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 Bethesda MEDEVAC ...Bringing them home, helping them heal
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It is Friday afternoon, and the Medical Evacuation (MEDEVAC) team is returning to Andrews Air Force Base to receive more casualties. In less than a week, the National Naval Medical Center (NNMC) casualty census has increased from 20 to over 75, the largest surge since the initial Iraq invasion in April 2003.

The corpsmen assigned to this run are preparing litters piled high with blankets and plastic orange pads designed to make litter transport a little more comfortable for patients coming back with painful injuries. They work quickly and quietly, performing their tasks with familiar repetition.

HN Kista Varnadore is the team leader. She deployed aboard hospital ship USNS Comfort during the initial stages of Operation Iraqi Freedom (OIF) and worked in casualty receiving where over 400 patients crossed the elevator threshold. With over 20 MEDEVAC runs under her belt at NNMC, she is considered one of the seasoned veterans of this fairly new process of casualty care.

She joined the Navy after 9/11, echoing the sentiments of many on her team who joined after this history-changing event.

"I knew I wanted to help, and I wanted to go into healthcare," said Varnadore.

Now, at the age of 20 with only two years in the Navy, she has seen more than she ever anticipated. Reflecting to her time on the COMFORT, Varnadore added, "This is hard, seeing people your own age, but the children we cared for were the hardest."

Currently, 160 corpsmen and eight nurses are assigned to the MEDEVAC watchbill, one of the toughest collateral duties. Though some supervisors give time off if a run goes past midnight, most corpsmen continue to work their regular jobs due to manning shortages. This makes for a long week when a surge of casualties may result in two or three runs a day, with an average run time of five hours.

Cmdr. Christopher Pratt, Senior MEDEVAC nurse, developed a Standard Operating Procedure (SOP) last July for MEDEVAC contingencies.

"There used to be just a couple of petty officers that may go out and pick someone up prior to OIF. When OIF happened, we realized there needed to be a more formalized approach, with nurses present for analgesic supervision," said Pratt.

The MEDEVAC nurse oversees the clinical and logistical support of patients through the entire process. Those who have been on the runs, like Pratt, feel very protective of their patients. "They are your Marines... This is not just a collateral duty. This is part of the whole system...we have got to ensure we do this right," emphasizes Pratt.

Part of "doing it right" is the ongoing evolution of the SOP, as patient documentation becomes fine-tuned. In addition, the Staff Education and Training Department is developing a computer-based training course for MEDEVAC personnel.

To acknowledge the teamwork required for this duty, a MEDEVAC patch has been designed, and those assigned to the MEDEVAC team will be authorized to wear the patch on their coveralls.

But for now, it's one day at a time, taking care of casualties. As the bus makes its way to Andrews through rush hour traffic, HN Peter Samuel, a pharmacy technician with nine runs this week alone, catches up on coursework. Like many on the team, Samuel is taking classes toward an advanced degree. Samuel, who is up for orders in February, expects he too may be sent to Iraq. "It makes me think about what it would be like being over there, ponders Samuel. "It really gives me a sense of compassion, knowing it could be me."

Pensive thoughts about possible deployment are quickly forgotten once the crew arrives at Andrews. Members from NNMC, Walter Reed and Malcom Grow meet in a room to receive the patient brief. They call out names, ages, body weight, types of injuries and associated equipment. Those at the Aeromedical Staging Facility know the almost solemn reverence when the American wounded land on American soil for the first time in many months.

"You see a lot out here that reminds you how privileged you are to be in the United States," reflects Pratt. He tells a story about the Marine Corps liaison, Warrant Officer Lester, running 300 yards toward the edge of the flight line. "Warrant was on his knees, digging at the ground with his hands to bring back some dirt for a Marine we had just off-loaded (the C-141) and placed on our bus. The Marine told Warrant he 'wanted to touch American soil.'"

"This whole thing has been an incredible learning experience...this is the largest movement of patients since Vietnam. We are part of the medical regulatory system from the moment they are injured," said Pratt.

Not only a learning experience, but a life experience for the young corpsmen taking care of these Marine casualties. Varnadore reaches for her cell phone and hands it to one of the Marines..."you want to make a call?...I have plenty of minutes." Samuel follows her lead, and hands his phone to the other Marine who's still awake. Samuel stands in the aisle, observing the patients in his charge. He unfolds a blanket and drapes it over a Marine's exposed legs.

The ride home is quiet. It is midnight when the bus pulls up to NNMC. A small group waits to take the patients to the wards.

Samuel directs the transfer of the patients from the bus to the gurneys. As he hands off the care of his Marine, their eyes meet. No words are needed....a look passes between them, as the Marine is wheeled past the Navy corpsmen statue at the entrance, as if to say, "Thanks Marine...we'll take it from here."

Dec 11, 2004
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