Page 162 - JSOM Spring 2018

support may not be the best for SOF operations. For example, map directly with historical medical support to guerilla forces.
conventional military medical support to SOF may have too For example, PFC’s treatment and evacuation principles of
large of a footprint. Large forward surgical operating teams ruck, truck, house, plane are what an injured World War II
with many personnel and the large amount of equipment and guerilla or partisan fighter might have experienced in an auxil-
resources required to keep operational may be too big for a iary and underground supported care and evacuation network
SOF team operating in a small compound with limited electri- in Europe or the Pacific. The 10 core PFC capabilities (avail-
cal power, space, and water or means of prompt evacuation. able at www.prolongedfieldcare.org) are equally applicable to
From Dr Farr’s cited examples, common historical factors of medical care in a GW environment. The principles of medical
medical support to UW forces emerge. Medical support is a support in GW are rooted in historical evidence; however, best
morale booster and force multiplier of guerrilla forces. There practices to medical support in GW are constantly changing
is a balance between the speed and convenience of locating with advances in medical and nursing science and technology.
guerilla hospitals along common lines of communication and Dr Farr explains that beyond the initial trauma management
the security of remote guerilla hospitals. A developed auxiliary skills needed in war zones with Golden Hour medical sup-
and underground (a theme especially repeated in Dr Farr’s his- port, SOF Medics need medicine, nursing, surgical, and pa-
tory review) is key to patient evacuation and medical resupply. tient management knowledge sets for prolonged and complex
Right-sized far forward surgical teams can make a difference modern GW environments and remote/austere operating envi-
in survivability of wounded guerilla forces. ronments. SOF medicine must evolve to reembrace, organize,
equip, and train in traditional GW medical skills.
The concluding chapters of Dr Farr’s monography refocus in
detail on the argument that after 14-plus years of the GWOT, In summary, Dr Farr’s monograph, The Death of The Golden
SOF commanders and SOF medicine have become accus- Hour and the Return of the Future Guerrilla Hospital, is well
tomed to Golden Hour medical expectations from compo- researched and referenced and cites scholarly work that sparks
nent medical services. However, medical support to evolving the reader’s interest in learning more about medical support
SOF mission sets and FID medical training requirements to to GW forces. The monograph explains current service com-
host nations are more typical of traditional medical support ponent medical support to SOF and how sometimes conven-
to UW and GW missions. The SOF medic receives training tional medical support is ill-fitted for unique SOF medical
on aspects of medical support in GW, but the SF course’s cul- needs. The author writes that the problem is that in 14-plus
minating “Robin Sage” exercise may be the last time an SF years of the GWOT, Golden Hour medical support to SOF has
medic can practice GW medical support skills. Only recently eroded the historical and traditional medical capability of SOF
have doctrine and organization tables changed to grow and to execute medical support in guerilla warfare. Six chapters
maintain organic SOF medical assists. Dr Farr highlights that of the monograph explore historical aspects of UW medical
the reemergence of traditional mission sets such as FID and support to guerilla and partisan forces from World War I to
other train/advise/assist missions are becoming more common modern-day wars in Iraq and Afghanistan. Dr Farr concludes
in non-warzone areas of the developing world and with fragile that evolving SOF missions in remote and austere locations far
nations. Dr Farr emphasizes that with the recent grassroots from conventional military medical support necessitates a re-
development of the Prolonged Field Care (PFC) movement ini- focusing of SOF medicine to include training, organizing, and
tiated within SOF, SOF medicine is experiencing a “back to the equipping for SOF UW medical support in GW environments.
future” moment. There are parallels in PFC philosophy that

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