Paradise General (7 page)

“Sure, coffee would be great—a beer would be better.”

In a thick New England accent he said, “I know what you mean, sir, but all we've got is the black gasoline—and come to think of it, foo-foo at that.”

Foo-foo?

I filled an empty cup and wandered down the line of stretchers toward the action—watching as IV lines were stuck blindly into the deep veins of the neck and groin and morphine injected to quiet the screams of men whose bodies had been assaulted by shrapnel. Blood flowed on the floor in a small stream, collecting in grooves and cracks of the crusty linoleum. Fresh blood has a unique smell—tangy with a bitter sweetness—and this morning it penetrated and attached itself to the deepest lining of my nose. I sipped at the coffee, hoping to wash away the putrid fragrance, and wound up spitting out a small mouthful in surprise. It was Almond Spice—one of the many flavors of “foo-foo” coffees favored by a crew who struggled for some sense of sensual calm in the face of daily carnage. I staggered out of the overcrowded room, fighting the rising bile in the back of my throat as I realized in a few days I'd be on the game field, not watching from the bleachers.

Before we were allowed any hands-on work, we all had to go through orientation—starting with a day-long PowerPoint presentation and a series of briefings on the rules of the camp, rules of the hospital, lab procedures, blood protocols, schedule of religious services, all piled onto an overflowing plate of topics no one paid attention to or remembered. But one thing did stand out: it seemed almost every female who gave a lecture spent a lot of time staring at the well-built body of the gently snoring Bernard Harrison as they spoke.

The briefings were held in a musty dark gray tent with a reluctant air conditioner, which combined with bewildered body clocks left us looking like a bunch of bobblehead dolls, lolling off to sleep, then jerking back to consciousness. Tumbling in late came Billy Stanton, who won the prize for the first to get onto the playing field. Last night, the copters I heard were ferrying wounded, and Bill never went to bed; staying up and helping the soon-to-depart overworked orthopedist with a series of amputations, compound fractures, and limbs torn to shreds by the hot fragments of roadside bombs.

“Holy shit, dude, it was some nasty stuff.”

He and the other surgeon had only just finished the cases I had wandered into that morning in the ER. In a place where almost everyone who came through the door had something blown off, torn off, or broken off, there was one orthopedist when there should have been four. Soon it would be Bill who was operating night and day without help.

Next up was a quick meet with the medical boss, Dr. Greg Quick, the kindly colonel who had picked us up at the airfield the night before. Greg was an ER doc from Massachusetts who opted to spend an entire year with the 399th supervising the groups of doctors rotating through the facility. Just around the corner from the mandatory retirement of age sixty, Greg wore oversized glasses that spotlighted his quirky facial expressions, which mainly consisted of a bemused ability to raise his gray eyebrows all the way to his hairline while talking. His voice was high-pitched and he had a consistent way of finishing a
statement with a rising question mark of “Hmm?” We had no clue of how bad his year had been to this point but would gradually learn how far he would go out of his way to make sure “his doctors” were taken care of, as well as keeping us one step ahead of the Army's “stupid rule” police.

“Your only job is to take care of patients—that's pretty simple, wouldn't you say, hmm?”

He filled us in on some of the unpleasantries of our stay: we were short a surgeon and two ER docs, so we'd be pulling extra shifts. Greg's voice was soft and cheery, as if discussing a gorgeous springtime morning instead of one with ominous clouds and deadly tornadoes in the forecast.

Sure, Mike and Dave, we know you're family doctors but since you each have ER experience in the States, we're all sure you can handle trauma here—but we'll talk about that later in private. And Dave, we know you can work a scalpel so maybe you could help out the surgeons when you're not in the ER. And don't worry, you'll all have some free time—but not really—you're technically on twenty-four-hour-a-day call every day of the deployment. Sorry, we have no phones to the barracks—we use pagers to communicate with the doctors. Going anywhere, including the latrine, without your pager is a sin punishable by screaming. We wouldn't want that, would we, hmmm? Oh, one more, sorry, but you do have to salute outside the hospital compound—but inside we are a no
-
salute zone. And don't forget to take your cap off when you enter the hospital grounds, we wouldn't want something sucked into the engine of a medevac, hmmm? Finally, we don't do neurological or facial surgery here—the one phone we do have has a direct connection to the Air Force hospital in Balad. They've got specialists—use them.

We sat there stunned trying to soak in all in.

A few minutes later, we broke for lunch and a self-conducted mini-tour of the camp. The blast furnace outside was actually a relief from the musty steam of the overcrowded tent. As we pushed through
the flap, Bernard said, “I've got a feeling we are in for a fucking hell of a ride.” Grim nods all around.

Few words were spoken as we crunched our way toward the DFAC or dining facility. We'd seen a glimpse of it last night when we arrived, but in daylight were surprised at its mammoth size: easily two football fields with seating for a few thousand. Quite a difference from the little fifty-person fly-infested shitholes that fed me during my first tour. The shiny concrete and steel DFAC was newly built and quite a contrast to our hospital of drab tents. After armed guards checked our IDs, we were directed to a mandatory hand-washing station, then finally into the DFAC itself. Stationed at the door was an enlisted soldier whose sole job was to work the “clicker,” a little handheld counter than clicked every time a diner entered the facility. And each click was $32 into the pocket of some faceless multigazillion-dollar civilian corporation. Not a bad business deal, figuring the Camp Speicher megacomplex fed more than fourteen thousand soldiers and contractors three meals a day. Do the math and it totaled a nice
1.3 million dollars a day
—give or take a few hundred thousand bucks for skipped meals. Not that the service, at first glance, didn't seem worth it—we were waited on by bow-tied white-shirted contract workers from countries such as Sri Lanka and Indonesia. But the food choices left a little to be desired. The menu moved through a three-week cycle of deep-fried, artery-clogging monotony. If something could be cooked in a deep fryer, in it went, except for fresh-off-the-grill burgers, which we suspected were actually ground camel; mushy fruit that had suffered through countless cycles of freezing and thawing on its journey to us; and honest-to-goodness stir-fry, though we were never sure exactly
what
was being stirred and fried.

On the plus side were huge refrigerators filled with soda, Gator-ade, and chocolate milk, which sat on the periphery of the huge hall, right next to the plasma flat screens that typically showed sports or political programming. I grabbed what looked like a Diet Pepsi from the fridge, but a closer look revealed its foreign lettering. I think
Turkish, which proclaimed “Harika Tat!” in big letters. The translation, we later learned, was “Tastes Great!” I watched Rick stuff six cans into his now bulging cargo pockets—while I was the coffee addict, his vice was consuming gallons of diet soda each day.

We sat munching our fare at long tables with clean plastic-covered white tablecloths that were meticulously brushed of crumbs when our meals were finished. Lest you leave your sweet tooth unsatisfied, you could top off your meal with an assortment of cakes, pies, brownies, and ten different flavors of ice cream—they'd even make you a sundae if you asked. Maybe that's what the $32 was spent on, because it sure wasn't health food. The battle of Iraq for many rear-echelon and support troops was really the battle of the bulge—the average weight gain of a soldier serving a year in Iraq was 10.5 pounds. This was definitely not my father's war with its K rations, nor my 2004 tour with MREs or little cans of ravioli.

We had about ten minutes to make it back to our orientation—and that was about nine more than we needed. COB Speicher was a huge base, about twenty square miles in size—little wonder it took so long to get from the airfield to our barracks the night before. With the pounding the base had taken in the early days of the war, craters dotted the landscape. As it was slowly transformed into an American superbase, the camp now had paved roads, bus lines, and stop signs—as well as military police with radar guns who would issue a ticket to the poor Humvee driver who exceeded the 10 mph speed limit.

Yet most of us would never see that part of the world; we were cautioned not to venture off the miniature half-mile-square section tucked into a distant corner of the base. Our little universe consisted of barracks, DFAC, hospital, gym, shower trailers, and latrines, so closely nestled, all could be reached in three minutes—and in the case of an emergency run to the latrine, fifty-two seconds. All routes were covered by those ankle-twisting chunks of hot gravel. We wondered how long it took them to truck it all in and where in heaven they got
it from. The distance from the DFAC to the hospital was literally a gravel throw.

As we reentered the orientation sauna tent, we were sentenced to more Death by PowerPoint—but this time we walked through slides overflowing with information we actually needed to learn: resuscitation guidelines, head trauma and blunt abdominal trauma protocols, transfer procedures, hypothermia and shock, use of whole blood and some experimental blood-clotting product with a science-fiction-type name: recombinant factor VIIa. I was blown away and panicked at being force-fed an avalanche of material—then having to know it inside and out within the next twenty-four hours. The others seemed to squirm in their seats as well. Rick gently elbowed me and whispered a reassuring, “We'll be okay.” He was right: if we each learned the basics, then picked one topic to become expert on, we could bail each other out. But I still felt like I was now in a brave new world, and I was feeling more and more like a coward.
God, please don't let me hurt anyone.

In walked Colonel Brent Smith, the current head of emergency services, who was slated to leave in a couple of days. Although he was supposedly years younger than most of us, he shuffled slowly and had deep crevices around his eyes that surrounded thick bags of fatigue. His tour had been rough, and a three-month collection of trauma cases deeply etched his face. Smith was loved by the staff and had a stellar reputation as a trauma doc. He spoke in a near whisper.

“Hi, everybody. I need you all to hook up with your counterparts for right seat/left seat this afternoon.”

Right seat/left seat was the Army policy similar to a pilot/copilot situation on an airplane. We would be the copilots until we learned how the CSH flew, then we would move into the left seat and be in charge. The normal right seat/left seat orientation takes five to seven days. We would have one with maybe a second if lucky.

Brent gave what sounded like a canned spiel about the hospital, and then told everyone to get lost except for the three ER trauma docs.
Gerry, Mike, and I sat quietly as Brent explained the cases we would be seeing, and how most of the wounds would challenge even the most experienced trauma surgeon. As family practitioners, Mike and I were terrific at treating colds or giving flu shots, and while Gerry was an actual ER doc he never saw IEDs in Cleveland. There was no question we would be like first-day interns who were suddenly told to perform brain surgery. Colonel Quick sat quietly in the corner of the tent as he waited for Brent to finish scaring the shit out of us. He could clearly read the anxiety on our faces and after giving us a few seconds to let things sink in, told us we could accept our assignments in the ER, or instead, take a more comfortable job staffing the sick call clinic. No questions or loss of respect, the hospital would get by. One by one, we answered. Gerry: yes. Mike: yes. Me: Uh, I'm scared shitless. Quick: That's the best answer I've heard yet. You'll do fine. Across the tent, Brent's sad eyes sagely nodded agreement.

I didn't sleep well that night, or, for that matter, any night for the next few months. The helicopters returned en masse with their overnight deliveries and I tossed and turned as each one whizzed by our barracks. By now, I had a little better sense of direction—I realized if I simply looked out the window of our rooftop room to the southeast, I could peer over the blast walls and make out the blue landing lights of the helipad at the hospital. It hit me: many of the birds zooming by were actually Cobra attack helicopters or Black Hawks ferrying troops on and off the base, not incoming medevacs. I only saw a few of the speeding shadows make use of the vaguely lit landing zone of Paradise General. But even a few meant the doctors who we would replace within the next twenty-four hours were getting hammered.

T
HE NEXT MORNING
started with three large cups of weak coffee and a bowl of Cheerios drowning in semiwarm milk poured from a carton with Turkish lettering. Ka-chingg! For $32, I could have had a gourmet breakfast with seconds and thirds back in the States.

The medical menu for the day showed us breaking into small groups and following our counterparts to finish our right seat/left seat orientation. Gerry, Mike, and I tracked down Brent Smith as he helped another doc clear the ER of a group of soldiers jolted around by an IED. Except for a couple of bloody eardrums, the men looked stunned yet relatively unscathed.
Doesn't look too bad,
I thought.
Maybe I can do this.

We attacked the computer system first. Everything was documented in a very standard and regimented format, and it was important that we got this part right. The medical records would follow wounded soldiers to places like Landstuhl Medical Center in Germany, Walter Reed in D.C., and the burn center at Brooke Army Medical Center in San Antonio.