Former Navy SEAL and pioneer combat medicine physician is awarded Presidential Citizen’s Medal

On January 2, 2025, former Navy SEAL platoon commander Dr. Frank K. Butler, Jr, was awarded the Presidential Citizen’s Medal by President Joe Biden at the White House. Butler’s over three decades of foundational work in Tactical Combat Casualty Care (TCCC) — a set of guidelines and procedures to reduce combat casualties — was cited by the White House in announcing the award. The prestigious honor, one of the highest awarded to American civilians, is bestowed on U.S. citizens who have “performed exemplary deeds of service” for the country or their fellow Americans.

Butler began his career in the U.S. Navy back in the early 1970s, when he entered BUD/S training with class 64. After completing that training, he went on to serve in Underwater Demolition Team 12 (UDT-12) and SEAL Team ONE. Following his service as a SEAL, Butler remained in the Navy as a medical doctor, specializing in undersea medicine and ophthalmology.

Before focusing on eye surgery for a number of years at Naval Hospital Pensacola, Butler served at the lesser-known Navy Experimental Diving Unit (NEDU) in Panama City, FL. There, he would come to appreciate a number of the methodologies that would become so crucial in the later development of TCCC. While testing diving equipment and protocols for the Navy diving community, Butler spent hours underwater performing various tasks and pushing his body to its limit to better understand the effects of open and closed circuit diving on the human body. In the process, he suffered both decompression sickness and oxygen toxicity, illustrating the lengths he and his colleagues would go to ensure that Navy divers had the best equipment and used the most effective and safest protocols.

Related: US SpecOps were the vanguard of a revolution in battlefield medicine

Butler returned to the world of naval special operations in the early 1990s, accepting a leadership position as the director of biomedical research for the Naval Special Warfare Command (NSWC), the parent command of the SEALs. It was in that role that he began his decades-long effort to revolutionize battlefield trauma care. In 1996, he co-published the founding document of TCCC, entitled Tactical Combat Casualty Care in Special Operations.

From there, a decades-long effort to save as many American battlefield casualties as possible consumed Doctor Butler and the many others who worked alongside him. He would continue the effort as both Command Surgeon of the U.S. Special Operations Command, and later, in post-retirement from the Navy, as the civilian Chair of the Committee on Tactical Combat Casualty Care. That committee continues to this day to oversee battlefield trauma care for the U.S. military. Dr. Butler was instrumental in both its creation and eventual successful functioning.

The Presidential Citizen’s Medal caps off a long list of accolades and awards bestowed on Dr. Butler, including the inaugural Tactical Combat Casualty Care Award, which would later be re-named “The Captain Frank K. Butler Award” in his honor. He was also inducted into the U.S. Special Operations Forces Medical Hall of Honor, received the 2017 Major Jonathan Letterman Medical Excellence Award, and the American College of Surgeons Distinguished Military Lifetime Achievement Award. Finally, Dr. Butler and two co-authors (including the author of this article) published in 2024 the definitive history of TCCC, Tell Them Yourself: It’s Not Your Day to Die.

Dr. Butler was one of 19 awarded this year’s Presidential Citizen’s Medal, including former NBA star and U.S. senator, Bill Bradley, and former congresswoman Liz Cheney. He attended the ceremony with members of his immediate family, including this author, who is a proud son.

Feature Image: President Joe Biden presents Frank Butler with the Presidential Citizens Medal during a White House ceremony on Jan. 2 in Washington, DC (White House photo by Chip Somodevilla)

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