For two and a half years, Air Force Capt. Blake Sellers donned a green U.S. Air Force flight suit, and motored across barren Wyoming grassland in sun, rain, sleet or blizzard, for 24-hour shifts, 60 feet below ground, in a fluorescent-lit buried capsule. Sellers was one of the roughly 600 officers, known as missileers, who are responsible for launching America’s 450 nuclear-tipped intercontinental ballistic missiles. Each ICBM in the arsenal is capable of rocketing to the other side of the planet in 30 minutes or less and incinerating 65 square miles. Missileers are the human beings who have agreed to render whole cities — like Moscow, Tehran or Pyongyang, but really anywhere there is civilization— into, in the jargon of the base, smokin’ holes. Air Force Academy graduates like Sellers tend to dream of flying jets. In a corps full of eagles, he and his compatriots are the moles.
The route down America’s underground WMD silos begins with five months of training at Vandenberg Air Force Base in California. There, the first requirement is signing a document committing to end the world if so ordered by the president. But what if, somewhere along the way, a missileer has a change of heart and decides he or she is not OK incinerating millions of civilians? “They say, ‘Well that’s OK, but we are going to separate you from the Air Force and you will pay back everything we paid for your education,'” Sellers recalls. “In the Air Force Academy, that’s $300,000. So you will be unemployed and owe $300,000.”
During training at Vandenberg, pairs of missileers enter a simulated launch capsule, with swivel chairs facing a console — four black-and-green screens, and two keyboards — that resembles Matthew Broderick’s workstation in the 1983 movie, WarGames. The pairs open a small metal box with two coded padlocks, and the senior member of the crew removes The Key. A grid on one of the screens displays the status of 50 nuclear missiles, 10 of which are under his or her control. The senior commander and the deputy read and repeat a series of steps and codes from various manuals. When the word “critical” flashes in small red letters on a screen, the senior missileer inserts The Key.
Together they turn three switches at once. A missile grid on the screen blinks and in each box the green letters “EN” for “enabled,” changes to “LIP,” for “Launch in Progress.” Minutes later, the weapons enter the upper atmosphere. There is no turning back.
After a few months of key launch exercises, the nation’s missileers have participated in so many theoretical Armageddons, they know the drill by heart. “Of course you become utterly desensitized to tending nuclear weapons,” one former missileer says. “The first time it’s like, ‘Whoa!’ After about ten alerts? ‘Eh.'” That’s when they are ready to be shipped off to the launch sites.
There are three ICBM bases. In May 2006, Sellers reported to F.E. Warren Air Force Base in Wyoming, which is jokingly referred to as “the Caribbean” because of its relatively balmy temperatures compared to the other two: Malmstrom Air Force Base in Montana and Minot Air Force Base in North Dakota. When he got to Warren, Sellers was still abiding by the ethics drilled into him by the Air Force Academy, where the first commandment forbids cheating. That was the first principle that missileer duty drilled out of him.
The particulars of ICBM work are outlined in thick manuals — 50 to 400 pages long — in detailed, step-by-step protocols for dealing with everything from a maintenance issue to a simulated war order. For each event, and each fake event — because the missileers are constantly being readiness-tested inside the capsules — a corpsman or woman is expected to follow checklists of instructions, while moving between different manuals and the buttons on their consoles.
“In missiles, there is a checklist for everything,” Sellers says. “That’s the job, figuring out which checklist I need for this situation. So those who are good at that kind of thinking become leaders. They drink the Kool-Aid. And it is very difficult to impress on folks outside of this what that looks like. Any problem that arises, anything that happens: ‘Let’s put a checklist on that!'”
Monthly proficiency tests are meant to ensure missileers are familiar enough with their manuals to follow the right checklist during hypothetical alarms. (Separately, they are tested on the Emergency War Orders, a top-secret document that is so sensitive its exam is administered in a classified room reportedly called “the vault.”) During Sellers’ first examination, a proctor pointed out five wrong answers on his test, and corrected a few of them on the page. Sellers was horrified. He glanced around, worrying that other test takers had noticed, and saw that senior missileers throughout the room were comparing answers. “I felt terrible,” he says. “Everyone else is cheating.”
That incident was the first of many, and before long, Sellers was a full participant. But maybe because his Marine Corps father had drilled a “don’t cheat” philosophy into him as a boy, he never got over the guilt. “I did not talk to anyone about it,” he recalls. “I should have, but I was too ashamed of it. And also, no one else is saying anything, no one else has said anything, and as far as I know all the people four or five years ahead of me are all going to get in trouble if I do say anything. And you want them to like you. Your career depends on them.”
The cheating was only the most obvious problem. Sellers quickly saw that morale at Warren had bottomed out. Eventually, the adrenaline rush is long gone, and the prospect of another three years of sleepless nights following checklists out on the American tundra feels like a prison term. That might explain why a disproportionate number of nuclear commanders and missileers have recently been charged with criminal acts.
The end of the Cold War and the advent of the hot War on Terror has meant less attention and less prestige on the job at ICBM bases. The fallout has been unusually high rates of criminality, domestic violence and security lapses. Currently, four court-martials — for drug use, rape, assault, sexual assault on an unconscious person and larceny — are underway at Minot. At Malmstrom, two missileers are being court-martialed for using and selling bath salts — a synthetic substance that can render users psychotic. And at Warren, three airmen have recently been or are due to be court-martialed for drunk driving, using and selling pot and “indecent filming of the private area of another person without consent.”
Top brass is not immune either. In October 2013, Michael Carey, a two-star general overseeing the entire nuclear command, was ousted for “misconduct” on an official trip to Moscow. He reportedly started getting drunk on the flight over and didn’t slow down for the next three days in Russia. He slammed at least half a dozen shots at one official lunch, was “rude” to his hosts, arrived late for appointments, and took up with two young women who, he later admitted, seemed “suspect” given that they kept showing up wherever he was. That same month, another nuclear force brass, the deputy head of U.S. Strategic Command (STRATCOM), Vice Adm. Tim Giardina, was removed from his command for gambling with counterfeit poker chips at a casino in Iowa.
Then, a few months later, an Air Force investigation into drug use uncovered a massive cheating scandal. Two lieutenants at Malmstrom AFB in Montana sparked the inquiry after they were caught sending phone messages to 11 other officers about “specific, illegal drug use that included synthetic drugs, Ecstasy, and amphetamines.” That prompted the Air Force to inspect more missileers’ phones, where they found dozens of people sharing not drugs but proficiency exam answers. After an investigation, nine members of the chain of command at Malmstrom were removed.
The Air Force has ordered countless studies trying to figure out what’s wrong with its post-9/11 missileers. Most of these blame burnout on what researchers call the culture of “micro-perfection” and the general “inability to accept small errors” at nuclear launch centers. But interviews with current and former missileers suggest that the monotony and perceived irrelevance of the job also led to ethical breakdowns, like cheating and criminal behavior. In 2013 researchers with the defense contractor RAND linked severe burnout to fears over job security in the post-Cold War era. They found that with a realignment of the nuclear world, there was a pervasive fear among missileers that one wrong move could end in discharge. But that fails to explain another finding from an unpublished RAND study: court-martial rates in the nuclear-missile force are more than twice as high as in the overall Air Force.
Sellers says he found the cheating excusable because it was the only way to survive the grinding minutiae of a job that is arguably obsolete. “I don’t know if it was ever prestigious,” he says. “The leaders, they try to rah-rah you every day — a little at Vandenberg and then more when you get to the bases. They kind of know how shitty and awful it is. So it’s ‘Hey, guys, this is so important, we are saving the world every day from nuclear annihilation.'”
The missileers corps — under the 20th Air Force, Air Force Global Strike Command — was born in the coldest days of the Cold War, in the late 1950s. Scientists in New Mexico and California were still perfecting the first rocket-launched, nuclear-tipped weapon of mass destruction (later models were named “Peacekeeper”) when the Air Force began planting them in holes across 45,000 square miles of American backlands as fast as they came off the assembly line. In the half century since, about 30,000 men and women have held the job of missileer, signing on for tours of four years or longer.
Today, fresh recruits just out of ROTC or the Air Force Academy undergo almost the same training as when President Kennedy presided over the Cuban missile crisis. The principle drilled into them from Day One is a mission called “deterrence.” Like the swivel chairs and the 1980s consoles, deterrence — mutually assured destruction — as a defensive strategy has gone the way of the Soviet Union, atomic bunkers and schoolhouse duck-and-cover exercises, but the same mighty missiles are ready to eliminate the same targets over Russia. When I met with a group of Sellers’ former missileer colleagues who still work at F.E. Warren, each repeated, like a mantra, “Our mission is deterrence.”
Deterrence means that any nuclear strike on America is guaranteed to provoke a devastating response, whether or not the nation is reduced to smoldering ash first. In an era when the perceived threat is far more diffuse — stateless terrorists or rogue nuke states like North Korea that might act irrationally — having ICBMs aimed at Russia is no longer the defense it once was. “People often fail to realize that in a crisis leaders put nuclear forces on higher alert and run higher risks of triggering a nuclear war by accident,” says Bruce Blair, a former missileer who co-founded the anti-nuke advocacy group Global Zero. “North Korea is believed to be prone to risk-taking and provocations that could escalate and override deterrence.”
Meanwhile, the nuclear family has grown to include not just North Korea, which conducted its first nuclear weapon test in 2006, but sworn enemies Pakistan and India, whose mutual nuclear war, which has been a threat for decades, we could do little to deter. There are now nine nuclear nations, and at current rates, another nation goes nuclear about every decade. (The current nuclear negotiations with Iran aim to buck this trend.)
No one in the U.S. government seems to know how to respond to this new existential question, besides throwing more money at the program. The Obama administration, unable to fend off entrenched political and military-industrial interests — tens of thousands of people work in production facilities and in the government apparatus — has ordered up billions of dollars worth of new weapons and upgrades, despite the fact that the president is on record admitting their reduced strategic need. Last year, the Congressional Budget Office estimated that the modernization program would cost $355 billion over the next eight years.
All of which amounts to a game of brinksmanship that Eric Schlosser, author of Command and Control, a history of America’s nuclear weapons, has described as humanity’s collective death wish. Over the years, safeguards have failed so spectacularly that even an atheist might suspect divine intervention. A hydrogen bomb fell out of a plane in 1958 and leveled a South Carolina home without detonating. Another bomb accidentally parachuted towards Goldsboro, North Carolina in 1961, but failed to activate. A warhead shot into the air in Arkansas in 1980, after its silo exploded; it traveled 100 feet but didn’t detonate. As recently as 2007, workers at Minot AFB in North Dakota accidentally loaded six nuclear-tipped missiles on a plane that crossed the continent to a base in Louisiana — the error was discovered only after the plane landed. On October 23rd, 2010, 50 missiles in the fields around Warren went “offline” for nearly an hour. The Air Force blamed the incident on a circuit glitch.
Most experts say America’s nuclear bombs will not accidentally detonate. The fact that they have fallen from the sky and landed in people’s backyards over the years without detonating seems to confirm that notion. But the human element will always be a hazard. Even the presidential part of the nuclear equation is subject to error. Carter and Clinton both reportedly lost the launch code cards that presidents are expected to have on them at all times — Clinton for months, according to a former chairman of the joint chiefs of staff. Carter allegedly sent his out with a suit to the cleaners.
Sellers is now a 32-year-old telecoms employee and MBA student in Denver. Last summer, he drove me around his old stomping grounds, the grassland around the Colorado-Wyoming border where the WMD are planted east of F.E. Warren. He knows these back roads in his sleep, having driven them twice a day for over two years, and steers his battered Volvo easily over the bumpy gravel. Some of the launch-control capsules are a three-hour drive from base, past cows, tractors, fields and the occasional agricultural hamlet. Residents here are accustomed to Humvees and armed men in camo passing through, or having their roads closed when WMD are being moved.
Sellers, a burly, dark-haired and affable video-game nut, is third-generation military, on both sides of his family. One grandfather can be seen in an iconic photograph of Eisenhower in Europe during the Second World War. His mother’s father was a chaplain in Korea. His father served in Vietnam. Sellers grew up in Florida, near the Navy Seal Museum, watching Cape Canaveral rocket launches in real time from his backyard and binge-watching Top Gun. Like most missileers, he did not feel called to the job of pulling crew duty in an underground capsule, babysitting 50 ICBMs for 24 hours at a time. The Air Force chose that duty for him, just months before he graduated from the Academy, because a shellfish allergy disqualified him from a career as a pilot. He sucked it up. “The Air Force perspective is you should be so jazzed about serving your country you should not care where we put you,” he says. “If I complained, they would have thought I was a spoiled baby.”
The Missile Alert Facilities aboveground look like any other prefab family home, with the exception of the barbed wire and radio towers outside. But inside, they are not exactly homey. They have kitchens and lounges, but they also have shelves of grenades and assault rifles, and each one houses an elevator shaft leading to the capsule. Over the course of a four-year tour, officers pull about 225 alerts down below— night and day, winter and summer, and always at the edge of the End of the World.
After two years at F.E. Warren, Sellers could complete a launch exercise in less than a minute, between scenes of Mad Men or bites of a burger. Once missileers learn their checklists by rote, many of them have hours of idle time on their hands. Some binge-watch TV, or read; a few study for advanced degrees. Inside the capsules, little has changed since the Cold War, from the constant vibration and foot odor to the eight-inch floppy disks in the consoles. “It’s absolutely all the same whether it’s Christmas Day or the Fourth of July,” Sellers says. “You are in a constant state of jet lag. You are up at 1 a.m. under fluorescent lights. After a year and a half I was never fully awake or fully asleep. You reach this zombie state.”
Sleep deprivation is known to induce hallucinations and impair judgment. The CO2 levels in the silos don’t always meet OSHA standards either. The combined effect may make missileers groggy and even impulsive and aggressive. The Air Force has revealed that two missileers once stayed in a malfunctioning capsule breathing noxious fumes for hours, rather than ask their leadership for help, and were hospitalized. Crew partners are paired for at least eight months at a stretch. Privacy is obviously limited in a 170-square-foot capsule behind four-foot-thick walls, so teams get to know one another extremely well. And what happens in the capsule stays in the capsule. “The trust between members of a good crew is near-unbreakable,” one missileer says. “Eating, sleeping and working in such intimate quarters for months together builds an incredibly strong relationship.”
According to Sellers and others, missileers stash all manner of personal contraband in what one called “weird cubbyholes” whose original Cold War purpose in the silos, Sellers says, has been forgotten. The cubbyholes hide porno, DVDs, and often a banned group journal filled with black humor and complaints about commanders, written under pen names, called a “log book.” Sellers says he once filled out a page with the five stages of grief that Air Force officers suffer when they are assigned to ICBM duty. The little books are unique to the missileer corps, and disapproving commanders occasionally descend, seize and confiscate. Six months later, someone starts one anew.
Condoms have also turned up in capsule cleanups. Women have served as missileers since the Eighties, and heterosexual missileers have more opportunities to hook up underground. But conditions for romance are hardly ideal in capsules that smell like locker rooms. One missileer said the cootie factor alone would have made capsule sex impossible for him. Germophobes are on high alert for other things besides the Russians. One crew member wrote on a missileer chatroom recently: “After change-over the first thing I did was break out the Clorox wipes and clean every surface I knew I would touch.”
At Malmstrom, the plumbing system in some of the capsules was so degraded that the recycled air was “90 percent rotting sewage,” one ex-Malmstrom missileer says. The two-man crews went down with instructions to defecate in buckets and urinate in jugs, and bring it all back up at the end of 24 hours. “You’re thinking, ‘They’re not going to tell us how important we are up here,'” he says, “while we’re literally sitting over rotting shit!” When he complained about having to work “over this two-foot pool of sewage,” his commander told him to “suck it up,” and reminded him that American troops in Third World countries were dealing with far worse. He couldn’t argue with that.
From the antique black phones in their bunkers, missileers also command enlisted men and women upstairs — “cops,” in the lingo — who patrol cow pastures with automatic weapons, grenades, even a camouflage chain saw. Whenever sensors detect movement in the fenced perimeters where the missiles are buried, the missileers must decide whether to dispatch security teams to investigate. In the grasslands around Warren, the sensors have almost never been activated by anything human — with the exception of some anti-nuke nuns who snuck onto the missile field and banged on the concrete caps with hammers in 2003. The security officers’ main duty is to scare off rabbits, cats and antelope. And since Air Force regulations prohibit shooting them, airmen grow adept at gently shooing small mammals away from the nuke sites, no matter if it’s a fine summer day or a Great Plains blizzard.
Projecting authority from 60 feet underground by antique telephone is one of the main challenges of the job, according to Lt. Kathryn Congdon, a 30-year-old missileer currently stationed at Warren. Tensions arise over who has it worse — the officers down below in their chairs or the armed grunts dispatched into blizzards to chase rabbits. “A lot of times, it’s tough for me to know, how severe is this?” Congdon says. “I can’t get that vibe from them over the phone and when I first got here that was like, ‘Hey, wake-up call.’ You gotta be able to tell if they’re telling you the truth or what’s going on. We lead through the phone.”
The man at the helm of the nation’s missileer command is Maj. Gen. Jack Weinstein, a former missileer himself, who lives and works at F.E. Warren in Wyoming. Since taking the job in 2013 (after his predecessor, Maj. Gen. Carey, was removed for that drunken binge in Moscow), Weinstein implemented some changes, including making the tests pass-fail and getting money to upgrade the decaying capsules. Weinstein acknowledges that a culture of “micromanagement and perfection” damaged morale among missileers. But he also insists that deterrence remains as relevant as ever. “The only existential threat to the United States of America is a nuclear weapon,” Weinstein says. “That’s the only thing that can fundamentally change who we are. The only force that is out there 24 hours a day protecting this nation is the ICBM force.”
Bruce Blair, the anti-nuke activist, says Weinstein’s fixes have meant “the trappings of missileer life are definitely being improved.” But he says fixing clogged sewers is not enough. “Nothing is being done that will alter the basic problems that missileer duty is painfully tedious, so mind-numbing that you can just feel yourself become almost comatose during alert duty.”
Sellers had lots of time to think in his subterranean hole. He still had to “pucker up” for inspections or when nukes were being moved around, but the edge was off. Fake attacks came in at all hours with flashing lights and buzzing sounds — practice nuclear-war alerts often designed by commanders at the base or STRATCOM in Nebraska — requiring him to flip through his manuals and perform a series of button-pushings and nozzle-switchings on the console to reset the system. In practice, though, he typically just deactivated the alarm using a button called the “plunger.”
One time, sitting in one of the swivel chairs, his crew partner dozing, Sellers let his mind wander. What if, he thought, this is all an experiment or an elaborate ruse? Maybe there aren’t even real nukes planted in the fields out there. Or maybe, just maybe, the control capsule does not control them at all.
He now compares the “deterrence” mission that every missileer learns is his or her duty to a fantasy plot point. “It reminds me of the wall in Game of Thrones,” he says. “There was this threat long ago and they built the wall and it’s long been forgotten, and all of the dirtbags get sent to the wall. It’s allegedly this super-prestigious thing, but it’s really not. That reminds me so much of missiles.”
At Malmstrom in northern Montana, where temps often fall below zero in the winter, missileers similarly joked that they might be subjects in a grand Pavlovian experiment. “We were always looking for the secret camera in the capsule, like somebody was studying us,” one officer recalls. The alarms always seemed eerily timed to go off just as they were slacking off. Like, nothing going on, and then, just as the crew stares up at the capsule’s 17-inch TV for the Super Bowl kickoff, “out of the blue, 15 things would break and alarms are going off in the capsule and you’re just pushing buttons not sure what’s going on.”
The Air Force is aware that life on remote bases is hard to endure. Commanders organize what Sellers calls “mandatory fun” — like luau parties in the dead of winter — funded by car washes and bake sales because taxpayer money can’t be wasted on goofing off. At Warren, mandatory fun included a requirement that missileers participate in the annual Cheyenne Frontier Days festival, a two-week jamboree replete with live country music, bull-riding and calf-roping contests. Off-duty missileers man the Air Force’s beer-selling booth. And during one of these festival weeks, in July 2009, Sellers inadvertently ended his career.
After a 24-hour shift, he showed up for his Frontier Days booth duty, but didn’t feel like attending the next day’s mandatory administrative Commander’s Call, an all-hands-on-deck rundown of official updates and announcements. So, after two years of obeying orders, he went home to his apartment and slept through it instead. Sellers later sent a letter to his commander, Lt. Col. Mark Schuler, explaining why he had missed the meeting. “I decided the best course of action would be to simply not attend,” Sellers wrote, “and with any luck move on so that I could continue to stave off mental disaster and keep pulling alerts.”
The Air Force has a self-reporting scheme called the Personnel Reliability Program, or PRP, that requires missileers to monitor their peers’ and their own fitness for duty. New missileers are required to pass a mental health evaluation to become “PRP certified,” and the list of reasons to be decertified, or to “go down on PRP,” is long and specific. Seeing a specialist for a sprained ankle; getting a wisdom tooth removed; taking any medication stronger than Tylenol; dumped by girlfriend; cheating on wife; dog hit by a car; or a sick parent are all acceptable excuses for missing a shift or two. “PRP is intended to work so that only the most reliable people work with nuclear weapons,” says Schuler. “If a commander ultimately deems you reliable, and if you win back his trust, you can go back on duty.” And like the silos and the checklists, the program has been around since the beginning of the nuclear age.
Sellers says he was first “PRP certified” — that is, deemed reliable to work around nukes — by an officer whose training to assess his mental health and fitness seemed to consist of a series of PowerPoint slides. “It is so cursory!” Sellers says. “It was basically, ‘Are you a problem child? Do you have any relationship issues?'” Depression, anxiety and alcoholism are probably the chief mental-health bugaboos on the bases, but it’s a rare missileer who self-reports any of those categories. “Hanging over all this,” Sellers says, “is, you know, that if you want to get decertified, you can say, ‘Yes, my dog died.’ ‘My girlfriend broke up with me.'”
Of course, “going down” means someone else, someone equally dog-tired and sick of being in the capsule, must pull double-duty in the interim. “You can say that you don’t have the right mind, but if you do that, then your boss will look at you like you’re a coward or you can’t handle it,” one former Malmstrom missileer says. “You feel terrible doing it because there is a special place in hell for those who burn the backup.”
Another missileer recalls being on shift when his relief unexpectedly went down on PRP. “I was down there once, underground for 72 hours —straight,” he says. “I couldn’t take the vibration anymore. I had to go stand in the concrete entryway where the restroom was, just so I could feel not vibration anymore. It was making me nauseous and antsy.”
Sellers had broken an unwritten code mentioning “mental disaster” in his letter. Schuler had temporarily decertified Sellers after he missed the Commander’s Call, and now he called him in for a meeting. Sellers told Schuler everything — from his frustration with the endless tedium to his guilt over the rampant cheating. According to Sellers, Schuler, who holds five master’s degrees in subjects that include business, organizational management and military operational art, was famous around the base for his devotion to protocol. He sent Sellers to a base psychologist for what Sellers describes as a “whistleblower rundown.” “Your behavior and expressions do not appear grounded in reality,” Schuler wrote in his report of the meeting.
Air Force clinical psychologist Capt. Sheri Fluellen wrote that Sellers was not a “safety risk to himself or others.” She also found that “member has shown significant frustration when placed in situations when his abilities are not maximized and when his logic is not acknowledged.” She diagnosed him with “adjustment disorder” and recommended that base commanders “encourage” Sellers to “seek psychotherapy to expand his coping skills and to improve his communications skills with leadership.”
In response, Lt. Col. Schuler permanently stripped Sellers of his missileer certification and kept him in menial jobs on the base, including one in which he literally polished the knobs on commanders’ doors. “All the disciplinary issues with Sellers was about reliability,” Schuler says. “First, this was a temporary concern, then it became permanent.” Schuler notes that Sellers had a previous infraction as well, for riding in a government vehicle that was damaged on an unauthorized road. “My duty as a commander was to not allow any individual to be around nuclear weapons if he’s not reliable,” Schuler says. “The actions I took with Capt. Sellers were based on a series of observations and evaluations by myself and others based on his overall reliabililty.”
Sellers still has a handwritten note listing one day of duties toward the end of his career at F.E. Warren.
Blake – 1 Please take trash out that is by the back handicap ramp door – 2 Dismantle candy canes for fliers – Toss fliers – Put candy canes out in bowl for customers – 3 Finish gym floor – 4 Sweep/mop lobby café.
In March 2014, two years after Sellers was discharged, the missileer scandals, including the mass cheating revelations, made the news. Lt. Col. Schuler was eventually removed from his command.
Sellers remains angry that the Air Force treated his genuine job concerns as a mental-health issue. He is also paranoid that the NSA will track him and his fellow former missileers now that they have spoken out. He says he’s having a hard time adjusting to civilian life and is finding that the very specific skills he developed in the capsule are not transferrable to the real world. He does value certain aspects of his experience at F.E. Warren, though. Working around America’s WMD program, he says, gave him a “higher tolerance for stress and working with assholes.”