Memories of 6-month Afghanistan tour linger for Reserve nurse Published April 7, 2010 By Megan Just 452nd Air Mobility Wing Public Affairs MARCH AIR RESERVE BASE, Calif. (AFNS) -- Maj. Deborah Lehker's job isn't an easy one to leave behind. For the past six months she has been a member of a three-person team of medical professionals caring for critically wounded servicemembers during medical evacuations in Afghanistan. When she arrived at March Air Reserve Base March 10 for outprocessing, she was ecstatic to be back in the United States and just hours away from the short flight that would take her the rest of the way home to her family in Phoenix. "It's going to be awesome," she said with tears in her eyes and a huge smile on her face. But even in her excitement, she said her mind was still swirling through emergency care checklists from her duties in Afghanistan. "You have to make sure they're ready to fly," Major Lehker said, as she recounted the factors she had to consider when preparing patients for air transport. "Do they have enough red blood cells to carry oxygen? How are their labs? Have they been resuscitated? Do they have enough medication on board? Are they still bleeding from their wounds? Are they still hypertensive? Do they need to be on pressers? Do they need blood products for flight?" As a reservist, Major Lehker is assigned to the 452nd Aeromedical Staging Squadron. In her civilian job she is a trauma nurse in the intensive care unit at the Banner Good Samaritan Medical Center in Phoenix. "(The hospital staff)] have supported me in every single deployment," she said. "They have sent packages and letters and I would not be surprised if there are quite a few of them at the airport when I get home tonight." The major said the Banner Good Samaritan staff supported her through not only this deployment, but also previous deployments to Iraq in 2007 and Kuwait in 2004. In 2007, the hospital nominated her for the Phoenix Business Journal's Military Nurse of the Year and March of Dimes' Military Nurse of the Year. She won both. Surprisingly, Major Lehker's entrance into the field of nursing didn't happen until 1994 when she graduated from nursing school and left her management career with a major grocery store chain. "A door opened up and it was a great opportunity," she said. "I haven't regretted it since." Major Lehker's two daughters and one of her three stepsons have followed in her footsteps in the health care field. Her 24-year-old daughter works with her at Banner Good Samaritan as an open-heart nurse, and her 23-year-old daughter will graduate from college in May as a pre-med student. Her 18-year-old stepson plans to become a nurse. In 1995, wanting to do something to give back to her country, Major Lehker and two close friends from nursing school became nurses in the Air Force Reserve. "We were as green as our (battle dress uniforms) when we joined," she said. Senior Master Sgt. Teresa Higgins, the superintendent of administrative services for the 452 ASTS, has worked with Major Lehker for eight years and said she has always noticed the major's dedication as she commutes to the base from Phoenix once a month for unit training assemblies and puts even more time in when she can. "She really wanted to be a critical care air transport team nurse and she went through all the training to become one," Sergeant Higgins said. The recent deployment to Afghanistan was Major Lehker's first as a member of a CCATT. A CCATT is a three-member team comprised of a physician, nurse and respiratory therapist who prepare and care for wounded servicemembers who need to be transported by air to hospitals for more advanced care. While many CCATTs are comprised of members who have never met before the start of deployment, Major Lehker's team was unique. The other two members of her team, Lt. Col. Christopher Ryan and Tech. Sgt. Matthew Blondie, are also members of the 452nd ASTS. "CCATT is an intricate part of the whole, total system of the medical care for a patient," Major Lehker said. "It just works so well together with the hospitals and air evacuation and casualty evacuation. It continues the excellent patient care that everyone gives." During her deployment, Major Lehker's team conducted missions between several locations in Afghanistan and hospitals in Germany. They flew 49 missions, transporting 74 NATO patients. The members of the team carried pagers and cell phones and were on call 24/7. After activation, the first step in the team's process was to review the patient's record and ensure the patient was strong enough to travel. If they were, the team would sedate the patient to reduce the stressors of flying and they would "package" the patient for air transport. "It takes a while. There's a lot that goes into it," Major Lehker said of the packaging process. "You take the patient off all their ventilators, their triple channels, their pumps, their suction machines, everything. You put them onto your equipment and transfer them to a litter and put a SMEED over it to hold the equipment so you can transport them." Once the patients are loaded onto the aircraft, one of the major concerns is blood pressure, especially for patients with head injuries. "You can watch them on the monitor when they take off," she said. "Either their blood pressure really rises or it drops and their heart rate changes." After delivering the patient to their destination, the CCATT returned to Kandahar Airfield, Afghanistan, on a plane re-loaded with cargo or other air evacuation crews. On occasion, the team would be "quick turned" directly to another patient mission. During one period, Major Lehker's team was quick turned five times in a four-day period. The major said the one thing all their patients had in common is the severity of their injuries. "Life, limb or eyesight. That's what makes it an emergency priority and gets CCATT involved," she said. As she treated patients, Major Lehker said she was always thinking about the patient's family. "It's somebody's father or grandson and they're expecting him home. I can't imagine getting the phone call that they didn't make it," she said. "I can't even imagine getting the phone call that they're injured or they've lost a limb. I just can't. So I just take care of them." As the mother of five children between the ages of 16 and 26, Major Lehker was often treating patients her own children's age, which she found especially difficult. Whether in a combat zone or at her hospital in Phoenix, Major Lehker said she always talks directly in her trauma patient's ears, introducing herself and letting them become familiar with her voice. "Even though they're sedated, they always hear," she said. She compared her treatment of patients to caring for children, giving soothing touches and reiterating where they are and what's going to happen next. "You transport them with limbs missing and head injuries or even mutilation, and you don't ever know the outcome," the major said. Major Lehker predicted that it will be memories of her patients and her wondering where they are now that will be one of the biggest challenges as she readjusts to civilian life. She said she'll also think about the servicemembers who are still in Afghanistan. "You know what you left behind," Major Lehker said. "You know what has to be taken care of. And the need."