Medal of Honor Image
Megan Sullivan
801 9th St NW
Washington, DC 20220
Dear Megan:
Here is my input for the Dust Off Crews CGM Design. It is based on input from many Dust Off crews over the 9 years I have worked on this.
The main points of discord will be the inclusion of Kelly, which offends some because he is already famous, and Medevac. As you will see my bill was changed without my involvement. I have two maps of Vietnam one for just Dust Off units and the other which is called Air Ambulance Units and includes the two Division units,
the 1st Cavalry, Medevac, and the 101s‘, which used Dust Off. The one from Senator Cornyn’s visit is more accurate but the other may solve the problem.
I am sure that any member of Congress who introduced a Bill and then had it changed without their knowledge, would be upset; especially if it changed the intent of the Bill. I am not a MOC but that is what happened to me. The title of the bill and the inclusion of Medevac is contradictory. I know this is not a
concern of yours but trust that historical accuracy will be.
I had hoped to hold this up until I had input from the Surgeon General. She has been briefed and is very interested in
providing input. I will send it to you as soon as I get it.
I included my Bio at TAB 4
My best to the three year old.
All God's Best.
//Pat//
Dustoff Crews of the Vietnam War Congressional Gold Medal Design Brief
Background: The evolution of battlefield evacuation and the origin and efficacy of Dustoff.
I know that the design people are very interested in historical accuracy so I think some background on this subject may be useful. Many who are involved in this project have little knowledge of Vietnam let alone Dust Off. Unfortunately, this holds true of many crews flyingaeromedical evacuation today which is a sharp change from Dust Off in Vietnam. Additionally, as one who has been critical (15) of the changes made to aeromedical evacuation in the Army | hope, through this Medal, DOD will be educated on the superiority of the Dust Off system.
Military medicine has had a profound influence on medical innovation, from Hippocrates, the father of modern medicine, to Florence Nightingale, the mother of nursing. Both developed their skills in combat. In the words of Hippocrates: “ He who would become a surgeon should join an army and follow it.” Few, if any have had more influence on military medicine than U.S. Army Maj. Charles Kelly who revolutionized battlefield medical evacuation, the single most decisive factor in survival during the Vietnam War. One caring, fearless and dedicated individual alone can inspire monumental improvements.
Early on, the Roman armies recognized that caring for the wounded was not only compassionate but a combat multiplier. Men fought better when they knew they would be cared for. Casualties were a drain on readiness -- not just the loss of the wounded, but those who cared for them. Accordingly, the Romans developed a system of echeloned medical care in an evacuation chain that is used to this day. The purpose was to conserve fighting strength by treating and returning to duty those so disposed and clearing the battlefield of the others. Time, the golden hour, was life or death, and, again, it was clear that the battlefield evacuation system was the cornerstone of effective and efficient medical care —indeed, military readiness.
Medical evacuation, or Medevac, began on the backs of soldiers. Often times these soldiers were combat essential and effected the readiness of their units as they labored to rescue their wounded comrades. Baron Percy, a French surgeon, founded a corps of stretcher bearers for this task. They were highly trained and equipped but most of all of “proven valor’. Combat evacuation progressed to horses, even camels, then horse-drawn “flying ambulances” developed by Dominique Larrey, Napoleon’s surgeon. Larrey, who once performed 200 amputations in a 24-hour period, also developed a system of triage designed to conserve the fighting strength by sorting casualties by wound gravity and evacuating only as far back as necessary. Finally, he organized field hospitals, the forerunner of today’s military hospitals.
As is too often the case, hard learned lessons in combat are forgotten as time goes by. (We saw this in the Vietnam War and today). By the time of our Civil War, the care of combat casualties was abysmal. In fact the transportation of combat casualties was under the control of the quartermaster and in competition with other logistical priorities.
All that changed when Major Jonathon Letterman, to be known as the father of battlefield medicine, was appointed medical director of the Army of the Potomac. He may have been aware of Percy and Larrey. He immediately addressed the hygiene/disease issue which was a primary cause of casualties. He then established a dedicated
ambulance corps under medical control and connected to mobile field hospitals as close to the fight as possible. Medics were given distinctive uniform markings (to become red crosses). In other words he put medics in charge of medical issues the importance of which is not well understood to this day. At the battle of Gettysburg, wounded
were evacuated within six hours and in surgery within 24 hours. It was a significant improvement but by necessity echetoned with terrain and transportation being the great obstacle to improvement.
Medevac further evolved through our nation’s wars. World War | and World War II saw motorized ambulances. Helicopters were used in World War Il but with minimum effect on casualty survival. They were more effective in the Korean War but remained pretty much in the echeloned evacuation system, limited by the machines available. However, known as Solo Pilots, the helicopter ambulance pilots in Korea, albeit non medical, were heroic pioneers and | believe should have their own CGM.
Vietnam and the birth of Dust Off:
The 57 Helicopter Ambulances Detachment preceded Kelly by 20 months arriving in country in April 1962 initially without operational definition, doctrine or support and located remote from most combat operations. Their mission was U.S. casualties for all of Vietnam, some 30 hostile deaths to that point. The rest of 1962 they flew 235
evacuations hardly a days work in future times. They struggled constantly to keep other aviation units from cannibalizing the 57th aircraft for non medical missions. On one operation they were ordered to turn over key parts of their aircraft for an air assault rendering them unflyable and the assault without aeromedical coverage. Such was the
ignorance/indifference of the leadership regarding casualty care at the time.
1963 was not much different with the 57th evacuating only 1972 patients. There was a lot of down time which was not lost on BG Joe Stilwell their boss. He coveted their Hueys. His plan was to use their slack time for missions of his choice and slap a portable red cross on for medical missions. This would be similar to the Marine system. They had no red cross helicopter and patient evacuation was essentially a logistics mission as we saw in the Civil War. Stilwell actually tried to put the 57th under a Transportation unit.
Such was the situation when Kelly arrived in January 1964. Kelly was an experience Medevac “solo pilot” in Korea (not during the war). He was, of course, outraged. Thus began the battle for control of Dust Off as Kelly went one on one with Stilwell, Major versus General.
I was in the unit when Kelly returned from meeting with Stilwell. After warning that the higher-ups did not wish us well, he said that if we were to save Dustoff, as a dedicated patient resource, under medical control, we had to prove we could rescue patients better than anyone else. He led the way, and we tried to follow. Our helicopters were moved to the areas of heaviest combat. Kelly marketed us, flying day and night throughout the countryside to tell our advisers that we were there for all casualties, day and night -—and on the battlefield. Up to this time there had been little night flying. Reaction time is immeasurable in life-saving. Why must a patient wait for sunup when helicopters fly just as well - actually, better —at night, and the crew is safer from enemy fire?
Our casualty load increased significantly, breaking all previous records. Kelly became a legend, known as “Madman” Kelly, ( e.g. Tab #3 ) flying up to 150 hours a month. Entire villages turned out for his pickups, and a Pulitzer Prize-winning writer began covering him. Because routine night missions were unprecedented, many actually
thought that Dust Off was specially trained for night flying. One commander ordered a study into how we did it, which concluded that night operations were too dangerous. But Dust Off defeated those dangers every night.
Dust Off pilots, of course, were not specially trained. But because we had a dedicated resource, under medical control, and through repetition, we became specialists in combat pickups at night, in weather and under fire. Through trial and error, we found ways to get patients with an alacrity previously unknown. If we encountered a
situation beyond our capability we could call Kelly, but we never left a patient in the field no matter the situation; the welfare of the patient was our universe. Dust Off missions, under Kelly, thought by many to be too dangerous became routine for the Dust Off crews.
The issue of portable red crosses was still pending in late June 1964 when, as Stilwell was leaving country, Kelly presented him with a plaque listing our tail numbers. “Here, General,” Kelly said: “You wanted my helicopters so damn bad, take them.” Stilwell smiled. Photo in article #14 and Tab #3.
The issue was decisively settled a few days later.
On July 1, Kelly was called into a supposedly secure area for an urgent U.S. patient. As he landed the enemy - mixed in with friendlies, as they often were - cut loose. The friendlies screamed at Kelly to get out. He replied stubbornly, “When I have your wounded.” He then curled up from a single bullet shot right through his heart, the 149th American to die in Vietnam. The ship curled with him and the rotors beat it to pieces.
The entire U.S. and Vietnamese hierarchies attended Kelly’s funeral. Stilwell wept when told of his death. In a December 1966 McCall’s article titled “A Gift of Love,” Gen. William Westmoreland chose Charles Kelly out of thousands as a beautiful example of “the greatness of the human spirit.” He said Kelly was “a living legend” who stood out among those who gave “America more than they have taken from her ... for when the going gets rough, and an extra ounce of effort is needed, Maj. Kelly’s last words still shine brightly: ‘When | have your wounded.”
Dust Off, a new Battlefield Operating System:
We never heard again of portable red crosses, and more helicopter ambulance units were programmed for Vietnam. Westmoreland agreed that we could do our mission better than anyone else, and we kept the resource. The medical helicopter was firmly under medical control, as it should be.
The successor to Larrey’s flying ambulance was the ultimate flying ambulance, the magnificent UH-1 “Huey” designed specifically as a flying ambulance. This machine, with men of “proven valor” led by Maj. Charles Kelly, the father of modern combat evacuation, replaced Medevac with Dust Off perhaps the most effective and efficient
Battlefield Operating System ever. The slowness of echeloned evacuation and triage was replaced by direct, lightning-fast transport of wounded from battlefield to appropriate medical care day and night in all manner of weather. In the words of General Neel (1), the helicopter “virtually eliminated the battalion aid station, and often the
division clearing station, from the chain of evacuation”.
The Golden Hour, life and death, was now minutes, in my unit 33.
Dust Off became a free-enterprise Battlefield Operation System. Individual initiative ruled. Pilots determined the risk (although | don’t remember ever hearing that word) by launching immediately and flying to the site. We had a dedicated Dust Off radio frequency and dealt directly with the grunts at the pickup site. There were no middlemen.Launch authority rested with the pilot not some remote staffer. Although we had three categories of patients —urgent, priority and routine —we responded to all calls instantly if we had the resources. This is the only way to prevent over classification. (See #6,7,8,10, below for some of our techniques unique to Dust Off)
Thus was Dust Off defined, a BOS unique in prior medical history. The helicopter, and Kelly, killed the deadly battlefield killers — time and terrain. Dust Off was as in the Bible “ Here am | Lord, send me”. And for 10 years Dust Off crews ran toward the fire. It is an old aphorism that soldiers are easier to get into the fight the first time than later after they have seen the horrors of combat. Not so with Dust Off they returned over and over, daily.
As a result, Dust Off became the most revered and effective battlefield operating system in Vietnam, with close to 1 million souls rescued and unprecedented survival records. Although one in 10 Gis were wounded, only one percent of wounded reaching a Medical facility died. Your chances of survival if you were wounded in a jungle in Vietnam were greater than if you were in an accident on a highway in America. Dust Off is easily the most famous radio call sign, and most effective BOS, in the history of warfare.
In the words of Gen. Creighton Abrams, Army chief of staff from 1972to 1974, “A special word about the Dustoffs ... Courage above and beyond the call of duty was sort of routine to them. it was a daily thing, part of the way they lived. That’s the great part, and it meant so much to every last man who served there. Whether he ever got hurt or not, he knew Dustoff was there.”
Additionally, because Dustoff crews carried civilians, women and children -- and even enemy personnel -- it had a positive effect on the battle to win hearts and minds (WHAM) vital in guerrilla warfare. Dust Off was so well known and effective that post Vietnam a MAST (Military Assistance to Safety and Traffic) concept was initiated in
which military helicopter ambulances were used for civilian medical missions. It was a forerunner to many civilians system used today.
Themes and Concepts:
Essentials: Kelly, Vietnam, When | Have Your Wounded, Dust Off Huey, each Dust Off unit if possible. | think it would be unique if part, or all, of the bullet that killed Kelly be melted into the Medal. It is now at the NMOHM in Arlington, TX but | am sure they would agree. The background on the bullet is in my book.
I have attached some concepts. Initially | thought it would be simple, aimage of Kelly (painted by his daughter) representing all crews and an image of the 57* the original Dust Off unit; representing all units. It evacuated over 100,000 casualties with 10 KIAs.(tab 1) Some were worried that Kelly was already too famous? | found a medal for the 65* Infantry Regiment and used it replacing Kelly in the forefront and images of Dust Off missions/crews in the back ground ( Tab 1).There are multiple images to select from the key being a representation of a crew. The back should not be a problem. It should include Vietnam, Dust Off units and a Dust Off Huey. | attached a couple of ideas. ( Tab 2) within the outline of Vietnam you could include the terrain and multiple aircraft. You will notice in one image it includes a gun ship and slick ship — they carried patients also, but with the call sign Medevac.
Potential Inscriptions:
The most, actually only, appropriate inscriptions are: Dust Off and When I have your Wounded ( see # 16 below). However, the units could be inscribed as per my design. There is no tribute to Dust Off anywhere, or discussion/museum of Army Aeromedical Evacuation in Vietnam, that does not include those words and Kelly.
Sensitivities. Origin and Background of the bill:
We often hear MOC take credit for various bills. | will take credit for this bill since I initiated it, in fact | wrote it although Senator Cornyn’s staff put it in the proper format, signed up the House, and dropped it. In 2015 I was alerted and alarmed by the fact that no unit from Vietnam had ever been awarded a CGM. | thought Dust Off crews would be a good starting point. Senator Cornyn agreed. Senator Cornyn and I are the only two people who have been involved in this effort from the beginning nine years ago. His staff has turned over many times requiring constant reeducation. That is essentially why it took nine years for a no brainer. Finally, it was Senator Cornyn’s personal involvement in the 118 Congress that got it done.
Cornyn’s staff had meager knowledge of Vietnam and none about Dust Off. Much of the bill came from my book, Dead Men Flying. As a life member of most veterans organization, | was able to garner their support. They went to work for the bill. At the time there was only one Significant organization of Dust Off crewmen, the Dust Off Association. Since MOC were interested in numbers in their states/ districts, and the DA covered the United States, they signed up to coordinate with senator Cornyn’s office and work the grass roots.
Over the nine years of this effort, some who supported the bill, were outspoken in their definition of its intent. As the author of the bill, | have some insight on its intent. Again, | was disturbed that no unit from Vietnam had ever been honored with a CGM. I thought Dust Off would be a perfect starting place. My intent was to honor Charles Kelly, who gave his life to save Dust Off, the crews he inspired, their phenomenal record, and the gold star families of the crews who died that others might live. | also believed that this bill would open the door for other deserving warriors from Vietnam.
Additionally, and clearly specified in the original bills (S:2268, HR:5299), the CGM was for:
SEC. 2. FINDINGS.
The Congress finds that—
(1) a United States Army Dust Off crewman is a helicopter crew member who served honorably in the Vietnam War aboard a helicopter air ambulance under the radio call sign “Dust Off’; (Tab 3) I specifically did not include Medevac. Some where along the way, someone perhaps from the DA weaseled in Medevac (S:2825).
SEC. 2. FINDINGS.
The Congress finds that-—-
(1) a United States Army Dustoff crewman, including a pilot, crew chief, and medic, is a helicopter crew member who served honorably during the Vietnam War aboard helicopter air ambulances, which were both nondivision and division assets under the radio call signs ~‘Dustoff'' and ~*Medevac’';(Tab 3).
I did not know about it nor was I consulted which would have been the class thing to do. Nor | am sure was Senator Cornyn but one of his staff made the change not knowing the difference between Dust Off and Medevac as distinct BOS.
Medevac is mentioned once and distorts the history and the purpose of this bill. Dust Off is not a Division asset and that is what makes it Dust Off. To include Medevac is this bill is the same as including cargo planes in a CGM for Fighter pilots; or an Artillery unit in a CGM for an infantry unit. The both have the same mission, but do it in vastly11 different ways. Dust Off existed only in Vietnam, Medevac continues today. ( #14)
I was there before Dust Off and after. | flew with Dust Off and Medevac. I commanded units under both systems, They are distinctly different Battlefield Operating Systems. Medevac, l.e., casuaity evacuation, is a system that is amorphous; It can mean medical evacuation by land, sea or in the air — or by litter. The Marines used it as did the Air Force. Dust Off is very clearly Army Aeromedical Evacuation in Vietnam as defined in the official Army history (#3).
Several of us who flew with Kelly were assigned to what became the 15th Medical Battalion training at then Ft Benning in 1965 to help them before they deployed. They made clear to us they would not fly as Kelly did and accordingly, would not use the call sign Dust Off. They used the WW2 system of evacuation as “far as the battalion aid stations or division clearing stations.” That may have changed but in my unit in Vietnam we were called to backhaul patients from the 15th to a hospital 5 minutes from them which was 30 minutes from us? They had not flown in Vietnam and did not understand that the helicopter “virtually eliminated the battalion aid station and often the division clearing station from the chain of evacuation”. (Spurgeon Neel, #1)
This has nothing to do with the pilots who flew Medevac, many of them also flew Dust Off, as did. As | said in my book “MEDEVAC crews .. were every bit as heroic as most Dust Off troops.” it is about two historically different BOS. Additionally the heroism of the Marines, the Army gunships and slick ship crews who flew Medevac missions were equally heroic as the Dust Off crews. They are justly proud of their accomplishments. | have recommended they apply for their own CGM.
But they were not the same and this is about a distinct BOS, Dust Off that existed only in Vietnam and is now extinct as Army Aeromedical Evacuation is controlled by combat arms. | have criticized this system see 13: The Decline of Dustoff. American Legion Magazine June 2013. | found it noteworthy that they actually designated a two hour Golden Hour? | am told that they did change this.
Dust Off was an Army level area support asset. It was controlled by the medics. Launch authority rested with the Dust Off unit/pilot. Launch decisions were not governed by higher HQs and risk assessment. It did not have mounted weapons. It had a crew of four. Missions did not require two ships or armed escort. There was no such thing as a green area requirement. Dust Off had a dedicated frequency available to supported troops. Patient were flown directly to appropriate medical facility. Night missions were routine, flown as any other mission.
Medevac in Vietnam consisted of 12 out of 144 helicopters. It was and is a direct support asset controlled by non medics. Launch authority is governed by higher HQs determined by risk assessment algorithms. By all accounts there is an obsession with risk. Some Medevac aircraft have mounted machine guns and a fifth crewman. Some Medevac are forbidden from landing in areas not rated secure, green, for a certain period of time. Some Medevac's required two aircraft and armed escort for missions. Some did not have a dedicated troop shared radio frequency. Patients were moved through an echelon of medical facilities. Night missions were carefully scrutinized and not flown as other mission.
Clearly, in the Vietnam war, as General Neel said: “... Dust-off was preferred...”
The contrast between Dust Off and Medevac is clearly define by AMMED doctrine. “Dustoff was very specific and was only used to describe aeromedical evacuation by Army air ambulance under medical command and control.” See Tab #3. To include Medevac in this Medal is a distortion of history.
Presentation
I believe it should be be presented to the Kelly family as representatives of all the Gold Star Dust Off families who lost a loved one so that other might live. Other wise to living crew members from the time of Kelly or early Vietnam. The first Dust Off recipient of the PH, who flew for Kelly, is still alive as are some members of his unit. But it should be presented to a PH recipient (s).
References
1. Vietnam Studies. MEDICAL SUPPORT. Major General Spurgeon Neel 1973.
2. Soldiers. A History of Men in Battle. John Keegan and Richard Holmes. Chapter 7, Casualties 1985.
3. Dust Off. Army Aeromedical Evacuation in Vietnam. Peter Dorland and James Nanney. Center for Military History U.S. Army, 2006.
4. Military Medicine Through the Ages. BG Ret, Lim Meng Kim. (Kim identifies Vietnam and Dust Off as the epitome of Battlefield Medicine).
S. Physician Forever Changed Army and Civilian Medicine. Army Magazine, December 2024. Brigadier General John Brown.
6. We Were Soldiers Once and Young, LTG Harold Moore and Joseph Galloway, P 147-148.
I have written numerous articles and participated in many documentaries/videos, on the origins, execution and excellence of Dust Off as a unique BOS in Vietnam — And the role of Charles Kelly as its father. My book, Dead Men Flying is the only eye witness account of the Kelly struggle to save Dust Off. | also taught the techniques of Dust Off flying at the Academy of Health Services at Ft Sam Houston to prospective Dust Off pilots. Below are a few examples supporting the CGM design.
7. Dead Men Flying. Victory in Viet Nam, The Legend of Dust Off: America’s Battlefield Angels. It has been in publication since 2010.
8. Solo Missions. U.S. Army Aviation Digest, July 1968.
9. Instrument and fiares. U.S. Army Aviation Digest, January 1969.
10. Dust Off Operations. Army Logistician Magazine, July August 1973
11. When I Have Your Wounded. Army Magazine, June 1989
12. Armed With a Red Cross, Dust Off Tactics in Vietnam, Flight Journal Magazine, October 1999.
13. When I Have Your Wounded. Tail View, Flight Journal.
14. Dustoff crews receive Congressional Gold Medal. American Legion Magazine December 2024
15. The Decline of Dustoff. American Legion Magazine June 2013
16. Honored in Vietnam, Huey hero, humanitarian, pioneer Maj. Charles Kelly memorialized. The American Legion Magazine, December 2022.
NOTE: This is believed to be the only memorial to an American military person or unit allowed by the communist in Vietnam.
16. Army Aviation Magazine, December 2024. (Tab 3)
I just got this and noticed that the entire aviation community still uses
Kelly’s final words to define Army MEDEVAC today.
17. The FOB American Legion Magazine, February 2025. A response to 14 above and an example of the mistake of using Medevac. At Tab 3