The Combat Medic (Healthcare Specialist) provides an extremely important function in delivering first responder care and evacuation coordination to an emergency care facility. There is not and infantry soldier who does not appreciate and admire the work, and the heroic valor of a Combat Medic. However, the evolution of the modern Medic has a long history, and is one that should be investigated to understand just how far we have come.

Medical Care of the combat wounded can be traced back to the First Crusade (1096 – 1099). A hospital established in the Christian District in Jerusalem in 1023, whose primary directive was to provide care for the poor, sick, and injured pilgrims in the Holy Lands, treated the wounded and the ill defenders of Christianity during the Crusades. The caregivers were Benedictine Monks trained in the medicine of that time. In 1113, an order of caregivers was created by, Pope Paschal II, called the Knights Hospitalliers (Order of St. John). They provided care throughout the Crusades until the Christians were finally expelled from the Holy Lands.

Advances in medical technology proceeded throughout history:

*Battle of Shrewsbury (England) in 1403, a specialized tool was used to remove arrows.
*Siege of Málaga (Spain) in 1487, a dedicated ambulance cart was used to remove wound from a battlefield.
*French Surgeon Ambroise Paré (circa 1537) fathered what is considered modern battlefield wound treatment.

The next huge leap forward in battlefield medicine came in the early 1800s when Surgeon Dominique Jean Larrey directed the Grande Armée of Napoleon Bonaparte. Under the leadership of Surgeon Larrey, the Mobile Field Hospital (Ambulance Volantes) was created, and a specialized Corps of trained and equipped soldiers to provide battlefield aid was instituted.

Another major advance in battlefield medical care did not surface until the American Civil War (1861 – 1865). Major Jonathan Letterman, Surgeon and Medical Director of the Army of the Potomac, developed a system of dedicated vehicles, organizations, facilities and personnel to care for the war wounded. Major Letterman’s plan was first implemented in September of 1862 during the Battle of Antietam.

In 1864, the First Geneva Convention convened to set policies for civilized warfare. Article twenty five provided rules governing battlefield caregivers. Under the rules, it made it a war crime to knowingly fire upon medical personnel wearing a clear insignia. It also provided for Combat Medics to carry personal weapons to protect themselves or those within their care however, if the weapon is used offensively, it would negate protection under the convention. From this point on, all U.S. Medical Personnel did not carry weapons onto the battlefield.

Further advances in medical technology were:

*The Spanish American War, in 1890, the first battlefield field dressings were utilized.
*World War I the U.S. Army Ambulance Service and the Sanitary Corps were established in 1917. These organizations controlled all facets of medical logistics and management of patient care and disease.
*During World War II it was found that eighty five percent of wounded soldiers survived if treated within the first hour.
*On August fourth 1947, the U.S. Congress created the Medical Service Corps.
*The Korean War (1950 – 1953) was the introduction of the M*A*S*H Unit (Mobile Army Surgical Hospital) and the first use of the medical evacuation by helicopter.
*The Vietnam War (1955 – 1975) saw advancements in battlefield treatment and helicopter evacuation. There was a ninety eight percent survival rate of the wounded if evacuation occurred within one hour. This was the first time medics did not wear a medical insignia and armed themselves. This was due to the fact the Viet Cong and the North Vietnam Army did not recognize the Geneva Convention.

As of 2005, the United States Armed Forces have reengineered the Combat Medic. A facility was constructed at Fort Sam Houston in San Antonio, Texas. This is a joint military facility where the Army, Air Force and Department of the Navy all train together, with some specialized training that is branch specific. The name of the Combat Medic has changed, as has the training. The new name is Healthcare Specialist.

The Healthcare Specialist is qualified as an Emergency Medical Technician (EMT). They are trained in Advanced Airway Techniques, Shock Management, and Evacuation. They must re-certify every two years and have seventy two hours of continuing education credits between each re-certification.

On the battlefield, they must be able to provide first aid; treat battle injuries and disease; deliver frontline trauma care; continuing medical care, in the absence of a physician; and, monitor the ongoing health of the troops with which they are working. All of this takes specialized training to act calmly when the manure hits the fan.

We have come a long way in over nine hundred years of treating the war wounded. Our Healthcare Specialists (Combat Medics) do a fantastic job in keeping our men and women, in the service of our country, alive and well. The next time you meet one of these heroes of the battlefield say, “Hey Doc, Thanks.”