Paradise General: Riding the Surge at a Combat Hospital in Iraq

by Dave Hnida

  I felt like the guy behind the butcher counter on coupon day at the supermarket, racing from customer to customer—at one point skidding, then falling hands down in a slick puddle of blood. As I snapped off my gloves and walked to rinse off my stained arms, I heard a faint whisper.

  “Excuse me.” Then again. “Excuse me.”

  I looked up. It was our Triple Threat soldier. I glanced over at my other two patients. They were stable so I figured I could spare this guy a couple of seconds.

  “What can I do for you?” I asked.

  He was an soldier in his early thirties, with horn-rimmed glasses and severely combed back dark hair. He sat with his head sagging toward the floor and avoided my eyes.

  “Is there any way you can loosen or take these shackles off my wrists? They’ve been on for six hours now and I’m cramping up.”

  “I can’t take them off. The rules are they stay on until you get to Germany. Sorry.”

  “Please.” He looked up as he spoke. Behind his glasses were eyes that were empty of everything but sadness.

  I don’t know why I asked, but I had to know.

  “Why you here, man?”

  In a calm, rational voice, he explained how his wife had left him for another man. These days, there weren’t any “Dear John” letters, they were replaced by “Dear John” e-mails or phone calls. This guy got both. She’d taken the kids. Emptied the bank account. He couldn’t get home to fix things, and said his superiors wouldn’t grant him emergency leave. The only way out of here was in a box.

  “Say, what’s your name, pal?”

  “Rob.”

  I looked around and wondered if I was the biggest chump in the zoo.

  “Okay, Rob, here’s the deal. You’ve got to promise me you’ll sit still. Not move except to stretch out your arms. Two minutes max.”

  “I promise.”

  My mind exploded with visions of a lunatic springing off of the stretcher, grabbing a guard’s weapon, and gunning us all down before finishing himself off. Insane people can act and sound normal before they kill everyone. My mind raced. I shouldn’t do this, couldn’t do this. It was against all the rules. I felt like I was making a major mistake by freeing Triple Threat’s hands. Yet, I rolled the dice.

  “Okay. Two minutes. I trust you.”

  His eyes brightened as I motioned for one of the guards to come over.

  “Do me a favor and take the wrist shackles off—let him stretch. Two minutes.”

  A look of “What are you, the stupidest guy in Iraq?” met my request.

  “I know, I know. Just. Do. It.”

  The shackles came off and I went back to my other two patients. Things got so busy I didn’t make it back to Rob for another half hour. But every so often, I’d glance over. He just sat quietly. As promised.

  When I did get back, he gave a weak smile and said, “Did your watch break?”

  “I failed telling-time class in medical school. Couldn’t remember which hand is more important—the big one or the little one.”

  I didn’t know what else to say. Hang in there. It’ll be all right. You’ll work things out when you get home. You’ll get the kids back. Your wife, too. Life is worth living. Rah-rah-sis-boom-bah. There was nothing I could say that wouldn’t be the most hollow and worthless statement to ever exit my mouth.

  I just stuck out my hand and said good luck.

  “Thanks. And thanks for being kind to my wrists.”

  “See you, man.”

  But I never would. Rob was reshackled and led out the door by two burly MPs. Who knew whether he would fix things up after the mental health and military justice systems got done with him. Maybe things would work out. But maybe he’d become another statistic—a vet who blows his brains out after going home. I couldn’t worry about it, at least not now. The blown-up soldier in Charlie bay was starting to moan again, he needed morphine—that I could do something about. But Rob was a patient I just couldn’t fix.

  It was a horrible morning. One guy had lost his leg. Another had lost his soul.

  17

  BLURSDAY

  I SAW HIM AS soon as I pulled back the blanketed opening of the OR tent. A dark night, the moon reflected off the young soldier’s dirt-stained face as he stared unseeing into the distance. He looked tired as he smoked a cigarette and leaned against a wall that seemed to be holding him up.

  “Can I help you with something?” I asked as I ripped off my surgical mask and cap.

  Startled, his head jerked up.

  “Uh, yes, sir. Maybe, sir. I’m looking for some buddies. People inside told me they were in getting surgery.”

  It took a second to add things up.

  “Your buddies, did they hit an IED this morning?”

  “That’s right, sir. I thought we all bought it when we hit that bomb.”

  I stared at him for a few seconds.

  “We?”

  “That’s right, sir. We got hit this morning doing a convoy escort.”

  “So you were in the vehicle. You were the fifth guy, weren’t you?”

  “Yes, sir. They all got hurt but I’m okay.”

  “Well, I’m glad you’re okay,” I said as I continued to stare. “Hell. We all thought you were dead.”

  He looked down, sighed, and then flicked his cigarette onto the ground.

  “No, sir, I’m alive. At least I think I’m alive.”

  He paused for a few seconds, looked straight into my eyes, and then said, “It’s been a helluva day, sir.”

  I answered softly, “It sure has, hasn’t it? Tell me about yours and I’ll tell you about mine.”

  “MAN, WHAT DAY is it?” Rick asked as I squeezed into his plywood room.

  “Blursday,” I responded wearily. One day just melted into the next. There were no weekdays, no weekends, no true days off.

  “I swear I’m getting too old for this,” Rick said as he struggled to put on his boots.

  “You’re too old for everything. Let me get your walker, Gramps. Carpe diem. Seize the day. Neither of us on first call. I vote for take it easy.”

  With those not-so-chipper greetings, Rick and I started another day in paradise. It was 6:20 A.M.

  THE FOUR-VEHICLE CONVOY formed up less than a mile from our barracks. Known as gun trucks, each heavily armed Humvee was manned by five soldiers. The job for the day was routine, providing security and escort for a few tractor-trailers doing a supply run from Baghdad. Before rolling out the gate, the group performed a mandatory stop at the range and test-fired their .50 caliber machine guns. The deep staccato cracks came in bursts of four and echoed across the camp. Boom. Boom-boom-boom. Boom. Boom-boom-boom. Weapons ready, the group left the security blanket of the base.

  THE BIG SCREEN TV blared throughout the chow hall as we choked down make-believe eggs and tubes of fat masquerading as sausage. Some talking head on Fox News was shouting that our borders were full of holes and we were being overrun by illegal immigrants. His solution, from the comfort of a TV studio, was to send in the Army. Our group didn’t want to hear it.

  “Turn that shit off. How about some sports or something?”

  “It’s all Rumsfeld’s fault. We don’t even have enough troops here. Jesus, we just can’t pull out early.”

  “Tell you what, Rumsfeld’s father should have pulled out early.”

  “No shit. Let’s go, gang, rounds start at seven.”

  THE GUN TRUCKS sped down MSR Tampa, the main supply route that passed the outskirts of the base. Eyes were peeled for any debris in the road or the outline of a freshly dug and hastily filled hole that might conceal a newly planted IED. A few soldiers munched on cold remnants of their MRE breakfast. There was little small talk among the five men in the Humvee at the head of the pack; their vehicle was the one at highest risk. Bob was a twenty-five-year-old from a small town in the Midwest who nervously fingered a good-luck leather wristband as he drove. Jeremy, the vehicle commander, was tempted to flip off his goggles, which were tight and blurred hi
s vision, as he surveyed the landscape. He would yell at his men if any of them took theirs off. The goggles stayed in place.

  “SO, WHO IS our final hospital resident worth discussing?” Colonel Quick glanced over his glasses at Bernard.

  “Sir, it’s our Iraqi policeman, Mr. Abbai. Wounds clean. Chest tube was pulled two days ago. He’s ready to go this morning.”

  “Excellent. So what’s that make our census? Zero. Excellent again. Let’s keep it that way. An empty hospital is a good hospital.”

  AT 0815, THE Humvees rendezvoused with the supply trucks traveling up from the south. Each vehicle lined up in its appropriate place as the baton of protection was handed from one escort group to the next. The train of vehicles took off, speeding up the road to avoid becoming a target, yet driving slowly enough for eyes to scan the road for IEDs. Trash and garbage along the roadside flew into the air as the trucks rolled by. An easy run so far.

  AFTER ROUNDS, I decided to blow a few minutes in the ER.

  “Hey, Mike, I hear you’ve got the medic lecture this morning. What’s the topic du jour?”

  “Cutting health care costs. How we can save money if more people had primary care docs. How about you, Dave?”

  “I’m up Friday. Spermodynamics. How to make your sperm work like nuclear-tipped cruise missiles.”

  “I’m not sure that’s what Colonel Quick had in mind when he told us to teach the medics.”

  “These are special medics. They’re real hungry for real-world knowledge. I’m even thinking of opening a chain of franchises when we get home. “Super Sperm.” If you’re interested, I bet it would sell big-time in St. Louis.”

  IT LOOKED LIKE the dead body of a small dog, a favorite hiding place for insurgents to pack full of explosives. And it was perfectly placed in the middle of the roadway. Bob hit the brakes and jerked the wheel toward the side of the road. Time to radio for demolition experts to investigate and detonate the suspicious carcass before continuing down the road. Just as Jeremy lifted the microphone to his mouth, the tractor-trailer following their Humvee drove straight over the dog.

  I CHUCKLED AT the look on Mike’s face, and then looked around the room. The elongated ER was quiet, a word that can be thought but never said aloud. In every single dictionary and reference book in the department’s mini-library, the word “quiet” was crossed out. I lifted a bottle of chilled water from the ER’s mini-fridge and tipped it toward Mike. “Here’s to an easy day, man.”

  THERE WASN’T TIME to duck or cover heads, the Humvee crew could only hold on tight as the truck rolled over the dead dog. And kept going. The now flattened carcass didn’t contain any hidden bombs or explosives. It was simply a wild dog that was probably hit by some car and lay where it had died. The crew swallowed hard as Jeremy told Bob to roll out and catch up, but not before spitting out a torrent of curses at the driver of the tractor-trailer, who had his head up his ass.

  I TOOK a giant swig from the bottle and immediately spit a mouthful onto the floor. Pure plastic. Huge pallets of water were stored around the base where they’d sit for weeks in the 130-plus-degree temperatures. The plastic from the bottle leached into the overheated water, where it silently sat waiting for an unsuspecting mouth. Two of three bottles tasted like a perverse commercial for plastic and got tossed into the trashcan. We would win the war but die of plastic water bottle poisoning.

  * * *

  THE TRAILERS MAINTAINED a steady pace while the Humvees buzzed about like bees. The key to living until tomorrow was looking for changes today. Something that wasn’t there yesterday. The dog carcass should have been obvious. More frightening were the subtle differences. And just ahead was a spot that indeed looked subtly different. Fresh dirt spread thinly just to the right of the middle of the road. The gunner stood upright through the roof of the vehicle and scanned the horizon. He was six-three and called “Tall Paul.” Tall Paul saw it first. Definitely not right. Shit.

  RICK WANDERED INTO the ER and saw the puddle of spit-out water at my feet. “Wet your pants again?”

  After flipping him off, we decided to head over to the phone tent to check on life back home. The line for phones was short and the connections went through quickly. It was an agriculture disaster day for both of us. Prices for bales of hay in Oklahoma weren’t looking good, and my lawn was turning yellow. We held the phones to our ears and silently listened to how things couldn’t get much worse back home. All we could do was send each other looks of sympathy, though we both realized how stressful it was for the voices on the other end of the line. We should be home with our families, even if it was to bale hay or water the lawn.

  BOB SAW IT, too. This quick jerk of the wheel probably saved a few lives yet wasn’t speedy enough for a complete escape. First came a thump. A split second later the sensation of being forced underwater and all molecules of air being sucked out of lungs. A deafening loud bang quickly followed. Hundreds of pieces of hot metal ricocheted throughout the inside of the vehicle. Everyone was hit, even Tall Paul, who was blown down the turret, toppling onto the other soldiers.

  * * *

  “MAN, IT’S DEAD this morning. How about we get a haircut?” Rick asked as we pushed our way through the opening of the phone tent into the burning air.

  “Sure, why not?” I agreed. As we sauntered down the road to the local barber, we had little to say. It was too hot to talk except for a rare sentence to break up the monotony.

  “These days make me crazy,” Rick mumbled.

  “Well, just be glad you’re not checking hemorrhoids over at sick call.”

  “Good point.”

  AT 0920, THE interior of the vehicle was a suffocating mix of moans and smoke. Tall Paul was drenched in blood, mainly from his legs, which had been struck by a dozen shards of flying metal, as well as the blood of the men he had fallen on. As the smoke cleared, he started what’s called “buddy care”—slapping pressure bandages wherever he saw or felt the warm stickiness of blood. It was one of the first lessons he learned years before at basic training.

  IT WAS ONLY three bucks for a military cut, a simple act where an electric razor quickly buzzed over your scalp, then zigzagged the nooks behind the ears. The whole operation took a full two minutes if the barber was slow. As I waited my turn, I tried to figure which country the barbers were from; indecipherable Indian-sounding pop music blared from a cheap radio. Some Pink Floyd or Springsteen might give the joint some atmosphere. A nap was starting to sound good.

  A SPECIALLY TRAINED combat medic raced from his Humvee to the damaged one a hundred yards up the road. Smoke billowed from under the vehicle for several seconds, then dissolved to nothingness. A tangle of men tumbled out. The medic quickly applied tourniquets to blood-gushing arms and legs, and started IV lines, all while trying to quiet and calm the screaming. His quick actions were automatic, but came with a price. Attached to the unit, he knew these men well. As the medic worked, the unwounded surrounded and protected him in case the IED explosion was a prelude to an ambush.

  The stricken convoy radioed for help. It took less than five minutes for a pair of unarmed medevacs to spin up their rotors and launch. They sometimes traveled in twos in case one chopper went down or extra room was needed.

  I HAD JUST settled in for a long morning’s nap when my pager went off. All available docs to the ER. Four urgents by litter inbound. As I laced up my boots, Rick barged through the door. “You get paged? Sounds like they need some extra hands down at the ranch.”

  “I’ll be ready to go as soon as I untie my laces from my fingers,” I replied. “They’re stuck.”

  “Do the wounded know you work at this place? I think I better tell the pilot to keep going to the next hospital.”

  NINE MINUTES LATER, the choppers landed on the road next to the convoy. Four soldiers were placed on stretchers and launched to the next stop. Bob and Tall Paul were placed into one copter; Jeremy and a new guy, whose name was forgotten in the chaos, went into the second. The men were loaded with morphine,
except for the new guy, who was struggling to breathe. A sharp splinter of metal had ripped through his neck. The flight nurse started treatment in the bouncing, cramped cabin of the medevac while the chopper radioed the CSH with an update. The pilots zipped through hazy skies, trading comfort for speed. The entire crew had to make all the right decisions in the worst of conditions. The margin for error was zero.

  Our walk to the hospital was brisk and we hit the door just in time to feel the vibration of blades beating the air. We checked inside to find where we were needed most. Mike was working Alpha bay, I went to Bravo, Gerry to Charlie. Rick waited with the other surgeons until we sorted things out.

  THE FLIGHT TO the CSH took just under nine minutes. We were designated as “level-three care,” a hospital equipped to perform more advanced emergency and surgical care. Sounds impressive, but we really could only offer fast-food medicine: get ’em in, get ’em out. We kicked into action as our medics raced to the helipad and returned blood-soaked and heaving for air, asking where to take each stretcher. Yet they had already made the decisions, bringing the soldiers in the order they thought was right: “The worst comes first.” As usual, they were on the money.

  “We’ve got a penetrating neck wound. Respiratory distress en route. Resuscitated. Vitals now stable.” The New Guy.

  “Multiple lacerations. Suspected multiple fractures. Open fracture left wrist.” Bob.

  “Blunt trauma to head. Multiple shrapnel wounds to face.” Jeremy.

  “Multiple lacerations and fragment wounds lower extremities. Vitals stable.” Tall Paul.

  We split up and got to work stemming the flow of blood, inserting tubes and IV lines, and pumping in blood. The New Guy made us the most nervous and we decided it was smart to speed-roll his stretcher into surgery before he tanked.

  As Bob lay quietly, the medics cut off his good-luck bracelet. His wrist was broken and a small splinter of bone poked through the skin. A few burns scorched his hands and legs.

  Jeremy had raccoon eyes, his face blackened with soot and peppered with shrapnel except for two circular areas around his eyes. Leaving those goggles on meant he would leave the war with his vision.