Authors: Dave Hnida
We left the OR a little wilted, and very tired as the twenty-hour
marathon of a day groaned to an end. We walked through the ICU on our way out, silently staring at the still blue body of the Smurf, chest heaving up and down as the respirator forced oxygen into his unconscious lungs.
Damn.
I don't know if we beat the record for the removal of an appendix that evening, but I do remember the song that was blasting through the room as we finished: “Only the Good Die Young.”
I
T WAS YET
another “first day,” although this one would take place in darkness. I was finally scheduled for the night shift, which meant I had the whole day to kill before showing up for work at 7
P.M.
, or as my Army watch would say: 1900 hours. After more than a week of going to work in the light of day, this would be my first time working alone in the dark and loneliness of night, and I had to admit, I was more than a little skittish.
I was gradually getting used to the blood and gore of the ER and my confidence was rising steadily with each case that rolled through our doors. But when I worked the day shift, help was only footsteps away. At night, I would be the only doctor in the hospital, and without phones, my sole tether to help was the pagers my fellow doctors kept next to their pillows.
Although my buddies would be less than half a mile away snoring in their bunks, that half a mile would seem like a continent especially if a bird made a surprise landing or I had someone tank out in the ICU. The only three doctors with instant availability would be me, myself,
and I, and the way I was feeling, that trio reminded me of the Three Stooges. As I lay in bed waiting for my watch alarm to beep, all I heard was
Dr. Howard, Dr. Fine, Dr. Howard
, quickly followed by a cadence of
Dr. Hnida, Dr. Hnida, Dr. Hnida.
I shook the chant out of my head and skipped down the stairs to pick up Rick. Like me, he had been wide awake for hours, reading, killing time, and watching mental reruns of the experiences of the last few days. I envied his ability to read. At home, I normally knocked off about two books a weekâusually spy or adventure novelsâbut here I found I couldn't read more than a sentence or two before I had to put the book down. It was a loss I would carry the entire rotation, and I mourned not being able to mentally escape each night, even for a few minutes. Rick, on the other hand, was now reading some book that claimed God was dead, or maybe never existed in the first place. The thought creeped me out and our morning together started off with me calling him a perverse shithead.
By the time we made it to breakfast, most of the doctors and staff were already there, having a heated discussion over some obscure worthless piece of trivia. The game took place on a regular basis no prizes or reward, just the satisfaction that you knew something of no practical value. The morning's stumper was “What is Barbie's real name?” courtesy of Bill Stanton.
Answers and comments flew up and down the table as we raced against an imaginary clock.
“She's a fucking doll. How can she have a real name?”
“This is a bullshit question.”
“I know this one, it's Barbie Mattel.”
“Who cares? She's a little plastic doll with little plastic boobs.”
Bill looked smugly at the group. “Barbara Millicent Roberts.”
“You're on drugs, man.”
“No way.”
“Yes, gentlemen, Barbara Millicent Roberts. And she was born in 1959, which means Reutlinger might like to date her.”
Rick shot back, “Yeah, well, what about Ken?”
From down the table: “Rick, she's make-believe, for Christ's sake.”
With that, we carried our trays away and took off for the hospital.
Medical rounds were held every morning at 0730 in the Ortho offices just around the corner from the OR, and even though I wasn't formally scheduled to work until night, I still had to show up for morning rounds.
The exercise basically consisted of all the docs, head nurses, therapists, and psych people getting together to review the progress of the patients in the hospital, look at any interesting X-rays or CAT scans, and make sure no one had screwed up in the previous twenty-four hours. Most days things were fairly painlessâthe main pressure was making sure we got the wounded evacuated as quickly as possible, and getting the injured Iraqis out of the gate to the local hospitals. The latter was the pressure-filled job of Arabic-fluent liaisons who worked their buddy lists to try to find a family member or a friend who would assume the care of an Iraqi we wanted out the door. As far as the U.S. Medical Command in Baghdad was concerned, an empty hospital was a good hospital.
The numbers that day weren't bad, only seven patients. With a capacity of eight beds in the ICU, and twenty in what was called the intermediate care ward, we could hold twenty-eight, with a special lying-room-only section for overflow crowds if necessary. We didn't know it, but there would be days ahead when the “No Vacancy” sign lit up at the door to our CSH.
The first order of business was to review X-rays and scans. As we crowded around a small computer, images of splintered bones underlying mangled arms, legs, and hands lit up the screenâthe kind of injuries none of us ever really saw back in the States. A few murmurs and holy shits cycled through the group. We then moved on to some CAT scan images, which still looked like Rorschach tests and mud puddles to me. The realization was a slap in the face; I was still a lost
soul wandering aimlessly in CAT scan land and needed to hit the
CAT Scans for Dummies
book harder.
Rick's appendix kid was doing great, and would be out of the ward in another day. And stunningly, the Smurf turned pink in the predawn hours and would be weaned off the ventilator over the course of the day. First glances didn't show signs of brain damage; maybe the kid would luck out. In any case, his next stop would be the States and then legal charges and court-martial. As would be the case with most of our patients that summer, the former Smurf would soon be out of sight, out of mind; there simply wasn't time to dwell on former patients, at least not while we were constantly replenished with new.
The last American soldier on the agenda was one I hadn't seen or heard about, a young soldier with hysterical blindness. After one too many missions swerving IEDs, this guy lost his vision. It happened a few days before and the patient was flown in from an outlying post during the night. He claimed he couldn't see the hand in front of his face, and a bright light was only a shadow. That meant he had to be led by hand from the ICW to the latrine or to the sidewalk for a smoke. Last night, he said he wanted to be left alone while having a cigarette, and when his nurse walked away she peeked back as she rounded a corner and saw him bend over, pick up a stone, and toss it at a sign. He then flicked his butt on the ground, walked over, and ground the embers out with his heel. This twenty-four-year-old wasn't blind but was an everyday young man who had cracked under the stresses of war.
Now our eyes were blank and peering at the floor, confused, yet a little frustrated at the young soldier for taking up valuable resources and time, then, just as quickly, disappointed at ourselves for feeling anything but pity. He'd be shipped to Germany, and we'd never learn if therapy would fix him or if he'd be dodging mental bullets and bombs to the day he died.
We had a few “housekeeping” items to discuss before being dismissed, the most important of which was the rumor of a big offensive slated to start within days, or weeks, depending on the setting of the
bullshit-o-meter. The Surge was beginning, and its opening act would start with a bang. Although we minions weren't supposed to know details, for fear we would leak the info by e-mail or phone, it was important for the hospital to ramp up and be ready from a staffing and supply standpoint. But as far as we were concerned, it didn't matter. There would be no extra doctors sent to help usâbusy or slow we would trudge to work and do our jobs each day.
After rounds, we ambled over to the ER for coffee, and were told flight conditions were “red”âmeaning there were swirling sandstorms in the area and no copters would be flying. No business expected at least for a few hours. Which meant it was time for the morning matinee. The morning's feature film on someone's laptop was the medics' favorite:
Kill Bill
. Male and female, the medics watched, and then rewatched, testosterone-laden DVDs with the highest violence and gore ratings.
I knew I couldn't go back and nap; Rick had little going on at the moment, so we decided to hike down the road and check out the PX, a small building that served basically as our little corner grocery. We didn't need anything, but thought some window-shopping might break up the day. The store seemed well stocked, especially with essentials like toothpaste and deodorantâthere was even hair dye for the female soldiers on the base, as well as, I suppose, the vain males who were showing a few gray strands. One aisle led to another, and with each came an increasingly surprising item to be stocked in a war zone. A great selection of CDs, DVDs, audio systems, video games, and video game systems. For off-duty enjoyment on a not-so-cool summer evening were barbecue grills and a variety of patio furniture, even some with umbrellas. And to help you speed off into the sunset, a separate trailer next to the PX, which housed an actual All-American auto dealership. Not that there were any cars on the lot, but you could sit and pick a sleek beauty out of a catalogue, get financing on the spot, and have that baby waiting for you when you hit the States at the end of your deployment. Just one more thing to widen the chasm
separating my war and that of my father's.
“What in the name of shit's sake is all of this stuff? Cars? Trucks?” I said to Rick.
“I guess it's to keep morale up.”
“Hell, I've got a truck back homeâI need one here. This gravel is kicking the shit out of my feet. My feet need morale, not me.”
Which was trueâthe combination of heat, sweat, and suffocating boots worn twenty hours a day had caused an entire layer of skin to peel off my feet and every step on raw skinless soles felt like a walk across hot coals.
Hands on hips, Rick stared at the trailer. “Let's see if they've got any Harleys in there.”
“No, thanks, I've satisfied my midlife crisis by joining the Army and coming here.”
Curious, we went in to browse and kick some imaginary tires. The small office was staffed by a contractor with a clipped accent we couldn't quite pin to a location.
“May I help you gentlemen?” asked the contractor-salesman.
“I'd like to buy a car,” I said.
“Excellent. And what precisely are you interested in?”
“Anything but brown. I'd lose it in this country. Good air-
conditioning. And something fastâwe've got places to go, people to see, soldiers to operate on.”
Eyebrows raised, the salesman stared at us with the early symptoms of confusion. And I was just getting revved up.
“Plus these are new cars, right? You're not a used car salesman? You know what they say about them.”
Turning, I looked at Rick.
“Can we trust this guy? I mean, he's got a good face.”
Rick nodded thoughtfully and said, “I think so. He's so trustable, I'd even let him pick one for you. One other thing, though, a siren would be good.”
“Excellent idea, Dr. Jekyll.”
Turning back, I said, “Okay, so why don't you pick a winner for me and we'll come by, say a week from Tuesday, and pick her up.”
The answer was a series of hems and haws.
“Uh, I don't think you understand, sir, the cars, uh, they are not here. You buy them today at a discount and then get the vehicle when you return home.”
“But that really doesn't help me a bit,” I said. “I don't have wheels here. And me and my friend here are old guys who need transportation.”
“Dave, I think that's why the lot looked empty. I think the Army has let us down for the first time ever. Let's hit the road.”
The bell above the door gave a small ring as we left.
I turned to Rick as we began our trek back to the hospital. “So tell me, man, is this why we're in this country? I never knew one of the perks of war was a new car.”
“Who the hell knows? I could use a new pickup, though. Mine's got two hundred thousand miles on it.”
As we walked, the ground began to shake with the vibrations of incoming medevacs. So much for condition redâthe starter's pistol had been fired into the dissolving haze. The ER was abuzz with activity; Gerry Maloney was running today's show and had his hands full with IED-damaged limbs.
Rick and I both stepped in and eyeballed the less severely wounded men, but the bigger view showed three bays filled with ortho cases. Bill Stanton went from stretcher to stretcher, prioritizing the injuries and deciding who would need the knife or, today, the saw first.
A sandy-haired kid in his midtwenties quietly wept on his stretcher, knowing his mangled leg was hanging by a thin sinew of flesh at the knee.
“Please don't take my leg. God, please don't take my leg,” he murmured.
In the chaos of a noisy room, Bill picked up the soldier's plea amidst the chatter, came to an abrupt stop, and walked straight to the
crying soldier.
He knelt down to eye level and placed his hand on a soot-smeared forehead. In a soft voice whose words flowed with a gentleness that seemed foreign in a war zone, Bill comforted his new patient, lying helpless on a stretcher, forced to trust a man he'd hoped he would never meet.
“I'm Dr. Stanton, the orthopedic surgeon. I'm going to level with you and tell you your leg is in bad shape. But I promise you, I will do everything,
everything
, I can do to make it better. Dude, if there's any way I can fix it, I will do that.”
His hand gently stroked the frightened soldier's head as tears leaked a path down the soot-covered cheeks.