by Dave Hnida
I knew I wasn’t the only one who stared at the ceiling for hours on end fighting the war—we all did it. And the personalities we showed to others were a reflection of our personal battle plans for surviving this hellhole. I was the wise-ass; Rick the make-believe hard-ass; Billy a noble man with an intense sense of duty; Bernard cool, unflappable, and privately thoughtful. Though we got an occasional peek into each other’s minds, it was only a peek—we each fought our own war, on our own terms.
Relieved that Bernard’s loved ones were safe, rounds took off like a rocket, much of it spent chuckling at the story of some Iraqi soldiers guarding some governor of some province. In a bad case of “Oops,” they wound up shooting each other instead of the bad guys. Maybe they needed orange safety vests that said, “Don’t shoot, I’m a good guy,” in large Arabic letters. It wasn’t really funny, but it was better to laugh than cry at the absurdity of a gang that couldn’t shoot straight.
Since we had rushed over from breakfast, we finished rounds with our trivia question of the day: what is the weight of the average human fart?
“What’s average mean?”
“Who’s the farter … or is it fartee? I mean if we’ve got Reutlinger here we’re talking some heavy poundage.”
“What are the meals the past forty-eight hours? People food or what we get here?”
“Ask Anesthesia. They’re experts at passing gas.”
I stood there wondering, How do you measure something like that? A plastic Baggie? And who the hell would pay to study the question? Probably the Army.
After rounds, we watched Bernard take off into privacy while Rick and I looked for a place to hide. We both had a little paperwork to clear up, then I’d head back to my room and clean while Rick looked in on his post-surgical patients.
Out of the blue, Rick blurted, “What the hell are they doing out here?”
I looked up from the charcoal-hot gravel and saw groups of medics replacing all the sandbags in front of the hospital tents. It was one hundred and twenty-five fucking degrees Fahrenheit and some clown decided scores of perfectly good sandbags needed rearranging and replacement.
The work detail crew was shirtless, and rivulets of sweat drained down their faces and chests. Several looked like they were ready to keel over and perform an Olympic face-plant. Sergeant Courage was in charge of the chain gang.
“Top of the morning, Sergeant Courage. A tad warm for yard work, wouldn’t you say?” I asked.
“Fuck you … sir.”
His tongue was hanging like a Mississippi hound dog in the dead of summer.
“Sorry, sir. Top of the morning back to you, too. Just a little assignment to keep us out of trouble.”
His scowl told us what he really thought of the idea.
“It seems like we’ve got our green sandbags over here, and our brown ones over there, and that mismatch is keeping some people awake at night.”
Holy Christ, we were in the middle of a war and someone was worried that the sandbags don’t match? Did the wounded complain as they flew in or something? Hey, pilot, this place looks a little sketchy, let’s fly until we find something a little nicer. It was total bullshit. We needed the medics to be rested and hydrated and at the top of their game if we had casualties.
“Who’s the asshole, Monsieur Courage?”
“Sorry, sir, not at liberty to say. Never speak poorly of those who outrank you.”
“Need drinks?” we asked.
“A case of ice cold Bud here in our front yard would hit the spot.”
He pronounced it “yahd” in his thick New England accent.
“We’ll see if we didn’t empty the fridge last night. Say, if anyone collapses, let us know but not before the sandbags look pretty.”
We wandered off, cursing the administration. They seemed to have no concept of what these youngsters did day in and day out. They pulled twelve-hour shifts caring for broken soldiers—washed the gore off their uniforms so they could finish their day pulling guard duty at the chow hall or PX—then they had to get up extra early working as a landscaping crew in desert heat. Jeez Louise.
Back at the room, I surveyed the damage of living for two weeks since the laundry was dropped off, trash emptied, and floors swept. In our rooftop locale, we had a door that opened directly to the outside, with the door made of badly cut plywood that was so ill fitting it allowed heat and sand to steadily flow in. The most important job was the air-conditioning filter—we had a small window unit, which brought the temperature down to a subarctic 90, but was better than life on the outside. Puffs of smoke rose off the foam as I beat the filter against the side of the roof. Next came the big black trash bags. They were quickly filled with weeks-old partially eaten snacks, Mike’s old New Yorker magazines, and a sorry collection of filled piss bottles. I counted fourteen old Gatorade bottles filled with middle-of-the-night urine—about half were mine, a couple sat next to Mike’s table bed, and the rest next to Ian’s mattress.
When we moved in, we vowed we’d each throw out our own nocturnal pee every morning, but it never quite worked that way. The bottles seemed to multiply like uro-bunnies. So I performed an official random act of kindness, disposing of more than a dozen bacteria-laden warm jugs of piss. It may not have seemed like much of a gesture, but in our world it was considered the ultimate humanitarian mission. In one arm an overfilled bag of bottles, in the other a laundry bag filled with dirty socks and nonregulation boxer shorts imprinted with pirate skulls or polka dots, I headed downstairs praying neither bag split apart.
After I sterilized my hands, I walked over to the chow hall to meet up with Rick for lunch.
“Three-point-five ounces,” he proudly proclaimed.
“What? Your brain? Your pecker?”
“Three and a half ounces. That’s the weight of the average fart. I Googled it.”
“Well, when I Googled ‘douche bag,’ I got fourteen thousand hits with your name.”
“Shut up. I win. I got the answer. I get the prize.”
“And that prize is what?”
His face deflated. We’ve never had a prize for getting a trivia question right, and he’d walk away empty-handed despite his correct answer.
“But I still haven’t been stumped yet,” he said, as his face split into a toothy grin.
“Great, you can go home and years from now tell your grandkids you won the trivia question contest in the war. And the clincher was a question about farts. What is Oklahoma like, anyway? Do they have paved streets, indoor toilets, or refrigerators?”
“It’s a lot nicer than Colorado. At least we don’t get snow every day.”
Our insults were interrupted by the chirping of his pager.
Two patients inbound with lacerations of the face. Sounded simple. I decided to walk over to the hospital with him and lend a hand to the ER doctor on duty. Gerry was running the show and said he’d take Alpha bay for the worst patient; I’d take Bravo for the other. The copter landed and in came the litters, bearing surprises in the form of two Iraqi soldiers.
Man number one didn’t have simple lacerations. His face was blown off.
My guy, man number two, had a flight medic straddling his chest doing CPR. Simple? Lacerations? I think what we had here was a failure to communicate … but considering the conditions, it was no one’s fault. My God, the chopper ride in had to be chaos.
My guy was dripping blood from his mouth and nose. A tube was in his throat but I couldn’t hear any breath sounds in his lungs. Pulse was a racehorse 190. Blood pressure didn’t even register. He felt burning hot. His eyeballs were bulging. Where were his wounds? We started IVs, replaced the breathing tube to the lungs, and scissors slid through clothing so we could check for other wounds. I saw none.
I’m worried about the head but I can’t feel anything besides some small pieces of shrapnel in the scalp. Maybe it was more than shrapnel. We put a tube into his stomach, which quickly returned a solid flow of bright red blood. We checked his temperature—107.9.
Highest I’d ever seen. We packed him in ice, filling bags with cubes and stuffing them into armpits, crotch, and around arms and legs.
Less than three minutes had passed. His head on the right side started to literally get bigger, which meant he was bleeding into the brain and that blood was pushing his scalp out. He needed neurosurgery down in Balad. Stat. But a quick X-ray showed shattered bones and a thin metal fragment that probably entered through his face—all I saw there was a small red cut, the size of a BB, but that’s where the metal went in. He was going to die.
Gerry’s man without a face got stabilized and was ready to go. He also needed the services of the experts in Balad, specialists who could reconstruct his facial bones. But did my guy have a chance? Do we put a second bird in the air and risk a crew and medics? I talked with my nurses, my medics, and Rick, but ultimately it was my call. We stayed. He stayed. No life-saving surgery. No surgery existed that would save his life.
The best we could do was make him comfortable. But I doubted he was in pain. I wished we could ask him if there was anything to make him feel better as he died. I was helpless. We were helpless.
We CAT-scanned his head just as the other soldier left in a helicopter. The scan showed my guy had four jagged fractures of the skull with lots of bleeding within the brain. The horrific images confirmed it was a good call to keep him here and let him die in peace. I wondered if he even knew what hit him. My question was interrupted by an interpreter who was called in to help.
We learned he was an Iraqi soldier blown up by a roadside bomb. The guy who came in with him was his older brother. One is twenty-four, the other twenty-one. Two brothers who would never see each other again.
We had no powers of attorney here. No living wills. We gathered around the stretcher to figure out if there was anything we could do to save this fellow. Change our minds and fly him out? No, not with that much brain damage. He’d never survive a flight. Do brain surgery here? No, the operation would be like trying to reconstruct a smashed pumpkin. Or do we just turn off the machines and see if he dies? The worst, but best, call. We would just make sure he was comfortable as he quickly traveled the road to death.
Yet he kept ticking along. His brain was gone, his lungs needed a respirator, but his heart was young and strong. So we waited. And would wait. Until his heart gave up the fight or we needed the bed and the equipment keeping him alive. That was the call no one wanted to make.
The hours ticked into the next morning. When we returned, he was still in the bed just as we left him. Unbelievable. We did a series of neurological tests—he was brain-dead. The heart just didn’t know that yet. A steady series of beeps from the cardiac monitor reminded us.
We heard there was a big offensive push by our soldiers coming up, which would spell more wounded and the need for beds. I felt nauseated thinking about the decision that needed to be made. Our doctors and surgeons had thought of every possibility to help this guy survive but we all agreed there wasn’t anything that could be done. Yet no one wanted to give up the fight and turn off life support.
Then we heard a family member had been located—a relative who was an officer in the Iraqi army. He made it to the hospital by mid-afternoon. He spoke little English. And we didn’t know who he actually was; he only identified himself as “kin.”
I placed my right hand over my heart, slightly bowed, and said, “Salaam alaikum.”
May peace be upon you.
He returned the greeting. “Alaikum salaam.”
And upon you be peace.
Through a translator, I explained the injuries and the outlook. I prayed that the word “hopeless” was conveyed in the soft manner I would say in English. The kin’s eyes were dark and very intense; I don’t think the translator was necessary. He knew. He knew without words being spoken. The decision was made to slowly turn off the machines.
We closed the curtain around the bed, and left the two alone. It took about ten minutes for the young man to die. But it was a peaceful ten minutes in a solemn, respect-filled environment. I was called back from the ER to pronounce him dead. The kin and I stood for a few minutes without a word. You could see the moisture in his eyes as well as a sense of thanks for all we had done. We shook hands, tried a few words in English, and then did a traditional Arabic goodbye: hand over heart, wishing each other peace and the love of God. His final word to me was “friend.”
21
YOU SHOOT ’EM, YOU OWN ’EM
HE COULD HAVE been a commercial for a product promising a close shave, a really close shave. The bullet had zinged straight through the Iraqi soldier’s neck, halfway between the chin and Adam’s apple. In one side and out the other. And just deep enough to split the skin and fatty tissue, but not hit anything important. A random shot fired during a raid on a suspected insurgent hideout.
He knew he was lucky—he kept on smiling, and each grin opened a second mouth. It wasn’t even close to the grossest wound we had seen and a dozen or two stitches would close things up just fine. It didn’t even bleed that much. The Iraqi spoke a few words of English, and when I looked across the stretcher at one of the medics and said, “What a lucky son of a bitch,” the man with two mouths let out a heavily accented “Me lucky son of bitch.” Then laughed.
Man, a half inch higher, lower, or deeper, and our friend would have bought the falaha.
Soon after, we got our next customer from the raid—another Iraqi, but this one was on the wrong side of the law. He had been hit by a few gunshots during a firefight with our troops and was also lucky to be alive. The scenario was a familiar one. As our soldiers descended on a village, this insurgent stood in the middle of the street, then slowly and methodically worked his way toward a specific building. Too slowly and methodically. It’s as if he wanted our soldiers to chase and follow him inside. He was a rabbit, and his job was to get chased and lead our guys into a building brimming with booby traps. It was a trick that had been used by the insurgents for a while, but by this stage of the war, units that have been over here and have combat experience don’t fall for the ruse, even in the rushed heat of battle. They nailed him before he got inside; now it was our job to repair the damage.
As I surveyed the destruction, I heard soft moaning coming from the blood-crusted lips of the insurgent. With gunshot wounds to all four extremities, he had to be hurting, but there are times when your sympathy meter just isn’t set to the same level as it is for a good guy. Then, eventually, as always, the physician inside your soul kicks in and you dose the enemy with liberal amounts of morphine and use a more gentle touch to probe his wounds.
The rest of the doctors are no different. We’ve all seen our own people suffer at the hands of guys like this, yet we simply follow our oath and do our jobs. I think the worst we’ve ever done is look down at a helpless form on a stretcher and say, “Welcome to Infidel General Hospital, now we’re going to save your life.” Then we go to work and heal a fellow human being.
I looked up at the soldiers who chased him down—they stood at a distance and let us do our jobs but their eyes projected a blank stare. Some of it had to be fatigue, after all, they had been out in the heat chasing down people all night, but I think it was more that their eyes were a closed door to the room of emotion. Over the weeks, I’d had a chance to shoot the breeze with some of the men and women who bring in prisoners and many were frustrated. Frustrated they didn’t finish the job. Frustrated to see insurgents get four-star medical care. Frustrated at the ever-changing rules of engagement that define when they can fire their weapons. At one point, a sweat-stained soldier with bulging forehead veins told me they weren’t allowed to shoot at anyone from behind even if they’d just planted an IED; you had to see the whites of their eyes before pulling the trigger. Yet this day, like all days, they just stood stoically and silent as we worked to save those who would hurt us. They are good men and women, wise beyond their years.
And with their latest delivery, we thumbed to a well-worn chapter of our medical guidebook
titled You Shoot ’Em, You Own ’Em.
That’s the unofficial name of the policy when it comes to taking care of insurgents. If we catch them doing something bad, they get popped and we become responsible for their health care. It’s a rather unique plan—a form of free, universal coverage not available even in the United States. No matter their wounds, prisoners are blindfolded, cuffed, and brought to the hospital. We doubled-check them outside for explosives, and quickly but cautiously cut their clothes off. Only then are they brought into the ER and their injuries repaired. We simply can’t take a chance on a suicide belt or weapons inside our hospital. And as the Surge pushed more bad guys out of Baghdad, the more insurgents our guys got to chase and wound. That was why our August census had seen a big jump in the number of patients who hated us.
We didn’t know the name of my patient, which was often the case when a bad guy was dragged in. So we christened him, as we did the others, with a special surname solely for the purpose of medical records: “Unknown.” This month it seemed like we’d had the whole Unknown family come through: Sammy Unknown, Mohammed Unknown, Khalaf Unknown, Ahmed Unknown, and now, Unknown Unknown. The Unknown family had been up to a lot of dirty tricks lately.
Ian and Bill would wind up taking Unknown Unknown into surgery, then he would go to the ICU to recover. He’d have guards with him twenty-four hours a day and would be kept separate from other patients, hopefully with more than a flimsy portable screen.
At times, the insurgents really didn’t trust or understand us. One guy had skin grafts to repair his burnt and mangled arm, and he couldn’t figure out why the newly grafted areas had a different color and texture compared to the rest of his arm. He concluded we had sewn a new arm onto his body while he was asleep in surgery. Worse, he was a Shiite and thought we had attached a Sunni arm.