by K. Sue Roper
By early morning on the second day after our arrival at Camp Chesty, both OR number one and OR number two were set up and ready to receive patients. Once again, both ORs were austere. Each featured a dirt floor, two OR tables placed head-to-head, and poor lighting. Neither room had air-conditioning for several days. With the temperature often reaching 110 degrees during the day, we would open the tent flaps when we were not performing surgery just to let in some air and diminish the stifling heat of the interior. Unfortunately, when we opened the flaps, we could not prevent flies, bees, and mites from entering. Although we tried to keep the OR environment as clean as possible, flies were everywhere, buzzing over surgical fields and open wounds. All our patients received hefty doses of antibiotics.
One of the first patients received for surgery in OR number one was an EPW whose name was General Hussein. He was a cousin of Saddam Hussein, and he had been shot in his right arm. Among his personal belongings was money equivalent to $45,000 in U.S. currency. His resemblance to his cousin was uncanny; he sported the same short dark hair, heavy eyebrows, bushy mustache, and dark eyes. We also could not help but notice and be astounded by the condition of his feet. Whereas our feet were filthy, bloody, and full of calluses and blisters, General Hussein’s feet were clean, smooth, and blemish free. They typified the easy, complacent, and luxurious life in which he must have been living prior to the war. As was the case for all EPWs, a marine guard carrying an M-16 was assigned to the general, and he was shackled to his cot when he was taken to the recovery ward.
I received my first case in OR number two at five o’clock that evening. He was an EPW who had sustained severe injuries to his right foot, lower abdomen, right arm, and buttocks. His surgical repair required a right-foot amputation, the debridement and irrigation of the right arm and buttocks, and a bowel resection and colostomy. Because we did not have commercially manufactured colostomy bags, we taped an empty IV bag to his lower outer abdomen to serve as a collection reservoir for bowel contents. The complicated and intense surgery lasted three hours. After removing his breathing tube, I transferred him to the ICU, where he continued recovering. He would survive his wounds.
I returned to my berthing tent at 8 PM and had barely fallen asleep when choppers arrived, bringing in more casualties. The crew of OR number one, having had an opportunity to rest, were up and readily agreed to take whatever surgical cases came in. They would work until two o’clock the following morning caring for five patients, including a marine who had sustained severe head trauma as a result of shrapnel ripping through his helmet. Neurosurgeon and CNN correspondent Dr. Sanjay Gupta opened the marine’s skull and removed bone and shrapnel fragments. He then placed an empty IV bag over the area, in effect creating a window because the transparent quality of the plastic bag allowed the doctors and nurses to see the operative site and closely monitor it for potential bleeding, swelling, or infection. It was absolutely amazing and nothing like anything we had ever seen before.
During the first eight days in Camp Chesty, the flow of incoming wounded remained steady but not overwhelming. In addition to Bravo Company’s two operating rooms, an FRSS unit was set up and was actively performing surgical procedures. Periodically, the staff of both OR number one and OR number two were given a day off, and the eight-person team of the FRSS unit would assume the duty, taking any surgical cases that were brought in. Still, we remained on standby in the event that more cases than they could adequately handle arrived.
The wounds we saw and the stories of how the injuries occurred were horrific. We provided care to our wounded marines, EPWs, and noncombatant civilians, never turning anyone away and providing the same standard of care for all. Injuries sustained by our fighting coalition forces were generally orthopedic in nature, and we performed many fasciotomies (surgically incising and dividing the fascia or deep tissue) to remove bullets or multiple shards of embedded shrapnel. In addition, if someone suffered multiple bone fractures as a result of being struck by these projectiles, he would need to have open reduction (surgically exposing the bone and realigning the bone structures) and external fixation (stabilizing the bone alignment by inserting long steel pins through one outer side of the affected arm or leg, through the fractured bone, and then out to the other side of the limb). Many of the fractures we saw may have benefited from internal placement of screws, rods, plates, or other prostheses to immobilize the bone during healing, but we were not equipped with these more modern orthopedic hardware devices routinely used in stateside hospitals.
One such marine was brought to us for emergency surgery, having been shot in the arm by an Iraqi sniper. After he was wounded, his battle buddies immediately fired back, and the sniper was shot through the head, killing him instantly. The buddies in the marine’s unit diligently sought out the body of the dead sniper and retrieved his identification. We also saved the bullet extracted from the wounded marine’s arm, and both “war trophy” items were presented to him. The pieces were well received and seemed to mean a lot to him.
The exhibition of bravery, camaraderie, and loyalty the marines shared with their buddies was extraordinary. A thirty-five-year-old marine sergeant named James was brought to OR number two with shrapnel embedded and dispersed throughout his abdomen and arm. He, along with five of his fellow marines, had been attempting to safely detonate a rocket-propelled grenade. The grenade exploded prematurely, killing two of the marines instantly and fatally wounding another, who died in the chopper en route. The remaining three, all severely wounded, were brought to us.
James was conscious when he was placed on the OR table. Just as I was placing the mask over his face, more helicopters began to land. Hearing the sound of the approaching choppers, he looked up at me and said, “I’m okay. If someone else is worse, take him first.” Emotionally moved by his remark, I explained to him that we would assess him thoroughly, as well as the arriving wounded, and that we would take good care of everyone.
Just before the anesthesia took effect and he fell asleep, James looked up at me and said, “Commander, I have three sons at home who expect me to come home and to play hockey with them.” I promised him that we would all do our best. The surgery was extensive and would take six and one-half hours to perform, but he would pull through. I thought about his homecoming and the joy his sons would experience being reunited with him. They may be too young to understand all that their dad sacrificed, but he is a true hero in my book.
Several noncombatant foreign nationals (civilians) were brought to us for care. They had severe traumatic shrapnel wounds from exploding ordnance or bullet wounds sustained from being caught in crossfire. Some we could help, but others were just too severely injured. An Iraqi mother was brought in after her ten-year-old son had found a live grenade and brought it into his home. When the mother attempted to take it away, it exploded, decapitating the boy and blowing off half of the mother’s skull. Although in the field she had had a tube inserted in the trachea, by the time she arrived at Camp Chesty, she was already demonstrating signs of imminent certain death. Another family of four had been brought in after sustaining injuries when they tried to run through a marine barricade. They all survived, including the four-year-old girl who had shrapnel embedded in her skull.
One day a middle-aged Iraqi man was brought into OR number two after having sustained a significant injury to his arm from a blast. We were told that he, along with two other foreign nationals, had attempted to run through a marine barricade. The other two men riding in the vehicle with him had been killed instantly. As we prepared this man for surgery, he told me he was a civilian pharmacist. I was amazed at how well he could both speak and comprehend the English language. He was well educated, and he discussed with me the actions, indications, and compound structure of various medications I was administering to him. I did not question his story or his alleged status as an Iraqi civilian pharmacist, for he seemed well versed when it came to pharmaceuticals. Still, I found it curious that someone who seemed to understand English to
the degree he did would choose not to heed the marines’ command to stop when approaching the barricade.
After I had administered anesthesia to him and while the surgery was taking place, other members of our company inventoried his clothing and personal effects. When they found his identification, they were shocked, as was I. He was a three-star general in the Iraqi Republican Guard. I no longer viewed this person whom I was breathing for as a fellow health care “civilian” provider. He had lied, and we realized that we could not be as trusting of those coming to us for care as we wanted to be and that we needed to keep our guard up.
Initially I thought, “How dare this man lie to us?” and it made me angry. Still, I knew I could not allow my feelings to overtake my duty and responsibility to render the best care I was capable of providing. I put my emotions aside and continued to provide him with the same professional standard of care afforded to all who were brought into OR number two. The general survived the surgery, and because of the change in his status from foreign national to EPW, he was transferred to the recovery ward and, like the other EPWs, shackled to his cot and watched by a marine armed with an M-16 rifle.
Our feelings of resentment toward the EPWs for whom we provided care grew as we witnessed the horrible, devastating wounds and injuries sustained by our young American fighting troops. As health care providers and human beings, we fought to curtail these feelings of resentment and hate. Despite this tumultuous emotional battle that raged deep within us, the care we provided to the patients who were brought to us would continue to be equitable for all.
We did make a few logistical modifications in care provision to diminish tensions between our troops and the EPWs for whom we provided care. At no time, whether they were in a chopper, the OR, or the postoperative ward, were the Americans and EPWs housed together. To prevent cross contamination of potential infectious diseases inherent in the various cultures, we separated the anesthesia equipment we used and designated the items either “EPW” or “American.” We never used the same anesthesia equipment on EPWs that we used on our American troops.
As the days continued to pass at Camp Chesty, the number of helicopters bringing in wounded became fewer and fewer. We even found ourselves experiencing a three-day period when no surgical procedures would be required. Our company’s mission began moving away from surgical treatment to caring for more medical and humanitarian cases for the foreign nationals. Because we were a surgical company equipped to deal with surgical trauma and not medical issues, we could do little to care for some people, such as the child with leukemia who was brought to us by his parents. We also began medically treating some of our own surgical company members suffering from gastroenteritis and other ailments associated with prolonged living in less-than-sanitary conditions.
Bravo Company continued to care for a total of 667 patients, 63 of whom required more than one hundred intricate and convoluted surgical procedures. The injuries were traumatic, bloody, and debilitating, but no member of the U.S. armed forces brought into the ORs for surgery died. They all survived and were transferred to an EMF.
We had worked long and hard and were pleased with our success rate. We were also proud that we had the opportunity to be working in the service of our country and especially proud that we were able to save the lives of so many of our brave American fighting men.
20
“NESTING” IN CAMP CHESTY
Life in Camp Chesty was far from paradise, but every day brought positive changes and improvements to our living conditions. Despite the unpleasantness we experienced visiting the rustic, fly-infested “bathroom” stalls, these stalls were better than running out into the desert to empty our bladder and bowels into a hurriedly dug shallow hole. Water, though constantly rationed, was available for washing our bodies and our clothes and for quenching our thirst. We had shelter, and even though it required constant reinforcement so that it would remain upright, at least it was there, sheltering us from whatever unexpected surprise Mother Nature had in store. Breakfast and dinner meals were hot, and now that our seabags had been delivered, we had access to a few additional personal and much-needed items. We were safe, and life was good, especially in comparison to the chaotic, tumultuous world we had experienced at Camp Anderson.
We had no idea how long we would be at Camp Chesty. It could be a matter of days, or it could be months. Everything depended on the expediency and success of our fighting forces in accomplishing their mission to take control of and liberate Baghdad. Considering the on-again, off-again departure we had experienced when we left Kuwait, and the unreliable and chaotic transportation system inherent with war, we figured we would be staying for a while.
One morning we attended an officers’ call and were informed that the U.S. Marine Corps wanted surgical teams established and maintained in three areas: Camp Coyote (northern Kuwait), Camp Viper, and Camp Chesty. We were told we might remain at Camp Chesty for up to three months. I hoped that if we were required to stay in the combat theater of this war, we would remain at Camp Chesty, where we were gradually making improvements and growing accustomed to our living conditions. With fewer surgeries and more free time available, we had started to focus our attention and efforts on “nesting” and making our austere environment as pleasant and as tolerable as possible.
Outside the male officers’ berthing tents and close to the ORs, we built a crude, but homey, patio that we referred to as “the OR pad,” or simply “the porch.” It was a perfect gathering place for OR personnel because we could easily see any injured being brought in and could be at our assigned OR stations within seconds.
We put up some camouflaged web netting to serve as a roof adjacent to one of the tents. Several guys who had carried portable collapsible camp chairs on their backs along with all their other gear set these chairs up and designated them for community use. Whoever dropped by the porch was always welcome to occupy one of the chairs, relax, chat, read magazines and books, or do most anything that person desired.
As seasoned scavengers, we easily located some old boards left behind by the Iraqis and made additional stools and a coffee table. I built the coffee table by filling sandbags, stacking them about four bags high on each side, and placing a large board across these sandbag foundations. The coffee table became the centerpiece of this “pad,” where magazines, books, and even personal letters and photos from home were placed to be shared with visitors.
Much of my downtime was spent under the shelter of the porch. The berthing tents were extremely hot and stifling during the day, and our makeshift open-air patio was a much more comfortable and inviting place to sit, read, write letters, socialize, and simply unwind. If any of the OR folks needed to be located quickly, the pad was the place to go because most of us were there when we were not sleeping, running, exercising, or working in the OR.
Our incoming mail had not caught up with us when we first arrived, but it gradually began to filter in. Most of the letters I received had been written well over a month prior. It amazed me how many people back home, whether they knew me or not, truly cared about my well-being. Their words inspired me to take pen in hand and write back, thanking them for their words of support and encouragement and for their thoughtfulness in sending small packages of essential as well as fun items. I cherished every letter and package I received.
Our flimsy general-purpose berthing tent had become well fortified after countless hours devoted to driving stakes, tightening ropes, and placing sandbags around its perimeter. This tent was nothing more than a hot and dirty shelter that housed our belongings and served as a place to sleep, but it was still our home. We had been issued cots on which to sleep, and the installation of electricity that allowed two lightbulbs to be strung across the top of the tent’s interior was a welcome addition to our humble abode. We were now able to accomplish a few menial tasks after the sun set, including locating our cot and lying on it without tripping over some article or object that had gone adrift. Adapting to the eccentricities of one a
nother took time, patience, and understanding, but, in general, on most days we all got along well.
A small exchange had been set up within the camp’s perimeter. This store, about a thirty-minute walk from Bravo Company’s location, offered us an opportunity to purchase such items as junk food (Pringles, cookies, small jars of salsa), flashlights, batteries, soap, cigarettes, chewing tobacco, stationery, green T-shirts, white socks, lip balm, gauze pads, and other small items. The brand and variety of these commodities were limited; you either chose Dial soap or no soap at all. Periodically, the exchange would receive a supply of soda or bottled Gatorade, both of which would sell out quickly. If you were fortunate enough to be in proximity to the exchange, or if you received advance word that a delivery of this cherished commodity was coming in, you might be lucky enough to purchase the strictly enforced limited supply of two sodas per person. Soda, no matter what brand or flavor, with or without caffeine, was a delectable, awesome treat that was so much better tasting than the bleach-treated water we obtained from the water bull. Despite our diligent efforts to make our daily ration of “bull water” more palatable by adding Kool-Aid or other powdered artificial flavoring, it always seemed to taste and smell like bleach.
I had established a comfortable daily routine. An early riser, I would usually meet up with Lt. Cdr. Tom Leonard, an OR nurse, at the OR pad, where we would heat up water for coffee. Tom had a small propane cylinder torch apparatus that he would light and set under a metal cup. Once the water was heated, we would mix it with the instant coffee from one of the MRE packs, and then we would sit back in one of the chairs on the porch, sip our coffee, and greet others as they awoke and joined us. Some of my friends had laughed at me when we were in Camp Guadalcanal because I was constantly picking up and saving single-serving coffee packets I found lying alongside the road or in the trash. Now, as they ventured over to the porch, they would humbly ask me for one of these scavenged packets so they, too, could enjoy a hot cup of coffee to start their day.