Page 150 - Journal of Special Operations Medicine - Fall 2017

An Ongoing Series

We Cannot Afford to Lose the Lessons We Have Learned

COL (Ret) Rob Lutz's Reflections on a 20-Year SOF Medical Career

Interviewed by COL (Ret) Andre Pennardt, MD

Please provide us with an overview of your SOF career support. We had a generation of commanders, surgeons,
including key assignments. and medics who cut their teeth in Afghanistan and Iraq. Their
My SOF career includes 3rd SFG(A) Surgeon, JSOC Deputy medical experience of never being more than 1 hour from
Surgeon, JSOC Surgeon, USASOC Deputy Surgeon, Special surgical or other higher-level support is not the reality of
Warfare Medical Group Commander, today’s missions in Africa, South America, Central America,
and SOTF Surgeon. and the Pacific/Southeast Asia. It is vital that we continue to
evaluate the requirements and match the training to meet
Can you describe some of your most those needs.
memorable combat casualty care ex-
periences for us? Do you think that SOF Medics are provided sufficient
The most memorable was my first mass time and opportunities to maintain their critical medical
casualty, on 5 Dec 2001. ODA 574 was skills? If not, what would you recommend be done?
hit by a 500lb bomb, and we received SOF Medics are required by regulation, and have the opportu-
COL (Ret) Rob Lutz the casualties at a transload point and nities, to maintain their critical medical skills. That being said,
evacuated them to Oman via MC-130 the majority check the box with minimal investment. Over
for care. The key learning point for me my career, I saw many opportunities for
was that it was just like many of the train- “ The role of telemedicine medical proficiency training die after the
ing events I’d participated in prior to the effort had been expended to create the
mission, and it formed my opinion on should be to provide memorandum of agreements (MOAs) for
the need for realistic training. expert consultation for the Medics to train. After a year or two
the identification and of minimal attendance, the agreements
As a former commander of the Special fell by the wayside and it wasn’t worth
Warfare Medical Group, what changes treatment of ‘zebras.’” the time and effort to renew them. Com-
have you seen in the SOF medical manders must encourage and support
training pipeline? Are there further changes that should medical proficiency training, and we need to ensure that those
be made? Soldiers who are selected for SOCM or Special Forces Medical
The big changes were beefing up trauma skills around 2005 Sustainment (SFMS) training want to be there and are invested
for the Special Operations Combat Medic (SOCM) training in a career that requires life-long learning.
and then, in 2011, increasing the medical/clinical training
of the SOCM course. Each change was in response to the What do you see as the role of telemedicine in SOF?
needs of the force. Further changes need to be reflective The role of telemedicine should be to provide expert con-
of what is happening on the battlefield, and the feedback sultation for the identification and treatment of “zebras.”
loop needs to be faster and more agile. In each of those “Zebras” are uncommon diseases or injuries that can be a
situations, the need was present for several years before the challenge to diagnose and treat. Reach-back to experts in
course was modified. There must be a process that “moves these situations can be invaluable. The day we start to rely
at the speed of war” to get new requirements into the SOF on telemedicine for the diagnosis and treatment of common
medical training system. injuries and illnesses is the day we have failed to adequately
train and sustain our Medics and medical officers. I want to
What is your assessment of the importance of providing clarify that I do not consider telemedicine to be the appro-
SOF Medics with training and experience in prolonged priate reach-back to the medical officers of the organization.
field care? This is part of the professional relationship between the team
Prolonged field care came about in response to the develop- of physicians, physician assistants, and SOF Medics in a bat-
ing requirements for small teams to operate far from medical talion, group, or regiment.

146