Medevacs & Medics, Angels of mercy
By Ed Marek, editor
March 17, 2012
Birth of the 45th Medical Company (Air Ambulance - AA)
I’d like to use the 45th Medical Company (AA) as a means to explain the medevac business from Vietnam up through the Iraq War, which will include a bit of the Afghan War as well. To keep this manageable, I m providing samples of what is clearly a much larger story.
We have not been able to find a single history of the 45th on the internet, but have one pieced together. The overall story this history tells is one of great heroism and dedication to saving lives. The significance of the 45th, and other similar companies that preceded and accompanied it, was that they were full-fledged medical companies rather than taking the job on as an extra duty.
Long Binh, South Vietnam, from the air. Photo credit: from Dennis Mansker's Long Binh Post Gallery
45th Dustoff parking ramp, Long Binh, Vietnam Oct. 1969-70. Submitted by Del Williams. Presented by dustoff.org
This is the 45th Med Co.'s "gate" and area at Long Binh. Presented by dustoff.org
The 45th was formed on September 13, 1967, at Long Binh, Vietnam, located near Saigon and just northeast of it. The 45th Medical Company (AA) was at Ft. Bragg, North Carolina, but it had been on what the Army calls "deferred status" since 1965. That meant it had 25 obsolete H-19 helicopters and virtually no one able to fly them.
"Wild Child II," typical of the brand new UH-1Hs sent to the 45th Medical Company (AA) at Long Binh, Vietnam (it so happens Wild Child II was replacing one of the new ones already lost in combat). On the left is Richard Cunnare, the crew chief, on the right, Dennis Telischak, the medic, 4th Flight Platoon, 45th Med. Co. (AA), on March 1, 1968.
Fliers and aircraft came from many locations throughout the US to form up this company. The Army outfitted it with 25 new Bell UH-1H, the latest and, at the time, the greatest, with powerful engines for lift, new navigation kits, and improved hoists. The 45th's aircraft actually came directly to Vietnam from the factory in Texas.
Bullet hole through diffuser section. 45th Med, Long Binh 1970. Submitted by Del Williams, presented courtesy of dustoff.org
We read one wife's account of her husband's tour as a pilot with the 45th in Vietnam. She wrote:
“He was shot down once, surrounded by the enemy, under fire, but got out without a scratch. Crashed once because of a faulty tail rotor, survived that without injury too. At times he assisted the Docs and medical personnel as arms and legs were amputated. He helped in any way he could and went above and beyond his job description and duties (He said he felt it was the 'least' he could do. It was such chaos at times. I'm so proud of him. It had to be really hard. There are visual and other sensory memories that he will never forget, like the smell of burning flesh, and blood). He carried the wounded, sick, dying and dead back to the Medevac Units. The BIG RED CROSS on the side was supposed to signal to the enemy that it was an air ambulance, and was hands off, but as many of you know, it didn't stop them. We lost many a Medevac Pilot in Nam. Art had a Co-Pilot hit. Bullets would wiz through the cockpit.”
This wife understood the enemy well. Sgt Kenneth Rucker, a 19 year old medic with the 4th Platoon, 45th Medical Company, was aboard a 45th Dustoff over Binh Long province, Vietnam on May 27, 1968. His pilot hovered the red cross marked aircraft above wounded special forces soldiers and Rucker was trying to hoist a badly wounded Green Beret aboard. Enemy gunners operating two Chinese communist machine guns rattled the aircraft with fire. The pilot held his hovering position, continuing their hoist operation. Then the enemy fired a B-40 rocket at the helicopter, it crashed and exploded, all souls aboard lost.
45th Dust Off revetments, we believe at Tan Son Nhut Air Base, Saigon, 1969-1970. Submitted by Del Williams, photo courtesy of dustoff.org.
We have read several accounts of what a 45th mission could be like, by men who were there. Allow us to point you to one, written in 1997 by the 4th Platoon crew chief shown above with Wild Child II, Richard Cunnare. Let us summarize the picture quickly to underscore what a tough business this was and is:
In mid-February 1968, a platoon of the 1st Infantry Division was ambushed and cut off. All the squads except one managed to retreat. That one squad had to surrender. The Viet Cong (VC) pulled them into a mangrove and 13 men were now missing. Cunnare's medevac helicopter orbited near the area. Play Boy 33, a Cobra helicopter gunship, went to the area to destroy escaping VC. During his attacks, Play Boy 33 reported spotting the missing troops. He hovered over the area while squads on the ground that had broken loose rushed to the area. The 45th Dust Off with Cunnare and his medic, Dennis Telischak aboard, were ordered by their aircraft commander to lock and load their M-16s, the rescue team on the ground popped yellow smoke, and the Dust Off went in.
The final approach to the rescue zone was low level and high speed followed by rapid deceleration and massive aircraft vibration. The Dust Off landed.
Soldiers began dragging men to the helicopter. There were bodies of men with their hands tied behind their back, shot through the head from the front and the rear, and shot through their necks and chests. They were all dead, the only recourse was to throw the bodies in the Dust Off and stack them so they fit, one pile of five, then a second layer, and another body on top, then a badly wounded lieutenant loaded on top them all.
Amidst the anguish of all this were indescribable rage, crying, yelling, but then, the command to lift off, the crew popped into action, "Ready right," "Ready left," "Coming up," "Clear up left," "Clear up right," lift-off, suppression fire coming from those on the ground and aboard the Dust Off, above the first tree line, low, picking up speed, break over another tree line, a hard cyclic climb at full power to 3,000 feet, the medic climbing over the dead bodies to get to the lieutenant and replace his blood-soaked dressings, and then, a successful recovery at Long Binh where all who saw the carnage had to "process the horror."
Average time from wounding to surgical table was under 100 minutes. 97% of soldiers who reached hospital alive survived. 390,000 wounded were evacuated during the course of the war. Courtesy of Digger history, an unofficial history of the Australian and New Zealand armed forces.
This is a photo of the 3rd Platoon, 45th Medical Co. in support of Australian troops in Phouc Tuy Province. It demonstrates well the environment on the ground while the mission we have just been discussing took place.
Three Dustoff crew received the Medal of Honor for service in Vietnam.
Warrant Officer Louis R. Rocco receiving the Medal of Honor from President Ford. Photo presented by Neal Mishalov.
Sgt First Class (SFC) Louis Rocco (later CWO), Advisory Team 162, MACV, on May 24, 1970, volunteered to accompany a medevac team to evacuate eight critically wounded South Vietnamese soldiers northeast of Katum, South Vietnam. He laid down heavy suppressive fire while the pilot brought the aircraft toward the landing zone, but the aircraft was struck and crashed. He broke his wrist and hip, and bruised his back. Nonetheless, he extracted the pilot, co-pilot, crew chief and another medic from the burning wreckage and, while under intense fire, dragged each unconscious man over 20 meters of exposed terrain to friendly positions. He then administered first aid until he himself lost consciousness. Two helicopters came in the next day to pick them up, and both were shot down trying to make the rescue. Another helicopter came in the day after that and picked them up. Rocco has said:
"They didn't have time for litters or anything else. They just threw us into the helicopter and took off."
Despite the great horrors witnessed, there were many, many more who were saved during the course of air ambulance history in Vietnam, tens and tens and tens of thousands were saved. Rich Cunnare was kind enough to send us a present-day photo of his commander, Major Nelson Luce and wife, Vivian. Major Luce was the original commander of the 4th Platoon, 45th Medical Company (AA), and a long time friend of "Combat" Kelly.
Life goes on, for most of us, because of men and women such as represented by Major Luce. You're looking at two great patriots who have spent much of their lives surrounded by similar great patriots. Our country is filled with them. They're everywhere.
The 45th stayed in Vietnam through 1971. The company was deactivated thereafter.
Creation of the 421st Medical Battalion and reactivation of the 45th
There was a reorganization of Army medical units in Germany in the late 1980s and on October 16, 1988, the 421st Medical Company was re-designated a battalion and subordinated to the 30th Medical Brigade. The battalion took the motto:
"Anyone. Anywhere. Anytime."
Command Sergeant Major Hank A. Barttosik, 421st Medical Battalion, standing next to an UH-60 Black Hawk medevac helicopter, photo courtesy of military.com
The 45th Medical Company was re-formed as a result and was subordinated to the 421st Bn. One of the significant aspects of this reorganization was to integrate the ground ambulance (GA) organization with the air ambulance (AA) people. The 421st, and its four companies, became the only air and ground medical evacuation battalion in the U.S. Army Europe. Four medical companies were assigned: the 45th (AA), 159th (AA), 236th (AA) and 557th (GA). As of 2002, the 557th (GA) was the only ground ambulance medical company in the active Army.
M-997 Field Litter Ambulance, photo courtesy of airfieldmodels.com
The 557th employed the M-997 Field Litter Ambulance. It is a four-litter ambulance that accommodates two medics, one of whom is the driver, four litter patients or six ambulatory patients, providing transport for up to eight ambulatory patients or four litter patients and two attendants. The ambulance has armor protection, self-contained heating, air-conditioning, and collective Nuclear-Biological-Chemical (NBC) protection for crew and patients.
As we indicated earlier, assembling a history of the 45th Medical Company has not been an easy chore, and we suspect the same might be true of many other such medevac units. We have learned that the company has a number of detachments which can deploy all over the world. The 45th is subordinate to the 421st Battalion, and is fundamentally a European-based battalion, but their basing has not been confined to Europe. Elements of the 45th have been to Iraq several times, Somalia, and Afghanistan.
Operation Desert Storm: a self deployment first
The 45th served in Operation Desert Storm, the first war with Iraq. It was among the first units from US Army Europe (USAREUR) to deploy to Saudi Arabia. It moved over there in August 1990 (We believe it remained through 1992; war ended in April 1991).
Self-deployed medevac helicopters, 45th Medical Company (AA), photo courtesy of Capt Larry Connel, 236th Medical Company (AA), Landstuhl, Germany and The Journal of the US Army Medical Department
There was another first in this move to Saudi Arabia. It executed what the Army calls a “self deployment.” That is, the unit deployed on its own to Desert Storm, without requiring US Air Force military airlift, which freed the Air Force to deploy other units. This was the longest helicopter unit self-deployment in US Army history. The deployment of 12 aircraft began on August 20, 1990 with the first set of six crossing the Alps to Brindisi, on Italy's southern coast. On day two and three they went to Athens. Day four took them to Cyprus, day five to Cairo West and day six to Tabuk, Saudi Arabia, day seven to Riyadh, and day eight to their final destination at Dhahran. The second set of aircraft left on August 20 as well, but after the first group, and as a result of lessons learned on the fly, deviated somewhat from the route described above.
Fleet Hospital 5, Al Jubayl, Saudi Arabia. Presented by The journal of the US Army Medical Department, from an article, "Fleet Hospital Five - Ashore in Saudi Arabia," by Capt. Riichard A. Mayo, MC.
As an interesting footnote to the 45th's service in Desert Storm, and yet another first for the 45th, two 45th Blackhawks were attached to the Navy's Fleet Hospital Five, FH-5, located in Saudi Arabia near Kuwait. This was the first fleet hospital ever mobilized and deployed as an ashore medical mobilization facility. Within two weeks of notification, the 900 medical providers assigned to this medical facility, which was a 500 bed combat zone hospital capable of providing major trauma surgery and critical care, were on their way to Al Jabayl, Saudi Arabia.
FH-5 was primarily tasked with providing casualty care support for the 1st Marine Expeditionary Force (45,000 troops) and the British 7th Armored Brigade. FH-5 set up a Navy Medical Casualty Clearing Company (MCCC) at Jubail International Airport and the 45th flew patients to FH-5.
Operation Restore Hope: Peacekeeping to War fighting
Following Desert Storm, the 45th served in Operation Restore Hope, Somalia, part of the second rotation, May - August 1993, part of the 42nd Medical Task Force. During the 45th's tour, on June 5, 1993, twenty-four Pakistani peacekeepers were killed and 44 wounded in an ambush when they attempted to close down a radio station of Somali General Aideed's militia. The next day, a UN Security Council resolution was passed to take a more aggressive stance against Aideed. The US requested four AC-130 Spectre gunships be sent to the region, they arrived in June and they began striking targets immediately. A five month battle ensued.
What is important to note here is that the 45th Medevac, like so many other units, came to Somalia in a peacekeeping operation that overnight turned into war. The US transitioned out of a humanitarian mission to a full-fledged combat mission and that meant a lot more medevac flights.
From a medical standpoint, this was a tough operation to plan and support. The Army referred to it as an "Operation Other Than War," OOTW. This was to be a peacetime and humanitarian operation. Troop levels were quite high in the first rotation, and tapered off quickly in the second and third. As force levels declined, so did the number of medical personnel, especially primary care providers.
Then came the surprise ambush of the Pakistanis during the second rotation and the killing of the 18 Rangers during the third rotation. In addition, there were persistent issues associated with the level of care that ought to be provided the Somalis. The net impact was that the level of medical care that was needed constantly fluctuated between peaks and valleys.
Medevac choppers landed and took off immediately at the soccer stadium in Mogadishu in early October 1993 continuously bringing wounded and dead soldiers in and out. This occurred during the October 3-4 Ranger firefight in the downtown which left 18 Americans dead and 73 wounded. The firefight was a culmination of an extended manhunt by U.S. troops to capture General Aideed for his alleged role in masterminding the June 5th ambush of 24 Pakistani peacekeepers. Presented by Doc J's Somalia photos.
In the summer of 1996, the 11th Aviation Regiment of the 1st Cavalry Division was alerted to train and prepare for deployment to Bosnia-Herzegovina. In October, the deployment orders came through, and, by October 28, the 45th was in place at Guardian Base, otherwise known as "Blue Factory," about 15 miles from Tuzla.
Blue Factory US-Norwegian Hospital, Guardian Base, near Tuzla, Bosnia-Herzegovina, presented by Global Security.
The Blue Factory was a nickname given to the US-Norwegian hospital there, which had blue-tinted connexes.
The 1st Armor deployed as part of NATO's Rapid Reaction Corps to Bosnia-Herzegovina in December 1995 as part of Operation Joint Endeavor. It enforced the ceasefire, supervised the marking of boundaries between warring factions, and enforced withdrawal of combatants to their barracks and removal of their weapons to storage areas.
In November 1996, the 1st Armor transferred responsibility to the 1st Infantry Division, "Big Red One." The 45th Medevac was part of what was called the Task Force Eagle Covering Force, led by Big Red One, tasked to cover the withdrawal of the 1st Armored Division.
45th Med Co, Winter 1996-97 Slav Brod, Croatia. Submitted by Andrew Risi. Presented courtesy of dustoff.org
Flying conditions in this region were often marginal, and quite frequently you might see simultaneous launches of helicopters and a SISU, a Swedish-built amphibious, six-wheeled armored personnel carrier with a medevac configuration, just in case the Blackhawks could not make it to the target. That said, we will note that Major John P. Cook, the 45th's company commander, said:
“We can take off at a moment’s notice. Our aircraft are in hangers, safe from ice, so we are ready 24 hours a day, seven days a week. We can reach any base camp within 30 minutes flight time. Our pilots don’t have the option of waiting out bad weather; they have to fly. We have to go if someone is out there dying. I feel totally confident that my pilots will find a way to get to that patient. This theater of operation has the best medevac company watching over it.”
This is professionalism at its finest, and a reflection of a legacy of leadership and tradition begun by Major Charles "Combat" Kelly, the father of the Dustoffs, saying unequivocally:
"No compromise. No rationalization No Hesitation. Fly the mission. Now!"
A 45th Medical Company (Air Ambulance) aircrew practices snow landings in their UH-60 Blackhawk at the 21st Combat Support Hospital (CSH) airfield at Guardian Base, otherwise known as "Blue Factory." Photo credit: Spc. Aaron Reed, presented by The Talon, January 3, 1997.
45th Med Co Croatia, 1997. That helipad looks like it's made of wood to me! Submitted by Andrew Risio. Presented courtesy of dustoff.org
Soldiers from the 498th FSMT evacuate a critically injured patient to Blue Factory. Photo credit: Spc Janel R. George, presented by The Talon
45th Med in Kosovo Nov 2002, Submitted by Felix Ramos, Jr.. Presented courtesy of dustoff.org
45th Medical Company (AA) in Kosovo. Submitted by Pete Smart. Presented courtesy of dustoff.org
Santa teases Sgt. Robert Ramos, a cannon crew member for Company A, 1st Battalion, 7th Field Artillery, about not receiving a gift unless he promises to be a good boy next year. Photo credit: Spc. Cheryl A. Kraning, The Talon, December 27, 1996.
Spc. Cheryl Kraning, reporting for The Talon, tells us that the Santa in the photo above is none other then CWO Cliff R. Gilliland, a UH-60 Blackhawk helicopter pilot with the 45th Medevac. Apparently Gilliland had been playing Santa for five years, but this was the first time he handled adults!
Operation Enduring Freedom, Afghanistan
Tracking the 45th Medical Company in Afghanistan has been a challenge in the early days. For purposes of the 45th, we know it merged with the 717th Medical Company (AA) National Guard (NG) out of New Mexico and Oklahoma.
We believe the two units operated mainly out of Bagram Airfield near Kabul and the Salerno Forward Operating Base (FOB) near Khowst, Afghanistan, south of Kabul and close to the Pakistani border. The 717th deployed to Afghanistan with some 27 soldiers from the New Mexico detachment and 13 from the Oklahoma detachment and, we believe, five Blackhawks. The 45th provided 18 soldiers, and a three-helicopter slice of the company. We also believe they both arrived in September 2003 and returned home in April 2004. We do not have numbers on the 45th, but we understand the 717th crews flew 1,600 combat hours in 302 missions and were credited with saving 525 lives, including those of 80 children. We also understand that in Afghanistan, the medevacs always flew with an armed Apache attack helicopter escort.
U.S. Army Chief Warrant Officer (CWO) Jason LaCrosse of the 45th Medical Company pilots a Black Hawk helicopter back to Bagram Air Field, Afghanistan, after the mission, Jan. 25, 2004. U.S. Army photo by Sgt. Martin K. Newton. Presented by Defend America.
Map showing location of Shkin, Pakita Province, Afghanistan presented by Christian Science Monitor.
CWO LaCrosse of the 45th was involved in a medevac mission responding to 10th Mountain Division casualties in Shkin, Afghanistan near the border (6 miles) with Pakistan on September 29, 2003. It was an area very friendly to the Taliban. US forces there guarded a pass through this area into Pakistan. Col. Rodney Davis, an Army spokesman, told reporters in September 2003:
"Shkin, we call it the most evil place in Afghanistan. We have lost more soldiers in Shkin than any other place in Afghanistan."
LaCrosse was the co-pilot, CW4 Dave Burnell the pilot, SSgt Jay Shearer the medic, and Sgt. Blain Condreay the crew chief; their callsign was Dustoff 64.
Taliban had been regularly attacking the American outpost near Shkin, and targeting government officials, aid workers and Afghan civilian workers there. Taliban would strike at Shkin, and then slip back into Pakistan. Pfc. Evan W. O'Neill of A Company, 1st Battalion, 87th Regiment (1-87), 10th Mountain Division, was part of a patrol engaged by a large enemy force. A firefight ensued and O'Neill was wounded, shot in the back on the front lines. Alpha company moved to destroy the enemy force and called in significant fire power which included F-16, A-10 and AH-64 aircraft and 105mm artillery, mortars and direct fire. LaCrosse reported the battle scene this way:
"Upon arrival we were told to hold to the east until the Landing Zone (LZ) was 'Ice' (clear of the threat, vice 'hot'). After holding for about 5 minutes we were told the LZ was Ice and to come get the casualty. The enemy had not been firing the whole time we were on station until we came in to land at the LZ. Upon approach into the LZ (just as the tail wheel touched down) the ridge line above us lit up with machine gun fire, and 6-10 RPG's (rocket propelled grenades) were fired at the aircraft. The RPGs landed approximately 10-20 ft outside our rotor disc. The ground personnel (call sign Gator 6) called us on the radio to get out of there as we were taking fire, CW4 Burrell pulled in power and we got out of there quick. The Apaches came in and lit the hillside up as well as the A-10. After holding for about 10 minutes I got on the radio to see if we could get back in there to get the patient who was dying, we were told no, the LZ was still hot. Knowing the golden rule of life saving my crew opted to go in and get him anyways. I called the Apaches on the radio and told them when we go into the LZ fly over the top of us and lay down suppressive fire on the hillside so we could get the patient out. We went in, the Apache swept over us, and as soon as we touched down SSG Sheare jumped out and got the patient. Within a minute we were off the ground and headed to Orgun-E where they had a small FSMT (forward support medical evacuation team). That day the Apache crews from the North Carolina NG killed approx. 55 Al Qaeda. But the story ends with a US soldier sacrificing his life for freedom, and his name is PFC Evan O'Neill. My crew will never forget him."
In a memorial message, LaCrosse reflects the emotional strain on medevac crews that often attends their work. He wrote:
"Hey Evan, it has been almost two years since I Medevac'd you out of that firefight. There is not a day that goes by that I do not think of you and your heroism. I am back in Afghanistan again, and have Evac'd more fallen soldiers but none hurt more than you. I pray to God everyday that your family is coping with the loss of you, and ask why did we have to lose such a young hero out there. My crew will never forget you. With regrets CW2 Jason LaCrosse 45th Medical Company (Air Ambulance); 29 Sep 03 will always be remembered."
Captain Janet Bradley organized two Salerno-based 45th Medevac UH-60 crews to respond to a call to pick up three Americans and an Afghan injured in a remote canyon in Afghanistan. It turned out that one of the Americans and the Afghan died before they got there; that soldier was Spc Pat Tillman, a former NFL football player. The canyon was narrow, with only room enough for one Black Hawk. The first medevac flight piloted by CWO 2 Tom Wallis went in first and picked up two. SSgt Jay Shearer, Wallis' flight medic, stabilized both and applied pressure dressings. Bradley then came in and picked up two body bags, the Afghan and Tillman, both killed by mistaken friendly fire. Tillman's Ranger outfit invited the medevac crews to attend Tillman's memorial service a year later.
Major Bruce Balzano of the 126th Medical Company of the California Army National Guard has added an interesting outlook when describing medevac flying in Afghanistan. Commenting on the fact that his base was already at 5,000 ft altitude, he said:
"It just gets worse from there. Everything goes up. Everything is a mountain flight. It was strange to have those altitudes with dust."
A Black Hawk helicopter from the 717th Medical Company (Air Ambulance) flies through the scenic mountains of the Gardez Pass in Afghanistan returning from Salerno Forward Operating Base, where its crew conducted an equipment switch, Jan. 25, 2004. The 717th Medical Company (Air Ambulance) and the 45th Medical Company deployed to Afghanistan to provide medical evacuation in forward-deployed locations in support of Operation Enduring Freedom. U.S. Army photo by Sgt. Martin K. Newton. Presented by Defend America.
The 45th Medical Company of the 421st Medical Battalion went to Iraq for the second Iraq War in December 2003 or early 2004, taking, we believe, 15 UH-60 Blackhawks with them.
The 45th was stationed at Camp Taji just north of Baghdad. The company used the callsign "Medicine Man."
45th Med Co birds in sandstorm, Iraq Feb 2004 Submitted by Dale Hlavacek. Presented by dustofforg.
45th Medical Company pilot contemplates while sitting in his UH-60 Blackhawk in Iraq.
Crew members of the 45th Medical Company scramble to respond to a call for help on October 10, 2004.
Aboard a Blackhawk helicopter on a medevac mission, Major Kathleen Feeley operates a ventilator to help an injured American soldier breathe. Presented by PBS.
A Blackhawk air ambulance prepares to land at the now fully operational 21st CSH at Camp Anaconda, built on the grounds of the captured Balad air base. Presented by PBS.
Medicine Man 27 and 68 were scrambled on April 14, 2004 to respond to a convoy from Camp Taji struck by roadside bombs. Four soldiers were hurt badly by flying shrapnel and two flight medics, Sgts. Dale Yarwood and Dale Hlavacek rushed to their aid. Then they all came under fire, and both Black Hawks took off to get out of the line of fire. The soldiers in the convoy laid down a barrage of suppressive fire, the medics remained on the ground, and they hooked up IVs, administered oxygen, wrapped bandages and moved the four injured men onto litters. Once done, the two Black Hawks swooped in, picked up the litters and their two medics, and got everyone back to the base safely.
Corporal Benjamin Cossel of the 122nd Mobile Public Affairs Detachment wrote the following on December 18, 2004:
"It's the call no Soldier wants to make or hear. 'Break! Break! Standby for nine-line medical evacuation.' When those words come across the radio, radio traffic comes to an immediate halt, Soldiers are down; Soldiers need help."
Matthew Green, reporting "Black Hawks scramble to save US Troops" published by Reuters on August 11, 2004, wrote this:
"An American soldier screams as medics hoist him into a helicopter on a stretcher, his face twisted with pain from shrapnel wounds to his arm and head.
"Roaring rotor blades drown out the young man's cry as the Black Hawk lurches upwards, its wheels seeming to brush the flat roofs of central Baghdad in a full-throttle race to hospital.
"For U.S. medics riding to the airborne rescue of the wounded, a surge in fighting in Iraq since Aug. 5 has shattered weeks of relative calm at their base.
"Working round the clock, crews have tripled their missions since the clashes erupted between U.S. forces and militia loyal to Shi'ite Muslim cleric Moqtada al-Sadr in Baghdad and Najaf.
"The leap in activity not only points to a sharp increase in U.S. casualties, but provides an insight into the cost in life and limb to the men doing the fighting.
"'It's not like anything in the movies,' said Major Christopher Knapp, 40, a pilot and commander of the 45th Medical Company based at Taji, just north of Baghdad. 'There's torn flesh, blood everywhere. There's no way to be able to describe it, it's just horrific,' he said at the base housing Black Hawk transports and Apache gunships."
"Skimming just above the power lines at speeds approaching 150 knots, these Blackhawk helicopters dodge enemy fire to be among the first on the scene when things go wrong. The crews fly some of the oldest choppers in the Army, and yet they go where pilots flying more modern equipment dare not follow ... When a call comes in, the bird is off the ground in a matter of minutes. Flying in Iraq presents unique challenges for Blackhawk pilots, who maneuver the choppers low and fast to avoid enemy fire. By skimming just above the surface, an observer on the ground will be unable to see the helicopter until it is just overhead. At the speed these Blackhawks travel, that gives the enemy very little time to fire. This requires great skill by the pilots, who must fly the same way at night in a country where tall buildings and power lines are infrequently marked with beacons. Even with the aid of night vision, the pilots must take the additional precaution of memorizing tall structures to avoid inadvertent collision ... Day after day, these men jump into a 16-year-old, unarmed helicopter to fly to the scene of some of the worst fighting in the country. They do so without hesitation, and they do so to save lives."
Matt Green, reporting for Reuters on August 11, 2004, in an article entitled "'A sharp increase in US casualties,' Black Hawks scramble to save US troops," he adds a footnote to these Blackhawk flights worth noting:
"'Pigeons are an issue for us,' said Sergeant First Class Luis Arzadon, 40. 'Sometimes we get them sucked into our engines which becomes a significant problem for our maintenance.' Swirling dust devils that materialize in an instant can bounce a helicopter around like a ball, while power pylons force pilots to vault and dip in a gut-wrenching rollercoaster ride."
Green also talks to the stark realities of caring for the injured in the back while the pilots throttle their way to a medical facility:
"As the helicopter banked toward the U.S. military hospital in Baghdad, a medic in a bulky flying helmet and visor searched the wounded soldier's wrist for a pulse. There was none. A roadside bomb blast that morning appeared to have severed an artery, draining the life from the man's arm, swathed by his comrades in bandages stained with dried blood. On the stretcher stacked beneath him lay an Iraqi man who had been working alongside the soldier as a translator, his knees bandaged to cover less serious shrapnel wounds ... On bad days, the metal deck of the helicopter is slick with blood. There are often surprisingly few screams -- the wounded have already been doped with morphine by soldiers on the ground."
Medics remove the Iraqi translator from the UH-60 and take him to the doctors. Photo credit: Chris Halgren, Reuters
A wounded U.S. soldier of the 1st Cavalry Division, who was injured in a roadside explosion, is carried on a stretcher to awaiting doctors. Photo credit: Chris Halgren, Reuters
By the way, the soldier without a pulse in his one arm, the one on the stretcher in the photo directly above, would regain use of that arm and survive.
During its December 2003 - December 2004 deployment to Iraq, the 45th evacuated more than 3,000 patients while conducting about 2,500 medevac missions totaling 4,550 flying hours.
Closing: Birds and crews of mercy
Leslie Sabbagh, writing "Birds of Mercy" published in the October 2005 issue of Popular Mechanics, reported on the 50th Medical Company, the "Eagle Dustoffs," stationed at the time at Balad Air Base, Iraq. We commend this article to your attention.
The 50th's commander, Major Bill Howard, was quoted saying this:
"The (air) assault) community in Vietnam swore there was a special school that taught medevac pilots how to fly, but there wasn't. You learn (on the job) to fly single ship between light poles and land in brownouts."
Howard said he never stopped his pilots from launching.
The "medevac, medevac, medevac, one urgent litter, US soldier with abdominal wounds" call comes in on the radio. Within four minutes, Command pilot Capt. Scott Brown and CWO Craig Parker are in the cockpit, SSgt. Jamilah Posey the medic and Spc. Bill Myers, the crew chief are in the aft compartment, the rotors are spinning and up they go. They call for their coordinates, they ask the status of armed escort; they get the coordinates, but no armed escort. They get to their pickup zone, the PZ, and find it's a ghastly urban setting, homes, buildings, crosswinds, telephone poles and power lines. The skipper looks for the casualty, puts his Blackhawk into a steep descending turn, his crew chief calls out the power lines. The skipper clears all the obstacles and sets her down, 200 ft. from a damaged Humvee surrounded by other vehicles. The crew chief jumps out and sets up to provide security with his M-4. Posey, the medic runs to her patient, while the skipper, Brown, turns the controls of his rotor beast over to his co-pilot, unholsters his Beretta and watches the crowd.
Posey gets to her patient and finds she has two, not one. The first is a 6 ft, 230 lb linebacker-type with both legs partially amputated by the IED blast, and one arm completely amputated. His colleagues carry him to the waiting Blackhawk. Posey runs over to the other patient, calls the crewchief, Myers, for a stretcher, and Myers breaks his security task and gets a litter to her. The second patient has lost both arms and has IVs in his legs.
Spc. April Krueger, a medic, escorts an Iraqi guardsman wounded by a car bomb back to her crew's Black Hawk for a medevac to the Army's Combat
Support Hospital in Baghdad's International Zone. Photo credit: Lucien Read, presented by the Christian Science Monitor.
As the litters are placed in the hold, the rotor downwash sprays blood through the door. The medic goes to work. The co-pilot, Parker lifts off in a steep climb to avoid the powerlines, and the crew chief hollers, "Clear wires." Parker cranks his machine up as fast as she'll go, the medic injects morphine, and works to comfort her two patients. Parker spots his landing pad, banks the UH-60 toward it, and comes in low and hot, spitting out dust in every direction. Hospital medics are waiting, and the medevac crew's 18 minutes of hell are over.
The aircraft gets a powerwash, the crew meets before dinner, downcast, the worst set of injuries they've yet picked up. Parker admits he was too shaken to go back to home base, acknowledging the tears when the triple amputee was placed into the aircraft. The skipper agrees they'll go back in the morning. Parker, a former barber, says:
"Sometimes the eye contact is a flash into a hell that I'm not sure I'm able to comprehend fully. It goes home with me. But I love the medevac mission, and I'm glad to go into harm's way to retrieve our wounded soldiers."
The triple amputee dies, the double makes it. The medevac crew waits for the next call.
The case of Staff Sergeant Jessica Clements