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

by Dave Hnida

  As I stood in line, I eyed the group huddled together at one end of a long table, pointing fingers and slapping knees with laughter. Jokes, insults, and BS were flying like the sand on the other side of the walls. We’d been together for more than two months, and were getting along well. No one wanted to kill each other, at least not yet, and I didn’t think we’d ever see the day we would. Each of us knew we were in a fix, and unconsciously recognized the only way to survive our time here was to hold each other up. Left alone, we would become the walking psychologically wounded.

  Even better, we genuinely liked each other. So much so, it was time for a nickname. M*A*S*H had the Pros from Dover; we had to become the pros from somewhere. The eight of us were reservists from all over the country with little in common except for one locale: Newark, New Jersey. Rick Reutlinger once worked in Newark. Bernard Harrison had done his residency in Newark. Ian had flown through Newark. I grew up just outside Newark. And the rest had at least heard of Newark. So Newark it was.

  That morning the Pros were hammering at each other over the latest trivia—it was a double bonus round:

  Where are Panama hats made?

  What are the Canary Islands named after?

  We had all day to ponder the questions, and hopefully we’d have time to sneak on to a computer and Google the answer.

  We talked as the group left the chow hall, noticing the wind had calmed and the sky was breaking. As always, Bill and Rick stopped and checked on the guards who stood for hours in the whirling sand and intense heat, making sure they had bottles of water, Gatorade, or a couple of cookies snuck from the chow hall.

  When we crossed the gravel-strewn field to the hospital, we heard the crackled sound of “Big Voice.” Just like on M*A*S*H, there were giant loudspeakers attached to poles high above the ground: it’s how we got announcements and important information. However, our Big Voice was hoarse—we couldn’t understand a word coming from it. It sounded like a broken drive-through speaker at a fast-food joint.

  “Vvvvepppmgrrrrrrrrrssvava. Hhhhhhhhwwwwwwchchchvavava.”

  We stared at the pole, then each other.

  “I think either we are about to get mortared … or salsa lessons have been pushed back half an hour tonight.”

  Nonetheless, we quickened the pace, eyes and ears peeled to the sky. The only things we saw were unexpected patches of blue. That meant a day of work. It turned out to be one filled with some of the oddest cases of my war.

  The first was a nineteen-year-old soldier with a cough that just wouldn’t quit. Ordinarily we’d have told him to shove off and go to sick call; the ER wasn’t the place for him. But something just didn’t look right. A pleasant cherubic-faced kid with the weak sprouting of a grown-up mustache, his skin carried a paleness that shouted serious illness.

  A chest X-ray, then a quick CAT scan of the chest gave us the reason: the huge clusters of lymph nodes signified cancer, in this case, a lymphoma.

  He took the news he’d be flying to Landstuhl then the States within twenty-four hours, without much change in expression.

  “Sure beats hell, doesn’t it, sir? Here I am in Iraq, and I got cancer. Wait until my mom hears this one. At least I ain’t going to get blown up. That’ll make her happy. But Jesus, cancer?”

  I’d sat and had “the talk” with dozens of patients and their families when bad news needed to be delivered, but this was a first for me. You simply don’t think cancer is going to attack in a war zone. And this young man needed the same tender kid gloves any wounded soldier would get. We talked for more than an hour as we waited for the travel arrangements to be made.

  As we finished, I felt the vibration of our first incoming of the day. A chopper was furiously beating the air as it hovered over the helipad. I scooted inside and quickly donned a pair of goggles and gloves. Our patient was an Iraqi soldier, and he left a trail of blood as he was wheeled in.

  The flight medic told me the soldier had been in a complex IED attack—first blown up, then shot as he crawled and squirmed out of the smoking vehicle.

  “He’s got open wounds all four extremities, facial lacerations, and multiple puncture wounds to the torso. And double-check the groin—it’s starting to seep blood. Ten milligrams of morphine on board.”

  Ten milligrams and still moaning, to the point no one could hear themselves think.

  I asked the flight medic, “How long ago did you morphine this guy?”

  “Ten mikes.” That was more than enough time for some relief to kick in.

  I shook my head. If there was one common denominator among Iraqis besides their ability to shoot each other by mistake or change sides overnight, their pain tolerance sucked. Paper cut to gunshot—gallons of intravenous morphine never seemed to ease their pain.

  “Give him five more milligrams IV. Then let’s get the translator in and figure out what we’ve got.”

  I ran through my exam—step by step as always. In the meantime, the medics performed their usual rituals of IV lines, medications, and clothes cutting.

  One had just snipped away the patient’s shirt and pants when he noticed an expanding stain of blood on a pair of underwear that looked unchanged for weeks.

  “Hey, Dr. Hnida, this guy’s got a problem down south,” he said.

  I mentally said, “Shit,” then pulled down the underpants. The IED fragments had done a clean amputation of the left testicle and nipped part of the shaft of the penis. No wonder he needed more morphine. There probably wasn’t enough morphine in the world for this guy. I think every male in the trauma bay unconsciously bent at the waist and went knock-kneed.

  “Folks. It’s gone, as in clean gone. Sorry for the thought, but double-check the clothing so a bloody ball doesn’t fall out and roll across the floor.”

  It didn’t. The testicle was nowhere to be found, and was probably still lying in some reed-filled field next to a roadway miles away. Probably to be eaten by some birds. The thought made me queasy.

  “Let’s pack this thing up and staunch the bleeding. Let’s move, too. I’m not worried about the testicle but we’ve got some stat X-rays and scans to get done. Could be some other stuff happening. Look at him, he’s covered with bloody polka dots.”

  A few minutes later, I trotted over to X-ray where our Iraqi was now lying on the table having a series of films done. Hovering over the operation was Sergeant Wolloff, the enlisted head of Radiology. He was a rough tough NCO who had no qualms speaking his mind, especially to officers he felt were getting in the way. He just threw them out of the X-ray tent. Wolloff was a quirky guy: his morning ritual included drinking coffee out of a plastic urinal while chewing on an oversized stogie as he strolled around the hospital.

  “What’s this sheet doing across this guy’s lap?” he barked.

  “He’s got a wound down there. Doc wanted it covered,” answered one of the X-ray techs.

  “Covered, my ass. You know the rules: everything removed if we’re going to get good films.”

  Just then, I walked into Radiology.

  “I don’t think I’d take that off.”

  “I think we do.”

  “No.”

  “Yes.”

  “Okay, you’re the boss of this place.”

  Wolloff smirked, then ripped back the sheet. His face then went as white as the sheet. He stumbled to the chair and quickly crossed his legs for imaginary protection.

  “Holy shit. Where’s his ball?”

  “I don’t know. Can we leave the sheet?”

  “Oh yeah, leave the sheet. Please leave the sheet.”

  Wolloff had seen some horrendous wounds during his time in Iraq, but had never flinched … until that morning. Must be a guy thing.

  As for our Iraqi policeman/soldier, he did fine. And through the translator said he would gladly trade his testicle for his life anyday; he was just happy to be alive. Good perspective.

  We had expected a not-so-busy day but things were hopping, and we were a little bummed—sort of like kids who thin
k they’re going to wake up to a blizzard and a day off from school, yet when the morning comes, not a flake has fallen.

  But that didn’t mean we couldn’t have our cake and eat it, too. It was my birthday. I hadn’t told anyone except maybe in passing many weeks before, but the date became imprinted in someone’s mind.

  One second the ER was empty, the next it was filled with marching people singing “Happy Birthday.” Bill Stanton was to thank, or blame. He and a couple of nurses in the ICU had gotten some cake mix from home, stirred it up, and baked it in some little plastic play oven. Bill applied the frosting and a crooked-lettered “Happy Birthday, Dave” in Charabic on top.

  It was jellylike and undercooked in places, rock-hard in others, but it was real honest-to-goodness birthday cake. And best of all, it was baked for me. We all enjoyed it, even after I held it up for a picture, and the top, icing and all, slid onto the floor. The five-second rule for picking up dropped food doesn’t apply in a combat zone—I cleaned off my spilled share and ate it anyway. Even Gerry, each day becoming thinner and thinner, had a couple of pieces. All in all, a great way to celebrate the ripe age of eighty-five, which was how old I felt that particular day.

  The party ended, not with a whimper, not with a bang, but with the whirling of incoming aircraft.

  Up next were two guys who had been on the receiving ends of bullets. One walked in; the other rolled in via stretcher but was alert and stable.

  The walker was a piece of work. He’d had his body armor off and took a glancing sniper shot to Satan—meaning a $500 tattoo of the devil on his upper back had taken the brunt of the bullet, shearing off most of Satan’s pitchfork. The soldier would need a little repair work from us, then some follow-up body work down at Mr. Mohammed’s House of Tattoos. We couldn’t keep him still on the table, he was hyped and jumpy, I think the loss of his custom-designed devil had done a number on his head.

  “Listen, buddy,” I said, “you know what a bullet is? It’s nature’s way of telling you to slow down. It might be a good idea to listen to the sounds of nature. And don’t worry, your horned friend will live to fry in hell another day.”

  Devilman’s buddy was a little quieter; he’d taken a slug to the upper thigh and was bleeding like the proverbial stuck pig. As I did my exam, something seemed weird—I just couldn’t put a finger on it.

  The bullet wound was deep and stuffed with some sort of a cottonlike material I’d never seen before. Then I saw the cotton had a piece of string attached so I pulled. It was a tampon. It seemed many soldiers had been buying tampons at the PX, and then bringing them out on patrol to supplement their first-aid kit. Whatever weird looks these guys must have gotten at the checkout counter, buying a box of Tampax was well worth it. The tampon had done a great job slowing the bleeding and helped save the soldier’s life.

  He needed to go to the OR to have the thigh repaired, but first needed his tank topped off.

  “Sorry, buddy, you’re going to need a little bit of blood before we take you in to the body shop,” I told him as I threw the tampon into the trash.

  “Blood?”

  “Yeah, blood. Like the commercial says: Blood. It does a body good.”

  He started to get a few tears in his eyes. I think the realization he’d been shot was finally sinking in.

  I leaned over and tried to speak quietly into his ear. That’s when it hit me. The weirdness. The odd thing about this guy. It was more than the tampon. It was the fact that he smelled. Really smelled. But the fragrance wafting from his body wasn’t the usual unwashed sweaty nastiness—it was really nice.

  “Hey, man. Don’t take this the wrong way. But you smell really good. What do you do, put on aftershave every day?”

  His mood brightened.

  “Actually, cologne.”

  “Oh. Sorry. I’m kind of a Dial soap guy. Or use whatever samples I can rip out of magazines. What are you wearing?”

  “Allure by Chanel,” he answered. “It’s full-bodied, but not overpowering, you know what I mean? A touch of wood and a hint of spice. About forty bucks for a small bottle and worth every drop.”

  I wrinkled my nose as I unconsciously sniffed my stained armpit.

  “So tell me, do you usually go out on patrol smelling like a holiday in Paris?”

  “Well, man, I mean, sir, it’s like this. I’m just one small piece of a big machine. I can smell bad and look like shit just like everybody else, or I can be my own man by dressing up. And since I can’t dress up, I’m going to smell good. Plus, if I get killed, I’m going down with style.”

  It was like talking to a different human. For the next ten minutes, I got schooled on the latest in style and grooming from a twentysomething fashionista. By the time we were done chatting, I realized I’d never be a poster boy for classy. The units of blood were in, and the Army’s fashion plate was calm. He wound up doing great, and looked great while doing it.

  The docs ended the day the same way we started it, gathered around the table, pushing food around plates, and seeing if salad dressing on potatoes would fool the palate. It did, a little.

  Like a family supper, the meal essentially revolved around questions like: “And how was your day, honey?” Or: “Did anything interesting happen at the hospital today?”

  The answers were flat and quick—and normal for our typical day.

  “Ah, not much. Kid who shouldn’t have cancer has cancer. Couple of guys got shot. Iraqi dude had his nut shot off. The usual.”

  We even joked about a blood drive we had a week before. An insurgent was bleeding to death on the operating table and the blood bank had run dry, so we called for all the blood donors we could get. Our soldiers responded and filled up our bleeding insurgent with dozens of units of All-American blood. So many units, we wondered if the insurgent woke up with an unexplained and insatiable appetite for mocha cappuccinos, fast food, and NASCAR.

  Our meal took a full two hours; none of us ever spent that kind of time at the dinner table at home. The typical stateside doctor inhaled a full meal in less than a minute, a bad habit left over from the days of internship. A few guys gradually filtered out, but not before we covered our important questions of the day—the trivia. None of us had Google time so we were at the mercy of the trivia panel for the answers.

  First the Canary Islands. I thought it was named after a bunch of birds in a cage; instead it came from the Latin Insula Canaria: packs of wild, fierce dogs.

  0 for 1.

  Next. Where do Panama hats come from? Answer: Ecuador. The name comes from the fact that many of the hats were stolen from ships as they passed through a shipping point in Panama on their way to points in the Orient.

  0 for 2.

  But at least my deployment wouldn’t be a big fat zero—I would go home saying that I learned something, no matter how useless.

  It had been a wonderful birthday. I went over to the phone tent to call my family, and we agreed I would call again in the morning, when it would be my actual birthday back home. And would save any celebration until I got home. After I hung up, I shot a quick e-mail to my coworkers in Denver. The day before, they had sent a huge box of goodies. It was already empty, quickly devoured by a lot of people who needed a goodie to get through their day. My personal goodie was the thick stack of letters and cards tucked in the corner of the box. In my e-mail, I wrote:

  so there’s this war movie cliché where a soldier gets mail and lies on his bunk reading and re-reading his letters. Well, it’s not so much of a cliché. I spent last night reading your cards--and then reading them again- then again. Your care package arrived and it couldn’t have come at a better time. We had our busiest day yet yesterday- gunshot wounds and ieds galore. The look on the troops’ faces as they got to dig into boxes of goodies was something we will never forget. It sucks being far from home. Then to get even a small taste of it gives you a few mental minutes away from this hellhole. Your gifts were shared with literally dozens of soldiers--- and as of this a.m.--are all gone. You
guys made a lot of people very happy. I can’t thank you enough. Personally, the cards were a giant pick me up- i walked out of the hospital at 10pm dragging my butt to my bed- then took my time savoring each and every card in the box. I was up until 2am reading them and it was the first night in a while i didn’t have bad dreams. A blessing since today I needed all of the strength I could get- I know it helped me help others. Now it’s time to hopefully get another peaceful night’s sleep. I will read your cards once again before turning off the light. I will never be able to thank you enough.

  Dave.

  20

  TALE OF TWO BROTHERS

  IT WAS AN easy August morning. I finally had a day off to gather up laundry and sweep out the three inches of dust camped on our floor. First, though, I needed to grab a bite and head over to see how the hospital was agreeing with our customers. Before saying goodbye to my room and the pinups on the wall, I X’d out another day on the calendar—we’d be winging home in a few weeks. But this day turned out to be a rougher one than the start promised, and it had nothing to do with Iraq.

  It was odd how we were able to cope with the sights and screams of war, yet would get sour stomachs and jitters when we were forced to confront things over which we had no control—such as events back home.

  After flashing our ID cards, and being counted by the meal clicker, we were greeted in the dining hall with images from the big screen that looked like an action flick with stuntmen and special effects. But it was no movie. A bridge had tumbled into a river, swallowing dozens of cars and people. It was the I-35 span in Minneapolis, home of Bernard and his family. As we sat with our eyes glued to the TV, our breakfasts picked at, we noted Bernard wasn’t with us. He was already working the phones, sitting and fretting in the phone tent for information about the who’s and what’s and where-was-everybody.