Nodding to the attending anesthetist that all remained well, Katie paused, taking a brief moment to gaze down at her patient. A hasty pre-op wash had removed much of the blood and dirt from the young man’s face and body, and now that she had a few minutes’ respite, she noticed with a deep sense of sadness that he was much younger than she had at first thought, probably in his early twenties, with shorn, dark hair. Stubble covered his chin and jaw line as though he had not shaved in some time, and his skin was pale, almost translucent, making him look as vulnerable as a child, a telltale sign of the trauma that had assaulted his body. He had obviously been out in the field for some time, as he appeared not to have washed in days and a strong smell exuded from his still body. Body odors from soldiers brought in from the field were a normal occurrence for the medical staff. The fetid smells barely stirred or offended their senses.
The young soldier’s injury from the IED explosion that day had resulted in the complete destruction of his lower left leg. Even though the golden hour for medevacking him back from the field to the CTH then assessment followed by surgery, was not breached, the leg had been too damaged and had been amputated just above the knee.
So young. The sad thought often intruded into Katie’s weary mind of late. What will he do now? His Army career had been abruptly and cruelly terminated, the lifestyle to which he had been accustomed had changed irrevocably. He could go on to lead a relatively normal life—most amputees did, and adapted and coped well. With counseling and rehabilitation, the young man would resume his life, but the harsh reality was that it had changed forever. There would be no going back to reclaim what he had once had and moving forward would be the ultimate test for him.
A sudden movement caught Katie’s attention, disturbing her thoughts about the patient. Leading surgeon Major Josh Macintyre of Surgical Team One had stepped back from the operating table. Stripping off his bloody surgical gloves, he raised his plastic visor and pulled down his face mask. Rubbing his eyes tiredly, he once again inspected the heavily bandaged stump of the soldier’s amputated limb before commenting wearily in a broad but lilting Scottish accent, “Well, that’s it, ladies and gentleman. That’s all we can do for the poor wee laddie. As long as infection does’na set in and he remains stable, he’ll do. Thank you all for your assistance.”
Major Macintyre turned away from the operating table, his body posture stooping now as though all the adrenaline and energy that he had drawn on to save his patient’s life had drained away. He walked toward the door of the theater, feet shuffling in their protective bootees, and left, Katie knowing full well that he would make his way unerringly down the long corridor to the R&R—rest and recuperation-room—at its far end.
Lance Corporal Henry Barrow, Katie’s CTM colleague on Surgical Team One, left the theater unbidden, unknowingly leaving a trail of bloody footprints behind him. He returned moments later pushing a gurney that he aligned lengthwise against the operating table. The five remaining members of the surgical team positioned themselves to each side of the patient and, with Katie carefully handling the IV stand, lifted the young soldier gently onto the gurney.
With the lance corporal pushing and Katie wheeling the IV stand and keeping an observant eye on her patient for any downward turn in his condition, they left the theater, turned left down the long corridor and, moving at a steady pace, guided the gurney with its precious passenger some meters until they arrived at the critical care unit—CCU—beyond the wards on the right. Lance Corporal Barrow and Katie wheeled the patient into the brightly lit CCU where four trauma nurses awaited their arrival. Working in well-honed synchronization, the two CTMs transferred the still-sleeping soldier to a pristine white hospital bed, ensuring that the sheets and blanket were tucked securely about his motionless body.
Two trauma nurses immediately took over from Katie and Henry, deftly arranging the IV bags, checking the IV line for kinks and air bubbles and placing a finger heart rate monitor onto one of the young man’s fingers before turning on the heart rate and electrocardiogram monitor. It immediately began to beep quietly in rhythm with the patient’s heart rate and a normal, if slightly rapid tracing in green began to show on the LED screen. Katie moved to the end of the bed while one of the trauma nurses unclipped the patient’s blank chart and returned to his side to check his vital signs. Methodically, the nurse took the patient’s pulse, noted it on the chart, then took his temperature and listened to his heart and lungs. Katie heaved a deep sigh of relief as the nurse hung the clipboard back on the end of the bed without comment, and glanced at her colleague.
Henry pulled his face mask down around his neck, sighed, rubbed his eyes and smiled at her wearily. “Are you all right?” he asked.
Katie rotated her neck tiredly, stretching the stiffness out of her shoulders and spine. “I’m okay, I suppose,” she answered, her voice muffled by her own face mask. With irritation, she pulled it down so she could speak more clearly. “Although I wonder sometimes if I’ll ever get used to all this, day in, day out. It makes me so bloody mad and sad at the same time. All these people are so young. They don’t deserve injuries like these. What a waste of young lives.” She suddenly felt exhausted and depressed and it showed in the flat tone of her voice.
“I hear you,” Henry responded sympathetically. “It’s a hard call and no, nobody deserves to end up injured or dead, I agree with you on that one, but—and this is going to sound pretty harsh—it’s what we all signed up for.” He stopped speaking, studying her face closely. “Are you sure you’re all right? You’re looking pretty pale.”
“I’m just tired,” Katie explained, lightly brushing off his concern, then she chuckled quietly. “Perks of the job, I suppose.” She was not about to admit to her work colleague that she was beginning to feel ill. She felt lightheaded and nauseated, and while she was positive that the symptoms were simply the effects of the long hours she had spent in the hot and humid operating theater, her self-diagnosis did nothing to help her to feel any better.
At that moment the second patient from Theater One, accompanied by the two CTMs from Surgical Team Two, was wheeled into the CCU. Transferred to a bed next to the first, the remaining two trauma nurses commenced their post-op observations and procedures, identical to those carried out on Katie’s still-sleeping patient. Katie and Henry, nodding to their CTH counterparts, left the CCU to go back to Theater One.
Outside in the corridor, the temperature was far cooler than it had been in the theater and the CCU. While Lance Corporal Barrow went on into the now-empty theater, Katie paused, taking a deep breath of the fresher air. Leaning against the cool wall, she raised a hand to wipe away clammy perspiration from her forehead. She would never get used to the heat, no matter how long she stayed in Afghanistan. Her earlier nausea becoming worse, she tried to distract her thoughts from her unsteady stomach by studying her surroundings.
The CTH was one of the few solid builds on Camp Churchill. A large, single story, sand-colored structure, it sprawled over an area of two thousand square meters, its rigid, straight lines at odds with the khaki canvas tents, sand-colored office containers and dun-colored, hard-packed sand and dusty earth that comprised the rest of Base Independence. It had started life as a MASH-style field hospital but as the base had expanded and become more developed and permanent, so had the Role Three Combat Trauma Hospital, a medical facility in miniature with state-of-the-art equipment, giving it the ability to be able to cope with the most complex of cases, something that was paramount in a war theater.
Its interior décor was spartan in its gleaming whiteness with spotless walls and dark green, rubberized flooring that ran throughout each room and the long central corridor bisecting the length of the building. A large, red-lettered sign—easily observed by all who entered—was placed just inside the double entrance doors, prohibiting the carrying of weapons beyond a certain point. Camp Standing Orders stipulated that everyone entering the building, including all medical personnel, had to leave their personal weapons in
a small room simply called the weapons room, just inside the double doors, and collect them when leaving.
Leading off from the corridor were two operating theaters, each containing two operating tables. This gave the CTH the ability to perform four surgical procedures at the same time. In addition, there were two trauma rooms, each with a portable X-ray machine, capable of keeping four casualties stable until taken to surgery. The main rooms consisted of an MRI room, a twelve-man critical care unit, two twenty-man wards, the R&R room, shower and locker room facilities and a number of other rooms, all making up the labyrinth that was the CTH.
A lifeline to the sick and injured, the CTH was a safe haven for those who needed to know that in the midst of war there were people who cared—that there was a place of peace and protection where wounds were treated and damaged limbs and psyches healed. It was where the medical teams and staff worked beyond the call of duty to offer survivors compassion, care and an unfailing hope of survival, together with dedication and commitment. All the skill and competence in the world, could not save some, but the majority of the casualties who passed through the CTH’s doors survived and went home to their families. This ultimately gave all the medical staff a sense of victory and achievement over those whose sole intent was to maim and kill.
Katie jerked herself from her reverie. There was more work that needed to be done before she could rest, so straightening up from her weary slouch against the wall she went to the door of the theater. She paused there, her weariness intensifying, dismayed at the mess that greeted her. The room—the scene of the two earlier surgical procedures—now lay silent and empty but there was blood everywhere—droplets sprayed on walls, smeared liberally across countertops, the operating tables, and staining instruments and instrument trays. A curdled miasma of smells inside the room, combined with the heat and humidity, were such that Katie felt as though she was about to suffocate. Perspiration immediately broke out on her forehead and her stomach churned rebelliously with a surge of the earlier nausea. Attempting to ignore her escalating discomfort, she swallowed and moved into the theater to commence the task of restoring it to its prior cleanliness.
After use of the theaters and trauma rooms, each needed to be thoroughly cleaned and sterilized. An infection control policy was in force and all surfaces—including walls, floors and anywhere that had come into contact with a casualty’s bodily fluids—needed washing with an anti-bacterial, water-based solution. Instruments had to be autoclaved for optimum sterilization and all equipment used, cleansed thoroughly in boiling water. Every swab and retractor had to be accounted for, instrument trays replenished and drug cabinets re-inventoried, depleted drugs replaced. Each room was always restored to its pristine condition smoothly and quickly, those personnel that carried out the tasks aware that there was always the chance of further casualties arriving at the CTH.
Katie joined Lance Corporal Barrow, and while she worked, she listened to the muted voices of medical personnel drifting to her from the direction of the R&R room where everybody had congregated for a much needed coffee or cold drink and where, she knew having been party to the discussions herself, they would be going over the surgical procedures of the day and discussing the status of the patients. She longed to join them but the bloody mess in the theater needed tending to.
Although they were both tired, Katie and Henry were adept at doing this particular task, and they cleaned the theater quickly and thoroughly, collecting all the bloodstained bandages, pieces of uniform and swabs together before sealing the bundles in bags to prevent further contamination and throwing them into a waste receptacle in preparation for incineration. At one point Katie discovered a set of dog tags lying in lonely isolation on the floor in a small pool of blood. Picking them up, she allowed them to dangle from her gloved fingers for a second then ran them under hot water and set them aside to place with the other personal effects.
The CMTs from Surgical Team Two eventually joined them to assist with the clean-up. All four went about their work in silence, exhausted but with a quiet sense of efficiency. When they had finished cleaning Theater One, the four moved on to Theater Two then to each of the trauma rooms. It was when they had nearly completed their tasks in Trauma Room Two that Katie’s nausea abruptly returned with a vengeance. Breaking out in a cold, clammy sweat, she paused in her task of wiping down an examination table and swayed dizzily.
Glancing down at her gloved hands in an attempt to distract her thoughts from how ill she was feeling, she noticed a liberal coating of dried blood on them, and geometric swathes of quickly drying red down the front of her scrub smock. She gagged slightly and put a hand to her mouth, remembering at the last minute about her stained gloves and jerking her hand away from her face. She knew instinctively that at some point in the very near future she was going to be very ill, and to avoid the embarrassing scene that this might create, she needed to get outside the CTH in the hope that some fresh air might help her feel better. Her face pale and covered in perspiration, Katie turned to Henry. “I need to go outside for a few minutes,” she announced, her voice shaking slightly.
“Okay, no problem,” Lance Corporal Barrow replied, glancing at her. Seeing how suddenly pale and unwell she looked, his expression became one of concern. “Katie, you look terrible. Are you feeling all right?”
“No, not really,” she answered abruptly. “I’m feeling a bit sick. I’ll be back in a couple of minutes.”
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About the Author
Sharon spent eight and a half years in the Women’s Royal Air Force. Originally based in London, after she met her husband, Sharon relocated to Scotland to settle in Edinburgh. Already loving the country after having been stationed there during her time in the military, Sharon has never looked back. She lives with her husband and rescue West Highland Terrier, Snowie, (who thinks that she is a Rottweiler in disguise).
In 2014 Sharon started to have visions of writing a contemporary military romance. The ideas started to pile up and there was nothing for it but to get them down on her laptop, regardless of time and place.
Sharon Kimbra Walsh loves to hear from readers. You can find her contact information, website and author biography at http://www.totallybound.com.
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