Preparing for the Next War: Special Operations Medicine, Small Surgical Teams, and Ridge Healer Training for Care Without Evacuation, with MSG Anthony “Tony” Meza

Episode Summary What happens when the medevac helicopter is not coming? In this WarDocs and OpMed TV collaboration, recorded at the Defense Strategies Institute Operational Medicine Symposium in San Antonio, MSG Anthony “Tony” Meza answers that question from the front of a training pipeline built to find out. MSG Meza started as a Navy corpsman, served as a Fleet Marine Force corpsman, and became a Special Boat Team operator in Naval Special Warfare before moving to the 20th Special Forces Group. He now serves as the NCOIC of Ridge Healer, an irregular warfare medical exercise run out of West Virginia under the Greater Ridge Runner program. Ridge Healer brings special operations surgical and resuscitative teams from the United States and allied partners into a covert-status scenario where they care for patients embedded with the local population, with no base, no proctor prompting them, and live role players in cut suits. The driver is Ukraine. MSG Meza describes how the targeting of medical personnel there pushed small, portable surgical and resuscitative teams to the front, and how that exposed a gap in the U.S. force as it moves from the Global War on Terror toward large-scale combat operations. His blunt assessment of what Ridge Healer is teaching: the force is not prepared. It still relies on loadouts and assumptions built for air superiority and rapid evacuation, and it hasn't trained to hold a patient after surgery. He puts numbers on the problem. A team of eight that has just performed a thoracotomy or a laparotomy may have to hold that patient for seventy-two to ninety-six hours while more casualties arrive. The realistic load is not forty patients from one strike but forty over twenty-four hours, six to nine surgeries, and constant questions about triage, logistics, and the next resupply. Some patients who would normally be saved may become expectant when two units of blood are not enough. MSG Meza explains why “old is new,” pointing to portable surgical hospitals from World War Two and Korea and the small logistics lines built through partners. He describes allied teams that arrive rigid and demanding a perfect layout, then learn to move from one patient to the next and sort out the rest later. The episode closes with practical guidance. Ridge Healer runs four 12-day courses a year, and interested units can start through the West Virginia National Guard portal. For young medics and corpsmen, MSG Meza’s advice is to find a mentor and show up ready. Chapters (00:00-01:29) Introduction: What Happens When the Helicopter Is Not Coming (01:29-04:31) From Navy Corpsman to Ridge Healer, and What Ukraine Changed (04:31-06:35) Training Without a Safety Net and the Lesson That the Force Is Not Prepared (06:35-08:35) Old Is New: Small Teams, Thin Logistics, and Hard Triage (08:35-11:28) Allied Demand, Bloody Gloves, and Testing New Technology (11:28-13:49) Joining Ridge Healer and Advice for Young Medics Chapter Summaries (00:00-01:29) Introduction: What Happens When the Helicopter Is Not Coming The episode opens with the central question and introduces MSG Meza’s path from Navy corpsman to the 20th Special Forces Group. Dr. Soderdahl frames the conversation around a training model that no longer assumes quick evacuation. (01:29-04:31) From Navy Corpsman to Ridge Healer, and What Ukraine Changed MSG Meza traces his career through the Navy, the Marines, Naval Special Warfare, and the 20th Special Forces Group. He explains how Ukraine’s targeting of medical personnel and its small surgical teams exposed a gap, and describes Ridge Healer as the response. (04:31-06:35) Training Without a Safety Net and the Lesson That the Force Is Not Prepared Teams train on live role players in cut suits, embedded with the local population and without a proctor. The central lesson is that old loadouts and the assumption of air superiority will fail, and that teams must learn to hold patients after surgery. (06:35-08:35) Old Is New: Small Teams, Thin Logistics, and Hard Triage MSG Meza describes forty patients over twenty-four hours rather than one mass-casualty event, and the triage and resupply problems that follow. He points to portable surgical hospitals from World War Two and Korea as a model for denied environments. (08:35-11:28) Allied Demand, Bloody Gloves, and Testing New Technology Partners are asking for future course dates and arriving with open minds. Rigid teams learn to move from one patient to the next, and Ridge Healer serves as a realistic laboratory where industry can test equipment. (11:28-13:49) Joining Ridge Healer and Advice for Young Medics Ridge Healer runs four 12-day courses a year, with academics, rehearsals, vehicle load-out, and an infiltration phase. MSG Meza closes with advice for young medics and corpsmen: find a mentor, and do not show up unprepared. Take Home Messages The golden hour is no longer the plan: Ukraine shows that medical personnel are targets and that evacuation cannot be assumed. Surgical teams have to train for places where air superiority and a short flight to a hospital do not exist. Surgery now ends with a long hold: A small team that performs a thoracotomy or a laparotomy may keep that patient for seventy-two to ninety-six hours while new casualties keep arriving. Training that stops at the operating table leaves a gap that costs lives. The volume problem is a grind, not a single surge: Forty patients over twenty-four hours and six to nine surgeries strain triage, logistics, and resupply as much as one building strike does. Teams must plan for sustained load and for patients who may become expectant when blood runs short. Old lessons apply again: Portable surgical hospitals from World War Two and Korea, and the small logistics lines built through partners, offer a model for denied environments. Teams should plan staging and partner support instead of expecting a large equipment set to follow them. Realism changes behavior: Live role players, cut suits, and no proctor over the shoulder turn rigid habits into practical ones. Providers who arrive demanding a perfect layout learn to move from one patient to the next and sort out the rest on the backside. Episode Keywords military medicine, special operations medicine, Ridge Healer, irregular warfare, prolonged casualty care, prolonged field care, large-scale combat operations, LSCO, golden hour, Ukraine lessons learned, resuscitative surgical team, austere surgery, Special Forces medic, 20th Special Forces Group, Navy corpsman, combat casualty care, triage, medical logistics, OpMed TV, Defense Strategies Institute, Operational Medicine Symposium, military medicine podcast, WarDocs Hashtags #WarDocs #MilitaryMedicine #SpecialOperations #LSCO #ProlongedCasualtyCare #IrregularWarfare #RidgeHealer #OPMED More from the Operational Medicine Symposium This episode is part of the WarDocs and OpMed TV interview series recorded at the Defense Strategies Institute Operational Medicine Symposium in San Antonio, March 2026. 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