That Others Might Live

Warrior / Rescuer / Healer

Ready for anything.

“If” (when) I next get injured, I’m going to Resilient Performance Physical Therapy to get put back together. They are aligned with my intent to optimize performance, not coast along at some arbitrary minimal standard. Their mission and ethos comes from their co-founder and owner, Dr. Doug Kechijian. He was at an elite progressive university en route to medical school when 9/11 altered his course. He chose to serve and discovered a perfect role for his abilities and interests: Air Force Pararescue.

When the military dials “911”, the PJs go. Anywhere. That means that they need all of the special forces skills to get anywhere and fight off anyone necessary to rescue or recover Americans. While it is specialized, there’s a lot about the necessary mindset that is broadly applicable. That’s why I want to share this conversation with my friend Staff Sgt. and Dr. Doug Kechijian:

CD: To kick off, it has been a little while but how did you prepare for the selection process to become an Airforce Pararescueman (PJ), knowing that the attrition rate is so high?

DK: Fortunately, even though I went through selection when there wasn't as much transparency about the process as there is now, there was still enough information available on the internet that I had a pretty good idea about what I was getting myself into. I knew what the graduation standards for the course were and decided that I wasn't even going to talk to a recruiter until I could meet those benchmarks, not just the entry level criteria. Growing up and playing sports, I always enjoyed the process of training and did ample running, calisthenics, and weight training so the land-based activities in selection didn't require anything novel beyond continuing to work backwards from the graduation standards. Regardless of the task, I used different work/rest ratios and intensities to raise both the floor and the ceiling so to speak. The water aspect of selection worried me the most because I never swam competitively so I worked diligently on surface and underwater swimming technique through self-study and mentorship. Fitness alone is not sufficient in the water; technique and efficiency is everything. Once my technique in the water was dialed in, I was able to manipulate the training variables as I would with any other "problem"- by knowing the end game and progressively building up from the starting point.

CD: Did you show up in shape for it on day one or was this a process? Can you get strong while you’re going through the process or is that too late?

DK: I didn't talk to a recruiter until I could comfortably complete the graduation standards for selection. Even being able to meet the standards in the physical training assessments doesn't ensure course success because there are so many other stressors and variables. I thought it would be a shame, however, to endure the course (e.g. not quit) but fail out of the program because I missed the standard by one pull-up or a few seconds on a run. The course is immensely difficult even when you are prepared. Some people, though not very many, do succeed by "winging it" but they are usually exceptionally talented and tough. If you show up to the course in top condition, I think fitness progressively diminishes because the course is meant to select people, not necessarily develop them. For less conditioned people, assuming they don't self-eliminate or fail a performance evaluation, the course will build fitness by virtue of the sustained workload and exposure. I personally felt physically better and fitter before the course than afterwards. The self-knowledge gained from completing the course was transformational, however.

CD: If you look at the minimum standards for entering selection, they’re lower than what most need to pass selection. Was there anything you struggled with as the standards kept rising?

DK: There was one particular event, buddy breathing, that I struggled with throughout the course. In buddy breathing, you share a snorkel with a teammate and pass it back and forth while being harassed by an instructor. You're supposed to take one breath and then pass the snorkel to your buddy. The instructors steal breaths from you by covering the snorkel with their hand, dunking and flipping you underwater, and otherwise assaulting you while you remain defenseless. When you're not being harassed, the point is to float calmly and quietly on the surface while taking your breath. I am extremely negatively buoyant and had to extend quite a bit of effort just to remain neutral on the surface and not sink. My instructors would scream at me to not kick my legs while floating on the surface because in most cases it's a waste of energy. In my case, kicking on the surface provided a counterbalance against my sinking legs and torso. Otherwise, I could sink to the bottom of the pool even with a lung full of air.

CD: Were the physical abilities and skills you needed to get the job the same as what you needed to do the job? I knew a lot of guys who were pretty beastly at training several decades ago, but they had a wide range of food they’d eat, often drank a lot, and I never even heard the word “recovery” back then. But sustaining a kinetic career for years without your body breaking is often going to come down to that other stuff. Could you just follow the program or was there a part of health and fitness that you had to do on your own to optimize performance as a PJ?

DK: Training for selection is much different than the training that is required to perform the job and stay healthy. Selection is about enduring a beating and avoiding attrition hence preparing for selection requires way more endurance and work capacity training than is required to do the actual job well. I don't think qualified PJs or other SOF types "need" to do any distance running, as an example. Aerobic work, sure, mainly in the form of uphill walking with a pack and something like sled dragging. In selection, distance running is just a cheap and logistically simple means of physically stressing candidates- there's nothing magical or job specific about it. Once people made it through selection, there wasn't really a structured physical training program- people just did what they liked. Some people trained like bodybuilders, some like powerlifters, others like crossfitters or triathletes. As long as people passed the annual physical training evaluation and didn't fall out during training scenarios, there was little scrutiny or oversight into how individual operators physically prepared for the job. However, the SOF community ultimately realized that poorly designed physical training was decreasing operational readiness and diminishing people's careers independent of the trauma inherent in the job itself. Towards the end of my career, the SOF community began incorporating human performance teams to address this problem. Even now though, team members aren't required to train under the guidance of a performance team member. Poorly planned and executed physical training compounds the downside of an already arduous job.

CD: Can you tell who will make a good PJ among the people who start the process? There are the special warfare skills and attributes along with the rescue and medical skills and attributes. Being a warrior and a healer don’t always go together. Can you identify people who are both or do you just need to wait and see who makes it?

DK: This is a question the SOF community has spent a lot of money and time on and still hasn't come up with a completely satisfying answer otherwise the attrition rate in these programs wouldn't be so high. I don't think being a warrior and healer require different skills per se but for the caveat that people who want to be PJs, as opposed to other SOF career fields, need to be ok with being medics and rescue specialists first and shooters second. Ultimately, however, any SOF career field is looking for people who put the team first and are trainable, mission focused/task oriented, and display a high degree of emotional regulation.

CD: If you were advising a teenager today who thought he might have what it takes, would you recommend trying to become a PJ and any advice on judging if it might be a viable path and, if so, preparing for it?

DK: My experience as a PJ was very rewarding and allowed me to work with the most capable group of people I could possibly imagine. I try to be careful not to tell people what they should and shouldn't do with their careers. Instead, I try to help them ask certain questions so they can gauge for themselves whether undertaking something like Pararescue is a good fit for them. Preparing for it, as mentioned previously, is about working backward from the endpoint and once at selection, controlling the controllables and not dwelling on all the "what ifs" over which you have no influence.

CD: Today, are you able to enjoy the skillset that you honed as a PJ? Is open water swimming, rucking, scuba, and skydiving fun or is it different when it is something you had to do as work? Do you like to keep up with the things that you once had to, or did you put them away when they weren’t needed? I imagine it is a combination.

DK: Most of the skills I learned in the military that I still continue to pursue are actually more "fun" now even though I have to foot the bill for them. Things like skydiving and SCUBA diving are tools, ways to get to work in the military. You usually do them in the dark with loads of equipment attached to your body. They're way more "fun" in the daytime when done for their own sake and not as a means to an end.

CD: Since getting out you founded a physical therapy company that treats patients including military personnel and athletes. Has having a mission treating serious problems been a help in transition to civilian life? Is being a civilian leader more similar or more different than how you led the people you were responsible for in the Air Force?

DK: It was "time" when I separated from the military but it wasn't easy to leave. I'm happy to have moved on but there are certainly things I miss- mainly the people and the sense of shared purpose. Starting a physical therapy practice gave me a new purpose and a new team. Like rescue in the military, sports rehabilitation is about mission planning, risk mitigation (not risk avoidance), and managing available resources, including personnel. There are a lot of parallels between the two worlds as they share many of the same first principles. While I have obviously cared for people and been responsible for various things, I struggle to identify as a "leader" though I understand what people mean when they talk about "leadership". There is a certain degree of ego and self-righteousness that comes with identifying oneself as a "leader". Zero self-righteousness means somebody with no values and zero ego means somebody with no identity so I'm not advocating for the complete absence of these qualities. Sometimes getting the most out of the people around you is part of the mission though. I think the best leaders are those who are authentic and truly seek to empower the other people that contribute to mission completion and success. Focusing on the mission and serving others is more effective than trying to personify whatever the stereotypical characterization of a "leader" is these days, in my opinion.

CD: Once you understand how the human body is supposed to work properly, is work repairing pro baseball players, basketball players, and MMA fighters similar, or do you need to get into the specific demands of their sports? I imagine that you’re mostly dealing with high performers. Are they mostly arriving motivated? What part of their mental game needs attention during recovery? I imagine that it is hard to confront the risk of atrophy and being away from the thing that gives them purpose and identity.

DK: Some understanding of the specific job or sporting demands is important but probably a bit overstated these days in light of our obsession with optimization and individualization. I feel like I have done my job as a physical therapist if I can eliminate the physical limitations that impede the manifestation of a specific skill like dunking a basketball, throwing a baseball, or fast roping out of a helicopter. Most of the rehab process is about restoring foundational physical skills and general athleticism. Latter stage rehab might look a little more "specific" but ultimately there's only so much one can do in a gym or training room to simulate the main thing hence "doing the thing" is the part of the rehab process once certain physical benchmarks have been met.

The psychological side of rehab is obviously very important but the physical and psychological aspects of recovery are complementary. Thoughtful physical progressions build confidence, reduce inhibition, and develop mental robustness. A basketball player that can't jump on one leg because of pain and lack of range of motion and strength should have anxiety about playing in a game. Imagine taking a test you have not studied for. In most rehab cases, we know the answers to the test. The difficult part is putting in the consistent work to achieve the necessary results. Sensible progressions and reverse engineering the sport/job generally inspire more confidence in rehab than working on "mental skills" in the abstract, though they are not mutually exclusive.

CD: Are there issues you see specific to treating vets? Many, perhaps most, of the guys I’ve rolled with in jiu jitsu are vets. They seem to have varying degrees of back issues and post-concussion syndrome, but it varies between moderate and severe. Very few with none. And they tend to not complain, so it is hard to tell what pain they’re dealing with. Do you often see patients trying to tough it out in situations when they shouldn’t?

DK: The greatest challenge in working with vets is that they often wait until the point of irreparable damage/trauma before seeking medical attention for a particular injury. Most people in the military do not want to be seen as complaining or as someone who might jeopardize the team. Trust is everything in the military and people are fearful that displaying any degree of vulnerability will erode their teammate's trust or get them grounded from a mission. There's clearly a balance to be struck here because one can only withhold an injury for so long before compromising individual and collective performance. There is a way to maintain a warrior ethos/culture without stigmatizing people who seek necessary medical care in the interest of preserving health and operational longevity.

CD: What’s next? Any big fitness/athletic goals from here? Not asking to name names, but anyone you’re rehabilitating with big goals that you’re fired up about? When you make decisions about your own training, eating, and recovering, are you just making yourself a better human generally, or do you have a particular goal you’re training for?

DK: I am excited to work with anybody that consistently attacks their rehab and values the end state. I truly derive no more satisfaction from working with a professional athlete compared to somebody from the general population.

At this point, I don't have any specific goals for myself beyond being physically prepared for anything I might reasonably encounter in life. I enjoy training for its own sake but also train so that physical ability will not be the limiting factor in the active hobbies I enjoy- things like tennis, martial arts, skiing, and kiteboarding. I also have two young boys to keep up with and I want to delay reminding them about all the things I used to be able to do and instead, demonstrate those capabilities in the present.

CD: Last question – what role does fitness play in your family life? Anything that you’ve incorporated into your home life? My kids are a bit older now, but one of the things I’ve loved is experimenting with ways where we can do things together that are challenging for each of us (I run and they bike or I open water swim and they kayak, etc.) But my favorite moments are doing hard things together.

DK: My children are still very young but I know they're constantly watching what I'm doing and modeling their behavior off the people they observe most frequently. My kids play (which basically consists of them "reorganizing" whatever they can get their hands on) while I move iron around and throw medicine balls in the garage gym. They bring their beach toys to the nearby turf field while I do sprints. I've lugged them around in the baby carrier while dragging a sled in the driveway and skinning around the neighborhood after a snow storm. I want my children to appreciate that being physically competent allows one to explore the world and forge incredible memories with people dear to them. I expect that some of our family's best memories will be forged while we're on the move. Both my boys are under 5 years old and have seen the training montage from Rocky 4 countless times already. That's the type of indoctrination that I unapologetically endorse as a parent.

CD: Thank you so much for taking the time to discuss your experiences, Doug. I hope we cross paths again soon!

Learn more about USAF Pararescue here. High school students may start their application as early as the end of their junior year. Everyone can get ready for PJ selection (or just get more ready for life) with their 21-day fitness program. Not everyone needs to serve, but everyone should try to be capable and ready.