10th Mountain medical officer receives inaugural 'Ditch' award in Afghanistan

FORT DRUM, N.Y. -- For Army medics, lifesaving measures for wounded comrades must be fast and instinctive, tactics and techniques so effectively hammered in classrooms and training lanes that instructors refer to the desired effect as "muscle memory."

Being that such capabilities are so crucial, officials with U.S. Central Command's Joint Theater Trauma System (JTTS) recently created the Ditch Medicine Award to recognize excellence in casualty care compliance and leadership in the world's most dangerous settings.

A 10th Mountain Division (LI) Soldier described by supervisors and subordinates alike as caring, genuine and "user-friendly" has been named one of the award's inaugural recipients.

Capt. Russell Burnham, battalion physician assistant with 1st Battalion, 32nd Infantry Regiment, 3rd Brigade Combat Team, received the honor Jan. 23 during a ceremony at Assistance Platform Airborne in eastern Afghanistan.

He is the U.S. Army's first recipient of the "Ditch" award.

"Doc Burnham is the best PA I have ever seen," said Lt. Col. Theo K. Moore, Task Force Chosin (1-32 Infantry) commander. "This is just one more indication."

The recognition was well-deserved, added a physician at the brigade level to whom Burnham also reports.

"Capt. Burnham is a phenomenal physician's assistant," said Maj. Nathan K. Friedline, Task Force Spartan's brigade surgeon. "I could have predicted the outcome of this, because he is that engaged to figure out problems before they develop."

'Blessed with a team'

Burnham, whose military career began in the enlisted ranks as a medic in 2001, provides for the primary care of hundreds of Soldiers at AP Airborne and for the emergency care of some 1,000 others.

According to the citation, he was singled out for his role in ensuring his battalion medics were compliant with medication and treatment recommendations associated with DOD's evidence-based Tactical Combat Casualty Care Guidelines.

A survey conducted by JTTS of 22 outlying "Role I" battalion aid stations found that Burnham's medics not only complied with the guidelines but also completed advanced levels of training that demonstrated superior skill with medical techniques that far exceeded standard medic training.

"This action not only improves combat casualty survivability on the battlefield but also endorses the trust and competence of the Army medic," said Maj. John B. Robinson, JTTS pre-hospital coordinator who helped coordinate the assessment.

According to JTTS, the Ditch Medicine Award represents excellence in the care of the wounded, rendered under the most austere conditions on the most far-flung outposts and dangerous ditches on the globe.

"To be identified as No. 1 in all of Afghanistan, that is a pretty big deal," said Sgt. 1st Class Joseph A. Belt, platoon sergeant with Medical Platoon, Headquarters and Headquarters Company, Task Force Chosin.

As encouraging as it is to be recognized as a leader in casualty care on the front lines, working alongside Soldiers who know the importance of each passing second -- often the difference between life and death after the point of injury -- continues to be what most drives Task Force Chosin's top medical officer.

"I've been blessed with a team of highly qualified and committed medical professionals who understand what's at stake," he said. "This award just helps prove that."

Burnham said he was also happy to see Army Achievement Medals go to eight of his medics as well as 2nd Lt. Veronica Vazquez, HHC Medical Platoon leader.

"I think their level of commitment is what separates them and makes them such amazing people," he said. "They are great Soldiers."

Burnham credited many others for his success as well. In addition to "tons of support" from his battalion commander and brigade surgeon, he said his platoon sergeant has been a tremendous asset, bringing "invaluable information" with him from multiple combat tours as a medic.

For his part, Belt explained that training hard helps save lives.

"We rehearse, rehearse, rehearse and rehearse some more," he said.

Afternoons for Burnham's medics are packed with everything from learning about the most recent trauma literature to tirelessly repeating simulated casualty drills. They receive additional training as essential players during regular base defense exercises at AP Airborne.

Mass casualty events help medics test their instincts on patients who simulate amputations, burns, broken bones and bullet wounds.

"Our battalion commander was very impressed when he saw Capt. Burnham and the medics during these exercises," Vazquez noted. "He said he felt very comfortable knowing that Soldiers would be taken care of."

Burnham also holds classroom instruction on emergency medicine, anatomy and pathophysiology, explained Sgt. Carolyn N. Watts, medical treatment noncommissioned officer with HHC, 1-32 Infantry. Elaborating on subjects down to the cellular level, Burnham does not move forward until everyone understands each ailment and the corresponding treatment, she said.

"He teaches simplicity and common sense. His philosophy is 'See one. Do one. Teach one.' When he feels it is understood why, when and what is being done, we teach the next (class)," Watts said.

Burnham also helped ensure his medics were knowledgeable about the drugs they carry by writing an exam to test them in everything from dosage and route of administration to side effects and contraindications.

Analgesic drug recommendations point to using the newer, more tested ketamine for pain control over morphine, which has been around since the Civil War, Burnham said.

"Very few studies have been done showing the efficacy of morphine," he said. "We just used it for so long that it had become doctrine. But ketamine is now the go-to drug for pain in combat."

JTTS's second in command noted that it takes bold leadership to implement any change at any level.

"Capt. Burnham has exemplified this type of leadership," Robinson said. "And it is in keeping with JTTS's mission to improve survivability of combat casualties on the battlefield."

'Chosin' leader

Burnham received his commission three years ago. He moved his family from Hawaii to Fort Drum and assumed his first physician assistant role with 1st Squadron, 89th Cavalry Regiment, 2nd Brigade Combat Team.

After joining 1-32 Infantry last year, Burnham sent some medics down to University Hospital in Syracuse to train in the emergency room there. In addition, he volunteered to work as an instructor at Fort Drum's Bridgewater-Vaccaro Medical Simulation Training Center, later bringing his medics to the facility for a week of intense training before deploying.

"Capt. Burnham has always been an avid proponent of the Fort Drum MSTC and its curriculum," said Capt. Martin L. Stewart, officer in charge of the Bridgewater-Vaccaro Medical Simulation Training Center. "Before deploying, he put in the long hours training at our facility to ensure his medics' competency in all aspects of Tactical Combat Casualty Care."

In Afghanistan, with his medics well-equipped to handle anything thrown their way, Burnham looked for ways to do more. Since it is estimated that some 97 percent of casualties on the battlefield are treated by nonmedical personnel first, he said medic-trained line units could provide one of the greatest chances of survival for Soldiers severely wounded in remote areas of Afghanistan.

"So that meant we had to start taking the information to the people," he said.

Burnham is now in the process of personally training every battalion Soldier in emergency first aid that would most likely be rendered in an assault on AP Airborne, which was last attacked with rockets that killed two civilian contractors.

While ensuring battalion assets are trained, Burnham has also offered to train the civilians on his outpost.

Soldiers under him say it is very natural for Burnham to worry about others.

"He spends his time either talking about his wife and five kids or mentoring us to be better medics," Belt said. "He has genuine concern and care."

Vazquez noted that Burnham's unexpected recognition last month reflects his humble leadership and relentless commitment to improving combat casualty care.

"His hard work and dedication as our PA are evident in his passion for providing the best care possible to each and every Soldier," she said.

"His passion for medicine and teaching others is contagious in the best way possible," added Watts, who was inspired to re-enlist in the Army under Burnham's leadership. "I cannot say enough good things about his excellence.

"Having worked with him for only a few months before deployment, I have learned more from Capt. Burnham than any other medical provider."