From Whence Anger...

I fall back again on the original premise of why I started writing about my experiences in the war zones: to record for anyone who’s interested what it feels like to go to war. I hesitate tonight because I am angry, and conventional wisdom says to do nothing in anger. Then again, if I am to capture the feelings of being in war, I should record this accurately as well.

I’m not even sure why I am angry.  I returned today from a two-day trip to visit a team south of us. While there, I finished up my meetings and went to the recreation hall to try to call my family. On the sign-in desk was a two-word message that I did not immediately understand. Turns out it was code for “commo equipment to the outside world is turned off.” That was an ominous sign.

Only two other people were in the rec hall at the moment, the attendant, and a Marine. He was watching a movie, so I sat down and watched as well. It was the ending of one of the Batman movies. I barely paid attention. My mind raced. By that time, I was pretty sure I had figured out the meaning of the two-word message, and I was already familiar with the circumstances that brought it about – 3 of our Marines from that post had lost their lives that morning.

Who were those men? I wondered. The incident had occurred less than three hours earlier. That meant that we had risen at nearly the same time. I had gone to meetings; they to meet destiny. Chances were that they had been in that same rec hall the night before, possibly sitting in those same chairs watching the same screen. I had been there then. Had I seen any of them? Perhaps they had used the same computer I had when trying to contact home. Perhaps in weeks past, they had come to sign into the rec center only to find the code words I had just seen, and wondered about those for whom the words expressed the message, “we are gone.”

Yesterday and today, I watched the Marines. When casualties occur, word spreads fast. They know, rapidly. These are youngsters with incredible resolve, skill, and dedication. Every day, they wake up knowing they might not see the end of the day. They do it for all sorts of reasons, but underlying all is love of country, and a determination to keep the wolves away from their loved ones back home. Would that the country matched their care and dedication. They cope. They are there for each other. They pick up, and move on to the next mission. Those who were close to the ones lost wear the loss on their faces – it appears in their gait, in the slight slump in their shoulders. But, they breathe deep, square shoulders, prepare for the next mission, and carry on.

On one occasion while I was in Iraq, I was sent out with my team to take the pulse of a local population. An IED had been detonated a month earlier and killed two US soldiers. The Command wanted to know if such acts were supported by the population local to that area, or if outsiders had set it.  Security was provided by the same platoon that had been attacked. By the time we left on patrol, I knew them. I knew them individually, and as a group. I saw the haunted expressions they wore, and the little things they did to support each other. They were led by one of the best and most caring platoon leaders I have ever met. They provided security escort for our team to the IED site, and set up protection while we set about doing our work. As usual, children showed up, and I snapped one of the most poignant pictures I have seen of either war: It was of this platoon leader and his men handing out school supplies and toys to these Iraqi children in the same place where only a month earlier, their comrades had been blown apart. That is the quality of our fighting men and women.

Today is Easter, and I woke up wondering about the families of the Marines lost yesterday. Had they been notified yet? How will/does their anguish feel? Despite knowing the dangers, I am sure that none of them started their days yesterday expecting the news that would come via official uniformed officers appearing at their doors.  At what point did it dawn on them the gravity of the news they were now bound to receive? What mothers, fathers, fiancées, wives, children were about to have their lives totally upended? Does our country continue to deserve such selfless devotion? Do its citizens even know, viscerally, that we are still at war?

As I made my way back to home-base today, I watched these young fighters. They sit or stand in their uniforms, their heavy equipment fitting them like a second skin, their rifles carried as another appendage. They relax into their immediate surroundings, their faces expressionless behind dark glasses, their helmets held tightly in place by chin straps. No one approaching them will doubt the damage any one of them can wreak when ordered. In the confines of the open flight terminal, they relax in the shade waiting for their flights. One stone-faced Marine approaches another. The second recognizes the first, sits up, and takes off his helmet and dark glasses. A bright smile crosses his face – joy at seeing a friend. They greet and joke, and personality pours in and transforms them back to what they are – our kids, who deserve every ounce of special support that we can send their way.

Those Magnificent Troops In Their Flying Machines

Cirque de Soleil cannot match the performance that US, British, Danish, Georgian, Jordanian, Afghan, Australian and other NATO and Coalition Force warfighters see every day when they ride in the indomitable machines that fly them from here to there. Pilots sit in their cockpits studying charts or flipping switches. At lift-off, we are strapped down in the rear of the aircraft, so we no longer see them at all. However, by “wheels-up” we have been guided by the skill and professionalism of the flight crew, who quadruple as baggage handlers, cargo wrasslers, flight attendants – and gunners.

Regardless of whether it is an Army Blackhawk or Chinook, an Air Force C-130, a British Merlin, or one of those big, ominous Marine helicopters that Hollywood loves to put in movies so much rising from obscurity; regardless, the routine is the same: Passengers are met at the tarmac by a crew-member dressed in flight-jump-suit with all the paraphernalia required for his/her job – to include special helmets with dark visors that completely engulf heads and hide faces. We are in the care of strangers whom we cannot even see. We are outfitted in our own required equipment, which for flight, means wearing body armor, helmets, and ear-plugs – and most people are carrying heavy instruments required to do their jobs, with most passengers being soldiers and marines on their way to or from the battlefield.

At night, the effect is magnified. Airfields are all but blacked out, so we approach and deplane at the instruction of dark phantoms who communicate mainly by hand-and-arm signals. Regardless of rank, they are in charge, and they set about bringing weary, deathly quiet passengers into the yawning cave that is the rear of most of these aircraft. (Blackhawk helicopters are much smaller, and do not carry heavy cargo, and thus do not have the cavernous doors. They load from the side. However, their crew/gunners are every bit as lithe and professional as described below.)

When time arrives to board, passengers form in a single line, and follow a crew-member across the landing zone to the rear of the aircraft. The engines are already roaring, and we stand in a heat-blast, waiting for final word to board – on a cold night, that heat blast can be welcome. On command by a hand-signal, we follow the person ahead of us to the lip of the ramp, careful to take the high step while not jarring the machine gun setting there. Rollers on the floor for cargo handling require stepping carefully. Inside, another crew member directs us where to put our carry-on bags – usually back-packs, and typically they go onto the center of the floor, and form a pile that is then strapped down.

After we are seated and secured, we gain full appreciation for these men and women of acrobatic prowess. As often as not, having guided tired strangers carrying implements of war through the dead of night lit only by isolated diodes, and having safely seated them within the dark holds of military aircraft, they now become cargo handlers, wrassling large crates and sling-loads of materiel into already cramped spaces. When they are done with that, the night has just begun…

The noise of thunderous engines winds up. Meanwhile, these slender, lithe, athletic crew-members move into their respective positions. On Blackhawks, they swing themselves through incredibly small openings, strap themselves in, and pull their machine guns into position in front of them. For the duration of the flight, they will scan and cover every inch of ground with watchful eyes, poised to react.

On the larger aircrafts, gunners take up positions along the sides near the front of the plane. They have more room than their Blackhawk counterparts, but just like them, their real jobs now begin. At the rear of the aircraft, the crewman there transforms. He pushes a button, and hydraulic controls lift the ramp - not all the way closed – it remains open, and now becomes the platform for this very brave crewman to man his machine-gun, which juts out over the end of the ramp. As the aircraft taxies and begins its ascent, he straps a safety-tether just around his chest and back, just below his arms. It is attached to the ceiling of the aircraft so that he has full motion in every direction. Another line attaches to his helmet so that he has clear communications with the cockpit. Then, he sits on the deck of the ramp, facing into the night, legs spread on either side of the machine-gun, toes out over the lip of the ramp – and he peers through his goggles into the dark void, his hands guiding the gun in the direction of his line-of-sight.

On landing, these incredible people once again become cargo holders, flight attendants, and ground-crew. With all of the flying I’ve done here and in Iraq, I have never seen one act impatiently or inappropriately. Quite the contrary.

About 10 days ago, I made a night flight from a location up north. The aircraft was scheduled to make several stops over a four-hour journey. My destination was at the end of those four hours. At the first stop, the man who was the tail-gunner for this flight motioned for me to deplane. I indicated that my destination was further on, at which point he took off his face-mask, uncovered his ears, and yelled above the engine, “I know. We have some other stops we have to make. We’ll come back and get you.” I yelled back, “OK. I can stay or I can go, but please don’t forget me.” He laughed and yelled back, “Don’t worry, sir, we’ll make sure we get you.”

I waited at the terminal for about an hour, and then received word that the big Marine helicopter was on its way back in. Once again, I lined up with passengers, and once again made my way through the dark to the back of the helicopter. The night was cold, and I basked in the heat of the engines. Then, the gunner came and got me out of the line. He guided me to the ramp, past the machine-gun, and into a seat near the ramp where I would not be soaked by dripping hydraulic liquid and condensation. Another crewman handed me a card.

That had been a long day. It had started early, been challenging, and I still had hours to go in front of me. Nevertheless, my tasks already seemed small before the physical and mental challenges faced by these magnificent crews for hours at a time, day after night after day after night, in a war-zone.

I pulled a flashlight from my pocket and pointed it at the card. On one side it read:

YOU HAVE BEEN SERVICED BY HMH-

 463 PEGASUS, FLYING THE OLDEST MOST

COMBAT PROVEN AIRCRAFT IN THEATER,

THE VENERABLE CH-530 SHITTER.

HMH-463 PEGASUS

SUPPORTING THE INFANTRY SINCE 1944

On the back-side of the card was the following:

CLOSEOUT ON TAP

REDEEMABLE COUPON FOR

ONE FREE ICE COLD BEER

AT HANGAR2, BAYSIDE

MCBH KANEOHE BAY, HI

The circumstances of travel prevented a proper thank-you, but I did my best. Those guys put a very big smile on a very tired face. I cannot say enough good things about them.

Crossing Paths With Alexander The Great

Alexander the Great passed this way 1000 years ago, and left his mark in the form of this ancient fort where I spent last weekend. At least his army came this way. To be honest, we’re not sure he or his army ever came here, but it makes a good local legend, and the fort is sitting at what was back then a major trading juncture (actually, he came to this part of the world about 2400 years ago - still makes a good legend, though). Remarkably, it is still largely intact, and strong enough to be used in today’s defenses. The mud walls are many feet thick, held together with wattle – fine stems of wheat, because insects would get into and eat wood, and rebar was in short supply in those days.

From the battlements, picturing marauding armies on horseback is easy - and so is imagining Clint Eastwood in slow-motion glint-eyed pursuit of the Good, the Bad, and the Ugly. Wide wheat fields stretch from one side of the fort, and poppies on the other. In the distance is a low mountain-range, and nearer is a cliff that looks like it belongs in the Painted Desert. Within the walls of the fort, the rooves of pre-Taliban health facilities are now decked with satellite dishes and communications antennas. The bad guys had this place for a while, and when they departed (rather hurriedly), they stripped out all of the copper wiring and fixtures, and set the buildings on fire. Of course, being constructed of cinder-block, they only succeeded in adorning the ceilings with an ash patina. In this austere world, though, any splash of color is appreciated.

We got out into the local populace – to be accurate, I should say we got out into about half of the local population. I never saw one single woman or one little girl. Only the men were out and about. They look beleaguered. In Iraq, despite their travails, much of the population was vibrant. Girls and boys played in the streets, and followed us enthusiastically. Not so here. The boys listened intently, but they looked aged beyond their years. Their clothing is colorful, but smiles were scarce. That they currently feel fairly secure reflects in one of their most repeated concerns: the lack of cell-phone service. Beyond that, they say, they are not sure how they will earn livings when the poppy crops are gone for good.

Marines here do what Marines and soldiers do everywhere – accomplish their missions and find ways to pass time when not on mission. In this place, they have a dog adopted as a puppy, and now intent on staying with its wards when they patrol – and keeping danger away from them. In self-appointed air-field security detail, he is aided by his friend and companion – another dog. They have captured the hearts of the Marines – we only fear for their futures when we depart.

At any time, the MWR is in active use – Marines calling home. Ironically, here it is easier than in the larger FOBs. Without the large numbers attempting to access at the same time, connections are easier and faster. And, because they are constantly aware of those waiting, if a line forms, it moves quickly – our kids, sent to fight, and considering each other.

Somber Note From A Combat Surgeon

I am very honored to be allowed to post (below) a letter home from a combat surgeon. He gave permission to put this on my blog on condition that I remove identifying information. Otherwise, it is just as he wrote it. Keep in mind that this was written by a very tired man who takes care of our kids when bad things happen in combat:

Dear Dad

I apologize for not writing sooner. But having said that . . .

Well here it is. The halfway point in my deployment in Afghanistan. I spent so much effort to get here and now I am halfway through. We were VERY busy last night. Many operations, many injured and no sleep. I am never really told when the injured will come but they make an announcement over head just like in MASH when the character Radar would announce that helicopters where arriving. The injured come by Hummer/MRAP ambulance, helicopters, and transport. I head down to the ED and find organized chaosbut they know what the are doing. They are so young . . . The good news is that the American and coalition service personnel get "patched up" by us and then are flown (out). I don't know if you will remember the several weeks I spent at (the) Regional Medical Center as a surgeon. That is where we would work on them some more before being sent back home. For lack of a better term, this is bloody work, Dad. May be I should have become a Cardiologist. (Jets are taking off overhead - something is up). The Americans then fly home to … or … or … or if burned to ... There are also a lot of elective cases like laparoscopic appendectomies, gallbladders, hernias, etc. I find that we do a lot of elective cases here as well. However, I am sure that the Vietnam physicians and surgeons saw a hundred times more. Their numbers were staggering with many more dead. Either we have become better or the warefare in Vietnam was hell. I do not mean to minimize the other doctors work here in Afghanistan, but Vietnam and the lessons learned there still reverberate in the halls of our hospital.

The helicopters also bring in EPW's (Enemy Prisoners of War) or really Enemies of Peace as they are now being referred to. [Deleted (sic)] They get the same care as the coalition troops. Don't worry. I carry a shoulder holster (lent to me by my friend and LTC in the US Air Force) with a 9 mm at all times. My friend and combat medic, Lt. X, taught me how to use it well enough plus before I left I took a bunch of classes at Shooter's World. We don’t (talk about it much) as it is serious business here but you know this from when you were overseas. I take my 9 mm even to the shower. I remember as a child the story of a US Air Force hero and (my friend’s) uncle, carrying his gun to the showers which saved his life. He is a Vietnam vet. Anyway, [Deleted (sic)], I am planning on coming home . But weariness, long hours, and lack of sleep, take a toll. I find church and sleep are my only reprieve. I am feeling all the years of my age.

The weather is getting warm so action is picking up. We were treated to a dust storm here that obscured the tall mountains around us. The winds felt like they were going to blow down our huts they were so strong. The dust is everywhere and you constantly have the taste of dirty in our mouth when outside or smell it in the air. You wash your hands about one thousand times a day.

As for the people, it is like everywhere. Some are good leaders and I love working with them in fact it is a pleasure. Others are just bad. But I feel that many of the times people are just inexperienced and make up for it by acting tough or hard, etc. Or perhaps they think they need to do so for their superiors for a promotions. All I see is fear in them and their lack of experience but hopefully in time they will learn that being a good leader does not have to be conveyed with hostility, anger or cold toughness. I remember what you and mother used to say about "winning more flies with honey than with vinegar".  You both were correct. She was a wonderful women and not a day goes by that I remember some lesson she taught me. I miss her.

I am learning several of the languages here. Well, kinda sorta! Just some phrases but mostly have interpreters speak to my patients. I spend some amount of time telling the captured that they will be alright and that I will fix their wounds or their injuries and to trust me. I tell them that I care for them and that we will fix them. Once you gain their trust and they see that you do not mean them harm they are generally friendly back to you. But this cannot be taken for granted. I have no illusions that My kindness and caring will win this war. The horror stories of what brought them in or what they did to our troops or their country men are for another day and not for e-mail. [deleted (sic)] Actually, I think I will just as well forget all of that as it does no good to hold onto the memories of such events. I just do what I can on a daily basis and pray for the best.

American medicine is great. This country has nothing like the United States. Even our little hospital does its best but we must send the injured Americans on for higher level of care. The local hospitals in Afghanistan for the local nationals are nothing more than places for people to go and if sick enough to die. The seriously injured or sick all want to come to us as to stay there means months of care, poor care and / or possibly death. Families constantly try to bring their loved ones to us. It is heartbreaking. Often triage is done by a marine or soldier at the gate. Many times people are turned away. We just cannot open our base to the masses of sick and injured otherwise we would never be able to care for our tropps or the colaition troops and other priority peoples like those friendly Afghans injured by the enemy or the enemies of peace. I will never again complain about not having something or about some resident or nurse or anyone's lack of experience or poor judgment. You have to leave the United States to see just how lucky and privileged we are at home.

Home. I miss home. I want to come home. There is no place like home. Home is where the heart is. I speaking about the heart of the matter, I want to get home to see my true love and you and all of my friends. I know it is halfway through this rotation but it is hard. Anyway, I suffer from lack of sleep and not speaking to my wife for 48 hours. I miss you and I love you dearly and hope to see you in a very few weeks.

Your son,