CHARLESTON AIR FORCE BASE, S.C. –
Deep in Afghanistan a soldier is quickly placed on a litter by his comrades. With severe leg fractures, wounds to his abdomen and a head injury, he is loaded onto a U.S. Army Blackhawk Helicopter. Needing surgery that is unavailable at his forward operating base, the soldier is bound for a location halfway between his operating base and Bagram Air Base, Afghanistan. Critical moments later and back on the ground, he is surrounded by dust and other flying debris during his transport from the Army Blackhawk to a U.S. Air Force Pave Low Helicopter. This is where he meets a dedicated, focused and dirt covered technical sergeant charged with keeping him alive and stable until he reaches the operating table at Bagram.
Under pure darkness, the sergeant, with the aid of night-vision goggles, meets the aeromedical team on the Blackhawk, receives the patient's medical description and vital signs and secures the soldier in his new helicopter. In the air he will be all the soldier has between life and death.
Tech. Sgt. David Peacock, a medical technician assigned to the 315th Aeromedical Evacuation Squadron, remembers this night all too well.
"He was on a ventilator, monitors and heavy IV drips," said Sergeant Peacock. "His oxygen stats started dropping. I had to do medical interventions in-flight to keep him alive."
In addition to the unstable patient, the flight itself was a threat all its own. The mission occurred under complete darkness to avoid enemy fire. Since Operation Enduring Freedom began, terrorists have often tried luring rescue helicopters into an area only to attack them once they landed. This reality doesn't stop Army and Air Force units from risking their lives to rescue others.
"We knew we had a young American kid's life in our hands," said Sergeant Peacock. "The pilots really pushed the helo's limits to save him."
As a medical technician assigned to the 33rd Rescue Squadron, Kandahar Airfield, Afghanistan, Sergeant Peacock cared for American and Coalition troops. He often had to adapt any way he could to keep patients alive. On one mission specifically, he taught a gunner to pump an oxygen bag while he attended to malfunctioning equipment, which in the end, saved the patient's life.
These medical evacuation missions are appropriately termed "Dustoff." This radio call sign was first used during operations in Vietnam. Since the country was at times dry, medical teams and their aircrews would often get covered in dust and dirt due to the helicopter's rotors stirring up debris. So, throughout the conflict, evacuation helicopters were given the Dustoff call sign along with a number. To this day, the term has stuck. However, there is a major difference in today's Dustoff missions and those of the past.
"On a standard Dustoff you have a red cross on the helo, but when you put a gunship in the mix you are legally a combat target," said Sergeant Peacock. "It is a different midset; you realize you are a free open target."
In addition to his medical duties, Sergeant Peacock and other medical technicians like him act as back-up gunners. When not caring for a patient and armed with an M-4 carbine assault rifle, he was charged with watching the tail of the helo.
"I've seen many helos come back with holes in them," he said. "We were shot at many times."
On low-illumination nights, when the moon is half-full or less, the Army Blackhawks are unable to fly. On these dark nights, the Air Force Pave Lows fill the flight role for aeromedical evacuations. Additionally, the Air Force helos acted as the wingman for the Army special operation helicopters on other missions. Sergeant Peacock provided extra gunner support on these missions as well, which gained him a new appreciation for flying in a mountainous terrain.
"We were three feet from a mountain ridge," he said. "I'd have to watch up and down because of how the ridges are. It is an impressive feat to do that kind of mission. It's a dance, it's a waltz in the mountains."
No matter what the analogy, reminders of the risks were all around.
"We would see memorials in the alert room of medics who've given their lives," said Sergeant Peacock. "It reminds you of how dangerous it is to be a flight medic out there."