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and after-the-fact urgent medical care. By 2035, it should be possible to have full wellness programs with continual monitoring of many physiological and psychological processes, job-specific performance enhancers, and genetic testing for physiological and behavioral strengths and vulnerabilities. Moreover, advances in biomedical and behavioral sciences may salvage a significant number of persons who are currently excluded from military service because of physical or psychological problems.
In combat, the process of medical prevention and treatment will continue with the aid of special devices and procedures that have been designed to enhance protection from, or provide immediate treatment for, injuries resulting from battlefield hazards. These hazards include direct enemy action as well as dangers imposed by the hostile environment.
It is important to have a medical system in place through telemedicine that enables the connection of remote sites (ships, battlefield) to medical facilities located in the continental United States (CONUS). Naval operations in 2035 will pose new types of antipersonnel threats combined with the familiar threats of explosive devices and projectiles. The new threats will include chemical and biological warfare agents delivered by artillery, bombs, rockets, or missiles, and directed-energy weapons such as lasers, high-powered microwaves, radio-frequency waves, and other forms of nonionizing as well as ionizing radiation.
Also likely is the addition of environmental and geographical extremes associated with contingency operations that require U.S. forces to deploy to remote areas of the world. Fighting in these areas carries with it the added significant threat of infectious diseases, a special form of environmental hazard.
Finally, future operations will expose naval forces to extraordinary levels of psychological stress resulting from highly accurate and lethal weapons; silent and deadly chemical or biological agents; equally silent and dangerous directed-energy devices; sustained operations; increased dispersion and isolation of small units; and the uncertainty of contingency operations in remote areas.
PROTECTION AND PREVENTION
One major concern of military medical departments is specialized preventive measures. These include drugs and vaccines to protect our forces against nuclear, chemical, and biological agents; physiological monitoring of body temperature, hydration, and alertness; specially designed ensembles for protection from projectiles, directed-energy devices, and chemical and biological agents; and psychological aids, such as land navigation and local communication devices that enhance security and provide information regarding available support. The Department of the Navy should seek to integrate lightweight body armor into its combat forces so that each sailor or marine within a group will be wearing unencumbering body armor with an integrated personal status monitor. This will provide real-time updates of combat personnel status.