Lieutenant David Irving

Lieutenant David Irving, a physician assistant aboard U.S. Coast Guard Cutter Bertholf, stands beside the ship's embarked helicopter Feb. 26, 2019. Bertholf is on a months-long deployment in support of the U.S. Navy's 7th Fleet. His permanent duty station is Kodiak.

There are a few things Coast Guard planners can count on when putting together a ship’s deployment to some of the most remote areas of the globe.

Things on the ship will break, plans will change – and there’s at least a chance someone will get hurt. It’s that last factor that concerns people like Lt. David Irving, a Coast Guard physician assistant aboard U.S. Coast Guard Cutter Bertholf. His permanent duty station is Kodiak.

Normally, a Legend-class national security cutter such as Bertholf carries an independent-duty health specialist, typically a chief petty officer, to attend to the medical needs of the ship’s 126-person crew. At present, however, Bertholf is engaged in a deployment to the Western Pacific Ocean under the tactical control of the U.S. Navy’s 7th Fleet to support U.S. foreign policy and national security objectives. When a deployment takes a ship outside the Western Hemisphere, its permanently assigned health specialist is augmented by a physician assistant such as Irving, a former U.S. Army combat medic who served previously in Iraq and Afghanistan.

Physician assistants provide a higher level of medical care in areas where medically evacuating a sick or injured member of the crew can take days.

“Even an embarked helicopter only extends our range 200 miles or so,” Irving said. “The fact is, it may take five days of steaming before we can medevac a patient,” which means Irving needs to think creatively about how to treat patients for extended periods of time.

“This is it,” Irving said, looking around a well-equipped, but by no means comprehensive, sickbay. “So we ask ourselves, ‘What can we do with the resources we have?’”

As a battle-tested combat medic in Iraq, Irving occasionally faced a similar calculus when sandstorms or bad weather limited his ability to transfer patients to higher levels of care.

Fortunately, Irving added, military patients tend to be young and healthy, which can help them when they become sick or injured. Irving also said he draws on the extensive experience of Chief Petty Officer Tani Grindheim, Bertholf’s permanently assigned health specialist.

Grindheim said she draws on Irving’s experience, too.

“Being able to bounce ideas off Lt. Irving is really helpful to me,” Grindheim said. “Having him aboard gives me a lot more time to devote to patient care and my other duties.”

The deployment also provides both health care professionals better opportunities to engage more closely with a smaller pool of patients.

“There are things I really do like about shipboard life, and being more connected with patients,” Irving said. “It was the same thing in the Army – you were a medic for your unit, and you got to know people in a more personal way.”

The married father of five, who calls Irvine, California, home, has served nearly five years in the Coast Guard and more than 17 years in the military. He got interested in medicine during college mission trips, where he worked with physician assistants in Haiti, and he enlisted in the Army as a medic in the wake of the Sept. 11 attacks. After serving two tours in Iraq, he attended a two-year Department of Defense physician assistant course at Fort Sam Houston, including a 12-month clinical rotation at Fort Leonard Wood, Missouri. Upon graduation, he earned a master’s degree and a commission as a first lieutenant.

After serving a year in Afghanistan as a physician assistant, he moved to the Coast Guard, and he has since earned an aviation designation. 

“I’ve been around a little bit,” he said with a smile.

He and his wife have five children ranging in age from four to 11, and they’re in the process of adopting a child from China – the second time they’ve adopted a child from the country.

Leaving his family for a deployment is never easy, Irving said, but it helps him remember what’s important about the relationship between patients and health care providers.

“Some of it is learning to treat people as people, learning to treat them the way I would want someone to treat my kids,” he said. “Deployments also help me remember that in the Coast Guard, people are doing this hard stuff day in and day out.”

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