MEDEVAC

Monday 23 July
2230

MEDEVAC = Medical Evacuation, and that is what has happened to me.

For those of you who don’t know this yet, don’t be alarmed – it is neither serious nor permanent. I had a medical issue that needed to be addressed, and they do not have the capability to do it in theater. I fully expect to return to duty when it is taken care of, but I don’t know how long it will take.

I am almost old enough now to be in danger of becoming one of those old fogies who want to tell you all the details of their latest doctor visits and medical problems, so I will make a studied effort *not* to do that. Suffice it to say that this is a condition that runs in our family, and I have gone longer than anyone else I know before having it finally dealt with. So now it’s time.

The actual process of being evacuated was very interesting and impressive. It started out at the hospital on Camp Arifjan, which is run by the Navy. The front desk is called the "quarterdeck", the latrine is called the "head", all just like on a ship. It was kind of funny to hear after months on an Army base.

They took us to Ali Al-Salem Air Base on a bus (which they call a "bus"), and we came to the CASF (Contingency Aeromedical Staging Facility). This is a little medical clinic run by the Air Force where we each got a folding cot and they took our vital signs, read our medical records, etc. This was a holding area for us until a MEDEVAC plane was ready to leave.

They did the normal security check for flying before we went in, so once we were in we could just get on the plane later.

In addition to all the medical stuff, they have showers and toiletries, a TV room, books, computers, food, etc. I read a book and slept.

I finished the novel I brought along and started one of two professional books I brought: Robert M. Utley's "Frontiersmen in Blue". It is the first of two volumes that discuss the Army's experiences fighting Indians. This volume covers 1848-1865, and "Frontier Regulars" covers 1866-1890. I first read about this book in the bibliography of "Imperial Grunts", the book that got me thinking about getting back into the Army. Many of the experiences of the Army fighting Indians are said to be extremely relevant to modern counterinsurgency warfare. It seems the Army has learned all these lessons before, but has to re-learn them each time we get into a new COIN operation.

It was hard to find since it's been out of print for awhile, but I found a set of almost-new copies at John King books in downtown Detroit. They told me that someone had just sold them a 400-volume library of military history books. I would have loved to see it all together, but they had dispersed it into their collection already.

I read a few pages awhile back just to get a feel for it, and it seems to be engagingly written. So I am looking forward to it as a combination of entertainment, history lesson, and professional development.

We were awakened well before 0-dark-thirty and told to report in an hour. I got up, had some breakfast, brushed my teeth etc and got ready. Then they had a ten minute briefing and told us to come back in 50 minutes. Typical military procedure – hurry up and wait! We finally got out of there 1 ½ hours later, and were driven out to the runway where the C-17 was waiting.
The C-17 is an enormous aircraft. It is a very large cargo plane, big enough to load a lot of cargo, several vehicles, or a whole helicopter inside. This one was carrying cargo on the way in, but was outfitted with litter racks for MEDEVAC. We waiting on the tarmac for quite some time while they messed with the cargo and refueled the plane (more hurry up and wait). Finally they gave us the signal to load, and we were taken on board.

C-17 On the Runway

C-17 with Fuel Line

Loading Patients

First most of the litter patients were loaded on board. Then the ambulatory patients (me included) walked up the cargo ramp and were seated in seats along the outside of the cargo bay. Finally they loaded the last litter patients from a different vehicle – these were the most serious cases. It was a sobering sight to see a soldier or marine with all kinds of medical equipment around him on his litter (oxygen tank, respiratory equipment, monitors, etc), and only one leg coming out from under the end of his blanket. As I watched the Air Force medical personnel around him, tears came to my eyes.

This was not only a reaction to the tragedy of a wounded young person who will have to live his life with one leg. It was also due to a feeling of pride and admiration for the people who make the system work and were taking care of him (and the rest of us).

I joke about “hurry up and wait” and the typical military inefficiency, but in this case the delays were due not to inefficiency but to the thoroughness of the process. It was an awe-inspiring and humbling process to go through. The first thing that struck me was the inter-service cooperation and uniformly high level of competence and professionalism exhibited by everyone with whom I came into contact. I started at a Navy Hospital in Kuwait, staged at an Air Force base, and watched a combination of Navy Hospital Corpsmen, Air Force medical personnel, and Army Medics work together seamlessly to ensure that everyone was taken care of. They left absolutely nothing to chance.

As I sat on this huge plane watching the medical people going through the various routines involved in getting us situated and getting the plane airborne, I was overcome with feelings of pride and gratitude. No other nation on Earth could build that aircraft, outfit it, put together a team of professionals like that, and send them halfway around the world with such organization and thoroughness. Never, at any time, did I feel the slightest sense of worry or apprehension. They were there to take care of us, and they did. They were so obviously expert at their jobs that it was almost like any other commercial passenger flight. Like the navy crewman in the movie “The Longest Day”, it gave me goose pimples just to be a part of it.

I felt for the litter patients, though. They had to be strapped in, and it cannot have been comfortable for them. The crew did everything they could to make them comfortable. They were there all the time, checking on them, helping them, even just holding their hands at times. Each patient also had an assigned attendant from their home unit to help them around. Those of us sitting nearby helped out with small things when needed, like adjusting a pillow or blanket. Watching them with their straps, bandages, monitors, and IVs made me feel like my little problem just didn’t amount to very much.

C-17 Medical Equipment and Supplies

More Medical Equipment

C-17 Cargo Bay

I had to laugh at one point about an episode that unfolded right in front of my eyes. One of the medics was having trouble with a piece of monitoring equipment that didn’t seem to be getting electrical power. Reflexively I reached for the ever-present electrical tester I keep in my pocket, but it wasn’t there! I had put it in my drawer before leaving, thinking “I won’t need that”. Wrong! I ended up helping them anyway, using my iPod. I put it on the charger, and by plugging it first into the outlet on the plane, and then into the extension cord, we determined that the fault was in the electrical cord on the piece of equipment. They got a new cord and it worked fine. But I was chagrined that my nifty little special purpose electrical tester was sitting in my desk drawer in Kuwait instead of in my pocket where it belonged. “Be Prepared” - you never know when you might need something!

The flight was uneventful, (unless you count landing in Iraq). We made a stop there to pick up some more patients, and I got to get out and stand on the ground for about ten minutes (They let people take a smoke break, so I hung out with the smokers for awhile). So I did actually get “Boots On Ground” in Iraq on this tour, albeit not in the way I’d expected.

Brad in Iraq

Once we landed in Germany, the process was equally smooth. We were organized into groups and put on busses based on our destinations. I was taken to Landstuhl Regional Medical Center, where we inprocessed prior to getting sent to our quarters on a nearby Kaserne.

Inprocessing included getting a meal (first), and then a briefing on their facilities and processes. They have a very complete orientation to the community and the facilities. They assign a liaison officer based on your service component, and explain how to go about finding your various appointments and how to check in at the control points in the process. After that they drove us to our barracks and got us billeted there. More briefings, rules, and regulations. I got assigned to a room (E7 and above are together in a room, although it’s the same as all the others – 12 to a room), drew linens and a blanket, and was released.

They do have wireless internet in the building, so I was able to get online, although I kept getting kicked off. I moved around from place to place until I found a reasonable spot, but by then it was almost time to go to bed.

Getting to sleep was quite a trick. I was assigned to the bottom bunk. When I got there someone was already in it. I decided not to make a fuss since I didn’t expect to be here long, and just took the top bunk. That means I can’t reach anything or get up and down easily, but oh well. I had a hard time getting to sleep because the lights were on and someone kept snoring. I will have to use the same tricks I did last summer in Korea, and use a blindfold and my iPod to sleep.

Once they explain the process you are pretty much on your own. There is an accountability formation in the morning, and you take the bus to the hospital in Landstuhl. As I walked around the building I kept seeing familiar faces of people who I traveled here with. But we each have our own issues and our own places to go within the facility. People get processed based on their medical needs, and may be here anywhere from a few days to a few weeks.

My own process was pretty straightforward. I got up this morning and went to formation, and rode the bus to the hospital. After breakfast I went to my appointment. It took a long time to get in (what doctor’s office doesn’t?). But once we had a chance to talk and he went over my condition, he recommended that I should return to CONUS for surgery. It was too late to complete the process today, so I will go back tomorrow and finish up, and will be on a plane sometime later this week. I don’t know yet where I will go, not how long it will take. But I will add more later when I know more.

There are a couple of additional wrinkles to the process that are pretty cool. One is that they really take care of your needs while you are here. Since many people arrive here straight off the battlefield, they are geared up to provide *everything* that anyone might need. I literally didn’t need to bring anything at all along except my ID card. They issued a set of uniforms (including PT uniforms), as well as toiletries and personal items as needed. In addition to this, they gave us a $250 voucher for the PX to buy civilian clothes, since these are required for commercial travel. After I was done at the hospital I took care of the uniform issue and went to the PX to get some clothes. There is also additional support available through the Chaplain channels, but I didn’t take advantage of those. But they really take care of us. As I see all these young guys walking around with various wounds and injuries, I can’t help but think of all the people back home anxiously wondering how they are and if they are ok. I wish I could give an adequate sense of just how well provided for we are, and how professional the care is. I hope each of these people has told his family and friends just how well our system works. I know I’m impressed, and can’t imagine people getting any better care than we have here.

I guess that’s enough for now. I’ll get this posted and get ready for bed. Tomorrow will be another busy day, and I should find out more details about what happens next.

Music: Mid ‘70’s top 40 (at the club)
Mood: Relaxed