He was driving an eight-wheeled Stryker armored combat vehicle, keeping watch while most of his unit surveyed a roadside ditch for improvised explosive devices, or IEDs. Suddenly a rocket hit below his vehicle. There was a moment of confusion and panic. What was that and where did it come from?
The second strike, a direct hit, answered those questions. Keene was blown from his seat into the side of the vehicle, crushing and breaking vertebrae in his back. In the next moments he took stock of his injuries as the gunfire continued: he thought his legs had been blown off despite the fact that he could see them beneath his pants. The crushed vertebra had damaged his nerves and he could not comprehend the new way his body felt.
Yet, there were other concerns. His gunner, the only other man in the vehicle, was imploring Keene to move so they could get in better position to defend soldiers who were now pinned down next to the road. Keene did all he could to drive the vehicle a few hundred yards before it succumbed to the damage of the rocket blast and could go no farther.
Their lieutenant, a recent graduate from West Point, lay injured in the road. Their gunner struggled with a rear weapon that had jammed. Since the vehicle was no longer operable, Keene crawled through it and took his position at one of the guns. It was painful and he could not stand. Yet, he soldiered on, unjammed the gun and took aim behind it. He fired on a group of about eight Taliban fighters who were moving to get a better angle on the pinned troops. Since his legs were not working, Keene had cinched himself in the hole that allowed him to rise out of the vehicle and operate the guns. He didn’t take his finger off the trigger until there were no more bullets left to fire.
“He was in shock I think, but they let him make a call,” said Brenda. She chokes up thinking about those moments, and contemplating how easily it could have been worse.
“At least I could hear his voice,” she said.
The recovery was difficult, both physically and practically.
He arrived back on base in Alaska without identification, wallet or credit card, and walking across campus was next to impossible. Yet he didn’t complain and didn’t ask for help.
“He’s not very aggressive as far as asserting things,” said Brenda.
Yet she doesn’t think that contradicts what he did that day in the desert, when lives depended on his actions, his ability to pull through pain and do what was required.
“He did what he was trained to do,” she said. “I’m not surprised he reacted the way he did. That’s just the way he is. If he didn’t do what he did, who knows how many would have died.”
The largest American hospital outside the United States is set for a $405 million upgrade.
Set for completion in 2014, a five-story tower would house inpatients at Landstuhl Regional Medical Center.
Landstuhl commander Army Col. Brian Lein received official word Thursday the project had been approved. Construction is slated to begin in fiscal 2011.
...
The Landstuhl tower has been a long time coming.
Constructing a tower at the hospital has been talked about for at least 20 years. U.S. troops wounded in Iraq and Afghanistan receive treatment at Landstuhl before flying back to military hospitals in the States. Since 2001, Landstuhl has treated more than 50,000 patients from Iraq and Afghanistan.
As the Pentagon and Congress argue over how to shrink the military to fit smaller federal budgets, no debate over matching money to mission is more heartfelt than the order to shut down the premier overseas hospital for grievously wounded troops and replace it with a new one.
With scant public notice, the Defense Department is closing, and relocating, the aging hospital, the Landstuhl Regional Medical Center in Germany, the only top-level military trauma center outside the United States.
The hospital has earned its vaunted reputation over the past decade as it has evacuated, treated and stabilized all American military personnel wounded in Afghanistan and Iraq. It treats 500,000 patients a year.
There is no dispute that replacing the hospital, which opened 59 years ago, is a good idea. And building its replacement next to Ramstein Air Base in Germany would reduce transit time for patients. Additional savings would be found by closing Ramstein’s existing clinic and combining it with the Landstuhl replacement.
In a blistering critique of the Pentagon’s initial plan, the Government Accountability Office, the auditing and investigative arm of Congress, rejected proposals from Dr. Jonathan Woodson, the assistant secretary of defense for health affairs, because he had failed to show how the Pentagon had come up with a $1.2 billion price tag for the hospital.
...
In the Pentagon’s official response to Congress, Dr. Woodson wrote that he accepted the Government Accountability Office’s criticisms. He emphasized that the Defense Department had conducted a reassessment of the $1.2 billion proposal. A new plan — along with “a documented audit trail of how the size, scope and cost of the alternatives” were determined — would be provided to Congress after it was approved by Defense Secretary Leon E. Panetta, he wrote. No timetable was provided.
DOD was awarded $71 million this fiscal year for the first phase of construction, money which will allow the department “to begin some site preparations as we address the concerns raised by the Congress,” [Pentagon spokeswoman Cynthia] Smith said in an email.
BETHESDA, Md. – American troops are suffering more extensive physical damage — measured in lost arms and legs — to buried explosives in Afghanistan than ever before, according to data collected by the Army Surgeon General's office.
This year through May, 60% of all combat amputation casualties in Afghanistan — 31 of 52 cases — were troops who lost two, three or four limbs, according to statistics. The vast majority are caused by makeshift bombs known as improvised explosive devices, or IEDs, the Army says.
In 2009, about one in four combat amputations involved multiple limb-loss. That increased to one in three in 2010 and nearly one in two last year, when there were a record 225 amputation cases in Afghanistan.
Half of the six American troops left quadruple amputees during 10 years of war in Iraq and Afghanistan, suffered their wounds this year, data show.
Two lethal trends in Taliban bombmaking are larger explosives targeting U.S. foot patrols and bombs that have less metal and are more difficult to find with detection devices, says the Army and the Joint IED Defeat Organization, or JIEDDO, the Pentagon's lead agency for combating makeshift bombs.
...
The military has responded by placing more highly skilled medical personnel on helicopters that retrieve wounded servicemembers from the battlefield, including critical care nurses from the Army and doctors and nurse anesthetists from the Air Force.
"We believe that by placing this higher-level medical capability farther forward faster, that we will be able to save the lives of more of these servicemembers," says Brig. Gen. Bart Iddins, Air Force air mobility command surgeon.
Face of Defense: Chaplain Tends to Wounded Warriors
By Senior Airman Alexandria Mosness
U.S. Air Forces Central
BAGRAM AIRFIELD, Afghanistan , June 4, 2012 – The chaplain gave the cross he brought from home to the young injured Marine from Florida.
The Marine had been hurt in a roadside bomb explosion and had lost the cross that was on his body armor. When the chaplain presented the cross to the young Marine, both men cried.
This was Air Force Chaplain (Lt. Col.) Brian Bohlman's first experience as the night shift chaplain at Craig Joint-Theater Hospital here about six months ago.
The chaplain would experience these types of scenarios and more throughout his time at CJTH, one of the largest and best-equipped trauma facilities in Afghanistan.
Bohlman said his pager goes off each time a trauma patient is admitted to the hospital.
"Our role in the trauma room is to introduce ourselves, and we tell them we are praying for them," said Bohlman, who deployed from the 169th Fighter Wing at McEntire Joint National Guard Base, S.C. "We will also follow them while they are in the hospital."
Bohlman said he and his assistant generally see about 15 patients nightly.
"I always ask them [about] their hometown," he added.
Bohlman, a 20-year Air Force veteran, said caring for people is nothing new for him, noting he always had a strong desire to serve others. He didn't initially meet the requirements to a become chaplain so he enlisted in 1992 as a chaplain's assistant. After serving four years on active duty and a year in the reserve, he earned a commission through the Air Force’s Chaplain Candidate Program.
"Our mission is to care for the warrior's soul," Bohlman said. "There are three functions we do. One, is nurturing the living; two, is caring for the wounded; and three is honoring the dead.”
Bohlman carries a small green book in his left breast pocket. Though the book is not worth more than a couple of dollars, he said, it holds a deep meaning to him. Bohlman said he records the name, rank, service and some descriptive passages of every injured military member he comes in contact with.
"I try and write a little bit about everyone I meet," the chaplain said. Some service members, he said, have heart-wrenching stories.
"In April, we had a lot of traumas. At one point there were four patients in the trauma room, and I looked down and realized there was a lot of blood on the floor. I still have those stains on my boots. I thought about the sacrifice, and how our job can be a dirty one. I just thought about how they truly left their mark on me."
After his first week at the hospital, Bohlman told the staff that he can pray and chew gum at the same time, meaning he could help out the staff if needed.
Soon, Bohlman said, he was "taking temperatures, putting on the blood pressure cuff, and getting warm blankets.”
Bohlman has been a great asset, said Air Force Maj. (Dr.) Micah Schmidt, an emergency room physician.
"He participates in all the traumas. He is very helpful. It is not expected, but it's nice,” Schmidt said of Bohlman. “Just the other night, he helped me change the dressing on a gunshot wound."
The chaplain said it's not just the patients he watches over, but also the staff at the hospital.
"We're here to listen to their stories," Bohlman said. "A lot of times, the staff will compartmentalize what they deal with. You can have an enemy prisoner of war and the soldier who was injured by the enemy POW, but you have to give the same exact care. They have to keep their feelings and emotions out of it."
The chaplain said he tries to keep abreast of the hospital staff’s well-being.
"I usually ask if they've talked to their family lately," Bohlman said, or if they’re keeping up on their exercise.”
“My goal is to build resilient airmen,” the chaplain added. “I tell them I'm here regardless of their faith or denomination.”
A lot of times, Bohlman said, the people he encounters just need someone to talk to.
"They have seen a lot but the way they deal with it is knowing that many would die if they weren't here," he said. "They see the big picture. It helps them during difficult days to pull through."
Bohlman, who’s on his fifth overseas deployment, said losing people is always difficult.
"At the end of the sermons I give, I have a slideshow of the service members I've worked with who have died, and I always tell my congregation, 'These are the faces of freedom!’”
CAMP DWYER, Afghanistan – In the midst of combat, acts of valor and bravery are performed so often they are sometimes overlooked. This was almost the case with the story of the soldiers who rescued Marine Lance Cpl. Winder Perez. This is a story that will finally be told, months after it occurred.
On Jan. 12, 2012, a call was passed over the radios to a medevac (medical evacuation) crew to rescue a 3-year-old Afghan girl who had suffered from a gunshot wound and shrapnel to the back. After dropping off personnel and equipment from their current mission, they headed back out to the location for pick-up.
Upon contacting the ground crew on the directed frequency, the pick-up location had moved. After verifying the medevac request and landing safely to retrieve the patient, the landing zone controller came over the radio with a loud, frantic voice, “the patient has (unintelligible) unexploded ordnance!”
The patient was no longer the girl, but Perez who had a rocket propelled grenade embedded in his leg extending to his lower abdomen. The RPG had not detonated yet meaning the slightest wrong move could set it off.
“That call will be in my mind all my life,” said Sgt. Robert Hardisty, a crew chief with C Company, 1st Battalion, 171st Aviation Regiment, New Mexico National Guard, who was attached to 25th Combat Aviation Brigade. “First you land thinking it’s a little girl and the next thing it is a Marine with an unexploded RPG embedded in his body.”
Spc. Mark Edens, a flight medic with C/1-171, was the first to see the RPG round visible in Perez. At this point the crew had to make a decision. “Because of the level of danger, if the crew left Perez on the ground and decided not to take him, no one would have ever blamed them. We all would have understood,” said Maj. Christopher Holland, C/1-171 commander.
Capt. Kevin Doo, the pilot-in-command for this mission, the pilot of the crew decided they would only take Perez if the entire crew agreed.
“There was no doubt to anyone that we were going to take this Marine and get him the medical attention needed to save his life,” said Doo. “When dealing with this, not knowing that any moment could be your last. Eighteen inches from the patient’s legs was about 360 gallons of aviation fuel.”
The crew transported Perez as quickly as they safely could landing at Forward Operating Base Edinburgh 24 minutes from the time the RPG hit Perez.
“After Lance Cpl. Perez was loaded on the Black Hawk, it was a total of 11.2 minutes of flight time where every minute felt like an hour,” Doo said. “During that time, we were on the radio coordinating with our escorts, the Explosive Ordnance Disposal team, and medical personnel who were going to treat Perez.”
The crew’s coordination paid off. The coordination included telling the armed escorts of the medevac helicopter to stay a good distance away for their safety, calling the EOD team to handle the disposal of the RPG, and ensuring medical personnel were aware of and prepared for the situation they were about to handle.
Upon hearing the news of the RPG, the medical team set a plan in motion to properly remove the round as they gathered necessary supplies and met the medevac at the landing zone. When Perez arrived at FOB Edinburgh, he was transported to a safe area to extract the round with only the necessary personnel present.
Lt. Cmdr. James Gennari, department head, Surgical Company B, 2nd Supply Battalion, noticed the wounds Marine Cpl. Perez received were life threatening. If he had not been transported by the speed of medevac, then he would have died of those wounds.
After removing the round and closing up the wounds, Perez was transported to Bastion Hospital for further care. The same crew who evacuated him from the battlefield were the ones who transported him to the next higher medical facility.
Although the RPG round was now miles away from Perez, other issues arose for him and the crew. His ventilator failed during the flight prohibiting his oxygen flow. At this moment, Spc. Edens and Sgt. Hardisty acted rapidly manually giving oxygen and bringing the Marine back to a stable condition.
“After stabilization, I witnessed Spc. Edens and Sgt. Hardisty work in a calm, cool and professional manner ensuring the safety of this patient who suffered a second near catastrophic event with the loss of the oxygen ventilation machine,” said Gennari. “I distinctly remember thinking that if Dustoff could risk their lives to bring this patient to us, the least I can do is take some risk and get that thing out of his leg.”
Stories of heroism like these happen more than we think. While the fog of war keeps most stories hidden so they will never be told, this one escaped from the mist so it could find a place in our hearts. As for Perez, it was thanks to these heroic acts that allow him to read this story today from the comfortable safety of the United States.
