A ‘not-so-routine’ operation Published Jan. 20, 2023 By Robert Whetstone Brooke Army Medical Center Public Affairs JOINT BASE SAN ANTONIO-FORT SAM HOUSTON, Texas -- Aug. 26, 2021 was a terrible day of bloodshed and destruction near Hamid Karzai International Airport, Kabul, Afghanistan, when a suicide bomber killed an estimated 170 Afghans and 13 U.S. service members. That same day, shortly after the bombing, U.S. Air Force Maj. (Dr.) Dominick Vitale, Brooke Army Medical Center critical care/trauma surgeon, and the remaining members of the Critical Care Air Transport Team were on the first aircraft to land and evacuate the severely injured to Ramstein Air Base, Germany. Vitale and the entire crew, dubbed ‘MOOSE 98,’ received the Distinguished Flying Cross with “C” device for their actions during a ‘not-so-routine’ operation. U.S. Air Force Maj. (Dr.) Dominick Vitale, Brooke Army Medical Center critical care/trauma surgeon, stands inside a C-17 Globemaster III with wife Megan O’Toole and son Antonio Vitale after receiving the Distinguished Flying Cross at Travis Air Force Base, Calif., Dec. 9, 2022. Vitale and members of a Critical Care Air Transport Team were on the first aircraft to land and evacuate the severely injured following the Aug. 26, 2021 suicide bombing near Hamid Karzai International Airport, Kabul, Afghanistan. (DoD courtesy photo) Photo Details / Download Hi-Res Vitale attended Coastal Carolina University as an undergraduate student, then went to the University of South Carolina for medical school. He joined the military after his first year in medical school as part of the Health Professions Scholarship Program. He then went to Westchester Medical Center in New York for his general surgical residency and on to BAMC for his trauma and critical care fellowship. He deployed for six months in 2020 during COVID operations, then ended up in Qatar in 2021 for a three-month deployment where he found himself on the verge of a CCATT operation that would take him to Afghanistan for the first time in his military career. “My wife went through quite a bit with me deploying back-to-back years with a 1-year-old child who turned 2, kind of by herself,” he stated. Before the CCATT mission to treat and evacuate seriously injured patients from the suicide bombing, Vitale said his family was unaware he was heading into such a dangerous area. “I was very vague and said I was just going back out,” he explained. I told her (wife) not to expect any contact for 24 hours because routinely there is no Wi-Fi where we are.” Vitale’s wife was at work while world events were going on near the area where her husband was deployed. “She probably put two and two together,” explained Vitale. “I’m sure she was very stressed for that period of time.” U.S. Air Force Maj. (Dr.) Dominick Vitale, Brooke Army Medical Center critical care/trauma surgeon, stands inside a C-17 Globemaster III with wife Megan O’Toole and son Antonio Vitale after receiving the Distinguished Flying Cross at Travis Air Force Base, Calif., Dec. 9, 2022. Vitale and members of a Critical Care Air Transport Team were on the first aircraft to land and evacuate the severely injured following the Aug. 26, 2021 suicide bombing near Hamid Karzai International Airport, Kabul, Afghanistan. (DoD courtesy photo) Photo Details / Download Hi-Res MOOSE 98’s CCATT support to Operation Allies Refuge was very different compared to other deployments in which Vitale had participated. While in Germany, the missions were routine, flying patients back to the states. He said some were complicated when they had patients on ventilators, but they were not transporting combat injured patients during combat operations. Early on in Qatar, he was providing medical care to thousands of Afghan refugees on the ground, situated in airplane hangars. “They needed nurses and doctors to run kind of like a battalion aid station,” he added. “We had very minimal supplies like anti-nausea, pain medication, hydration stations and stuff like that.” The CCATT was also taking blood pressures and conducting physical exams until they got the call to fly into Afghanistan. “We flew into Afghanistan at least three times before the Abbey Gate (one of the gates into the airport) bombing,” explained Vitale. “Typically, we only fly with one CCATT. This mission, (the day of the bombing) we didn’t know how many or what types of casualties we were expecting; we weren’t really given any information,” he noted. There were two CCATTs in Qatar and both were sent the day of the bombing. “It is very unusual,” said Vitale. “Usually there is one left behind and one goes out at a time, but they expected enough significantly ill, critical care casualties that they wanted to send both teams. Time was of the essence; they were shutting down the local hospital and they needed to get people out.” As the director of both CCATTs, Vitale initially had to check the compatibility of the equipment being used. They were working with Afghan and Norwegian medical teams when they arrived after the bombing. “It was a challenging experience, but the whole team did an amazing job,” said Vitale. “Patients were on drips for sedation, blood pressure medicine, pain control, and ventilators.” The CCATTs had to set up their equipment and ensure compatibility and stabilize them for transport in preparation for evacuation. U.S. Air Force Maj. (Dr.) Dominick Vitale, Brooke Army Medical Center critical care/trauma surgeon, was recently awarded the Distinguished Flying Cross with “C” device for his actions during a Critical Care Air Transport Team mission, Aug. 26, 2021. Vitale and his team were on the first aircraft to land and evacuate the severely injured following a suicide bombing near Hamid Karzai International Airport, Kabul, Afghanistan. (DoD photo by Jason W. Edwards) Photo Details / Download Hi-Res The CCATTs were on the ground for about three hours with the C-17 engines running the entire time. “They (pilots) didn’t really know what was going on in the back with us, which I think was good for the both of us,” he said. “We didn’t have to worry, we just had to do our own job. We took off not knowing where our fuel was coming from, or if we were going to have enough to get back to Germany. We ended up air-refueling.” During the operation Vitale and the CCATTs did not know how historic the mission was. “We just knew how serious it was,” he quickly admitted. “We tried to stay humble about it. The award is great and it’s nice to be recognized. Once we hit the ground and had a job to do, it was kind of like, just a blur.” Vitale said he felt like what they did, people were doing daily at the height of the wars in Afghanistan and Iraq. “We stand on the shoulders of the people that came before us,” he added. “I’m proud and humbled by what we did and the experience of getting recognized, but I feel like there are a lot of other people that deserved just as much.” It is not every day in the modern era a service member receives the DFC. History shows Vitale and the crew of MOOSE 98 find themselves in some distinct company. Former president George H.W. Bush as well as actors Jimmy Stewart and Clark Gable received the DFC for specific operations during World War II. El Paso native Gene Roddenberry, creator of the “Star Trek” franchise, also received the award for service in WWII. According to the Department of the Air Force Manual 36-2806, Military Awards: Criteria and Procedures, the Distinguished Flying Cross is awarded to any person who, after April 6, 1917, while serving in any capacity with the Air Force, distinguishes themselves by heroism, or extraordinary achievement while participating in aerial flight. Both heroism and achievement are entirely distinctive, involving operations that are not routine. The DFC is a military medal that can be awarded to any officer or enlisted person of the U.S. armed forces. “We were just doing our job, but what was going on around us made it special,” said Vitale. Learn more about CCATT.