The Outpost: An Untold Story of American Valor (45 page)

The second-leading cause of preventable death is something called tension pneumothorax. If a bullet punctures a soldier’s lung, air can leak from that hole into the “pleural space,” or cavity outside the lungs. That air can build up and eventually interfere with the functioning of the heart. This can be a relatively simple problem to correct: a medic can simply stick a big needle in the soldier’s chest to relieve the pressure in the pleural space.

Physician’s assistants (PAs) receive much more training than medics—two years’ worth versus the medics’ four months’ worth—but they are still not doctors. Forced to respond to dire situations with nothing more than a small kit of supplies, including tourniquets, IVs, and combat gauze (a cotton fabric impregnated with a substance that speeds up clotting), they can often work miracles, but there are severe limits to what they can do. The lack of refrigeration facilities at most smaller bases means that no blood can be stored there; instead, PAs have to learn how to do the “buddy transfusion,” a risky procedure conducted under emergency conditions, whereby blood withdrawn from a donor—a battlefield volunteer—is pushed directly into the vein of the patient.

Pfeifer’s eyes were open; he was conscious but delirious and obviously in great pain. Other members of the team immediately carried him from the roof down to the aid station as Newsom called the operations center to have a medevac ordered. At the aid station, Captain Bert Baker, a former Special Forces medic and the outpost’s PA, treated Pfeifer as best he could, but it was clear that the soldier needed to be evacuated at once if he was to stand a chance. There was massive bleeding from the exit wound in his lower back; Baker shoved a combat bandage into the hole. He twice inserted a needle into Pfeifer’s chest to let out air that was building up in the cavity, a procedure that succeeded in getting Pfeifer’s blood pressure up and his respiration rate down. Luckily, one of his lungs was still working. Baker had held people’s lives in his hands before: he’d been a paramedic in St. Louis and a Special Forces medic in Haiti. But in both of those places, a hospital had usually been no more than ten minutes away. At Combat Outpost Keating, it was an hour-and-twenty-minute helicopter flight to the nearest hospital. Baker wasn’t sure Chris Pfeifer would make it.

The PA did what he could for the wounded private and then waited for the bird; each passing second was excruciating.

Sarah Faulkenberry left her husband’s bedside on August 15 to attend Tom Bostick’s funeral at Arlington National Cemetery. She was worried about John, who was still in the intensive care unit. It seemed as though every other day, he had to have some surgery or other to close up his leg wounds. He still had some circulation at the bottom of his right leg, so the doctors were hoping they’d be able to save it.

Then, two days later, Karen Pfeifer, Chris’s wife, called her.

Karen was in Germany, on post. She’d just left the mail room after dropping off a huge care package for her husband—containing cashews, baby wipes, sunscreen, short pants, and T-shirts—when she was beckoned in to the commander’s office and informed that Chris had been shot. He was still alive, she was told, but he’d been critically wounded and had to be evacuated to Forward Operating Base Naray, where he’d undergone surgery. He’d lost a lot of blood, so the command post at Naray had put out a loudspeaker call for O-negative donors, and troops had immediately begun lining up to donate.

Several hours and some forty units of blood later, Pfeifer had been stable enough to be flown to Bagram, where he’d had more surgery and received another forty pints of blood. The commander didn’t have much more information to give his wife. The doctors at Bagram, he said, weren’t sure when or even
if
Chris would be able to return to Germany.

Army spouses are taught to be there for one another, and Sarah Faulkenberry tried to console Karen Pfeifer. Although the two of them had become friendly while stationed with their husbands in Germany, on one level, Sarah was a bit surprised to get her call. But she knew that Karen had been raised in a foster home and didn’t have much of a support network beyond her husband, his family, and her brother, a Marine at Camp Lejeune in North Carolina. Adding to Karen’s feelings of isolation and panic was the fact that she was seven and a half months pregnant.

Eventually, just as Sarah herself had been able to accompany John from Germany back to Washington, Karen met her own husband in Germany and flew in a medevac plane with him from Landstuhl to the United States—though instead of landing in the nation’s capital, they continued on to San Antonio, Texas, where Chris was to undergo further treatment at Brooke Army Medical Center. The Air Force officers almost didn’t let Karen fly because she was thirty-four weeks pregnant and they were worried she’d go into labor during the flight, but ultimately they relented. She told them she was getting on that plane to be by her husband’s side, and they weren’t going to be able to stop her. If she did go into labor, at least there would be medical staff on board to look after her, thirty thousand feet in the air.

Up the mountain at Observation Post Warheit, Dave Roller and the men of 1st Platoon were getting used to a lifestyle even more spartan than the one down the hill at Combat Outpost Keating.
Hygiene
had become a relative term: six weeks into their stay at Warheit, Roller had yet to use any shampoo and was still on his first bar of soap. The troops bathed in a mountain stream; that part was kind of fun. Roller hadn’t worn deodorant in three months, and he rotated his socks, shirts, and uniforms on a monthly basis. The platoon had run out of forks and spoons so many times that it was common to see soldiers sticking any spoons they found into their pockets for later use, or licking forks “clean” so other soldiers could use them.

There were no longer any women permanently stationed at either Observation Post Warheit or Combat Outpost Keating; with plans scotched for a PRT in Kamdesh, First Lieutenant Candace Mathis’s MP unit was not replaced. Since Afghan women universally hid from U.S. soldiers, the 1st Platoon troops literally hadn’t seen a woman in months—except for Roller, of course, through his scope before the battle at Saret Koleh. It was an odd sensation for the Americans—as if men were the only ones left on the planet. Whenever this one particular female Apache pilot flew in the area, soldiers would crowd around the radio just to hear her voice. They’d never seen her, but they were all convinced she was gorgeous.

The two tribes had been trying to kill each other for years and years now, but Navy Commander Sam Paparo was going to give diplomacy one more shot.

Paparo was head of the area’s provincial reconstruction team, which was located about a hundred miles distant from Kamdesh, at Kala Gush, in western Nuristan. Insurgents had continued to try to exploit the bitter rivalry between the Kom and the Kushtozis, stoking the dispute that had begun decades before over water rights and persisted ever since. After burning down a Kushtoz village in 1997 and displacing its twelve hundred or so residents, the Kom had placed mines throughout the ruins so the villagers couldn’t return. It was in the midst of an attempt to encourage the groups to reconcile that Fazal Ahad, head of the erstwhile Eastern Nuristan Security Shura, had been killed.

Paparo had been working with the United Nations Mining Action Centre for Afghanistan to make Kushtoz hospitable once again. Before that agency could take any action, however, the dispute between the two ethnic groups had to be resolved, and the area made secure enough to allow the U.N. workers to do their jobs in safety. Each of these tasks was considerable. But that was what he and his colleagues were there to do, Paparo told himself. Even if the conflict was generations old and the land insecure, the United States was there to bring peace and stability.

In August, at Parun, the district center of Nuristan, Governor Nuristani, along with some national government officials, hosted a conference to map out a development plan for the province. The governor also invited representatives of the Kom, from Kamdesh Village, and the Kushtozis to come and discuss ways of settling their dispute over water rights. One of the possible solutions being proposed had long been debated by the PRT at Kala Gush: building a canal that would serve both communities. Paparo hoped that a canal might resolve the initial basis for the dispute, though State Department official David Katz had counseled him to refrain from involving the United States in the squabble in any way—the Americans would inevitably become entangled, whether they wanted to or not, Katz said, which would end up making the feud even more difficult to sort out. In any case, at Parun, the matter went unresolved, as the Kom argued that the Kushtozis had no right to the water that would flow through such a canal.

One day at the unfinished compound where the PRT personnel were encamped, Paparo heard a skirmish erupt just outside the gate—thankfully, a fight without armaments. He and other troops from the PRT ran to the entrance of the camp and saw two ancient men beating the life out of each other. Each elder—one Kom, one Kushtozi—was brandishing a large rock, and as the pair rolled around on the ground, each pummeled the other’s skull with his stone. Paparo and the U.S. forces balked for a minute; laying hands on these elders might create a whole other host of issues, they knew. But it really looked as if the seniors were prepared to fight each other to the death, so the Americans at last intervened, pulling them apart. Both men had nasty cuts and bruises on their heads.

The physician’s assistant at the PRT was a Navy lieutenant commander whose previous deployment had been on the White House medical team. Not so long ago, he’d been in Washington, treating the leaders of the United States and their families—the Bushes and Cheneys, the Clintons and Gores—and now here he was in eastern Afghanistan, patching up the lacerations of a couple of old men who were fighting over water rights.

It was a long way indeed from 1600 Pennsylvania Avenue.

The joke about “military intelligence” being an oxymoron was so old as to be beyond a cliché, but Lieutenant Colonel Kolenda and Captain Joey Hutto had in fact begun to seriously doubt the intelligence and conventional wisdom about Kamdesh. They’d been briefed that the insurgents they were fighting against were primarily from Pakistan, which squared with the notion that the fight in the valley related to the larger showdown with Al Qaeda, that all of this had something to do with 9/11. But over time, the 1-91 Cav officers had made a number of observations that called that conclusion into question:

• The fighting stopped during the planting and the harvest and then flared back up again afterward. It didn’t seem logical that Pakistanis would defer to the local agricultural calendar.
  
• On their hand-held radios, the insurgents spoke in the local dialect, Nuristani, which was relatively obscure and difficult to learn.
  
• The insurgents seemed to know every nook and cranny of the surrounding terrain.
  
• The local elders with real influence refused to meet with either the Americans or the district administrator, Anayatullah; those “elders” who did come to the shuras with 1-91 Cav were members of a dwindling group of Anayatullah’s cronies.
  
• Despite both the severely depressed local economy and the relatively high pay offered by the Americans, the number of locals who now worked at Combat Outpost Keating, Combat Outpost Kamu, and Observation Post Warheit could probably be counted on one hand. This could be explained in part by the fact that some young men had begun providing security for the illegal timber-smuggling industry that President Karzai had inadvertently boosted when, concerned about deforestation, he banned the felling and export of trees. But anecdotally, the Americans had also heard that other locals were either working as guards for gem smugglers or joining yet another local growth industry: the insurgency.
  

Putting the pieces together, Kolenda and Hutto realized that they were facing nothing less than a popular insurrection.

They weren’t the only ones. In the Waygal Valley, southwest of Combat Outpost Keating, the 173rd Airborne Task Force ROCK troopers were likewise having difficulty with the natives. Near the village of Aranas, twenty-two U.S. troops, along with some ANA soldiers and Afghan Security Guards, occupied a combat outpost called the Ranch House. Before dawn on August 22, RPGs and small-arms fire hailed down upon them; within minutes, it became frighteningly clear that the enemy planned to overrun the camp. Soon the troops at the Ranch House operations center lost contact with their men at the guard posts. The Afghan Security Guards—locally hired contractors—fled altogether, allowing the insurgents to breach the wire. Then more than three dozen ANA troops ran off toward the western side of the base, and the encroaching insurgents grabbed their ammunition and even some of their RPGs.

Thankfully, A-10 Warthogs arrived on the scene fairly quickly and, under the direction of First Lieutenant Matt Ferrara, began beating back the insurgents with “danger close” runs on enemy positions within the base. The Warthogs provided enough cover for Chosen Company to regain control. By the time the firefight came to its end, an ANA soldier and an Afghan Security Guard had been killed, and half of the U.S. troops had been wounded. The defenders felt certain that their antagonists were not Pakistanis.

For Kolenda and Hutto, the attack on the Ranch House reemphasized the need to take every precaution possible to protect such vulnerable outposts in remote areas. Aggressive patrolling and the cultivation of positive relationships with the local population had to be top priorities. But those measures alone wouldn’t suffice. Bulldog Troop would also need to conduct regular outpost defense drills specifically to prepare for the worst-case scenario: a breach, or “enemy in the wire.” The men would have to be ready.