Forefathers of modern MEDEVAC crews flew through hell for their soldiers in Vietnam

Vietnam War Dustoff crews flew countless missions into unsecured landing zones with one mission: save the wounded.
An American medical evacuation 'dustoff' helicopter takes aboard a casualty during operations in the jungle.
An American medical evacuation 'dustoff' helicopter takes aboard a casualty during operations in the jungle. Photo from the Australian War Memorial via Wikimedia Commons.

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He was a helicopter pilot they called “Combat Kelly,” and in the early years of the Vietnam War, Maj. Charles Kelly set the example for the daredevil flyers who would come to be called Army “Dustoff” units, flying ambulances that saved thousands of U.S. troops.

As the commanding officer of the 57th Medical Detachment (Helicopter Ambulance), Provisional, Kelly flew a mission on July 1, 1964, to evacuate wounded soldiers. The ground commander called Kelly on the radio to tell him the landing zone was too hot and that he should turn around.

Kelly’s reply: “When I have your wounded.”

Minutes later, a bullet pierced his heart, killing Kelly.

Kelly’s example and the mission he pioneered — mid-battle air evacuation — became known as “Dustoff.”

This week, veterans of Dustoff units gathered at the Army’s hub for combat medicine to celebrate an honor bestowed on their community in September, the Congressional Gold Medal.

Brig. Gen. Clinton Murray, Commanding General of the U.S. Army Medical Center of Excellence in San Antonio, Texas, spoke at the ceremony of the legacy Dustoff crews left for modern military medics. 

“When you hear about them flying through the fog so deep you can’t see, it’s the people,” Murray said. “When you think about flying backward because the enemy fire is so intense, the only way to get to the casualty out is flying backwards. To think the helicopters could be so overweight, six, 700 pounds overweight, that they had to jump the helicopter off the ground to get enough lift to actually carry them off. Amazing.”

The Congressional Gold Medal is the highest award that the legislative branch can bestow. The medal was proposed by Sen. John Cornyn (R-Texas) in late 2023. President Joe Biden signed the bill, “Dustoff Crews of the Vietnam War Congressional Gold Medal Act,” into law on Sept. 26. 

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The law encompasses all Dustoff crews but specifically highlights the actions of the 57th and 54th Medical Detachments. 

At the height of the war in 1969, two air ambulance companies, 11 separate helicopter ambulance detachments, and nondivisional area support comprising 140 aircraft, with a total of 16 numbered helicopter ambulances, were based out of South Vietnam. 

“The helicopter ambulance loss rate was one and a half times higher than non-medevac platforms,” said Scott Woodard, a historian from the Army Medical Department Center of History and Heritage, at the ceremony. “The human toll for killed or wounded pilots, crew chiefs, and medics was 1,136. If you were a member of a Dustoff crew in the Vietnam War, you had about a 33% chance of getting killed or wounded.”

Dustoff crews were experts at medical evacuations, or MEDEVACs, often flying through dangerous fog and smoke and almost always coming into landing zones under intense enemy attack. Their primary air ambulance was the UH-1 Huey helicopter. 

The Dustoff crews would evacuate civilians, enemy fighters, and all types of American and South Vietnamese military personnel, often going past the maximum weight limits to ensure the survival of the wounded. They developed medical treatment modalities that paved the way for today’s medical capabilities in both military and civilian medicine. 

One event attendee was retired Maj. Gen. Patrick Henry Brady, a Dustoff pilot, and Medal of Honor recipient. 

For three rescue missions flown on a single day — Jan. 6, 1968 —  Brady landed on active battlefields, including on a minefield, while under intense enemy fire, to save a total of 51 American and South Vietnamese soldiers. Throughout the day, Brady’s first helicopter was shot up so badly, he switched to a second, then had to abandon that helicopter after a mine exploded next to it during one of the rescues. He completed the day’s missions in a third helicopter. President Richard Nixon presented Brady with the Medal of Honor on Oct. 9, 1969. 

Retired Maj. Gen. Patrick Brady, a Medal of Honor recipient and former Vietnam Dustoff pilot, was a guest speaker at ceremony recognizing the passing of the Dustoff Crews of the Vietnam War Congressional Gold Medal Act. The ceremony was held at the U.S. Army Medical Department Museum on Joint Base San Antonio, Fort Sam Houston, TX on Oct 28, 2024. Members of various veteran organizations and associations representing the “Dustoff” Crews were in attendance. The event was an opportunity to highlight the historic recognition of the aircrews who flew directly into danger to save lives. President Joe Biden signed the act into law on Sept. 26, 2024. This gold medal recognizes the pilots, crew chiefs and medics who “served honorably during the Vietnam War aboard helicopter air ambulances.” The official Congressional Gold Medal ceremony will take place in Washington D.C. once the medal is finished.
Retired Maj. Gen. Patrick Brady, a Medal of Honor recipient and former Vietnam Dustoff pilot, was a guest speaker at a ceremony recognizing the passing of the Dustoff Crews of the Vietnam War Congressional Gold Medal Act. Army photo by Jose Rodriguez.

The Dustoff crews assigned to the 54th Medical Detachment established a reputation for their rapid turnaround time and high survivability rate.

“So if you go to the Vietnam War, one of the big lessons, we transition from a MASH in the Korean war, to evacuation by helicopter in the Vietnam War, to get them to care within 33 minutes that has a survivability rate of all but 100%,” Murray, the commanding general of the Army’s Medical Center of Excellence, said of the unit. “We continue to have that goal with something called the golden hour that we do every day in the wars in Iraq and Afghanistan.”

All Vietnam Dustoff crews embody that message and they will receive the Congressional Gold Medal once it is minted. 

Murray pointed out how Dustoff crews advanced medical knowledge and expertise by administering blood products, and vascular intervention that significantly reduced the need for battlefield amputations, mechanical ventilation, CT scans, and the world’s most advanced battlefield intensive care units.  

“All of those lessons are on the back of all that you did in the Vietnam War, and all those advances are not near as impressive as it’s the people,” Murray said. “Without the people, none of that happens.” 

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