by Ray Wiss
It looked as though I would not have much to write about, but that changed shortly after lunch. Two distinguished-looking gentlemen wandered into the UMS. One of them introduced himself by saying, “We are here to replace you.” I had no idea who he was so I flippantly answered, “Yeah, right! In my dreams!”
It was a poor choice of words. I was addressing Commander Robert Briggs, the head doctor of the rotation arriving in September. He was accompanied by Major Graeme Rodgman, who will be in command of the FOB medics. They were performing a “tactical reconnaissance,” a direct eyeballs-on look at the combat area. As part of this recce (pronounced “wreck-ee”), they had come to Ma’Sum Ghar to check out the FOB UMS, to learn what our capabilities were and to see where their people would be deployed starting this September. I showed them the UMS and our quarters, and we discussed the medical work of the FOB.
Not wanting our guests to be bored, Master Seaman Turcotte (one of the Bison crew commanders) decided to provide us with a chance to show them how sophisticated the care in our UMS could be. So he got on top of his vehicle . . . and fell off.
A Bison is not a small vehicle. A fall from the top generates precisely the kind of kinetic energy necessary for one of those blunt trauma cases I described in the previous entry. To enable us to display even more of our skills, MS Turcotte helpfully landed on his face. This gave us a tricky facial laceration to repair as well. This was an act of selfless devotion to the job, one that we will be reminding MS Turcotte about for some time.
I got the patient sewn up quickly. Apart from the cuts on his face, he had no other apparent injuries. That left the non-apparent injuries he might have suffered in his chest or abdomen. This presented me with the opportunity to give an impromptu lesson in EDE to my two visitors, neither of whom were familiar with the technique. They were interested in the ultrasound examination, so we discussed ways they could integrate this into the practice of their physicians.
We ended the visit with a run up to the hilltop observation post. You can see most of Zhari-Panjwayi from up there. You can also see where 85 per cent or more of the Canadians who have been killed in Afghanistan met their end. Neither of my colleagues had fully appreciated that before.
I brought them back to the UMS, and we talked about a few more things before it was time for them to go. I wished them well as they headed back to KAF.
I hope they have the most boring tour imaginable.
JULY 11 | Visitors
Two notable encounters with visitors today.
MORNING: THE QUIET ONES
Every morning, right after I wake up, I run to the top of Ma’Sum Ghar a few times to get my daily exercise. It is a steep climb, and I need to breathe a bit at the top before coming back. I usually say hello to the men manning the observation post located there. Depending on the situation, they could be from the private security company or some of our own troopers. Not today.
The men looking out over the Panjwayi valley this morning were unlike any you would ordinarily see on the FOB. They had beards and longish hair. They wore no insignia of rank or unit, no name tags. Their weapons had silencers and more sophisticated scopes than the ones on a standard infantry rifle. Their body armour was custom-made and lighter than that normally issued. This represented a tradeoff: less protection in exchange for increased mobility. Their demeanour, while polite, was distant. They asked no questions and offered no information about themselves, and introductions yielded only a first name.
The Quiet Ones had come to Ma’Sum Ghar.
When a soldier joins the combat arms, he is timid. The environment is new, his instructors are terrifying, and the skills he is being asked to master are foreign. No one feels self-confident in this situation.
When a soldier finishes basic training and can now call himself an infantryman, the opposite is true. He feels like a Dangerous Man. Even if he had no self-confidence before joining the army, he has a lot now.
If the soldier receives further instruction, such as paratrooper or reconnaissance training, his self-confidence grows even more. He may even become somewhat annoying, adopting an aggressive, in-your-face attitude. I can state this with some assurance, having been that annoying guy when I graduated from the Combat Training Centre. Most soldiers mature over the course of a few years, retaining the self-confidence while shedding the bluster.
There are a few soldiers who choose to go beyond the advanced infantry training available in the regular battalions. They go on to become some of the most skillful and lethal soldiers in the world. They are our best and they take a backseat to no one, regardless of what you may have heard about the British SAS, the American Green Berets or SEALs, or the Israeli Commandos.
The paradox is that, with this additional training, the linear relationship between training and bravado is broken. Instead, the opposite occurs. You can be in a room with several of these men and still feel like you are alone. Far from bragging about their considerable accomplishments, they prefer to fade into the walls and they do so quite effectively.
I had the opportunity, a few weeks before coming back to Afghanistan, to train a number of these men in some advanced emergency medical techniques. Even in that setting, with a man who was a veteran as their teacher, they kept to their strict code of self-effacing silence.
The Quiet Ones are not assigned to any particular FOB. Rather, they wander around Afghanistan on various assignments. They will not get into major confrontations with the Taliban. They will not be involved in reconstruction work. They will not help rid the country of IEDs. What they will do is watch. Silently. And with infinite patience.
The Quiet Ones are looking for a face, one that has been identified beyond any reasonable doubt. More often than not, their patience is rewarded. The face suddenly appears in their binoculars or telescopes. Just as quickly, the face disappears. But now they know where the face is.
The culmination of all that watching is coming soon. The Quiet Ones are human, and they are no doubt feeling excited and apprehensive about what is to follow, but you could not read that on their faces. Their conversation is muted, limited to an exchange of information as the plan is developed. Their faces remain neutral.
The Quiet Ones continue to watch, until the most propitious moment. Then they move, in the same silence and with the same patience they displayed while they watched.
Then they strike.
When I was at my first FOB during Roto 4, there was a poster on the wall showing the faces of the Taliban commanders in our area of operations at the start of the rotation. Roughly half of the faces were crossed out with a red X.
Thanks to the Quiet Ones, the life expectancy for Taliban commanders in Zhari-Panjwayi is not very good.
AFTERNOON: THE PRISONER
The ANP captured a Taliban soldier last night. The circumstances of that capture are unclear to me, but the Talib was in a prisoner cage this morning. It is also unclear to me how he got out of that cage, but get out of it he did. He then attempted to flee at high speed. The ANPobjected to this. An AK-47 bullet shot through the Talib’s left leg settled the squabble in the police’s favour.
It was a nasty wound. The bullet entered just above the calf muscle and exited in the middle of the leg, just below the kneecap. When a high-powered bullet such as this goes through a limb, it shatters the bone and causes a small explosion to occur where the bullet exits. While the entry wound was the size of the bullet (smaller than a dime), the exit wound was somewhat larger than a kiwi.
This was bad news for the patient. There are two bones in your leg: a small one on the outside that you can do without—the fibula— and a larger one on the inside—the tibia—that carries all your body’s weight. The part of the tibia closest to the knee had been destroyed. When I explored the exit wound, the bone seemed to end five centimetres short of where it should have. I could not detect a pulse in the foot, indicating that the patient’s blood vessels had also been damaged.
If a patient was to have a chance to keep his leg he
needed surgery as soon as possible, so we called for a helicopter medevac, priority Alpha. We controlled the bleeding, bandaged the wound, splinted the leg and gave him intravenous antibiotics and pain medication. When I was done, I allowed two military intelligence types to question him.
It was interesting to watch this process. If you have visions of the interrogation sessions straight out of a James Bond movie, you could not be further off base. I had the impression I was watching the neighbourhood cops questioning a well-known and mostly harmless delinquent. The questioner was only mildly stern. He did not touch the patient, even when the patient tried to doze off. His questions were factual, and neither his words nor his tone were ever threatening. His companion took notes but said nothing.
Within thirty minutes we got word that the medevac choppers were arriving. I took a minute, as I always do in these situations, to tell the prisoner that we were Canadians and that we had taken very good care of him. I hoped that this would convince him to turn against his former Taliban mentors. Failing that, I hoped he would remember our kindness if a Canadian ever became his prisoner. Even if neither of these results ever occurs, this doesn’t change my approach: I will fight this war as hard as I can, but I will fight humanely.
JULY 14 | The Elements, Part 2: Earth
The FOBs are on the front line of a war zone. Although things are better than they were during Roto 4, our existence here is still one of physical discomfort. I would be denying a key part of the soldiers’ experience if I did not recognize that.
I have already described the effects of the heat. I am shielded from the worst effects of this because both the UMS and my bunker are air-conditioned. But none of us can get away from the dust, which is all-pervasive. It is a fine powder that coats everything it touches. Every footfall raises a small puff. Even in this relatively windless area, the dust seeps into the most remote recesses of our buildings. Master Corporal “Red” Ricard wages a daily battle, armed with mop and broom, to keep the floor of the UMS clean.
The dust also seems to impregnate all our belongings. Food becomes gritty before the meal can be finished. Clothing comes out of the dryer with sand trapped in the fibres. Even right after stepping out of the shower, you get the feeling that you are not completely clean.
It is in the air, however, that this phenomenon is most apparent. There was a stretch of three consecutive days last month when the dust in the air was so thick the sky looked like grey milk. There is menace in such a sky: dust is responsible for nearly all the “medevac red” periods, when our helicopters are grounded.
These are times of considerable anxiety for a FOB doc. I can do anything the patient needs for the first thirty to sixty minutes of resuscitation care. After that, the treatment options available to me are exhausted. If I have been unable to stabilize the patient, as would be the case with ongoing bleeding into the chest or abdomen, he or she needs to be in the O.R. at KAF. These patients need a blood transfusion and an operation, neither of which I can offer here. If the medevac birds are not flying, I might have to watch one of our soldiers bleed to death.
JULY 15 | Stand To
Stand to: the procedure whereby all soldiers on a base, regardless of their normal tasks, will grab a weapon and take a defensive position. Used when the base is under imminent threat of attack.
The FOB Ma’Sum Ghar combat team left for an operation at first light this morning.
It is impossible to conceal the departure of a dozen or more tanks and other armoured vehicles. The Taliban spies will have noted this. Usually, they are more concerned with where the combat team is headed. This time, it seems they focused their attention back towards the FOB.
It is unusual for the Taliban to attempt a ground attack against one of our FOBs, but it does happen. During one such attack against Ma’Sum Ghar during my last tour, the gunfight lasted so long that the soldiers on our perimeter began to run low on ammunition. The FOB commander ordered the cooks and the medical staff to reinforce them.
At today’s unit commanders meeting, we were told that our intelligence had reported the FOB being observed, possibly with an eye to a ground attack. Given our reduced numbers, the FOB commander called on all of us to be more vigilant than usual and to be prepared to repel any assault.
I reflected on our previous experience and thought that we could do better this time. The cooks and medical staff, though more than willing to get into a gunfight, are initially tasked to defend the UMS. On Roto 4, it had not been clear where the commander had wanted the perimeter reinforced. I mentioned this to the FOB commander, and he agreed to come by later to give us a precise assignment.
But once an infantryman, always an infantryman. When I got back from the meeting I went for a quick walk up the hill behind the UMS to look at where I could best place Red, the remaining Bison crew (one crew went on the operation) and myself to defend our little patch of ground. As frightening as it would be to get involved in a close-range gunfight, I found that prospect far preferable to sitting in our bunker, unable to see outside and waiting for someone to come to the door.
Before the FOB commander could come to visit us, the Taliban hit us with another rocket. This one landed right on the helipad, narrowly missed one trooper, bounced up and over another trooper and then slammed into one of the concrete walls but did not detonate. Had we been running a helicopter medevac or personnel transfer at the time, it could have done a lot of damage. The EOD team went to get the rocket and placed it on the other side of the little hill located right behind the UMS. How comforting. They plan to BIP it tomorrow.
The threat of a ground attack takes everybody’s anxiety up a notch. It is one thing to know that there are people here who want to kill us. It is another thing to contemplate that they might come and try it tonight.
JULY 16 | Terror
When you’re wounded and left on
Afghanistan’s plains,
And the women come out to cut up what remains,
Jest roll to your rifle and blow out your brains
An’ go to your Gawd like a soldier.
—RUDYARD KIPLING, “The Young British Soldier”
The day started badly. When Red and I came into the UMS and checked our communication devices, we saw that we were in “coms lockdown.”
This meant that one of our own was dead. As bad as that was, things soon got much worse.
One of our recce patrols had been deployed southeast of here onto a mountain known as Salavat Ghar to support the operation that jumped off yesterday. It is their job to explore the battlefield, to detect the enemy and report their location to the main body of our troops.
The recce troopers are highly skilled and extremely fit. During a pre-deployment exercise I underwent prior to this mission, I was taken on a patrol by one of these men. He was so adept at camouflaging himself and was able to move through the bush so quietly that I felt I was walking with a ghost. Usually when these men go out, the Taliban have no idea they are there. Today was one of the rare exceptions to this rule.
The recce soldiers were establishing an observation post when one of them, Private Sébastien Courcy, tripped a mine. The explosion threw him off a cliff. At the same time, the patrol was under fire from a Taliban mortar. After the blast, the other members of the patrol had no idea where Private Courcy was.
That news travelled back to the FOB at lightning speed. As bad as we feel when one of us is killed, this was much, much worse. Our comrade might have been captured. It has been said that the Taliban do not take prisoners. That is inaccurate. What they do not do is allow prisoners to live. And the way they torture prisoners before killing them is nothing short of barbaric. When we heard the first reports about our missing recce trooper, we were terrified that this would be his fate.
Within an hour of the initial reports, we had more details. It was uncertain whether he had been blown off the mountain by an explosion or if he had slipped off while running, but there was no doubt that our comrade had fallen a long distance, to his d
eath. It was nonetheless some small comfort that his body was found by Canadians, and not by the enemy.
THE POWER OF FEAR
Terror works.
If it did not, terrorists would not use it. By torturing and beheading their captives, al Qaeda and the Taliban extremists demonstrate how far they are willing to go to achieve their goals. When they threaten the local civilian population with reprisals if those civilians co-operate with us, those threats are often effective.
Occasionally, I hear a Canadian soldier complain that the Afghans are not doing enough to ward off the Taliban themselves. When I hear that, I get annoyed and I say so. For a member of a heavily armed Canadian battle group to compare himself to unarmed Afghan civilians is beyond ridiculous. Our experience of terror in Canada is limited, mostly confined to the 1963–70 bombing-and-murder campaign of the FLQ. We cannot know how we would react if we were constantly subjected to it. But the historical record is clear. When a powerful group terrorizes a population, nearly all the members of that population—regardless of ethnicity, nationality, religion or anything else—try to get along with those who are able to harm them. This is true even if it is virtually certain that the intent of those in power is to kill everyone. The key word in that last sentence is “virtually.” People in these situations will cling to the slightest hope that they might survive, and they will go to unimaginable lengths to appease those who might kill them rather than commit suicide by fighting them.
But if terror can make people do unspeakable things, is it a source of real power? Only in the short run. Terrorists can cause unimaginable suffering and be very difficult to oppose, but they cut themselves off from any legitimate claim to authority. All through history, tyrants have done their best to terrorize populations. They have always fallen.
JULY 17 | Boredom
Against boredom, the gods themselves struggle in vain.
— FRIEDRICH NIETZSCHE
Reading the entries in which I describe dealing with multiple war casualties, you might get the impression that those days are busy. Nothing could be further from the truth. Even a MasCal with multiple casualties only occupies me for an hour, two at the most if we include cleanup and debrief. After that, all the casualties are either evacuated or have been treated and released. The busiest day here does not begin to approach an average shift in a large emergency department.