Dr. Baghai, just slipping his hand into his glove as the circulating nurse tied his gown, reached over and dipped his hand into a bowl of sterile saline solution on the instrument table. “Watch this,” he said.
Dr. Baghai placed his wet hand on the protruding brain and firmly pushed it back into the man’s head.
“Put your hand on mine, gently,” he said.
I placed my hand over Dr. Baghai’s, gauging the pressure he applied. He looked at me. His brown eyes, all I could see of his face, held a hint of anticipation.
With our hands still in place holding the brain, Dr. Baghai took a small catheter in his other hand, closed his eyes for a moment, and then slipped the catheter between our fingers, deep into the man’s brain. He drained about 20 ccs of cerebrospinal fluid, which relaxed the brain enough for it to stay within the head. Dr. Baghai then calmly removed the hematoma, closed the wound, and stepped away from the table.
“Never let the brain roar out at you like that,” he said. “Be prepared for swelling, and handle it immediately or prevent it. You have to maintain control, Lee.”
The patient did not die. He eventually fully recovered. Every time I have seen Parviz Baghai in the fifteen years since, he says the same thing in his crisp British English: “Do you still think that guy’s going to die?”
The plane’s vibrations began to seriously challenge my wisdom in having both coffee and Mexican food before the flight. It was utterly dark, I was utterly miserable, and I couldn’t stop hearing Parviz Baghai’s advice, “You have to maintain control.”
Control had been the biggest issue in my life for the past several years. During the one-hundred-twenty-hour work weeks of my residency, I had acknowledged to myself that any semblance of a loving relationship at home had become playacting, purely for the benefit of the kids. That was the only thing keeping our marriage together — that, and the teaching of my parents’ church that the only thing more sure to send you straight to hell than outright blasphemy was divorce. I had no tools to deal with interpersonal conflict because I was raised to believe that if you were really a Christian you never fought, you were always happy, and you never had problems. So instead of trying to discuss my feelings, I just smiled. Psychiatrists call this incongruity, when you display one emotion and feel another. In retrospect, it would have been frustrating and painful to be married to me during those years.
I satisfied my need for control at work. But by learning to have a white-knuckled grip on every aspect of my life outside my home, I became a miserable person. Only nobody knew it. I kept my Happy Christian with a Perfect Marriage face in a jar by the door like Eleanor Rigby, wore it when anyone could see, and never talked about it.
And so as I heard the echoes of the advice of my mentor, Dr. Baghai, about maintaining control, I was hurtling through the air, strapped into an airplane on a nonstop flight into the unknown, and I was terrified.
I felt nauseated. I really regretted the coffee now, and we were only halfway through the flight. I reminded myself to breathe. I checked my pulse along with my faith: heart racing, faith plummeting. In fact, my faith had been on life support recently, and my prayers over the past few months had seemed weak and ineffective. I had not stopped believing in God, but I was almost convinced that he no longer believed in me.
The guy to my left was young, probably twenty or so, much taller than my five-foot-nine. He had huge arms; I figured he was a mechanic or something that required great strength. He’s a lot stronger than me, I thought. Why are they sending a couch potato like me off to war?
To my right was a man about my size. I had noticed his rank before the lights went out: lieutenant colonel. He had the look of a professional, and even in the darkness his calm presence told me he was less scared than I was. That makes no sense, I thought. How can I feel someone else’s fear level in the dark?
I realized what I was doing. My old insecurities were bubbling to the surface, and my thoughts were just a symptom. I’ve always secretly believed that everyone around me was smarter than me, better at the task at hand. I think this is one of the reasons I’ve been successful professionally — I’ve been so afraid that I would fail and that everyone would finally realize I wasn’t really smart enough to be there. The joke would be on me. Now, on the C – 130, I found myself doing it again.
A wild, erratic movement of the aircraft, followed by another, and then another in quick succession, shook me out of my thoughts. I had been told by other C – 130 pilots that they frequently took ground fire when flying through Iraq, and that they made evasive maneuvers as they began to descend prior to landing. Even with the warning, I wasn’t ready for this.
Were we being shot at? Was someone trying to kill me? I didn’t know — but I do know that the pilot gave us a ride I’ve never experienced on any roller coaster. Several people vomited, and the smell of whatever they had eaten filled the cabin.
When we finally landed, we taxied for what seemed like hours. My heart was beating out of my chest as I imagined stepping off the plane into a hail of bullets as the base was overrun by screaming, bearded Al Qaeda terrorists on black horses, their scimitars and AK – 47s flashing in the light of tracer and machine-gun fire. That was the first time I realized how long it had been since I’d slept, and I reminded myself that I was landing on a very secure American military installation and not in the middle of some movie about Ali Baba and the Forty Thieves.
The engines kept running as the C – 130’s rear door lowered, and I could see the headlights of a forklift driving on to remove the pallets of gear. Someone climbed on board and instructed us to stand and form two lines. We followed him out of the plane and into Iraq. I looked down in the darkness and saw my boots on the ground of a foreign nation at a time of war.
I was hungry, needed to use the bathroom, and felt terribly alone. But at the same time, I was fascinated that the Bible says God chose this very area — the zone between the Tigris and Euphrates Rivers — as the place to begin human history. The canopy of stars twinkling above me would have looked the same to Adam and Eve peering up from Eden.
My second thought was that Iraqis had built the concrete runway on which I stood. Americans had fought to capture this base at the start of the war last year.
Three buses waited on the Tarmac. I thought they were for us. They were not. As we approached, we were ordered to form two lines and wait. I could see the same forklift loading gear onto the plane from which we just exited, and as we got to the buses, I saw that they were filled with fully armored and armed troops. They looked so young and innocent, but their faces conveyed no emotion; they were robots with grenades and machine guns, their eyes clear and jaws set. The plane that had delivered me safely to the base was about to take these robot-soldiers off to some less-safe place, like a bus hauling one person home and another to work. The engines never even shut down.
Other buses arrived for us. We would be driven to a processing center and checked in to the war, as packages might be processed in customs before delivery to their final destinations. I looked back at the C – 130, now filled with troops on their way to battle, and watched the ramp retract, sealing them in. It reminded me that I was now here, for better or for worse, my ride about to depart and the path I’d just walked getting farther away.
My bus drove into the coming dawn. I heard in my head: You have to maintain control, Lee.
Good luck with that, I thought.
CHAPTER 2
JUST A LITTLE BOMB; NOBODY DIED
The bus delivered us to a gravel parking lot in front of a cinder-block building sometime around five in the morning. In the light of the street lamps I could see a metal sign — Welcome to Balad Air Base — on a high chain-link fence topped with razor wire. We walked single file into the building, which turned out to be a classroom. A low grumble went through the crowd. I suspect we all had the same thought: Are you kidding me? We travel for thirty-six hours and you’re going to make us sit through a lecture?
I smelled c
offee and noticed a long table along one wall. Cold muffins in plastic wrappers, room-temperature bottled water, and lukewarm coffee from several pump-top containers made up our first meal in Iraq. I ate a lemon-and-poppy-seed muffin like it was manna and quail straight from the Lord.
After a few minutes, a tall, tired-looking senior master sergeant walked in and cleared her throat. She was holding a clipboard, her hair in a tight bun, and she yawned while she waited for us all to find seats. She clicked a key on her computer and a slide appeared on the wall behind her. She nodded to an airman in the corner, who turned off the overhead lights.
“Welcome to Balad. We have a few things to cover, and then you’ll each meet someone from your duty station to take you to your quarters.”
We learned that the Army had another name for Balad Air Base; they called it Logistical Support Area (LSA) Anaconda, and it was the largest US base in Iraq. We were but a few of the thirty-six thousand military and civilian personnel stationed there.
She continued, “Now let’s talk about mortar attacks.”
The lecture deteriorated from there. A room full of glassy-eyed, sleep-deprived people heard about Alarm Reds, bunkers, sand vipers and scorpions, the perils of camel spiders, and how to avoid starting international incidents by staying out of the base mosque. After filling our heads with visions of all the ways we might get ourselves killed here, we experienced the excitement of filling out forms. When the bureaucracy fest was finally complete, we were dismissed. We filed outside and saw representatives from each duty station. The man waiting on me was yet another sergeant — where were they getting all these sergeants? He threw my gear into a Humvee and drove me to the hospital — my duty station — to check in.
How much longer before I could go to my quarters and sack out?
We drove through a gate, the Humvee on the rough road bouncing my helmeted head against the door a couple of times. Everything smelled like dirt — although it probably smelled better than I did in my sweaty, three-days-without-a-shower DCUs. We stopped in a dark gravel parking lot in front of a group of tents. One had a red cross on the door and a sign, “Emergency Department.”
“Here we are, Major,” the sergeant said. He waved for me to follow, then walked through the door with the red cross on it. This “group of tents,” I suddenly realized, was the hospital.
I stepped over a two-by-four plywood threshold and saw my first casualties of the Iraq War.
Wood-and-canvas stretchers on metal-frame tables were lined up along the tent walls, four on each side. The nearest bed held a naked brown man, his left arm wrapped in bloody gauze. Eyes open, he was staring at the ceiling, but he wasn’t moving. A nurse, wearing a purple shirt, DCU bottoms, combat boots, body armor, and helmet, worked on him, her back to me. I stepped close enough to see around her. She was inserting a Foley catheter into his bladder. The patient’s chest, belly, and left thigh were covered in small cuts and larger gashes, as if someone had swiped a weed eater over the left side of his body. His neck and face were covered with burns. When I looked where the nurse was working, I winced — and prayed that he’d already had all of his children, because he certainly wasn’t going to have any more.
Someone had written on his forehead in black marker a number, 1856.
The nurse found her target, and bloody urine filled the catheter bag. She looked up at me from her work — but really, she was looking through me. Her green eyes blinked so slowly I wondered if she was falling asleep, and her shoulders sagged under the weight of the Kevlar. She was chewing gum.
“Somebody call the urologist,” she said to no one in particular.
I looked around. The other beds were filled with equally bloody and burned brown people, but all medical personnel standing by the beds were busy attending their own patients. The sergeant with me said, “I’ll go get him, ma’am.”
He crossed the tent and disappeared through another door. I looked back at the nurse, who was now wiping blood from the man’s face.
“What happened to him?” I asked.
She looked at me and chewed for a second, then answered as if I had asked her about the weather. “Just a little bomb. Nobody died.”
I pointed at the 1856 on his forehead. “What does that mean?”
She pushed her helmet up with the back of her gloved hand. “That’s his name.”
I leaned closer, thinking maybe it was written in Arabic and I’d misread it. Nope, definitely just a number. “His name?”
She snapped off her gloves and dropped them on the bed. She yawned and rubbed her eyes. “I’m sorry, I’ve been on duty for eighteen hours. You must be new. These terrorists never have any ID on them. We use the numbers to keep track of their care until we find out who they really are.”
Terrorist? I looked down at the semiconscious man. He obviously had some type of head injury to go along with the burns, not to mention the nightmare in his groin and the bloody bandage over the stump of a wrist where a hand used to be. He looked to be maybe twenty or so, and he had a kind face. At least the right side looked kind; the left side was pretty torn up. I’m not sure what I thought the first terrorist I ever saw would look like, but I know I didn’t expect him to be a skinny college-age kid. He looked like the guy who delivered pizza to my house in San Antonio. His blood looked like everybody else’s I’d ever seen.
The sergeant returned, along with two other men wearing hospital scrubs. They stopped at the bedside and the sergeant pointed at me. “This is Major Warren, the new neurosurgeon.”
The red-haired man on the left was pulling on latex gloves. He reached down to the patient’s groin and explored the wounds there. “I’m Bob,” he said without looking at me. He shook his head and grimaced. “Great, he blew them off. Debbie, tell surgery to get ready for an orchiectomy.” He looked up at me, puffed out his cheeks, and shot his gloves into the trash can. “Nice to meet you,” he said as he turned and walked back from where he’d come.
The other man was thin, about my height, with a shaved head. He extended a hand. “Hi, I’m Pete. I’m your partner. Welcome to Iraq.”
I shook Pete’s hand. His pale-blue eyes were bloodshot and looked as if they’d seen things they wished they could forget.
Pete pulled a penlight out of his pocket and looked at 1856’s pupils. “Pupils aren’t dilated. Probably just a concussion. Debbie, get him a head CT after Bob puts the boys back together.” He beckoned to me as he turned to leave. “Come on, Lee, I was just about to make rounds.”
The sergeant held up his hand. “Major, Doc here’s been traveling for three days. Maybe hold off on the tour until tomorrow?”
Pete looked at his watch. “Give us fifteen minutes, Sarge. I’ll just show him around a little.”
I followed Pete down the hall and into another tent. This one had about twenty stretchers, and the people on them were different. The first patient was a large black man whose burned and blistered face was covered in Vaseline gauze to keep the bandages from sticking to his charred skin. “This is the ward where we keep the Americans before they medevac them out. Airman D here hurt his back trying to get out of his Humvee when they hit an IED. He’s going to Walter Reed tomorrow.”
Most of the patients were asleep; the few who were awake looked at me without speaking. All were bandaged in various ways, and some had casts or head dressings. I had seen the war wounded before, when the ones from home finally made it to Wilford Hall, the Air Force hospital in San Antonio where I worked. By the time they got home, they were clean, healing, and looked pretty much like any other patient.
Then, when I was deployed to Germany in early 2004, I’d seen them a little closer. Stable enough to fly out of Iraq but not enough to cross the Atlantic, some patients stopped at Landstuhl Regional Medical Center, an Army hospital. There they had a faraway look, smelled earthy, and didn’t sleep well. Even in Germany, though, I’d only caught a whiff of what they would look like here. These were men who’d recently been boys but would never be again. They smelled l
ike sorrow and fear and fire, and they all looked like they wanted to go home.
Pete checked a couple of charts, gave some orders to a nurse, and led me back to the sergeant. “Get some rest, Lee. You’ll need it.”
The sergeant drove me to a long row of ten-foot-square metal cubes, walked me to one of them, and handed me a set of keys, a broom, and a dustpan. In the gathering daylight I could see piles of sandbags stacked about four feet high lining the outside of the cubes. He pointed out the Porta-Potty just outside my room, and instructed me to report to the hospital commander at 0730 the following morning. I had about twenty-four hours to rest.
Beyond the departing sergeant, I saw the first rays of sunlight starting to probe the horizon. It was the dawn of my war.
I dropped my body armor to the floor and flopped onto the bed with its one-inch thick mattress, oblivious to the probing steel springs. On later nights I would try to find solutions to their merciless interruption of my sleep. But after three days of travel and the stress of the C – 130 flight, they didn’t bother me at all. I did not care that it was the beginning of my first day in Iraq; I had to close my eyes.
Several hours later, I woke to the sound of sirens, reminiscent of my Oklahoma hometown’s tornado warning alarm. According to the lecture we’d been forced to sit through on arrival at Balad Air Base, this was an Alarm Red, which meant the base was under mortar or rocket attack. I remembered the sergeant’s parting words as he left me in my trailer: “Major, tomorrow I’ll give you a tour on our way to the hospital. Remind me to show you where the bunkers are.” Not knowing exactly what to do, I covered myself with my body armor, donned my helmet, and fell back asleep. I woke up a few times during that day, ate power bars and snack crackers I’d brought in my duffel bags, organized my room, and finally went back to bed again.
Since none of the enemy’s projectiles found their way onto my trailer that evening, I slept through the night. On my first morning as a participant in the Iraq War, sleep finally gave way to an acute awareness of how badly I smelled. Three days of travel without a shower, followed by a day of terror-filled, sweaty sleep, produced a body odor offensive enough to motivate me to head out into the unknown in search of a shower.
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