From Ramstein Air Base, patients headed to Landstuhl Regional Medical Center are loaded onto Ambulance buses (yes, the ubiquitous Blue Birds which have been adapted with litter stanchions for the ten minute up the mountain drive. Taking the autobahn, the buses crawl up the hill and in the out gate before cutting through the campus to end at the Emergency Room entrance.

From there, it should be ordered chaos again. Perhaps a bit too much of a handover in public, especially when the weather is Germany winter (a bit colder than downrange), as a quick discussion ensues before each patient is rapidly moved toward ICU or hospital ward.

For outpatients, the process is even quicker: individuals are hooked to an LNO (liaison) who makes sure that they are fed, housed, organised and headed toward their appointments. The limit is two weeks. For those whose issues can not be solved within that time with a return to duty, they will face a trip back to CONUS. The rest will once again face the challenges of the Air Force Space A system as they attempt to get a ride back to theater.

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