KANDAHAR AIRFIELD, Afghanistan - In any game plan, success requires time, focus and consistent mental and physical effort from every one of the players. A team with heart and the same end in mind can counter just about any offensive that comes their way.
The Role 3 Multinational Medical Unit at Kandahar Airfield, Afghanistan, is such a team. Their patients' well being is their central focus, and they strive to prepare for everything the battlefield of Afghanistan gives them.
"We're really good at what we do here," said Lt. j.g. Trosper, a native of Petaluma, California, who has served Role 3 MMU as an intensive care unit and trauma nurse. "And we strive to get our patients through our continuum of care as fluidly as possible."
The constant care provided by Role 3 has been tested many times. However, there is a day that the Role 3 team will remember for years to come, and their performance that day will be remembered forever by those they treated.
Capt. Mary E. Neill, a Baltimore, Maryland, native who serves as commanding officer of the NATO Role 3 MMU hospital described the scene March 30, 2014, when a Romanian security element serving with the Black Scorpions was conducting a mounted patrol near KAF and was suddenly struck by an improvised explosive device.
"One Romanian soldier was immediately taken by the blast, another was critically wounded with an arm amputation, and the other four had injuries as well, of varying severities," Neill said. "They received immediate care from the medics and were immediately medevaced here."
Lt. Cmdr. Dan Grabo, a native of Pittston, Pennsylvania, who serves as a trauma surgeon and chief of trauma for the Role 3 MMU, recalled the situation as the "page that you don't want to get. We are built to be a trauma hospital, that's what we do. However, we don't want it to be a situation that is a mass casualty (event) that overwhelms our capabilities."
When the medevac helicopter landed, a litter team was rushed to get the Romanians off the litter and into the ambulance, which took the casualties directly to the emergency bay for triage and care, Trosper explained.
As chief of trauma it was Grabo's job to triage and coordinate appropriate care for the wounded Romanians.
"We kicked right into action; it was a great team effort," Grabo said. "With everyone doing their job at each station, taking care of the patients as they came to them, it made my job very easy."
During triage outside the emergency room, it was evident that one Romanian soldier who had all but lost his limb in the blast would need immediate care.
"When this patient came in, he had a very ashen look to him and we all became very concerned," said Cmdr. Josh Tobin, a Los Angeles native who serves as the department head of anesthesiology and critical care at the NATO Role 3 MMU. "So we immediately put in a breathing tube in less than a minute of him arriving at the trauma bay. The corpsman and surgeons were simultaneously working on getting him exposed and finding a good site for an IV."
After the trauma team had worked on the wounded soldier for a brief time, it became necessary to try a different approach.
"Unfortunately, he had lost so much blood from his wounds that his heart actually stopped," Tobin said.
With a flat-lined patient in the trauma bay, the doctors had every indication they needed to perform a very invasive lifesaving procedure.
"It required the most aggressive and invasive procedure you can have in the emergency department," Grabo said, "a resuscitative thoracotomy, which is cracking the chest, cross clamping the aorta so the blood only goes to vital organs such as the brain, heart and lungs, and then pumping the heart by literally squeezing it."
Just a short while into the procedure, the trauma team achieved what they set out to do, which was getting the patient's pulse back, Grabo said.
"In that moment, we immediately took him to the operating room for damage-control surgery for his arm and other concerning wounds in his leg, abdomen and pelvis."
While all of this was going on, the Role 3's other trauma teams were simultaneously taking action to ensure all of the other casualties received the care they needed.
"Amongst the chaos, the other trauma teams were giving me information on every other critically-injured patient," Grabo said. "We were sending them to the imaging scanners to get more information, and to the intensive care unit, while we went to the OR with this really sick guy."
Grabo explained after damage-control surgery was administered to the most critically wounded patient and everything was under control, they got him into the recovery room and on to the intensive care unit in a very successful and timely manner.
Lt. Cmdr. Sean Conley, a native of Doylestown, Pennsylvania, who serves as an emergency physician and department head of trauma for NATO Role 3 MMU, reflected on the team effort that took place that day.
"It's a reminder of the resiliency of the human body," Conley said, "and it's amazing what you can do when you have the right tools and the team that works with efficiency to make it happen."
"It was the first time our team had seen a patient come in straight from the point of injury and only having tactical field care administered by a field medic," he said. "It was awesome to see how well the team reacted to a new situation."
Collectively speaking on behalf of the team, Lt. Cmdr. Ashley Humphries, a native of Palm Beach, Florida, who serves Role 3 MMU as a trauma surgeon, said that saving lives is why they are here.
"We all come from very different backgrounds, whether civilian or active duty military, but we're here for a purpose," Humphries said, "and that purpose is to take care of our coalition troops at a moments notice."
Sadly, not all Soldiers can be saved. To commemorate the fallen Romanian Soldier who died that day, the NATO Role 3 MMU team conducted a solemn ceremony in respect of their sacrifice.
"Any time that we have any coalition or U.S. Soldier die in our facility, which is very rare, we have a dignified transfer so that we can all render honors and dignity to our fallen warrior," Neill said. "It was quite moving for the Romanian soldiers."
Neill explained that two of the wounded Romanian Soldiers were able to stay behind and go through the Role 3's physical therapy program until they were able to go back to their duties. The remaining three were shipped forward to Landstuhl, Germany, and eventually home.
Six member of the trauma team were awarded the Romanian Medal of Honor for their actions that day, and the whole team was recognized for their lifesaving efforts. The NATO Role 3 MMU was awarded a framed certificate from the Romanian army that reads: "For your professionalism, commitment and effective work with a decisive impact in saving our servicemen's lives. Your great devotion, compassion, and friendship shown to Romanian allies, were the last barricade in front of death, darkness and desolation. Our endless gratitude for your firm hands, brilliant minds and beautiful souls. God bless you all."