I was about 4 weeks into my assignment as the Ship’s Surgeon on board the USS Carl Vinson.  The Ship was just coming out of its eleven month DPIA, or Docked Planned Incremental Availability.  The USS Carl Vinson had done a six month deployment to the Persian Gulf in 1999, and then entered Puget Sound Naval Shipyard adjacent to Naval Station Bremerton for its DPIA.  During this eleven months, the ship was in drydock undergoing refurbishment, repairs and updates.  The aircraft carrier was being upgraded and prepared for its next six month deployment to the Persian Gulf.  Computer systems were overhauled, power and electrical infrastructure was improved, living quarters and facilities were renovated.  Approximately 260 million dollars went to refitting and refurbishing the aircraft carrier.  This phase was completed in June 2000, and now the ship was beginning its IDTC (Inter-Deployment Training Cycle), the pre-deployment phase of operations.  The ship would spend the next six or eight months embarking on a series of training missions to get the crew certified and prepared for deployment.  These missions would last anywhere from one to ten weeks at sea, followed by a period back in port.  As the months progressed, we would eventually train with our airwing, and have the other ships in the battle group join us.  We were scheduled for a six month deployment back to the Persian Gulf the following June. 

     While the ship was in drydock, there was no surgeon attached, because Naval Hospital Bremerton provided all the surgical and emergent care the crew needed.  The medical department on the ship still provided routine care, screenings, and preventive care.  I learned that when a ship is in port, it is not normally permitted to function as a hospital.  By Navy instruction, if a shore facility is available, surgical care is provided there.  Now that the ship was coming out of drydock and would be operational, they needed a surgeon on board.  My assignment was for one year.  Most Navy assignments are two to four years, but they decided to make the surgeon billets on ships one year assignments.  A surgeon on a ship does not do a lot of surgery, and they really haven’t come up with a simulation that is any good at providing useful surgical experience.  To avoid deterioration of surgical skills, they made the assignment for surgeons on ships short.

     The ship’s first training mission would consist of simply disconnecting from the pier and basically pretending we were at sea for a week.  All electrical, communications, and physical connections to the pier would be gone.  This would allow testing of all systems vital to the survival of the crew and the operation of the ship without the risk of being far from help.

     The medical department was two floors, or decks, below the hangar bay.  Narrow ladder wells connected the decks.  I was going to have to get accustomed to a whole new jargon here on the ship.  Floors are decks, ceilings are bulkheads, stairs are ladders, there was port and starboard, fore and aft.  Everything and everyone was known by sets of initials or by their position.  Proper names were not used that often.  In the medical department, I met HN and HM1 and HM2 and some more HM3’s.  The initials and numbers identified the rank and specialty of the crew.   The HM’s and HN’s were all enlisted Hospital Corpsmen.  I met MAO (pronounced mayo) the Medical Administrative Officer, and SMO, the Senior Medical Officer.  SMO was a psychiatrist and had been the Medical Department Head on the ship for several months.  His actual name was John, but everyone just called him SMO.  The administrative office and the SMO’s office were at the entrance to the medical department.

     The main area of the medical department consisted of a treatment room with two treatment tables and various pieces of medical equipment.  This is where the corpsmen saw patients and took care of problems.  Hospital corpsmen function as the primary triage and caregivers for the crew.  They take care of many routine health problems, with physician’s assistants and physicians helping as needed for more complex issues.  The GMO, or General Medical Officer, saw patients here as well.  In the military, doctors often have to do a one year tour as a General Medical Officer before being allowed to finish their residency training.  They come out of medical school, finish one year of residency training as an intern, then go out to a ship or some other command as a GMO.  Once they complete this, they can try to get into the specialty residency they want, like surgery or anesthesiology or internal medicine.  So I basically had an intern and a psychiatrist to help me deal with any potential life-threatening medical situation that might come up.  I had done a residency that was very strong in surgical critical care experience, so I felt pretty confident taking care of things like heart attacks and pneumonia and diabetic crisis.  We should be fine, I thought.  The GMO and I each had an “office” off the treatment room.  My office was about the size of my linen closet at home.  It had a file cabinet, some shelves, a little built-in desk and chair, and an exam table. We couldn’t completely open the door without hitting the exam table behind it, and I had to roll the desk chair back into the corner to open or close the door.

     Right next to my office was a back entrance to the scrub sink and the operating room.  I had two scrub techs, HN Phillips and HM2 Bradley, that would assist with any surgeries.  Bradley had been around the block and had a lot of experience in the operating room.  Phillips was fresh out of tech school and learning.  He seemed enthusiastic and eager.

“Sir, if there is any specific equipment you want, just let me know.  We definitely have the capability to do any general surgery case right now.  If there are any other instruments or suture you want, we can get a list together and get it,” HM2 said.  I thought he had called me Sir, but decided there was really no harm in that.  In the Navy, you are supposed to address anyone of a more senior rank as Sir or M’am, preferably using the correct gender. 

“Okay,” I replied.  “Maybe tomorrow we can go over all the equipment and suture in more detail and see what we have.”

“Yes, Sir,” he responded, then quickly corrected himself.  “I meant Ma’am, yes, Ma’am.”  He was flustered and slightly embarrassed at his lack of proper military protocol to address a female superior officer.  He explained that it wasn’t very common to have a female surgeon on the ship.  Poor HM2 Bradley continued to address me as “Sir” frequently, quickly apologizing and following with “Ma’am”.  Over several months it became an almost automatic “Yes, Sir, I mean Ma’am” then progressed to a more consistent “Yes Sir/Ma’am”, just combining the two into one.  I didn’t mind, it seemed odd to be called “Ma’am’ anyway.  He did a great job as the surgical assistant in cases and was always on top of things and well prepared, so I decided if that was his biggest flaw, I could certainly live with it. 

     Directly across the hall from the OR was the physical therapist’s office and the ship’s psychologist office.  The physical therapist was known as Stretch-O, and the psychologist, of course, was Psych-O.   The “O” stood for officer.  Many positions throughout the ship had nicknames.  The Department Head for Supply was Supp-O.  The Maintenance Officer was Fix-O.  The surgeon was Slice-O.  We wore baseball-type caps as part of our uniform, and the position nicknames were embroidered across the backs of the caps, so people could tell who you were from all directions. 

     I walked into the medical treatment room and found GMO and HM2 Patterson in the middle of a rather lively discussion.

“It is not biohazardous.  If it was a biohazard, then we would have to deal with every head on this ship.  This is just total bullshit, pardon me, sir, but it is,” Patterson griped.

“Head” is the Navy word for bathroom.

“I know it is, I know, but if we don’t go and deal with it, they are gonna go crying to their chief, then it goes up the chain of command, and the next thing you know, the Medical Department is not living up to its responsibility, we let the crew down, blah, blah, blah.  It’s easier just to go and take care of it” GMO answered.

     I wondered what had happened, if there had been some type of chemical spill or accident or something.

“When they find out who this asshole is, I’m personally going to shove his face in it, then testify at his court martial.  This is my third time,” he grumbled.

“What’s going on, what’s with the biohazard stuff?” I asked as HM2 started pulling out the red biohazard waste bags.

“Oh, the Phantom Shitter again,” he replied, expecting me to know what he was talking about.  The puzzled look on my face made it clear I had no clue.

“Oh, my God.  You don’t know about the Phantom Shitter?”.  He was stunned.  “I thought everyone knew about the Phantom Shitter.”  I reminded him I was the new guy on board, so he explained.

     About two months before coming out of drydock, the medical department had been alerted to come to aft berthing (enlisted living quarters) for a biohazard situation.  A “Medical Alert” had been called.  For a medical emergency anywhere on the ship, repeat announcements are broadcast on the ship’s overhead announcement system and a medical team rushes to the site, carrying bags of equipment to handle the common medical emergencies.  The corpsmen and GMO had suited up in their yellow suits and hoods, got their equipment and made their way to the site.  Upon arrival, they encountered a small crowd gathered around a pile of feces on the floor.  When the guys awoke, much to their dismay, they had found this pile of human feces deposited right on the floor of their living area.  Medical scooped it up and flushed it, and GMO declared the biohazard situation clear.  It was annoying, but a problem easily solved.  However, about three weeks later, another pile of feces was found on the floor near a shared head in another berthing area..  Right in the middle of the hall.  Again medical was notified to come clean up this “biohazardous waste”.  The third time it happened, GMO protested, arguing this was a complete waste of medical personnel time, that someone just needed to pick it up and flush it.  Of course, no one wanted to pick up someone else’s poop, so this went all the way up to the CO, who ruled that it was the job of laboratory technicians or the biomedical tech from the medical department to secure and properly dispose of this potentially infectious material.  GMO had tried to make the argument that it was legal evidence, and should be collected and kept by the legal department.  He tried to claim it was a safety hazard, with possible injury if someone were to slip in it.  The Safety Department’s objective was to provide a safe and healthy working environment for all, so they should manage it.  The S-9 division of Supply handled hazardous waste, but they dealt with chemical and nuclear waste, and laughed at the idea of scooping poop.  He got nowhere, so the medical department was stuck.  Someone on the ship was randomly crapping on the floor in different areas, and he was dubbed the “Phantom Shitter”.  He struck every two or three weeks, and some poor corpsman had to suit up in the biohazard gear and go scoop it up and flush it.

     The CO had made a demand that this person be caught and off the ship prior to the six month deployment for WestPac.  The general belief was that this was probably someone doing it with the intent of getting caught and kicked off the ship or maybe get kicked out of the Navy.  Some thought it was just some idiot’s idea of a joke, or that maybe several people were involved in a copycat situation.  The corpsman had developed a seething hatred for the Phantom, which I could definitely understand. They had all been involved in a cleanup at least once.   GMO would report each incident to the XO, who had security and legal working on the task of catching him and figuring out what to do if he was caught.  It sounds like they had already determined that if this was some ploy to get sent off the ship, they would do worse than that.  They would keep him here. 

 “At least we can use this as a biohazard training opportunity,” Patterson grumbled.

I slapped him on the back as he suited up in his yellow biohazard garb, directing one of the HN’s to go with him and learn the ropes.

 “That’s the spirit.  Go get ’em, men.  Remember you’re doing this for the honor of your country, and America appreciates your dedication to your work,” I offered in support.

“Thank you, M’am.  That makes this all worthwhile.”  I loved the sarcasm of the corpsmen. 

SMO came walking in at about this time, and his face just suddenly deflated as he saw them in their suits.

“Oh, no.  Not the shit patrol?” he asked, already knowing the answer.  “Sorry, guys.  You know what to do.  Carry on.”

     They trudged off to do their job, muttering about what they would like to do to this guy.

Several days later, I was the duty officer for the day.  The medical department always had one provider on “duty”, which was the equivalent of being on call in the civilian world.  Being the only surgeon on the ship, I was always on duty for any surgical issues.  We rotated duty for all the general medical issues between myself, SMO, GMO, and PA.  We all carried these rather bulky phones that attached to our belts.  Being surrounded by all the advanced technology one finds on an aircraft carrier, you would think we could have had some nice, small, ultra-efficient type of communication device.  But we had these big, old- looking walkie-talkie type things.  All the departments used them, and they got the job done.  Because they were so bulky, most people wore them on the back of their belt, off a little bit to one side.  Hence they were named “buttphones.”  

     My day on duty had been quiet, as was my usual, but just as I had managed to drift off to sleep, my buttphone rang.

“Surgeon,” I barked into the phone. 

     I had developed a habit of always answering my phone with a rather unfriendly-sounding “Surgeon” or “Sawmiller”.  I think it was lingering contempt that I had developed for my pager as a resident, because when that thing went off, it always meant there was a problem somewhere.  But this answer was short and to the point, and gave the caller the information they needed, which was that they had reached the ship’s surgeon.

“M,am, this is HM2.  I am in officer laundry, deck 2, forward berthing.  We have a situation.”

I arrived to find HM2 and HN decked out in their haz-mat suits, with a very unhappy XO looking on from a few feet away.  They were focused on a good-sized pile of brown stool with some bright red streaks smeared around it. 

“Are you kidding me?  He has stepped up his game, right?  Now we are shitting in the officer laundry room!” I exclaimed.

“Is this blood?  What is all this?” the XO inquired. 

It did not look like blood to me.  I have seen lots of blood.  This looked a lot like ketchup.  We looked around and found three nearly empty open ketchup packets in the trash in the corner.

Two weeks later we encountered another big mess of stool with mustard on top, right in the middle of the hangar bay.

     Both the CO and XO were getting pretty furious with the increasingly frequent attacks by the Phantom Shitter.  For whatever reason, this became an issue the Medical Department was tasked with stopping.  The Shitter became a folk hero to some, seen as someone standing up to authority, protesting to make some grand point.  He was seen as a coward and a traitor by many, not worthy of the honor of the uniform they wore.  There were many theories that circulated around about the identity of the Phantom Shitter.  Everyone seemed to agree it was a male.  Maybe that is sexist, but it seemed more like something a young man might do to express his dissatisfaction.  Some thought it was just a prank, a series of dares by different sailors to try to get away with increasingly bold displays of disrespect.  Psych-O thought it was a cry for help, and she had several people in her care whom she suspected.  Maybe it was someone who wanted to get caught and kicked out of the Navy.

     There were some areas in the ship that had security cameras, but not in places the Shitter showed up.  XO wanted to try to do some type of testing on the stool to identify the source, but we did not have that technology on the ship.  Legal had interrogated multiple suspects with no solid leads.  We were nowhere close to identifying our suspect.

After the incidents increased to more than once a week, we started to think about a different strategy.

“What if we never catch the guy, but we can make him stop?  Would that satisfy XO?” HM3 tentatively asked.   We all thought XO would like nothing more than to catch this guy and publicly humiliate him and make an example of him.  But we were failing miserably at that task.

And the Corpsmen were very, very tired of going on these clean-up runs.

“What if we somehow announce that we have been doing DNA testing on the poop, but we need one or two more samples to be able to identify the person it comes from?  Get that word spread all throughout the crew, so they will be afraid to do it again.  That might scare them, if they think they can be identified” he suggested.  Most of the crew would have no idea that we had no possible way to identify the Phantom from a DNA analysis of his poop. 

     The Phantom Shitter was already legendary throughout the ship.  Everyone knew about each occurrence, and it always generated a lot of talk.  It would not be hard to get this rumor spread throughout the ship.  It could not be any type of official announcement.  If we leaked this information out, as if we did not want anyone to know we were DNA testing poop samples and were very close to identifying the perpetrator, maybe it would be believable.

       Slowly, we started to casually talk about this in the officers ward room, and in the enlisted dining halls. We ordered test tubes through supply, and some reagents associated with PCR DNA replication testing.  We started to talk to legal about submitting DNA evidence for prosecution for court martial proceedings.  We notified the brig we would be needing a cell to house the  Phantom Shitter.

      A whole week went by with no new stool alerts in halls or laundry rooms.  The Medical Department became cautiously optimistic that perhaps we had cleaned up our last excremental deposit.  Then a month went by without incident.  There were no more surprise bowel movements left for some unsuspecting sailor to wander into.  The medical department put away the haz-mat suits and buckets, and eventually got back to a normal routine.  The Phantom Shitter quietly faded away into the lore and legend of the USS Carl Vinson.