Evacuating troops critically injured overseas and providing them with acute care may be first things that come to mind when aeromedical evacuation missions are mentioned. But, AE missions don't end when patients are taken out of harm's way. In fact, some may consider what comes next a new beginning.

The 775th Expeditionary Aeromedical Evacuation Flight is responsible for Integrated Continental United States Medical Operations Plan missions, which wounded warriors are treated for injuries they received in the area of responsibility and transported back to their home stations stateside. The 775th EAEF consists of three detachments spread across the country, all of which transport patients: Joint Base Andrews, Md., Scott Air Force Base, Ill., and Travis Air Force Base, Calif.

"You're helping Soldiers who've had their lives permanently altered," said Lt. Col. Michael Gainer, 446th Aeromedical Evacuation Squadron operations officer here. "We're trying to ease that transition back to their military and nonmilitary families. They're tough people. But, they're transitioning from the military into the civilian world, or coping with their injuries while in the military, and rejoining their families. Their mental stresses are pretty extreme."

Gainer, who oversaw about 350 patient movements spread over 60 missions during his four-month deployment as the 775th EAEF commander, elaborates some of the differences between evacuating patients from combat areas compared to bringing them to their stateside homes.

"In the AOR, we're moving patients who are more acute and current to their injury and less stable, said Gainer, from SeaTac. "You're also moving them from facilities that are less established. In (the continental United States) we deal with an established facility on the front end when we receive the patients, and on the back end when we deliver the patients. From that aspect, it's quite different."

Even though the facilities at home may be of a higher quality than those near combat areas, the urgency doesn't change.

"The urgency is the same in both the AOR and CONUS," he said "We don't move as many (urgent patients) when we get to the United States, because at that point, they've been stabilized to where their movement isn't urgent. Here we focus more on the quality of care."

One of the hard points Gainer hit home to his troops was the stress wounded Soldiers have after their lives have been altered.

"The (patients) aren't as focused on their personal injuries," said Capt. Joel Oyama, 446th AES flight nurse, who worked under Gainer's command while deployed to the Travis detachment. "They're more focused on the 'what's next?' and how to integrate back into 'life' again."

Oyama, from Gresham, Ore., helped treat patients travelling from Joint Base Andrews and redistribute them to locations on the West Coast and Hawaii.

"You answer a lot of questions about what happens next and 'how do I do this?' rather than, 'hey my leg's fractured.' It's more like life after the AOR and the transition," he added.

According to Gainer, the quality of care portion of the mission couldn't be stressed enough.

"We focused on clinical quality," said Gainer. "It's always our focus but we wanted to focus on it more to see where we could make improvements for the patients' comfort."

Gainer tips his hat to his staff for putting their service before themselves with the mission.

"I had excellent medical professionals, all focused on the quality of patient care," said the Reservist. "You consistently find people who are dedicated to what they're doing. It's very easy to be dedicated to what we do."