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Nurse reflects on battlefield lessons

Though combat is thousands of miles away from Travis Air Force Base, California, Col. Erwin Gines, 60th Inpatient Squadron commander at David Grant USAF Medical Center, Fairfield, California frequently leans on the first truth, that humans are more important that hardware.

Though combat is thousands of miles away from Travis Air Force Base, California, Col. Erwin Gines, 60th Inpatient Squadron commander at David Grant USAF Medical Center, Fairfield, California frequently leans on the first truth, that humans are more important that hardware.

TRAVIS AIR FORCE BASE, Calif.--There are five Special Operations Forces Truths, written by retired Army Col. John Collins in 1987.  They state that humans are more important than hardware, quality is better than quantity, special operations forces cannot be mass produced, competent special operations forces cannot be created after emergencies occur and most special operations require non-SOF assistance.

Though combat is thousands of miles away from Travis Air Force Base, California, Col. Erwin Gines, 60th Inpatient Squadron commander at David Grant USAF Medical Center, Fairfield, California, frequently leans on the first truth, that humans are more important that hardware.  Thirteen years after his time serving as a critical care nurse on a Special Operations Critical Care Evacuation Team during the 2003 invasion of Iraq, Gines reflects on how his training, with roots laid at DGMC as a young  Lieutenant help him best serve his airmen today.  

To date, Gines served in many roles.  He began his career in nursing at DGMC, before working in the emergency department at Wilford Hall USAF Medical Center in San Antonio, Texas.  While serving as an emergency department nurse, there was a callout seeking medical professionals to join a newly formed special operations critical care evacuation team.  Gines volunteered, and was selected for the team.  Gines first deployment with the SOCCET took place during the 2003 invasion of Iraq with Army 2nd Battalion 10th Special Forces Group, serving the larger Joint Task Force Viking. 

The position Gines served in was unique, greatly influencing his perspective.  What stands out the most for Gines about his time as a SOCCET nurse was the outside the box thinking, and outside the wire work. 

“Coming from the conventional world we had very strict ways of thinking and what confines us,” said Gines.  “In the special operations world, the environment compels innovative thinking at all times.”

The tasks required of the SOCCET had no bounds.  They had a wide range of duties, inside and outside the wire.

“We would convert bare bones rooms in old Iraqi administrative buildings to makeshift operating rooms, surgical suites and critical care work areas, in addition fulfilling the special forces teams needs,” said Gines.  “We did whatever was asked. It was not a standard set of work, you just had to make things work.” 

During the deployment, Gines realized how serious his role as a specialized nurse was.

“We were the only medical unit, and I was the only emergency critical care nurse on the team,” said Gines.  “If they needed something from me, I was the only guy with the specified training.  We learned to rely on each other a great deal.”  

Gines believes that the innovative thinking he leaned in the field helps him continually.

“I have always had a feeling that innovative and outside of the box thinking was useful to me, even before I entered special operations,” said Gines.  “Working in the ER you have to keep adapting to what you do, and going to special operations was a natural extension of that, allowing my skills to flourish.  One of the things I think helped me was working with a unit in the field, with people who innovate a great deal.  It allowed me to think and innovate my plans now.”

One patient Gines and his team treated during his deployment in Iraq stands out in his memory.  One of the leaders of the Kurdish forces was injured, and the Kurdish forces perception was that the United States was to blame for the injury.  When they found out that their brethren was hurt, the Kurdish they called the United States for help, specifically Gines’ team.  Gines and two other teammates went to meet the patient who had a head injury, working in a makeshift hospital while providing treatment.    

“It was just three of us, and the crowd was growing, one hundred, eight-hundred, and then what seemed like a thousand people all converging on the hospital,” said Gines. “There was no way we could fail at this, or we would be in big trouble.  If this man died in our hands, we would have been mobbed.” 

This however, was not the reason that Gines and his team provided such expert care.

“We just did what we were trained to do,” said Gines. 

Though Gines and his team were following standard procedures and relying on their training, they impacted something much greater than one life. 

“Knowing that we helped preserved a strategic alliance with the Kurdish forces by simply doing our jobs was incredible feedback to receive.”

Gines’ training at DGMC and at Wilford Hall was instrumental in making sure that his team was safe when treating this patient.  Dealing with large concerned crowds, identifying a patient’s needs, recognizing what factors will effect care and how to talk to people as a nurse benefitted him greatly at a time when his life, the life of his teammates, and the lives of the special operations forces he deployed with were on the line.  

“All of the skills I used flourished out of what seemed mundane years ago,” said Gines.  “No kidding, it continues to build today.  When I do my job now, I am constantly honing skills that I learned then.”

Gines urges his airmen to recognize the value in their daily tasks.     

“To those that think it is mundane, it might seem that way,” said Gines. “But so is exercise sometimes, and later on when you lift four-hundred pounds or when you sprint a 100-meter race you will realize that what seemed like painful exercise at the time proves to benefit you later on. There was no course that prepared me, it was doing the job every day, and doing what was right.  Whether you are attending to the KC-10 or attending to vehicle operations think ‘what does it need to look like, for real’ because when you need it to work, you don’t need it to fail.  You will have habitually done it every day, and know how it needs to work.”

Gines believes that the skills you learn at work are slowly built, but have a high value of return.  “Learning is not instantaneous, but suddenly knowledge comes, which is just amazing,” he adds.

The skills Gines depended on throughout his deployment and career would not have been developed had he not had mentors along the way.  He credits the men and women who shaped him for his success to date, and stays true to the first SOF truth, that humans are more important than hardware.   

 “The most rewarding part was realizing the importance of the human dimension, and one of these factors was that humans are more important than hardware.  Then and now, that is something I have always held as one of my key tools.  You cannot do what you are doing without considering the human weapons system or the human dimension. They are capable of amazing things but you still have to know what the limits are.  Right now, I command a great squadron of humans and I try to be mindful of that human dimension.”

It is important for all airmen at DGMC and even across the Air Force to not lose sight of the fact that they have a worldwide impact, serving to heal, train, and protect heroes.  

“Even though at times because we are here on the West Coast and not in the middle of CENTCOM or right in the middle of the fight, we can feel detached from what is going on.  But we still have everyone’s back, their ‘6’. We must continually realize how we can get better at care, because our proximity to protecting someone else is going to be closer one day.  That was my experience, I went from just the nurse on floor 3 West to moving on to the ICU, and then taking everything I had learned to the battlefield.”

Recently promoted to the rank of Colonel, Gines hopes to continue to use his unique experiences to lead his airmen well. 

 “It is a humble symbol of faith to me that the Air Force thinks I can do more,” said Gines. “It is humbling to be part of the system that gave me the opportunity to grow.  I will be wearing the rank as others do, but it is a projection of the culture that gave me the tools and the abilities to project them.  I am given the opportunity to express the best of what they gave me, through me.”

Gines’ role in the squadron is not without challenges. 

“The hard part of this job is being away from my family,” said Gines, whose wife is also Active Duty and stationed in San Antono.  “But this is temporary, at some point, this will be done.  What drives me is to be a good husband and father, and for me to be that I have to be a good airmen…I have to be able to hold my promises.  I swore an oath, and I cannot look my family in the eye and say I did not keep my promises.  At some point in time, I’ll relinquish my time as commander, and move on to be with my family full time, to be a husband and father.  But it is work right now, It is not easy.  This is one of the hardest experiences I have ever had because of the family separation.” 

Borrowing a Gen. McChrystal term, Gines refers to his airmen as a team of teams.

“They look after each other in ways I have not seen in every aspect of my career, but they do that here, said Gines. “At one point in time, I will hang up the uniform as everyone does, but to have had the chance to be a part of the Air Force, and pay the lessons I have learned forward is quite the honor.”