JOINT BASE LEWIS-McCHORD, Wash. –
Iran’s retaliatory attack against the U.S.’ drone strike killing Iranian Gen. Qassem Soleimani in January 2020 sent 11 ballistic missiles carrying warheads weighing more than 1,000 pounds each to annihilate the Al Asad Airbase in Iraq. Miraculously, there were no casualties. But more than 100 Soldiers and Airmen suffered traumatic brain injury due to impact proximity.
Two of those Soldiers, Sgt. 1st Class Andrea Hayden and retired Maj. Patrick Sylvers, were awarded the Purple Heart by Brig. Gen. Michael Yost, 807th Medical Command (Deployment Support) deputy commanding general, on Sept. 11, 2022, at Joint Base Lewis-McChord for their actions following the attack.
On Jan. 7, 2020, Sylvers, a survival, evasion, resistance and escape (SERE) and aviation psychologist, and Hayden, a behavioral health specialist, both assigned to the 1972nd Medical Detachment (Combat and Operational Stress Control) (COSC), an Army Reserve unit out of Joint Base Lewis-McChord, were at the Al Asad airfield waiting to meet their replacements flying in from Kuwait that day.
Sylvers and Hayden were the 1972nd COSC’s last two-man team on a three-month rotation from the Camp Arifjan, Kuwait, Wellness Clinic providing behavioral health prevention and outreach support for all service members at Al Asad Airbase.
Earlier that evening, Sylvers and Hayden drove to the Air Force compound for a scheduled behavioral health appointment with an Airman. Upon arrival, they found the entire squadron in the midst of evacuation. With an uneasy feeling, they contacted their replacements in Kuwait, who confirmed their flight was still scheduled.
The base had been operating at an elevated level of caution, but as they arrived at the airfield, they saw an unusual line of planes, leaving one by one, but hurried. Sylvers reached out again to their replacements, only to be told everything was still scheduled for movement that evening.
The airbase was on alert for a retaliatory attack, and a mass email was sent base-wide requiring service members to be under hard buildings for the night and cease all movement on base at 10 p.m. Sylvers and Hayden did not receive the email as they were away from their workstations, but Sylvers reached out to his commander for information on their location. Neither she nor their point of contact (POC) for the Operation Inherent Resolve (OIR) medical command were tracking anything.
The U.S. military had kept their planned semi-evacuation of Al Asad Airbase as quiet as possible to not alert Iran. Soldiers and Airmen were briefed to prepare for an attack by 11 p.m., so bunkers filled by early evening. By midnight, there had been no strikes, and service members began thinking they should “get back to business as usual…but I didn’t feel certain that people should be leaving,” said Sylvers.
Sylvers made the decision to leave the bunker himself to again reach out to their commander, being further reassured there was no need for concern.
A voice then came over the base PA system yelling, “TAKE COVER!”
Sylvers pushed people into the bunker while being warned, “If you don’t get in, we’re going to close the door!” Once inside, Sylvers realized the iron latch on the door wasn’t fully engaged. As he went to engage it, the first missile hit less than 100 meters from their bunker. The pressure slammed the door and knocked him backwards.
“I had a screaming headache and couldn’t hear very well,” remembered Sylvers.
The attack lasted 80 minutes, with 11 missiles striking the airfield, equipment, and buildings.
“It was like an earthquake,” said Hayden.
Sylvers said he later recalled images during the traumatic brain injury (TBI) clinic debrief and was unsure if they were real or what he imagined seeing.
“There are weird pieces of memory…I remember sitting next to someone breathing heavily in tune and only three booms…yelling over the loudspeaker to ‘Take Cover’ several times,” said Sylvers. “I know it happened and I think I can remember hearing it, but I don't know if it’s true.”
Once given the “All Clear,” they came out of the bunker in the middle of the morning, leaving the darkness for the blinding Iraqi sun beating down. As Sylvers and Hayden took their time getting oriented, Sylvers called the commander letting her know they were alive. A call with the OIR medical POC led to the recommendation that Sylvers and Hayden should be medically evacuated, “but there was a lot of chaos. I remember a helicopter, like half [of a] helicopter being in the middle of the street like it had been blown over a wall and just laying on fire in the middle of the street,” said Sylvers.
Hayden and Sylvers found their vehicle in the parking lot - somehow the only vehicle without damage - and returned to the passenger terminal as debris blocked the roads back to their work area near the hospital. Despite the OIR medical POC expressing her doubts the two were capable of doing their job, there were no other “behavioral assets anywhere that could remotely have a chance to get there. So…we took a ‘get to work’ approach,” said Sylvers.
Once roads were cleared, the two drove back to their work area.
“I don’t know how the plan came together, but we knew we wanted to check on service members, especially those working up near the airfield that were not evacuated,” said Hayden.
Hayden and Sylvers checked in with the main post chaplain who was in the process of scheduling stress debriefings. They volunteered to supplement their services through Traumatic Events Management interventions, taking turns sitting and debriefing with people to figure out how to move forward.
“In the acute, immediate time, there’s not a whole lot you can do – just let people know that we are there and all their feelings are normal, valid and ok,” said Hayden.
They did ‘walkabouts' to different units and the mayor's cell to advertise their availability to meet with service members and base personnel.
“This was a MASCAL (mass casualty) for TBIs…people are not psychologically there and not knowing how to manage their emotional response to that situation,” said Sylvers. “We talked with the infantry battalion commander because his Soldiers were in guard towers, blown out of guard towers, and following missiles to pick up potential casualties.”
But as Hayden and Sylvers offered their services, their bodies were processing their own experiences. Sylvers realized he was not OK when he had a slight altercation with another officer that was completely out of his character.
Hayden explained, “I was in denial the first day and just running on muscle memory. This was my third deployment and not my first traumatic event…and [we] jumped straight into this is what we do for combat stress when something bad happens. I started noticing as the days were progressing that I was not remembering the things I knew I knew…people’s names that I'd known for months.”
After near-constant traffic in their clinic, Hayden and Sylvers didn’t sleep much for the next three days. As other behavioral health assets filtered in from different locations, the two were finally able to return to Kuwait four days later.
Upon return to Kuwait, Hayden and Sylvers were escorted directly to the 349th Combat Support Hospital at Camp Arifjan by their commander, Col. Renn Polk, and Detachment Sergeant, Master Sgt. David Cantu, for evaluation. It was evident that they needed medical attention.
“These were not the same Soldiers we sent forward,” said Cantu.
That initial evaluation set into motion the Soldiers’ treatment journey and long road toward recovery.
“I had a lot of problems with my balance, my memory, finishing sentences, and finding words,” said Hayden. “I went to physical therapy for balance…I would lose track of myself in space and just fall over.”
With a background in mental and behavioral health, Hayden thought she was experiencing emotional shock or acute stress reaction.
“When it wasn’t getting better after three days of regular sleep and meal times and routine, maybe something else was going on. More than just this ‘I had an extreme emotional reaction’ and it was physical as well,” she said.
Hayden had studied the brain and emotions her entire Army career and explained, “To experience it first hand is very different from supporting somebody who is recovering themselves.”
“Combat Stress Control is a small Army community…[there have been] several traumatic incidents specific to combat stress control,” said Hayden. “As a coping strategy, if I have someone else to help, I don’t worry so much about what I’m going through….It’s more comfortable to me helping than thinking about what’s going on with myself.”
Hayden joined the Army Reserve in 2000, a member of the 55th COSC in Indianapolis, Ind., deploying to Baghdad in 2004 and again in 2009 to Camp Victory, Iraq, working in combat stress control outpatient/prevention. There she endured Sgt. John M. Russell shooting two providers and three Soldiers awaiting treatment in the Camp Liberty stress control clinic. In Nov. 2009, while her unit’s replacements were conducting pre-mobilization operations at Fort Hood, they were attacked by Maj. Nidal Hasan who fatally shot 13 people at the Soldier Readiness Processing Center. Hayden attended Advanced Individual Training (AIT) with a service member who died.
But the Al Asad Airbase missile strike “injuries directly impacted me being able to retrain and assess what kind of [civilian] career I wanted to have,” said Hayden.
“Both of us realized over time just how much we were physically impacted by that… It kinda creeps up on you… You kinda know your limitations in one sense and the other sense you don’t know the degree to which things have changed for you,” said Sylvers.
For Sylvers, headaches were constant and his vision went from 20/15 to 20/70, plaguing him with double vision for over a year as his eye muscles were uncoordinated from the nerves from the blast. And for the first year after redeploying, he didn’t know if he could return to his civilian job. He received much support from his Army Reserve unit and his position at the VA, but he eventually stepped down from a leadership job running a primary care mental health unit in the VA and lost his tenure-track position at the University of Washington. Sylvers medically retired from the Army Reserve in December 2021.
“I can’t function at that level any more,” said Sylvers, who now works at a Vet Center, an off-shoot of the VA conducting TBI and post-traumatic stress disorder counseling.
In his remarks at the Purple Heart ceremony, Brig. Gen. Yost highlighted Sylvers and Hayden’s actions. “Even though they were injured…, they had to begin to do their jobs and start treating the Soldiers involved in the incident while they themselves were surely experiencing new difficulties performing their duties. What they did and had to do at that time was simply remarkable.”
Both Polk and Cantu, the 1972nd COSC leadership team, attended the ceremony to witness the awarding of the Purple Hearts, a process more than two years in the making.
Polk emphasized, “Their actions following that attack were the epitome of selfless service; they tirelessly attended to the needs of their comrades for days, while neglecting their own - these Soldiers are truly exceptional.”
“I'm glad that those wounds were observed,” Hayden said. “It was really important for my sons to be here [at the Purple Heart ceremony]…they are the reason I keep going…and I know when I came back I was a different person, and I wanted them to know it wasn’t for nothing.”
“I’m really grateful that the Army, and the Department of Defense in general, has realized that internal brain injury is a serious injury that has life altering consequences, and I’m so grateful that it’s one step forward for having mental and brain health be treated as seriously as the health of rest of the body,” Hayden continued.
“It’s extremely humbling [receiving the Purple Heart],” Sylvers said. “It’s an indication and acknowledgement of sacrifice. There are a lot of grievances and losses that you endure, but I mean, we’re alive.”