When I was asked to meet and capture the lives of the medevac crews of Company C, 3rd Battalion, 25th Aviation Regiment, 25th Combat Aviation Brigade, located at Pasab, a small outpost in a highly-active and dangerous region of Afghanistan located west of Kandahar Airfield, I was slightly concerned.
I expected to meet a rag-tag group of medevac crews. It would have to make sense, I thought. Pasab has the most challenging medevac missions in Regional Command-South due to the high frequency of missions and traumatic nature of the injuries common in the area.
Pasab averages 30 percent of all Category Alpha medevac missions in RC-South. The medevac crews at Pasab also see the worst injuries as they only respond to urgent medical calls, known as CAT-A missions. These are calls with injuries, such as a multiple amputee patients, that require a response from mission start to medical facility delivery of less than one hour - known as the golden hour.
When I arrived to meet the medevac crews, I was greeted by a very energetic Capt. Margaret Larson, a pilot and the executive officer for C/ 3-25. She gave me a two-minute tour of their footprint. There were two sleep tents and a third tent that served as an operations center and crew rest area.
As Larson introduced me to the Pasab flight crews, I noticed my expected vision of them was way off. These were professional soldiers with overall impressive statures.
"We send our strongest flight medics out here because of injuries we see," explained Larson. "This area is the worst, so we need soldiers that can handle it."
I sat down with many of the crew members who were eager to share their experiences.
The soldiers explained some of the challenges of life in Pasab.
First was the secret behind their high levels of energy and calm. Due to the nature of the Pasab mission, no single medevac crew is allowed to stay in Pasab for more than two weeks at a time. Instead they rotate out to Pasab from Kandahar Airfield, on an either weekly or bi-weekly basis depending on the mission tempo.
The one to two weeks they are at Pasab, though, are rough, as the crews cannot leave the small area they operate in. There are two full crews at Pasab which rotate every 24 hours from being first responder to second responder. As a result, if there are two missions, everyone is flying.
Members of the crew explained this can mean long times without showers, and that they find the time to sleep and eat when they can. Sleeping sometimes comes in spurts while food comes from piles of care packages stacked in the corner of their operations tent.
Regardless, they all expressed a love for what they do.
"I like doing what I do," said Spc. Arnell James, a flight medic for C/3-25, from Savannah, Ga., who has been on the Pasab rotation five times. "I like the mission tempo and being able to do our job, to be able to use the skills we trained for."
I was informed that some of the medics on the crews were not flight medics, rather medics who served as a second hand to the flight medics. While this is not a common practice, it is deemed necessary in Pasab.
Spc. John Hill, a medic with 209th Headquarters and Headquarters Support Company, 209th Aviation Support Battalion, 25th CAB, and a native of Austin, Texas, is one of the selected "second-hand" flight medics at Pasab.
"I signed up to be a medic to help other people," said Hill, who is on his second rotation to Pasab. "That's the kind of person missions like this need; someone who wants to help but doesn't expect anything in return."
The crews began to share their lighter and humorous stories. One involved a miscommunication where a call over the radio to request a replacement crew chief due to losing one from "intestinal distress" was wrongly heard as "emotional distress." To make a long story short, the poor crew chief, who was simply trying to relieve his "intestinal distress" in a nearby portable bathroom, was surprised to find an army of leadership was outside trying to talk him out before he hurt himself from "emotional distress."
The humorous stories continued when a loud, alerting sound came from the operations desk where all medevac missions and updates are monitored. Everyone was on their feet in an instant, many gone with amazing haste. Others stood ready to take action as they waited for the official call.
"It's just a weather update," yelled the operations sergeant. The soldier standing closest to me took a deep breath, placed one hand on his heart and another on my shoulder as he told me the adrenaline was always pumping around there.
The crews slowly returned to sit around and share some more. For some reason, the false alarm caused the crews to start sharing their sadder stories.
"The harder days are when we have to go pick up kids," said James, as he stared down at his feet. "It hits close to home. I picked up a girl once who looked just like my daughter."
The crews started to discuss other challenges at Pasab, ranging from extreme, dusty environments to the threat of land mines on landing zones and common instances of random gun fire.
The discussion turned to treating Afghan National Army soldiers.
"Treating local nationals can be a challenge," said James explaining they sometimes resist treatment. "Some have never seen a helicopter and they get scared, and on top of that we have the language barrier. But we push through it, we do our job and we are successful."
The Pasab medevac crews have a 98-percent success rate of retrieving, treating and transporting their patients to a medical facility within the golden hour.
The conversations continued into the night as I chuckled to myself about how wrong I had been about this group.
No medevac calls came through while I was there, but, sometimes that's just how it is.
Article by Capt. Richard Barker, Army.mil