First HH-60 Pave Hawk Flight

Flying is an essential task for a flight surgeon. The initial appeal of being a flight surgeon for many of us is the coolness factor with being able to fly in a wide offering of impressive military machines. This alone however isn't the reason we need to fly. Flying gives us a perspective into the mission we are supporting and allows us a first hand view of the aerospace stressors our patients experience on a daily basis. Being able to wear all the gear, be exposed to the elements, and try different things in the back of an aircraft makes us better versed at being able to relate the medical condition to the occupation. We also fly to show face to the aircrew. Flight surgeons wield an unruly tool in our ability to ground and return flyers to flying status. Aircrew are fickle with their trust in medical providers, there is frequent fear that the smallest medical complaint will result in being grounded from flying duties for prolonged periods of time. A flight doc that they know, fly with, and can relate to their job pays back dividends in gaining trust.

I made a priority to get up and fly at least once in my first week with the 210th rescue squadron. Often a flight will involve live fire training with the two 50 caliber machine guns that are on either side of the HH-60 helicopter, when this happens a medical provider, per policy needs to be on the aircraft. Although I need to fly for all the reasons mentioned above, I found the idea of having an actual medical mission on the flight significant and more meaningful.

After looking at the scheduling board of flights for the next couple of days I penciled my name in on a night flight that involved live firing with night vision goggles (NVGs). Night flying is also a term used fairly loosely here in December in Alaska when the sun goes down at 3:30 in the afternoon.

One of my biggest concerns walking into my first flight was not having the proper gear. My time in the Air National Guard had never warranted me being issued cold weather gear, so I came to Alaska with only a fleece and some thermal underwear. The day before my flight I went to the squadron supply guy hoping to at least score some warm gloves. Everyone kept telling me it "get's pretty cold" in the back of the helicopter, issuing this warning were Alaskan natives which only compounded my alarm. When the guns are firing, the windows are open, it's also Alaska, at night, and winter; my mid-weight fleece seemed woefully inadequate.

In the supply room the sergeant issued me an extra thermal shirt and not much else. I tried to show my gratitude, but hid my growing concern. We engaged in some small talk and he realized I was actually attached to the squadron and not just a random doc from the med group looking for a flight. With this realization, he said the phrase I had been hoping to hear, "I'm gonna hook you up." The next hour involved filling up a duffel bag with a full assemblage of the newest and best cold weather tactical gear. This was reminiscent of my deployments with Air Force Special Operations Command while on active duty. Prior to each deployment we would basically be given an allowance for whatever North Face and Patagonia swag we deemed mission essential. Basically, it's good to be part of a well funded unit that can take care of their people.

The afternoon of the flight the weather started to fall apart as it often can in Anchorage. During the crew brief discussions about the flight were overshadowed with the looming freezing fog rolling in. As they planned out the various activities such as aerial refueling and shooting the guns the discussion of training with the hoist came up. Much of the language being used in the brief was a foreign jumble of acronyms and terms I was unfamiliar with. Out of garble came the phrase, "So Doc, you wanna ride the hoist?" Caught off guard by this, I simply mumbled "ya, sure." My enthusiasm and terror about riding a wire down from a helicopter in the alaskan winter was cut short when one of the flight engineers objected to this noting how the inclement weather would make this a poor decision.

About an hour after the brief while waiting to step to the aircraft we were informed that the flight was canceled due to the weather. Thankfully the mission was also set to repeat the next day, so it wasn't difficult to get on that line.

The next day was a repeat of the last, but the confidence in the flight happening was much higher. as the weather was perfect. After the that day's brief, which for better or worse, did not include a hoist-riding offer, we again waited to step to the aircraft. During this time I checked out and tested a pair of NVGs, put on my warm gear, and got some last minute snacks.

There was a casual, but calculated attitude from the aircrew when heading to the hanger. Their demeanor spoke to the fact that they were accustomed to being on alert for the state of Alaska and are one of the busiest rescue squadrons in the world. My only comparison to this was flying with crews in Afghanistan that made complex operations feel as familiar as brushing their teeth.

In the helicopter hanger I loitered around while the crew inspected and prepped the aircraft. One of the things I found enjoyable was the ability to take pictures and even write about the experience. I've been part of plenty of missions in the past that due to secrecy forbid any form of pictures or documentation.

I did what I could to help load bullets and bags before strapping in. By strapping in I mostly mean wrapping a large belt around my waist that was tethered to the floor, and sitting on that same floor. There are no seats in the back of the helicopter, so any available real estate on the cold floor was what you get. I brought a medical bag with me that I secured to the floor next to me that made for a nice arm rest.

It didn't take long for me to understand the occupational stress on the neck and upper spine from wearing helmet and NVGs. Almost immediately I had sympathy for the SMAs in the back of the helicopter. SMA is a newer term for Special Mission Aviator that groups together the former designations of aerial gunners and flight engineers. These guys often have a variety of tasks in the back of the helicopter: shooting, scanning out the windows, operating the hoist, and tending to various cargo are all within the responsibility of the SMA. It's easy to see how this could be cumbersome with a 20 pound lopsided brick on your head.

The first objective of the night was to link up with the C-130 for aerial refueling. The trees and mountains of the Alaskan landscape glowed a phosphorescent white through the NVGs as we buzzed rivers and lakes heading to the intercept point. Watching the helicopter link up with the gas hose of the C-130 through NVGs was a bit like watching a video game. It was cool to see how it all came together.

In the fuselage with me was another pilot. Before heading to the shooting range the intention was to make a stop and switch out pilots so he could fly. To accomplish this they simply just put the bird down in a snowy field, got out, and changed seats Having really only flown in fixed wing aircraft this was a pretty amazing feat; to be able to just land in whatever field they wanted, jump out, and rotate drivers. The helicopter has giant skiis on the bottom so landing in a depth of snow was not a big deal, this didn't however help the pilots when they jumped out into thigh deep snow.

The shooting range that we headed to next was a long strip of land on the Army side of the base. Set up on this strip were several abandoned vehicles that served as targets. Before we engaged with these targets we dropped a chem light to the ground close to the tree line. The chem light represented the friendly hostage we needed to rescue. It seems a common training scenario for combat search and rescue is to neutralize a threat and then perform a rescue.

With the hostage in place we started making fast paced runs at the targets. In planning for the mission I heard this referred to as the 'racetrack' which now makes more sense. We raced into the the target area opened up fire with the guns and then quickly circled back around for another pass. It was an incredible thing to hear, feel and see. The 50 caliber machine guns have been a staple of US military firepower since WWII. I was told prior to the flight that someone once looked up the serial numbers on the guns, and a couple of them were even in service during WWII.

After the targets were destroyed we flew back over the chem light and simulated rescuing it by dropping down the hoist. Although no-one rode down the hoist it was still good practice. This was an operation in aerial precision that again showcased the capability of the helicopter as the SMA announced that he had touched the chem light with the hoist: Incredible!

As we floated back to and landed at Joint Base Elmendorf-Richardson I felt a sense of mixed excitement and gratitude about my new assignment with this unit. I just experienced one of the best flights of my flight surgeon career. It's going to be awesome to see what other adventures being part of this unit will bring while exploring the low level skies of Alaska.