MARCH 14, 2025 – A thick blanket of white snow covered the environment as clear directions rang out in the cold, with the breath from the medic’s mouth forming frost on his eyelashes in temperatures well below zero degrees. The pounding rhythm of a Black Hawk helicopter thumped louder and louder as calls were made to ensure care for a wounded service member. After exchanging the simulated patient with the causality evacuation personnel, teammates high-five as they start their journey back to the camp site.
This scenario was common in Ft. Wainwright, Alaska, for nearly three weeks where more than 100 Special Operations Forces (SOF) personnel, 30 organizations, and two partner nations came together for Special Operations Forces Arctic Medic (SOFAM) 2025.
SOFAM, hosted by Special Operations Command North, introduced Naval Special Warfare Operators (SEALs), combat medics and surgical teams to an extreme cold environment that they would face when treating patients in the Arctic. Participants were challenged to adapt and innovate while in this harsh climate, enhancing SOF’s warfighting capabilities and lethality when operating in the Arctic.
“The sub-freezing and Arctic environment is just as violent to a casualty as enemy fire,” said Senior Chief Hospital Corpsman Wayne Papalski, the tactical medicine senior enlisted leader assigned to Naval Special Warfare Group TWO. “Equally, the environment is always working against you as a provider; from your gear, treatment, performance, as well as your own health.”
Army Lt. Col. Maxwell Sirkin, a trauma surgeon and the trauma medical director at Womack Army Medical Center in Ft. Bragg, North Carolina, and SOFAM surgical expert, echoed the sentiment.
“I have spent the last six years of my life as a trauma surgeon for a special far-forward surgical team,” he said. “Part of my life and purpose in the organization is to provide surgery in very unusual and often inhospitable environments. The purpose of this exercise was to assess the functionality and adaptability of our current surgical platforms and partner force surgical platforms in Arctic conditions.”
Throughout the exercise, medical teams were tested on how they handled caring for point of injury casualties, enroute care, and surgical procedures, all while operating in sub-freezing temperatures.
“We have been preparing to fight, and fighting war, in moderate and desert climates for the last 20 years,” said Sirkin. “Performing surgery even in ideal combat scenarios and settings can be extremely difficult and resource costly.”
Going into an unknown environment can have growing pains and lessons learned. SOFAM allowed the SEALs to increase their Arctic warfighting capability by working alongside other SOF and interagency partners in unique scenarios. They casevaced simulated patients via Black Hawk helicopters using hoists and long-range ski patrols pulling sleds.
“I learned that our personnel need to be prepared for the mindset of fighting and practicing medicine in the cold,” said Sirkin. “First, they need to acclimate to living in the cold, surviving in the cold and being comfortable in the cold. Second, they need to be able to alter their clinical practice guidelines slightly to do less interventions at times and instead focus on heat production and generation.”
For the course participants, it was a shock to the system as many of them had never trained in these conditions. It was vital to treat the patients in field hospitals, testing new capabilities.
“This exercise gave the medics a taste of the environment and an idea of how to prepare and train to it,” said Papalski. “There is no real course or training outside of specific exercise that allows for this training to be conducted.”
Overall, the lessons were invaluable to future training and operations in extreme cold environments worldwide.
“The training is important because the environmental factor completely changes the treatment game,” said Papalski. “It also established a precedent to train in and to prior to coming out to conduct training or operations in this environment.”
Sirkin said he was challenged by the exercise and he will take the lessons learned forward to future operations. SOFAM gave the experienced trauma surgeon new ideas and problem sets that he, and the medical community, can use to refine current warfighting capabilities to fight and wins wars.
“This is a very difficult environment to perform surgery in, with many challenges that must be critically assessed and overcome if we are to own this battle space in the future,” said Siskin.
Naval Special Warfare Group TWO produces, supports, and deploys the world’s premier maritime special operations forces to conduct full-spectrum operations and integrated deterrence in support of U.S. national objectives.
From Petty Officer 1st Class Trey Hutcheson