Mountain Medicine Course

Review of the Military MMED Course.

Phase Three: FEX

Earlier that week the instructors gave a WARNO (Warning Order) brief detailing the scenario for our final practical exam – the Field Exercise (FEX). Our mission as a combined medical support team was to assist the “South Toiyabe Army” and the associated 24th MEU with any medical requirements and MEDEVACs. Our enemy – the “North Toiyabe Army” (read North Koreans) – were infiltrating small units across the border who were engaging in irregular warfare, attempting assassinations, and disrupting any vulnerable infrastructure. We spent the rest of that evening studying topographical maps and satellite imaging, planning our movements, packing our gear, establishing our callsigns, ensuring our communications were functioning, and mentally preparing for the next few days. For the FEX,  we added more team gear to our load: radios, SKEDs, Medbags, squad rope gear, and all of our climbing gear.


Early the next morning, we loaded onto two large transport trucks which then drove up the mountainside and deep into the Toiyabe National forest where they inserted us at a pre-established Command Post (CP). After another short brief, we formed into tactical files and began our trek across the mountains to our next CP. Due to forest fires in the vicinity, we established a defensive perimeter at an alternate CP near a lake, collected water for the group via our filter systems, and then built ad hoc shelters for the night utilizing survival training from earlier in the course.

After establishing our camp, we were tasked with a CASEVAC mission and given the ten digit grid of the injured servicemember. Utilizing our topo maps, land navigation, and a GPS backup, we located the individual about 700 meters away up a steep mountain ridge. After stabilizing medically, we began the extrication process with a SKED and our lowering system. The height of the ridge required constructing the lower system multiple times and slowly relaying the injured man down the slope in phases. But after a few iterations, we established a routine and became much more efficient. After a debrief back at our camp, we settled into our shelters for the evening and established our night security with roving patrols.


The next morning we were awakened by the sharp bark of radio traffic, another large enemy force was detected by an ISR (Intelligence, Surveillance, Reconnaissance) platform and appeared to be heading in our direction. At this point, we realized that whenever the instructors thought we were moving too slowly or needed us to move in a different direction, they would create an imaginary enemy force that was about to descend upon us and wreak havoc. So, we quickly packed our gear, dismantled our shelters, and again marched off in tactical files hurriedly up and over a neighboring ridge line.


The surrounding scenery was breathtaking, each moment we paused, the mountain wind and eery silence and austere beauty enveloped us. We spent the first half of the day climbing up and down the mountain slopes dodging the enemy force behind us, but we were eventually ambushed and sustained casualties. Thankfully, the casualties were ambulatory, so we cross-loaded their gear and walked them down the mountain to an open field where they were “MEDEVACd,” and then put back into play. We were getting good at our movements, navigation, communication, and medical care so the instructors began inflicting casualties on our leadership disrupting our groove and forcing others to assume leadership roles.


After a brief break in that valley, we were assigned another CASEVAC mission. A friendly unit had taken casualties nearby and needed medical assistance. Their location was only a few hundred meters away, but nearly straight up a massive ridge on the opposite side of the small valley. So again we began our trek. At ten thousand feet in elevation, loaded down with gear, and with the steep grade, we slowly meandered up the ridge taking one or two steps before pausing momentarily to catch our breath. It took more than an hour to reach the ridge line and find the casualties, but we again began the CASEVAC process. We tended to medical needs, wrapped the injured snugly in the SKEDs, found sturdy trees for anchors, assembled our lower systems, and began to carry the casualties back down the mountain. The height of the ridge forced us to relay the casualties down the slope, build another lower system, and begin lowering again. We repeated this process half a dozen times before reaching a grade that allowed us to just carry the litters. After crossing a large boulder field and a small stream, we arrived at the MEDEVAC landing zone (LZ), but the instructors informed us that we were too late and the LZ had changed locations to another 1500 meters down the road.


At this point it did not matter. We were exhausted, caked in dirt and sweat, but quickly assembled our squads and raced down the road with our two casualties in order to make the LZ in time. At least we were on level ground, the easiest litter carry ever. We again made rapid transitions, pushed hard for about 100 meters, then switched the litter teams. Each squad was flying, we had refined our process to an art, and were at the pinnacle of functioning for that course. We could see two large transport trucks in the distance, and methodically and rapidly moved in their direction. After arriving at the LZ, the instructors informed us that the transport trucks were there for us and the FEX was terminating a day early due to the approaching forest fires. They had pushed us extra hard that day since we were stopping early. After a short debrief, we loaded onto the trucks and headed back out of the mountains to our squad bays and the schoolhouse. That last drive down the mountains was beautiful, absolutely beautiful.


The last two days were admin days that allowed for graduation, turning in all of our gear, cleaning the squad bays, and preparing for our return home. The surrounding forest fires prevented most travel, but some were able to escape to Yosemite and other surrounding unique tourist sites. On the last day, we were given course certificates and then separated heading in all different directions. What a cool 18 days.


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