Paradise General (27 page)

“These days make me crazy,” Rick mumbled.

“Well, just be glad you're not checking hemorrhoids over at sick call.”

“Good point.”

A
T 0920, THE
interior of the vehicle was a suffocating mix of moans and smoke. Tall Paul was drenched in blood, mainly from his legs, which had been struck by a dozen shards of flying metal, as well as the blood of the men he had fallen on. As the smoke cleared, he started what's called “buddy care”—slapping pressure bandages wherever he saw or felt the warm stickiness of blood. It was one of the first lessons he learned years before at basic training.

I
T WAS ONLY
three bucks for a military cut, a simple act where an electric razor quickly buzzed over your scalp, then zigzagged the nooks behind the ears. The whole operation took a full two minutes if the barber was slow. As I waited my turn, I tried to figure which country the barbers were from; indecipherable Indian-sounding pop music blared from a cheap radio. Some Pink Floyd or Springsteen might give the joint some atmosphere. A nap was starting to sound good.

A
SPECIALLY TRAINED
combat medic raced from his Humvee to the damaged one a hundred yards up the road. Smoke billowed from under the vehicle for several seconds, then dissolved to nothingness. A tangle of men tumbled out. The medic quickly applied tourniquets to blood-gushing arms and legs, and started IV lines, all while trying to quiet and calm the screaming. His quick actions were automatic, but came with a price. Attached to the unit, he knew these men well. As the medic worked, the unwounded surrounded and protected him in case the IED explosion was a prelude to an ambush.

The stricken convoy radioed for help. It took less than five minutes for a pair of unarmed medevacs to spin up their rotors and launch. They sometimes traveled in twos in case one chopper went down or extra room was needed.

I
HAD JUST
settled in for a long morning's nap when my pager went off.
All available docs to the ER. Four urgents by litter inbound.
As I laced up my boots, Rick barged through the door. “You get paged? Sounds like they need some extra hands down at the ranch.”

“I'll be ready to go as soon as I untie my laces from my fingers,” I replied. “They're stuck.”

“Do the wounded know you work at this place? I think I better tell the pilot to keep going to the next hospital.”

N
INE MINUTES LATER
, the choppers landed on the road next to the convoy. Four soldiers were placed on stretchers and launched to the next stop. Bob and Tall Paul were placed into one copter; Jeremy and a new guy, whose name was forgotten in the chaos, went into the second. The men were loaded with morphine, except for the new guy, who was struggling to breathe. A sharp splinter of metal had ripped through his neck. The flight nurse started treatment in the bouncing, cramped cabin of the medevac while the chopper radioed the CSH with an update. The pilots zipped through hazy skies, trading comfort for speed. The entire crew had to make all the right decisions in the worst of conditions. The margin for error was zero.

Our walk to the hospital was brisk and we hit the door just in time to feel the vibration of blades beating the air. We checked inside to find where we were needed most. Mike was working Alpha bay, I went to Bravo, Gerry to Charlie. Rick waited with the other surgeons until we sorted things out.

T
HE FLIGHT TO
the CSH took just under nine minutes. We were designated as “level-three care,” a hospital equipped to perform more advanced emergency and surgical care. Sounds impressive, but we really could only offer fast-food medicine: get 'em in, get 'em out. We kicked into action as our medics raced to the helipad and returned blood-soaked and heaving for air, asking where to take each stretcher. Yet they had already made the decisions, bringing the soldiers in the order they thought was right: “The worst comes first.” As usual, they were on the money.

“We've got a penetrating neck wound. Respiratory distress en route. Resuscitated. Vitals now stable.” The New Guy.

“Multiple lacerations. Suspected multiple fractures. Open fracture left wrist.” Bob.

“Blunt trauma to head. Multiple shrapnel wounds to face.” Jeremy.

“Multiple lacerations and fragment wounds lower extremities. Vitals stable.” Tall Paul.

We split up and got to work stemming the flow of blood, inserting tubes and IV lines, and pumping in blood. The New Guy made us the most nervous and we decided it was smart to speed-roll his stretcher into surgery before he tanked.

As Bob lay quietly, the medics cut off his good-luck bracelet. His wrist was broken and a small splinter of bone poked through the skin. A few burns scorched his hands and legs.

Jeremy had raccoon eyes, his face blackened with soot and peppered with shrapnel except for two circular areas around his eyes. Leaving those goggles on meant he would leave the war with his vision.

Tall Paul needed almost a dozen metal fragments removed in surgery but escaped with otherwise minor dents and dings, or at least what we considered minor.

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.

“S
O 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.”

T
HE 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 hell'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.