Medevac

Medevac: Flying the Irish Air Corps HEMS Mission , by Declan Daly

Anyone stationed in northern Europe, especially aviators, knows that the weather is often unpredictable, unforgiving and a major factor in any operational planning and execution. For those operating in the British Isles, it goes double. Such is the environment that the pilots and crews of the Republic of Ireland’s Helicopter Emergency Medical Services (HEMS) system contend with daily.

Medevac is Irish Air Corps pilot Commandant Declan Daly’s firsthand account of how teams from the Irish Air Corps and the National Ambulance Service set up the country’s first HEMS system.

In any technical/military book, a glossary of terms is essential to give the uninitiated reader a chance of following the narrative and gaining something from having read the book. Commandant Daley, no doubt anticipating how daunting a book on “helicopter aeromedical evacuation“ might first appear, admirably confronts this issue head-on. The book starts with an expansive glossary, irreverently titled “Glossary of Barely Intelligible Aeromedical Speak,” which also sets the stage for further dry, wry, and often self-deprecating humor.  

The book describes how the overall system works, driven by the need for efficiency with the limited budget and resources of a small country. Again, with the weather such an important consideration, it was ingenious to find that in addition to the hospital helipads, airports, and other military/government facilities cataloged as landing sites, a formal inventory of football pitches (soccer fields), with their known clear area and height of obstacles (stadium light poles) immediately around them, was incorporated into flight procedures. Several “edge of your seat” flights in poor weather during urgent medical situations keep the reading flow along with the nuts-and-bolts aspects of the missions and organization. A map of Ireland, with some detail and some of the locations/routes mentioned in the book highlighted would have been helpful.

To round out the story of the Irish Air Corps’ helicopter operations, other military and civil aid missions are briefly described, including a few casual pages covering the author’s deployment to Chad on a United Nations mission. While briefly mentioned in the book, the Republic of Ireland’s military forces have a proud, sixty-year tradition of participation in United Nations peacekeeping operations. As a neutral western democracy with no imperial history, Irish military personnel have been in the field continuously since 1958 for the UN and are currently in Mali and Syria (Golan Heights and mine clearing operations in various locations). Since their first deployment for the UN, 90 members of the Irish military have died in the line of duty on peacekeeping missions, according to UN statistics.

Take-Aways

Military aviators, especially rotary-wing pilots, and some in the military medical field will appreciate the “day in somebody else’s office” feel to the descriptions of flying and patient care. Interestingly, the primary pilot, at least in the Irish Air Corps system, is not initially informed of the specific nature of the medical emergency when the call for service comes in. This creates a “black box” type of decision-making process whereby the pilot makes the “go/no go” decision solely based on safety of flight factors, such as weather, uninfluenced by knowing the patient is a child or in need of immediate emergency surgery. The author also has some insightful thoughts and experiences on how the act of making one decision sets up other whole decision-making processes.

As the Republic of Ireland is not a member of the North Atlantic Treaty Organization, and even during World War Two was technically neutral, Americans may enjoy reading about how the military of a non-aligned western democracy organized, trained, and operated their air forces. One particular example was that a live-fire obstacle course (real bullets flying overhead) was part of pre-deployment training for the Irish forces, including their Air Corps.  Also, the Irish military aids the civil authorities in law enforcement, a concept alien to American service members.  

Contrary to what many people might think given the history between the Republic and the British United Kingdom, there is cooperation for cross-border operations. These operations consist of emergency situations, like bushfires that ignore geopolitical boundaries, and for Irish patients to be transported to U.K. hospitals when extreme medical situations exceed the capabilities of the Republic’s medical system.

On a side note, Commandant Daly, a talented author, career military officer, and aviator has a new book coming out,Borderline, a fictional “what if” story of Brexit gone wrong in Ireland.  

On balance, however, given the uniqueness, applicability, and utility to military veterans, Stoic Wisdom is recommended strongly to anyone seeking practical methods to build or rebuild mental resilience.

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