Theodore's World: Because We Never Forget "Military Medical Team Makes the 'Toughest Call'

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July 03, 2009

Because We Never Forget "Military Medical Team Makes the 'Toughest Call'

Pfc. Channing Moss, far right, stands on a hilltop in Afghanistan in February 2006 with his Alpha Company squad from 2nd Battalion, 87th Infantry, 10th Mountain Division, from left, Sgt. Harold Jarrell, Spc. Collin Reynolds, Cpl. Kirill Tikhonenkov, Spc. Justin Randall holding a rocket-propelled grenade launcher, and Pfc. John O'Brien. Moss was wounded the following month when, during an ambush, he was impaled with an RPG.


A fellow soldier was impaled by a live RPG. For medics and a helicopter crew, there was only one choice.


Military Medical Team Makes the 'Toughest Call'

Unexploded Rocket-Propelled Grenade Impales Army Private in Afghanistan

Thursday, March 16, 2006, was a beautiful sunny day in Paktika Province, eastern Afghanistan -- the front line in a half-forgotten war. It borders a lawless region of Pakistan that is home to some al Qaeda and Taliban forces. Snow in the mountain passes along the border had melted giving them access again to Afghanistan where they came looking for American soldiers. They soon found them.

At dawn, the 10th Mountain Division's Alpha Company headed out on a mission. Lt. Billy Mariani, the unit commander, noticed something about his troops.

"There was definitely a sense of uneasiness. There was an air about them of, you know, maybe something was going to happen," he said.

The convoy included some two dozen 10th Mountain Division soldiers mounted in five armored Humvees and a handful of Afghan National Army troops riding in a pickup truck. Their mission was to visit a remote village to meet the tribal elders. No roads existed in this no-man's land and they had to drive through waddis, dry narrow river beds with high, dangerous ground on either side.

Four hours into the drive and just miles from the village, gunfire broke out. They'd been ambushed from above. Twenty-three-year-old Pvt. Channing Moss, the gunner, said it sounded like rattling spoons.

Then came the big guns. Volleys of rocket propelled grenades rained down. The Afghan National Army pickup exploded. Two of the Afghan soldiers died.

One RPG skidded past Lt. Mariani's vehicle. All of the vehicles had to quickly get out of the "kill zone." But before they could get to safety, two rockets hit Pvt. Moss' Humvee.

Staff Sgt. Eric Wynn, 33, the soldier in the front passenger seat, felt one slice through his face. Moss remembers the truck practically lift up. He was thrown up against the Humvee and then moved to return fire.

"I smelled something smoking and I looked down ... and I was smoking," he said.

Wynn turned to tell Moss where to fire and saw the tail fins of the RPG sticking out of Moss' side.

Roughly the length of a baseball bat, an RPG travels at the speed of a bullet. At the front end is the warhead -- a large grenade. The detonator and fuel are contained in the shaft. On the back are its fins, pieces of metal that stick out like legs on a camera tripod. The RPG is the weapon of choice for many of the world's guerillas.

Luckily for Moss, the company medic Spc. Jared Angell, 23, who the soldiers call "Doc," was in his Humvee. With Alpha company still under fire, it would have been nearly impossible for Angell to get to Moss in time if he hadn't been close by.

A Human Bomb

The RPG that had plowed into Moss' lower abdomen stretched from one hip to the other. If the RPG went off, it would kill everyone within 30 feet of him. Yet Angell stayed close, bandaging his wounds and stabilizing the weapon so that movement wouldn't cause it to explode.

Moss was still fully conscious, so Angell ordered him to not look down at the injury. He didn't want Moss to panic.

"I'm gonna do everything I can," Angell said to Moss. "You keep fighting with me and I'll keep fighting with you."

Wynn held his wounded face together with a bandage and reported their casualties over the radio while he also reached for Moss' hand.

He was squeezing my hand ... making sure I was staying alive," Moss said.

Reports of injuries had been radioed to the medical evacuation helicopter (MEDEVAC) base in Salerno, Afghanistan -- minus one crucial piece of information.

"We didn't tell them that, you know, Moss had live ordnance in him," Mariani said, "because there was that possibility that, you know, they might not want to transport him with live ordnance in him."

Preparations began for the rescue mission. But first the Blackhawk crew had to wait for clearance from commanders because the area was "hot" -- the battle was still raging. For MEDEVAC crew chief SSG Christian Roberts, it was a very long 15 minutes.

"When you know you have wounded people out there that are waiting for you to come pick them up, it seems like an eternity," he said.

The firefight died down and Mariani went over to check on Moss. Even though he was stunned by the fins sticking out of him, Mariani said, "I grabbed his hand and I just said, 'Hey, buddy, we're gonna get you out of here.'"

"Doc" continued working frantically to stabilize Moss even though the RPG was a danger to everyone around Moss. He knew that his only chance for survival was to get out of there and to a hospital quickly.

"I constantly was looking at my watch, saying, you know, 'When is the bird gonna get here, when is the bird gonna get here,'" medic Doc Angell said.

When Lt. Mariani pulled "Doc" aside to ask him if he thought Moss would make it, he could only shake his head no.

If Pvt. Moss was to not survive his injuries, his wife, six months pregnant with their second child, would lose her husband and his daughter Yuliana would lose her father. But just as Moss felt he would die, he heard the chopper. An Apache helicopter escorted the MEDEVAC chopper in case there was more gunfire.

Spc. Collier, the flight medic, quickly realized what they faced with Pvt Moss.

"I see a metal object protruding out, and there are fins on it, and I am like, 'This looks like this guy got hit with something, and it's stuck in him, and it didn't blow up,'" he said.

Army policy states that they are not supposed to transport soldiers in Moss' condition. The risk of catastrophic loss is too great -- four MEDEVAC crew members, three wounded soldiers and a helicopter could all be blown out of the sky.

But they also knew if they didn't take Moss. he would die.

Pilot CW2 Jorge Correa conferred with his soldiers: "I asked my crew, you know, 'Are you guys comfortable with this?'" he said. "Because I wasn't gonna put my crew in jeopardy if they weren't comfortable with it."

The crew quickly decided to take the risk.

Co-pilot Jeremy Smith recalled the tense moment.

"We all said, 'Yeah, let's get him on board and let's get outta here,'" he said.
As crew chief Christian Roberts said, "We are not gonna leave a U.S. soldier to die in the middle of Afghanistan."

Past the 'Golden Hour'

The MEDEVAC helicopter flew over mountains fully loaded with Moss and three other wounded, racing the clock. Moss' best chance of survival was to get advanced medical care within one hour of his injury. Trauma surgeons call it the "golden hour." But Moss' had already ended.

Radio dispatches let the trauma team know that they had one critical patient coming whose blood pressure was dropping and heart rate was dangerously high. But reports of the true nature of Moss' injury had not reached the closest medical facility at the Orgun-E base -- a former goat shed transformed into a rough field hospital. They were told it was "shrapnel injury." The aid station had two doctors, Maj. John Oh, a general surgeon, and Maj. Kevin Kirk, an orthopedic surgeon. At this point it wasn't clear which Moss needed most -- a surgical team or a bomb squad.

It was only when Oh started cutting away all the bandages that "Doc" Angell had delicately wrapped around the RPG that he saw what they were facing.

"It had fins coming out of the left side of his body and had a big bulge in the front of his right thigh," Kirk said.

Still conscious, Moss remembers the faces dropping in shock as they took in the sight.

Incredibly, both Oh and Kirk had drilled for this exact scenario, because the Army has a protocol to handle patients with unexploded ordnance in them.

"You're actually not supposed to bring them into an aid station," Oh said."And actually, he wasn't supposed to be flown with the other patients either."

According to the "War Surgery Manual," Moss should have been placed far away from other patients and operated on last. If procedure had been followed, Moss would likely have bled to death, but the doctors felt compelled to save him.

Then Pvt. Moss had another life-saving break -- Staff Sgt. Dan Brown, the explosives expert who spends his time disposing of bombs and captured weapons, was on the base. In his spare time, Brown had been watching an episode of ABC's "Grey's Anatomy" about a patient with an unexploded grenade in him. In that story, the bomb technician is blown up. Brown was about to play a leading role in his own non-fiction drama.

Brown was shocked to see that Moss was still alive. Most of the time his patients are deceased. Brown confirmed that they were dealing with an RPG. Moss' life hung on whether or not they would remove the rocket.

Brown explained the different scenarios of what could happen. The worst case was that they would all become "pink mist" -- everyone in the room would be killed. But to identify how much explosive power they were facing, they needed an x-ray to determine whether the RPG's warhead was inside Moss. Their notoriously temperamental x-ray machine malfunctioned, and it wasn't until the third attempt that they got a decent image.

The doctors and Brown were relieved by what they didn't see. The deadliest part of the RPG -- the main explosive charge -- was not in Moss. But their relief diminished when Brown explained to the surgeons that it would still have enough force to kill Moss and destroy their hands.

At that point, Oh ordered everyone except the critical staff out of the aid station, the two doctors and three surgical staff remained. They all knew the risk they faced.

"I looked everybody in the eye and said, 'You guys understand what's going on here, right?' And I knew everybody heard me, but nobody said anything. They just kept doing their jobs," he said.

Oh told them it was okay to leave -- but nobody did. With no words exchanged, each had decided to risk their life to save Moss.

Extreme blood loss had caused his heart to stop. Unable to do chest compressions for fear of setting off the round, they gave him epinephrine. His heart soon restarted and they could finally operate to remove the RPG.

Sgt. Brown used an unusual instrument to gently remove the RPG's tail fins -- a hacksaw. The surgeons reached inside Moss, steadying the still lethal rocket, inches from the soldier's beating heart. They then gently eased the rocket out, with the detonator aimed at Brown's flak vest.

Brown quickly walked out of the aid station to a bunker and detonated it. The sound of the explosion thundered through the base. As the surgeons closed up Moss' incisions, Sgt. Brown sat down outside to collect himself. Finally, the impact of the drama hit him.

"I started shaking. I just sat there. I knew I did everything I could to help him live. And that was very, very intense for me after the fact," he said.

Coming Home

In a matter of days, after stops at hospitals in Afghanistan and Germany, Pvt. Moss was rushed to Walter Reed Army Medical Center in Bethesda, Md. There his wife, Lorena, saw him for the first time and it was almost too much to bear.

"He looked very vulnerable. I went in, and ... I walked away. I couldn't stay in the room. I broke down outside in the hallway," she said.

Moss' pelvis was shattered, his internal organs were severely damaged and he was unable to walk.

For Moss, this was another challenge in a lifetime of obstacles. Raised by family friends after a tough childhood, he had become a high school football standout, got into college, got married and had a family.

As broken as Moss' body was, he focused from the very start on recovery. He said he didn't need a doctor to tell him if he'd be able to walk again.

"I told [the doctor] ... I could feel my feet, I'm going to walk again. Told him just like that," Moss said.

For his wounds in combat, Pvt. Moss had a Purple Heart coming. But he wanted to wait. It was important for him to be able to stand to receive it.

He underwent four major surgeries followed by intense physical therapy. Pvt. Moss' recovery was steady … moving from a wheelchair to a walker to a cane.

"I wanted to walk and get my medal, I wanted to stand up, to let them know I fought hard to get where I came from," Moss said. "They say 'Army Strong' [and] I wanted to be an example of that, and I was. So I stood up, I walked over there and got my medal."

A year later Moss is home with his family and the new baby daughter, Ariana, he thought he would never meet. Despite the aches and pains, he is grateful for the risks so many soldiers took that day.

"I was given a second chance. And to whom much is given ... much is expected. So a lot is expected of me," Moss said.

For Sgt. Brown, there was never a question about taking the gamble.

"He was American, he was a solider, he was a brother and he was one of us. And there was nothing gonna stop us from doing what we knew what we had to do … We knew we did right. In that screwed up world we did something right," Brown said.

Moss is missing about two-thirds of his intestines, part of his pelvic bone and needs more repair to his left hip. A member of the staff at Walter Reed calls him “Rocket Man.”

But the infantryman, who joined the Army to help give his family a better life, said he knows he’s alive because of his fellow soldiers.

“I don’t think there has been a day in the last year and a half that I haven’t thought about them, that I haven’t prayed for them. They saved my life,” said Moss, 24, whose slender 135-pound frame belies the hearty young man who went to war 55 pounds heavier.
“I knew it was love of country and brothers in arms. I hope God watches over them if they get deployed.”

The soldiers responsible for saving Pvt. Moss were recognized for their service that day and the Army has not changed its policy regarding unexploded ordnances in soldiers.

Epilogue: Recognition for Service

Several soldiers involved with saving Moss have since been honored or promoted. Here are their current ranks and awards they have received.

Maj. John Oh, general surgeon -- The Soldier's Medal
Maj. Kevin Kirk, orthopedic surgeon -- Army Commendation Medal with Valor
SSG Eric Wynn and Pfc. Channing Moss -- Purple Heart
CW3 Jorge Correa, MEDEVAC pilot, and Sgt. John Collier, flight medic -- Air Medal with Valor
CW2 Jeremy Smith, co-pilot, and SSG Christian Roberts, crew chief -- Air Medal
Sgt Jared Angell, field medic, and SFC Dan Brown, explosives expert -- Bronze Star with Valor

Wild Thing's comemnt.....

Tears running down my cheeks! God bless our brave soldiers.

Even though this happened a couple of years ago it is such an honor to post about our Heros. I don't think a lot of people saw this story when it happened. I don't remember the media covering it. and it is the first time I have heard about it.

This is quite a story!

God bless all the people who risked their lives to save this soldier! From the medics, to the helicopter crews who willingly took “unexploded ordinance” on their flight. Talk about bravery! Loyalty, courage, in the face of death.

Every time I read about incidents such as this one I am overwhelmed by the bravery and strong ties the Brotherhood that our awesome military has and it goes on into forever with our Veterans.

God bless all of you Veterans too, you touch my life every single day !

......Thank you RAC for sending this to me.

RAC has a website that is awesome. 336th Assault Helicopter Company

13th Combat Aviation Battalion - 1st Aviation Brigade - Soc Trang, Republic of Vietnam

Posted by Wild Thing at July 3, 2009 06:49 AM


I have read this incrediable story with tears in my eyes. It reminds me of similar situations from Vietnam.

My cover (hat) is off to Mr. Moss and all the men and women involved with his survival.

Maj. John Oh, general surgeon -- The Soldier's Medal
Maj. Kevin Kirk, orthopedic surgeon -- Army Commendation Medal with Valor
SSG Eric Wynn and Pfc. Channing Moss -- Purple Heart
CW3 Jorge Correa, MEDEVAC pilot, and Sgt. John Collier, flight medic -- Air Medal with Valor
CW2 Jeremy Smith, co-pilot, and SSG Christian Roberts, crew chief -- Air Medal
Sgt Jared Angell, field medic, and SFC Dan Brown, explosives expert -- Bronze Star with Valor

G_d Bless you all and Happy Fourth of July.

Posted by: Steve Gaston, USMC at July 3, 2009 08:36 AM

For a Medical Team that is indeed above and beyond the call...That is certainly putting your fellow soldiers above your own life and safety to save a life.

Doctors and Nurses, Corpsmen, Medics are always doing some type of heroic life saving procedures. Where else but in American could you find this type of dedication. You can't find this dedication anywhere else in the world.

This is the Health Care in America, and this is what obama is trying to screw up.

Posted by: Mark at July 3, 2009 09:11 AM

An incredible story. Similar stories of live ordinance being surgically removed have been documented in WWII, Korea and Vietnam. Always a hair raising event.

Pfc Moss is very lucky and very brave. His comrades are very brave and very dedicated. My guess is that if this happens again that Army rules will be broken again. Soldiers do what has to be done.

Posted by: TomR at July 3, 2009 01:09 PM

Whew, an RPG, jeez, I know all too well what one of those does up close. Have I ever mentioned that I don't like rockets? Just for the record, I don't!!!
Who can witness what these people went through and not have a tear in their eyes or extreme pride for our medics? Like Steve, Mark and Tom, I'm reminded of scenes like this at several of the field hospitals I've visited like the 27th Surg and the 312th Evac, the worst scenes were at M.U.S.T.(the 18th Surgical Hospital )at Quang Tri, during the transition from 3rd Marine Division to 101st Airborne, it supported Marine and 1st Infantry Division combat troops, 101st Airborne, 1st Air Cav, MACV and Marvin the ARVN, nothing can steel you for triage and the hopelessness of that 'Expectant' area. Traveling lets you see that carnage whether you are delivering beans, bullets, bandages, a buddy or you're merely there for your own personal snip, tuck and a zipper. Sometimes when your were there it was all hands on deck pulling litters off the Helos when they came in, everyone dropped what they were doing to carry wounded to the appropriate place in triage, rank, unit affiliation meant nothing when time did. Those Marines appreciated the help. Triage is a misnomer at best.

Immediate: The casualty requires immediate medical attention and will not survive if not seen soon. Any compromise to the casualty's respiration, hemorrhage control, or shock control could be fatal.

Delayed: The casualty requires medical attention within 6 hours. Injuries are potentially life-threatening, but can wait until the Immediate casualties are stabilized and evacuated.

Minimal: "Walking wounded," the casualty requires medical attention when all higher priority patients have been evacuated, and may not require stabilization or monitoring.

Expectant: The casualty is expected not to reach higher medical support alive without compromising the treatment of higher priority patients. Care should not be abandoned, spare any remaining time and resources after Immediate and Delayed patients have been treated.(Sometimes synonymous with Deceased.)

Deceased: Those who didn't make it.

I couldn't remain sane with all that every day. Yes Tom, "Soldiers do what has to be done." We all broke the rules to survive.

God bless 'em all!!

That's what July 4th is all about - Americans at their best.

Posted by: Jack at July 3, 2009 02:20 PM

You are all so awesome, Thank you for
your sharing and for being here.

Posted by: Wild Thing at July 4, 2009 12:11 AM

Damn You Wild Thing!:
You didn't forewarn me that I would need the large box of kleenex! Hooray for Moss, and a giant HOORAY for his heroes who didn't walk away from a tough situation. Who sez our soldiers of today are not up to the job at hand? We have the best of the best on the planet!
Y'all have a great Independence Day, and a beter year ahead.
nuf sed

Posted by: Frankly Opinionated at July 4, 2009 12:44 PM