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Dispatches

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An ambulatory patient strapped on his seatbelt and a sedated Canadian soldier was loaded.

After detailed preparations, checks and rechecks, they were ready to receive a critical care patient. Medical staff explained that this Canadian soldier had been wounded during training by a Claymore mine. In total, four Canadians were wounded when another Canadian soldier, Corporal Joshua Caleb Bake, was killed near Kandahar.

Doctor Chris Ryan works with the wounded Canadian soldier. During flight from Kandahar to Bastion to Bagram, the team was at his side constantly checking this or that.

The CCATT (Critical Care Air Transport Team) consisted of Tech Sergeant Matt Blonde (respiratory therapist); Major Debbie Lehker (nurse); and Lieutenant Colonel Chris Ryan (doctor). I asked Doctor Ryan what precautions troops should take to reduce the wounds he is seeing. Some of the advice was obvious. NCOs push soldiers to wear their ballistic glasses, for instance. Burns were a constant, serious problem in Iraq, but less so in Afghanistan, due to the nature of the bombs.

Dr. Ryan mentioned that Special Operations folks often take the worst injuries because their body armor offers less coverage, and so they often take from 1-3 amputations. He gave considerable credit to special operations medics. “They are studs,” he said. High praise indeed, coming from someone with his experience.

Strykers are great vehicles, but none of our vehicles is ideally suited for combat here. Stryker vehicles typically have about three soldiers standing up in hatches, sometimes on MRE boxes. Dr. Ryan said that when the bombs detonate under the vehicles, soldiers often suffer 5-7 fractures in each leg. Other fractures include feet, pelvis, back, ribs, arms, and neck.

Doctor Ryan stressed repeatedly the value of wearing seatbelts. The bombs smash you into the vehicle. Dr. Ryan served with Dustoffs during the worst times in Iraq. He’s seen many more wounds than most soldiers will ever see. So I listened to him. But often when soldiers see me putting on a seatbelt in a Stryker, they warn me to take it off. “Wear it if you like,” they say, but they warn that if we get launched and are upside down, I’ll be stuck in a possibly burning vehicle. This has happened plenty of times. So we all carry seatbelt cutters that can also be used to strip off boots and uniforms of wounded soldiers. But the soldiers are adamant that wearing seatbelts worsens your odds. I do not know who is correct. You get thrown hard without them, and stuck with them.

So, I asked Command Sergeant Major Jeff Mellinger, who served almost three straight years in Iraq. We drove thousands of miles around the country, visiting units everywhere. CSM Mellinger also visited Combat Support Hospitals twice per week. He read every single casualty report—thousands—and was the CSM for General Casey then General Petraeus. In short, CSM Mellinger knows the combat side, and the statistical side. Today he is the CSM for AMC—Army Materiel Command—with responsibility for every bean, bullet, bandage, helicopter, tank and seatbelt in the Army inventory. He talks bluntly and I take his word as the final statement. CSM Mellinger emailed about the seatbelt question with the Bottom Line Up Front (BLUF):

"BLUF - only a fool would ride without seatbelts. The feeling of not needing seatbelts started in MRAPs started as troops got to feeling invincible because they were riding in the beasts. Fact is there are lots of casualties that survived the blast, but did not escape unscathed by being thrown around during the blast or rollover. The first two soldiers killed in MRAPS were thrown free and rolled over by the vehicle.

I have high speed video showing 250 pound dummies being slammed to the floor, then the roof, then the floor again in blast simulation after blast simulation. Many of these crash-test dummies sustain breaks of arms, legs, necks and backs.

Far more likely than being trapped in a seatbelt is being upside down in your belt due to rollover. To prevent that being a problem, each troop was issued a webbing cutter. I am the guy who demanded cutters (2005) that everyone would be issued and keep on their body armor in order to cut themselves or anyone else out should the highly improbable happen. But if you are riding without seatbelts and rollover, you will surely have injuries.

Not long ago at Walter Reed, I visited most of the crew of a vehicle that had rolled over, and none were wearing seatbelts. Every single member of the crew had injuries, from open fractures to missing teeth. The squad leader told me that he was solely responsible for their injuries, as he had told them they didn't need seatbelts, and he knew that they would likely have escaped unhurt had seatbelts been worn.

Please look at the NHTSA link on seatbelts http://www.nhtsa.dot.gov/people/injury/airbags/buasbteens03/index.htm. Also see the Snopes link http://www.snopes.com/autos/techno/seatbelt.asp.

Use your belts, and try to get those who do not to see the error of their thinking. You will save lives!"

Jeff emailed another important missive just before this dispatch went to press:

“From my personal notes gleaned from reading every casualty report during my MNF-I CSM time (1 August 2004 - 6 May 2007):

We had 56 killed and 190 injured in rollovers -- thrown free from the gun turret or out the doors. Rollovers, Michael, not IEDs, not enemy action, rollovers. Add to that another 39 killed and 186 injured in vehicle accidents, I think one can safely say there would be more alive today were all wearing belts!”

That matter is settled: I’m wearing the seatbelt.

Co-pilot Captain Tanner Bergsrud spots fighter jets coming out of the sun.

We took off from Kandahar and headed west toward Camp Bastion in Helmand. The sun was blindingly bright at times and there was much air traffic, and so the pilots were on sharp lookout. We could hear radio traffic from all sorts of aircraft, and air traffic control alerted our pilots about some fighter jets that happened to be coming out of the sun at approximately our altitude. Despite the bright sun, co-pilot Captain Tanner Bergsrug somehow managed to spot the aircraft.

Lieutenant Colonel Ash Salter is the Commander of the 772 Expeditionary Airlift Squadron and he came along for the mission. He answered all one hundred questions I threw at him, while keeping watch for undeclared aircraft. Like all the other pilots and crew, LT. COL. Salter gives high marks to the C-130 platforms; it’s conceivable that C-130s will eventually have been in the American inventory for over a century.

We landed at Camp Bastion, and another C-130 pulled up behind us, and then came this ambulance. Two Apaches flew over to land and LT. COL. Salter noticed that their Hellfire rails were empty. Aircraft were coming and going as if this were the Atlanta airport.

We picked up two wounded Afghan soldiers. This one didn’t speak English but he was happy when I stopped a couple times to say hello and give a thumbs up.

Another C-17 comes in. By now, we must have seen every C-17 in the American inventory. Many of the wounded are first picked up by helicopters such as “Pedros, ” and then transported via C-130J, and then to these C-17s or KC-135s. I once flew Under Distant Stars from Iraq with Jeff Mellinger on a C-17 to Landstuhl. Patient treatment was attentive and top-notch. The wounded also say Landstuhl treatment is great, but when they get back to the United States the treatment can be shamefully poor.

We fly ammunition into Afghanistan on C-17s. Senior Airman Joe Hawkins, closer to the C-17, is the silent crew member. Joe is quick with a smile but doesn’t say much.

After a patient is loaded, Tom Parsons gives the signal that they’re ready for the next.

In addition to the doctor, nurse and respiratory specialist, there were five other medical specialists on the flight: TSGT Kat Hamblin (flight medic); TSGT Mark Russak (flight medic); MSGT Garry Sheets (flight medic); 1st LT Tom Parsons (flight nurse); and Major Marsha Schuman (flight nurse).

All are reservists and some have considerable other military experience. Tom Parsons said he spent 20 years as a reserve SEABEE and was in Ramadi, Iraq from June 2004 to April 2005. That was a period of serious danger. He’s also spent three years in the Air Force reserve, and mentioned that he works in the Butler VA hospital north of Pittsburgh, and that he will take care of these troops when he goes home.

Marsha Schuman did a tour in Iraq and this is her second in Afghanistan. Marsha was so busy we didn’t get to talk much. Marsha’s colleagues said she has been in the Air Force 24 years and is a wealth of knowledge, having worked with all the aircraft.

Kat Hamblin is the baby on the trip. She had been a cheerleader at Sacramento State and is now studying online. Kat said she did a back handspring on an A-10 wing and I asked what she would have thought if she broke off the wing. (A-10s are mighty sturdy and Kat looks light as a gnat.)

Gary Sheets was in the Marines for nine years and is on his first deployment to Afghanistan. Gary said that being a flight medic is “the best job in the Air Force.”

Mark Russak was in the Army for eight years and did 364 days in Al Anbar Province, Iraq, from June 2005 to June 2006. Mark said he was at places like Habbaniya, so I asked if he had been to nearby Coolie Village. Mark said his group lost four soldiers in Coolie, and I told him that I went there in 2007 with Marines after it was flattened by a truck bomb, described in “Ghosts of Anbar.”
This is Mark’s second Afghanistan tour in the last year. His personal motto: “It’s all about the man in the litter.”

TSGT Matt Blonde did three deployments to Iraq at the trauma center in Baghdad and up at Balad, one tour in Oman, and this is his first in Afghanistan. “Iraq in ’07 is the most memorable part of my career. Trauma non-stop. I worked every day. We saw at least four or five really significant mass casualties where we were nearly overwhelmed. Up to fifteen patients at once. There was not an injury type that I did not experience. If there is a worse injury to be seen, I never want to see it.”

Tom gives the okay to load another patient.

Hand and arm signals are used on the flight line. The engines are running and there is another C-130 behind us, also with engines running, while jets and helicopters swoop in and out.

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Comments

0 # Simon 2010-02-21 19:42

Thanks for the updates on the wounded Michael. We hear very little about them. I had heard about the Canadian training mishap and wondered how there were five casualties from a "firing range accident" - now I know it was a claymore which explains it.

Likewise the wounded Aussie. We sometimes hear that they are wounded but it's never been reported that this guy lost an eye. Tragic.

Whispers

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