Growing up outside Chicago in a frugal middle-class family, Brent Blackwell never thought about becoming Brent Blackwell, MD. His father worked as a warehouseman and his mother as an administrative assistant, and he and his brother (a half brother lived in Maine) weren’t strangers to hearing that money doesn’t grow on trees. Though educators saw that the young Blackwell had the brain for honors classes, he spent more time appreciating the local music scene than he did hitting the books.

Like the people he was hanging out with, he was not passionate about any career at that point in his life; but unlike them he didn’t see himself being happy with a future of doing whatever as long as it kept food on the table and a roof over his head.

So once again, in what has long been part of Americana, a kid who didn’t have a lot of financial resources, who didn’t want to be directionless, who wanted to live a life with purpose, joined the Army. He was only 17, halfway through his senior year of high school, when he signed the enlistment contract that would forever change his life. As he moved through his teenage years, with the nightly news showing the American military chasing down terrorists in Afghanistan, he had decided he wanted to serve his country while also learning a skill and challenging himself.

“Medicine wasn’t a career I had thought about at all,” says Dr. Blackwell, now a Kirk Kerkorian School of Medicine general surgery resident, a former combat medic awarded the Purple Heart after he was hit with grenade shrapnel in Afghanistan. “A recruiter said one job open to me after I graduated from high school was as a healthcare specialist, combat medic, so I figured I could use that for work as a paramedic in civilian life or even just to help friends or family.”

After basic training at Fort Jackson in South Carolina, the recent high school graduate was shipped to Fort Sam Houston in San Antonio to become a medic. He wasn’t turned on by the initial course work that he felt was suited to a quiet clinic. But when the curriculum focused on what a combat medic does to help keep comrades alive who’ve been hit on the battlefield, it was a different story. “The more I learned about trauma care, the more interested I was.”

He volunteered for Army airborne training and for an opening as a medic with the Army Rangers, one of the military’s elite special operations forces – the Rangers spearheaded the Global War on Terrorism with the initial ground invasion of Afghanistan in the wake of the September 11, 2001 attacks on the U.S.

While as many as 80 percent of those who attend the U.S. Army Rangers School wash out – would be medics for the fighting force must meet the same grueling physical and mental training demands – the teenager from Illinois thrived in an environment where little or no sleep is commonplace, where you are seemingly pushed 24/7 beyond what you can endure.

“I really wanted to push myself and make the most of my service by working to be among the best,” Blackwell says. “I figured that if I was going to serve, I was going to be directly involved with the fight.”

As the Army’s premier raid force, members of the 75th Ranger Regiment 1st, 2nd, and 3rd Ranger Battalions were continuously rotated and deployed to Afghanistan for more than 20 years, destroying strategic facilities and capturing or killing enemy forces while often using nighttime infiltration techniques that included airborne, air assault and ground methods of insertion. Ranger medics were trained constantly when not deployed, capable of both bringing the fight to the enemy and also to save lives on the battlefield.

After training at Fort Sam Houston, Ranger medics attend the Special Operations Combat Course at the Joint Operations Medical Training Center at Fort Bragg, North Carolina. Though some of the training is based in the classroom, much of it is hands-on realistic training, with Ranger medics rotating through trauma centers in the U.S. to work side by side with physicians. “Here I was,” Dr. Blackwell says, “only 19 with no college, learning from some of the best trauma surgeons in the country.” He learned how to do surgical airways in the neck, put in chest tubes for a collapsed lung, how to manage complex medications ... “I came to realize the incredible opportunity and responsibility I had been given.”

Military Medicine, a monthly peer-reviewed medical journal covering all aspects of medicine in military settings, completed a review in 2023 of the 75th Ranger Regiment’s trauma care during its several years in Afghanistan and Iraq: “Before and throughout these engagements, the Ranger Regiment was an early adopter and innovator of cutting-edge prehospital trauma care protocols and practices … This included the understanding, implementation and utilization of tourniquets, tactical combat casualty care, blood product resuscitation and rapid evacuation of casualties using both medical and non-medical transport platforms … the Ranger Regiment was one of the first units to document zero prehospital preventable deaths in recent military combat operations.”

Two years of training had preceded the first of the teenage Blackwell’s five deployments to Afghanistan, where he generally slept during the day and went out on missions in the darkness wearing night vision goggles. The realistic training, which included the use of live ammunition, Dr. Blackwell says, kept American casualties down.

“The principle of rapid casualty evacuation is heavily emphasized, as we have limited resources on our missions and many patients need to be assessed and treated in a much more resource-heavy setting. We carry medical supplies to manage immediate life threats, stabilize patients, and prepare them for evacuation. We can hold on to patients if immediate evacuation is not available, and we have tools we can use to manage critical patients until evacuation is possible. We were trained to administer pain medications and sedation, place emergency airways, draw blood from one Ranger to give to another, and more.

"However, none of these methods compare to the capabilities that an operating room has. The terrain of Afghanistan made many things difficult, to include traversing terrain and casualty evacuation. There were also limited areas where a helicopter could land, as we operated in villages with many compounds too small to land a helicopter and potential enemies nearby that the helicopter would be exposed to.

"Luckily, we worked with some of the best helicopter pilots there are in the 160th Special Operations Aviation Regiment; the things they were able to do to evacuate a patient were incredible. They also had medics on board that would continue to manage our patient while they were en route to a higher level of care.”

In 2011, during the third of his deployments, Blackwell says Rangers were inside a compound that was thought to house an important enemy leader. A prolonged firefight saw grenades thrown back and forth. “I was in an alleyway and a bunch of us got hit. It felt like a huge force hit my leg as I treated other casualties. There were two of us medics and we split up to stabilize people and move people for evacuation. After securing the compound and moving our casualties out, I found out I had shrapnel in both legs and other parts of my body. Doctors got out what shrapnel they could and I went back to work.”

It was his work as a Ranger medic – the former staff sergeant earned two Army Commendation Medals with Valor Device – that Blackwell says ultimately convinced him he wanted to study medicine and train to become a trauma surgeon.

On the way to his residency in general surgery at the Kirk Kerkorian School of Medicine – he also plans on pursuing a fellowship in trauma surgery – Blackwell completed his undergraduate work with highest honors at the University of Illinois in 2018 prior to earning his medical degree at the University of North Carolina School of Medicine in 2022. While there, he married his wife, Emily, a surgical technologist he met in the service while stationed stateside at Fort Lewis in Washington state. The couple now has two daughters, 4-year-old Savi and 18-month-old Wren.

“I wasn’t sure that I would pursue medicine as a career until the night I treated my first casualties as a Ranger medic,” says Blackwell. “The frantic pace and limited resources were challenging, but these challenges were far outweighed by the reward of treating someone at their worst and playing a hand in their improvement. My desire to become a trauma surgeon started as I handed off my first casualty to the flight medics in Afghanistan. While I was proud of the work I did on the ground, in the prehospital arena, I didn’t like handing my patients off. I wanted to be there with them, to continue to treat and provide definitive care.”