by Dave Hnida
We never did the math except to calculate the order each of the four customers to our CSH would go to surgery. We were too busy to think about the missing fifth occupant of the blown-up Humvee; he was probably dead but no one seemed sure.
The surgeries took longer than we thought, but we had the luxury of time. The New Guy became more stable the longer we worked; Rick and Bernard relaxed as they meticulously explored and repaired the crowded and complex architecture inside his neck. The other men were sedated as they waited their turn on the table. By the time all were finished being poked, prodded, pulled, and splinted, it was evening, and a lifetime had passed since they had test-fired their weapons that morning. The surgeries were a success and the men would be fine.
Back home, the combat support hospitals got a lot of credit for the high survival rates in Iraq, much higher than in wars past. Here, more than 94 percent of the wounded made it home compared to the 70 percent in World War II, and the slightly better 76 percent in Korea and Vietnam. But we were not the only ones who deserved pats on the back. It was a long medical chain of care that saved a life, and like a chain letter, it had to be kept intact. It was not only bad luck to break the chain, it was deadly. And these men would survive thanks to buddies, combat medics, flight nurses, pilots, and a long line of links in the chain of care.
I was beat after spending my day off holding retractors, suctioning blood, and tying sutures. All I wanted was to dig into the sandwiches the other docs left for us to munch on as we finished. First, I wanted to check the ER and make sure the not-so-quiet day wasn’t looking like a not-so-quiet night. And that’s when I saw the exhausted soldier leaning against the wall.
“SO THEY’RE ALL okay, then, sir?”
“Peachy keen. Good as new. Right as rain. They’ll check in to our resort for the night, but should be on their way to Germany tomorrow.”
His shoulders slumped in relief and his body rattled with an involuntary shiver. “You know, sir. Maybe I should be dead. If it wasn’t for them, I would be.”
“How’s that?”
Each minute of the day was stamped into the mystery man’s mind. In clear detail, he described everything: the heat, the road, the goggles, the dog, the dirt … and how he had made it out of the vehicle without a scratch. The other men had shielded his body and absorbed the blast.
“Thanks, sir. Thanks for taking care of my buddies. Tell the other docs thanks, too.”
“I will.” I smiled at the exhausted soldier. “Say, have you eaten anything today? Looks like you’ve been living on cigarettes.”
He sheepishly shook his head and grinned as he glanced at the mound of butts at his feet. “Yeah, it’s been a long day.” Pausing, he looked up at the desert moon. “Say, what day is it, anyway?”
“Blursday, my friend. Every day is Blursday.”
18
THE GUNS OF AUGUST
THE FOLLOWING morning at breakfast, we made an executive decision: our small group of scalpel wielders was going to take the month of August off from the war. The reason for our last-minute vacation plans was an announcement on TV that the Iraqi government was calling a thirty-day time-out from running the country.
Prime Minister Nouri al-Maliki said they’d deal with the war when they came back from their little break. And it sounded like a very sincere “cross our hearts and hope to die” promise. Even Vice President Cheney said it was a “sovereign right” for the Iraqis to take a little summer hiatus. And if Cheney said so—it must be so. Maybe he invited them all on a little hunting trip during their vacation. Knock ’em off one by one.
But when we heard that the reason for the summer break, per our White House spokesperson, was that it probably was going to be too hot in August for the Iraqis to go to work, shit, we got hot ourselves.
News flash: July was hot. August would be hot. And our men and women would still go out in full combat gear and patrol the country and get hot, too. Damned hot. We wondered if the politicians on both sides of the ocean had a clue about what it’s like to go out in full combat gear in 130-degree heat? One idea was to have them put on a couple of overcoats and sit in a microwave set on high for ten minutes.
The cool of the evening isn’t so cool, either. One night I had a gun crew come into my emergency room at 3 A.M. They had sped off the base to help a unit under attack and were out on the road for several hours lugging weapons, crawling around, you know, doing real Army stuff. By the time everything was under control and they made it to me, I had four men and women so dehydrated they could hardly walk.
We took off their shirts—heavy with sweat—and hooked them up to IVs ASAP. One liter of fluid, then a second, then a third. They still hadn’t pissed so we negotiated a fourth. They gobbled ice chips like starving animals. We put their soaking-wet shirts on a scale and the dial read ten pounds. Nine of those pounds had to be sweat. Now these soldiers didn’t ask for time off when they paid us a visit. Didn’t even voice a single complaint; in fact, their biggest concern was for each other.
“Take care of Jones. He needs it.” Or “Check Haley. She really is dry. Fix her up first, Doc.”
They got their fluids and quietly walked out the door to grab a few minutes of valuable rest before they got called out again.
As we sat spooning cereal, we pondered the question: How would a civilian deal with it if they were fine one second, then found their mangled leg lying on the other side of the car the next? Or what if they were out for a stroll when they heard a crack, felt an excruciating pain in their thigh, then got hit in the face with spurts of blood as they looked down to see what happened? We weren’t dumping on the folks back home; hell, we didn’t know how we would react. But we were awed by some soldiers who had to deal with those exact scenarios in recent days.
The shattered leg guy was, first, worried about his buddies, and second, angry he was wounded. He simply didn’t want to leave his unit.
The thigh guy was also one tough fellow. Fortunately, his wound was just one bloody mess. The bullet missed all the important stuff—the arteries, veins, nerves, and bones were fine. But a half inch north, south, east, or west, and that oblong ball of ammo, no bigger than your pinkie nail, would have caused life-altering damage.
This guy was a piece of work, the kind of patient you wished every patient would be. For starters, he lay quietly on the gurney—then moved, shifted, and rolled cooperatively as we examined him. This soldier even propped himself up to adjust the X-ray plate we were
trying to squeeze under his wounded leg. “Not straight enough for a good picture, is it? Hang on here. I got it.” Finally, he didn’t even want to go to surgery and get knocked out for the wound to be cleaned.
“Can’t hurt any worse than this,” he said with a teeth-gritting smile.
So a couple of shots of a local anesthetic into the deepest reaches of the leg were good enough for him.
“Save the happy gas for someone who really needs it.”
War was a piñata of surprises, and the soldiers were the ones being pummeled. We hoped all those who drove around with Support Our Troops stickers and ribbons on their cars truly knew the type of people they were supporting.
After finishing breakfast, we went through the motions of rounds, and then took off on our separate ways.
I headed straight for the Love Shack and a nap; I was scheduled for the night shift and was dragging from the marathon surgeries of the day before. Asleep within minutes, I managed to catch a few Zzzs before my pager jolted me awake. Was it another controlled det (detonation)? Mass casualties coming in? The message simply read: Reutlinger wants you now!
As I raced to Paradise, I didn’t see any choppers spinning on the pad; no bustle of activity around the hospital. Something was fishy. When I walked into the empty ER, I was met by a chorus of “shoooshes” and fingers held to lips.
“Head to the OR, sir. Quietly.”
Did that mean tiptoe or take off my boots and slink in?
“Would you mind telling me what the he
ll’s going on?”
“The most important case we’ve had all year. But we had to sneak the patient in because one of the surgical administrators said he wouldn’t let it in his OR. So we sent him off to an emergency meeting over at HQ.”
Now my head was swimming. It couldn’t be a VIP, couldn’t be a regular good guy, couldn’t even be a regular bad guy; we simply didn’t turn anyone away. Why would we have to sneak a patient in? And what did they mean by “it”?
The bark gave it away.
When I pushed through the doors of the OR, my eyes spied the secret patient: Tino the dog. He worked with a local military police unit and while relaxing the night before, decided not only to play with a tennis ball, but swallow it as well. Tino now had an emergency intestinal obstruction. The man of the hour was our veterinarian in a previous life: Dr. Reutlinger.
“It’s ’bout time you showed up. I knew you’d want to watch.”
Me and about twenty others, all stuffed into our miniature OR, shoulder to shoulder, craning our necks to make sure the pooch would be okay. Worried that the pooch would be okay.
Another vet from across the base worked with Rick; she was young, and it was one of her first surgeries. Rick took his time, spoke slowly, and talked the young veterinarian through each step of the surgery. Halfway through, I realized he had done the exact same thing with me all summer. Subtly guiding me through case after case, making me feel like I had saved the patient, when in reality I would have gotten lost in a dark place deep in someone’s abdomen. Rick was a good man, and, more importantly, a kind one.
Twenty minutes later, it was my turn to return months of favors. A two-and-one-sixteenth-ounce slightly frayed tennis ball was successfully delivered; Tino was slowly weaned off anesthesia and he awakened with a soft whimper and a wag of the tail. Then it was time to make a beeline toward HQ and the “meeting.” A few of us saw the boss striding briskly back toward the hospital, with a little steam coming out of his ears. But a lot of small talk, BS, and inane chatter delayed him enough to where Tino was out of OR number 1, placed in a truck, and returned to his worried handlers. And for weeks afterward, every time we’d see any of the administrators, we’d slip one hand behind our butts and wag it like a little doggy tail. It was the best, if not sneakiest, case of the deployment.
The canine surgery was definitely worth the lack of sleep. When 7 P.M. rolled around, I went straight to the ER, hoping for a stressless shift, but it wasn’t to be.
We had a series of soldiers bent and broken by roadside bombs arrives in waves through the night. The surgeons came back to work and I spent a lot of time making sure the brains inside the blown-up soldiers weren’t too jarred. The CAT scanner hummed for hours as I searched for subtle bleeds, then subtle signs of brain injury even when the scans were normal.
My worst case of the night, though, wasn’t even combat-related. I had stabilized the wounded that eventually made their way to surgery and was numb from the rapid parade of full stretchers that traversed my ER. Feet up, I was glad to look down the room and see a series of empty trauma bays at 2 A.M. Then I heard a faint noise.
At first, I thought the sound was coming from the medics’ movie—an irregular series of soft shuddering sobs. What tearjerker was the pick of the night? Then I realized the sound was coming from just outside the door.
“Guys, something’s going on that doesn’t sound good.”
My boots hit the ground with a loud thump as I swung my legs off the desk. Before any of us could make it to the door, it swung open, and standing in shadows was the outline of a female soldier straining to hold up what looked like a week’s worth of laundry under her arm. It wasn’t dirty clothes, it was another female soldier. She was small, thin, and sagging toward the ground. The sobs were coming from her. We ran to her and half dragged, half pulled the quietly weeping soldier into the safety of the ER.
She was a young girl, with short-cropped brown hair. At first, I couldn’t tell if her face was stained or bruised. It turned out to be a combination of the two. We got her to the closest stretcher where she collapsed into a tight ball, lying on her side. The sobbing had stopped, so had the short bursts of muscle spasms that accompanied the tears. Now she just lay in the fetal position, shivering and silent. Her mouth opened and closed rhythmically, but no sound came out. Our eyes turned to the woman who brought her in, now she was on the floor, trying to mouth a few words in between sobs.
“Some … guys … jumped her.”
Shit, it was an assault. A sexual assault. Her clothes were torn, and face bruised and scratched.
Her friend tried to tell us what happened.
“She … was … on … her … way to … the shower.” The friend also began to cry.
My mind flashed to my daughter Katie. God help me here. During my first deployment I put a pistol to the face of some asshole who was sexually harassing one of my female bodyguards. I told him I was just a stupid doctor; everyone would just say it was an accident, that doctors can’t be trusted with weapons. And he’d be dead.
It’s hard to explain the rage of a father whose child has been violated. Leaving the curtains around the stretcher open, I told the male medics to take care of the friend, call the MPs, get a couple of the nurses from the ICU, and then asked the two female medics on duty that night to help me out.
It took three minutes of soft gentle questions to realize there would be no replies. I stepped away, asking the females to take over.
She thought she had been in a safe place, the fifty-yard walk from barracks to shower. Fully clothed, she walked alone in the dark. Just before opening the door, three guys grabbed her from behind, threw her to the ground, and started to pummel her face and stomach. Clothes were pulled in an effort to rip them off—but they didn’t tear. Instead, there was a nasty ring of torn skin in a perfect collar line around her neck where her top caught while being forced over her head. Hand over her mouth, she kicked, punched, and bit. We’d be on the lookout for a male with an infected hand over the next few days.
Rape, sexual assault, and harassment were raw wounds for me after what my daughter went through. Hearing the story I felt maniacal, wanting to stick my pistol against the attackers’ heads, then realized I need to quash my own feelings and remain calm: revenge wouldn’t undue tonight’s damage. This young soldier’s needs and well-being came first.
The MPs were good; especially a female from CID, or criminal investigations, whose job it was to deal with victims of assault. The young woman finally let me back into the bay, allowing me to look and examine her beaten body. I needed to document every little piece of evidence I found. It was tough to consider her body as “evidence.” I wondered what her father would think, if she ever had the strength to tell him.
Done with our medical role, we stepped away and let law enforcement do their job. But it was so hard to watch the evolution of looks on the soldier’s face. Terror, anger, sadness, a quick hint of a smile, then eyes sinking deep into darkness. The pain would never go away, even on good days. I knew that personally.
We sat and talked among ourselves about the statistics—we didn’t know the rate of assault in the military compared to the real world, but the Army was doing a better job in at least attempting to acknowledge there was a problem. Then I told them about my Katie; it was painful even years later, and would be painful until my last day on this earth. It was a wrong that could never be righted.
Although the assault took place somewhere else on the base, well away from the hospital, over the next few days we were told to be extra careful as we walked, that females needed escorts every time they showered or needed to go out at night. Even the males should be on the alert, as there had been a few robberies.
What the fuck kind of place was this? I guess like any community in America—nowhere perfectly safe—no place perfectly secure. But how could we possibly be afraid of our own soldiers? I thought the enemy was on the other side of the fence. Yet from that night to the end of my deployment, every time
I wandered in the dark, my pistol was unholstered and ready to use. And it wouldn’t take me a second to pull it out and squeeze the trigger.
I had changed over the years, there was now a hurt, angry man deep inside who occasionally bubbled to the surface. I didn’t like him, and didn’t like seeing him around. Fortunately, the kind person who lived with him kept the angry one at bay. The kind man was the one I liked living with.
19
THE WOUNDED
WORE AFTERSHAVE
WE LONGED FOR a beautiful sunrise or sunset, yet on most days in the desert the sun either rose or fell like a window shade—rapidly, with little time for enjoyment. This day would be no different. When we stepped out into the swirling wind called the Tongue of Fire, we couldn’t see three feet in front of us. The floodlights were still on and would remain on through most of the morning, at least. Bad dust storms, so Paradise General would be on flight condition red until the haze evaporated.
I’d been in desert sandstorms before, but few like this. I felt like I inhaled a playground of sand before we’d walked halfway to the chow hall. And my face was raw as the fine particles blistered the skin from my face and blasted their way into every crevice of my body. Rick and I didn’t even bother to try to spit a few syllables; we just tucked our chins and forged onward, heads down into the wind until we eventually reached our destination. We stood for a few minutes, shaking our bodies of sand like a wet dog that has just come out of the rain. But all the gyrations in the world wouldn’t get rid of the fine particles that made their way into butt cracks and groins, and every step I took for the rest of the day felt like I were wearing sandpaper underwear.
Most of the guys were already eating by the time we walked into the cavernous hall. Checking the menu we saw tonight’s fare would include stir-fry along with the usual alleged beef dish, baked potatoes, and soggy salad bar. Although our meals could be as bland as wet straw, we ate better than any soldiers in history. It’s true that an army travels on its stomach, and with a short three-minute walk from chow hall to hospital our stomachs couldn’t complain.