Afghanistan ER

“Curmudge, a few weeks ago, on October 11, you shared a note from Mack describing injuries that he and the troops sustained from improvised explosive devices (IEDs).”

“Right, Julie. It brought the war in Afghanistan awfully close to home. He recently provided more details about the mission in a letter to an old friend from Appleton. Mack sent me a copy; I’ll read part of it:

‘Dear Joe,

The last 5 months have been quite an adventure. It would take quite a while to detail everything, and I can tell you stories on end if you are interested. I will tell you about the mission where the IED attack happened. To start with, I am a ‘battalion surgeon’ in an infantry battalion. The term ‘surgeon’ in this case, means the chief medical officer for a military unit as opposed to being a surgeon who takes out gall bladders, etc. As you know, my specialty is Emergency Medicine, i.e. working in an ER.

I have gone on all the major offensives/missions. What happens is I usually go with whichever platoon or company looks like they will encounter the most resistance and have the greatest potential for casualties. I carry an M-4 (it's a shortened M-16 with a collapsible stock like the riflemen carry) and function pretty much like a rifleman the way the medics do until something happens. There is a combat medic in each platoon and I "plus up" the given platoon in these situations.

This particular mission was a Clear and Hold, where we move through the countryside, clearing houses/ compounds to ensure no enemy there and identify/destroy any IEDs that are found. The second evening we were settling down to eat a meal and sleep when the radio call came in that one of the guys in the next platoon over had stepped on an IED and had lost a leg. I ran with the company commander who was with our platoon up to the area where they were, (a grape field). The guy was pretty messed up, one leg gone, open pelvic fracture, severe rectal and pelvic injuries. The medics and I got the guy stabilized and we called in a helicopter to fly him out. We were somewhat shaken up by what had happened to him. I went back to my platoon and we went to sleep. The next morning we were to move to a new compound (Afghani houses, or compounds are mud-walled courtyards with individual rooms built into the walls as opposed to the whole building having a roof like an American house), and we packed up and moved to the place. It had been searched to ensure no bombs were rigged or anything. We had just moved inside when the first bomb went off. It was about 15 feet from me, but it was inside the foyer and I was just around a corner so that protected me from shrapnel. In the explosion guys were thrown through the air, lots of smoke, etc. and lots of confusion. I was checking out the guy who landed right in front of me; then people started shouting that someone was badly injured. I yelled that everybody who could walk should go toward the walls and bring the badly injured to the middle.

We were working on this guy who had shrapnel to his face, legs, etc, left middle finger partly blown off, fragments in right elbow, etc. in the middle of the courtyard when the second bomb went off along the wall. My medic and I fell across the guy to keep the dirt chunks/ fragments, etc from falling on him, then got him wrapped up to fly out. Because of the concussion there was an increasing number of people vomiting, losing balance, etc. I sent out 5 on the first helo, then 12 on the next one. We sent out some more on a convoy that brought the battalion commander to the scene later. By this time the platoon was not really combat effective, so the rest of us flew out late that night on a Blackhawk. My medics at the base camp with my PA checked the remainder of the people out including me. I just had a headache and jaw ache the next day, then pretty much felt back to normal aided by my pounding max doses of Tylenol. My parents did get a call the next morning from Fort Campbell saying I had had a mild ‘TBI’, but fortunately I had e-mailed my dad late the night before so he know I was still coherent.

I hope that wasn't too laborious a read. This week has been somewhat difficult as we lost two guys who were killed outright by IEDs. My PA and my medics and I were in the Aid Station three nights ago when the locals brought in two girls (age 4 and 7) who had been badly burned in a gasoline explosion. Apparently the parents had bought what they thought was diesel fuel but turned out to be gasoline for their heater. When they filled it and lit it, Boom! Burns about 80-90% of bodies. We intubated the kids, dressed the burns, and flew them out. Apparently they both died the next day, judged by the hospital to be not survivable burns, changed to comfort care only.

I should be home next spring/summer and certainly plan to stop to see you the next time I'm in Wisconsin.

Take care---Mack’”

“What’s the lesson, Curmudge? It sounds as if the good guys took it on the chin.”

“Julie, when I read this, my only feeling is the knot growing in the pit of my stomach. Let’s think about Mack’s letter and talk more about it in a few days.”