A look into how Ohio airmen train for the unpredictable in their flying hospital

DAYTON, Ohio — Have you ever wondered what it would be like if an ambulance could fly? For the 445th Air Lift Wing, it’s not a ‘what if’ but a ‘where and when’ as it pertains to transporting our nation’s heroes from hospitals and battlefields around the globe.

I was invited to take a flight with the 445th Aeromedical Evacuation Squadron to get a closer look at how Ohio airmen are always preparing for their next mission.

“Within 24 hours I can be ready to go,” said flight medic Madi Potts.

She’s what’s called a traditional Air Force reservist. One day Potts might be in the classroom at her university or working as a nurse. The next day, she could have orders and be in her military uniform working on a C-17 or other type of military transport.

“I just got out of flight medic school for this about two months ago,” she said.

The 445th Aeromedical Evacuation Squadron consists of both full-time military members and reservists. Training is the same for everyone.

On the tarmac at Wright Patterson Air Base, a C-17 Globemaster III sits whirling with activity as airmen work with training mannequins — and live actors — labeled with a variety of health conditions lying on transport litters.

While the pilots are busy readying the aircraft to taxi and takeoff; flight nurses and flight medics ensure patients are assessed and loaded. It’s a well-orchestrated process the airmen of the 445th appear to be able to do with their eyes closed.

Master Sergeant Brenna Pogoy, the mission clinical coordinator, is putting the airmen through a variety of scenarios to ensure the unit remains at the top of its game for when it matters.

“This is nothing like a real world but that’s because you’re not having a fire every flight on a real world, you’re not having an emergency landing all the time,” she said.

But the overload of events is to drive the nurses and medics to the brink of their ability, so they learn to dig a little deeper during an emergency.

“When it does happen and when a patient does have an emergency, or the aircraft has an emergency you are ready and there’s muscle memory in that,” Pogoy said.

The Aeromedical Evacuation Squadron’s mission is broad.

This crew could be called to transport service men and women from different military air bases within the U.S. from Walter Reed Hospital to their hometown hospital or military base, for example.

The mission can also take them near the front lines, most recently in Iraq and Afghanistan, picking up the wounded and transporting them to Landstuhl Regional Medical Center in Germany or other military bases for more treatment before returning to the U.S.

“On the C-17 we can max floor load, we can do 12 on the ramp and another 48 on the main floor,” Master Sergeant Marjorie Butcher said.

That’s a total of 60 patients on litters strapped to the floor at one time with a team of two nurses and three medical technicians providing care throughout the duration of the flight. In addition, depending on the severity of injuries full medical teams can set up a hospital-like setting within the transport planes.

“The Air Force trains us well and they trust us to do our job,” Butcher said.

Then there’s the mission Butcher would deem as unregulated. The unplanned scenario was seen around the world in August 2021 as the U.S. evacuated from Kabul, Afghanistan as part of the U.S. withdrawal.

“My first deployment in the military was to Kabul. That was my first flight ever I’d never flown patients or anything,” Butcher said.

She enlisted in 2015 and received her wings to fly with the Aeromedical Evacuation Squadron in April of 2021, just months before the historic images seen around the world as hundreds of thousands of Afghanis flooded the Kabul airstrip trying to get on a C-17 to freedom.

“I was the last AE flight out of Kabul,” Butcher said.

At least one of those C-17s taking part in the evacuation was photographed with a reported 800 men, women, and children.

Colonel Michael Baker, Commander of the 445th Operations Group, told me that members of his unit on one of those flights dealt with a live birth on the flight out of Afghanistan.

Baker said what happened in Afghanistan was part of several debriefs and analyses on how to improve training and mission preparedness.

In all military training, there are checklists. The pilots go through them step by step and operators like flight nurses and medics within the 445th AES go through them. However, training must also prepare airmen for what’s outside those normal checklists.

“We put a lot of emphasis on what are called contingency operations where we really try to flex and push and challenge ourselves and get outside of the letter of our regulations and say where can we flex,” Major Issac Cade said.

Cade is the flight nurse on this flight and the medical crew director.

“We’ll run different scenarios just to see what happens, stress inoculation,” Cade said.

That stress inoculation allows them to run through multiple scenarios that push the limit way beyond the norms in an environment where it’s safe to do it.

“Ultimately the buck stops here,” he said. “If something goes wrong, we answer for it.”

For Cade, this is another day in the life of a reservist.

“I’m a nurse practitioner for Premier Health,” he said. “So tomorrow I will put on my civvies, my work clothes and then go into the office like nothing happened.”

It’s what tens of thousands of traditional reservists do regularly. Living their daily lives, contributing to the community they live in, ready to drop everything at a moment’s notice to answer the call for our country.

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