Sign This... Just about every doctor has had the experience of a patient bringing a form in to the office to be signed that is essentially a medical excuse for non-medical reasons.

"I've been summoned for jury duty, but if you sign this, I won't have to go."

"I haven't paid my gas bill for two months, but if you sign this, the gas company will give me a reprieve."

"I bought plane tickets for a trip I've decided I don't want to take, but if you sign this, the airline will refund my money."

"I missed two days of work because I was at Lollapalooza, but if you sign this I won't get in trouble with the boss. (Does it help that I spent most of the time vomiting drunk?)"

"I hate looking for parking spaces at the mall, but if you sign this, I can easily find a parking space right up close."

So it's no suprise that combat surgeons would encounter the same sort of behavior in their practices.