Page 100 - JSOM Summer 2025

Tell Them Yourself, It’s Not Your Day To Die*

Including Interview with Frank Butler

Frank Butler, Kevin O’Connor, Jeff Butler. Tell Them Yourself. It’s Not Your Day To Die. ISBN: 979-8-99-022570-1
(Breakaway Media, LLC, 2024).

*This book review and interview were first published in Netherlands Military Medical Journal (NMGT), May 2025.

Where the title of the book comes from
A U.S. Soldier on a night patrol hears a gunshot and feels a family – you can tell them yourself. It’s not your day
sharp pain in the right side of his body, and yells, “I’m hit.” to die.”
The unit medic quickly moves to the casualty’s side. Far beyond any other battlefield trauma care program in
history, Tactical Combat Casualty Care has enabled Ameri-
The wounded Soldier thinks of the family waiting at home ca’s combat medics to make good on that promise.
and says to the medic:
Tell Them Yourself is the extraordinary account of how a
“Doc – will you please tell my family that I love small group of world class trauma experts joined forces
them.” with America’s best combat medics to rewrite the rulebook
The medic responds, “Hey – shut up! I’ve got this. in battlefield medicine – and then to sell these revolution-
You’re gonna be fine, and you’re going home to your ary new concepts to a disbelieving medical world.

ell Them Yourself provides the reader with an insight previous medical dogmas were refuted. The question often
into the history of Tactical Combat Casualty Care, posed by COL (Ret) Bob Mabry kept coming up: “Who owns
Tthe most successful battlefield trauma care program in battlefield medicine.” As the book describes, medical leaders
history. may develop concepts and advise their line commanders, but
it is line combat commanders who have the final authority to
Very little changed in prehospital combat casualty care for dictate what happens on the battlefield, including the care of
over 100 years after the U.S. Civil War, despite studies from the the wounded.
Vietnam conflict that showed that the vast majority of combat
fatalities occur before the casualty ever reaches the care of a Evidence-based medicine is considered the Gold Standard in
combat surgeon. Training for combat medics in 1992 was still medicine, but double-blinded, controlled trials are not feasi-
conducted based on civilian courses such as Emergency Medi- ble in battlefield settings. That is why the best possible use of
cal Technician-Advanced [EMT-A] and the Ad- all available published battlefield trauma care
vanced Trauma Life Support [ATLS] courses. evidence must be reviewed by the Committee
Realizing that these courses discouraged tour- on TCCC and considered in the light of the
niquet use, despite the fact that that bleeding to combat experiences of medics, corpsmen and
death from extremity wounds was estimated to pararescuemen.
have caused between 3,000 and 4,000 prevent-
able deaths in Vietnam, the Navy SEAL Bio- At the start of the war in Afghanistan, only a
medical Research Program began an extensive few U.S. Special Operations units had adopted
review of battlefield trauma care in 1992. This TCCC. By 2004, when CAPT Butler assumed
was the impetus from which the first Tactical the duties of Command Surgeon for the U.S.
Combat Casualty Care (TCCC) Guidelines Special Operations Command, there was no
emerged in 1996. The guiding principle of comprehensive information on how U.S. service
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TCCC was to provide a set of evidence-based, members had died in combat and what might
best-practice prehospital trauma care guide- have been done to save them. CAPT Butler
lines that combine good medicine with good tactics. TCCC is asked COL John Holcomb, then the Commander of the U.S.
now the standard for battlefield trauma care in the U.S. mili- Army Institute of Surgical Research, to undertake a study to
tary, NATO, and most other developed countries. answer those questions for Special Operations troops that had
died in Afghanistan and Iraq. COL Holcomb assembled a tram
In Tell Them Yourself, the authors describe the long road that that included such luminaries such as Dr. Howard Champion,
has led to where we are now. The book includes many combat CAPT Jim Caruso, COL Rocky Farr, and MSG Sammy Rodri-
examples of TCCC in action. The reader is taken on that jour- guez. This research team found that most special operations
ney, in which many barriers had to be overcome, and many deaths had resulted from non-survivable injuries, but there

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