—WILLIAM TECUMSEH SHERMAN
I spent several days inventorying and restocking the clinic outside of the firebase, with the assistance of the 10th Mountain physician assistant and his senior medic. It didn’t take long before the foot traffic from local villages was keeping us busy, but it was still only the tip of the iceberg of what needed to get done within the area. If we were going to have any real impact, we needed to get out to some of the remote villages before the winter snow. Now seemed like a perfect time; fall was just settling in, and the brutal heat was subsiding, which resulted in fewer cases of heat exhaustion and dehydration. Still, traveling up and down the steep, rugged mountains in 70 pounds of body armor and weaponry kept that threat alive.
We began by frequenting the local villages and building a rapport with the population before pushing out to remote areas where we were needed the most. Wil or Vic would lead the group, which generally included one of the Toms and myself. I would concentrate on treating the locals, some of whom had never met or even seen Americans. Afghans by nature are a very insular people and trust very few people outside of their tribes, including our team and the 10th Mountain personnel who accompanied us. Because of the distrust on both sides, we’d often meet on the outskirts of the village rather than in the village itself, which is normally where I’d set up my medical clinic. It was inconvenient for the villagers, but it afforded us additional protection. Relations began to thaw over a series of visits, and the villagers’ trust eventually grew to the point where we were allowed to attend some of the local jirgas, a sort of town meeting of tribal elders. There I learned a great deal about the distrust they had for both the Taliban and the United States. In their mind their village was a separate entity unto itself, making everyone an outsider. I understood why Doc C kept stressing the importance of establishing a medical clinic that would reach both sides of the border, and the need for putting an Afghani physician in place to run it. If these people were ever going to feel the need for national unity it had to come from their government proving the benefit it brings to their lives and not by the work done by a foreign military force. We had the ability to get it under way but were unsure if the Afghani government could continue it, especially since it might take decades for it to take hold.
A month after my arrival, intel started flowing in from nearly all the villages. I kept up with the latest reports by going into the comms hooch at least twice during the day. During one of my afternoon visits, Wil asked me to join him.
“Hey, Doc.” Wil smiled as I entered the hooch to find him alone, marking up maps pinned to the crude plywood walls. “Pull up a chair.” He motioned to one of the plastic patio chairs commonly found in stacks outside Walmart. “Great work on the clinic. You got everything you need?”
“No, not really, but we’re making do.”
“Good man. That’s all I ask.” He pulled up a plastic chair and joined me at the plywood table that lined the front wall. “We’ve had a mission on the burner for the past few months and scrapped it twice. It just went to boil again, and I’m putting you in Chris’s place. You’ve got the skills we need, especially as a medic and shooter. It’s an added bonus that you were a radio guy.” Wil gazed at me levelly, then gestured for me to speak openly.
“I’m good to go. Can you tell me about it, or do you want to brief everyone at once?”
Wil smiled and then started searching for his pack of cigarettes, which he’d lost under the rat’s nest of maps and materials on his desk. He continued speaking as he searched. “The other guys are up to speed and have been itching to roll on this for months. We’ve learned of a target holed up about thirty miles from here in a place just beyond Khand Pass. We know he’s been coordinating the transfer of troops and weapons from Pakistan into Afghanistan, and we believe his orders are coming from top al Qaeda leadership. We’re going in to put eyes on him, assess his current location and troop strength, then call in the cavalry to grab him.”
“Thirty miles? I assume we have good intel on the area?” I asked as I slipped from PA mode into SEAL mode. Because special operations teams are composed of such a small group of operators, everyone wears multiple hats; actually, mine was more like a sombrero. Unlike trauma medicine, clinical medicine had a tendency to envelop me and shade me from the outside world. Caring for smiling children dressed in brightly colored gowns would often take me away from the cruelty of war, but the evils of al Qaeda always dragged me back to reality.
“We’ve got the best intel possible this time around. Chris, Chief, and Muscle Tom were out there a few times earlier this year, and they all know the area well.” Wil was alluding to the inaccuracy of past intelligence reporting; naturally any team would prefer to have firsthand knowledge of their AO (area of operations), and thankfully we did. “We’re also receiving collaborating information from multiple other sources, including several Taliban captured last month.” He paused long enough to hand me some pictures, then continued looking for his cigarettes. “The satellite imagery seems to back everything up.”
Special operations missions rely heavily on intelligence reports, especially when the troops involved are in small groups and far from base. Human intelligence, acronym HUMINT, is the information gathered from people on the ground, and it’s not limited to local populace; anyone with eyes and ears can be an asset. Signal intelligence, acronym SIGINT, is collected by eavesdropping on radio and telephone transmissions, or any device that produces a signal, and geospatial intelligence, acronym GEOINT, is derived from satellite imagery and related sources. There are other intelligence disciplines, but those were the ones most important to our mission, and Wil was a master at interpreting its value.
“Unfortunately Chris won’t make it back on time to go on this pump. That means you’ll be picking up his duties for the op.”
Wil, who was normally meticulously suspicious about missions, was much more at ease for this one, so the intel must have been strong about Khand Pass. It wasn’t that he was risk averse; it was simply that he valued American lives more than he believed in the outcome of this war. Vietnam veterans who built the special operations community mentored Wil during his early years, and despite their valiant service and mission success rate, the conflict didn’t end the way America had intended. I think he was concerned this war would turn out the same.
“So what’s next?” I asked, ready to get to work.
“Aha,” he said, finally finding his pack of cigarettes. He picked up a laser pointer and turned to a map tacked to the plywood wall. “The team will be rolling out in approximately three weeks, along this main route for the first few miles, then off the grid for the rest.” He traced the route with a red dot while simultaneously jabbing a cigarette in his mouth.
“You’ll get a warning order when we receive final approval.” He turned to me. “Doc, I wanted to let you know why I’m pulling you away from the clinic after you pushed so hard to get it up and running,” he said, now searching his pockets for his lighter. “It’ll be you, Vic, Muscle Tom, and Chief on this one. Vic will be team leader and primary comms. You all will be leading a platoon of the Afghan commandos, along with Ned and three terps [interpreters].” Ned, the Afghan commander, was a fierce warrior with extensive combat experience. He was raised in Kunar Province but educated by Westerners in Kabul. His English was nearly perfect and his courage unrivaled. I was happy to hear he would be wrangling the commandos. “Come on,” Wil said as he motioned for me to head outside with him for a smoke. I followed him to the porch and watched him light up. He then continued. “Time to dial back your time at the clinic while we wait for the green light. I spoke with the major in charge of 10th Mountain, and he’ll have his PA take care of it for now.”
“I appreciate the heads-up.”
“Get with Muscle Tom if you have any questions on what personal gear you might need. I’m sure it’ll be approved by the end of the week, and we’ll have a formal brief then. Did I leave anything out?” he asked, taking a hit from his cigarette.
“No, that about sums it up.”
“Not a problem, Doc.” He patted my shoulder and nodded.
“Wait, there are a couple of other things,” I said.
“Fire away.”
“I noticed we have some ballistic blankets in the armory. Can I use those on the vehicles? Also, I’d like to get some more medical supplies on the next resupply for additional medical kits. If we’re going deep into Indian country, I want to be prepared for anything.”
Wil smiled and flashed thumbs-up as he turned and headed back into the hooch. “Done and done!” he yelled over his shoulder.
A decade prior to my assignment at Shkin, I attended a briefing by two Special Forces medics who, after returning from the streets of Mogadishu, set out on personal journeys to share with all of special operations the lessons learned from that battle. One of the more salient points was the need to be able to return to sticks and rags in the treatment of casualties “because eventually you’re going to run out of supplies, and you will need to improvise.” The SOF medical community heeded their advice and adapted their training accordingly. In addition to reinforcing the basics, the units also began building their own medical resupply to an existing system, called “kickout bundles.” The idea of throwing essential equipment or resupply out the door of a hovering helicopter or a slow-moving aircraft, or cross-decking from one patrol boat to another, wasn’t anything new, at least not for beans or bullets. The medics’ briefing just made it more commonplace for teams to use kickout bundles for Band-Aids, too. I reaped the benefit of their experience during the early part of Iraqi Freedom, so I was damn sure I was going to try to have some backup equipment ready for this mission as well.
I knew Wil would move mountains to find the gear I requested, but as a SEAL and a spec ops veteran of Central and South America, I thought I’d utilize an old friend from a Special Forces Group that specialized in that part of world. He had recently joined an Army Special Forces team operating in a small base outside of Khowst, only five klicks, or roughly three miles, away from the air base, so I contacted their medics to ask if they would build a couple of bundles and drop them off at the helicopter medical evacuation teams for me. They gladly obliged. I had no reservations asking for help even though it meant adding more work to another team’s plate; if they needed help, they would have asked me, and I would have gladly pitched in. In the SOF community, we took care of one another like family.
While awaiting the warning order, we capitalized on every free minute. An extremely important element of special operations is the preparation, cleaning, and function check of every piece of equipment, starting with the team’s gear, with everyone pitching in to make it happen. No matter your rank or position, you get your hands dirty. Once the team gear is good to go, the operator can start prepping his own personal gear. It’s all part of the team mentality that’s instilled from the first day of training.
Like the others I started going through my gear, ensuring everything was clean and fully operable. An odd feeling of uncertainty settled into my chest as I checked my weapon’s laser sight and my night-vision goggles, or NVGs. It wasn’t fear but rather a sense of internal compass recalibration as I shifted more and more from caregiver to frogman. For years, I’d been focused on healing the sick and injured, and thoughts of firefights were water under the bridge, and now I was reverting to the training I’d received as a young Recon Marine and SEAL. I felt no fear of the pending mission and knew I’d perform just as I had in Iraq and on other missions, but something felt different this time. Since returning to the spec ops community, I’d felt an internal conflict knotting up deep in my core. Once again I would carry my medical bag and M-4 with a good chance I’d need both. I was no longer a medical officer in San Diego, treating patients in a sterile clinic. I was once again a combat medic, and inside, caregiver and warrior were beginning to battle for my soul.
Wil called us together and announced the mission was a go. We all helped formulate the plan and then rehearsed day after day for the next three weeks until we knew our parts so well we could perform them in our sleep. On downtime, Big Tom, Vic, and I tuned the vehicles and augmented the armament on each. We placed ballistic blankets over the seats to add an additional layer of protection against incoming rounds and land mines buried in the road. Modifying the vehicle was a delicate balancing act. We needed protection, but we also needed power and speed. It didn’t matter how much armor the trucks had if they couldn’t get us off the X. We focused on weak points exposed from previous battles and added armor to fragile areas on the doors and along the floorboards.
I had become obsessed with vehicle maintenance, and the others knew it. It was as if each one had become a patient of mine. Even when they were completely tuned and tightened, I would spend hours going over them. I would perform a detailed physical exam, testing and refining every component. Just like any good medical provider, I greatly valued the tools of the trade. I kept my mechanic’s tools clean and organized like surgical instruments. I even made my own tool roll-up from an old blanket that resembled an oversized surgical instrument pack. If they weren’t in my hands, I hid them away from the others so I’d have them when I needed them.
In typical SOF fashion, my teammates quickly discovered one of the best ways to annoy me was to borrow a socket wrench and bring it back covered in axle grease or, worse, not return it at all. Since the dawn of special operations, teammates have used humor to lighten the stresses of the job or impending combat, and my colleagues were no exception.
Early one morning while I was at the clinic checking on one of our wounded Afghan soldiers, Chief crept over to my sleeping hooch and swiped my tools. He took them back to the comms hooch, where he posed with them stuffed down his pants. He then returned them exactly as he found them, careful not to reveal his shenanigans. Later that evening, when the team sat down to watch a movie, the “previews” were actually picture after picture of my tools going toward some very dark places. Although I wanted to laugh my ass off at the dastardly deeds, I knew any reaction would only fuel the fire, so I sat and viewed the movie’s preview stone-faced as the rest heehawed like jackasses. They had me and they knew it, and the next day Chief stopped by to “borrow tools” and have one last laugh as he watched me soak each one in chemical sterilizer. Needless to say, I kept them under lock and key for the rest of the deployment.
* * *
Once my tools were back in acceptable working order, I joined the Toms, along with a few of the ANA soldiers and our terp named Ali, and we prepared the vehicles for the mission to Khand Pass. We attached new equipment mounts on each of them, which would allow immediate release of the medical kits and stretchers yet still withstand the constant bouncing from the terrain. Then we moved the spare tires, replacement parts, tools, and even the five-gallon water cans into positions that would provide some protection against fragmentation or penetrating rounds. Ali was a Pashtun from Kabul who was a sociable man with a wiry build but a bit too skittish. It was obvious he was there for the extra money, which was much better than what he earned at his past job with the State Department in Kabul. I was unsure how he’d hold up under fire, and it concerned me. His English was good, however, and he had decent proficiency in Dari, which made him a valuable asset.
On the day before launch, we met with the leadership of the 10th Mountain and went over the basics of our mission. Operational security, or OPSEC, prevented us from telling them all the details, but they knew enough to assist us should it come to that. They were the closest ground troops available, and it was important we maintained communication with one another. We had our own QRF (quick reaction force) troops standing by at one of the major bases, but they were hundreds of miles away and relied on air support to get there. We needed a contingency plan, and 10th Mountain provided that for us. They would be traveling by ground, which also meant they would be bringing large-caliber machine guns and automatic grenade launchers to the fight. Initially, I had doubts when I heard the 10th
Mountain had replaced the Rangers that helped establish this outpost, but it didn’t take long before I grew to respect the men of the 10th Mountain Division. Since my arrival I had watched them defend continual attacks against their patrols and the firebase with the same proficiency I was accustomed to within the special operations community. The 10th Mountain had lost three good soldiers in less than a month, which can shake any military unit, but their leadership was strong, and men followed suit. We supported them and they us, and each man on my team was confident they’d have our backs if things got heavy.
Chris had recently returned from the States and sat in on the briefings, providing valuable input to supplement the intel. He’d been in the target area several times over the last twelve months and gave critical advice about navigating through the rough terrain. After the meeting wrapped, Chris pulled me aside and wished me the best. He was clearly disappointed that I was going in his place. We all understood what he was feeling, especially since he’d spent so much time training the ANA soldiers from the initial stages of this program. However, there are golden rules in the special operations community that simply aren’t broken. Most notably, if you’re not part of the workup, you don’t go on the operation. It doesn’t matter how good an operator you are; if you don’t rehearse, you don’t go. Chris knew this but felt he was abandoning the very men he raised up from the ranks of ANA. He helped select the men, eliminated the weaker links, and trained the remaining few until they were a formidable fighting force. I believe he felt obligated to be by their sides, especially on the more dangerous operations. This one certainly fit into that category.
* * *
We launched at dusk and headed slowly east across the flat, rocky terrain. The unit was comprised of nine vehicles with roughly four men in each: four Americans traveling in swim pairs, a mechanic, two terps, the Afghan leader, who also worked as an interpreter, and twenty-four Afghan commandos. Each vehicle had a man designated as the vehicle commander, a driver, a machine gunner, and someone to work comms—except, of course, our vehicle, which held only the three of us and our terp. We all wore beards and dressed in patchwork uniforms and local dress with no indication of unit or even nationality. Most of the men wore manjams, free-flowing one-piece robes commonly worn by Middle-Eastern guerrilla fighters and Afghan tribesmen. If I didn’t know better I’d swear they were Taliban. The vehicles were two American Humvees and six Toyota Hiluxes, which looked exactly like those used by the enemy, and the mechanic’s truck. Each vehicle was fortified with ballistic armor and blankets, and carried a camo net that could be pulled over it to disguise it during our daytime lay-ups.
Battle Ready: Memoir of a SEAL Warrior Medic Page 15
