I was the expectant team leader at Minot, the one designated to survive “a little longer than the others” if nuclear war came. My role was not glamorous. It was a reminder that even in medicine, some of us were expendable. Years later, I was nearly sent to the First Gulf War, and I watched colleagues deployed to Afghanistan, developmental pediatricians pressed into service far from the children they were trained to help. Some came back grievously injured.
Even as a child, I understood that death was my greatest enemy, one I vowed to confront armed with every ounce of medical knowledge I could gather. And yet I swore an oath to God to defend the Constitution of the United States with my life. That paradox (fighting death while pledging my own life) followed me throughout my career and into “retirement.”
That vow carried me to countless premature births, each one a battle between fragility and hope. I stood at the front lines, the first to respond to every code, praying for the skill to save each child. But sometimes, God’s answer was “No.” In those moments, I carried the weight of a life too brief. The base chaplain taught me to baptize with glucose water, a ritual that became my prayer, my offering of peace for children who came home to Paradise far too soon.
My other role as a medical officer was chief of the expectant team: for war fighters who had no hope of survival. I would administer morphine to ease pain; the chaplain would administer last rites to ease the soul. Thank God I never had to serve that role, missing the First Gulf War by only 32 days. But every premature birth, every code, reminded me of the fragility of life and the certainty of death.
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From the nursery to the runway, the paradox followed me. Had Ronald Reagan declared a conventional war against the Soviets, my posting would have been at an aid station barely 100 yards from the runway. Instead of using four years of medical training, I would have relied on a two-week C-4 Combat Casualty Care Course: performing tracheostomies, placing tourniquets, packing wounds, an overtrained medic, not a pediatrician. I carried a gas mask with glasses inserts already installed, ready for chemical or nerve agent attack. Drop the helmet, don the mask, suit up, and get back to work.
One colleague returned from Afghanistan with a shattered leg. A developmental pediatrician trained at the cost of millions of dollars, sent as cannon fodder while internists and family physicians remained safely in their offices. The Army adopted the Marine Corps mantra “every man a rifleman,” as if we were interchangeable soldiers. She came home, after a long recovery, carrying a K-Bar knife in her boot (against regulations) not for combat, but to kill any rapist who threatened her.
We ultimately used that knife for a peaceful purpose: unscrewing battery cases in ADOS-2 toys to replace old batteries. Not quite swords into plowshares, but knives into screwdrivers for children’s assessments. You won’t find that parable in the Bible.
Later, in Phoenix, even the building itself became hostile. My colleague’s “sick building” complaints were dismissed as hypochondria, but they led to real medical crises for me. Typing reports while receiving albuterol nebulizations left my hands shaking so badly I couldn’t finish. Twice I ended up in the emergency room. And yet, the final blow was not the building or the asthma, it was being fired for seeing too many Hispanic children. Equity was treated as insubordination.
I signed a blank check to the Constitution, payable with my own life. That oath was not symbolic; it was lived in every deployment order, every expectation that developmental pediatricians could be treated as expendable. My colleagues carried scars from Afghanistan, and I carried the memory of being designated “expectant” at Minot, the one meant to survive just long enough to bear witness. Even our survival tools, like a K-Bar knife hidden in a boot, were repurposed for children’s assessments, not combat.
What we gave was not expendable. It was service, sacrifice, and dignity. If the nation can honor surgeons, it must also honor the pediatricians who stood ready to help children even in war zones. Our blank checks were cashed in ways that ethics should never allow. It is time to reckon with that truth.
Ronald L. Lindsay is a retired developmental-behavioral pediatrician whose career spanned military medicine, academic leadership, and national advocacy for dignity-centered neurodevelopmental care. His NIH-funded work with the RUPP Autism Network helped define evidence-based approaches to autism and related developmental disorders.
He directed the LEND Program at The Ohio State University and founded JBLM CARES, a $10 million autism resource center for military families. His writing spans clinical scholarship and long-form fiction. He is the author of The Mercy Directive and the six-novel Cassandra series, a completed political and medical fiction saga tracing the rise of the Cassandra system from its origins to its national and international legacy. His forthcoming memoir, The Quiet Architect, examines how conscience and structure collide in modern medicine.
He shares updates on LinkedIn.
