When I stepped off the C130 with my 40-pound backpack and fellow members of the Florida Advanced Surgical and Transport Team (FAST) in Fort McCoy, Wisconsin, I really wasn't sure what to expect. It was my first time participating in Patriot Warrior/Global Medic, a two-week military exercise at a rapidly constructed forward operating base (FOB) designed to replicate wartime deployment within 60,000 wild Wisconsin acres. The Global Medic side of the exercise would simulate all aspects of combat medical service from point of injury in the field through aeromedical evacuation (AE) to a fixed location military hospital overseas for more extensive care. For five days in June, our role as FAST was to participate in this highly orchestrated flow of medical treatment as a rapidly deployable critical care unit alongside Army, Air Force, Navy, British, and Canadian (active, guard, and reserve) forces.
From Fort McCoy, we were transported to the newly constructed Camp Young--a FOB in the imaginary country of Atropia--to experience the "austere" living of a military base. As my boots hit the recently graded dirt road, I saw military personnel in shifting shades and patterns of fatigues adorned with a plethora of patches that read like an extensive secret code I couldn't begin to decipher. On people's chests, shoulders, hats, and packs were symbols of past experience and current skill sets, clues to rank and placement. Some personnel threw us curious glances. As the only civilian team in navy uniforms, we were somewhat of a mystery.
South Florida felt like a million miles away. A purpose of this exercise is to give reservists a taste of deployment, and there were many young reservists here, some who would be deploying to Iraq for the first time soon. The dusty expanse of land that formed our FOB was ringed with overflowing portable toilets and dotted with enormous rounded tanks of potable water that reminded me of big black bloated cows. Rows of green and tan nylon tents contained everything from sleeping quarters and showers to surgical units and mobile hospitals. Black Hawks crossed the sky with Humvees dangling beneath like enormous steel spiders. A C17 took flight while inside intensely focused critical-care teams crisscrossed the plane's leviathan belly. Young soldiers with rifles and a hundred pounds of gear on their bodies trotted for miles down a seemingly endless road. And there we were--a team of 20, containing doctors, nurses, respiratory techs, and firefighter/paramedics dropped in the middle of it all!
FAST's specialty is emergency disaster medical care. It has highly trained personnel ranging from paramedics to trauma surgeons and can respond within hours to provide critical care treatment and transport of disaster victims on a variety of aeromedical evacuation platforms from Black Hawks to C17s. The FAST team is designed to be fast, and on the morning of day two we set up a fully operational critical care unit and received our first simulated patient in 60 minutes. People were impressed. Although we consisted of various levels of providers, from surgeons to firefighters, we worked together harmoniously. Soon after the tent was set up, medical personnel from all branches began streaming in to check things out. They were intrigued. We had a refined and effective setup along with medical equipment chosen to seamlessly integrate with the United States Air Force aeromedical evacuation system.
Drills and Training
Over the next few days, as we waited for the Global Medic mass casualty incident (MCI) drill to begin, pictures were snapped, questions were asked, and training ensued. A major picked our logistics guru's brain about our fabulous O2 transportation and delivery system. Freshly brewed cafecito, a rare and precious commodity, was shared with all. Dr. Farcy, our critical care emergency medicine doctor, ran Black Hawk medics, Army, Air Force, and Royal Air Force doctors and nurses through drills with his hi-tech simulation man. Carlos, our respiratory therapist, demonstrated the SMEED, a piece of equipment AE teams use but don't have on hand to train with. And Dr. Lynn, the medical director of surgery at Ryder Trauma Center and former chief of trauma for the Israeli military, gave a lecture on joint theater trauma systems and the echelon of military medical flow.
During the MCI drill, Dr. El-Haddad, another one of our trauma surgeons, assisted the Forward Surgical Team (FST); Dr. Farcy ran our critical care tent; and Dr. Lynn performed triage and directed the team's overall performance. Wounded flowed through our FAST, the combat support hospital (CSH), the FST, and onto C17s. It was great training for everyone. I'm not a critical care paramedic, nor am I in the military, so there was a learning curve for me, and I soaked in everything I could from as many different people as possible.
As a flight medic with Miami Dade (FL) Fire Rescue's Air Rescue, one of the highlights for me was talking to a friendly Black Hawk flight medic who was certified in critical care paramedicine. Not only does he deploy from the helicopter to treat point of injury wounded while wearing about a hundred pounds of gear, including body armor, medical pack, and rifle (and we thought bunker gear was heavy!), he is the only medic in the helicopter with critically wounded patients. We talked about equipment and techniques--he's been practicing IVs while wearing night vision goggles--and he gave tips for starting IVs in the dark. There are female Black Hawk medics as well, and I found it all very humbling.
Despite taking two showers in five days, surviving on meals ready to eat and highly suspect military coffee (bless our logistics chief for bringing a cafecito kit!), and not being entirely sure if the Air Force could find a C130 to take us home, the experience was incredibly enlightening. Not only did I climb through a Black Hawk, ride in a Humvee, and fly in a C17, I met friendly and fascinating people, shared tips, and learned from their experiences. I left Global Medic knowing our injured troops are in highly skilled and dedicated hands from medics all the way to surgeons. The emotional investment of the medical teams is obvious. These men and women, many of whom are reservists, leave home for months at a time, travel to foreign and hostile territories, and provide expert medical care under extremely challenging circumstances. As a constant seeker of inspiration, I found it in these men and women who put themselves in extreme situations so that every member of the military, no matter where he or she may be injured, has a very real chance to make it home.
I also learned how special the FAST Team is. This is a highly motivated and dedicated group of people. Our firefighter logistics team (no one sets up unwieldy equipment faster than firefighters!) is wondrously creative and adaptive. Our medical personnel are highly skilled and experienced. We have insanely busy and prestigious doctors who take time off with no pay from their packaed schedules. Many of the firefighter/medics on FAST are officers with major fire departments and hold critical care certifications and nursing degrees. Everyone burned their own time to participate for free and remained upbeat and positive despite the long days and uncertain schedule.
Treading New Paths
It was an incredible honor to work with such qualified people on FAST and in the military and to be warmly welcomed by everyone I met at the Patriot Warrior/Global Medic exercise. I was surprised by how friendly and helpful everyone was, from the women in my tent to a two-star general who stopped by to talk. We were working primarily with medical personnel who are constantly learning and adapting to new techniques, and it showed in their willingness to embrace our team. But, I also learned how a life in the fire service can lead you down paths you might not have envisioned early on in your career.
I've known firefighters who have traveled across the world responding to tragedies or to train fire departments with far fewer resources than those in America. And I've known firefighters who have self-deployed to tragedies here on our own soil, a risky proposition, on their own time and money.
Many of us would work for free if that meant being in the thick of things. This is the power of the fire service. We are willing and able to act. We are adaptable. We move fast. And when tragedy strikes, no one longs to be there like a firefighter.