There’s solace associated with it. But before I talk about this special cohort of American patriots, Memorial Day allows me to kind of just think about, there really are a lot of patriots in this country. It’s not just those in uniform. And if we think about a patriot doing something selflessly for the people or the population, we have our teachers and educators who train the people. We had government workers who support the people. We have a firemen, policemen, first responders who protect the people. Nurses and doctors care for and treat the people. Appointed and elected officials represent the people. But it is a special cohort of individuals who volunteered to put on the uniform of this country to defend the people. And so I think of this group as signing the proverbial blank check payable to the United States of America for up to and including their very life. And it doesn’t matter what they do. Everyone is prepared and trained to engage the enemy and defeat the enemy on behalf of this country. Not for an individual, not for an administration, but for the ideals of freedom and democracy. And so on Memorial Day, we think about this 1% of the population, those individuals who then made the ultimate sacrifice. No greater love than to put one’s life down for a fellow human being. These individuals in combat died so that we could enjoy the freedoms and liberties that we have today. So when I think about Memorial Day, I try to take a moment just to think in honor and in awe and in respect for those individuals who sacrificed for me and my family and for generations of Americans going forward. And I also think about the gold star mothers and fathers, the husbands, the wives, the sons, the daughters, those who shared their treasure with this country who no longer have them in this life. I honoe them as well. So that’s what Memorial Day means for me.

[00:09:17] Dr. Gary Bisbee: We will close with Lieutenant General Elder Granger, retired, a physician who is President and CEO of the 5 P’s.

[00:09:27] MG Elder Granger, M.D. (Ret.): Well, first of all, let me go through what I call some of the history. Memoria Day got started by Brigadier General John A. Logan in 1868. And that was at the height or after the Civil War between the north and the south. However, the first celebration, we call decoration, Memorial Day took place in 1865 in Charleston, South Carolina, when free African-American soldiers exhumed the bodies of Union soldiers and honored them with decoration. So what does it mean to me? It means that freedom is not free. We must honor those who paid the ultimate sacrifice going back to the American Revolution, the Civil War, the various wars participated, War of 1812, the Spanish American War, World War One, World War Two, the Korean War, Vietnam, Desert Shield, Desert Storm, the Iraq, Afghani War, to including up in modern day time, what is happening in the country of Ukraine, when we have laws, individuals who believe in freedom of the press to include journalism, their technical support staff, and others. So it’s important that the last Monday in May, that we take the opportunity to have a moment of silence or visit a cemetery to acknowledge those who paid the ultimate sacrifice, men and women in our uniform services, as well as civilians, who sometimes we don’t mention, who have paid the ultimate sacrifice in the defense of this nation, both home and abroad. So I say again, Memorial Day means to me, let’s pause and honor in a moment of silence or visit a cemetery, honor those who paid the ultimate sacrifice. And again, freedom is not free. So thank you.

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