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Darci Marchese, special to KSL NewsradioIt's something we rarely think about: How wounded soldiers and Marines travel from the battlefield to the United States. I was given unprecedented access to be part of that journey.
Headed Home
Once the wounded troops leave the battlefield in Iraq, they are flown to Ramstein, Germany. A massive coordination effort takes place in Germany to determine where the patients receive treatment after landing at Andrews Air Force Base in Maryland.
Most of the decisions are based on the military member's type of injury. Amputees are usually sent to Walter Reed Army Medical Center in the District; the most critical go to National Naval Medical Center in Bethesda; burn victims are sent to San Antonio, Texas. Others are sent to facilities near their residence or home base.
As I mentioned, every person wounded during war lands on American soil at Andrews Air Force Base, usually on a C-17 aircraft.
I became the first reporter ever allowed aboard the C-17 aircraft when it arrived at Andrews filled with the battle-wounded on a cold, windy day in October.
Walking up the steps to the large aircraft, I was apprehensive, not knowing what to expect.
One Air Force employee warned me to "take a deep breath" before walking into the aircraft, and I quickly realized why. I was first struck by the smell -- the smell of fresh wounds, medicine and hospital equipment.
There were 44 patients on the plane, most laying on metal cots stacked three-high across the aircraft. There was very little room in between the beds, and I couldn't imagine traveling like that for 10 hours.
Many of the patients were sleeping, groggy or just waking up. They looked disoriented. Many were wearing casts, with broken bones. Patients who could sit up and move around on their own -- called ambulatory patients -- were strapped in seat belts on the sides of the aircraft.
ICU in the Sky
My most anxious moment was walking toward the back of the aircraft, where the CCAT patients -- the most critical -- are located. They are enclosed in their own hospital bed or "litter" that can weigh up to 300 pounds. There were IVs, cardiac monitors, respiratory ventilators and other life-saving equipment surrounding the patients.
I saw a bag of blood dangling near the one patient who had a white sheet of paper taped to his litter, reading "skull injury." I later learned he was now blind, from shrapnel wounds to his skull. He was heavily sedated, like the CCAT patient next to him.
Each CCAT patient has their own medical staff responsible for keeping him alive during the 10-hour flight. It's easy to see why this aircraft is known as an ICU in the sky.
Upon landing, the back of the plane is lowered, so the patients can be taken off the aircraft.
The CCAT patients are the first to be unloaded. Since the litter weighs as much as 300 pounds, it takes a team of at least six to lift the litter out of the plane and into a bus. Seven people had to carry one of the patients, and they definitely struggled to lift him up into the back of the bus.
Buses soon leave the Andrews Air Force Base. One heads to Walter Reed Army Medical Center, the other to National Naval Medical Center in Bethesda.
It takes well over an hour to carry all of the patients out of the plane. The last to leave are the ambulatory patients who walk onto their designated buses.
Officials pre-determined where each patient will go -- 22 will spend the night at the 79th ASF (Air Staging Facility) at Andrews Air Force Base, before flying out the following morning to another medical facility.
Giving the Best Care
There is a lot of coordination here. A flight team, made up of a flight nurse, surgeon, doctor and technicians are busy, checking the condition of patients, making sure each is properly medicated. There are also members of the Army and Marines at each flight line, to offer support to their wounded members. A chaplain staffs every mission as well.
Personnel at Andrews Air Force Base handle three of these types of missions a week, carrying 750 patients a month. There's a permanent staff, along with Air Force personnel who get deployed to this unit, to staff it 24 hours a day, seven days a week.
The wounded military members who stay at Andrews are usually there for 24 hours or less.
But despite the short stay, Air Force personnel take their role very seriously.
Maj. Pamela Petree, chief of clinical operations at Andrews Air Force Base, says patients there are someone's brother, dad, sister, and they're going to do the best they can to make sure that patient gets to his destination with the best care.
Lt. Colonel Jose Soto, the flight commander of the Andrews Air Force Base Air Staging Facility, says their mission "[is] touching those warriors that come back."
Of the patients who stay at Andrews, 5 percent to 10 percent are treated for mental health problems. About 30 percent have battle injuries, mostly from improvised explosive devices (IEDs), followed by gunshot wounds.
