War, What Is It Good For? Probably More Than You Think

I recall learning in school that the American Civil War caused a massive increase in the production of canned food. Also, that same war was the first one where machinery, specifically steam powered locomotives and ships, played a significant role. The use of railroads dramatically expanded during the war and in the post-war years they stretched from coast to coast. 

Mobile army surgical hospitals (MASH) were developed as a concept in the late 1940s, after the close of WWII, but put into practice during the Korean conflict. Additionally, Korea is where the Army first used helicopters as rapid casualty evacuation vehicles. Lessons learned in Korea greatly benefitted soldiers in future conflicts and, just as importantly, became the proof of concept for EMS in the United States where MedEvac helicopters were to become commonplace.    

War, What is it Good For? 

Despite what Edwin Starr said in the song “War” more than half a century ago, good God y’all, war often does indeed benefit people in ways they seldom realize or understand. Going back to Korean, those MASH surgeons returned to the United States and put their experience to work in emergency rooms and trauma centers from coast to coast. Their work influenced trauma care advancement that ended up benefiting average citizens who never went to war, but who’d been in terrible car wrecks and industrial accidents.  

Combat corpsmen and medics who served in Vietnam returned to the United States and went to work in Emergency Medical Services. Many became paramedics and began treating people on the scene as opposed to the old tradition of ambulance drivers loading up patients and transporting them, not even stabilizing them. The combat corpsmen and medics were able to positively influence and improve the EMS system and how paramedics treated patients on scene. Once more, American civilians benefitted from the lessons learned in war.  

GWoT 

The Global War on Terror, now viewed in the hindsight, turned out like every conflict since WWII. The men and women on the ground in the war zones did their jobs. The men and women in Washington, DC undermined and hampered the warfighters and eventually grew weary after they had laundered enough money and filled the pockets of their cronies.

When the GWoT began, the US military was still operating under the old Cold War era thinking regarding battlefield trauma care. All the serious medical care was left up to the corpsmen and medics. The average soldier or Marine was given only basic first aid training and taught never to use a tourniquet unless “all other means have failed.”

That old, Cold War, mentality resulted in the completely unnecessary loss of thousands of lives during the first couple of years of the conflict. There were rarely enough medics and corpsmen to address every casualty and even the professionals didn’t have the gear needed to stop massive hemorrhage from arms or legs. The Army did a study and found that massive hemorrhage from the extremities was the #1 preventable death killer. Loss of airway and tension pneumothorax were #2 and #3 on the preventable death list. 

The US Army’s Medical Corps report forced two important changes. First, every soldier, sailor, airman and Marine deploying to a combat zone would undergo newer, better traumatic medical training and second, the Army needed commercially made tourniquets immediately. That same report showed that improvised TQs (rag and stick) failed 90 to 95 percent of the time.    

Tactical Combat Casualty Care

The Tactical Combat Casualty Care program was developed in the mid-1990s and rolled out for the Special Operations Forces; Navy SEALs and Army Special Forces. By the late ’90s the high speed guys had updated their battlefield trauma medicine, but they represent only a tiny percentage of the entire force. 

It’s hard to put an exact date to when the entire US Military started adopting TCCC because such things are always incremental. I can say that by early 2007, when I went through the TCCC instructor program, all troops deploying to combat zones were required to go through the course. In the beginning, we had three different commercial tourniquets in our training kits in addition to the rag and stick improvised TQ.   

The Old Way of Thinking

In 1987, when I attended USMC Infantry School, our medical training was basically the Red Cross standard first aid program with some “buddy carry” techniques thrown in. No serious trauma care was taught. Five years later, when I went through the Ohio State Peace Officers Academy, the story was much the same; CPR/Heimlich and basic first aid. No serious trauma training was offered.

As a patrolman, I quickly learned that I was more often than not the first person on the scene of a car crash or other medical emergency. I always beat the ambulance there and the only people who might beat me were volunteer firemen/EMTs who happened to be out in their POV listening to the scanner. My situation wasn’t unique.

Despite the fact that troopers, deputies, and patrolmen were almost always first on the scene of a medical emergency, it never occurred to the powers-that-be to train or equip us to stop-gap life-threatening injuries while we waited for the pros to arrive. The first aid kits in our cruisers were the typical little white plastic boxes with adhesive bandages and alcohol wipes. We were issued no traumatic medical gear whatsoever. I bought my own nitrile gloves and a special pouch to keep them on my duty belt. 

The Eventual Crossover 

If there is a silver lining to the miserable failure of GWoT, it’s the eventual crossover that took place between the US military and American law enforcement. Just recently, I had the opportunity to talk with one of our local police officers. Front and center on his duty vest was a tourniquet in a designated holder. I complimented him on having that piece of gear and he informed me that he had been given traumatic medical training in the Police Academy. 

Last month, one of our graduates from SOTGU, a Sheriff’s Deputy, called us to let us know that he used the tourniquet that he had gotten in the class he took from us the prior summer. Our alumnus was dispatched to a gunshot wound call and was the first one on the scene. Being out in the country, he beat the ambulance by 15 minutes. The grad applied the tourniquet and later on the Emergency Department doctor credited that action with saving the victim’s life. 

As I write this article, it’s much more common for law enforcement officers to have the training and the gear to stop-gap life-threatening medical emergencies than not. It’s easy for some to believe that cops have always had the training and gear. I’m here to tell you that they didn’t and it was a long, hard road to get American law enforcement to where it is today. 

In my book “Beyond the Boo Boo” I documented a 15-year-long struggle to defeat the “tourniquet boogeyman” mythology and finally get police agencies to do the right thing. I was called “reckless” and “dangerous” for suggesting that cops and citizens get TCCC-like training and carry tourniquets. For years myself and a few others who pushed trauma care were told we would be sued into poverty for “teaching civilians” to use tourniquets. We could teach people to shoot and kill felonious attackers, but we could not teach good people how to save lives. 

Today, police officers using tourniquets to save lives has become so commonplace that it doesn’t seem to be as noteworthy as it was only a few years ago. While the current system isn’t perfect, the training being given and the gear that’s available is lightyears ahead of what it was when I wore a badge. We can’t deny that it was the hard lessons from GWoT, a war, that got us to this point. I truly believe that, minus the lessons from Iraq and Afghanistan, we wouldn’t be where we are today. 

Walmart Attack

I started this article and before I could finish it, reports came in of a mass stabbing attack in Traverse City, Michigan. Eleven innocent people were stabbed by a lone monster. Two former US Marines were instrumental in stopping the attacker and holding him at gunpoint for the police. 

WATCH: Knife-wielding man confronted by armed citizen after mass stabbing at Michigan Walmart pic.twitter.com/d5nXUO19Lf

— BNO News Live (@BNODesk) July 27, 2025

While having medically trained law enforcement officers is a positive thing, we cannot avoid the truth that it is the citizen who is first on the scene when such attacks happen. It is the citizen who has the opportunity to prevent someone from bleeding to death while waiting for the professionals to arrive. 

Our local Walmart now has a “Stop the Bleed” box/station located up front next to the AED. There are tourniquets and trauma bandages inside, BUT you need to know how to use the gear. At Student of the Gun University, it is our sincere belief that every responsible adult in America should take some type of traumatic medical training. Over the years we have had numerous graduates who were credited by ER doctors with saving the lives of trauma victims. 

As it has always been, lessons learned in war eventually crossover from the military to law enforcement and then lastly to the citizenry in general. If you have been “thinking” about taking training and getting gear, the time to make the commitment is NOW. 

Paul G. Markel is a combat decorated United States Marine veteran. He is also the founder of Student the Gun University and has been teaching Small Arms & Tactics to military personnel, police officers, and citizens for over three decades.