by Ray Wiss
The medic of that Bison is Corporal Marie Gionet, a remarkable thirty-one-year-old woman who earned an anthropology degree before joining the CF Health Services five years ago. She was attracted by Egyptology but realized that not many people can earn their livelihood doing this. She describes joining the CF as a wise career move. In Afghanistan, you could argue that she has the best of both worlds: a secure career in the military and a job where an attractive lady still gets to wear shapeless clothing, live cheek-by-jowl with a bunch of smelly guys and work in a hot, sandy environment.
On the evening of August 25, Corporal Gionet heard a blast so loud that she thought it had taken place right outside the camp walls. She rushed to get her gear on and she reported to the sergeant in command of the QRF. He told her to stand by until they had a clearer idea of what was going on. She went back to her Bison and got ready to head out.
The order to deploy into Kandahar City came thirty minutes later. Corporal Gionet was shocked to learn that they would be going to a blast site over four kilometres away. This was her first inkling of how massive the bomb had been. Basing the ambulance at CNS proved to be a prescient move: this supplementary QRF was the first Coalition force to arrive at the scene of the blast.
Corporal Marie Gionet, Bison medic
When the QRF arrived, Corporal Gionet was faced with a scene of unbelievable destruction. An area the size of three football fields had been blasted and blackened. Many fires were burning, the air was thick with smoke and it was getting dark.
Contrary to what the media had first reported, a single vehicle was involved in the attack—a tanker truck filled with explosives. It had more destructive power than anything we drop from our planes. The priority was to secure the scene and light it. The QRF vehicles formed a circle around the blast area, guns pointing out and headlights pointing in.
Corporal Gionet relates that two events marked her strongly during this incident. The first occurred once the perimeter had been secured and she rushed out of her ambulance to render aid to the wounded.
There weren’t any.
Further information confirms that there were forty-one dead after the blast, but that the total number of wounded was seventy-six, not sixty-six as written above. Six of wounded died, bringing the total deaths to forty-seven. But not one of these seventy-six people was still on the scene when Corporal Gionet arrived. The Afghan civilian medical personnel had, in her words, done a spectacular job. They had secured the scene—ensuring that no secondary explosions (whether intentional or accidental) or any other hazard threatened the rescuers—triaged the patients effectively and organized an efficient entry-exit system for the many ambulances to come in, pick up a patient and depart. The job of saving lives had been done as well as it could have been done. By the Afghans themselves. Without anybody’s help.
This had quite an impact on Corporal Gionet. As a medical professional, she grasped the sophistication required to accomplish what the Afghans had done. “This was the first time I have seen a non-military branch of the Afghan government functioning at a high level without any outside assistance,” she told me. “I had been unsure about the mission’s chances of success until I saw that, but I’m more optimistic now.”
This reminded me of how distorted our perception of Afghanistan can become because we spend all our time fighting the Taliban in Zhari-Panjwayi. Not too far from here is a city of a half-million people that works reasonably well, by developing world standards.
These people dealt quickly and efficiently with the biggest mass casualty event Afghanistan has seen in two years. All that was left was to pick up the pieces of those who could not be saved. Corporal Gionet went through her entire supply of body bags. She then started to use baggies, and ran out of those as well. One of the baggies was being requested by a soldier who called on the radio to say that he had found a hand, but that it was not an adult hand. He kept repeating he needed a small bag for the small hand. I wonder if he was not saying that it was a child’s hand in order to avoid confronting what had happened to the child.
There were no Afghan or Coalition military personnel or installations in the vicinity of the blast—only civilians. And how did our enemies, the authors of this atrocity, choose to follow up on their actions? Did they express any regret? Did they say it had been a mistake? No. A few of them opened fire on the QRF. The ANA soldiers present quickly drove them off.
For the next four and a half hours, the Canadian QRF kept the site secure while Canadian infantry searched through the rubble with digging equipment, search dogs and their bare hands. They found only more body parts.
Sometime after midnight, an American unit arrived to take over from the Canadians. As Corporal Gionet was getting ready to leave, she had her second head-spinning experience of the evening.
Although the Afghans had conducted the evacuation of the wounded from the blast site efficiently, they had brought all these patients to hospitals with limited resources. Some of the walking wounded were therefore given first aid and told to return in the morning for definitive treatment, such as suturing or casting. One of these partially treated patients was brought to Corporal Gionet.
The patient in question was an eleven-year-old girl who had been brought to the Bison on her father’s back. The parents asked if it were possible for their child to be seen by a female medic, but Corporal Gionet got the impression that this consideration took a back seat to getting their child well treated. She invited the patient and her parents into the ambulance. Then, her world shifted.
The mother sat down across from Corporal Gionet, promptly removed her burka and fairly threw it at her husband. She then began speaking in fluent English, describing her child’s injury and thanking Corporal Gionet for agreeing to see her.
As a Bison medic assigned to a combat team, Corporal Gionet’s contact with Afghan civilians has almost exclusively been in the context of a combat operation. The connection she was able to achieve by caring for the child would have been remarkable in and of itself. But she was also able to connect directly, without interpreters, to another woman. “This was the first woman I have met here that I didn’t have to search,” she said. She found the experience extremely rewarding.
I wish every Canadian could have heard the conversation between Corporal Gionet and the mother. This Afghan woman could not comprehend why Corporal Gionet would have come all the way from Canada to help the Afghans. She emphasized to Corporal Gionet that this was very dangerous, as if she was unsure whether the corporal fully understood the risks Coalition soldiers face here. But as difficult as it was for this Afghan to grasp that Canadians would come here and risk their lives to help her, she and her husband were nonetheless deeply appreciative.
She then said something that should be juxtaposed with the media reports about the election. She said that there had been far less violence on election day than she had feared there would be. The Tal-iban attacks, other than in Zhari-Panjwayi, had been pinpricks, in her opinion. The media had made it sound like the roof was caving in.
Corporal Gionet finished taking care of the child. The girl had a nasty laceration on her knee, which was closed and bandaged. Throughout the treatment, the child remained calm and stoic. Once Corporal Gionet was done, the daughter reattached herself to her father’s back and the family headed off.
In talking to the mother, Corporal Gionet had discovered that the young girl was going to school. The mother felt very strongly about this—in a city where the Taliban will throw acid in the faces of girls who try to get an education. If they do not kill them. This family is fighting the Taliban as much as we are.
AUGUST 27 | Quick Draw
Earlier I introduced the “Battle Captain” of the armoured squadron. The equivalent in the infantry is the “LAV Captain” (“Capitaine d’assaut” in francophone units), an individual who plans operations and missions. The LAV captain of Combat Team Cobra is Captain Sacha Bois-vert-Novak. From my trips to the command post and the card table, I have gotten to know
him and have enjoyed his company.
Captain Boisvert-Novak knew he wanted to be a soldier from childhood and joined up when he was only seventeen. He had his university education paid for by the CF, earning a degree in political science. Given the complex nature of international conflict in the twenty-first century, this will no doubt serve him well.
Captain Sacha Boisvert-Novak, battle captain*
After graduation, Captain Boisver t-Novak completed his infantry officer training as well as paratrooper training. He then reported to his infantry battalion and began work-up training to come to Afghanistan on Roto 4. He spent most of his time on his first tour as a liaison officer with the British Gur-khas. Returning to Canada after Roto 4 , he immediately volunteered to return to Afghanistan. His wish was granted, and he was given that most coveted of positions for a young officer: infantry platoon commander in a combat team. But halfway through the year-long work-up training for Roto 7, his assignment was changed.
Captain Boisvert-Novak’s other assignment on Roto 4 had been to oversee the digitization of many of our command and control systems. As a combat officer he was not thrilled to be surrounded by techies and computers instead of infantrymen, but he did a fantastic job. Maybe a little too good—when Major Jourdain, the combat team commander, was rounding out his leadership team, he came looking for Captain Boisvert-Novak. As battle captain, he has made the command post “100 per cent more efficient” (in the words of Major Jourdain) because of his intimate knowledge of all the new technology.
Captain Boisvert-Novak, however, was bitterly disappointed. The accelerated promotion (coming two years sooner than it normally would) and the esteem of his superiors could not fully erase the frustration of no longer commanding men “at the sharp end of the stick.” But he is a soldier first and foremost; he took up his new post without complaint and with considerable energy. He is the only veteran among the officers of the combat team. As battle captain, he draws on his experience to advise the commander and to counsel the junior officers.
Joined the army at seventeen. Paratrooper. Volunteered for a combat tour, then a second one. Has already volunteered for a third. Civilians reading that curriculum vitae may decide that Captain Boisvert-Novak enjoys war, for some deranged reason. The motivation for such a career path is best explained by David Grossman in On Combat:
Everyone has been given a gift in life. Warriors have been given the gift of aggression. They would no more misuse this gift than a doctor would misuse his healing arts, but they yearn for the opportunity to use their gift to help others. These people, the ones who have been blessed with the gift of aggression and a love for others, are our warriors.*
Here’s how a warrior like Captain Boisvert-Novak puts these words into action. If you look in the dictionary under “phlegmatic,” you will see a picture of Captain Boisvert-Novak. Whether he is helping to coordinate the defence of the FOB while we are under attack or winning (or losing) a gigantic pile of poker chips, his face remains inscrutable. I had formed an impression of him as being unshakably calm in any situation. That impression was dramatically confirmed at supper yesterday.
Captain Boisvert-Novak and I, along with a couple of the combat team’s senior NCOs, were dining together at the same table. The discussion was lighthearted and jovial, mostly centring on how best to ingest massive quantities of alcohol while on leave. Everyone was enjoying themselves, things were quiet and the day’s work was done. So we lingered, remaining seated at the table long after our meals were eaten and the rest of the soldiers had left the mess tent. We were comparing stories of earlier excessive alcohol intake when the unmistakable sound of an automatic rifle on “full auto” was heard coming from much too close.
In unison, everyone seated at the table dove onto the concrete tent pad. The firing continued, but no holes were appearing in the canvas wall of the mess tent. Either the shooter’s aim was off or he was hitting some of the concrete barriers surrounding our tent. He could also have been shooting at something other than the mess tent.
I must explain that whenever we leave the FOB, we wear all our protective clothing. We are heavily armed and ready for anything. But when we go to dinner, we are only wearing our combat uniforms or gym clothing. The only weapon we carry is a 9 mm pistol.
With that background in mind, we return to the three senior soldiers and me as we land on the mess tent’s concrete floor. There was gunfire outside. Without leaving the tent, we had no way of knowing what was going on. Everybody was thinking about the worst-case scenario: Afghan soldiers who had never shown signs of disloyalty suddenly turn on their Coalition allies. Had a Taliban infiltrator made his way into the FOB?
Civilian readers might think that staying close to the floor inside the tent would be a reasonable option here. We could aim our weapons at the doors and challenge anybody who tried to come inside. This group of Canadian soldiers felt differently. Anyone attacking our FOB would have to fight their way in. In unison, we stood up and started running to the door.
In the few seconds it took us to get to the other side of the mess tent, we all had our pistols out of our holsters. I was so focused on the door that I experienced a classic case of tunnel vision.* But while I could not see my comrades, I could clearly hear the metallic chick-kachick of all our pistols chambering around. We did not have rifles, frag vests or helmets, but we were ready to fight if necessary.
FOB Sperwan Ghar mess tent (letters A and B indicate positions relevant to the story)
Because of where I had been sitting, I reached the door first. I went outside, turned to my right (the direction the firing had come from) and took cover behind a concrete barrier (position A in the photograph). That was far enough for me, but not for Captain Boisvert-Novak. I watched in amazement as he went running across the open ground in front of me to the next good position of cover some ten metres away. No frag vest, no protective gear, just a desire to protect his comrades.
From position A, I could not see very far at all. Captain Boisvert-Novak had sized that up in a heartbeat and gone to position B, from where he had an excellent view of the nearest side of the ANA barracks. I heard him call out to someone, asking where the firing had come from. In a few seconds, he had determined that the enemy shooters were still outside the FOB walls. The loud gunfire we had heard was likely someone on our side shooting from inside the FOB. Only then did Captain Boisvert-Novak turn and lead us back to the shelter of the command post.
As we headed inside, the heavy machine guns on the hilltop opened fire. Combined with the fire from the defensive positions on the FOB perimeter, this quickly drove the attackers away. Throughout this episode, Captain Boisvert-Novak looked like he was out for a Sunday stroll. As I said, phlegmatic.
AUGUST 28 | Doctor in an Undoctored Land
I have made a conscious effort to get to know the ANA soldiers at this FOB. Effort is perhaps too strong a word. All I have done is sit down to dinner with them two or three times a week and dropped by occasionally during the daytime for a conversation. But these regular visits have marked me as someone with a sincere desire to connect with the Afghans. This affection has been returned several times over.
I also warmly welcome the Afghan soldiers who come to the UMS and I try to make them feel at ease with my rudimentary Pashto. This has led to an increase in visits by Afghan soldiers to the UMS. This exposure to patients from another culture prompts me to make two observations.
In these parts of the world, modern Western medicine represents something of great value, something the people here could never afford. When they can access such medicine for free, they come to see the Western doctor with a minor ailment: a stuffed-up nose, a sore back or, my favourite, “total body pain” (a complaint I have now heard from at least five distinct cultural groups). They do not really think the problem will go away. They only want to have the experience of being seen by someone who appears to them to be a miracle worker.
A lot of Westerners fail to appreciate this and go down one of two err
oneous paths. The first mistake is to assume that the patient has a serious condition. This may lead doctors to provide treatments that are unnecessary and sometimes harmful.
The second mistake lies at the other end of spectrum. This occurs when Westerners assume that the patient is malingering. In these instances, the doctors often get angry and rudely show the patient the door.
The best way to deal with these situations is to respond as you would during any other patient encounter. Sit down, give the patient your full attention, take a thorough history and perform a careful physical exam. These patients want the same thing that patients in our emergency departments want: to be listened to, and to have the feeling that someone cares about them.
Beyond that, they often want a taste of high-tech medicine, and frequently ask for IV medication. But these people are not all that different from us. By giving them a sympathetic ear, I can achieve as much or more healing as I could by shooting them full of antibiotics. I have been here nearly four weeks now, and I have not given a single injection or intravenous drug to an Afghan soldier. And yet they seem very pleased with the service they receive.
The second observation has to do with a subset of patients who are unlike any I have ever had to deal with in emergency medicine in Canada or anywhere else in the world. At least once every three or four days, one of the Afghans on the base will come to me with a complaint having to do with sexual function. Not sexual dysfunction, but sexual function: things are going too well.
Usually, this takes the form of wet dreams. As observant Muslims, the patients are disturbed by nocturnal emissions because they are “unclean.” The first time I heard that one, I recommended the patient masturbate before going to sleep. I was informed that, because of the Islamic religion, this was not going to happen.