You WILL fight like you trained

Today is October 28th.?

29 years ago yesterday, at roughly 6:30 AM, I was the only medical officer in the building known as Robinson Health Clinic.? I was a brand-new Physician Assistant having graduated PA school just a few months earlier.?

About 3 months prior to the events that were about to unfold, I had been in the clinic earlier than normal.? As I was getting prepared for my daily panel of primary care appointments I heard a shout from the far end of the clinic.? “Help! ?Help! I need some help!”? I ran to the other side of the clinic to find a Soldier lying in the middle of the hallway, apparently unconscious.? However, as I approached the “patient”, it became clear that this was a mock drill meant to gauge response times, etc as part of the leadership’s routine assessment of clinic preparedness.? I wasn’t happy about it, but I “played the game” and the exercise went well.?

Now, on this day, once again I was the lone medical officer in the building. Most of my brigade was assembled at Towle Stadium for the Brigade run.? Ordinarily, I would have been with them, but on this particular morning I was waiting for a phone call from a buddy of mine from my enlisted days telling me where to be and when to be for an early morning jump.? The reasons behind me needing this jump are another story best told on another day.? For now, let it suffice to say that I needed to get out of an aircraft, or I was going to lose my supplemental pay for being a Paratrooper.?

As I was waiting for that phone call a Sergeant burst through the front door of the clinic and shouted “Help! Help! I need help.? Someone just shot my Colonel!”.? My immediate thought was, “Am I the ONLY one who they can find to run these stupid mock drills!?”? However, one look at this NCO’s face and I knew something was different.? It was clear that this was not a drill.? In front of the clinic was the NCO’s pickup truck and in the bed of that truck was a man who had sustained a through-and-through gunshot wound to the pelvis.? The round had entered anteriorly in the suprapubic region and exited posteriorly over the region of the posterior-superior iliac spine. He was alert and oriented, but tachycardic, pallorous, and extremely hypotensive.? This was not a drill.? This man had been shot and if I didn’t do something and do it soon, he wasn’t going to make it.?

Prior to PA school, I had spent 9 years as an enlisted medic.? In military parlance, my military occupational specialty (MOS) was 18D.? In more clearly understood language, I had been a Special Forces Medical Sergeant. Earning my Green Beret was, without question, one of the most physically and mentally challenging journeys of my professional life. As you might imagine, our training focused heavily on managing combat trauma. Our instructors held us to an incredible standard rooted in the principles of advanced trauma life support. By the time we graduated, all of us had run multiple simulated trauma scenarios that has been made as realistic as possible given the technology of the day. As a result, we knew how to think under pressure and apply clinical reasoning skills to address complex injury patterns.

As I processed the scene in front of me, my training as an 18D came rushing back to me. Without hesitation and truly without much forethought or deliberation, I started doing what I had been taught to do. The patient had a patent airway, he was breathing, but he was bleeding internally.? With the medics who were in the clinic, we rapidly gained IV access with two large bore catheter and started administering fluids as that was the protocol in those days. We dressed the entrance wound and exit wound as best we could and made a desperate call to 911.?We knew he needed to get to an OR if he was going to live. As soon as the ambulance showed up and we were able to get him transferred, I grabbed two medics and a trauma bag, and we made our way to Towle stadium. By the time I and my medics arrived, the shooting had stopped.?The suspect had been subdued and a casualty collection point had been established outside of one of the battalion aid stations. Medics from across the Brigade were doing what they had been trained to do.

As the first shots rang out on that early fall morning, men of uncommon courage went into action. Captain Cole Bricker along with First Lieutenant George Lewis, in keeping with their training in response to a near ambush, moved, unarmed, to outflank the shooter’s position.? SFC Tony Minor, SFC Bob Howes, SGT Edward Mongold, and SFC Paul Rogers were 4 Special Forces NCO’s (Green Berets) who were out for a morning run when they heard the shots fired.? They immediately recognized the gravity of the situation and, also unarmed, moved to subdue the shooter from the opposite flank. In the process of subduing the shooter, SFC Howes was shot in the foot.

These six men didn’t think. They didn’t rationalize.? They simply did what years of training had taught them to do. They moved to the sound of the guns. They fought like they had trained.? As a result, lives were saved.

This was my first exposure to a mass shooting.? Thankfully, my patient survived.? Three of my friends were also shot that day.? Thankfully, they survived.? Major Badger did not.? He suffered a gun shot wound to the head. He was the single fatality of that horrific day.?

As catastrophic as the day was, men lived that day because other men took action. They didn't think. They didn't deliberate. They fought like they had trained.