We close out the 20th anniversary interview series with another of the pillars of our SOF medical community - Doc Rush from pararescue. He helps us learn more about the tremendous advances in special operations en route care over the last 20 years. We also get to hear about his background and how he serendipitously become involved with pararescue in the latter part of his civilian physician career. Looking back through the retrospectoscope, he is able to describe the training and level of en route care provided at the turn of the last century. We learn about the many different aeromedical platforms used in GWOT, their capabilities, and the different mission sets by reviewing Doc Rush's own article "Forward aeromedical evacuation: A brief history, lessons learned from the Global War on Terror, and the way forward for US policy" (2013). Alex also has a great discussion of the literature, such as Dr Mabry's "Impact of critical care–trained flight paramedics on casualty survival during helicopter evacuation in the current war in Afghanistan" (2012). Doc Rush is able to guide listeners through an outstanding tutorial about how to change policy and improve patient care through the use of tailored research that is leveraged to relevant policymakers. As always, our guest concludes the interview by reminding us that the most important thing each of us can do to improve combat trauma care is to report your patient data to the JTS. We need your help to analyze patient data and provide data driven improvements in care. Visit our Social Media @jsomonline https://jsom.us/Podcast