In February 1722, four students entered the very first school of maritime medicine in Rochefort (Charente-Maritime). They were 14 years old, could read and write, had deformed hands, knew how to shave and practiced bleeding. The site has since trained 6,572 “navigan” surgeons until the closure in 1964 and the move to Bordeaux of the naval physician training center. The place is now a museum. 300 years later, the heirs of the first four practitioners within the Amicale Santé Navale et Outre-mer (ASNOM) gathered in Rochefort on June 10, 2022 to discuss this past and – with some concern – the prospects for the future of this curious army. to consider. profession.
The requirements for enlisting in the navy have obviously changed a lot in three centuries, most notably the date of 1743 when surgery shifted from the barber trade (ships were previously required to take on board a barber who could also act as a barber). carer served) to that of medicine. The founder of the school, Jean Cochon-Dupuy (1674-1757), then his son Gaspard (1710-1788) and finally their nephew Pierre Cochon-Duvivier (1731-1813), established the first rules governing the training in the 18th century. and obtaining diplomas and set up a course based on the practice presented by today’s hospital-university centers. †The ordinance of 1768 encompassed in its nine titles everything that affects the life of a training institution: working methods, buildings, assignments, duties, boarding rules, uniforms. recalled Claude Rouquet (Bordeaux promotion 1965).
In three centuries, the physician’s responsibilities on board have changed little
But this constant advancement has in no way undermined the foundation of the duties a physician must perform on board. Because there is nothing obvious about embarking on long months at sea when you practice medicine. †The mission is to ensure the health of the crew and intervene in the event of an accident on board as well as to ensure the good morals of the crew and many of our colleagues have, in addition to their medical training, psychology “, explains Georges Durand, president of ASNOM (Bordeaux class of 1964). In the days of the sailing navy, the ship’s surgeon had the same mission: to ensure the morale of the crew and report to the harbourmaster. Even today, the Navy has the peculiarity of bringing together hundreds of young individuals, mostly males, in a tight space over long months. This creates a special environment, not so easy to manage, not to mention you have to practice medicine in a place shaken by list and roll.
Marine surgeons clearly see their role magnified during wars. Thus the first trained surgeons were put to the test during the War of the Austrian Succession (1740-1748), the Seven Years’ War (1756-1763) and finally the war against Great Britain for independence from the United States (1778-1783). † The conflicts of the 19th and 20th centuries made it possible to define definitively the practice of the profession and the scope of intervention and the legitimacy of the doctor on board, depending on the management of the ship, but autonomous in his decisions. The attributions include areas of public health, such as monitoring the quality of onboard drinking water, hunting rats, or detecting parasitosis in a limited population. The Covid-19 epidemic on board the aircraft carrier “Charles de Gaulle” in 2020 thus brought back painful memories for some. †I had to deal with a flu epidemic on the aircraft carrier “Clémenceau”remembers François Desmants (Bordeaux promotion 1966). In a few days we arrived at 500 patients out of a crew of 2,000, which caused great concern to the staff, and then the epidemic died out in no time”†
The navy encounters more and more combat situations
François Desmants spent a lot of time on the Clémenceau (dismantled in October 1997). The practitioner from Toulon has the particularity of having completed his training in the United States where the rule is that a naval medic must also know how to fly an airplane in order to know the physical limitations associated with operating such machines. In his 30-year career, he has never had a chance to experience the aircraft carrier’s involvement in combat. †This is the big difference with my successors who are active today, François Desmants recalls. When the Charles de Gaulle intervenes in support of the American intervention in Afghanistan, you have about 15 pilots on board who really go into battle, bomb enemies, and for a doctor – as for the entire crew – that changes everything.”†
Is it for this reason that the military has difficulty recruiting surgeons these days? The increase in the opportunities for combat by the French Navy due to a changing geopolitical context that sees the increase in local conflict implies an increase in the number of personnel in the armed forces health services. The Navy now has 73 onboard medical services for 191 doctors and nurses. And it tries to attract callings. †Young doctors hesitate to navigaterecognized at the congress Michel Giroud, general practitioner, inspector of health services (Bordeaux promotion 1977). Embarkation is less rewarding than “external operations” (OPEX), averaging 200 days at sea per year, it is deterrent, isolation and confinement postponed, and living and workplace instability is less well supported”† Reluctance showing that the limitations of onboard medicine have hardly changed in three centuries.