Michael's Dispatches

The Army MEDEVAC Scandal: Report of Conspiracy

02 February 2012

An Army officer writes:

The Army is not resisting Dustoff policy change because our leadership honestly believes the current policy is superior, but rather because of AMEDD's [Army Medical Department] protectionist attitude toward "their" Dustoff MEDEVAC helicopters. I'm an active duty infantry officer, and I've been following the Dustoff issue since you first brought attention to it.  More importantly, I have a lot of contacts within the Medical Service branch.  While we have discussed this issue "around the watercooler" at work, Medical Service officers have been receiving briefings from senior members of their branch about a selectively edited account of SPC Clark's MEDEVAC mission, and what their message should be if anyone asks about it.

My contacts have highlighted that AMEDD's number one priority is protecting their "ownership" of the helicopters in question. They are concerned that removing the Red Cross from AMEDD's birds will result in those helicopters being assigned general purpose tasks, outside of the Medical Service Corp's control. In other words, their top priority is NOT providing the best possible care for our Soldiers and partners, but rather protecting their own fiefdoms. AMEDD is choosing to put Soldiers' lives in danger rather than chance losing "their" birds. Never mind that our sister services, special operations forces and allies are all able to field armed, dedicated CASEVAC/MEDEVAC helicopters! Somehow, despite all the evidence to the contrary, this is still the irrational argument AMEDD is sticking to, and directing its officers to spread. I'm concerned that in the dust-up over policy recommendations, comparisons with Pedro, and rebutting the JCS letter that we may be losing sight of the real obstacle in our path to reform. Sincere thanks for all you do, and keep up the fire!


+14 # SadRusty Shackelford 2012-02-02 14:19
Sadly, this makes sense. The attitude of “protect what is mine and screw everyone else” is a pretty common theme amongst some senior level officers. I don’t think I have seen it quite this bad though. If it is true (I’m not saying it’s not, but I don’t put 100% into anything unless I have seen it first hand), it will only take one medo to leak the briefing to bust this whole thing loose.

On another note; excellent use of the word “fiefdom”.
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+11 # Thank GodHeywood Jablomi 2012-02-02 14:19
Thank God that a man of integrity had the cojones to speak up and tell the truth.

Why we tolerate these stupid games from the armed services is a mystery to me. In an era of downsizing, there is no question whom I would hand their pink slips: the politicians, the cubicle warriors, the staff weenies who presume to perpetrate sick policies like this one despite simple common sense proof that their stance is immoral.

Fire 50% of the Pentagon. That will be a good start. Leave the grunts alone. At least the grunts have honor.
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+10 # ParochialismRon Rogers 2012-02-02 14:20
I believe this explanation. The sad thing is that this means that the Medical Services don't trust an Aviation Brigade CDR to obey orders which place a Medical Company (Air Ambulance)in his brigade with a dedicated medical mission.

Someone ought to be able to discipline any O-6 who diverts dedicated medical aviation assets to some general purpose support mission. Failing the Army's having any discipline, they should just remove the Medical Companies from the Aviation Brigades and make them independent again - but remove the crosses and arm them.
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+9 # Retired PJRescueman 2012-02-02 14:48
Michael, I agree completely with the Army Officer. When looking for a reasonable explanation for stupid, one must follow the dollars. This is about budget and control of assets. Their argument will always be that change might negatively effect capability--tha t "better is the enemy of good." That's why they throw statistics at you showing you what a wonderful job they're currently doing. My guess is that you'd lose the support of the Pedros as well if it became apparent that arming Dustoffs would result in a reduction of Pedro budget. As long as the real reason for the push back from the Army is dollars they'll continue to insist on bringing a knife to a gunfight.
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+9 # They ARE all laughing at us...GerryAtrickPilot 2012-02-02 15:15
A German friend pointed at the red cross on my helicopter the other day and told me how he'd heard that the Taliban will pay anyone who can prove they shot one. Peachy. How much of a laughingstock must we be to our allies here.
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+9 # Derelictionslomoco 2012-02-02 15:36
I don't know what the problem is but the most deplorable thing is that someone, whoever has the authority, hasn't stepped in and stopped all this nonsense.
It's a simple problem, and the solution is obvious enough(the Air Force and Marines have already found it)that it could be made between brushing your teeth and putting on your socks. I don't know who has the ultimate authority, but they should be sacked while they wait around for that Powerpoint presentation with the graphs, charts and embossed seals that proves that delayed treatment of injuries is unhealthy.
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+6 # RE: The Army MEDEVAC Scandal: Report of ConspiracyAl Reasin 2012-02-02 15:46
While one may attack AMMED over their guarding of their turf, and rightly so go after them, but don't forget the Army's policy of not allowing any helicopters other than Dustoff to respond to a causality. That would seem to be a general army directive, not one from AMMED. If true, the general Army brass has a hand in this tragic story. My research, that I documented on the last dispatch, indicated that Dustoff was used for more than evac of wounded in Vietnam, so the Geneva Accords cover has not aways been up held.
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+6 # RE: RE: The Army MEDEVAC Scandal: Report of ConspiracyFoliedeux 2012-02-02 19:20
regarding 'Al Reasin' comment about Vietnam helicopters doing more than picking up wounded in violation of the Geneva Accords. While I was in Vietnam doing ground and air PSYOP missions, our helicopters routinely flew emergency 'dust-off' missions when the call went out to 'all birds in the area, we need help' calls. We didn't ask questions other than if the LZ was hot and came in to assist if we were able. In the Delta we were within 30 minutes of a trauma surgical center, either at Dong Tam, 9th Inf, or up to Saigon. We had door gunners and no red cross. we did our own immediate first aid of wounded - stopping bleeding, treat for shock, but thats all we had to do in 30 minutes. It's a travesty rules like the Geneva Convention get in the way of common sense.
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-14 # RE: The Army MEDEVAC Scandal: Report of ConspiracySerge 2012-02-02 16:07
Economic factor has all along been behind the US armed invasion in both Iraq and Afghanistan. In the final analysis, the success (or failure) of a military campaign is assessed by the economic benefits it brings to those who had initially invested in it these days. There is a direct correlation between the AMEDD’s “choosing to put Soldiers' lives in danger rather than chance losing "their" birds” and the economically efficient operational guidelines on the part of Patient Evacuation Coordination Cell (PECC) which “tends to be risk averse to the point that troops die.”
The moral factor has been employed by the US Armed Forces only as a motivating and team building factor aside from the abstract ethical side of traditional morality. Therefore, US Armed Forces policies are guided by strict economic rules in every aspect. The troops on the ground may exercise their moral principles in combat routine (as they are expected to), but that does not stop their being “economic assets” or “entities functioning as stores of value and over which ownership rights are enforced by institutional units, individually or collectively, and from which economic benefits may be derived by their owners by holding them, or using them, over a period of time (the economic benefits consist of primary incomes derived from the use of the asset and the value, including possible holding gains/losses, that could be realized by disposing of the asset or terminating it)”.
I suppose, that says it all.
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+6 # RE: RE: The Army MEDEVAC Scandal: Report of ConspiracyIronV 2012-02-03 01:00
"...that says it all..." At least until Godot gets here... your rant has all the flavor of French absurdist theater.
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-1 # RE: RE: RE: The Army MEDEVAC Scandal: Report of ConspiracySerge 2012-02-03 02:12
You know the story of the Englishman in the brothel?
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+12 # Chriscnelsonmd64 2012-02-02 17:04
I am a former US Navy physician who has spent a great deal of time operating with both Army and Navy forces. I've been following this controversey closely, and from the beginning, I've suspected the real problem has been the Army MSC's (Medical Service Corps) protecting their turf. Over the years I saw it multiple times. That is, admin types screwing those they are supposed to be in support of in order to maintain their fiefdoms. In my experience, no one does that better than an Army MSC. As a surgical specialist, I was on "the tip of the spear" of military medicine, one of the people who actually treated combat casualties up close and personal. I was one of the people who sent "military medical bullets downrange". It is really analogous to an infantry officer "trigger puller" who is frustrated by "REMF's". The letter you just published by the infantry officer crystallized everything for me.
It is the Army MSC's who "own" those MEDEVAC helos. They like having those birds, and having control of them VERY much. They will do anything to keep them. They care more about that than anything else. I suspect it was an MSC who wrote that JCS letter that Michael so eloquently dissected and tore apart. You can tell that whoever wrote it knew enough lingo to sound legit, but in reality they don't know what the hell they are talking about, i.e. the obvious confusion the author had of .240 cal weapon vs the M240. They know enough to be dangerous, but that is about all.
Michael, go after the Army MSC's. Not the whole AMEDD, but zero in on the MSC's who control those helos. That is where the incompetence is, and that is where the answer is. If you shine a very bright light there, I'd bet the farm that you will see cockroaches scurry, and those ridiculous red crosses will just magically disappear.
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+7 # doctors are really slow to changepeter 2012-02-02 17:10
:-* Being a doctor, it is fair to say they are really slow to change. You definitely need proof, and should Emphasize Evidence,ie videos and several other Failed Medevacs where the patient care suffered, that this is HARMING patient care. The number one maxim of a doctor, taught to ALL first year medical students in Primum Non Nocere--First Do No HARM!
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+10 # Chriscnelsonmd64 2012-02-02 17:42
You are completely correct about primum non nocere, I learned that in my first weeks of medical school. But I can tell you, it's not the doctors that are the problem here. The doctors don't care how the patients/casual ties get to them, they, we, just want them in our trauma bays ASAP, how they get to us is irrelevant. And if having a red cross stuck on the front and sides of a blackhawk delays a combat casualty getting to me, then I want that red cross gone. Period.
Remember, the AMEDD is composed of 4 corps of officers: Medical (the doctors), Dental, Nurse, and Medical Service (admin/support) . It is the Medical Service Corps types who control the MEDEVAC helos. Not the doctors, or nurses, or dentists. I believe the key to getting rid of the red crosses, which I and anyone else who really cares about kids like Chazaray Clark, wholeheartedly support, lies in zeroing in, and shining light on the actual individuals who control those MEDEVAC Blackhawks. And those people have Medical Service Corps on the lapels of their Class A uniforms.
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+5 # I only wish it were true...peter 2012-02-02 17:51
thanks for responding. Thanks for your service. Sounds like you're a
doctor too, but in the "trenches" as it were. My main concern is those
doctors who have risen to the ranks for Administrative Zealots, and have
forgot they came from the trenches. They will be very hard, vis a vie,
resistant to change, unless you can show them it is harming patient care!
A. Peter Troedson, MD
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+7 # RE: Chrisin_awe 2012-02-02 18:51
The new Army Surgeon General and Commanding General of the Army Medical Department (AMEDD)in her video introduction to the AMEDD troops highlighted the fact that AMEDD runs the world's 5th largest HMO.

Take a look at the command structure for AMEDD and tell me who is the advocate for the MEDEVAC mission? Is it the dermatologist? The immunologist? Or is it one of these specialists:
Sociology/Health Administration
Family practice
Artillery Officer

The new Surgeon General does have a background as a Clinical Trauma Nurse Specialist, and the Command Sergeant Major was a Medical NCO/Combat Medic. But if you go back over a decade you'll see that MEDEVAC has never risen to the top of senior command despite 10 years of continuous war.

Who speaks for the wounded on the battlefield awaiting rescue? Who presses for continuous improvement in MEDEVAC? Yes, there are people within the organizational structure of AMEDD who do a great job in researching advances - but what BG or MG owns that mission?
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+6 # RE: RE: Chrisin_awe 2012-02-02 20:22
Sorry - meant to include the link to the page listing the senior command of AMEDD: http://www.armymedicine.army.mil/leaders/leaders.html

The medical specialties in my comment above are the actual specialties of the AMEDD senior command team.
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+5 # RE: The Army MEDEVAC Scandal: Report of ConspiracyEllie 2012-02-02 17:19
Classic and true to form.

Not only will it affect ownership it will affect what funding they will receive. Follow the money trail.
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+6 # RE: The Army MEDEVAC Scandal: Report of ConspiracyVernon Clayson 2012-02-02 17:51
I watched Secretary Panetta alight from a convoy of black SUVs to go to his office in the Pentagon, who wants to bet that there weren't weapons in every one of those vehicles? The president is surrounded by dozens of gun toting security personnel, Secret Service and local officers and probably more. But don't arm helicopters going into harm's way to rescue mere grunts???? The Army needs to realize the Red Cross means nothing to the insurgents, this isn't WWI with primitive motorized ambulances, and even horse drawn ambulances, displaying red crosses.
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+2 # MrRyden 2012-02-02 22:17
I don't quite see the connection between the protection details of the current administration, or any administration and the Bull's Eye marks also known as Red Crosses on MEDEVACs. Other than that, I agree with you to 110% and counting!
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+6 # RE: The Army MEDEVAC Scandal: Report of Conspiracyin_awe 2012-02-02 18:03
Here's a possible solution:

The MEDEVAC assets were turned over to the Combat Aviation Brigades (CAB) years ago. But the pilots and crews are still the responsibility of AMEDD (e.g. AMEDD trains them and maintains different MOSs for pilots and medics than comparable roles in the CAB)

Remove the red crosses and put guns on the MEDEVAC birds. Simultaneously, the Army should include in the CAB command evaluation process performance measures for timely and effective MEDEVAC missions during the period under review. If the CAB thinks he can snag some armed MEDEVAC copters for air assault roles fine. But if his Charlie Company of MEDEVAC copters fails to meet a new, tougher timeline for rescues then the CAB CO gets screwed in his performance evaluation. If a CAB commander wants to roll the dice when it comes to saving the wounded, then let him bet his career on it because he is already betting people's lives on it.

Since the Army is the sole source provider of MEDEVAC per DoD doctrine have the JCS approve the performance guidelines.
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+5 # RE: The Army MEDEVAC Scandal: Report of Conspiracy — in_awe 2012-02-02 13:03Jon 5051 2012-02-02 20:12
Firsttly what Mike has received does seem correct and the coments of in awe may be the solution BUT while we pontificate soldiers pay with blood. That is the un aceptable point that people in authority seem to be unable to resolve. Where is the moral componant here.
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+4 # Bureaucracy is the Enemy of MankindUSN - Ret. 2012-02-02 20:57
I have no trouble believing this explanation, because I know how the military works, and I have seen similar situations myself, more times than I can count.

In AMEDD's defense, while they may be misguided, they're not utterly evil. The concern of "losing control of their assets" is a valid one, at least to some degree. If the red crosses are removed, then it is only a matter of time before the MEDEVAC aircraft start being used for other purposes (I know, it's not supposed to happen, but it will). Then we run the risk of having Soldiers die because all the MEDEVAC helicopters are busy ferrying DVs around the theater. The only solution I can see is to remove the red crosses AND remove the MEDEVAC assets from the CAB.
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# MrRyden 2012-02-02 22:24
What about a new policy allowing AMEDD to arm its vehicles and paint them accordingly (that is without the Red Crosses if they're armed) whilst specifically keeping them under their command? And while we're at it, fit some MK19s to their MEDEVACs, to compensate for all the missions they've had to fly un-armed?
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+5 # RE: The Army MEDEVAC Scandal: Report of Conspiracymatt 2012-02-02 22:32
"owning" helicopters is a big deal. Let the Medical Corps own them, but remove the red crosses and arm them. It's a sensible compromise.

That way they cannot be diverted to other missions as others here have suggested.
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+3 # RE: The Army MEDEVAC Scandal: Report of ConspiracyKurt Olney 2012-02-03 00:50
Good to see this kind of input. All organizations have room for improvement. The life of the soldier that has been wounded and needs evacuation--tha t should be priority. Army officers are trained to leave no man behind. Officers--whate ver the rank-- should never put their careers ahead of doing the 'right thing."
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-1 # RE: The Army MEDEVAC Scandal: Report of ConspiracyIronV 2012-02-03 00:58
In FAIRNESS... Medical Corps may indeed be plotting to maintain "ownership" of the helos. But it may not be a matter of turf, it may be because they believe, that all things considered, they'll better serve the troops if they have that control.
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+2 # You may be right, but....cnelsonmd64 2012-02-03 04:44
You may well be right, I don't believe that anyone truly wants to do something that they know is hurting our troops. But I also believe that people working within bureaucracies can and do lose sight of the big picture. And I believe that they can lose perspective to such a degree that they start doing things that would appear to an outside observer to be really stupid. But in their minds, its perfectly justifiable and defensible. And it certainly appears that to me that is what is going on here.
There's just no excuse for not making every effort possible, and I mean every single one, to get a wounded troop to as high an echelon of care as soon as possible. To my way of perhaps simplistically thinking, that is the big picture. Everything else is fluff.
The idea of the "golden hour" is a great teaching tool, and sounds good, but there is nothing magic about 60 min. The reality is the sooner a trauma patient gets to an operating room, the better. Period. I read someone say elsewhere on this site that it should be the "golden as soon as possible", and that is really true. Minutes, seconds count. Hiding behind an arbitrary 60 min cutoff might be bureaucraticall y defensible, but morally it is not.
I've seen that video of Chazaray on a stretcher, holding his head up, looking around, and asking for pain medicine. That is huge, it has enormous implications. That means his blood pressure was high enough at the time to be supplying his brain with enough 02 to be functioning basically normally. He was likely entirely "savable" at that point in time. How long had it been since the IED went off? And how much longer after he did that did it take for him to get loaded on the bird?
That young man, in that situation, at that time, to me, is the big picture. Anything that impeded his earliest possible evacuation should be ruthlessly dealt with.
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+2 # Is it any surprise.FThomas 2012-02-03 03:20
I'm not surprised. I'm only shocked that it hasn't been brought to light in such graffic detail until now.

Now is the time for our elected Representatives to force the US Army to make the changes necessary to get the job done and done correctly.

To hell with their worry over assets assigned to their command. They are obstructionist and all responsible for the death of untold numbers of our soldiers. That is criminal and should result in a Court Martial under UCMJ!
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# One bad applescotch7 2012-02-03 19:26
Is it possible that this matter is stuck on the desk of a single officer, or a very small cluster of officers?
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+3 # Time to Name Names?scotch7 2012-02-03 19:32
Departments don't make decisions. Even committees don't make decisions. People do. Perhaps it's time to use this forum to name the person or people most likely to be fighting for turf instead of our people.

If names cannot be named with confidence, then nominating the most likely candidates may be in order. Anyone so nominated is then welcome to speak to their own actions.
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+1 # Here, here!cnelsonmd64 2012-02-03 22:24
Scotch 7,
I think you are right on the money. Individual people are making these decisions, hiding within the bureaucracy. I'd be willing to bet that it's not just one name, but it is few enough to count on one or maybe two hands. Locate, identify, and then prosecute those targets. As publicly as possible.
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+1 # SkipperRobert Newman 2012-02-25 06:50
The Army is using the tools in the Obama Administration' s seabag; 1) get alignment on the story and make sure everyone has the right story, Publish the story(even if it has lies, and then tout all kind of data that show how good that are. Kinda like LAPD closing ranks after Rodney King - except here it's not a beating, our men and women are being killed.
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