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SAWMAN TALKS RHINOS

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TACMED PREP FOR OPERATIONS In A Resource-Depleted And/Or Extended Evacuation Environment GATES OF FIRE By MIchael Yon CUTTING THE CHARGE: The Story of Medal of Honor recipient Sammy L. Davis, By Andre’ M. Dall’au

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AN INTRODUCTION By John Gomez

PERSEVERANCE An interview with SSG Nick Lavery

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CONTENTS

ISSUE 1, DEC 2014 8

GATES OF FIRE BY MIchael Yon

CUTTING THE CHARGE: The Incredible Actions of an American Soldier Alone under Fire. The Story of Medal of Honor recipient Sammy L. Davis, By Andre’ M. Dall’au

PREPARING FOR OPERATIONS In A Resource-Depleted And/Or Extended Evacuation Environment. By Gabe Corey, PJ, NREMT-P; Tim Lafayette, PJ (Ret.) NREMT-P

CONTENTS

50 SAWMAN TALKS RHINOS An Interview with Craig “ Sawman” Sawyer 58 ISIS: AN INTRODUCTION By John Gomez

68 PERSEVERANCE An interview with SSG Nick Lavery

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By Michael Yon

GATES OF FIRE

FRONTLINES

GATES OF FIRE First Published: August 31, 2005

By Michael Yon

osul, Iraq A LOOK BACK! Combat comes unexpectedly, even in war. On Monday, while conducting operations in west Mosul, a voice came over the radio saying troops from our brother unit, the 3-21, were fighting with the enemy in east Mosul on the opposite side of the Tigris River. Moments later, SSG Will Shockley relayed word to us that an American soldier was dead. We began searching for the shooters near one of the bridges on our side of the Tigris, but they got away. Jose L. Ruiz was killed in action. Although the situation in Mosul is better, our troops still fight here every day. This may not be the war some folks had in mind a few years ago. But once the shooting starts, a plan is just a guess in a party dress. The only mission I’ve seen unfold close to what was planned was a B Company raid a few months back. It actually went so close to perfect that we could hardly believe it. The sole glitch occurred when a Stryker hit an IED, but since nobody was hurt, we just continued the mission. In retrospect, it’s hard to imagine why I didn’t write about it. But times are busy, and, apart from it going nearly perfectly according to plan, it just seemed like any other old raid.

By Michael Yon

GATES OF FIRE

FRONTLINES

I had been talking with Captain Matt McGrew about the “The Battle for Mosul IV” dispatch, intending to spend the night with him and some Iraqi troops at one of their combat outposts, to glean additional insight, but the on-going battles in Mosul kept getting in the way. On the night before the planned ride-along, the obstacle was a big and sudden push of operations and tasks bun-

dled in a “surge operation.” Operation Lancer Fury was launched without notice even to the unit commanders here. When I’d sat in on the “warning order” (notice of impending operations) for Lancer Fury last week, the plan was so cleverly contrived that the leadership at Deuce Four had to grudgingly acknowledge its excellence, even though the idea had originated from higher-up. In every military unit I have seen, there is a prevailing perception that good ideas trickle down from the top about as often as water flows uphill, so Lancer Fury apparently was a wunder-plan. As a “surge” operation, Lancer Fury is sort of a crocodile hunt, where our people do things to make the crocodiles come out, trying to flush them into predictable directions, or make them take certain actions. And when they do, we nail them. The combat portion of the Surge amounted to a sophisticated “area ambush” that would unfold over the period of about one week. This Surge is a complicated piece of work, with multidimensional variables and multifarious moving parts. Those parts range literally from boots on our feet to satellites zipping overhead. So, of course, glitches and snags started occurring the first day. Among other things, key gear failed; but overall, the Surge was going well. A few terrorists had already been caught in the first 24 hours. Thursday night, a revised plan had me following some Deuce Four soldiers on a midnight raid. They had night vi-

In every military unit I have seen, there is a prevailing perception that good ideas trickle down from the top about as often as water flows uphill, so Lancer Fury apparently was a wunder-plan.

By Michael Yon

GATES OF FIRE

FRONTLINES

sion gear, so they moved quickly. I had only moonlight, so I nearly broke my leg keeping up. Sleeking around Mosul under moonlight, we prowled through the pale glow until we came upon a pond near a farmhouse. Recon platoon had already raided one house and snagged some suspects, then crept away in the darkness to another target close by. Five soldiers from Recon Holt, Ferguson, Yates, Welch and Ross were moving through moon-cast shadows when an Iraqi man came out from a farmhouse, his AK47 rifle hanging by his side. Suddenly encircled by the rifles, lights and lasers of four soldiers, the man was quickly disarmed. A fifth soldier radioed for the interpreter and together they sorted out that he was a farmer who thought the soldiers were thieves skulking around his property. Recon returned the man his rifle, and started making their way back, umbral and silent across the ploughed fields. During a halt in some trees at the edge of the field, I overheard the voice of LTC Kurilla, the commander of the Deuce Four battalion, quietly praising one of the soldiers for showing discipline in not shooting the

farmer. After loading the other suspects onto Strykers, we returned to base, where I fell, exhausted, at about 3 AM Friday morning. The Surge continued while I slept. Alpha Company had deployed during the early hours and was conducting operations around Yarmook Traffic Circle. SGT Daniel Lama, who is as much respected as he is liked, was pulling security in an air guard position of his Stryker, when a bullet flew straight at his neck, striking him. As he collapsed into the Stryker, his body clenched in seizure, fingers frozen, arms and legs rigid. I seldom get letters in Iraq, but waiting for me in the mailroom while I slept was a card. The return address sticker, an American flag on it, was from Jefferson, Pennsylvania. The postage stamp had an American flag waving. The card inside had a picture of an American flag for its cover. The sweet and heartfelt message inside ended withPlease tell our soldiers we care so much for them. -Dan and Connie Lama. I was still asleep when medics brought their son Daniel to the Combat Support Hospital, or “Cash.” It’s a familiar place for Deuce Four soldiers, who’ve seen some of the most sustained and intense urban combat of this war, receiving over 150 Purple Hearts in the process. Bap bap bap! on my door. I jumped up and there was CSM Robert Prosser, the top enlisted soldier at Deuce Four. Prosser is always professional, always direct: “Sergeant Lama’s been shot. We’re rolling in ten minutes,” he said. “I’ll be there in ten,” I answered, instantly awake. Within minutes, I was running out my room, still pulling zips and fastening buttons, when I came sweating into the TOC. LTC Kurilla was there asking a soldier for the latest report on Sergeant Lama, now in surgery. When a soldier is killed or wounded, the Department of Army calls the loved ones, and

despite their attempts to be sympathetic, the nature of the calls has a way of shocking the families. There is just no easy way to say, “Your son got shot today.” And so, according to men here, the calls sound something like this: “We are sorry to inform you that your son has been shot in Mosul. He’s stable, but that’s all we know at this time.”

He just laughs, “Yes, Michael, you look fine. Just checking.” But secretly, every time he asks, I feel a notch better. Chaplain Wilson came out from the hospital smiling and explained that Daniel (Sergeant Lama) was fine. The seizure was just a natural reaction to getting shot in the neck. It was just a flesh wound. As if offering proof, Chaplain Wilson said: “When they rolled Daniel over, the doctor stuck his finger in Daniel’s butt to check his prostate, and Daniel said, ‘Hey! What are you doing?!’” Everybody laughed. I changed the subject by snapping a photo of CSM Prosser while LTC Kurilla got Mrs. Lama on the Iridium satellite phone. I heard the commander telling this soldier’s mother that her son was fine. Daniel just had some soft tissue damage, nothing major. Kurilla told her that he and some other soldiers were at the hospital now with Daniel, who was still too groggy to talk. “Really, Daniel’s okay, and don’t worry about it when the Army calls you.” We loaded the Strykers and headed downtown. Some Strykers were scouting for the shooters, while others were working details at Yarmook Traffic Circle. Major Craig Triscari from the 1-17th Infantry from Alaska was with Major Mike Lawrence, “Q,” and other soldiers, when he noticed a car with its hood up. The 1-17th will relieve the 1-24th soon, so Triscari has been conducting operations with Deuce Four. The vehicle struck Triscari as odd: it hadn’t been there a few minutes earlier.

LTC Kurilla likes to call before the Army gets a chance, to tell parents and loved ones the true circumstances. Kurilla is direct, but at least people know they are getting an accurate account. LTC Kurilla likes to call before the Army gets a chance, to tell parents and loved ones the true circumstances. Kurilla is direct, but at least people know they are getting an accurate account. We loaded the Strykers and drove down to the Cash, and there was Chaplain Wilson, who might be the most popular man on base. Everybody loves him. Often when Chaplain Wilson sees me, he will say, “Good morning Michael. How are you today?” But sometimes he asks me, “Are you okay?” and I think, Do I look stressed? “Of course I feel okay Chaplain Wilson! Don’t I look okay?”

By Michael Yon

GATES OF FIRE

FRONTLINES

Automatic weapons fire started coming from at least two places. Bullets were kicking up the dust, and we got a radio call that troops were in contact at Yarmook Traffic Circle. Sitting inside the Stryker with LTC Kurilla and me were two new faces. A young 2nd lieutenant who had only been in Iraq three weeks, and hadn’t seen any real combat; and a young specialist, who, per chance, is one of the few Deuce Four soldiers who is not a seasoned veteran, though he has seen some combat. Also in the Stryker was “AH,” the interpreter, whose courage under fire I had seen before. But the more battle weathered fighters were not there. Chris Espindola, the Commander’s radio operator, a respected and experienced fighter, was down in Baghdad at the Iraqi Criminal Court testifying against two terrorists caught by Deuce Four months earlier. Like the card in the mailroom, the circumstances behind their capture were more germane to the events about to unfold than anyone might have guessed at the time. Kurilla’s reluctance to allow anyone outside Deuce Four ride with his soldiers - including writers - is well known. Partly because of writers, people hearing

about Deuce Four in the news might think of Mosul as some kind of thrill ride where everything will end okay after a few hairpin turns. This is not true. Newcomers, even soldiers, unaccustomed to this level of hostility, can only burden the men with added danger. So Kurilla makes sure they can be trusted by mentoring new officers and having them spend three weeks with him before they are allowed to lead men in this unit. Some months back, a new lieutenant named Brian Flynn was riding with the Kurilla for his first three weeks, when Kurilla spotted three men walking adjacent to where Major Mark Bieger and his Stryker had been hit with a car bomb a week prior. The three men looked suspicious to Kurilla, whose legendary sense about people is so keen that his soldiers call it the “Deuce Sixth-Sense.” His read on people and situations is so uncanny it borders the bizarre. That day, Kurilla sensed “wrong” and told his soldiers to check the three men. As the Stryker dropped its ramp, one of the terrorists pulled a pistol from under his shirt. Mark Bieger was overwatching from another Stryker and shot the man with the first two bullets, dropping him to his knees. LT Flynn was first out of the Stryker, and both he and the airguard CPT Westphal, saw the pistol at the same time and also shot the man. The other suspects started running. But all Kurilla saw was LT Flynn stepping off the ramp, and then there was a lot of shooting. Kurilla yelled FLYNNNNNNNNNNN!!!! and was nearly diving to stop Flynn from shooting, thinking the new lieutenant had lost his mind and was shooting a man just for running from Coalition forces. Soldiers can’t just shoot anyone who runs. Chris Espindola also shot the man. Amazingly, despite being hit by four M4’s from multiple directions, the man still lived a few minutes.

FRONTLINES

GATES OF FIRE

By Michael Yon

Soldiers outran and tackled his two associates when they made a run. During their interrogation on base, both admitted

platoon leader for six months, but today Kurilla had another 2nd lieutenant who was being mentored before he became a platoon leader. Our Stryker did not contain the normal fighters that I saw with LTC Kurilla, but we also had a

to being Jihadists. One was training to be a sniper, while the other was training for different combat missions. They also admitted that the terrorist who was shot down was their cell leader, who had been training them for three months. They were on a recon of American forces when Kurilla sensed their intent. The cell leader had a blood-stained “death note” in his pocket stating he was a true Mujahadeen and wanted to die fighting the Americans. He got his wish; and now, Chris Espindola, Kurilla’s radio man, was down in Baghdad testifying against the two surviving co-conspirators. Despite their sworn confessions, Kurilla was left with a young radio operator with little trigger-time. Flynn had now been a

section (two squads) of infantrymen in Strykers from Alpha Company. This section was led by SSG Konkol. We were searching the area for the source of that automatic weapons fire when Kurilla spotted three men in a black Opel and his sixth sense kicked. When Kurilla keyed in on them, he pointed his rifle at the car and signaled them to get out. The driver tucked his head and gunned the gas. The chase was on. Strykers are fast, but Opels are faster. We were roaring through little streets and along roads, horn blaring, cars zipping off the sides, the steady chatter of multiple radio channels colliding inside the Stryker. A Kiowa helicopter pilot radioed that he spotted the car. As the chase continued, the Kiowa pilot said, “It’s going about 105 mph.” How can the pilot know it’s going 105 mph? I thought. As if in reply, the pilot radioed that the Opel was outrunning his helicopter. Captain Jeff VanAntwerp came on the radio net saying he was moving his section into position to intercept the Opel. “Watch out for that kid!” yelled Kurilla over the intercom to our driver as we made a hard

turn, managing to avoid hitting the child. Opels may be faster than Kiowas on straighta-ways, but when the car made turns, the helicopter quickly caught up. Kurilla ordered the Kiowa to fire a warning shot, then quickly auLast steps © 2005 Michael Yon

About fifteen seconds later our ramp dropped. We ran into combat. thorized the Kiowa to disable the vehicle. Kiowas are small, carrying just two people; they fly so low the two flying soldiers are practically infantrymen. The pilot swooped low and the “co-pilot” aimed his rifle at the Opel, firing three shots and blowing out the back window. The Kiowa swooped and banked hard in front of the car, firing three more shots through the front hood, the universal sign for “stop.” The car chase ended, but the men fled on foot up an alley. We approached in the Strykers and I heard Kurilla say on the radio, “Shots fired!” as he ducked for a moment then popped back up in the hatch. Kurilla continued, “Trail section clear the car and clear south to north! I’m going to block the back door on the north side!” About fifteen seconds later our ramp dropped. We ran into combat. Folks who haven’t done much urban fighting might take issue with the wild chases, and they might say that people should always “stack up” and do things this or that way, but men in Delta Force, SEALs and the like, all know that when chasing wild men into the labyrinth, soldiers enter the land of confusion. If soldiers don’t go

By Michael Yon

GATES OF FIRE

FRONTLINES

fast, the bad guys simply get away. Just a few minutes ago, these three guys were going “105 miles per hour,” and outrunning a helicopter. There were shops, alleys, doorways, windows. The soldiers with LTC Kurilla were searching fast, weapons at the ready, and they quickly flex-cuffed two men. But these were not the right guys. Meanwhile, SSG Konkol’s men were clearing toward us, leaving the three bad guys boxed, but free. Shots were fired behind us but around a corner to the left. Both the young 2nd lieutenant and the young specialist were inside a shop when a close-quarters firefight broke out, and they ran outside. Not knowing how many men they were fighting, they wanted backup. LTC Kurilla began running in the direction of the shooting. He passed by me and I chased, Kurilla leading the way. There was a quick and heavy volume of fire. And then LTC Kurilla was shot. Kurilla was running when he was shot, but he didn’t seem to miss a stride; he did a crazy judo roll and came up shooting. BamBamBamBam! Bullets were hitting all around Kurilla. The young 2nd lieutenant and specialist were the only two soldiers near. Neither had real

combat experience. “AH” had no weapon. I had a camera. Seconds count. Kurilla, though down and unable to move, was fighting and firing, yelling at the two young soldiers to get in there; but they hesitated. BamBamBamBam! Kurilla was in the open, but his judo roll had left him slightly to the side of the shop. I screamed to the young soldiers, “Throw a grenade in there!” but they were not attacking. “Throw a grenade in there!” They did not attack. “Give me a grenade!” They didn’t have grenades. “Erik! Do you need me to come get you!” I shouted. But he said “No.” (Thank God; running in front of the shop might have proved fatal.) “What’s wrong with you!?” I yelled above the shooting. “I’m hit three times! I’m shot three times!” Amazingly, he was right. One bullet smashed through his femur, snapping his leg. His other leg was hit and so was an arm. With his leg mangled, Kurilla pointed and fired his rifle into the doorway, yelling instructions to the soldiers about how to get in there. But they were not attacking. This was not the Deuce Four I know. The other Deuce Four soldiers would have killed every man in that room in about five seconds. But these two soldiers didn’t have the combat experience to grasp the power of momentum. This was happening in seconds. Several times I nearly ran over to Kurilla, but hesitated every time. Kurilla was, after all, still fighting. And I was afraid to run in front of the shop, especially so unarmed. And then help arrived in the form of one man: CSM Prosser. Prosser ran around the corner, passed the two young soldiers who were crouched low, then by me and right to the shop, where he started firing at men inside. A man came forward, trying to shoot Kurilla

Then Prosser’s M4 went “black” (no more bullets). A shooter inside was also having problems with his pistol, but there was no time to reload. Prosser threw down his empty M4, ran into the shop and tackled the man.

with a pistol, apparently realizing his only escape was by fighting his way out, or dying in the process. Kurilla was aiming at the doorway waiting for him to come out. Had Prosser not come at that precise moment, who knows what the outcome might have been. Prosser shot the man at least four times with his M4 rifle. But the American M4 rifles are weak - after Prosser landed three nearly point blank shots in the man’s abdomen, splattering a testicle with a fourth, the man just staggered back, regrouped and tried to shoot Prosser. Then Prosser’s M4 went “black” (no more bullets). A shooter inside was also having problems with his pistol, but there was no time to reload. Prosser threw down his empty M4, ran into the shop and tackled the man. Though I have the photo, I do not remember the moment that Prosser went “black” and ran into the shop. Apparently I turned my head, but kept my finger on the shutter button. When I looked back again, I saw the very bloody leg of CSM Prosser inside the shop. It was not moving. He appeared to be shot down and dead. I looked back at the two soldiers who were with me outside, and screamed what amounted to “Attack Attack Attack!” I stood up and was yelling at them. Actually, what I shouted was an unprintable string of curses, while Kurilla was also yelling at them to get in there, his M4 trained on the entrance. But the guys were not attacking. I saw Prosser’s M4 on the ground, Where did that come from? I picked up Prosser’s M4. It was empty. I saw only Prosser’s bloody leg lying still, just inside the darkened doorway, because most of his body was hidden behind a stack of sheet metal. “Give me some ammo! Give me a magazine!” I yelled, and the young 2nd lieutenant handed over a full 30-round magazine. I jacked it in, re-

By Michael Yon

GATES OF FIRE

Reaching around the corner, I fired three shots into the shop. The third bullet pierced a propane canister, which jumped up in the air and began spinning violently. It came straight at my head but somehow missed, flying out of the shop as a high-pressure jet of propane hit me in the face. The goggles saved my eyes. I gulped in deeply. In the tiniest fraction of a second, somehow my mind actually registered Propane . . . FIREBALL! as it bounced on the ground where it spun furiously, creating an explosive cloud of gas and dust, just waiting for someone to fire a weapon. I scrambled back, got up and ran a few yards, afraid that Kurilla was going to burn up if there was a fire. The soldiers from Alpha Company were heading toward him when LTC Kurilla yelled out that he was okay, but that CSM Prosser was still in the shop. The Alpha Company soldiers ran through the propane and dust cloud and swarmed the shop. When the bullet hit that canister, Prosser— who I thought might be dead because of all the blood on his leg—was actually fighting handto-hand on the ground. Wrapped in a ground fight, Prosser could not pull out his service pistol strapped on his right leg, or get to his knife on his left, because the terrorist—who turned out to be

FRONTLINES

leased the bolt and hit the forward assist. I had only one magazine, so checked that the selector was on semi-automatic. I ran back to the corner of the shop and looked at LTC Kurilla who was bleeding, and saw CSM Prosser’s extremely bloody leg inside the shop, the rest of him was still obscured from view. I was going to run into the shop and shoot every man with a gun. And I was scared to death. What I didn’t realize was at that same moment four soldiers from Alpha Company 2nd Platoon were arriving on scene, just in time to see me about to go into the store. SSG Gregory Konkol, SGT Jim Lewis, and specialists Niccola DeVereaux and Christopher Muse where right there, behind me, but I didn’t see them.

When the very experienced medic, Specialist Munoz, put morphine into Kurilla, the commander still kept giving orders, even telling Munoz how to do his job. So SFC Bowman told Munoz to give Kurilla another morphine, and finally Kurilla settled down, and stopped giving orders long enough for them to haul him and the terrorist away to the Combat Support Hospital.

Prosser stands above the crocodile who bit his watch. ÂŠ 2005 Michael Yon

The propane canister at rest (left), the terrorist in view of the Commander. ÂŠ 2005 Michael Yon

CSM Prosser flex cuffs Khalid Jasim Nohe ÂŠ 2005 Michael Yon

By Michael Yon

GATES OF FIRE

FRONTLINES

a serious terrorist—had grabbed Prosser’s helmet and pulled it over his eyes and twisted it. Prosser had beaten the terrorist in the head three times with his fist and was gripping his throat, choking him. But Prosser’s gloves were slippery with blood so he couldn’t hold on well. At the same time, the terrorist was trying to bite Prosser’s wrist, but instead he bit onto the face of Prosser’s watch. (Prosser wears his watch with the face turned inward.) The terrorist had a mouthful of watch but he somehow also managed to punch Prosser in the face. When I shot the propane canister, Prosser had nearly strangled the guy, but my shots made Prosser think bad guys were coming, so he re-

leased the terrorist’s throat and snatched out the pistol from his holster, just as SSG Konkol, Lewis, DeVereaux and Muse swarmed the shop. But the shots and the propane fiasco also had brought the terrorist back to life, so Prosser quickly reholstered his pistol and subdued him by smashing his face into the concrete. The combat drama was ended, so I started snapping photos again. When Recon platoon showed up about a minute later, SFC Bowman asked LTC Kurilla to lie down. But Kurilla was ordering people to put out security, and directing action this way and that. When the very experienced medic, Specialist Munoz, put morphine into Kurilla, the commander still kept giving orders, even telling Munoz how to do his job. So SFC Bowman told Munoz to give Kurilla another morphine, and finally Kurilla settled down, and stopped giving orders long enough for them to haul him and the terrorist away to the Combat Support Hospital. The same facility where Daniel Lama was recovering from the earlier gunshot wound to the neck.

Combat Support Hospital The Surge operation continued as we returned to base. The Commander and the terrorist were both being prepped for surgery, when LTC Kurilla said, “Tell Major Bieger to call my wife so she doesn’t get a call from the Army first.” But someone gave the Commander a cell phone, and I heard Kurilla talking to his wife, Mary Paige, saying something like, “Honey, there has been a little shooting here. I got hit and there was some minor soft tissue damage.” The X-ray on the board nearby showed his femur snapped in half. “I’ll be fine. Just some minor stuff.” That poor woman. The doctors rolled LTC Kurilla and the terrorist into OR and our surgeons operated on both at the same time. The terrorist turned out to be one Khalid Jasim Nohe, who had first been captured by US forces (2-8 FA) on 21 December, the same day a large bomb exploded in the dining facility on this base and killed 22 people. That December day, Khalid Jasim Nohe and two compatriots tried to evade US soldiers from 2-8 FA, but the soldiers managed to stop the fleeing car. Then one of the suspects tried to wrestle a weapon from a soldier before all three were detained. They were armed with a sniper rifle, an AK, pistols, a silencer, explosives and other weapons, and had in their possession photographs of US bases, including a map of this base. That was in December. About two weeks ago, word came that Nohe’s case had been dismissed by a judge on 7 August.

The Coalition was livid. According to American officers, solid cases are continually dismissed without apparent cause. Whatever the reason, the result was that less than two weeks after his release from Abu Ghraib, Nohe was back in Mosul shooting at American soldiers. LTC Kurilla repeatedly told me of - and I repeatedly wrote about - terrorists who get released only to cause more trouble. Kurilla talked about it almost daily. Apparently, the vigor of his protests had made him an opponent of some in the Army’s Detention Facilities chain of command, but had otherwise not changed the policy. And now Kurilla lay shot and in surgery in the same operating room with one of the catch-and-release-terrorists he and other soldiers had been warning everyone about. When Kurilla woke in recovery a few hours after surgery, he called CSM Prosser and asked for a Bible and the book: Gates of Fire. Kurilla gives a copy of Gates of Fire to every new officer and orders them to read it. He had given me a copy and told me to read it. In my book, there is a marked passage, which I thought rather flowery. But I have it beside me on the table by the map of Iraq. “I would be the one. The one to go back and speak. A pain beyond all previous now seized me. Sweet life it-

By Michael Yon

GATES OF FIRE

FRONTLINES

self, even the desperately sought chance to tell the tale, suddenly seemed unendurable alongside the pain of having to take leave of these whom I had come so to love.” A short time after Kurilla gave me the book, following the death of one of his soldiers, he said to me, “I want you to write about my men. You are the only one who might understand,” the passage registered in my mind. I asked CSM Prosser if I could go with him to see the Commander. Carrying both books, we drove to the Cash. Major Mark Bieger arrived alongside Kurilla’s hospital bed, paying respect. After spending some time with the Commander, CSM Prosser and I drove back to the unit.

The Deuce 4 The truest test of leadership happens when the Commander is no longer there. Kurilla’s men were taking down and boxing up his photos of his wife and children, and his Minnesota Vikings flag, when they decided to keep the flag so everyone could autograph it. It wasn’t long before there was no room left to sign, but I found a place to scratch. I wanted my name on that flag. The place suddenly felt hollowed-out. When I came back into the TOC, Major Michael Lawrence - who I often challenge to pull-up contests, and who so far has beat me (barely) every time - looked me square and professionally, in the direct way of a military leader and asked, “Mike, did you pick up a weapon today?” “I did.” “Did you fire that weapon?” “I did.” “If you pick up another weap-

on, you are out of here the next day. Understood?” “Understand.” “We still have to discuss what happened today.” Writers are not permitted to fight. I asked SFC Bowman to look at the photos and hear what happened. Erik Kurilla and CSM Prosser were witness, but I did not want the men of Deuce Four who were not there to think I had picked up a weapon without just cause. I approached SFC Bowman specifically, because he is fair, and is respected by the officers and men. Bowman would listen with an open mind. While looking at the photos, Bowman said, “Mike, it’s simple. Were you in fear for your life or the lives of others?” “Thank you Sergeant Bowman,” I said. I walked back to the TOC and on the way, Chaplain Wilson said, “Hello Michael. Are you feeling all right?” “Yes Chaplain Wilson!” Why does he always ask that? Do I look stressed? But suddenly, I felt much better. Chaplain Wilson might be the only man in the universe with a chance of getting me into the chapel of my own free will, but I have resisted so far. Only a few hours had passed since Daniel Lama and the Commander were shot. It was around 9 PM when I heard Captain Matt McGrew was going to see Kurilla. I asked to come along. We entered the hospital, and saw that Erik Kurilla’s bed was beside Daniel Lama’s. Kurilla went from asleep to wide awake in about a quarter-second, said “hello” and asked us to sit down. After some conversation, the Commander looked over at the next bed and asked, “How are you doing SGT Lama?” “Great, sir.” “Good,” the Commander said, “You are my new PSD.” [Personal Security Detachment: Bodyguard.] Daniel Lama smiled, got out of bed and I shot a photo of him reporting for his “new duty.” It was near 10 PM when the airplane that would start their journey back to America landed outside, its engines rumbling the hospital floor. The terrorist who shot Kurilla, and who was now a eunuch in a nearby bed, might well have been the same terrorist who, after being released, shot Lama and Thompson and others. Kurilla could see Khalid Jasim Nohe, but made no comment. As Captain McGrew and I drove through the dusty darkness back to the Deuce Four, the Commander and SGT Lama, along with other wounded and dead soldiers from around Iraq, began their journey home. The next day, Iraqi Army and Police commanders were in a fury that LTC Kurilla had been shot. Some blamed his men, while others blamed the terrorists, although blame alone could not compete with disbelief. Kurilla had gone on missions every single day for almost a year. Talking with people downtown. Interfacing with shop owners. Confer-

encing with doctors. Drinking tea with Iraqi citizens in their homes. Meeting proud mothers with new babies. It’s important to interact and take the pulse of a city in a war where there is no “behind the lines,” no safe areas. It’s even dangerous on the bases here.

In order for leaders of Kurilla’s rank to know the pulse of the Iraqi people, they must make direct contact. There’s a risk in that. But it’s men like Kurilla who can make this work. Even and especially in places like Mosul, where it takes a special penchant for fighting. A passion for the cause of freedom. A true and abiding understanding of both its value and its costs. An unwavering conviction that, in the end, we will win.

Make no mistake about Kurilla - he’s a warrior, always at the front of the charge. But it’s that battle-hardened bravery that makes him the kind of leader that Americans admire and Iraqis respect. Like the soldiers of Deuce Four, Iraqis have seen too much war to believe in fairy tales. They know true warriors bleed. Iraqi Army and Police officers see many Americans as too soft, especially when it comes to dealing with terrorists. The Iraqis who seethe over the shooting of Kurilla know that the cunning fury of Jihadists is congenite. Three months of air-conditioned reflection will not transform terrorists into citizens. Over lunch with Chaplain Wilson and our two battalion surgeons, Major Brown and Captain Warr, there was much discussion about the “ethics” of war, and contention about why we afford top-notch medical treatment to terrorists. The treatment terrorists get here is better and more expensive than what many Americans or Europeans can get. “That’s the difference between the terrorists and us,” Chaplain Wilson kept saying. “Don’t you understand? That’s the difference.”

The Incredible Actions of an American Soldier Alone under Fire.

RECOGNITION

By Andre’ M. Dall’au

CUTTING THE CHARGE

The Story of Medal of Honor recipient Sammy L. Davis

S. Davis with LBJ

The Incredible Actions of an American Soldier Alone under Fire.

The Story of Medal of Honor recipient Sammy L. Davis

he Medal of Honor is the highest military decoration awarded for bravery under fire to all members of our armed forces. It comes in three distinct versions for the Army, Air Force, and for the Navy, Marine Corps and Coast Guard. The Medal of Honor (MOH) is bestowed upon an individual by a Joint Resolution in the Congress and is then personally presented by the President of the United States, on behalf of the Congress for â&#x20AC;&#x153;conspicuous gallantry and intrepidity at the risk of his or her life above and beyond the call of duty while engaged in an action against an enemy of the United States.â&#x20AC;?

Since 1862, approximately 3,500 Medals of Honor Sammie Dress blues have been awarded with over 600 (more than half since WWII) issued posthumously due to the brave selflessness of the recipients. The reasons, although different and valid for every medal awarded, centers on brave actions while in immediate and mortal danger during combat with enemies of the United States. Some individual reasons for receiving the light blue ribbon with white stars could include the following: â&#x20AC;˘ A soldier who successfully defends his position by single-handedly manning a series of automatic weapons discharging over a thousand rounds in the face of withering return fire to protect fellow soldiers in danger of being overrun.

By Andre’ M. Dall’au

CUTTING THE CHARGE

RECOGNITION

• A soldier who defeats a battalion-sized attack by singlehandedly and repeatedly loading, aiming and firing a howitzer while wounded even though the weapon was damaged and technically unusable and he was subject to both direct and indirect fire from both enemy and friendly fire. • A soldier who while wounded, crossed a river alone under fire and in the face of a numerically superior enemy, successfully and retrieved grievously wounded American soldiers from certain death, while protecting them with any available weapon. • A soldier who although seriously and painfully wounded, refused medical treatment to allow others to be evacuated to obtain life-saving treatment so he could return to the line and man defensive positions to assist in preventing an important position from being over-run by a superior force.

Shortly afterwards a helicopter landed with a Major who told the cannoners some sobering news; “your chance of getting hit tonight is 100%.” The officer had seen for himself a column of reinforced North Vietnamese Army heavy weapons battalion headed right for firebase Cudgel as he flew in.

Although each one of these acts could be grounds for a separate citation, these were all done by one man, a true American warrior, during the night of November 18, 1967 in an engagement west of Cai Lay, Republic of Vietnam. At 0800 on the morning of November 18, 1967 about fifty soldiers and four 105mm howitzers of 2d Battalion, 4th Artillery, 9th Infantry Division were airlifted into Fire Support Base (FSB) Cudgel and almost immediately began firing in support of operation Ken Giang in Western Dinh Tuong Province until 5:00 in the afternoon when the enemy finally broke contact. Shortly afterwards a helicopter landed with a Major who told the cannoners some sobering news; “your chance of getting hit tonight is 100%.” The officer had seen for himself a column of reinforced VIEWPOINTTACTICAL.COM

By Andre’ M. Dall’au

CUTTING THE CHARGE

RECOGNITION

Shaking off the effects of the explosion as best he could, Sammy got up on one elbow to see hundreds of the enemy surging across the river directly towards the center of the fire base. He then took up his M16 and expended his pre-loaded twelve, twenty round magazines to break up that charge. When he saw that he was down to his last three rounds, Sammy looked around and found a M60 belt-fed machine gun and ammunition which he dragged back to his foxhole. He used that weapon to fire one thousand rounds, all he could find, of .30 cal machine gun ammo breaking up subsequent waves of attacking enemy infantry.

North Vietnamese Army heavy weapons battalion headed right for firebase Cudgel as he flew in. One of the GI’s listening to the dire news was a redhaired, ex-lumberjack Private First Class fresh from Waverly Indiana, Sammy Lee Davis. Although they had been hit frequently before, that declaration was both unusual and sobering. The soldiers prepared for what they knew would be a tough fight and all was quiet until at 0200 when mortar rounds began raining down for a full half an hour. At 0230 the sounds of mortar rounds exploding were replaced by the shouts of “GI we are going to kill you!” from across a canal that separated the fire base and the attacking force. Soon waves of 150 to 200 enemy soldiers surged against the firebase security bunkers and foxholes each manned by soldiers of the tough and battle-tested C Company 5-60th Infantry of the 9th Infantry Division, some across the river from the guns. While the 105mm howitzer is an effective long range bombardment weapon, one of the rounds that can be fired for close range defense continued on page 30

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SIDEBAR

MEDAL OF HONOR CITATION

for DAVIS, SAMMY L., Sergeant, U.S. Army “For conspicuous gallantry and intrepidity in action at the risk of his life and beyond the call of duty. Sgt. Davis (then Pfc.) distinguished himself during the early morning hours while serving as a cannoneer with Battery C, at a remote fire support base. At approximately 0200 hours, the fire support base was under heavy enemy mortar attack. Simultaneously, an estimated reinforced Viet Cong battalion launched a fierce ground assault upon the fire support base. The attacking enemy drove to within 25 meters of the friendly positions. Only a river separated the Viet Cong from the fire support base. Detecting a nearby enemy position, Sgt. Davis seized a machinegun and provided covering fire for his guncrew, as they attempted to bring direct artillery fire on the enemy. Despite his efforts, an enemy recoilless rifle round scored a direct hit upon the artillery piece. The resultant blast hurled the guncrew from their weapon and blew Sgt. Davis into a foxhole. He struggled to his feet and returned to the howitzer, which was burning furiously. Ignoring repeated warnings to seek cover, Sgt. Davis rammed a shell into the gun. Disregarding a withering hail of enemy fire directed against his position, he aimed and fired the howitzer which rolled backward, knocking Sgt. Davis violently to the ground. Undaunted, he returned to the weapon to fire again when an enemy mortar round exploded within 20 meters of his position, injuring him painfully. Nevertheless, Sgt. Davis loaded the artillery piece, aimed and fired. Again he was knocked down by the recoil. In complete disregard for his safety, Sgt. Davis loaded and fired 3 more shells into the enemy. Disregarding his extensive injuries and his inability to swim, Sgt. Davis picked up an air mattress and struck out across the deep river to rescue 3 wounded comrades on the far side. Upon reaching the 3 wounded men, he stood upright and fired into the dense vegetation to prevent the Viet Cong from advancing. While the most seriously wounded soldier was helped across the river, Sgt. Davis protected the 2 remaining casualties until he could pull them across the river to the fire support base. Though suffering from painful wounds, he refused medical attention, joining another howitzer crew which fired at the large Viet Cong force until it broke contact and fled. Sgt. Davis’ extraordinary heroism, at the risk of his life, are in keeping with the highest traditions of the military service and reflect great credit upon himself and the U.S. Army.”

SIDEBAR

By Andre’ M. Dall’au

CUTTING THE CHARGE

RECOGNITION

is a “beehive” round that is filled with flechettes which are essentially finned, steel nails fired like buckshot in a shotgun. Sammy had just loaded a beehive round into his fully depressed and aimed cannon and was prepared to fire when three things happened in very short order. First came the order to fire followed by the report of the cannon as Sammy pulled the lanyard sending eight thousand needle nosed projectiles into the attacking wave of enemy infantry and then a searing blast as a NVA RPG-2 (then called a B-40 rocket) impacted directly on the M102 howitzer.

32 S. Davis with 105

“Wow, this is just like Christmas” is the first thoughts that Sammy had as he awoke dazed and deafened by the rocket impact eight inches from his head and looked up to see the criss-crossing red, white, blue and green tracers in the night air above him. Shaking off the effects of the explosion as best he could, Sammy got up on one elbow to see hundreds of the enemy surging across the river directly towards the center of the fire base. He then took up his M16 and expended his pre-loaded twelve, twenty round magazines to break up that charge. When he saw that he was down to his last three rounds, Sammy looked around and found a M60 belt-fed machine gun and ammunition which he dragged back to his foxhole. He used that weapon to fire one thousand rounds, all he could find, of .30 cal machine gun ammo breaking up subsequent waves of attacking enemy infantry. Out of ammo for the M60 with the enemy still coming across the river, Sammy looked around for another weapon to use. He noted that his cannon, a new M102 howitzer nicknamed “Cyclops” was damaged but might still be usable. The recoil mechanism, sights and adjustment wheels had all been blown off, but the barreled action was still in one piece. He recognized that the fearsome 105mm beehive round would be perfect to break the back of the assault so Sammy began to crawl around the area to find the components needed; unfired cases, the beehive rounds themselves and powder to shoot them with. However, during the fight the organization of separately stored shells, powder and projectiles was completely disrupted leaving what Sammy describes as “soldier hell.” Sammy resorted to searching all over and found some beehive rounds and unfired brass although the needed bags of powder were missing.

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The powder charge for 105mm shells are supplied in seven bags tied on a cotton string. The number of bags needed to blast the projectile to the distance desired are placed inside the brass shell. The remainder of the un-needed powder bags are purposefully left dangling outside of the cartridge case. When the projectile is set in the unfired brass case, the string is cut called “cutting the charge” with the spare powder set aside. Earlier in the firefight, that cache of powder had been hit and the bags burned or opened up leaving loose powder (that looks and feels like hamster food) all over the ground. Sammy scooped up handfuls of the loose powder to fill the unfired brass case he had found. Sammy was not used to dealing with loose powder but was trained by his sergeant who said that beehive rounds required a maximum charge for 105mm howitzer so he mistakenly thought that a “charge 7” filled the shell. Wanting to do it right, Sammy fully loaded the unfired brass case with the loose powder. As a result, the shell he inserted into Cyclops was charged far greater than allowed. Calculations by ordnance experts

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S. Davis with Westmoreland

S. Davis with shells

after the battle determined that Sammy loaded an equivalent “charge 21” which is three times the maximum, into his damaged howitzer. Then using brute strength he singlehandedly moved the cannon to realign the bore towards the enemy, waited until the enemy had advanced to almost right under the barrel and then pulled the firing lanyard. The fighters on both sides momentarily paused in wonderment as the tongue of flame from Cyclops reached over a hundred feet across the river to annihilate the enemy and arch to almost vertical as the entire howitzer bucked straight up in the air. Looking more like a flame thrower than cannon, Cyclops, airborne and still belching fire and flame landed on top of Sammy breaking his back and crushing some ribs on his right side. As both the smoke and Sammy’s vision cleared, he could see that the mass of enemy were gone, but more were preparing to cross the river. Sammy ignored his wounds and once again loaded and fired another beehive round - with a reduced charge, and then again and again for hours until he

By Andre’ M. Dall’au

CUTTING THE CHARGE

RECOGNITION

was left with only a propaganda round loaded with pamphlets which he found worked pretty well as an anti-personnel shell in the direct fire role! Throughout the fight Sammy had thought he “don’t shoot I’m a GI” during the fight but had ignored it because that was a common NVA trick used to confuse and kill GI’s. But a low illumination round revealed a figure across the river waving a boonie hat yelling “don’t shoot I’m a GI” who Sammy recognized as a US Soldier, Gwendell Holloway from the 5-60th Infantry. Sammy who had been fighting by himself for what seemed like hours was convinced he was the last American left alive, so he took it upon himself to get to Holloway and bring him back to the firebase. Sammy, a non-swimmer, found a “rubber lady” which is a GI inflatable air mattress, and made it air-tight as best he could and began to paddle across the river. He stashed it under some brush on the enemy side of the river and crawled the seventy-five yards towards the last place he saw Holloway. Pausing several times to avoid enemy soldiers still assaulting the fire base who literally ran right over him, Sammy found a foxhole containing Holloway and two other GI’s, all terribly shot up with wounds to the torso and

head and missing extremities. Knowing he had no time to lose, Sammy put one over his shoulder, and grabbed one under each arm and “away we went” back to the river. Sammy dropped down and hid every time an enemy came close. The ones that discovered the four wounded US soldiers were taken care of with a M16 taken off one of the wounded and when that ran out of ammo, Sammy used a tree limb that doubled as an effective club “like a baseball bat” for the last three NVA soldiers who spotted them. Finding the stashed air mattress Sammy used it to support Jim Deister, shot in the head from ear to ear, to recross the river, was relieved to find other Americans alive who helped him get Deister to safety. Sammy immediately got back on the makeshift float to get Billy Ray Crawford and Gwendell Hollo-

The ceremony in which the President of the United States presented Sergeant Sammy Davis his Medal of Honor has been seen in disguise by millions of people. In the movie “Forrest Gump” not only are the actions of Tom Hank’s character in Vietnam based on Sammy Davis’s heroic actions but the ceremony seen in the movie is actually Tom Hank’s head superimposed on Sammy Davis’s body. VIEWPOINTTACTICAL.COM

way across the river as well. When all three were within the FSB Cudgel perimeter and being tended to, Sammy then returned to help man the remaining two howitzers still firing until the enemy attack ceased shortly after daybreak about 0800. Although suffering from a broken back, crushed ribs, thirty (friendly fire) flechette wounds and an AK-47 bullet wound in the right thigh, Sammy helped load Jim Deister’s body on the Huey carrying the American dead from the defense of FSB Cudgel. Stepping back Sammy said goodbye to his friends and passed out, finally succumbed to his wounds. He was then added on top of the pile just before the helicopter, the last from FSB Cudgel, took off. The final count showed just eleven American soldiers still standing out of 42 cannoneers that started the battle. Out of a 1500 man battalion that attacked FSB Cudgel, the enemy lost 500 KIA by Sammy alone. An interesting fact is mixed in with the NVA dead the GIs found 20 light-skinned, over six foot tall foreign “advisors” wearing non-NorthVietnamese officer uniforms. The ceremony in which the President of the United States presented Sergeant Sammy Davis his Medal of Honor has been seen in disguise by millions of people. In the movie “Forrest Gump” not only are the actions of Tom Hank’s character in Vietnam based on Sammy Davis’s heroic actions but the ceremony seen in the movie is actually Tom Hank’s head superimposed on Sammy Davis’s body. The “in the buttocks” wound remark is in reference to some of the flechettes that holed Sammy’s upper, upper leg during the fight. I have known Sammy for years and he is gentle, honest and humble, more concerned for others than himself, slow to anger and fast to praise others. Sammy always centers his focus on the ones that didn’t come home – the friends that never left the battlefield; the “real heros” he calls them, not himself. Now Sammy and his incredible wife Dixie travels the

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country to talk of duty, honor and love of country. Listening to Sammy is an experience that starts with a smile and a laugh and ends with walking away richer in the heart and at least a few tears in the eyes. Why? Besides the heroism displayed manning a variety of weapons to defeat a determined enemy, Sammy saw trapped Americans across a fire-swept river but without hesitation and although very painfully wounded he found a way to get to them under fire. But that still was not the most amazing fact. The men that Sammy found were near death with wounds so terrible that battlefield triage could have determined them as “Immediate” or “expectant.” Sammy was determined to leave no brothers behind so he took each back across the river, occasionally stopping to hide them from the enemy or eliminating threats when he could not. But that is not the end of the story. What I have witnessed time after time when Sammy is asked to tell the story of that battle is the his listeners’ amazement and tears when he describes that much later, Sammy met the families of the men he brought back across the river. They fully expect a somber, quiet affair but to their surprise Sammy describes a raucous celebration full of joy, laughing and running kids. That is because every “dead” soldier Sammy toted back across the river, including Jim Deister, survived the night and recovered from their wounds. Every one of them. When the kids and grandkids of Jim Deister, Gwendell Holloway and Billy Ray Crawford who gathered around Sammy gave him the real reward, the best achievement and highest honor possible for this unassuming and humble soldier who was just doing his job as best he could. Sammy found that the quiet, almost inaudible “thank you for bringing my Grandfather home” from a young child can resonate louder than all the explosions, gunfire and horror from that fateful night. A true gift of life from the horror of war.

Gabe Corey, PJ, NREMT-P; Tim Lafayette, PJ (Ret.) NREMT-P

PREPARING FOR OPERATIONS

LEARNING CURVE

PREPARING FOR OPERATIONS

Re-Published wih permission of the Author from the Journal of Special Operations Medicine Volume 13, Edition 3/Fall 2013

IN A RESOURCE-DEPLETED AND/OR EXTENDED EVACUATION ENVIRONMENT

he wars in Afghanistan and Iraq are the only conflicts to which many medics have ever been exposed. These mature theaters have robust medical systems that ensure rapid access to full-spectrum medical care for all combat-wounded and medically injured personnel. As current conflicts draw to a close, U.S. medics may be deployed to environments that will require the ability to stabilize casualties for longer than 1 hour. Historical mission analysis reveals the need to review skills that have not been emphasized during upgrade and predeployment training. This unitâ&#x20AC;&#x2122;s preparation for the extended care environment can be accomplished using a 4-point approach: (1) review of specific long-term skills training, (2) an extended care lab that reviews extended care skills and then lets the medic practice in a real-time scenario, (3) introduction to the HITMAN mnemonic tool, which helps identify and address patient needs, and (4) teleconsultation.

Keywords: extended care, austere environments, long-term skills training, teleconsultation

ABSTRACT

Gabe Corey, PJ, NREMT-P; Tim Lafayette, PJ (Ret.) NREMT-P

LEARNING CURVE

PREPARING FOR OPERATIONS

Gabe Corey, PJ, NREMT-P; Tim Lafayette, PJ (Ret.) NREMT-P

INTRODUCTION

After conducting a 2-month training mission in Africa, a small group of U.S. Servicemembers, including a pararescueman (PJ), were finalizing the pack out to rotate home. The primary medical staff was already gone. Around mid-day, a flatbed truck arrived with 28 locals who had fallen victim to civic unrest within the past 2 days. The PJ began triaging casualties while other teammates alerted their chain of command that they would soon need support. A few hours later, a motor vehicle accident produced 5 additional casualties, bringing the patient count to 33. The less urgent injuries included broken arms and minor gunshot wounds; the more critical injuries were a tension pneumothorax, bilateral femur fractures, and a closed head injury with intermittent loss of consciousness. As soon as the opportunity was available, the PJ established communications with his medical director. The physician was briefed on the status of all casualties and then advised and assisted on performing advanced interventions that were required to stabilize the more critical patients. The scenario was handled well, maximizing the few resources available. The most immediate cases were able to evacuate to a U.S. facility in about 6 hours, while the less urgent patients were stabilized and referred to a local facility. A comprehensive After Action Report (AAR) was conducted and the feedback was eyeopening. First Tactical Combat Casualty Care (TCCC) and following interventions were executed without flaw. The situation was handled well but some were concerned that, if this happens again will the outcome be the same? Possibly not; the PJâ&#x20AC;&#x2122;s predeployment training included little exposure to this type of scenario; he had done TCCC scenarios numerous times, day and night, hot and cold with each one ending after an hour or so with a hand-off to a casevac or surgical facility. He had not trained for when that hand-off does not occur for several hours or even days. It occurred to us that different training and a new way of thinking are needed to help PJs and medics better prepare for these long-term care scenarios. Also, what will we do in Afghanistan as the medical footprint gets smaller? Medics and rescuers need to be able to think about medical requirements in a different way and, more important, recognize the hazards of these environments before they have to treat a casualty under those circumstances. VIEWPOINTTACTICAL.COM

LEARNING CURVE

PREPARING FOR OPERATIONS

Gabe Corey, PJ, NREMT-P; Tim Lafayette, PJ (Ret.) NREMT-P

PROLONGED FIELD COURSE

The exercise can be simple or complicated. Generally, our exercises are 5 to 8 hours in duration. Role players are preferred over live tissue training or dummies to provide better feedback to medics doing hands-on exams. A role player provides real pulse, respirations, oxygen saturation, and electrocardiogram. The role player provides also another opportunity for a medic to be exposed to this type of scenario and will usually provide excellent feedback and AARs, since they have had a front row seat for the duration of the exercise. Medical personnel are better role players when it comes to presenting illnesses and injuries.

Schedule • • • •

Skills

DAY 1 Skills stations review DAY 2 Extended care lab DAY 3 Skills stations review DAY 4 Extended care lab

It is preferable to practice skills unique to this lab before conducting an extended care exercise. The medics should already be competent at TCCC. Skills that should be taught or reviewed on day 1 are: • Foley catheterization • Mechanical ventilator • Burn treatment and fluid requirements

• Fasciotomy • Fresh whole blood transfusion procedures • Nasogastric tube and orogastric tube procedures • Anesthesia and analgesia • Cricothyrotomy • Intubation • Thoracotomy • Escarotomy • Electrocardiogram • Suprapubic bladder aspiration • Teleconsultation (simulate what will be used operationally) • Field laboratory measurement • Wound debridement • Suturing

Medical personnel are better role players when it comes to presenting illnesses and injuries. VIEWPOINTTACTICAL.COM

Role players are preferred over live tissue training or dummies to provide better feedback to medics doing hands-on exams.

PROLONGED FIELD LAB (The players)

Medics: Our experience has been that the optimal team size is 1 or 2 medics per scenario. They should already have a background as an emergency medical technician (EMT) or advanced tactical provider (ATP), but these are personnel that your unit will expect to handle an extended care scenario. One more medic can be a dedicated communicator focused on teleconsultation. The other trainees will be the hands-on medics, actually assessing the patient and performing interventions. Proctor: The proctor is overall in charge of the scenario; he coordinates the moulage and briefs and then coaches the patient (role player) on how to act and what to say during the scenario. The scenario should be scripted to ensure that all the skills are incorporated and it flows logically. Our experience is that physicians or physician assistants can readily adapt to the changing scenario. Role player: Here is another great opportunity to learn—a front row seat on all the action and spend most of the day lying down on the job. People with a medical background tend to do a better job since they will be familiar with procedures and will need less guidance on what symptoms the patient needs to exhibit. They should be included in debriefing. Online medical control: It is easy to simulate or skip this step; however, performing medical skills properly is critical to achieving

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good outcomes. This is a great opportunity for a new physician or physician assistant to practice this skill before he has to perform it on an actual patient. It should be someone who is familiar with the scenario already and is competent with the skills that they will be using. Observers: Other medics should be allowed to observe their peer’s performance and provide feedback. This will allow more students to participate. “Expert” observers are an excellent addition to this exercise. Emergency physicians, anesthesiologists, and surgeons can provide subject matter expert debrief.

(The plan)

The scenario should be loosely yet logically scripted out by the proctor. The proctor should also be ready to initiate a “kill plan.” Lessons learned in medicine come from patient death.

Gabe Corey, PJ, NREMT-P; Tim Lafayette, PJ (Ret.) NREMT-P

PREPARING FOR OPERATIONS

LEARNING CURVE

This exercise should allow this to happen. The kill plan allows the training medics to kill the patient and learn from mistakes. The proctor should then quickly end the scenario and give medics feedback to correct mistakes and gather lessons learned and then reset the scenario to just prior to patient death. Not killing the “patient” will reinforce bad medicine, waste time, and give medics a false sense of competency. • Do the minimal amount of simulation possible. • Require real vital signs be provided before scenario vital signs will be given. • Provide simulation equipment for any procedures that cannot be done on the role player. A couple of separate rooms or buildings are good for training areas. They should not be high-traffic areas, and it is better if the medics are unfamiliar with them. Optimal areas will provide enough climate protection to avoid damaging sensitive equipment but be bare enough to simulate an austere environment. Garage bays work well and a large van or box truck can be used to simulate a casevac platform.

SAMPLE PATIENT AND SCRIPT A 30-year-old man

• M: IED/ambush • I: GSW ×2 (1× chest, 1× L arm below elbow) approx. 300ml blood loss, 25% burned surface area (airway involvement) • S: Alert, no sensation in most of the burned area, P 110, R 22, BP 100/70, SaO2 88% on room air • T: TQT applied to L arm above elbow

Script

Patient is delivered to medics in first treatment room. Treatment begins with TCCC. When all indicated TCCC interventions have been accomplished, transition to extended care skills. Accomplish BLS before ALS. “MARCH as far as you can, then bring in HITMAN” • Cricotomy or endotracheal tube • Fresh whole blood transfusion • Escarotomy • Foley or suprapubic bladder aspiration • Chest tube • Teleconsultation • Trend patient’s vitals Move patient to casevac platform Transport patient in moving vehicle 20–30 minutes • Displaced tube Move patient to second treatment room • Fasciotomy Continue trending and reassessing Endex / Debrief/reset equipment

“Keep Marching On” has kept a lot of PJs out of trouble on numerous occasions. So it seems logical that a mnemonic would be the best way to set our medics up for success in the extended care environment. VIEWPOINTTACTICAL.COM

For TCCC, I found that the MARCH mnemonic was the most tried and true for me (Massive hemorrhage, Airway, Respirations, Circulation, Hypothermia). No matter what was happening around me, I defaulted back to MARCH and started looking for problems to solve and tried to improve earlier interventions. “Keep marching on” has kept a lot of PJs out of trouble on numerous occasions. So it seems logical that a mnemonic would be the best way to set our medics up for success in the extended care environment. HITMAN is borrowed from our UKSF brethren.

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“Some Problems Require a HITMAN”

HITMAN

H is for “Hydration”. We like to add “Hypothermia” • Properly perfusion of a person’s urine output should be at a rate of 30ml/h up to 50ml/h for burns (document and trend). • Need to know how to perform Foley catheters and understand when to do them as well as how to do them. • Healthy temp is about 37ºC (document and trend) I is for infection. We like to add “Increased compartment pressures” • Watch out for fever! Make sure people are using the same location and thermometer for accurate trending. • Wounds and venipuncture sites for redness, swelling, or discharge • Soft tissues in extremities for compartment syndrome, especially in unconscious patients (a pulseless limb means you are too late) T is for Tube management/“Tidy up” • Tidy up and trace electrocardiograph and intravenous lines so nothing gets inadvertently disconnected or kinked; ensure oxygen and vent lines are connected and functioning properly. • A Foley catheter bulb to squeegee out endotracheal tubes; document and repeat at least every hour.

LEARNING CURVE

“Teleconsultation Is Teamwork”

PREPARING FOR OPERATIONS

Gabe Corey, PJ, NREMT-P; Tim Lafayette, PJ (Ret.) NREMT-P

TELECONSULTATION

M is for Medications • Check your 6 rights: patient, medication, dose, time, route, documentation. It is nearly impossible to train for A is for Analgesia every contingency or medical emerOnline medicalcomfort control (not is not new not concept, is ex- that • Patient tooa hot, too nor gency Patient History may present. However; tended field care. The only resource that seems to show cold) the goal1. isWhen to always to project first Months? Year did it start? Days? Weeks? up in situationand in abundance is time.pain It is a good idea • this Maintain review a patient world medical care as far forward as 2. Patient symptoms now? to get with your medical director and decide what the plan (if the patient wakes up scream3. While Chronicity: Getting better? Worse? Staying the s possible. there inevitably will plan is going to be if you have to wait with a casualty for Spreading? ing, that is bad). be limitations in the operational envia long time. Determine who you will call and via what 4. when What was to previously treat the patient? • Is he supposed to be on aissurgical plane? ronment, this used happens, do what means. Video teleconferencing becoming more preva5. Effectiveness of previous treatments? lent• in deployed as well asthe high-speed How longlocations can we maintain patient Internet physicians do when they find a prob6. Laboratory and test results, if any? that may enable the use of Skype or other commercial with the medications we have with us lem they7.cannot solve: consult. Online diagnosis. Your diagnosis and/or differential video chat; have been used to send narrarightsmartphones now? medical8.control is not a new concept, Limitations you have in treating the patient su tive video to advanced providers, who then are able to • Roll patient to avoid bed sores. medications, procedures, labretests. nor is extended field care. The only make a more definitive recommendation about what in9. Include patient demographics: branch of service • Pad any areas where an arm or leg source that seems to show up in this terventions to make and casevac priority. and gender. If not U.S. military, may rest on a litter pole for a long time situation in abundance is time. It isstate their nation Identify if contractor, detainee, foreign military, There are basically major teleconsultation options. to avoid nerve2 damage. a good idea to get with your medical One• is Patient your unit’s organic medical director; the director other hygiene and decide what the plan is 1 is the Army’s teleconsultation program. Your own unit Include Digital Images If Appropriate N is for Nutrition going to be if you have to wait with physician will be more familiar with your mission, med 1. Use the JPEG format for images. • Feed the patients; food is medicine. a casualty for a long time. Determine plan and logistical considerations. However, the Army’s 2. Check images before transmitting to ensure the • Prepare to perform nasogastric/orogaswho call and via what means. teleconsultation program has access to more varied med-you will in focus and accurately portray the problem a tric tubethan procedures. Video ical disciplines most units (Table 1). see it.teleconferencing is becoming prevalent deployed 3.more Usually three toin five images islocations all we need. Table 1 Teleconsultation Specialties 4.asWhen overloadInternet us with images. well inasdoubt, high-speed that 5.may Other attachments: Medical Specialty E-mail Address enable the use of Skype or other a. PDFs of video ECGs chat; smartphones Burn-trauma burntrauma.consult@us.army.mil commercial b. JPEGs of radiographs have been used to send narrative vidCardiology cards.consult@us.army.mil c. Copies of laboratory and pathology reports eo to advanced providers, who then Dermatology derm.consult@us.army.mil are able to Do make a more definitive Ophthalmology eye.consult@us.army.mil What Not to recommendation about what interInfectious diseases id.consult@us.army.mil 1. Do not include any patient identifying inform ventions to make and casevac priority. Internal medicine im.consult@us.army.mil especially patient’s name or SSN. There are basically 2 major 2. Do not resend additional requestteleto the cons Nephrology nephrology.consult@us.army.mil consultation options. One consultants is your work who answered your consult; Neurology neuron.consult@us.army.mil call-roster andmedical look for director; consults only unit’s organic the for the p Orthopedics and they are on-call. They usually delete all consults ortho.consult@us.army.mil other is the Army’s teleconsultation podiatry they have answered them. A new consult program.1 Your own unit physician file is Traumatic brain injury tbi.consult@us.army.mil by the project manager for each file that is sent will be more familiar with your misPediatric intensive care picu.consult@us.army.mil generic email address and that re-consult will b sion, and logistical cononly med to the plan current on-call consultant. Preventive medicine pmom.consult@us.army.mil However, Army’s as certa 3.siderations. Do not include “archive”the attachments Rheumatology rheum.consult@us.army.mil types such files areprogram automatically teleconsultation has blocked. acToxicology toxicology.consult@us.army.mil 4.cess Do to notmore include any more than one patien varied medical disci1 Urology urology.consult@us.army.mil teleconsultation. plines than most units (Table 1). Notes: Other specialties “as requested”—send teleconsultation to chuck .lappan@us.army.mil

How to Send a Consult

Extended Care Training is an important part of a deployment train up for medics that may be ope outside a “golden hour” casevac time. The three pa an extended care plan are to: VIEWPOINTTACTICAL.COM

LEARNING CURVE

PREPARING FOR OPERATIONS

Gabe Corey, PJ, NREMT-P; Tim Lafayette, PJ (Ret.) NREMT-P

HOW TO SEND A CONSULT

Gather patient history, images, and other attachments and e-mail them to the specialty e-mail addresses listed in the specialties organized into e-mail groups or to chuck.lappan@us.army.mil for other specialties “as requested” that are not included in the specialties generic e-mails.

PATIENT HISTORY 1. When did it start? Days? Weeks? Months? Years? 2. Patient symptoms now? 3. Chronicity: Getting better? Worse? Staying the same? Spreading? 4. What was used to previously treat the patient? 5. Effectiveness of previous treatments? 6. Laboratory and test results, if any? 7. Your diagnosis and/or differential diagnosis. 8. Limitations you have in treating the patient such as medications, procedures, lab tests. 9. Include patient demographics: branch of service, age, and gender. If not U.S. military, state their nationality. Identify if contractor, detainee, foreign military, etc.

INCLUDE DIGITAL IMAGES IF APPROPRIATE 1. Use the JPEG format for images. 2. Check images before transmitting to en-

sure they are in focus and accurately portray the problem as you see it. 3. Usually three to five images is all we need. 4. When in doubt, overload us with images. 5. Other attachments: a. PDFs of ECGs b. JPEGs of radiographs c. Copies of laboratory and pathology reports

WHAT NOT TO DO 1. Do not include any patient identifying information, especially patient’s name or SSN. 2. Do not resend additional request to the consultant who answered your consult; consultants work on a call-roster and look for consults only for the period they are on-call. They usually delete all consults after they have answered them. A new consult file is made by the project manager for each file that is sent to the generic email address and that re-consult will be sent only to the current oncall consultant. 3. Do not include “archive” attachments as certain file types such files are automatically blocked. 4. Do not include any more than one patient per teleconsultation.1 Extended Care Training is an important part of a predeployment train up for medics that may be operating outside a “golden hour” casevac time. The three parts of an extended care plan are to: 1. Train personnel on the skills required in the extended care environment. 2. Conduct an Extended Care Lab (ECL) to simulate the scenario in real time and then conduct a thorough debrief captur-

VIEWPOINTTACTICAL.COM

Movement back to LZ in white-out (no fly weather).

The PJ who handled this broken femur had gone through our extended care course and he was able to turn this emergency into a non-event. ing best practices and correcting deficiencies. 3. Take ownership of the HITMAN assessment and interventions that might be indicated. 4. Talk to your medical director and communication shop before deploying, and make a teleconsultation plan using unit physicians and advanced providers or the Army teleconsultation program. The optimal scenario is probably a combination of the two. This patient presented with complaints of hip pain after conducting open ocean swim training. He had a history of leg surgery on the affected side. Radiographs were taken at the local hospital and then sent via smartphone to a surgeon and headquarters element. The patient was treated for 9.5 hours with an applied traction device and pain medications and then underwent fixed-wing casevac with a surgical team utilized. The PJ who handled this broken femur had gone through our extended care course and he was able to turn this emergency into a non-event.

VIEWPOINTTACTICAL.COM

HH-60 on approach to recover patient and rescue team.

SYNOPSIS OF OUR MISSIONS Extended Care Mission Analysis • • • • •

Africa South of Anchorage 1000 nm North of Guam 700 nm Nesbesna Glacier Extended Care training

Africa 2010

• 22 locals injured during civil unrest • 4 local injured in motor vehicle accident • U.S. Airman triages and treats patients for 36 hrs.

Nebesna Glacier Alaska • • • •

18 year-old female complains of vomiting blood >24 hrs Patient was as >10,000 ft Cloud deck was at 8,500 ft Rescuers infilled to 8,000 ft and conducted overland movement to recover patient then back to helo LZ • Provided BLS for 6 hours

Pacific Ocean

1000 miles South of Anchorage, AK • Crewman bedridden on civilian freighter complains of lower right quadrant pain for over 24 hours no food for 36 hours hasn’t urinated in 24 hours

USAF HH-60 landing on freighter to receive sick crewman.

Gabe Corey, PJ, NREMT-P; Tim Lafayette, PJ (Ret.) NREMT-P

PREPARING FOR OPERATIONS

LEARNING CURVE

• PJs parachuted into water via USAF Rescue HC-130 and boarded ship, established IV and Foley catheter administered pain meds and antibiotics via teleconsult • Cared for patient ~18 hours • Transloaded to helo and transported to Kodiak, AK. Patient fully recovered after appendectomy

OPN OLYMPIC TITAN

• Ship with two members injured due to crane accident • Reported injuries: – PT1: Severe head injury critical/ non-ambulatory – PT2: Multiple injuries, stable/unknown • 31RQS initiated planning efforts with 353d SOG • Parachute rescuers via MC-130 and recover via U.S. Navy MH-60 from Anderson AB, Guam *Native Russian speaker located on KAB short notice – proved invaluable to 353SOG coordination with Ukrainian crew.

Mission Statistics • • • • • •

Total mission duration: 57 Hours MC-130H duration of flight: 11 hrs, 37 mns Night personnel airdrops: 2 Night resupply airdrops: 3 Hours of continuous medical care: 32 hours, 30 minutes

The crewmember was treated on a civilian freighter. Prior to transload to the helo, the patient regained mobility following administration of pain meds and antibiotics.

• Hours of continuous manual ventilation: 32.5 hours • Longest continuous CPR: 105 minutes (est.) • MH-60 furation of flight: 75 minutes

Extended Care Training

• 8 hours of total care • 1 critical patient moved 3 times simulating long-term evacuation • 3 different field sites • 1 field expedient ambulance

REFERENCE 1. Lappan C. Special Operations Forces Medical Handbook Second Edition, Part 8 Medical Procedures, Teleconsultation.

AUTHORS MSgt Corey has been a USAF pararescueman for 17 years. He is also an advanced tactical practitioner, dive medical technician, and nationally registered EMT-paramedic, currently with the 24th STS. His prior assignment was as the 724th OSS NCOIC of Selection and Training. E-mail: gabe.corey@webname.com Mr. Lafayette is a civilian training specialist. In his prior life he was a U.S. Navy Corpsman for 12 years and a USAF pararescueman for 9 years. He also an EMT-Paramedic, advanced tactical paramedic (ATP), law enforcement medic, hyperbaric technician, and dive medical technician.

Improvised ambulance

Sample Extended Care Kit: Stethoscope, BP cuff, ECG monitor, chest tube kit, mechanical vent, AED, Foley cath kit, capno monitor, ENT exam kit, suction, hypothermia blanket, whole blood transfusion kit, drug box, fluid warmer.

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50 An Interview with Craig “ Sawman” Sawyer

SAWMAN TALKS RHINOS

LET’S TALK

SAWMAN TALKS

RHINOS

An Interview with Craig “ Sawman” Sawyer IEWPOINT: Sawman thanks for jumping onboard for the first issue of VIEWPOINT TACTICAL. Let’s get down to it! Sawman can you give the VIEWPOINT TACTICAL readers a brief history of your beginnings as an operator.

apparently the perfect environment to breed Navy SEALs, because so many great ones seem to come from our area. I grew up in a patriotic family and felt compelled to go stop our enemies before they ever came here to the USA. I started in the Marines, then went to SEAL Team One, then got picked up for DEVGRU after Desert Shield and Desert Storm. I’ve always SAWMAN: Man, I grew up in Southern Texas, felt honored to serve with so many great guys. playing football, fighting and hunting. It was VIEWPOINT: The life of an operator isn’t a 9-5 job working in an office taking coffee breaks….. things happen that a very many folks would not be able to handle…what makes u different SAWMAN: Well, I might be different from most civilians, but certainly not much different than

LET’S TALK

SAWMAN TALKS RHINOS

An Interview with Craig “ Sawman” Sawyer

most Operators. We all tend to be drawn forward to the fight, to stop threats against our country and our people. It’s just how we’re wired. I’ve always been that way. I’d rather die fighting for freedom than live kneeling under tyranny.

are actually relationships. Seeing that truth confirmed over the decades is what I think has affected my path the most. I learn and adjust every day, always seeking to improve and VIEWPOINT: Most of our readers feel the make a more positive impact, same way I am sure..so tell us who has been wherever I can. the biggest influence in your life? VIEWPOINT: Agreed! So what SAWMAN: The man who has impressed me code do you live by? the most with his strength and impact was actually my own father. By his powerful ex- SAWMAN: My code is to be ample, I learned that manhood isn’t mea- able to look in the mirror and, sured by testosterone, facial hair, or body even with an ugly face like count on a battlefield, but rather, the con- mine, be proud of the man tent of character and the positive impact I see, knowing my heart is in upon others. Instead of posturing and talking the right place and that I do tough, my father went into prisons and all I can to help those who are changed the lives of the utterly lost. He spent down and stomp out those days at a time praying with the dying in hos- who only bring bitterness, pitals, changing their outlook before passing hate and destruction. on and blessing their families in ways they would never forget. When you have men of VIEWPOINT: Well Craig you substance telling you they’re then man they have been there and done are today, due to your father, you can’t help that, you have the tshirts etc but feel the mighty surge and current of pos- so what motivates u? itive energy that flowed through such a man. Like so many who knew him, I will continue SAWMAN: Man, so many to learn from that man’s selfless example for things motivate me… Watchthe rest of my days. A truly inspirational ex- ing my son play his heart out ample of what manhood is really all about. in a football game motivates I’m honored to have met him. To have him as me. Seeing Old Glory prouda father was a true blessing I’m still trying to ly dance against a pale blue comprehend. sky motivates me. Hearing my talented daughter sing VIEWPOINT: Thanks for sharing that brother. like a beautiful little songbird Tell me what in your life has most affected motivates me. Seeing a bully you and your path? finally get what he deserves motivates me. My wife’s SAWMAN: I think seeing that life really is a beautiful smile motivates me. “big picture” kind of journey and realizing Having people hug on my fathe best things in life are not things at all, but ther in public, reminding him

An Interview with Craig “ Sawman” Sawyer

SAWMAN TALKS RHINOS

LET’S TALK

of whatever selfless thing he had done for their family motivates me. Knowing I’m forgiven motivates me. Seeing world-class athletes accomplish amazing things motivates me. Seeing people from so many professions doing cool things for others motivates me. Music has always motivated me, especially a perfect song for a special occasion, or the right heavy, driving rock song for a great workout. I could go on all day. I find motivation in so many things every day. It’s what inspires me to always do more. VIEWPOINT: Let us discuss how the rhino wars mission came to light? SAWMAN: I was approached by the head of a South African production company to head up a team of former U.S. Spec Ops veterans to run counter-poacher operations for a new TV series. Since I’m an animal lover and an Operator, it was an instant green light from me. I then rounded up the team and off we went. It was a crazy experience and now Rob, Biggs and myself have an even more impressive team put together to make an even bigger impact. As soon as we can get the green light, we’ll be back there helping save the last of the endangered.

VIEWPOINT: I love it! What did you take away from your time there? SAWMAN: The biggest takeaway was that we really could have a tremendous impact for the positive, if just given the chance. We’d really like to do just that, if it can be lined up. It’s something we believe in. The next takeaway, as a Team Leader, was that I need CLOSER security for my cameramen!! We learned one morning that we had been stalked by a pride of notorious lions the night before as we sat on ambush for a group of poachers inside a private reserve! Another ranger had been eaten by lions in an adjacent reserve,

Poachers are of every type over there. You have some highly sophisticated former military specops guys with night vision and silencers, but you also have local villagers.

just that week. Those cameramen had been about 5 yards behind us, behind cover from the poachers, but in hindsight now, I can clearly see that in the future, I’ll want armed security shoulder-to-shoulder with them anytime we’re in the bush at night! VIEWPOINT: Did your operations only include rhino defense? SAWMAN: Yes, while we were deployed on that trip, our only mission was to defend the rhinos in South Africa. Now, however, our mission has expanded to elephant and any other species in danger of extinction by poachers. VIEWPOINT: Lets talk defense missions….. who employed you? SAWMAN: For that gig we were actually hired by the South African security company, Quemic. VIEWPOINT: How many countries did you travel to supporting this mission? SAWMAN: Just South Africa for that one. VIEWPOINT: What were the rules of engagement? SAWMAN: Our ROE were much closer to law enforcement than military. We needed to announce first, rather than just execute an explosive ambush like

we would on military special operations. If the poachers raised their hands when confronted, they were captured alive. If they raised weapons against us instead, they would be shot.

LET’S TALK

SAWMAN TALKS RHINOS

An Interview with Craig “ Sawman” Sawyer

VIEWPOINT: Were you ever confronted by hostile forces? SAWMAN: Poaching was rampant in the areas we were working, so yes, we encountered poachers there. Since we were just there for 6 weeks the first time around, we were really just looking to get the ball rolling and share that on film to get the series green lit.

VIEWPOINT: How organized are these poachers? VIEWPOINT: What is the point of this poaching, is it only the horns SAWMAN: Poachers are of every type over that are the target? there. You have some highly-sophisticated former military spec ops guys with night vision SAWMAN: For the rhinos, the and silencers, but you also have local villagers horn is all they’re after. The Asian who just use stolen wire from the fence to en- culture still has people being told snare the animals and then break their backs rhino horn cures cancer and cures with an ax. It’s just a crazy and upsetting array the common cold. It’s ridiculous, of people who will do this. Without protection, but the myth gets perpetuated, the animals lose no matter what. because deceiving people is lucrative for the crooks. For the eleVIEWPOINT: Who are they working for? phant, they’re just after the ivory. They’re killing entire herds of eleSAWMAN: Most of the money all goes to phant now, just by poisoning their fat cat organized crime bosses in China and watering holes. It’s just bad. It gets Vietnam. They’re getting up to $500,000.00 per rhino horn on the black market. I can tell you, though, the actual poachers who kill the animals aren’t even seeing a fraction of that. All the big money is at the top, in Asia. VIEWPOINT: Where is this happening?

SAWMAN: There are lots of defensive efforts, some more effective than others, but there are definitely lots of good people trying their hearts out to make a difference. That’s pretty cool to see. On the other hand, there are just as many fakes who run charities to save animals, which give nothing to actually save the animals. So if people give, they really need to properly screen the group to ensure it’s one of the few that are legit.

SAWMAN: All over Africa. VIEWPOINT: Is this fight organized are you seeing other defensive operations from the local peoples?

One of the countries implemented a “shoot-on-sight” policy against poachers. From what we were told, it was tremendously effective at stopping the poaching. However, I now hear that the poaching has resumed there, due to political pressure against that government to soften the penalties against poaching. me shaking mad when I really stop to think about it. Until I’m allowed to get back into the fight, I try not to think about it, because I’m a doer. I’m geared to take action. If I can’t be allowed to take action, I try to block it out because it eats at me in a way that’s not healthy when I can’t take action on it. VIEWPOINT: I can’t express in words what I feel about this. We both know that its a losing battle to prevent poaching. Are any of the countries serious about this effort? SAWMAN: One of the countries implemented a “shoot-on-sight” policy against poachers. From what we were told, it was tremendously effective at stopping the poaching. However, I now hear that the poaching has resumed there, due to political pressure against that government to soften the penalties against poaching. So, people are the animals’ worst enemy in more ways than one. Those who are soft on crime are just as deadly to the endangered animals as the poachers, by my observation.

VIEWPOINT: What do you think and co-producing several new can be done? television series, as well as acting in films, hosting new SAWMAN: What we hoped to TV shows and creating various do with our mission was to have tactical products to increase whatever positive impact we the survivability of our warcould with our operations against fighters. Some great compapoaching, then share that with nies I’m working with will also the world through a good televi- be supporting my team for sion series, which was hoped to any future operations. Please educate people on the crisis and help us thank them by sharhelp bring about greater funding ing some love back for their for conservation of the endan- support. These great compagered and stronger legislation nies are: U.S. Patriot Tactical, against the crime. I think those S.W.O.R.D. International, U.S. 2 items are the most important Optics, Armasight, OSS Supways to help. pressors, Vortex Optics, NFW watches, SOD Gear, Pelican, VIEWPOINT: So brother what are Cobian, Safariland, 215 Gear, your future plans? TangoDown, Magpul, U.S. Night Vision, G2 Research, SAWMAN: I’ve got dozens of Tomcar, Blackpoint Tactical, projects in the works these Rudy Project, Savvy Sniper. days. I’m ambitious, after spending so much time in ser- VIEWPOINT: Sawman I want to vice of my country and having again thank you for the support my family do without much you have given to this first ispay, or much time with their sue. I wish you well and hope husband and father over those to have you in a future years. Now, I’m co-creating issue. Thanks!

By John Gomez

ISIS: AN INTRODUCTION

WORLD OVERVIEW

Members of the Iraqi Special Operations Forces (ISOF) prepare before going out on a patrol in the town of Jurf al-Sakhar, south of Baghdad, June 30, 2014. Iraqi troops battled to dislodge an al Qaeda splinter group from the city of Tikrit on Monday after its leader was declared caliph of a new Islamic state in lands seized this month across a swathe of Iraq and Syria. Alarming regional and world powers, the Islamic State of Iraq and the Levant (ISIL) claimed universal authority when it dropped the local element in its name and said its leader Abu Bakr al-Baghdadi, as leader of the Islamic State, was now caliph of the Muslim world - a medieval title last widely recognised in the Ottoman sultan deposed 90 years ago after World War One. REUTERS/Alaa Al-Marjani

ISIS

AN INTRODUCTION

osul, Iraq - A bearded man, wearing traditional garb and sandals, shuffles along a cramped street. His eyes dart methodically, but he pauses his scan to look up at the minaret, where once Abu Hadir once stood and ordered that all that he sees should be added to his lands. The man wipes his brow and reestablishes his pace.

again, noting the doors and looking for anything out of place. All appears as it did during his last few visits. He is recognized by a few and welcomed. He makes his way to the group of men, steeply and with a smile he asks “has there been any new visitors my friends, or I am still the neophyte?”

The men chuckle, “No I am afraid you are Below the minaret men and woman en- still the only one new visitor who has graced us ter the Great Mosque of al-Nuri, each gender in recent times.” through it’s own entrance. Once inside, men make their way to the bottom floor and find a “Well maybe we will be graced by visitors place on the floor. Woman are separated and soon and the gathering will grow, if it be Allah’s find themselves climbing the stairs to the sec- will” the bearded man says, as he continues to ond floor. search the crowd. The bearded man makes his way to the entrance of the mosque, but before entering he once again pauses, then looks across the narrow street and nods slightly to his partner. Inside he shuffles past those situating prayer rugs and exchanging greetings. He looks around

Behind him an elderly man makes his way and greets those as he moves towards the front of the hall. As he moves past the bearded man, he feels a touch, slight but firm on his elbow. It is the bearded man, “Peace be upon you.”

By John Gomez

ISIS: AN INTRODUCTION

WORLD OVERVIEW

The elderly man looks down, for some A man in his early 40s, wearreason his instinct is one of alarm. ing all black, enters. His hands clasped, head bowed in respect “Yes, and…” before he finishes the tra- and lips pursed, he avoids eye conditional response, the bearded man grabs tact. In the Great Mosque there more firmly and whispers to the old man, is not a sound, it is as if Abu-Hadir “I have a message for Imam, please tell him has reentered the mosque after that his services will not be needed today.” centuries. The man in black, continues across the hall and stops, The old mans eyes grow wide and he is then, with all humility, he ascends about to protest and pull away, when he the stairs to the pulpit and sits. As suddenly realizes that the bearded man is opening prayers end, he stands armed. He regains his composure, stutters a and delivers a twenty minute serlittle but is able to show accord, “yes, yes…I mon on the responsibility of bewill deliver your message.” ing a Muslim and declares that he is their leader and it is by his acts “Very well. I appreciate your support” the that those who follow will know bearded man replies, releasing his messenger. that he is appointed by Allah. The With that he pulls out of his pocket a cellphone man is Abu Bakr al-Baghdadi, and sends a pre-arranged text message that to the supreme commander and the casual observer would appear as if he were leader of ISIS. being polite and simply turning off his mobile. Very little is known about Seconds later a caravan of black SUVs, heav- al-Baghadadi, other than he ily armed pickups and assorted trucks, with no has a Doctorate of Islam from distinct markings begin racing to the mosque the University of Baghdad. He after getting the text message “Praise Allah His formed a small militant group Will be done!” in Salaheddin and Diyala provinces north of the Iraqi capital As the crowd in the hall begins to wonder before joining al Qaeda in Iraq. where is the Imam, the screech of tires, doors In 2010, when the then leader opening and commotion is heard just outside. of ISIS was killed in a joint USSuddenly armed men enter from multiple points Iraqi operation. and reassure those gathered that all is well and today is a blessed day as they will be hearing Since al-Baghdadi took the from the Emir himself, as is the will of Allah. top-spot, ISIS has been on a VIEWPOINTTACTICAL.COM

Abu Bakr al-Baghdadi,

trajectory that is nothing short of remarkable. There is no other terrorist group that has accomplished so much in so little time with the effectiveness of ISIS. Please do not mistake this adulation as support of their actions or applause. It is simply testament that ISIS is not al-Qaeda 2.0 or anything like the Taliban. ISIS is a well-disciplined, amazingly well organized and trained enemy who has short ordered taken Osama Bin Ladenâ&#x20AC;&#x2122;s vision and made it very real. The purpose of this article is to provide you with a clear insight into the workings of ISIS, beyond that which are readily available in the mainstream media. What is presented here is this article is rather similar to what you would be reading if you were obtaining an intelligence briefing. The hope is that by providing you with this education and background, you will be able to intelligently debate and persuade policy. You as an American citizen, have a responsibility to guide our leaders in the Government, but you should do that with understanding. Regardless of what you believe is the right action related to ISIS, hopefully at the conclusion of this briefing, you will be better informed. VIEWPOINTTACTICAL.COM

As opening prayers end, he stands and delivers a twenty minute sermon on the responsibility of being a Muslim and declares that he is their leader and it is by his acts that those who follow will know that he is appointed by Allah. The man is Abu Bakr al-Baghdadi, the supreme commander and leader of ISIS.

By John Gomez

ISIS: AN INTRODUCTION

WORLD OVERVIEW

Before we discuss the current state of ISIS, let’s travel back a few months. My hope is to provide you with a glimpse of ISIS activities. As you read through this timeline, please think about the maturity of logistics, coordination and operational planning required to accomplish these tasks. In 2009, right before al-Baghadadi, who now goes by the name Al-Khalifah Ibrahim, became the leader of ISIS, he was released from Camp Bucca. He spent four years as a prison of this US run detention center in southern Iraq. After his release, in 2010 he became leader of ISIS. Under his leadership ISIS became much more organized and evolved. al-Baghadadi introduced a variety of management systems and processes that allowed the growing organization to maintain alignment and focus on his vision of establishing an Islamic state or what is known as a caliphate.

Were his practices successful? Judge for yourself. June 9th - ISIS seizes Mosul’s airport, TV stations, governors office and frees 1,000 prisoners that they believe are being held illegally. Strategic Translation: Take control of major transpiration, media and command and control centers, while adding able-bodied fighters to your ranks. June 10th - ISIS takes control of the entire city of Mosul.

June 11th - ISIS takes control of Tikrit. Within three days, ISIS is able to take control of two cities and establish it’s form of government. A government based on Sharia Law and strict adherence to a Sunni view of the Quran. Keep in mind this is but a very small timeline, that only outlines three days of activities. Yes, these activities took time, but the end-result is rather impressive. Especially when you consider that within days of these accomplishments ISIS is able to restrict all border crossings in the Kurdistan region and takes control of Al-Qaim, a town on the border with Syria as well as three other Iraqi towns. June 29, 2014 - ISIS announces the creation of a caliphate (Islamic State). This may seem unimportant, but it is extremely critical to understand. In essence this means that ISIS believes, and has announced to the world, that all lands under it’s control are now property of ISIS. There is VIEWPOINTTACTICAL.COM

By John Gomez

ISIS: AN INTRODUCTION

WORLD OVERVIEW

no border between Syria and Iraq, in essence ISIS has rewritten the modern world map as we know it. It also means that unless challenged, which their declaration has not been challenged by other Muslim entities, they have also declared authority over the world’s estimated 1.5 billion Muslims, regardless of where they live. In the eyes of ISIS, if you are Muslim, you are a member of the Islamic State, not a citizen of your country. The laws of the country you happen to live in, do not apply to you, as you are a member of Islam, and hence only Allah’s laws apply. In fact if you joined ISIS you would burn your passport as a sign that you are free of your country and member of Islam. This declaration is as significant as the signing of the Declaration of Independence. It is the defining moment which created an “us and them” in the modern era, unlike anything we have seen, since probably the crusades. This declaration also changed the name of ISIS to IS. We will continue to refer to this group as ISIS, as it is the popular moniker here in the United States, but their official name is now IS for Islamic State. July 3rd, 2014 - ISIS takes control of the largest oil field in Syria. This oil field produces 75,000 barrels of oil daily. When we think about how ISIS is funded, this is a major source of income. ISIS owns several oil fields as well as several major businesses entities. In it’s early days, ISIS was funded through black mail, kidnapping and other more thuggish activities. Today, ISIS largely depends on the taxation of business and citizens within its caliphate as

well as the on-going production of oil and gas. You need to understand that all utilities are now owned by ISIS in it’s area of control. Financial analysis by economists, estimate that ISIS is generating about $10Million in revenue per day and has a war chest of $2Billion. This money is used to fund on-going operations, which includes a variety of programs, which will examine shortly. September 11, 2014 - Estimates are that ISIS now employs 35,000 people. You may naively think that this is the number of fighters ISIS has in its ranks. Much like the United States Marines, everyone in the ISIS ranks can fight and has received some level of basic military training. But to believe that these 35,000 people are only fighting would be rather short sighted. ISIS, as stated, is not yesterdays terror group. It is believed that ISIS has well over 750 computer programmers. This does not include those who manage their website and social media campaigns, but also highly skilled cyber-terrorists, game programmers who have built VIEWPOINTTACTICAL.COM

This map shows the 5 year plan for the Islamic State’s expansionist plans for a regional ‘caliphate’.

Today, ISIS largely depends on the taxation of business and citizens within its caliphate as well as the on-going production of oil and gas. You need to understand that all utilities are now owned by ISIS in it’s area of control. Financial analysis by economists, estimate that ISIS is generating about $10Million in revenue per day and has a war chest of $2Billion.

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By John Gomez

ISIS: AN INTRODUCTION

WORLD OVERVIEW

computer games that work and look very much like your favorite first-person shooter (think Call of Duty.) Except in an ISIS game the Americans are the targets and the heroes are ISIS fighters. These games include original soundtracks, Arabic language and extremely realistic graphics. The games are free to aspiring jihadists. ISIS also employs doctors, nurses, graphic artists and even magazine editors. Dabiq is the official magazine of ISIS as of this writing there are four issues in circulation. Make no mistake about it, these are not high school newsletters, these extremely professional magazines could grace the racks of Barnes and Noble or your favorite bookstore. Reading these magazines gives you some insight into the propaganda that is ISIS, but if you are looking for intelligence, look deeper. The fact ISIS can publish a remarkably professional magazine, means they employ professional photographers, artists, editors, editorial staff and are thinking deeply about how they keep their 35,000 motivated.

powerful in the UK and may also be a reason for many of the Lone Wolf activities we have seen. When you start adding up the success of ISIS, their methods of operations and wealth, they seem like the real deal to the Islamist, at least to those who question their own path.

If you still think ISIS is not all that sophisticated, here is one last thing to consider. ISIS publishes an annual report. Meaning, each year they publish an accounting of all their activities world wide, including their financial gains and losses. Many in the intelligence community believe that ISIS does this to demonstrate to their investors (yes they have investors) that their investments are being well Letâ&#x20AC;&#x2122;s think a little bit about motivation. We could say it is managed and applied. It is also believed simply religious fervor and duty for those who the ISIS view of that the annual report is used to attract Islam resonates with, but that again would be short-sighted. new investors. More importantly, in my One of the key tools that ISIS uses to attract followers, volun- eyes, it is a great rallying tool for ISIS tary followers, is heralding their success. members. Each year you get a report detailing your progress, how well you have ISIS does this through social media, magazines, web- done and just how quickly you are growsites, games and much more, but nothing is more effective ing. It is like being part of Apple and hearthan sharing the spoils of war. You can claim Allah is with ing Tim Cooke talk about Apples success you all you want, but until you show that Allah is blessing and areas of strength to Wall Street. your efforts, you are just another Imam. al-Baghadadi has done an amazing job of demonstrating the blessings. UnThere is so much more to know like the Taliban and al-Qaeda, ISIS has a very active human about ISIS, but for now, I believe this resources group, just like you may have in your company. should help you better understand the Joining ISIS means you will get a salary, you get one week depth of this enemy. Please underoff, after working three weeks (paid week off mind you), stand that nothing in this article should you get full health benefits (including dental and vision), be interpreted as an endorsement of you get paid life insurance, thirty daysâ&#x20AC;&#x2122; vacation and much ISIS. Their disregard for human life more. In fact depending on your position, you may be en- and humanity overall is not worth an titled to educational programs for your children, retirement endorsement. Yet, as we learned long benefits, car and housing allowances and other programs. ago, you should respect and learn your enemy. You should dissect them and Instituting these programs allows al-Baghadadi to claim regard them with care. It is through that he is chosen. That he is being blessed by Allah. It is deep analysis that you can ultimately why he could stand before a room of followers and declare defeat your enemies. My hope is that to the world, that he is the one to be followed. This distribu- you have a new appreciation for this tion of assets and wealth, do give people pause to question if group and realize that there al-Baghadadi is not truly the one chosen to reunite all Islam is much more to them, than across the world. This an extremely powerful tool, used by you may have learned from ISIS recruiters to attract new followers. It has been rather the popular media.

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Journal of Counterterrorism & Homeland Security International

Vol. 20, No.4

PERSEVERANCE

An interview with SSG Nick Lavery

PERSEVERANCE

SSG Nicholas Lavery

An interview with SSG Nick Lavery

IEWPOINT: Nick It was a pleasure speaking to you. I am truly grateful for your willingness to talk about this. So let us begin by you telling our readers a little about yourself.

NICK: SSG Nicholas Lavery. I am an active duty member of the US Army (enlisted in 2007). My job title (mos) is Special Forces Weapons Sergeant within 3rd SFG (A) at Ft Bragg, NC. Most commonly referred to a Green Berets. My current position is a SOCP (Special Operations Combatives Program) Instructor. My committee teaches operators hand to hand fighting techniques as it pertains to close quarter combat situations. VIEWPOINT: You said that you were in Wardak Province, Afghanistan when you were injured most notably in the leg that resulted in loss of your right leg. Can tell us what transpired?

NICK: My team was victim to a â&#x20AC;&#x153;green on blueâ&#x20AC;? ambush. I was struck with several rounds fired from a truck mounted machine gun at a distance of approx. 20 feet away. VIEWPOINT: WOW can you express what the initial shock was like and who helped you thru it? VIEWPOINTTACTICAL.COM

NICK: Although we train relentlessly for all types of scenarios, the initial shock is something you cannot completely prepare for. For me personally, my only concern was to stay in the fight for a long as possible. I relied on my medical and tactical training to provide as much support as possible throughout the event. Once MedEvacd off the scene, the fellow members of my Unit were with me the entire time. The SF community is a brotherhood which we take seriously. VIEWPOINT: You said it took 6 days to get back to the states and that members of your Unit

An interview with SSG Nick Lavery

PERSEVERANCE

accompanied you back? Give us an idea of is most impressive is your goal what you experienced in the beginning? of getting back to your job and MMA competition level. So NICK: Before leaving Afghanistan, my only have you become friends and concern / goal was to return to my team kept in touch with anyone? asap. Obviously not fully understanding the severity of my injuries. NICK: I made several friends while at Walter Reed. I keep in VIEWPOINT: Shock will do that.....what was touch with most. It is always good the surgery and rehab like? to have people who can relate to what you are going through. NICK: I was in the ICU at Walter Reed Military Bounce ideas and problems off Medical Center for approx. 3 weeks, and then each other. Discuss new adapmoved to impatient status. I endured some- tive devices or other services, or where between 30 â&#x20AC;&#x201C; 40 surgeries. I began just lend an ear to someone who my rehab almost immediately. I began work- needs to vent. ing with impatient physical therapists daily, sometimes right after a surgery. I had resis- VIEWPOINT: Talk to us about PTSD tance bands and other training aids set up on my bed so I could get additional strength and NICK: PTSD, in my opinion, flexibility training in throughout the day. Af- is one of those things that is ter approx. 8 weeks in impatient, I was moved just different for everybody. to outpatient status at Walter Reed. I began We are all wired differently. working with the outpatient physical thera- We all react and respond to pists and occupational therapists every day as situations and events differwell as working with the adaptive jiu jitsu in- ently. There really is no way structor and adaptive boxing instructor. Even- to know how you will handle tually I was fitted for my prosthetic leg. Aggres- the effects of a highly stresssive rehab continued with my therapists and ful event until it has already coaches focusing on functionality, strength, happened. As operators, we flexibility, and endurance. I was spending any- train for the worst. With that where from 5 â&#x20AC;&#x201C; 10 hours a day working with comes the need to mentally my prosthetist and physical therapist. prepare for the possibilities of our job. It is up to the inVIEWPOINT: Many people will be shocked to dividual to put themselves in know you had that many surgeries. But what that moment, in order to preVIEWPOINTTACTICAL.COM

pare as much as possible for both the immediate response as well as the long term result. We do this to mitigate the shock as much as possible. That being said, there is no way to completely prepare for the mental aftermath of such an event. For me personally, I do not suffer from PTSD. As part of my recovery, I met with several psychs, behavioral health providers, TBI specialists, the list goes on. Obviously I cannot predict the future, but as of now, I have no symptoms that would indicate any type of post traumatic stress. I am often asked how that can be; given the things I have experienced. The truth is I do not know why, Iâ&#x20AC;&#x2122;m not sure if the most seasoned mental health care providers in the world could answer that question. What I do know is that PTSD is real, I have several friends / co-workers who deal with it every day and I am glad that the military has programs and treatment options to get these people the help that they need. VIEWPOINT: That is good news, you told me you are coping well, sleeping well, have a support network, your family, friends, your hometown Boston, MA. and of-course your Unit. So tell us if you can about what affected you most? VIEWPOINTTACTICAL.COM

Before leaving Afghanistan, my only concern / goal was to return to my team asap. Obviously not fully understanding the severity of my injuries.

NICK: Really just the need to

PERSEVERANCE

An interview with SSG Nick Lavery

prepare for everything. I cannot be as spontaneous as I was before I was injured. It takes a bit longer to get ready for the day. Certain prosthetics I use need to be charged, I may need extra batteries, spare parts, tools to make adjustments, the rest of my prosthetic components, certain knees for specific activities, certain feet for specific activities. I need to be cognizant of the weather; dramatic changes in temp, my diet, how much water I consume, my

level of activity, all can affect the fitting of my prosthetic.

Rain, snow, ice, sand, gravel, etc are all things that were never something I had to even think about, now can pose a challenge. Itâ&#x20AC;&#x2122;s really not a big deal, I have always been a rather regimented person, I just now have more to plan for and take into consideration, but like anything else it just takes some time, some trial and error, discipline, and dedication. VIEWPOINT: What have you found was most difficult to process? NICK: My ODA (Operational Detachment â&#x20AC;&#x201C; Alpha) deployed again after I was injured. To not be with them was by far the hardest part of this entire process. VIEWPOINT: What was the easiest? NICK: Getting back into doing what I do. VIEWPOINT: What do you do that may be of help to others? NICK: I am very much into fitness. When not working or spending time with family VIEWPOINTTACTICAL.COM

CALL

can make a difference.

Served 1999-2003

ÂŠ 10/14 VHA

Con onffiden identtial cch hat at at Veter teran anssCrisis isisL Line ine..ne nett o orr tex textt tto o 8382 3825 55

PERSEVERANCE

An interview with SSG Nick Lavery

I am training. Types of training include: Yoga, it’s just about your commitment

Weight lifting, BJJ, MMA, HIIT, and Hand cycling. I am always studying and researching nutrition, looking for as much knowledge as possible to enhance my current program. Upcoming events include: The Detroit Marathon (hand cycle) next week, NAGA tournament in November, The All Army Combatives Tournament in December. The hand cycling is new to my program as a result of my injury, but I have been involved in everything else for many years. Yes, I have had to go back and re-structure and/or re-learn how to go about specific aspects of these hobbies. It has been and continues to be an interesting balance of frustration and exciting, specifically as it pertains to my fight training. With the help of the guys on my fight team and our coaches, we have had to go back to square one and adapt / modify every technique there is. Most of which I was proficient at for years. Imagine having to teach yourself a new way to tie your shoes or brush your teeth, an action you have done the same way every day without thinking for years. But the problem solving aspect of this process is awesome. We get in the gym, throw around some ideas, play with it a bit, and then I drill it over and over. When people hear what I do, you can see the confusion in their eyes, especially when they find out that I compete on one leg, without the use of a prosthetic. People have the image of a UFC fight in their minds, two people standing toe to toe in a fight. How does that possibly work? Do you only fight other amputees? All understandable questions. Ones I am happy to answer. The fact of the matter is, I train and prepare as any other fighter would. Granted I am not as well rounded as fully able bodied people, but I make up for that by putting in the extra time into the areas where I can excel. After that,

to your craft. Repetition, dedication, and determination….. period. I do what I do because I love it. If it happens to inspire and / or motivate somebody at the same time, than that’s awesome. Soldier, athlete, amputee, or whoever in between, if I can positively affect somebody in some way, it’s a win.

VIEWPOINT: How has your perspective of life changed?

NICK: I would say I look at life like this.....when you are having a bad day, nothing is going right for you, you are stuck in traffic, you didn’t get that raise you were hoping for, whatever….. there are people out there who are living in situations that you cannot possibly imagine and just maybe, things are not as bad as they may seem. VIEWPOINT: That is a fact! Nick again thanks I know this stuff is not easy to talk about. I appreciate you being part of this first issue. I wish you and yours all the best!

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