- BAGHDAD -- The U.S. Army
trauma physician reaches past the plastic tubes and blood-soaked bandages
to gently squeeze the hand of a wounded American soldier being wheeled
into the operating room.
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- "We're going to put you to sleep, but it's going
to be OK," Maj. Kim Wenner tells the soldier in a soft, reassuring
voice as the anaesthetic takes hold and surgeons prepare to repair damage
in his torso inflicted by an enemy bullet.
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- "It's these cases that really get to me, where we're
putting them [asleep], and I'm not sure they are going to wake up,"
Maj. Wenner said, recounting the incident during a recent visit to the
31st Combat Support Hospital in Baghdad.
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- One hears variations of the phrase "get to me"
a lot these days among the doctors, nurses and medics at the hospital.
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- April was the deadliest month for the U.S.-led coalition
in Iraq, with 136 U.S. soldiers, sailors and Marines killed. The Baghdad
hospital treated more than 500 wounded Americans last month.
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- The phrase "get to me" is used at times when
emotion surges to the surface, usually in quiet moments, supplanting the
cool professional detachment that allows trauma teams to stabilize the
breathing and blood pressure of wounded soldiers within minutes of their
arrival by helicopter.
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- It affects newcomers to war-trauma medicine, such as
Maj. Wenner, a family doctor by training. Until three months ago, her practice
at Fort Sill, Okla., consisted of treating minor ailments such as the ear
infections of soldiers' children and the aches of military retirees.
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- It also affects war-tested veterans such as Sgt. 1st
Class Karen Fish, a medic for 18 years who served with the 101st Airborne
Division during the 1991 Persian Gulf war and later in the Balkans and
Rwanda.
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- "When you can, you give [soldiers] the love they
deserve. Hopefully, we can save them. It's just that every once in a while
they are not savable," Sgt. Fish said.
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- She had just finished praying with a chaplain, a physician
and another medic over the body of a dead soldier, who had suffered massive
head and face wounds from a roadside bomb less than an hour earlier.
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- "If I didn't love soldiers, I wouldn't do this.
What I notice is usually the wedding ring. Sometimes I have to go home
and let it out. I don't do it here," she said.
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- On the polished hospital floor nearby, Spc. Bridgette
Smith sits quietly, cataloging the soldier's personal effects, from a single
combat boot to a wedding ring, to be sent to the wife, who does not know
yet that she is a widow.
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- "I don't care how long I'm here. This is always
going to break my heart," she says.
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- On more than one occasion last month, the hospital was
nearly overwhelmed with casualties, with battles raging in nearby Fallujah
and attacks occurring throughout the Baghdad area.
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- "When you have three people coming through here
and they're all dying, that's a panic. I try not to communicate that, but
on the inside, my heart is spinning around. I'm afraid that we don't have
enough people to handle that many. Then we get help from the other floors,"
said Lt. Col. Greg Kidwell, 48, head nurse at the hospital.
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- Col. Kidwell recalls times last month when the emergency
room overflowed with wounded soldiers on stretchers.
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- "There have been times when I've been running up
and down the halls with morphine. I say, 'This person needs morphine,'
and if a doctor says yes, I give morphine and move on to the next patient,"
he said.
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- Within 20 minutes of medics wheeling in a critically
wounded soldier 100 yards from the medevac helicopter to the emergency
room, a trauma team of six or more will have established an oversized intravenous
line into a vein, big enough to pump in fluids and medicine.
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- During that time, the team will place another line into
the artery to continuously monitor blood pressure, a catheter to drain
the bladder and perhaps a tube down the throat to clear a blocked airway
and allow air to be forced into a patient's lungs. Surgeons might be called
in to examine injuries to the limbs, brain and internal organs, and prepare
for surgery.
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- Col. Kidwell recently wrote an article titled, "We're
Still Human," which was published in a local paper in Plano, Texas,
near Fort Hood, where he was based before Iraq.
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- A self-described cranky perfectionist, he talks about
compressing the chest of a soldier in a failed, 12-minute attempt to restart
a stopped heart. When the physician declared the patient dead, everything
stopped.
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- "In the presence of all of these people, I am alone
reading the [soldier's] casualty cards. I read that he was married. There
was her name. He had two children, and there were their names. He was from
a town near my own hometown of Clarksville, Tenn.," Col. Kidwell wrote.
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- "I went back to the storage room and hid in a spot
between the supply shelves. I just wanted a few minutes to regain my composure.
...
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- "We have to perform well, and our competencies,
techniques and skills save lives. But sometimes, someone gets to us and
we tumble like a house of cards," he wrote. "This means we are
still human."
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- The battle to save a wounded soldier's life begins even
before the helicopter takes off from the battlefield or the site of a convoy
attacked far from the front lines.
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- Capt. Sudip Bose, 30, of Chicago often works at a primary
aid station and sometimes accompanies soldiers as they raid houses looking
for militants.
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- "Last week, we had to cut open a leg to get access
[to a vein] because the patient was in extreme shock, had lost 30 [percent]
to 40 percent of the total blood, was minutes from dying and all the veins
were collapsed," said Capt. Bose, who specializes in trauma medicine.
"We started pumping fluids into him. He lived."
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- Maj. Ginny Parker, 39, a vascular surgeon from San Antonio,
recalled operating on one soldier who had been shot in the shoulder blade
with the bullet coming out through the armpit, where it severed a major
artery and vein.
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- "It took a long time in the operating room, and
we had significant blood loss. We did a bypass on him, using veins from
his leg to get blood flowing into the arm, and at the end of the day, his
arm was viable."
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- In cases like this, Maj. Parker tags the severed nerves
and takes other steps to stabilize the soldier for a flight to Germany
and eventual evacuation to the United States, where surgeons will try to
reattach nerves and replace missing bone and tissue in an attempt to save
the limb.
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- "It's a comfort, I think, to the troops who are
out there doing the fighting and are in harm's way and to the families,
knowing that we're going to get them taken care of, no matter what it takes,"
she said.
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- Maj. Wenner, the family doctor from Fort Sill, Okla.,
recently wrote down her personal reflections after three months at the
hospital:
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- "It's not the names I remember as I go to sleep.
It is the faces and the injuries. ... I go to sleep and dream about them
all night long, awaking in a sweat because something is wrong.
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- "They are crashing, and I must help them. My alarm
goes off, and it is time to start all over again. Groundhog Day, we call
it," she wrote.
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- There are also uplifting moments, such as with the soldier
Maj. Wenner treated with the bullet in the torso.
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- "He came in and he was conscious, but he wasn't
looking right. I made a decision to intubate him and take him to the operating
room as soon as possible," she said.
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- "He'd actually been shot through the kidney and
one of the main arteries, which was very big, was bleeding. Everything
we were putting into him was going out and [the surgeon] had to go in and
clamp the artery. He made it through surgery, which was the big thing."
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- Seriously injured soldiers, sailors or Marines typically
arrive at the 31st Combat Support Hospital within an hour after being injured.
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- "If they're alive here, most of the time we can
save them, and that's the golden hour," Maj. Wenner said.
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- All site contents copyright © 2004 News World Communications,
Inc.
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- http://washingtontimes.com/world/20040505-122404-2923r.htm
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