Author: chrisclukey

Area hospitals rescue thousands with helicopters
Story by Christopher Clukey

The journey begins with a rushing noise like a stiff gust of wind being forced through a pipe. From under it comes another sound, an oboe-like bass note that levels off as a loud drone with a high-pitched whine mingled in. The rotors begin to turn, and soon the air is filled with their clatter. It’s been said that helicopters don’t so much fly as beat the air into submission, and that’s what this blue and silver craft seems to be doing. The helipad windsock is stretched by a strong winter wind, but the helicopter rises effortlessly on its own manufactured gust. A few hundred feet up, it hovers, rotates, and with a dip of its nose, picks up speed and departs on its mission.

Aboard is a young woman with a failing heart, tended by a crew dedicated to extending a lifeline of care from Rockford and Madison to hospitals like Freeport Memorial.

Bringing “DUSTOFF” home
Rescue helicopters have a surprisingly long history. The first helicopter rescue was a rescue of three downed airmen by a Sikorsky R-4 helicopter in the highlands of northern Burma in April, 1944. The craft was so under-powered that only one man could be rescued at a time, but the concept showed promise.

By the time of the Korean War, a helicopter evacuation system for wounded troops had been established. Pilots flying the Bell Model 47 (the “fishbowl” helicopter made famous by the M*A*S*H TV series) would transport two wounded troops from an “evac station” near the battlefront to a Mobile Army Surgical Hospital (MASH) a few miles to the rear. By the time of the Vietnam War, the Bell UH-1 “Huey” was the workhorse, flying in and out of combat zones, usually under the callsign “DUSTOFF.” With helicopters and other improvements the military’s medical system had been refined to a point where men with wounds that would have been fatal during World War II were not only saved, but often returned home healthy. Some even finished their combat tours.

The medical personnel who made this network function were at the core of a revolution in emergency medicine in America in the 1960’s and early 1970’s.

“When the physicians and nurses came back from Korea, and also from Vietnam, they saw a completely different system than the one that they had seen in the wars,” says Karen Daub, the newly appointed chief flight nurse at OSF St. Anthony’s Lifeline service. Air transport of patients was almost unheard. Ambulance crews drove slightly modified hearses, had little medical training and almost no lifesaving equipment.

Returning medical veterans realized that the military system could be adapted to civilian use. The Paramedic and Emergency Medical Technician positions were developed so that first responders would offer crucial medical care in the first moments with a victim. Hospital departments, and even whole hospitals, began to specialize in the treatment of trauma.

They also discovered “the golden hour.” The term was coined by Dr. R. Adams Cowley, who studied accident mortality statistics and found that victims who were seen by trauma specialists within an hour of their injury were far more likely to survive. In fact, Cowley found that those patients who took more than an hour were almost certain to die. “It’s quite an abrupt shelf,” says University of Wisconsin Hospitals spokesperson Tim LeMonds, describing graphs of the patient survival rate.

“They saw that it’s ‘out-of-hospital’ time that matters,” says Daub, adding that speed can be even more helpful if the patient is bound for a facility that specializes in treating their particular problem. “If you move quickly and trauma patients are going to a trauma center, pediatric patients are going to a pediatric hospital, cardiac patients are going to a cardiac center…the results can be wonderful.”

Helicopters are a crucial part of the network, especially for hospitals in smaller communities like Freeport.

Working together for specialized care
“We’re certainly doing a lot,” says Denise Brook. Brook is the clinical leader of the Emergency Services Area at Freeport Memorial Hospital, and “a lot” is an understatement. “We had 26,000 patient visits [in the emergency room] in 2005,” she says.

The hospital is served by three regional helicopter ambulance services: Lifeline from OSF St. Anthony, REACT from Rockford Health System and Med Flight from the University of Wisconsin Hospitals, based out of Madison.

Emergency room patients aren’t the only ones who sometimes require helicopter transfer, says Brook. Patients requiring advanced neurological care, open heart surgery or pediatric/neonatal intensive care are often transferred to Rockford hospitals, as are many mothers who are having premature birth or other drastic birth problems. Some infectious disease cases and patients requiring microsurgery to save a limb are sent to Madison. Transfers to Madison also occur if burn and neuro wards in Rockford are full. All three health systems maintain Level 1 trauma centers. To qualify as a Level 1 facility, the hospital must have surgical teams on duty around the clock.

“It’s very rare for them to come here directly from an accident scene,” Brook says. “they have to take weather into account, but if they respond to an accident they usually take the patient right to Rockford. When they’re responding to an emergency they can give the [first responders] at the scene an ETA and they can make decisions based on that. Sometimes they meet ambulances here if that will speed things up.”

Brook notes that St. Anthony’s is the “resource hospital” for the Freeport Health Network in the state’s trauma network. This means that St. Anthony’s assists FHN with continuing education and training in emergency issues as well as providing the radio equipment that they use to contact the rescue helicopters. “The trauma system here in Illinois is one of the oldest and most advanced in the country,” she says. Freeport has been part of the helicopter network from the time it was implemented. Brook recalls that before the wing housing her department was built, the hospital’s helipad was in a space that is now used for parking. Helicopters would also set down in Bidwell Park across Lincoln Boulevard from the hospital.

“What’s nice about this system is the good relationships and communications,” she says. The system allows local patients access to ultra-specialized care that even the best community hospitals can’t provide.

Ronald Meadors, the Emergency Services Manager at Rockford Health System (RHS), agrees. “You have a very good community hospital there,” he says, “but tertiary care requires a different system.” Primary care is the care you receive from when you first enter the system, either with your doctor or a first responder. Secondary care requires more specialized skills or equipment, and is usually provided by a hospital or specialist. Tertiary care is highly specialized care such as that provided by trauma centers, cardiac hospitals and neonatal intensive care units.

The flights and the fliers
The three services have similar missions, but they approach them with differing equipment and techniques.

According to Meadors, REACT has been operating since September 1987 and transported about 1,000 patients in 2005, with 176 transfers out of Freeport Memorial. Meadors notes that the service uses a rear-loaded helicopter (the MBB BK-117) and they often load an advanced isolette and an augmented flight crew with a respiratory therapist and a neonatal nurse to provide advanced care for premature infants. Normally the craft flies with a three person crew: Pilot, trauma nurse and paramedic. REACT owns their helicopters rather than leasing them, Meadors says, because of the reduced cost. “We try to keep costs down for the patient, and sometimes we’ll use a ground ambulance instead of a helicopter for just that reason.”

Madison’s Med Flight has two helicopters in service at all times, with a third for training and backup. While most services use a crew with a flight nurse and paramedic, the Med Flight teams have a nurse and an ER physician. Med Flight spokesperson Tim Le Monds says it is “a big financial commitment” to have doctors on the flight crews, but that it is worth the cost. He cited a recent case where a woman was being transferred for cardiac trouble, and the doctor was able to diagnose the problem while en route. Instead of being seen by a doctor in the ER, she was routed straight to cardiac surgery. “She was minutes from death, and she wasn’t bogged down [in another department]…time is critical.” Med Flight, Le Monds says, is one of only three services in the nation that uses flight physicians.

Karen Daub agreed that the physician approach works for Med Flight, possibly because their coverage area is more rural than the area covered by most EMS helicopters. She noted that studies show that flight teams with a paramedic and nurse have a clear advantage in patient survival.

Daub says she became interested in flight nursing when she was in high school, working as a unit desk clerk at the emergency room in Rochelle, often with just one nurse on duty. It was common for them to call helicopters in for transfers. “It looked like exactly the sort of thing I wanted to do,” she says. Her interests run in the family; Daub’s mother was an ER nurse there.

Daub prepared for flight nursing by serving as an ER “nurse extern” at St. Anthony’s during her final year of nursing school, followed by three years of ICU experience, several years of service in the emergency room and study for extra certifications.

On a typical day, she says, the crew does a preflight inspection on their Bell Model 222 helicopter and inventories their equipment and medical supplies. They then receive a crew briefing on weather conditions and planned missions. In some weather (what is called “condition yellow”) they must re-check the details of the weather every time they lift off. Then the team moves on to other daily duties while they are on-call between flights. Not surprisingly, they do a lot of paperwork. This includes following up on the care results of every patient they transport. They also provide lectures and training for EMS and hospital personnel so that the system is as helpful to those local caregivers as possible.

Daub says that TV viewers who’ve seen the interior of Donald Trump’s helicopter have a good idea of what her “office” is like. “It’s based on a corporate transport, so it has a similar [general] layout. The cabin has good noise isolation.” The equipment and crew, she says, transforms it from an expensive passenger model to “a flying ER and ICU.”

“But you’re not allowed to give birth while you’re flying with me,” she jokes. “That’s a rule.”

Le Monds echoes Daub’s assessment of the helicopters as “flying ERs.” “Our mission,” he says, is to bring the ER to the patient, instead of the other way around.”

“We’re ready to fly anytime,” Daub says, “and we’ll take the patient wherever they need to go.”

Freeport’s 333rd Military Police have returned home from Iraq, forever changed.
Story by Christopher Clukey

The men and women of the Freeport-based 333rd Military Police Unit knew they were in a different world the moment they stepped off the plane in Kuwait. When they left Fort McCoy, Wisconsin, less than twenty-four hours before, it had been -11°F and snowy. Now they filed out into the 130° heat of a desert kingdom.

At first, the troops had enormous difficulty adjusting. They were scheduled to stay in camp for two weeks to acclimate. “Everybody got sick,” said Specialist Tim Wenzel (pictured above), who served as a medic. Heat casualties were the most serious problem, but the soldiers also fell ill because they had no resistance to local bacteria strains.

During their early weeks of patrolling, Wenzel recalled putting every returning patrol member on IV fluids to rehydrate them. During one ten day period the temperatures inside their vehicles peaked at 160° each day. Soldiers did their jobs as usual, in full “battle rattle” body armor, riding in vehicles without air conditioning. “If you rolled down a window,” Wenzel said, “it was like having a hair dryer blowing on you.” When he returned to Freeport on leave in November 2003, Wenzel found it so hard to keep warm that he wore a stocking cap even when he was indoors.

The mission
The 333rd’s mission, as Sergeant Lance Leverton put it, was to “maintain law and order in our operational area” in the region surrounding Talil and Nasiryah below the Sunni Triangle. This included everything from mobile clinic visits in local villages (known as “medical presentations”) to “kicking in doors” on terrorist suspects. “I like to say that MP stands for ‘Multi-Purpose,’” said First Lieutenant Trevor Albrecht, a platoon leader and the current acting Executive Officer. “There is nothing that this company was exempt from performing.” They began with checkpoint duty and then moved on to crowd control, searches and raids, patrolling supply lines, perimeter security, guarding prisoners and rounding up “Baath Party members, gun runners and black marketeers” and other people of interest. “We had great PR people working with us,” said Wenzel, “so sometimes Baath Party members or people who knew things we could use would just show up voluntarily.”

Wenzel also mentioned the benefits of excellent intelligence work. Attacks on the unit were almost always detected ahead of time and pre-empted. “Our camp was only attacked once.”

They also escorted convoys of civilians or reinforcements going deeper into Iraq. Among these were a convoy carrying the contents of the British embassy, and another carrying the very first Burger King in Iraq to the Baghdad Airport. Saddam Hussein had sabotaged all Iraqi refineries, so oil had to be trucked to Kuwait to be refined. The 333rd would escort oil convoys to Kuwait and escort gasoline back, and escorted gasoline to Baghdad to quell fuel riots.

Albrecht adds, “[T]he unit as a whole performed on a level that exceeded the standard to reach mission accomplishment.”

The people
During most of their tour, the 333rd operated in rural areas of the country. Rural Iraqis endured crushing poverty. Most lived in mud houses grouped in communities that Wenzel described as “very tribal.” The economy was barter-based, and cash was almost nonexistent. Soldiers on patrol would buy lunches from the local farmers, who were eager to exchange food for cash. “Sometimes we were giving them the first money they had ever had,” recalled Wenzel, who estimated he had eaten 50 or 60 meals prepared by Iraqi families during his tour.

The Hussein regime had left rural areas with no utilities and a crumbling infrastructure. Electrical power was almost never seen, clean water was rare and some communities had to make use of open sewers. Hussein also tightly controlled who had access to motor vehicles, and a rebellion on foot would have been easily crushed. Access to weapons had also been restricted for decades, but shortly before the invasion Hussein gave out millions of weapons to civilians, hoping they would use them against Coalition troops.

The population the 333rd encountered had exactly the opposite attitude. “They were receptive. They liked what we were doing,” Wenzel said. Medical presentations helped gain goodwill. A team made up of a doctor, several medics and some translators would arrive at a local village around 9am, after the morning farm chores had been completed. Medics would handle most injuries and illnesses themselves, referring the most serious cases to the doctor. Sometimes they or the doctor would write the civilians a note so they could visit a U.S. base for more advanced treatment.

Often the locals simply needed basic medical treatment like the cleaning and dressing of wounds, or medicines that Americans take for granted. The medics saw “quite a bit” of evidence of past torture by the regime, Wenzel said. Mutilations were common. Some civilians reported being forced with torture to use their meager funds at certain businesses if government officials weren’t happy with the local economic situation. The medics also saw many men with severed Achilles’ tendons, which was the Hussein regime’s punishment for draft dodgers.

The home front
As soon as the word came that the 333rd would deploy, local organizations like the Red Cross and Operation Homefront stepped forward and a Family Readiness Group was established to meet the needs of the families and provide a liaison with the National Guard command structure.

One thing that was new about this war was the ease of calling home. Connie Wescott, a Family Readiness Group board member, had a son and daughter—Kirk and Erin Bausman—in Iraq. She said they never talked about anything combat related. She received a call about a day on checkpoint duty where the soldiers searched a car and found goats in the trunk, and another day when two Iraqis cruised through a checkpoint on a moped with a goat sitting on the seat between them. “They’d talk about the weather, the Iraqi people, what their living conditions were like, what we should send them…”

Tim Wenzel said, “My family would ask why I hadn’t told them about [unpleasant] things when I called from Iraq. They were disturbed by it when I was sitting at home with them, how would they feel if they’d heard about it while I was still over there? A lot of guys didn’t talk about the day to day stuff because they didn’t want to freak their families out.”

Support from home was strong, but sometimes didn’t match up with conditions. “Once somebody sent me a bag of marshmallows,” Wenzel recalled, “and by the time it got to me it was just a bag of white liquid.”

The prison
As their one year tour drew to a close, the 333rd was in Kuwait, preparing their equipment to be turned in. The soldiers were due to turn in their personal weapons when they were summoned for a briefing.

They were addressed by a Lieutenant Colonel. After telling them about recent combat developments in the area he told them “Before you guys can leave, we have to send you back into the fight.” At least one 333rd soldier who spoke to the Ink still felt some resentment toward the officer. “He gave us the ‘We Were Soldiers Speech.’ He must have seen that movie a lot of times.”

The unit proceeded to Camp Udari, where they remained for two weeks. The soldiers remained professional and unified, but the camp was tense. Wenzel remembers being upbraided for some minor infraction by some camp guards who were new to the theater and asking, “So, did you guys earn the Burger King patch or the Subway patch?” Wenzel had particular reason to dislike their new orders: The date he was supposed to be married came and went during the extra months.

By the time they crossed back into Kuwait, their orders had been changed. They would be sent to a prison called Abu Ghraib. Their duties would include patrols in the Baghdad area, including the dangerous route known as MSR Sword.

Oddly, the soldiers had found out about the Abu Ghraib scandal when the story broke on TV news after they had been there a week. The consequences were quick and brutal. The prison was shelled by terrorist mortars almost daily. Most of the mortar rounds were landing among prisoners being kept in outside areas. Any convoy that came near the prison came under attack. On any given day 100-300 Iraqis were at the main gate, trying to get in and check on relatives. They were convinced their relatives were being subjected to the same treatment as the prisoners in the infamous photos. The Marines guarding the gate of the prison were issued riot gear.

“There were lots of reporters around,” Wenzel recalled. “They filmed us and our prisoners any time we did a transfer or left the prison.” Lance Leverton went further: “The media was difficult…[They] did a lot of damage.”

Meanwhile, the Army initiated a training program for the soldiers performing corrections work at the prison, to reinforce proper prisoner treatment techniques. The 333rd covered the duties of each unit as they rotated into the additional training. One frustrated 333rd sergeant reportedly asked the troops, “You don’t need that, do you? Do I really have to sit down and tell you it’s not okay to take a chemlight and rape a prisoner with it?”

Then things got worse in the only way they could. On April 29th, 2004, Sergeant Landis Garrison was killed when his weapon accidentally discharged. The 333rd had experienced serious casualties before—Specialist Gabriel Garriga and Sergeant Steve Asche had received lethal burns from a Humvee accident—but Garrison was their first and only member to be killed. “Nothing we had been through prepared us for that,” said Leverton. “It took everyone aback.” At Garrison’s funeral, he would be called a hero three times over, because in civilian life he was a police officer and volunteer firefighter.

Lt. Albrecht said that when he looks back, what stands out is “the resolve that the unit showed when we were extended to stay an extra period of time. …Although upset and confused, we stuck together as we did the entire time…This shows that we had a tremendous unit that not only had confidence and competence, but also good leadership and astounding soldiers that were up to any task.” Leverton added, “We did a lot of good things, and there were a lot of bad things that happened. My hat’s off to our commander [Captain Ronald Bonesz] for bringing us through.”

The readjustment
In July 2004, the troops finally made it home. Well-wishers lined the streets, and over 600 had gathered at the National Guard Armory. Now the soldiers faced the difficult task of adjusting from combat to life at home. Connie Wescott said that “many families were expecting the worst” after briefings about the readjustment period. Though the trauma predicted in the briefings was overblown, no one’s transition to home life would be easy. And as both Wescott and her son Kirk Bausman said, everyone’s experience would be different.

One of the biggest problems was crowds. In Freeport, crowds mean crowds. In Iraq, crowds mean danger. No matter how friendly the group might be, a public gathering could provide excellent cover for a suicide bomber, or attackers hoping to kill American soldiers and then fade away quickly. When crowds of civilians were near, the soldiers had to try to watch every face and every hand, looking for malicious intent or a drawn weapon. These habits were hard to break. Wenzel reported it was at least two-and-a-half months before he could be in a group without feeling threatened, and his family noticed other things, such as a new habit of always sitting with his back to a wall. “It was hard not to just back away from people sometimes.”

Lance Leverton agreed, noting he still dislikes crowded places. He had a “very hard” adjustment period. His wife Jenna said “As soon as I saw him I knew he was different.” Over the next six to eight months she would notice him scanning nearby people whenever they were in public. “We would take the kids out for a buggy ride and it was like he was waiting for an attack.”

They also experienced problems because their approaches to family life had changed. Lance described Jenna before the deployment as “almost totally dependent on me.” Coping without him for sixteen months, she became very self-reliant and developed what Lance jokingly called “a Norma Rae attitude.” Worse, Jenna said that Lance “was so used to taking care of his soldiers,” and he was trying to take charge even more than before. “It was a lot of friction…we almost separated. …But now we know each other better. Our marriage is a lot stronger now [than before he left].”

Bausman, who is serving on active duty as an MP at Fort Greely in Alaska, had and still has some difficulties. “It has not been easy for me,” he said. “It has taken awhile to adjust to hearing loud sounds like fireworks and going to the pistol range. Those I have recently adjusted to. I still have issues with being in large crowds and I really can not stand to be crowded around.” Bausman was awarded the Bronze Star for heroic action in three incidents: at the accident that injured Asche and Garriga, for rescuing Iraqis trapped in a bus after a road accident, and for trying to save the life of a dying Iraqi policeman. But he doesn’t want any special recognition: “I just did what I was trained to do and what I felt was right. There are medals being awarded to soldiers today and there will be medals awarded tomorrow. Some of them will never be given to the soldier; they will go to a parent or spouse or child….Those are the true heroes, those who gave their life for people they never knew. … I would ask that we remember the fallen.”

Albrecht pointed out another difficulty: “I think that the biggest hardship for soldiers was not seeing each other every day. Granted, adjusting to everything back home was tough, but I think that [missing] the brotherhood and love that you have for each other was the hardest thing to adjust to. We went through experiences with each other that you will never experience with your friends and family back home. This is a special bond that can only be explained by a soldier.”

The future
The soldiers of the 333rd are building their futures. Some remain in the unit, and others, like Specialist Bausman, have gone to active duty. Leverton and Wenzel have both finished their military service.

“If I were single I would go back,” Leverton said. He tends bar at Diamond Dave’s. He said it’s common for those who oppose the war to give him their opinion at length, “whether I want it or not” when they find out he’s a veteran. “They don’t know the good we’ve done there…They just tell me ‘it’s all about oil.’”

“They’re experts,” his wife jokes. “They know way more about Iraq than he does!”

Wenzel made it to his second wedding date, and he is a phlebotomist at Freeport Memorial. He is jovial in his manner and optimistic about the outcome of the war, but he too feels he has a perspective that many civilians miss. “They watch all the same news shows that show people dying in a few cities and nothing of the good that’s going on.”

Lt. Albrecht was asked if there is any chance the 333rd will re-deploy to Iraq soon. He responded, “Being in the Army, there is always the possibility that you will deploy during wartime or in peace. You have to be ready for that. …It was a quick decision and we were in Iraq. As a soldier, you must always be prepared and think about this.”