The President of the United States of America, authorized by Act of Congress July 9, 1918 (amended by an act of July 25, 1963), takes pleasure in presenting the Silver Star to Captain (Army Medical Specialist Corps ) Christopher B. Cordova, United States Army, for gallantry in action against an armed enemy while serving with Headquarters and Headquarters Troop, 3d Squadron, 61st Cavalry Regiment, 4th Brigade Combat Team, 4th Infantry Division, for displaying mental endurance and technical competence in treating and evacuating 16 U.S. and Afghan National Security Forces casualties and an additional 27 “walking wounded” during a violent engagement with enemy forces at Combat Outpost KEATING on 3 October 2009, in support of Operation ENDURING FREEDOM in Afghanistan.
NARRATIVE TO ACCOMPANY AWARD:
At 0600 on 3 October 22009, Combat Outpost (COP) KEATING and Observation POST (OP) FRITSCHE, Kamdesh District, Nuristan Province, Afghanistan, came under complex attack by an enemy force estimated at 400 fighters. The fighters occupied the high ground on all four sides of the COP and initiated the attack with concentrated fire from B10 recoilless rifles, RPGs, DSHKAs, mortars, and small arms fire (SAF). During the first three hours of the attack, mortar rounds impacted on the COP and OP every 15 seconds. All six of the troop’s M1151 HMMWVs sustained direct hits from RPGs, half of which withstood as many as eight RPGs each. Within the first several minutes of the battle, mortar rounds hit the main generator on the COP, eliminating power and electricity to most of the camp, including the troop aid station. Enemy mortar rounds and RPGs pinned down the troop mortars at COP KEATING and OP FRITSCHE, limiting indirect fire assets to the Soldiers in the fight. In conjunction with the Afghan National Army (ANA) collapsing their positions, Taliban fighters breached the perimeter of COP KEATING and stormed the outpost, forcing the American Soldiers to fight on an extremely congested battlefield. As the fighting continued, enemy rounds set many buildings ablaze, eventually setting fire to and destroying close to 70% of COP KEATING. As a result, the troop was forced to abandon its tactical operations center (TOC) and aid station in order to continue operations. The outpost’s helicopter landing zone was controlled by enemy forces, which kept medical evacuation (MEDEVAC) aircraft from evacuating the numerous casualties. Throughout the 12-hour battle, as well as during the four days of enemy contact that followed, American Forces killed over 100 Taliban fighters and injured at least 80 more. Despite the resounding tactical success against a numerically superior enemy, eight American and two ANA Soldiers died and an additional 43 American and Afghan forces were injured. Communications were downgraded to only tactical satellite (TACSAT), battle positions ran out of ammunition due to a lack of covered re-supply routes, enemy forces temporarily controlled the ammunition supply point (ASP and helicopter landing zone (HLZ), indirect fire assets were pinned down, the perimeter breached, the COP was in flames, and the troop was sustaining multiple casualties. Throughout this devastating attack, Captain Christopher B. Cordova, the Squadron Physician Assistant and COP KEATING’s senior medical professional, acted heroically under heavy enemy fire by orchestrating the most essential supporting operations on COP KEATING; that is, maintaining the troop aid station and its ability to provide lifesaving medical care to the Soldiers. Captain Cordova’s calm demeanor and focus in the midst of mayhem inspired his Soldiers. He used his technical expertise to manage mass casualties (MASCAL) during the deadliest attack on American forces in more than a year in the Global War on Terrorism. The aid station served as a portion of the outpost’s outer perimeter, and on 3 October 2009, it sustained several direct hits from RPGs, mortars, and SAF. Throughout the day-long engagement with the enemy, Captain Cordova operated with the skill of a trauma surgeon, performing successful life-sustaining operations that only the most confident and skilled medical professionals have studied. Within the first few minutes of the attack, Private First Class Kevin Thomson was struck and killed by enemy fire. Knowing that more casualties were imminent, Captain Cordova began executing the MASCAL reaction plan he created and rehearsed with his staff during the months leading up to 3 October. While preparing the aid station, Sergeant Joshua Kirk was hit by an enemy RPG. Captain Cordova threw an aid bag to Staff Sergeant Courville, the aid station NCOIC, and instructed him to provide initial treatment to Sergeant Kirk and evacuate him to the aid station. Within minutes of Staff Sergeant Courville’s departure, an RPG exploded at the door of the aid station, causing shrapnel wounds to two of his medics, Sergeant Hobbs and Specialist Floyd, with a more serious injury to Specialist Stone. After ensuring that his Soldiers were conscious and safe, Captain Cordova focused on the final coordination for the MASCAL while he simultaneously directed Sergeant Hobbs to treat Specialist Stone. Immediately upon Sergeant Kirk’s arrival, Captain Cordova determined his prognosis was poor due to profuse bleeding from the skull, so he coordinated with the medics to control the bleeding. The enemy contact outside continued as a wall of SAF bounced off the exterior of the building, but Captain Cordova remained focused. While attempting to resuscitate Sergeant Kirk, five wounded ANA Soldiers arrived to the aid station and Captain Cordova directed Sergeant Hobbs and Specialist Floyd to treat them. Within a matter of minutes, Specialist Scusa was brought into the Aid Station with a gunshot wound (GSW) to his chest and no pulse or heart sounds. Captain Cordova continued to manage the flood of casualties in the aid station, pronouncing Specialist Scusa’s time of death at 0630 hours and placing him in the expectant area underneath a body bag. After concluding that their efforts to resuscitate Sergeant Kirk were unsuccessful, Captain Cordova pronounced his time of death at 0645 and placed him inside a body bag next to Specialist Scusa’s body. Despite the fact that Captain Cordova had been attached to B Troop for six months and thought of the Soldiers as his own, he maintained a clear head as a focused professional to provide necessary care to the remaining casualties. Upon the arrival of three additional U.S. casualties and two ANA casualties, Captain Cordova was now managing medical care for five American and seven Afghan casualties, and he was treating shrapnel wounds to the arms, legs, backs, and faces of six Soldiers, and eye injuries, chest and abdominal wounds, head lacerations, and broken legs for five others. During this time Captain Cordova led his medics in treatment and gave close oversight to the most critical patients, enabling the most effective use of the resources available. Meanwhile mortar rounds continued to impact on the small COP, shaking the building while Captain Cordova methodically treated the wounded. Specialist Grissette arrived to the aid station with Specialist Griffin’s body. After noticing copious amounts of blood in the Soldier’s helmet, along with a penetrating head wound, Captain Cordova attempted to detect heart sounds and a pulse, but found neither. While Captain Cordova pronounced Specialist Griffin’s time of death at 1030, placing him with the others in the expectant area, he remained calm, providing a sense of security and confidence to his men who were feverishly treating the wounded. Throughout the previous four hours, the COP, including the aid station, continued to receive mortar and small arms fire, but Captain Cordova never broke his concentration from the priorities at hand. Shortly after, another U.S. casualty, Specialist Dannelley, arrived with a GSW to his upper left arm. After treating the wounds and calming the Soldier, Captain Cordova placed him in the priority evacuation category. While providing treatment to Specialist Dannelley, Captain Cordova received radio traffic that the enemy had broken through the wire and were on the COP. Captain Cordova determined that all casualties had received initial lifesaving measures and continued to monitor the patients while he formulated an improved security plan for the aid station. Understanding the necessity of 360 degree security, Captain Cordova ordered Specialist Floyd to secure the front door and Sergeant McMurtrey to secure the back door. Soon after, an additional ANA casualty was brought to the aid station with profuse bleeding from the knee, so Captain Cordova and the available medics applied a tourniquet and treated him with a pain-reliever. During the few hours that followed, no enemy attempted to breach the aid station, but because of Captain Cordova’s quick thinking, the Soldiers inside remained calm and collected while gun battles and RPG explosions continued outside. In preparation for the incoming litter patients, Captain Cordova reorganized the crowded aid station, directing the movement of the two ANA litter patients to the overflow area. Captain Cordova used great foresight months earlier by organizing and reinforcing the overflow area with sandbags, which proved to be invaluable during the MASCAL. Throughout the day, Captain Cordova exposed himself to enemy fire to check on the Soldiers in the overflow area, disregarding the enemy mortars and RPGs that were impacting on the COP. Around 1200 hours, Captain Cordova was informed that PFC Mace had been secured from a gun truck. It was reported that he had serious injuries that occurred at approximately 0630, but no one was able to evacuate him because of overwhelming enemy fire. When PFC Mace was finally delivered to the aid station by a team of exhausted Soldiers, he had penetrating shrapnel wounds to his lower left abdomen and left pelvic region, shrapnel and a GSW to his left upper thigh and a tourniquet on the thigh to control the bleeding. There were no pulses in his upper or lower extremities, and his level of consciousness was diminished. Enemy sniper rounds continued to penetrate the COP, and RPG explosions seemed to never end, but the physician assistant continued to work on his casualty with intense concentration. After treating the Soldier for several minutes Captain Cordova confirmed with the ground commander that a MEDEVAC would not be available any earlier than 1930. As if the MASCAL was not large enough to manage, a fire that had originated on the eastern side of the COP was now spreading to 3d Platoon’s barracks, the DFAC, the overflow barracks, and the TOC, which was located three meters from the aid station. Fearing that the aid station would catch fire, Captain Cordova quickly reorganized the medical facility and ordered the movement of all ANA ambulatory patients to the Afghan Security Guard building. Concurrently, he coordinated for litter teams to be on standby to evacuate the three litter patients. As the building was evacuated, B Troops Soldiers cut down a tree and camouflage netting, ultimately preventing the aid station from catching fire. After exposing himself to enemy fire to confirm the aid station was not in danger of catching fire, Captain Cordova determined that Private First Class Mace’s vital signs had not improved and his mental status was diminishing. Private First Class Mace had lost a significant amount of blood, and because the air MEDEVAC could not land on COP KEATING, the Soldier remained without a vital blood transfusion. While the troopers continued their intense fight with the Taliban, the quick reaction force (QRF) was now making its way down the mountain from OP FRITSCHE. The dismounted infantry company would not arrive for several hours, and Captain Cordova determined that Private First Class Mace would not survive without a blood transfusion. Assessing the Soldier one more, Captain Cordova scanned over Private First Class Mace’s ID Tags, confirming the Soldier’s blood type. A field-executed blood transfusion had only been briefly discussed, not even practiced, during his training as a physician assistant. Private First Class Mace was fading fast, so Captain Cordova was forced to act without guidance from a senior medical professional or guidelines from any medical journals. He quickly surveyed the aid station and identified three people with PFC Mace’s blood type: his two medics and himself. Without hesitation, Captain Cordova gathered the blood transfusion kits, prepared the equipment, and collected one unit of blood from Specialist Floyd. Captain Cordova then slowly administered Specialist Floyd’s blood to PFC Mace with close observation for change in vital signs, mental status or transfusion related reactions. After the first unit of blood was completed, PFC Mace’s mental status improved, his pulse rose, and the Soldier began to make jokes with the men around him. The result of Captain Cordova’s care for PFC Mace raised the morale of every Soldier in the aid station, and word quickly spread across the outpost. Over the next several hours, Captain Cordova repeated the transfusion an additional three times, donating his own blood while monitoring PFC Mace’s vital signs every five minutes. Captain Cordova performed a transfusion to a dying Soldier and saved his life, all without any training or supervision in the matter. Captain Cordova’s actions exhibited mental stamina and personal courage. He kept PFC Mace alive for several hours until the Soldier could be transferred to the next higher level of care. Throughout the entire day, Captain Cordova led his team of medics in treating platoons worthy of injured Soldiers who refused to stop fighting. During the intense fighting, B Troop Soldiers recovered the bodies of Sergeant Justin Gallegos and Sergeant Vernon Martin, who also joined the expectant heroes after Captain Cordova pronounced their time of death. The final fallen Soldier, Sergeant Joshua Hardt, was not located until the QRF arrived on the COP and established additional security along the southern and western perimeter. At approximately 2015, Captain Cordova was notified that COP KEATING was secure, the QRF was on the FOB, and a MEDEVAC was en route. With great foresight, Captain Cordova packaged PFC Mace with a fifth unit of whole blood in a pressure infuser, ensuring the patient was adequately covered with blankets and a cap. He led the litters to the HLZ and handed PFC Mace and the two other ANA patients to the MEDEVAC helicopter. On the next MEDEVAC, Captain Cordova led the team in loading five ambulatory patients, and a final MEDEVAC returned and collected the remaining five ANA ambulatory patients. Later that evening PFC Mace died on an operating table during vitally necessary surgery. Captain Cordova gave PFC Mace a chance to life, which provided a great deal of pride and comfort to the men of B Troop and the 3d Squadron, 61st Cavalry Regiment. It was as if Captain Cordova’s leadership had its own medicinal value to the men around him. In the days that followed, Captain Cordova continued to treat injured Soldiers, American and Afghan, and coordinated for air MEDEVAC for those who were seriously wounded. During the 84-hour event at COP KEATING, a total of 16 U.S. and ANSF were treated and evacuated, and an additional 27 U.S. and ANSF walking wounded were treated and returned to duty. Throughout the intense 12-hour fight, Captain Christopher Cordova motivated his medics, inspired all B Troop Soldiers, and reassured the leaders in the fight. The men of COP KEATING fought with ferocity and valor, destroying a numerically superior enemy more than four times their size. Their actions were only possible because of the first-class medical support provided by “Doc” Cordova and his team during the emotionally-draining MASCAL. Captain Cordova’s diligent commitment to train his medics and constantly perfect their abilities enabled each of them to treat the dying and wounded with the highest quality of care. Captain Cordova’s actions saved the lives of several Soldiers, and he alone accomplished the work of four medical professionals without stopping for sleep or food. Captain Cordova’s heroic actions maintained the spirit of the Soldiers and the Warrior Ethos of the troop. Through his calm demeanor and thorough understanding of medicine, the troop continued to fight because they knew they would be in good hands if they sustained injuries. Captain Cordova’s leadership under fire and disregard for his own personal safety in the midst of heavy and sustained enemy contact are in keeping with the finest traditions of the Medical Service Corps and the United States Army.