Page 102 - JSOM Summer 2025

Interview with Frank Butler

By Maarten Leeflang MD, Former SOF medic trainer
and Ryan Woets, Former SOF medic

CoTCCC Chair in addition to their assigned duties as the 1
Marine Expeditionary Force Surgeon. Both of these individu-
als are superb physicians and leaders, but they served in their
CoTCCC role as volunteers in addition to their assigned roles
in the Marine Corps. Each job inevitably takes time and atten-
Captain (USN Ret) tion away from the other. What is needed is the appropriate
Frank Butler, MD. resourcing to provide for a civil service physician with TCCC
experience to serve as the CoTCCC Chair.
For the CoTCCC to continue to achieve the unprecedented
success that it has had over the past two decades requires the
ongoing participation of trauma care experts and leaders from
both the military and civilian sectors. The U.S. military needs
What made you decide to write this book, together with to treat these tremendously talented individuals with a level of
the co-authors? gratitude and appreciation that reflects the enormous gift of
TCCC has been an unprecedented transformation in battle- their time and expertise.
field trauma care and has saved thousands of lives. How
TCCC came about is a unique story that needed to be told The Department of Defense also needs to preserve and opti-
and preserved. mize the methodology used by the Joint Trauma System and
the Committee on TCCC in the past to identify needed ad-
Writing the book was also a great way to say “thank you” vances in trauma care, evaluate their ability to enhance the
to the many people and organizations that helped to develop lifesaving capabilities of combat medical personnel, and mes-
TCCC and have it become accepted as the U.S. military and sage these advances to all who could potentially use them to
NATO standard for caring for our wounded combatants. the advantage of their trauma patients.
What would be the number one reason you would give if Finally, military line commanders must realize that it is they
someone asks you: “why should I read this book”? who are truly responsible for the successful delivery of TCCC
The acceptable number of preventable prehospital deaths in on the battlefield. Line commanders must value TCCC and the
combat is zero. We know that historically many combat fatal- combat medics who deliver it as being just as important as their
ities could have been prevented with better battlefield trauma aircraft, tanks, and artillery. Otherwise the saying “Humans are
care. Tactical Combat Casualty Care has now been docu- more important than hardware” is just that - a saying.
mented to help combat units like the 75th Ranger Regiment—
ones that train every member of the unit in TCCC—to achieve What was your most poignant moment in the
that goal. 25 years that you have been working with TCCC?
It’s a battlefield tourniquet story—sadly, a tragic one. In 2006,
Would you say the book is only of interest for those I got a phone call from a long-time military medical friend.
concerned with combat medicine? Normally an outgoing, relaxed person, the caller was deadly
Absolutely not. Trauma is the number one cause of death in serious on this call. His message was that there could be abso-
persons aged 44 and younger in the United States. The same lutely no relenting on the pressure that the CoTCCC had been
is likely true of most other developed countries. Sadly, many applying to promote tourniquet use in the military. He related
of these civilian trauma deaths could have been prevented if a heartbreaking story about an individual in whose case he
prehospital medical personnel and other first responders were was involved. This woman was a 28-year-old Army Captain
trained and equipped to manage trauma patients using TCCC and the mother of two small children. But she was not coming
concepts. home to her husband and kids. She had just died from a gun-
shot wound—to the knee. No tourniquet was applied and she
What would you say is required for TCCC to remain the bled to death. It was another entirely preventable death.
backbone of combat Medicine and for TCCC to maintain
the qualities so hard fought for? Tourniquets are a battle that America’s military cannot afford
Since the end of the conflicts in Iraq and Afghanistan, both the to fight again.”
focus and funding for combat casualty care have decreased.
The Committee on TCCC in the past had a full-time physi- Why is the history of TCCC so important to those combat
cian Chair to guide its activities. Beginning in 2019, that is no medical providers new on the scene?
longer the case. There have been two outstanding Navy Emer- The U.S. military has a bad habit of forgetting about advances
gency Medicine physicians (CAPT Brendon Drew and CAPT made in trauma care once the nation enters a peace interval.
Travis Deaton) who volunteered to perform the duties of the We absolutely cannot allow that to happen with TCCC. We

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