Federal Practitioner: In your chapter in Women at War, you share your experiences serving on a naval vessel. Why do you think it is important to share these experiences?
Dr. Paulette T. Cazares: I think the period in which I served as a ship’s physician was unique; not just for me, but for anyone lucky enough to have the experience. Those outside the Navy rarely understand the day-to-day duties of a physician in that role.
FP: Can you elaborate on the psychological adjustment of fitting in to a mostly male world?
PC: I initially found that I was quieter than I typically am, especially in the wardroom and in leadership meetings on the ship. Once I became confident in my ability to find my way around the ship (literally and figuratively) and to understand my role on the ship, I was more outspoken, more of an advocate for my staff and my ideas, and more vocal at the right times and I believe, with the right people.
FP: How much evidence-based data are available on women’s health care in the Navy?
PC: Unfortunately, data on women’s health care is scant but is gaining interest, funding, and ground.
FP: What areas have been identified that need more research?
PC: Mental health outcomes are especially important and require significant research. This research can elucidate trends related to attrition, fitness for duty, and outcomes that require DoD interventions, such as those subsequent to military sexual trauma.
FP: Once women were permitted to serve, what medical care concerns needed addressing?
PC: Clearly, concerns related to women’s reproductive health were of immediate concern, but rates of substance abuse (including smoking), mental health diagnoses, asthma, and infectious disease, among others, are all of critical value.
FP: What changes regarding medical care were put into place?
PC: Women’s needs were given the same footing in print. Progressive, open-minded commanding officers implemented changes promptly, and those who resisted have slowly been eliminated over time.
FP: Is there any single health concern for women that stands out in your mind?
PC: I see women’s mental health as a largely uncharted frontier and one that necessitates great attention.
FP: You offer a number of clinical pearls in your chapter in Women at War. Can you share one?
PC: “Trust, but verify.” I have found that as the responsible officer, in many scenarios I need to be sure the facts are accurate. This was especially important on the ship, where the commanding officer relied on my advice and counsel and the crew counted on me to represent their needs.
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