Jonathan Kreske expected he would have to face potentially panicked mariners who did not speak English. But as soon as he was lowered from the hovering Coast Guard helicopter and his feet hit the deck of the Russian tanker, he knew something had been lost in translation.

A call had gone out for assistance for an injured man, but little else had been conveyed. Kreske was led first to a man whose feet had been severed at the ankles.

The Coast Guard rescue swimmer’s nightmare was just starting.

Through the hold and into another area of the ship, he was led to a second crewmember. A clearly catastrophic head injury was throwing the man into seizures, vomiting and bleeding.

Kreske’s training started kicking in — fast.

Kreske was 150 to 200 miles offshore helping multiple casualties, with no second swimmer to assist, no paramedic or flight surgeon present, and no time to call for assistance due to the severity of the injuries.

If they had known the extent of the situation, Coast Guard watchstanders would have deployed a larger team or a second helicopter. But now Kreske was alone. He had no backup and only one litter to perform the hoist and transport. He would have to get creative.

Tourniquets would not be enough in the long run to deal with the blood loss, shock and pain suffered by the man with severed feet. The fastest transport possible to a higher level of care was necessary if the man was to be saved.

After medically stabilizing both patients, Kreske came up with the idea of rigging the backboard insert for the man with the traumatic head injury to be hoisted first.

This configuration would allow for a second use of the same litter and maintain stability for the necessary extraction of the first patient from the transport litter to the floor of the helicopter.

He would have to struggle to fit both inside the cabin, and hope that his flight mechanic above was strong enough to pull the patient and backboard out of the litter on his own while Kreske stayed below to prepare the second patient.

He was determined to save both lives, despite the far- from-ideal conditions.

The first hoist accomplished, he turned his attention to his second survivor. The tourniquets and bleeding around the severed feet were in danger of worsening, so he was forced again to go outside the bounds of standard protocol by placing the man face down in the litter — usually not done for an array of reasons, including the potential for additional injury.

In the end, Kreske conquered that challenge from the Russian tanker Energy Conquerer on Jan. 18, 2013 off San Diego, Calif., and moved on to other heroic feats as a Coast Guard swimmer in Kodiak.

On Wednesday, the 31-year-old Kreske was awarded the Medal of Honor from the National Society Daughters of the American Revolution for his “outstanding service and leadership to his community, state and nation.”

Kreske is one of the youngest recipients of the award in the DAR’s 125-year history. Past DAR Medal of Honor recipients include NBC “Nightly News” anchor Tom Brokaw, former U.S. ambassador to Iran John Limbert, who was held captive during the Iran hostage crisis, and Brig. Gen. Susan J. Helms, a NASA astronaut.

Kreske said he was “surprised and honored” after receiving the award.

“Hearing the previous recipients kind of puts you in your place a little bit,” he told the Kodiak Daily Mirror.

“I love my job,” he said. “It is rewarding every day, it is challenging and it’s given me the opportunity to do pretty amazing stuff.”

In its nomination, DAR described the San Bernardino, Calif., native as neither flamboyant nor especially extroverted.

“You will immediately notice when you stand beside him that there is a seriousness and stillness to his demeanor,” according to the nomination.

Kodiak resident Debbie Refior presented the award on behalf of DAR, a volunteer organization with about 177,000 members worldwide.

Vice Adm. Charles Ray, Pacific Area commander, and Rear Adm. Dan Abel, the 17th District commander, also attended the award ceremony.

During a recent conversation about rescue gear with Coast Guard members, Kreske talked about the pain swimmers deal with when they search for survivors.

"We can't save them all,” he said. “So many times it's not a happy ending. It’s a very difficult thing.”

Tracey Mertens is a public affairs specialist with the U.S. Coast Guard Auxiliary. Roni Toldanes is managing editor of the Kodiak Daily Mirror.

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