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HELMAND PROVINCE, Afghanistan — The UH-60 Black Hawk medevac helicopter descends into a maelstrom of swirling brown dust and touches down in a field with a bone-jarring thump.

Staff Sgt. Robert Cowdrey, a flight medic, jumps off the aircraft, a stretcher in one hand, an M-4 carbine in the other. He makes his way through the dust to a group of Marines about 50 meters away.

The Marines are standing between two armored trucks outside a mud-brick compound. They’re clustered around a wounded Marine. He is stripped to his underwear, partially covered in a thin foil blanket.

The wounded Marine has been hit by a Taliban bomb. He has no visible injuries, but he’s barely conscious, and clearly in need of further medical help.

Cowdrey, 37, of La Junta, Colo., puts a neck brace on the Marine, who is taken to the waiting Black Hawk. It lifts off as soon as he and Cowdrey are aboard. The helicopter has been on the ground less than five minutes.

During the last three weeks, as U.S. and British-led offensives have sought to retake the Helmand River valley from Taliban insurgents, helicopter ambulance crews from the 2nd Platoon “Gypsies” of Company C, 3rd Battalion, 82nd Combat Aviation Brigade have pulled dozens of wounded — and sometimes dead — U.S., British and Afghan troops from the battlefield.

Their job is to make sure that nobody gets left behind.

Later, after Cowdrey’s Black Hawk is safely on the ground again, the Marine regains consciousness while being transported to a field hospital.

“Where am I?” he asks. “What happened?”

Cowdrey tells the Marine he’s been in a bomb blast. The young man immediately tries to sit up.

Cowdrey puts a firm, but gentle hand on the Marine’s chest.

“Take it easy,” he says. “You’re OK. You’re in an ambulance, and everything is going to be fine.”

“I sure hope you’re right,” the Marine says, as he drifts out again.

Day and night

The crews have been retrieving casualties from the battlefield day and night in Helmand province. The searing summer heat and the ever-present Afghan dust make for the toughest flying conditions. They’ve set down on some of the tightest landing zones imaginable and occasionally taken fire.

But some pilots and crew say they wouldn’t have their job any other way. They speak of their work in passionate terms.

“I love my job,” said Chief Warrant Officer Jesse Russell, 33, a self-described “Air Force brat” whose father flew helicopters in Vietnam. “I couldn’t imagine doing anything else.”

Spc. Nicole Hyde, 20, of Aberdeen, Wash., a Black Hawk crew chief, gave up a West Point scholarship to enlist in the Army as a private. For her, flying medevac helicopters is a moral imperative.

“War is bad,” she said. “Killing someone is bad. But saving someone is good. If I can go out every day and avoid killing somebody, but I get to save someone instead, then kudos for the medevac.”

The crews rotate on a schedule, going back for breaks at Kandahar airfield, the main NATO base in southern Afghanistan, about once a week. While in Helmand, their lives are dictated strictly by the ebb and flow of battle.

“You might have one day with 10 missions,” said Cowdrey. “Other days, you might not have any.”

Medevac calls come in on what’s called a “nine-line” message, transmitted by a secure battlefield computer that’s monitored around the clock. The message contains nine groups of essential data, including the grid coordinates of the pick-up site, how the area is marked, radio call signs of the units involved, the number and severity of wounded troops.

“That’s the information the flight crews have to be aware of so they’re not going in there blind,” says Spc. Kristi Maldonado, 27, of Apache, Okla., a flight operations specialist.

Once the message comes in, the medevac helicopter and an armed “chase bird” can be off the ground in just a few minutes, depending on the urgency of the call.

“A lot of the times, they’re off the site and on the ground within 15 minutes,” Maldonado said.

The U.S. offensive in Helmand, which began July 2, involves about 4,000 Marines and 650 Afghan troops.

The majority of the initial cases were heat casualties. But lately, it’s been bomb blasts more and more. Only a few troops have lost limbs. The number of dead has remained thankfully low.

‘It’s an honor’

“Most of the stuff we’ve had has been concussions,” said Sgt. Tony Bolin, 38, of Albuquerque, N.M., a Black Hawk crew chief. “The worst one we had, the guy came back in two bags.”

Some of the flight medics speak about what they do in blunt, direct terms.

“They bleed. I land. I stop the bleeding, and take them home,” said Sgt. John Collier, 31, of Ames, Iowa.

Others are philosophical, especially about the dead.

“It hurts, but it’s an honor,” said Cowdrey. “Because I’m the one who gets to start them on their journey home.”

Cowdrey estimates that he’s treated about 25 wounded troops since the Helmand offensive began.

Another medic, Sgt. Nathaniel Dabney, puts his total at around 40. Going out on a call, they say, sharpens the senses like nothing else.

“The biggest thing is finding the patient, making sure he’s alive and breathing. Then you get him on the aircraft and get out of there,” Dabney said.

“Most of the time, the adrenaline’s pumping, and you’re not thinking of anything else.”

‘No one dies in my aircraft’

One recent morning, Dabney’s crew is first in line for missions. The first call comes at 9:15 a.m. It’s listed as a priority.

The patient is a British soldier who has been hit by a concussion grenade. He’s loaded onto the aircraft in just his underwear and boots. He has no visible injuries, but he’s clearly hurting and scared.

Dabney puts an oxygen mask over the soldier’s face, then starts him on an IV drip. He then leans in close, rubs the soldier’s forehead and tells him he’ll be OK. The soldier’s eyes are shut tight, and he motions for someone to hold his hand. He doesn’t let go until the Black Hawk gets to Camp Bastion, the main British base in Helmand, about 30 minutes later.

The next “nine-line” message comes in at just after 9 p.m. Two Afghan soldiers have been wounded in a bomb blast.

One of them is dead. U.S. troops heave him onto the darkened helicopter in a body bag. The surviving one has a possible fracture near his eye.

Dabney cuts open the Afghan’s shirt, looking for further wounds, but finds none.

The patient’s vital signs are stable. Dabney again leans over, rubs the soldier’s forehead and speaks a few words of comfort, even though the Afghan probably has no idea what he’s saying. The soldier lies there calmly, but his face is etched in pain.

Later, after the flight is over, Dabney explains that before he joined the Army four years ago, he spent 12 years working as a paramedic. One of the most important things he says he learned is that the human touch goes a long way in keeping a patient calm — and can save that person’s life.

But for the medic, it can also become a source of vulnerability.

“Blood and guts, don’t affect me,” he says. “But it’s that personal bond that you establish with your patient, that’s what gets to you.”

Dabney has one rule: “No one dies in my aircraft.” So far, it hasn’t happened, he says, even if it is probably just a matter of time.

“It has nothing to do with my skills, he said. “I’ve just been lucky. I don’t know how I’d handle that yet.”

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