Page 159 - Journal of Special Operations Medicine - Summer 2015

from the
SEMA

”The Ground Truth”
By the time this is published and in not just run with it; they ran with it
your hands, I will be officially retired through the longest period of combat
from the military. It certainly seems operations has known. They proved
like the last 28 years have flown by. It that TCCC and SOF medic training
has been a fun and incredible ride, but was the way to do and prepare for
it is time to transition to a slightly dif- MSG Harold R. Montgomery combat casualty care. This genera-
ferent pace of life. Like many before USSOCOM tion has truly set a new standard for
me, I cannot help but look back on Senior Enlisted Medical Advisor SOF medics and essentially all tacti-
how much has changed and what the (Outgoing) cal medics worldwide. This genera-
future holds for Special Operations tion includes the medics from all our
Forces (SOF). partner nations and coalition friends who have taken up
the banner and continue to save lives on the battlefield.
Oddly enough, the easy part is behind us. Yes, we had it
Change—It Happens!
easy with short evacuation times, surgical assets nearby,
So much about SOF medicine has changed since I first and routine evacuation out of the theater.
entered the service and SOF. Years ago, we were prid-
ing ourselves on our training and perceived ability to I believe the next generation is truly the most important
execute ATLS protocols. We all had M-5 Aidbags or and the most challenged. These are the new SOF med-
monstrous trauma rucks filled with an assortment of ics who are taking up and will take up the challenge in
mostly civilian-based medical gear and supplies. Those the coming years. You have two challenges. The first
were heavy rucks filled with all the intravenous fluids challenge is to retain and propagate everything that has
we expected to infuse into trauma casualties. been learned over the past decade. Do not let our broth-
ers’ blood be wasted. Stand firm against the remaining
In the mid and late 1990s, things began to change, pri- naysayers and push for the right kind of training and
marily out of the experience from Mogadishu, Somalia. equipment for the SOF medic. The second challenge is
Some folks began to seriously question how we were that you will do this in a very different environment.
training our SOF medics. At first, that questioning was Your environment is global and in the far reaches with
an affront to everything we knew. There were some long-range evacuation routes and limited external medi-
who could not adjust and frankly fell off to the side cal support. It will be back to the traditional SOF roots.
and became somewhat extinct. There were a few who You must be prepared to manage patients in the pro-
championed the new cause and began to challenge our longed field care setting and on your own. It is not a
methodologies. I’ll admit that I was at first a middle-of- new concept but stretches through the lineage of all the
the-road guy until I, too, finally went off the deep end SOF units and missions. However, you must integrate
into the TCCC phenomenon. our newer concepts with that lineage and come up with
something better.
The generation of medics and medical officers who
questioned whether we were doing things right truly To the next generation . . . It is in your hands now. Be
helped set up SOF for success in the looming war. At better and take it to the next level. To quote COL (Ret)
first, TCCC was like a revolution, with only pockets Ralph Puckett, both a Ranger and Special Forces vet-
of individuals with challenging ideas. Slowly, the ideol- eran, “Be proud, but never be satisfied.” On behalf of
ogy of TCCC took a firm hold in most SOF units and my generation, I ask that you remember where it all
emerged as our primary means of training our medics. came from and the history of arguing, debating, pon-
dering, and bleeding that made the changes that you can
Then, there was the generation of medics who truly ran now take for granted. Be self-critical and always evalu-
with the newly codified concepts. This generation did ate yourself and your team as to how you can improve.

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