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

by Dave Hnida

  The issue of “where are we going to send these patients” was big at rounds this particular morning. We’d just gotten in a batch of Iraqi police from up the road at Bayjii, a small town north of Tikrit. These people were guarding something—it wasn’t clear what—when they saw something suspicious and opened fire. At each other. The ER was packed with cops full of holes. We patched them up, they’d stay a few days, then be sent to the right hospital. The liaisons were already working the Iraqi grapevine for a place for these guys to recover, and family members to become instant medical experts.

  In the meantime, we were still busting Bill Stanton over his bedside manner the day before, when the group first came through the doors. The ER was instant chaos—a million voices chattering over each other, the extra noise coming from the translators we needed to communicate with the Iraqis. Bill was the busiest doctor that day—he had his hands full with bone injuries—and was zipping from stretcher to stretcher, poking and prodding and trying to reassure the patients they’d be fine. The translators were good; they could listen to our rapid-fire English, convert it to Arabic, then quickly convert the response back to English. But I think for the first time in this war they got stumped. As Bill tried to talk and ask questions of a wounded Iraqi, the translator interrupted with a confused look: “Excuse me, sir, what is word: ‘dude’? Is that a person or an injury?”

  As we finished up rounds, a familiar face strolled in. Rick had made it home from his brain tumor consultation in Balad in one piece, sporting the wide crooked grin of a kid who had just come back from the amusement park. And in a way, he had. As he flew into camp on a Black Hawk helicopter, the bird passed over a firefight just outside our gate. The pilot looked to see if any support was needed, the chopper rocking, bobbing, and weaving as it spiraled down to avoid any rockets or gunfire. Just the kind of stuff Rick loved—we could picture him whooping and hollering as the speeding circles got tighter and the ground swooped up toward the chopper. A total nut bag.

  The flight was “administrative,” meaning it was a routine transport of noncombat personnel, so it was filled with a bunch of folks not used to the idea of getting killed by a stray RPG—rocket-propelled grenade—or strapped into a copter barreling toward the ground during a firefight. Rick said more than one guy peed his pants in terror. We stared at his crotch. Dry as the desert. The only odd thing was his bulging pockets. I realized they were filled with Harika Tats, and when he caught me staring, Rick answered, “I never leave home without ’em.”

  Even better than the war story was the confirmation of his e-mail, which said his brain was okay, or at least by his standards was okay. The neurosurgeons at Balad said the tumor could simply be observed; no need to go under the knife. He’d stay the rest of the deployment, even though we only had a couple of weeks to go.

  “So how was Balad?” I asked. It was a place we called almost every day, but never knew what things looked like on the other end of the satellite phone link.

  “You should see this place. A few years ago, they were just a bunch of tents, but now, holy smokes. Beautiful chow halls, an outdoor pool with lounge chairs, rock climbing wall in their gym, and an official movie theater with padded seats and popcorn.”

  Okay, we had a nice chow hall, but after that, we came in dead last in the beauty competition. Our swimming pool was bomb-damaged and bone-dry, the only rocks we had were the ones we stumbled over each day as we walked to work, and our movie theater was small and portable—personal computers we crowded around to watch DVDs. It was true; we had a bad case of Air Force envy.

  “So did they tell you why you mumble your words and bastardize everybody’s names?” I asked.

  “Nope, but it’s not because of the tumor. It’s just me.”

  Which made me feel better. I wasn’t mocking someone with a brain tumor, I was dealing with a medical mystery dressed as a surgeon—a guy who when looking at a badly broken arm would say, “This patient has a fraction of his radial.”

  “You mean fracture of the radius.”

  “That’s what I said.”

  “Christ, man, we’re not doing math problems with tires here. Bones. Skeleton. Hard long things inside the body filled with calcium.”

  “I know. Orthopedic stuff. That’s why we got Stalin.”

  “You mean Stanton.”

  “That’s what I said.”

  The thoughts of his lunacy made me laugh, and I wandered off and said a quick prayer thanking God my friend had made it back in one piece. We lived a safe life here, much different from what I found myself in a few times in ’04. Under my breath, I muttered a curse at myself for putting my family through this deployment. I was okay, but every day they probably still worried I’d get wounded or killed. I knew differently, or at least talked myself into believing differently, yet I wondered if every time the TV back home blared news of “Another death in Iraq,” the heartbeats in my household screeched to a halt until details spilled out. Relief on one hand, sorrow on the other. I was fine but another family would now begin a new life minus a loved one.

  I stopped in the phone tent and decided to make a quick call home.

  I’m doing okay, I said. No, nothing was up. Everything was fine. Just wanted to tell everyone I love them. Be home in a bit. Look for a box with some stuff. Yeah, my friends were fine. Glad the Rockies were starting to win some ball games. Talk to you soon.

  The hollow click at the end of the call matched the loneliness in my heart. What the hell was I thinking coming here? It wasn’t only me serving my penance; I had sentenced my loved ones to serve it as well. How could I be so selfish? I hoped one day I’d look back and believe I did the right thing, maybe helped a few people, and didn’t irreparably harm others. But that day was in another dimension. I couldn’t see it or feel it. I couldn’t even imagine it. I needed to sleep before my final night shift.

  I WAS STILL in the dumps as I slipped my holster off my belt and put it in the lockbox. I wished I could lock up my darkened mood as well.

  “It’s going to be a good night tonight, Dr. Hnida. Can feel it in the air,” one of my medics said.

  The only thing I could feel in the air were swirling hot particles of sand being blown across the compound as I walked to the hospital, followed by the running-into-a-brick-wall shock of air conditioners turned up to frigid as I opened the doors to the ER. No T-shirt tonight, I’d work in the long sleeves of my uniform top.

  “Yeah, let’s make it good.” I paused, knowing there was only one person who could lift me out of the dumps tonight. Me.

  “Feel like getting promoted tonight?” I asked.

  “Why not? I’m officer material,” answered my medic.

  I marched over, yanked the Velcro sergeant stripes off his uniform, and traded it for the golden oak leaf of major.

  “Let’s get to work.”

  It wasn’t long before the first customers of the night showed up, the first one a fellow with bites in all the wrong places. He had been out for a twilight run when he felt a pinch in his thigh. Then another pinch a little higher. Another yet higher. He finally stopped running when the next nip nailed him right in the penis.

  When he screeched to a halt and pulled down his shorts, a decent-sized scorpion dropped out. By the time he got to the ER, his penis was the size of the Goodyear Blimp. And definitely more painful. The good news for him was the larger the scorpion, the less toxic the venom. The bad news was the larger the scorpion the bigger the claws. While slipping on his shorts, our runner had committed the cardinal sin of getting dressed in Iraq: he didn’t shake out his clothes.

  After seeing the monster penis, I vowed to shake out every single piece of clothing twice—instead of the standard once—before it went on my body.

  He was followed into the ER by a guy with a kidney stone and another with a twisted ankle from a softball game. Easy-peasy. And a couple of confused looks about why an older sergeant was taking care of them, and giving orders to a baby-faced major of twenty-two. We were having a g
ood night until the sky erupted and angrily rained wounded.

  A convoy was hit by a couple of IEDs and our trauma bays went from empty to full in minutes. Before waking everybody up over in the barracks, I strode from one end of the room to the other. Nothing too serious at first glance. Everyone was conscious, alert; there was a little bit of blood but no gaping holes. And arms and legs were attached and working. It would take a while, but we could handle this without reinforcements.

  One by one, I again went from stretcher to stretcher—a longer glance and a few words to each occupant to make sure everyone knew they were okay and still on planet earth. So far so good. And a roomful of men and women who had just had an unexpected appointment with an improvised explosive device.

  It attacked with a bright flash that was quickly followed by a horrendous boom and pressurized blast wave that painfully smashed bodies and caused eardrums to burst. I’d tell people to imagine the loudest fireworks display they’ve ever heard and multiply it by ten thousand. Even when it wasn’t that bad a blast, you were stunned and confused as the interior of your vehicle filled up with smoke and dust—you could faintly hear the echo of voices screaming to see if anyone was hurt. The ringing in your ears got louder as the seconds passed. You fumbled and checked your body parts. Everything hurt since you’d been shaken like a rag doll, and you hoped when you struggled out of your vehicle no one was waiting outside to shoot at you.

  There was no magic number of blasts that bought you a ticket home—but we were really aggressive in making sure the soldiers were kept off duty until they were perfect, and if there was even a twinge of doubt we erred on the side of caution. Sometimes that caused a little conflict with the battle commanders—they were always short of people for missions, but once you explained the whats and whys of a blast to the head, they usually quickly backed off and put the soldiers’ well-being first. I never lost a rare argument with a commander who wanted to force a soldier back into the fight.

  That was for the soldiers who walked away from their vehicles after a blast. The saddest stories were about those who did not. A blast could be a very odd thing—depending on the size and location of the explosion, some guys would untouched while others sitting next to them would be killed. Often, one body would act like a shield for the others, yet no one knew when the vehicle pulled out of camp who might be the shield of the mission.

  Our medics went to work doing memory and word-association tests, called MACE exams, on our five guys. I circled the room as I watched and listened. It sounded like a couple needed a CAT scan, the others just some time off. As I eavesdropped, I noticed a young sergeant enter the ER—he must have belonged to the group. He said little to us, brushing by as he checked on his soldiers.

  We asked a couple of the men who the gruff guy was. NCO in charge of the group came the answer. Was supposed go out on the mission, but stayed behind. The first time he’d done that. His jaw was square and his look was mean. I didn’t think he liked us.

  His look got even worse as I started my part of the exams. Like a mother hen, he stared as if to make sure I treated his soldiers well. I tended to joke with the less seriously wounded—it was a prescription to put them at ease and assure them they would be all right. My dumb wisecracks came out of my doctor bag.

  “A five-year-old child could fix you up. If you wait a minute, I’ll go find a five-year-old child.”

  “Welcome to Allstate General. We’re the good hands hospital. It’s where the patient comes first … or thirtieth, depending on our mood.”

  “Hi, I’m Dr. Hnida, the former Sister Mary Elizabeth. That’s right, I used to be a nun, but I didn’t want to make a habit of it.”

  The patients laughed, the sergeant glared.

  It took a little over three hours to clear the crew. No one needed to stay overnight; they’d just be confined to quarters and head to sick call in a day or two for a recheck.

  By the time the paperwork was nearly done, the clock was striking four. As we dotted the i’s and crossed the final t’s, I asked a couple of the men what the hell was wrong with their sergeant—was he always such a hard-ass? Their answers surprised me and sent me for a walk.

  I stepped outside and sucked in a deep breath of predawn air.

  Sniffing a puff of smoke, I spotted the sergeant slumped against a wall.

  “Sarge, need anything?” I asked.

  He looked up quickly, glanced at me, and then quickly walked away.

  “Hey. Stop right now. I need to talk to you, man.”

  He slowed, then stopped, hesitated a few steps forward, then stopped again.

  “Yes, sir.”

  I caught up.

  “Hey, relax for a second. I don’t bite. What’s up? You’ve got a major bug up your ass and I think that major is me.”

  There was a long pause as he stared up at the dark sky. When his head tilted to eye level, I noticed a dirty face smeared by fresh tears that had been hastily wiped away.

  “It’s not you, sir. It’s me. I fucked up. One of these guys needed experience running the show so I stayed behind screwing around in my quarters. Then I get a call my crew hit an IED. I should have been there.”

  An “I fucked up” conversation on the same sidewalk three months ago flashed back and I shook through a momentary cold sweat.

  “How’d you fuck up? Your guys are fine. And I’m sorry I was messing around in there, but they needed to know they were okay.”

  “I know that, sir. Appreciate it. All I’m saying is I just should have been there. They needed me.”

  “Sit down, son.”

  We parked ourselves squarely on the sidewalk with our backs against a concrete blast wall. The only noise was the ever-present night wind, the only illumination the soft blinking of blue landing lights on the helipad.

  I told him the story of the first and only time I’d ever let my medics go on the road by themselves. It was back in 2004, and I was going home the next day. A little Iraqi girl had been burned in a bomb blast and was close to dying. I knelt in the middle of a road, a radio in one hand, screaming for a chopper, in the other a knife ready to cut a hole in her throat to make an airway. A chopper couldn’t come, none was available, so she either would die on the pavement, or we’d have to drive her over hostile roads to the British hospital. It was a drive I’d made too many times during my tour, so with one day to go before I left for the safety of home, I let the medics go by themselves. It was a haunting mistake and I sat worrying at the gate for their return. Six hours of fretting and worry. I almost cried when I saw the convoy safe and sound, rolling back up the road to camp.

  “Guilt is a horrible companion. And I never would have forgiven myself if they had been killed,” I said as I finished the story.

  He slowly stared up at me.

  “Yes, sir. You got that right. I sat by the radio all night, then worried my way to the hospital when I heard they got hit. I was thinking all that would be left of them would be a bunch of pieces.”

  The night was dissolving to dawn and I could finally make out his features. The sergeant looked about twenty-four. Hell of an age to carry the weight of command and make decisions of life and death. Only a little older than my dad at Anzio. The group inside the same ages as my own kids.

  “You did the right thing,” I said. “Now it’s time to let them know how you feel about them. Heck, they didn’t do anything wrong, especially the one who commanded the mission. Don’t take your guilt out on them.”

  He paused for several moments.

  “You’re right, sir.”

  Inside, they sat in a straight row of chairs, like school kids waiting for the teacher. Their faces a mix of worry and concern as they looked at the sergeant walking back in. As one, they stood. The sergeant drew them into a tight circle and spoke softly. I couldn’t hear a word, but didn’t need to. The tears and the hugs told the story and flavor of what was said.

  The young sergeant was already a man, but tonight became an even better one.

 
; 23

  LAST TANGO IN TIKRIT

  IT WAS LIKE Christmas in summer. Only our presents came down the chimney on a C-130 instead of a sleigh. A bountiful holiday it was: a full complement of replacement doctors. And an oh-so-very-welcome group since we were all paranoid they somehow, some way, would not show up and we’d be trapped here forever. I don’t think we really worried about it until the last couple of weeks of our deployment, when the walls surrounding the camp suddenly started a claustrophobic contraction. Here we were—a group of grown men penned into a shrinking half-mile-square world and now at the mercy of some faceless paper pusher who, alone, had the power to deny us parole.

  It was creepy in a way. Trapped, we had absolutely no way of getting home unless the Army gave us a ride. It’s not like we had cars, or could simply hop over to the local airport and book a flight home. Hell, sticking a thumb out and hitchhiking wouldn’t have gotten us more than a few miles down hostile roads.

  We threw high-fives and fist bumps at breakfast when informed our relief flew in during the night and were now officially on base. We would right seat/left seat with them after they caught up on sleep. It would be a great moment when we handed over the keys to the hospital, even better when the camp was in the rearview mirror.

  We had celebrated our jailbreak with the long-awaited farewell shindig: the Hos and Pimps Extravaganza. The blender was spinning a wicked brew, which those of us on duty were afraid to sample; smoky whiffs from a hookah we didn’t dare breathe. The strongest substance we dared go near were the always accessible cigars—we even got Bernard to take a few puffs. He’d warned us all summer about his aversion to smoke, now after two baby puffs, he looked like he was going to launch his cookies. As we laughed at the stud-man’s nausea, all he could gasp out was a weak “Bet you’ve never seen a black man turn green.”

  But we still had a blast. The party was a wild one, at least for much of the staff. They smoked, they drank, and the innovative ones had sex in newly discovered hidden corners.