The Air Force's Special Operations Surgical Teams: Saving lives in the line of fire

When most people think of special operations units, they tend to think of Navy SEALs, Delta Force, or Green Berets. In the minds of many, particularly our nation’s enemies, America’s Special Operations forces have earned a reputation as the most capable war fighters on the planet, able to train friendly foreign nations, take on missions no others could, and in the simplest possible terms, deal death to those who would stand against our nation and its interests.

Not all special operations units deal in death however, and for many that have been injured in combat in recent years, there’s one special operations unit that represents something completely different: another chance at life.

The U.S. Air Force Special Operations Surgical Teams (SOSTs), like other units that fall under the command umbrella of SOCOM, are made up of some of the best and brightest medical staff in the U.S. military. These highly trained teams carry the latest in life-saving field equipment intended to permit them to follow America’s elite war fighting groups like the SEALS, Rangers, and others into austere and high threat environments, all while providing advanced levels of care with a significantly smaller tactical footprint than conventional surgical assets. Each SOST is almost like a mobile trauma center, complete with modular load outs intended to help best prepare them to treat the types of casualties they may expect from a specific operation.

This ability to rapidly deploy to high risk environments and provide life-saving care to those injured in combat has meant many of America’s war fighters who would have otherwise died in the field or en route to treatment, are still alive today thanks to the bravery and hard work of men like Lt. Col. (Dr.) Benjamin Mitchell, an SOST surgeon who was awarded the 2017 Heroes of Military Medicine Award this past May for his life saving work while deployed in support of operations Inherent Resolve, Resolute Support and Enduring Freedom.

Just how important has Mitchell’s work been to Americans on the ground? The numbers speak for themselves. Throughout his deployments, Dr. Mitchell is credited with conducting or treating 414 trauma evaluations, 141 gunshot wounds, 270 blast injuries, 102 damage-control resuscitations, 51 chest tubes, 21 intubations and 15 urgent surgical operations. Those numbers are not only stunning, but represent hundreds of American troops that were given a chance at survival thanks to Mitchel, and his SOST team’s, hard work.

Lt. Col. (Dr.) Benjamin Mitchell (top left) along with his Special Operations Surgical Team

Battlefield surgical capabilities are decisive to mission success, and Mitchell is absolutely representative of the professionalism and skill required for the mission,” said Lt. Col. Travis Woodworth, the 720th Special Tactics Group deputy commander. “When you combine SOST’s close proximity to combat and crisis with the ability to conduct high-level surgical operations, it does more than save lives: it builds relationships with the local population, combats Da’esh rhetoric and military effects, and provides the ground forces psychological stability, knowing they will be taken care of quickly if they’re wounded.”

Each SOST is comprised of six team members: an emergency physician, general surgeon, nurse anesthetist, critical care nurse, surgical technician and respiratory therapist. This makeup, combined with highly specialized training and equipment, allows the SOSTs to offer four distinct medical capabilities in theater: advanced trauma resuscitation, tactical damage control surgery, post-op critical care and critical care evaluation.

In other words, they offer just about everything one might find in a more formal theater surgical hospital, but they do it in such close proximity to the worst kinds of fighting, that they are able to treat wounds, and save lives, that would otherwise be considered a lost cause to those tasked with combat triage.

An SOST operating room set up during training.

In one such incident Mitchel recounted, a local that had been fighting alongside U.S. forces arrived in their makeshift operating room with a serious gunshot wound through his collar-bone. The man was bleeding to death, but because of the heavy flow of casualties they had been treating throughout the previous few days, they had run out of blood to transfuse into the patient to keep him alive. There was no way to get a resupply of blood in time, so Capt. Cade Reedy, who works with Mitchell at University of Alabama at Birmingham, quickly chose to draw his own blood to save the wounded fighter.

Our team was so well-trained and focused; we controlled the bleeding, got him in surgery and saved his life,” said Mitchell. “Ten days later that guy walked into our tent and thanked our team … it was incredible and rewarding.”

“In SOST, you get to work with some of the best medical care providers in the military,” said Mitchell. “We operate at a high level of readiness and focus, and my team reflects the highest professionalism under extreme conditions.”

Of course, being so close to the fighting guarantees SOST members see the very worst of what combat can do to human beings. As is the case in any special operations team, SOST crews eventually develop a thick skin when it comes to treating the wounded, but even for people like Dr. Mitchell, some things can still be difficult to handle emotionally.

I specifically remember one of the pediatric mass casualties. We got through all the patients and got them transported out and two of our team just broke down crying. Sitting there, spent. Sometimes being the team leader I was more worried about having that responsibility of keeping the team functioning.” Mitchel said.

These special operations Airmen are among the best-equipped and most highly-trained combat medical staff to be found anywhere on the planet. Like any special operations unit, it takes a particular kind of person to have the mental, emotional, and physical toughness required to make the team, let alone to save lives in the most hostile environments imaginable.

This last deployment took a lot out of my team physically and emotionally because of the high level of casualties we saw,” said Mitchell. “I am really proud of my team. The professionalism and courage those guys showed, pulling off a stellar mission and saving a lot of lives.”

Images courtesy of the U.S. Air Force