by Ray Wiss
At 1145 I went to get some lunch, returning to the UMS about twenty minutes later. There were still at least forty minutes remaining before the general was scheduled to arrive. Wanting to be at my best, I went outside to brush my teeth, then stepped into our latrine to pee.
A few minutes later I stepped out of the latrine, toothbrush in one hand and zipper in the other, to find myself face-to-face with General Natynczyk. He already had his hand extended and Major Arsenault was introducing me, so there was no getting out of it. I tucked my toothbrush into my back pocket, took the general’s hand in my unwashed one and shook it.
We spoke for a minute or so. He was surprised there was an M.D. on the FOB, and even more surprised to hear that I was doing it for a second tour. I explained my combat arms background and he replied that going from the infantry to being a FOB doc constituted “retirement failure.” (Not bad for an off-the-cuff comment!) He then thanked me for my service and moved off with the major. The boys in the UMS had seen my move with the toothbrush and were all chuckling as I came back inside.
At 1245, we headed off to join the rest of the soldiers. The general joined us (almost) punctually,* asked us to huddle up and addressed us in French. As a French Canadian, I could tell that this language did not come easily to him—he must have worked quite hard to develop the facility he has. My fellow francophones and I appreciated his effort.
Whenever the CDS comes to visit a unit, he gives out CDS coins, large coins inscribed with his personal seal. They are presented to individuals who have distinguished themselves in performing their duties. I was pleased to see one of these coins awarded to Master Corporal Nick Raymond, one of the Bravo Company combat medics. Nick has dived into every casualty situation we have had since I’ve been here and was one of the two medics who responded to Private Peloquin. Everyone commented afterwards about how calm and competent Nick had been through this horrible event. His award was well deserved.
The general then moved off to a table that the combat team leaders had set up to show various pieces of equipment that they thought could be improved upon. They also had some gear that other nations are using which they felt was better than what we had. The general took in all these comments attentively.
Unfortunately, the items the medical team wanted him to see were not on the table but right beside it: two medic packs, one issued by the CF, and the other the one that many of our medics use. The regulation pack has one large pouch. Many of our medics, with their own funds, have bought a pack that has a large number of modular pouches inside it. When dealing with a casualty in the field, they open this pack up and instantly have a well-organized treatment area at their disposal. They can also close it just as quickly if they have to move out in a hurry.
Nick pitches the pack to General Natynczyk
Master Corporal Raymond was standing by to explain all this, but it was not obvious that the packs were part of the display. The general walked right by them and moved on to his next meeting. Nick did not feel comfortable enough to call out to him to come back.
I was made aware of this several minutes later. In a serious breach of protocol, I chased after the general, blew past some senior officer who tried to block me and told him my guys had something to show him. I added that it would be much appreciated if he would take a couple of minutes to come and talk to them. Although his helicopter was orbiting the FOB at the time, he came to the UMS and listened to Nick explain the advantages of this pack.
I made sure the general understood the most impressive thing about this pack: Nick had bought it with his own money so that he would be able to take better care of his guys. The pack in question costs $600; a medic makes about $3,000 a month.
Addendum, September 15: Going home in a few days. I have now met almost all the combat medics of Roto 7. Every one of them has bought the same pack.
JUNE 19 | Unsure About the Shura
A quiet day. There was a bit of combat activity up and down the main highway, but only one hit generated any casualties: a rocket strike that set a vehicle aflame. The four occupants, Afghan civilians employed as truck drivers for Coalition convoys, were burnt beyond recognition.
As things seemed to have wound down in the early afternoon, I took the opportunity to check out the weekly security shura (council meeting). This was attended by the Zhari district leader (a position somewhere between city mayor and provincial premier), the local chief of police, and representatives of the ANA and intelligence services. The Canadians at the meeting included the mentors we have assigned to the ANA and police, and those soldiers involved in development projects in the district.
The Afghans spoke first, giving an update on their activities over the past week. The highlight was the killing of a local Taliban leader, described by the district leader as a “beast.” Given the standards of bestiality among the Taliban, I am happy not to know what he did to deserve that title. Everyone agreed the world was a better place for his having left it.
The Canadians then passed their points, mostly administrative advice about how to obtain various items. The Afghans had recently asked for a lot of gear, particularly communication devices. There is an eternal tension in these situations. The Afghans would like the Canadians to obtain the equipment for them. The Canadians insist that the Afghans use their own resupply system so that the system becomes more efficient. We are going to leave one day, and when we do we want the Afghans to have a functional system that is familiar to them. This is something one encounters regularly when working in the developing world.
The shura
The more intriguing aspect of the shura was the performance of the translator. I have done a lot of translating, and I pride myself on my ability to provide simultaneous translation for speakers in all three of my languages. I like to watch good translators in action, but that was not the case here. Our guy was so minimally functional in English that I questioned not only his translation of what the Afghans were saying but also his understanding of what we were saying, which needed to be translated into Pashto. And yet the civilian and military leaders of Zhari district were counting on him to talk to each other.
Watching this process was disquieting. We knew as far back as 2006 that we were going to be in Kandahar province for a long time. That would have been the time to bring over a bunch of ESL teachers to KAF for four to six months to train a large number of superior interpreters. Given the importance of ensuring that allies in a war understand each other, this would seem to be a no-brainer.
This affects my work as well. I often tell medical trainees, “History beats physical exam. History and physical beats labs and imaging.” This means that talking to patients gives you more information than you get from examining them. Talking to them and examining them gives you more information than you get from blood tests and from radiological procedures such as X-rays, CT scans and MRIs. Even with all our sophisticated tests, most of our diagnoses are arrived at by talking to the patient.
For trauma care, my minimal Pashto is all I need. However, I also treat a few Afghan civilians or soldiers every day for non-traumatic ailments. If I can’t be sure of what the patient has said because the interpreter is incomprehensible, my diagnostic ability is limited. While some of our interpreters are quite good, the group includes some whose skills are clearly not up to the tasks required of them. I get the feeling that our generals do not appreciate how dysfunctional the translation service can be out here at times.
Very unusually, the day was not medically over at sundown. Our night vision equipment gives us such an overwhelming advantage in the dark that the Taliban rarely attack between dusk and dawn. FOB Wilson has not had a single trauma patient arrive after supper since this rotation began in mid-March. The case we had tonight involved another Afghan-Canadian communication breakdown, but of a more humorous nature than the one at the shura.
There is a medic attached to the ANA unit based here. If he is on the FOB when we have casualties, he comes over to help us out. He doesn’t speak a word
of English, but you can’t help but like this guy. He is always smiling and eager to learn. I integrate him into the team whenever he shows up.
Tonight, as he has done on a number of occasions, he popped his head in the UMS door. He stood there with his usual big smile as I greeted him from my desk. He looked at me. I looked at him. I waited for him to clarify what he wanted, but he just stood there holding the door open. At least half a minute went by before Dominic the Medic walked over to the door and looked outside.
“Hey,” says Dominic, “there’s a stretcher out here.”
“Uh-huh,” says I, thinking that he meant the ANA medic had brought an old stretcher that he would like us to repair or replace.
ANA medic in his UMS
“I mean,” says Dominic, “there’s a stretcher here . . . with a guy on it.
And he’s bleeding!”
As the GP I replaced had said: “Patients just show up.”
The UMS team went from zero to sixty in about two seconds flat, but the wound was minor. The patient, an ANA soldier, had a through-and-through gunshot wound of the left arm that had broken at least one of his forearm bones. The bleeding was easy to control and the fracture was quickly splinted and stabilized. The problem was that the patient had been terribly burned some years ago. His arms, legs and abdomen were all horribly scarred.
This made it impossible for us to start an intravenous line. The scarred tissue disrupted his anatomy so much that my skilled medics were unable to locate a single vein. After they had tried a half-dozen times, I had a look and couldn’t see a decent option either. To be able to give the patient the pain control and antibiotic medication he needed, I would have to use a large intravenous catheter called a central line, which can be placed in the large veins in the neck, the chest and the groin.
Central lines are far riskier procedures than regular IVs. There is always the potential of hitting something you don’t want to hit. The resulting complication can be anything from an annoyance to a life-threatening event. Fortunately, bedside ultrasound can be used to identify the large vein in the neck called the jugular vein. Once you see the vein, you can put a large intravenous catheter into it with very little risk.
The medics had never seen a central line placed, much less under ultrasound guidance. After the patient had been evacuated they peppered me with questions about the procedure, so we threw a (mostly) willing P.Y. (the Bison driver) onto a stretcher for an impromptu teaching session.
JUNE 20 | Combat Team Commander
How much responsibility do we have in our lives? Many of us are responsible only for ourselves. Parents are responsible for a small number of other human beings, but that responsibility is almost always shared with a spouse or extended family members. Some of us have responsibilities at work. In all of these settings, the risk of injury is negligible.
I want to introduce an individual who is responsible for the lives of several hundred people twenty-four hours a day. A large proportion of these people are regularly in extreme danger.
Major Tim Arsenault, from my hometown of Sudbury, is the thirty-four-year-old commander of the combat team based here at FOB Wilson. Centred on an infantry company, the combat team also includes an artillery detachment, a reconnaissance unit, snipers, combat engineers and various logistical trades.
Canada has three combat teams in Afghanistan. The combat team commanders are the most senior officers who still go into direct combat, leading their troops forward with rifle in hand. By the time our combat mission ends in 2011, well over thirty thousand Canadians will have served in Afghanistan. Fewer than forty will have been combat team commanders.
Major Tim Arsenault, combat team commander
To say that the soldiers chosen for these positions are exceptional would be a gross understatement. Major Arsenault’s CV includes paratrooper training, Ranger training (a specialized commando-type course run by the Americans, along the lines of what you may have seen in the movie G.I. Jane), a deployment as a platoon commander in Bosnia, a stint as an infantry instructor at the Combat Training Centre in New Brunswick, and other taskings that are considered plum postings for young infantry officers. Only a few dozen soldiers in our army have Major Arsenault’s skills as a combat leader.
Many civilians reading this will have a vision of combat soldiers that is grounded in Hollywood movies. The last paragraph may have conjured up images of Sylvester Stallone or Arnold Schwarzenegger in their prime. Although some of our similarly trained officers would fit the bill, Major Arsenault runs counter to type. He has a warm and engaging personality, he is invariably smiling and he speaks softly— loud enough to be clearly heard but not a decibel more.
We hit it off immediately, but I suspect that anyone who comes into contact with Major Arsenault feels the same way. Within moments, you know that you’re in the presence of someone who is sincerely interested in you and what you have to say. You also sense that he will give you good advice, no matter what your problem might be.
In my case, that advice came with regard to my relationship with my daughter. For several days, Michelle has refused to speak to me on the phone. She is angry at me for leaving—she has been crying at night, saying that she misses me—and this is her way to retaliate. There is not much to do in these situations other than ride it out, but the pain this caused was so strong it was physical. How badly am I hurting my child?
Major Arsenault has three children himself, aged four, six and eight. His youngest daughter is the same age as mine. When I told him about Michelle’s behaviour, he replied that a father was always a young girl’s first love and that nothing could change that. It was the perfect thing to say, and the anxiety that had been building up dissipated.
Being a military leader, of course, does not only involve reassuring and encouraging those around you. There are also times when firm correction must be applied. Again, Major Arsenault’s style might not be what you expect. A telling anecdote was shared by one of the combat team’s warrant officers. He told me that the first time Major Arsenault chewed him out, it took him several minutes to realize that he was getting blasted, because the major’s voice was so calm and polite.
Another story was related to me by the social worker who visited us last week. It is a cliché that soldiers like to complain about their officers. Most of this is inconsequential bitching and must be taken with a grain of salt, if not the whole shaker. But after spending a week interviewing soldiers who may have been less happy than their comrades about being here, she had not heard a single complaint about the major. Not one gripe. She found that extraordinary.
It would be a mistake to think that Major Arsenault’s gentle manner implies that he accepts anything less than 100 per cent effort from his men. I had the opportunity to discuss a discipline issue with him, and he had no difficulty “closing the feedback loop.” I am reminded of what Andrei Gromyko said about Mikhail Gorbachev: “He has a nice smile. But he has teeth of steel.”
For the past three years Major Arsenault has been the commander of Bravo Company, Second Battalion, Royal 22nd Regiment (“The Bastards”). There is a cycle in the life of infantry units such as this. A company will be built up, function at a high level for a few years and then be broken up as veterans are assigned to different tasks. Major Arsenault took over Bravo Company right after it had gone through one of these periodic breakups. Over the next thirty months, he rebuilt the company. Then he took them to war.
The commander of “Bastard Combat Team” on the battlefield
One day, I saw him gazing into the distance in a thoughtful manner. I asked what he was looking at, thinking we would have a superficial but nonetheless pleasant conversation about the terrain. He replied that he was thinking about the next operation. It was only then that I saw he was looking at some of his men playing volleyball some distance away. We talked for a while, and he described everything he was doing to try to keep his men safe.
Major Arsenault lost a man, Private Alexandre Peloquin, twelve days ago. H
e agreed with me that the death of one of his men was almost inevitable. It would have been invasive to ask him how he felt about that, but I did ask him if he’d been prepared for it. Major Arsenault replied that, in spite of the foreseeable nature of the event, he had not been.
A note on a leader’s weapons. Major Arsenault has been under direct enemy fire more times than he can count. I asked him how often he had used his personal weapon. He replied that he has not fired a single shot.
This is a mark of extraordinary coolness under fire. When someone is shooting at you, there is an overwhelming desire to shoot back. The act of firing your weapon gives you the feeling that you’re doing something to regain control of the situation. It is psychologically satisfying and goes a long way towards reducing the fear you are feeling.
Every time Major Arsenault has been under fire, he has had to suppress this desire. Instead, he focuses on the evolution of the battle, directing his platoons and the various “supporting arms” of the combat team (artillery, tanks, engineers, bombers and attack helicopters).
Upon hearing his answer, I complimented him on his self-control. He modestly waved this off, saying, “My weapon is my radio.” That’s not exactly true: his weapon is his mind, the skill with which he choreographs the various elements of his combat team as they perform their intricate and lethal dance.
Speaking of his radio, I will point out that the previous photograph shows that Major Arsenault carries it himself. The thing weighs a ton, and some commanders opt to have a young soldier carry it for them. Major Arsenault may not have the Rambo attitude, but he definitely has the Rambo physique.
Addendum—Why things got worse: Major Arsenault was able to shed some light on why the security situation had deteriorated since I had last been here. During Roto 4 we had fought to establish a ring of FOBs and outposts that encircled Zhari-Panjwayi. This had spread our forces so thinly that we were tied down defending all these bases. NATO had asked for more troops to be deployed to Kandahar province so that Coalition forces would still be able to patrol between our FOBs and outposts. No nation stepped up. When last summer’s fighting season rolled around, there was nothing to prevent the Taliban from bringing more troops and equipment into the area to reassert their presence.