Maj. Mark Rasnake was exhausted. The 32-year-old Air Force infectious disease specialist had worked through the night treating some of the worst trauma he'd seen in his life -- seven soldiers who'd been brought in after sustaining catastrophic burns when their Bradley Fighting Vehicle hit an improvised explosive device near Daliaya, Iraq, and erupted in flames. But back at his bunk at Balad Air Force Base, north of Baghdad, he couldn't sleep.
He opened his laptop and began to type a letter home. "I met a hero last night," he wrote. "I did not realize it at the time ... This is a place where the word "hero" is tossed around day in and day out, so much so that you sometimes lose sight of its true meaning. His story reminded me of it."
As a medical professional, Rasnake never identified his patient, even in a letter only intended for family members. As it happened, though, his words would travel further than he imagined. His local newspaper in Eastern Tennessee took it as a submission and reprinted it; and eventually, Air Force officials reached out to the paper so the service could publish it too.
Rasnake's letter survives on the Air Force's official website as the first public account of the bravery of Army Sgt. 1st Class Alwyn Cashe, who sacrificed his life running again and again into the fiery vehicle, ignoring his own burning uniform. It has been 15 years to the day since Cashe hauled his teammates out of the Bradley on Oct. 17, 2005; but Rasnake, now the residency program director for the University of Tennessee's Division of Infectious Diseases, says he's never stopped thinking about him.
"I kind of think about the guy all the time," Rasnake told Military.com in an interview earlier this month. "I've got a helmet bag that I use to carry stuff to and from work, and I put a 3rd Infantry Division patch on that thing, just to always have the visual thing to remember what he did. That's just always been important to me, to at least carry that memory."
Cashe, the most severely burned of the soldiers, was ultimately evacuated to Germany for intensive treatment, and then to Brooke Army Medical Center in Fort Sam Houston, Texas, where he would succumb to his injuries Nov. 8, at age 35. As the anniversary of his death approaches, those who loved him are newly hopeful: in August, Defense Secretary Mark Esper said he'd support a push to award Cashe the Medal of Honor. The U.S. House of Representatives has already passed a bill waiving a five-year time limitation for awarding the medal; a similar measure is expected to pass soon in the Senate.
Rasnake said he didn't learn Cashe's story until a few hours after he and more than a dozen other military medical professionals had finished treating the soldiers and loaded them on an air evacuation flight bound for Germany. He can't remember who shared the account of what happened in the aftermath of the Bradley explosion. But as word spread among his colleagues and across the base, it provoked a common feeling of awe.
"The discussions we had is, you know, if his actions don't deserve the Medal of Honor, we had trouble imagining anything that did that would," Rasnake said.
Cashe was initially nominated for a lesser award, the Silver Star, by his battalion commander, Gary Brito, now a major general. Brito, by his own account, pushed for an upgrade to the Medal of Honor as soon as he learned of the severity of Cashe's injuries. But as the years passed, no medal upgrade came.
At issue, according to various reports, was difficulty ascertaining accurate witness statements of what took place. While initial accounts led the Army to determine Cashe's heroism did not take place in active combat, current descriptions -- championed by lawmakers -- say he dodged enemy fire while hauling body after body out of the vehicle: six soldiers plus an interpreter, who died on the scene. Cashe refused medevac until the others were taken away, according to his Silver Star citation.
What Rasnake saw is in none of those accounts, but speaks to the pain and trauma Cashe's body endured because of his choice not to leave his brothers-in-arms behind.
"The surgeons worked for hours on his wounds and we worked for hours in the intensive care unit to stabilize him for transport. In the end, damage to his lungs made him too sick to be safely transported by plane to our hospital in Germany and then on to a burn center in San Antonio," Rasnake wrote in his later-published letter home. " ... Our air evac team loaded him into the plane for the six-hour flight to Germany. They had to deliver every breath to him during that flight by squeezing a small bag by hand."
Rasnake still has clear memories of that night, although the conditions and treatment of specific soldiers is a blur. Off-duty medical staff were called back up before the casualties arrived. A field intensive care unit was heated to treat those suffering from the hypothermia sometimes brought on by severe burns. Doctors had to intubate to keep the badly burned soldiers' blood oxygenated, and some required surgical incisions to allow burn-traumatized limbs to swell.
Six of the men needed ICU treatment; ultimately, three would succumb to their injuries.
Rasnake had arrived in Iraq earlier that fall, and it wasn't common for doctors at Balad to keep track of the wounded troops they'd treated once they moved on for additional care. But this case was different.
"It was heartbreaking," he said. "For the next two weeks ... Some of them didn't make it, including Sgt. Cashe ultimately, and he was the last one to expire of the ones that ultimately died. And it was just heart-wrenching for us to hear what was happening back home ... he had the entire [Air Force] 33nd Medical Group following daily what was happening."
As Rasnake sat typing that first night in his sleeping quarters, not knowing the fate of Cashe or the other men he'd treated, he thought of a hero from his hometown of Greeneville, Tenn.: Marine Sgt. Elbert Kinser, who threw himself on a Japanese grenade in 1945, saving his men and earning the Medal of Honor. A bridge in the city of Tusculum, Tenn., bears his name.
"How many of his friends are still alive to remember the story? How many grew old and had grandchildren because of his sacrifice?" Rasnake wrote. "Did they thank him every day of their lives? The next time I cross that bridge I will stop for just a few minutes of my life to read about a man that gave all of his."
Now 47, and 13 years out of the Air Force, Rasnake said he never lost hope that Cashe would receive the Medal of Honor that he never doubted the soldier deserved.
"The fact that he's up for the MOH, reliving this and kind of seeing some closure for him and his family is just amazing," Rasnake said. "I'm so glad; it's probably the first piece of good news I've gotten in 2020."
-- Hope Hodge Seck can be reached at firstname.lastname@example.org. Follow her on Twitter at @HopeSeck.