The Continuing Impact of USU Alumni on the Battlefield

Three Uniformed Services University School of Medicine Alumni Awarded The Bronze Star Medal

Amidst indirect fire and suppressive tear gas, the team volunteered to stay on. They provided unescorted and seamless coverage for the American forces until the last airplane lifted off. (Photo courtesy of Maj. Harris Kashtan)
Amidst indirect fire and suppressive tear gas, the team volunteered to stay on. They provided unescorted and
seamless coverage for the American forces until the last airplane lifted off. (Photo courtesy of Maj. Harris
Kashtan)

July 11, 2023 by Hadiyah Brendel

Three Uniformed Services University (USU) alumni from its F. Edward H├ębert School of Medicine were recently awarded the Bronze Star Medal for meritorious achievement for their actions in support of the evacuation from Afghanistan in August 2021. 

The Bronze Star recognizes the leadership, life-saving medical treatment, exemplary efforts and commitment to duty of Air Force Maj. (Dr.) Evan Richards, Maj. (Dr.) Harris Kashtan, and Maj. (Dr.) Samuel Bergin for their roles on an Air Force Special Operations Command Special Operations Surgical Team (SOST) from August 23-31, 2021.

Richards, Kashtan, and Bergin served as part of a six-person SOST team with the 23rd Expeditionary Special Tactics Squadron. The team supported removal of troops from Hamid Karzai International Airport, Afghanistan. The evacuation marked the end of the nearly 20-year Global War on Terrorism. 

Left to right: Maj. (Dr.) Evan Richards, an anesthesiologist (pictured here as a Capt.), Maj. (Dr.) Samuel Bergin, an emergency medicine physician, and Maj. (Dr.) Harris Kashtan, a general surgeon. (Photos courtesy of Richards, Bergin, and Kashtan, respectively)
Left to right: Maj. (Dr.) Evan Richards, an anesthesiologist (pictured here as a Capt.), Maj. (Dr.) Samuel Bergin,
an emergency medicine physician, and Maj. (Dr.) Harris Kashtan, a general surgeon. (Photos courtesy of Richards,
Bergin, and Kashtan, respectively)

A SOST is a highly-mobile unit of medically and tactically trained specialists who provide damage control surgery and resuscitation in austere environments, bridging the gap between point of injury and a conventionally established medical care facility. 

The SOST carries everything required to perform surgery and resuscitation, including all instruments, blood supplies, and portable ventilators. Therefore, they are able to provide critical care within the golden hour, and at times, even within what’s called the platinum ten minutes of when an injury occurs. 

Composed of six specialists, Richards, Kashtan, and Bergin served as an anesthesiologist, general surgeon, and emergency medicine physician, respectively, on the SOST. The three additional specialists included a critical care nurse, surgical technician, and a respiratory therapist. 

Richards, Kashtan, Bergin and their team collaborated with the hospital established at the airport over a period of nine days. The hospital commander and his staff were already drilling and preparing for what to do in case of a mass casualty event. The SOST was able to seamlessly integrate into the established protocols and provide austere surgical capabilities to personnel during evacuation. 

Bergin says there were three phases to their time at the airport. The first phase occurred on August 26th, when a suicide bomber detonated outside Abbey Gate. The team was less than 800 meters away from the detonation. They were the primary team on trauma call when the hospital received 62 patients injured in the explosion. 

In all, the team participated in the treatment of 47 trauma patients and 13 surgical cases in short succession. In addition to providing life-saving medical care while under threat of mortars, rockets, and indirect fire, they also coordinated the transport of patients to inbound aircrafts. Bergin credits the SOST’s ability to “operate both independently of one another as well as in harmony with” the other surgical support teams, and guidance of the triage trauma surgeon, for their successful coordination of the largest mass casualty event of the Global War on Terrorism. 

The second phase of their movements involved establishing a new casualty collection point and providing support for the final security forces guarding the airport. Their third and final moment, Bergin says, “was establishing a casualty collection point on the C-17 that we flew out on.”  

Amidst indirect fire and suppressive teargas, the team volunteered to stay on. And despite breach of the airport by unknown persons, they provided unescorted and seamless coverage for the American forces until the last airplane lifted off.

The 23rd Expeditionary Special Tactics Squadron included, left to right: Maj. Harris Kashtan, Maj. Samuel Bergin, Staff Sgt. Damien Quichocho, Capt. Anne Vayda, Master Sgt. Christopher Thoryk, and Maj. Evan Richards. (Photo courtesy of Maj. Harris Kashtan)
The 23rd Expeditionary Special Tactics Squadron included, left to right: Maj. Harris Kashtan, Maj. Samuel
Bergin, Staff Sgt. Damien Quichocho, Capt. Anne Vayda, Master Sgt. Christopher Thoryk, and Maj. Evan
Richards. (Photo courtesy of Maj. Harris Kashtan)

Speaking of their reaction to receiving the medal, Richards says “It’s been an incredible honor, and extremely humbling. I’m beyond proud to have been on a team recognized for their efforts, who volunteered for, and went to great lengths to move towards the chaos and reposition to Afghanistan.”

Richards, Kashtan, and Bergin credit the other surgical support teams and the established medical units at HKIA for making their endeavor possible. They say, without their professionalism and collaboration, it would have made bringing order to the chaos of that final push home impossible.

“It’s humbling to know 13 of our country’s finest paid the ultimate price standing the final watch in Afghanistan,” says Richards. “The fact that we were not able to get everyone home is what drives me to continue to train, improve, and remain vigilant for the next time our service members are in harm’s way.” 

The team also offers advice for students at USU, or any medical student, considering operational medicine. 

For those who enjoy field exercises such as Bushmaster, Kashtan says the experience can offer a glimpse into the more operational side of military medicine. “When you’re simulating setting up a mobile field hospital, running through a mass casualty event, it’s the beginning of training that – if you end up in an operational unit like ours – you just build upon.”

Richards recommends taking advantage of the training that USU provides. Experiences like Gunpowder was “the primer for me wanting to get involved in operational medicine,” he says. “I remember coming back and going right to the Department of Military Medicine and saying, ‘how can I get involved in operational medicine when I graduate?’”

Bergin adds that those interested should also “focus on developing and cultivating relationships with fellow classmates, both those in your year and the ones above and below you.” He says, “in the future, that’s going to make a big difference for your ability to go down different career pathways and also your ability to care for patients in austere environments.” 

“USU, probably beyond any other medical school, very deliberately prepares us for mass casualty scenarios, they prepare us for austere management of patients, but additionally, you learn to communicate and work with sister services and partner forces”, says Bergin. 

Before their arrival at Kabul airport, the team was already in contact with other USU alumni in the area. 

“There were multiple graduates who were there that we could communicate with, to get information from.” In addition to fellow alumni asking what they needed, the team was able to send supplies to them when supply chains faltered. Richards says “that networking was actually paramount in the planning for the final exfiltration.” 

The SOST members went through ten to twelve months of specialized training before deployment. It helped them understand each other's strengths, weaknesses, and how each diverse member contributed to the team dynamic. (Photo courtesy of Maj. Harris Kashtan)
The SOST members went through ten to twelve months of specialized training before deployment. It helped them
understand each other's strengths, weaknesses, and how each diverse member contributed to the team dynamic.
(Photo courtesy of Maj. Harris Kashtan)

Outside of the training and preparation provided by their time at USU, the SOST members went through 10 to 12 months of specialized training before deployment. That time together helped them understand each other’s strengths, weaknesses, and how each diverse member contributed to the team dynamic.

After their time in Kabul, Kashtan says that although “you’re never really gonna be 100% ready for any kind of mass casualty event, knowing that you can go through it and maintain a cool head,” helps him to address each patient as they arrive. 

Bergin is now part of a committee working to revamp some of the mass casualty policies at the Level One Trauma Center in Las Vegas. 

And Richards says he'll “keep moving forward, making the next right decision for the patient in front” of him. His time in Kabul helped him to “keep perspective of the bigger picture.”