Hard Hats Off to Diving Docs

By Fred Bove, M.D., Ph.D.

During 1999, I had the opportunity to visit two Navy diving schools and teach military physicians about diving medicine. One school is in Toronto, where the Canadian Navy teaches their medical officers to become diving medical officers who support diving and submarine operations. Their training includes several weeks of classroom work on diving medicine and physiology, experience in operating hyperbaric chambers and diving with the equipment used by their working divers. Among their many contributions, research by Canadian military laboratories has provided us with the DCIEM air diving tables that are used by many sport divers and have expanded our knowledge about cold water diving.

The other school is our U.S. Navy Diving and Salvage Training Center in Panama City, Florida. Panama City is also the home of the Navy Experimental Diving Unit where much of the Navy's diving research is conducted. The Navy teaches all aspects of diving at the NDSTC, including an intense program in diving medicine. Each year, the Navy trains two classes of Undersea Medical Officers who support diving and submarine activity of the Navy. This past fall I had the opportunity to spend a day with the medical officers teaching diving medicine.

Navy medical officers who elect to become Undersea Medical Officers attend a six-month program in submarine and diving medicine. The last eight weeks of the program is spent at the NDSTC in a combined classroom and practical diving program that includes diving with both scuba and surface supplied air and mixed gas. For many years, research both in the laboratory and in the oceans, to advance the field of diving medicine, has come from graduates of the Navy diving medical officers' program. Navy and civilian laboratories have been staffed by these graduates, and their contributions have helped sport diving to develop into the safe sport it is today. The Navy air diving tables, use of helium in diving, oxygen use in treatment of bends, saturation diving, and new methods for treating decompression sickness all are products of Navy Diving School graduates.

To better understand the contributions made by graduates of the Navy diving school (physicians, operational divers and diving officers), you should read the book Blind Man's Bluff by Sherry Sontag and Christopher Drew. This book describes the risky deep diving that was conducted during the past 40 years. To conduct such deep diving, research needed to be done, divers needed to be trained, medical officers needed to learn the problems of deep, mixed gas, saturation diving and teams needed to be assembled that could bring together all of the expertise needed for these operations. That they were done successfully, and without serious casualties, is testimony to the training provided by the Navy Diving School.

For physicians interested in diving medicine, the military schools are the most comprehensive, but a physician must be committed to considerable time in the Navy. As an alternative, a diving medicine program offered by the National Oceanographic and Atmospheric Administration (NOAA) is available to a selected group of civilian physicians annually.

My 1999 diving education journey also included the American Board of Preventive Medicine in Chicago. The ABPM is one of the medical specialty boards that provide certification for special medical expertise. Other boards certify surgeons, internists, family practitioners, etc.

The Preventive Medicine Board sponsored a new certifying examination in diving and hyperbaric medicine. This additional qualification in diving and hyperbaric medicine is available to physicians who are board certified in another medical specialty. Physicians who are certified by this board will be considered experts in diving and hyperbaric medicine. The board will announce those who are certified in early 2000. In the future, you will be able to find an expert in diving and hyperbaric medicine from a directory of medical specialists.
The last stop on this diving education journey brought me again to Chicago to attend the 40th anniversary celebration of the YMCA diving program. The meeting brought together YMCA instructors for several days of seminars. The YMCA has developed several new programs for divers with medical disorders. Their Diabetic Diver program has trained a number of diabetics who use insulin, and who are diving safely. The YMCA has begun a similar program for people with asthma. They are using recommendations developed over the past several years by the Undersea and Hyperbaric Medical Society (www.uhms.org) that provide guidelines for evaluating asthmatics who want to dive. We know there are many diabetics and asthmatics whose condition is mild or well controlled who are diving safely. With proper training, and use of guidelines for assessment of their illness, many individuals can find the opportunity to participate in sport diving.
You can find more about diving medicine including past Skin Diver articles, current news, and have an opportunity to ask a question about diving medicine at our website (www. scubamed.com).