by Dave Hnida
Out came a small chuckle that had to hurt the burnt flesh.
“Thanks, Doc.”
“Don’t thank me yet; wait until you get my bill. I get time and a half on the weekend.”
I scooted around the cluster of medics starting IVs and cleaning the wounds.
Kneeling down at the next stretcher, I saw the wide eyes of a terrified soldier. This morning young and invincible, now scared and vulnerable.
“Hey, buddy, I’m Dr. Hnida. And me and my crew are going to get you all fixed up.”
There were two rules I needed to follow when dealing with the wounded. The first was introducing myself as “Dr. Hnida.” Iraq was the first place I’d ever done that, I usually wanted people to call me “Dave.” But if there was one thing I learned about medical care in a combat zone, it was a wounded soldier wanted a “Doctor” to take care of them—not a “Dave,” or even a “Major” for that matter.
The second rule was to make sure that one buddy always knew how the other buddy was doing. Sure, a soldier was worried about his wound, but he always seemed to fret more about the unknown injuries of a friend on the neighboring stretcher.
“Antonio is fine and says hi. So he’s good. How about you?”
“Man, I hurt, especially my leg.”
“It looks a little gnarly but it isn’t going anywhere. We’ll take a couple of X-rays and square you away. Hey, what’s your name and where you from?”
“Todd. From Indiana.”
“It rings a bell. In America, right?”
“Yes, sir,” he chuckled. “Right smack in the middle.”
“Well, Todd, you’re going to be on crutches for a while but nothing is going to fall off when you walk around back home in the land of Hoosiers.”
I turned to the medics after finishing my exam.
“Let’s grab some films. Please give Dr. Stanton a call for Mr. Todd here and Dr. Nunnally for Mr. Antonio.”
I went over and parked myself at my desk. One of the medics wandered over and told me he was the bearer of bad news. Oh damn.
“Sir, some strange goings-on around camp the last couple of days. I mean, this is all rumor, you understand. But anyway, seems Moe, Larry, and Curly had a few mishaps.”
Ah, the revenge of the medics.
“Yeah, it seems Moe was sitting in a porta-john when a truck backed up against the door. Heard he was stuck for a while in the heat and stink. People walking by must have thought they were hearing things. A lot of yelling coming from the house of poop.”
I didn’t want to know any more details. But I certainly enjoyed the mental portrait of a screaming man stuck in 130-degree stench.
“Then Larry was taking a shower over in the trailer. Somebody must have taken his towel and clothes by mistake. Heard he had to streak back to the barracks. With that body, heard it was ugly. PTSD ugly.”
That was a picture I didn’t want to see.
“Then the air conditioner ghost came by the barracks. You know, the one who plays with the air-conditioning fuse box. Flips a switch. Turns it off. Guy comes out of his sizzling-hot room only to hear the air start running again when the fuse is flipped back on. Man, when that happens fifteen, twenty times, gotta be aggravating. That ghost sure must have been mad at Curly.”
And so were a lot of other people—for a long time. It seemed this trio of administrators had a knack for dishing out platters of grief instead of support. Our group of doctors caught our share of crap but it was minimal compared to what the staff endured. The worst came the day the young American died in our ER. The three went solemn, seeking out and consoling the guys in the dead soldier’s unit, as they should. But they said nothing to assuage the ER crew, surgeons, and support staff—and in some ways insinuated the death was a failure on our part. I learned it was a year-long pattern—the staff felt they were flyspecks who didn’t matter in the eyes of those in charge. The three administrators, they said, sucked up the glory of the hospital’s many successes, and faulted all others for its few failures.
The story of the medics’ revenge made my day fly by. Over the course of several hours my patients were surgically cared for and my shift ended with a whimper. It was one of my slowest days since arriving.
I grabbed my pistol from the lockbox and decided to stop in the phone tent before chow.
The small tent was packed with people calling home on a Sunday night to America, where it would only be Sunday morning. Everyone tried to make their calls before families headed off to church.
After a few seconds of indecision, I scribbled my name on the wait list and plopped into a chair. My eyes jumped between the latest issue of Stars and Stripes and the faces of the callers. I guess we all must have had a good day, expressions were light and the conversations airy. A pleasant Sunday was a welcome tonic.
I glanced at my watch, more than thirty minutes had ticked away. If things didn’t speed up, I’d miss my dinner. But then again, tonight’s menu was the infamous steak and lobster meal. It was the dining fare the contracting conglomerate loved to brag about: We’re feeding our men and women in the field—get this—steak and lobster! We’re making this war a culinary delight that will be hard to forget!
In reality, the steak tasted like camel and the lobster was actually crab legs that had been through numerous cycles of freezing and thawing on its long crawl to Iraq. And hard to forget my ass. I doubted the vision of a pseudogourmet dinner would erase the memories of gore I’d carry home. The hell with dinner, I thought, and would later grab a stale sandwich from the ER fridge.
I finally got my turn on the phone: The wedding was great and having the whole family there was even better. And you should have seen Grandma after she talked to you, Dad. We thought she was going to throw her cane away and do a polka. How was your shift?
As I started to answer, the hand holding the phone to my ear was bumped.
“Sorry, sir.”
I glanced up. It was Todd, the wounded soldier from the morning, and the bump came from one of his crutches. He was still trying to get the hang of using the awkward sticks.
“Hey, hold on a second,” I said into the phone, then looked back at Todd and the nurse who had escorted him to the phone tent. Unlike other hospitals in Iraq, we didn’t have cell phones that the wounded could use to quickly call home; when able they’d hobble into the communal phone tent and wait in line like the rest of us.
“You need to hop on and call home? Have you talked to your folks yet?”
He leaned against wobbly crutches and shook his head no.
“They don’t know I got hurt, sir.”
I looked at his nurse. “Let’s let him scoot in here. And let him use my phone card.”
I scribbled the code quickly on a piece of paper as I told my kids I would call back in a few minutes.
Todd sat down and we propped his now casted leg on top of a folded blanket on a rickety chair next to the phone table. I went back to my nook in the corner of the tent and tried to concentrate on the paper. Yet I couldn’t help eavesdropping on Todd’s reassurances to his parents that he was fine.
“Look, Dad, I wouldn’t be talking to you if I was in bad shape. Tell Mom to stop crying, I’m okay.”
It went like that for a solid five minutes—the back-and-forth of worry mingled with futile attempts at reassurance. I couldn’t take it anymore, his parents must have been a wreck. I would be a wreck.
I slowly walked over, and then asked Todd to hand me the phone.
“Hi. You don’t know me, but my name is Dr. Hnida and I’m the doctor who took care of your son today. I need you to understand something—he got a little dinged—but only a little. He will be fine. I swear. He will be fine. Do you have any questions for me?”
I listened to the strained voice of a pleading mother asking if her son will have any problems. Will he walk again? Be able to have children? Be just like he was before he left?
I looked over at Todd and winked.
“Ma’am, the only problem he will have
is if he doesn’t stop chasing the nurses. Otherwise, he’ll be as good as new. You’ve got my word. Here he is.”
I had talked to waiting families after surgery more times than I could remember—and always face-to-face. This was my first Iraq-to-Indiana post-op report. But it was a satisfying one. I could see the thanks in Todd’s eyes as he turned back to the phone and I could sense things had calmed down on the other end of the line. It had to be the most important conversation I had in my twenty-plus years of medicine, and I don’t know if I’ll ever top it. The simple act wasn’t anything noble, it was just part of the job.
As I went back to my chair, I turned and looked at the young sergeant. As he closed his eyes and talked, thousands of miles evaporated. It was as if the family were together once again and everyone were fine.
16
SUICIDE ISN’T PAINLESS
I WASN’T AFRAID OF the dark anymore.
It took a couple of months, but I no longer lay awake days worrying about the night to come. Yet I still dreaded working the overnight shift. True, I was finally used to being the only doctor at the hospital and felt like I could handle whatever landed on the helipad. The medics were good and if I needed help, the docs never slept through their pages and would scoot over within minutes.
It was the physical strain that had gotten to me. I just felt like shit as my body Ping-Ponged between working days, then working nights, then cycling back to days. That weird exhausted nausea likes to attack an out-of-sync body. And by the time the clock struck 3 A.M., or in Gerry-time, oh-three-hundred, I was a dead man walking. Coffee, Red Bull, and ice cubes down the back of my uniform worked for a while, but eventually I was looking for paper clips to keep my eyelids open. Even then, in due course I’d surrender and lie down in Delta bay and close the curtains around me.
The night medics were always bright-eyed awake in the wee hours. Since they didn’t do shift work, they clattered and clanged around the ER as if it were high noon. Even the movies they watched when business was slow were set on a volume that could be heard in downtown Tikrit.
But after a while, I could even snooze through that. The running joke was I could sleep through a bomb, which evolved from an explosion that shook the camp one night and brought dust and debris floating down from the ceiling into my wide-open snoring mouth. Never budged—I simply thought it was an industrial-strength case of cotton mouth. The only true wake-up potion was a patient. On this night, the alarm clock was named “Fook Yoo.”
I had just dozed off when we heard a werewolflike howling from the parking lot.
“Fook yoo … Fook yoo.”
Jumping off the stretcher, I shot a “What the hell?” look at the medics as they scrambled toward the door. “Fook yoo” came the cry in the otherwise dead night air as we swung the doors open.
The howling was now accompanied by a screech of metal on gravel. Like a car taking a curve too fast, a wheelchair was half tipped on its side as it was half pulled and half dragged to the ER. Its occupant was a vomit-covered, upside-down soldier whose head was between the footrests and legs were dangling askew up over the handles. It took four soldiers to get him to the door.
“What’s your name, son?” asked Captain Thorbahn, our night shift chief nurse.
“Fook yoo,” came the inverted reply.
“Hey, pal. We can’t help you if you don’t talk to us.”
“Fook yoooooooo.”
From name to unit to “What’s wrong,” each question brought the same reply:
“Fook yooooo.”
A tall sergeant with a puke-stained uniform handed me a clear plastic bag.
“Sorry, sir, he’s one of ours. His hooch mate found him gorked out with all of this shit around him.”
I brought the large Baggie over to a metal surgical table. Inside were a variety of pink and yellow pills, some sugary powder, and a plastic water bottle of clear liquid. The powder was in its own minibag—on it was a Magic Marker—drawn smiley face and the words: “Take it if you dare!!!”
Folded into a small square was a frayed piece of paper that read: “Enuf is enuf!!! Fuk you world. I can’t take this shit no more!!”
One of the medics opened the half-filled water bottle and took a whiff. His head spun away: “Jesus! I think this guy chugged rubbing alcohol!”
His statement was met with a bile-filled retch, and a gurgled “Fook yooo.”
Shit, this kid was going to choke on his own vomit. We needed to get a couple of IVs in him, a few vials of blood, as well as some urine to run a rapid drug screen. But it didn’t seem like the type of situation where he would stand quietly and volunteer a pee sample into a plastic cup.
“Get him on a stretcher,” I said.
It took six of us to pry him out of the wheelchair and get him onto the stretcher; a few of us remained sprawled across his body to keep him from wiggling off.
“Sir, there’s no way we’re going to get blood or IVs with him fighting like this. He’s going to bite one of us.”
“Got shackles?”
“Looking for them now.”
“Get me Anesthesia. We’re going to put him down. But I don’t want to hit him with anything until we’ve got an airway in place. Rubbing alcohol is nasty shit, makes you crazy one second, and gives you seizures the next.”
“Right, sir. And who knows what the rest of this stuff is.”
But his next move wasn’t a seizure. Fook Yoo abruptly turned blue and went limp.
Some frantic words came from the head of the stretcher.
“We’ve still got a pulse but it’s weak.”
Now I was starting to sweat.
“Give me a tube. Get a line in him. Catheterize him. Cardiac monitor. The works.”
As I maneuvered the airway into his windpipe, I must have hit a wake-up switch. The blue kid was no longer blue and quiet—he was beet red, thrashing, and trying to bite my fingers off. I quickly pulled the tube from his throat.
“Let me die! Fook yooo.” The words trailed off like they were falling off a cliff.
Captain Thorbahn stepped up and said, “I hate to do this stuff”—then gave a “Vulcan Pinch” to the base of the neck. The thrashing and biting stopped in an instant. It was like watching Star Trek.
The limp effect lasted well over a minute, and when Fook Yoo woke up, he quickly got a repeat dose of the Pinch. Bam. Squeeze. Silence. Bam. Squeeze. Silence. The cycle repeated itself for several minutes; as it did, we kept one eye on him and the other eye on any sharp instruments we were trying to stick him with.
We finally got the tube into his windpipe so he wouldn’t choke on his vomit, then hit him with our own cocktail of fentanyl and Versed to keep him down. We breathed for him with a handheld Ambu bag.
Amid the medical circus, the MPs came in, glanced at our patient, looked in the bag, then turned away to talk to the guys who brought him in. Three minutes later, they walked over to me.
“He’s a specialist. Twenty years old. Works in an office. Never goes outside the wire. Just got extended to fifteen months. Drinks every once in a while, but hasn’t tried to off himself in the past. Roomie thinks he had a fight with his girlfriend.”
It seemed like drugs, depression, and boredom made up the perfect recipe for a disaster waiting to happen in a war zone. And we had to deal with these situations more often than we had time. It wasn’t unusual to have an attempted suicide on one stretcher, with blown-up guys on the gurneys next to him. A couple of the attempts were guys who cracked under the strain of invisible IEDs and ghostlike insurgents. Yet they seemed, at least where we worked, to be more the exception than the rule. Many of the attempts we saw were support staff; they never left the base and never saw the face of the enemy. Their tours were twelve to fifteen months of paperwork, overbearing superiors, or problems on the home front. Fook Yoo was a poster child for suicide in Iraq.
When we finally got him settled in for the rest of the night, we collapsed in a group heap. It was physically exhausting fighting to keep aliv
e a kid who wanted to die, the mental exhaustion even more draining. Fook Yoo would stay with us for less than a day, then be flown to Germany for a mental health evaluation.
The overwhelming stress of the night’s events might have been easier to swallow had he been the only one, but through our summer the number of suicide attempts stunned us. The Smurf who came in my first days was a distant memory but should have served as a storm warning for what was to come.
Sure, there were studies and statistics—suicide rates among record highs, we heard—but we didn’t look at numbers. We were too busy shining penlights into the nonresponsive eyes of unconscious kids who decided their time was up. I had seen suicides in the States, but for some reason the attempts here were much more painful. And frankly, none of us knew how to handle it. One case, in particular, I knew would haunt me forever. We called him the “Triple Threat.”
Triple Threat came through the ER a month before as he was being transported from a forward base in northern Iraq to Landstuhl. We were just a stopover as he waited for a connecting flight. The day before, he’d been caught just as he was about to set the cascade of suicide in motion. His plan was elaborate and well thought out. It would take place on the roof of a building away from the hustle and bustle of the base. First, he would douse himself with gasoline and place a lighter against his fuel-soaked clothes. As the flames erupted, he’d fire a bullet from his M9 into his brain. As he fell, the rope around his neck would catch, breaking his neck as his body tumbled toward the ground. His scheme was thwarted when another soldier caught sight of him wandering on the roof looking for a place to secure the rope. Now, even though Triple Threat was just passing through, he’d require medical observation until he was placed on the night flight to Germany.
We were busy that morning—a couple of roadside bombs had broken some bodies and the burn/shoot/hang guy needed to sit shackled to a stretcher until we all had a chance to catch our breath and eyeball him before signing off on the next leg of his journey.