Early this morning, asleep in my hooch dreaming of beer, food, and women ( Hooters chain embodies all of one's basic needs, eh?) when we get jarred awake by the CP with a call that only means one thing: casualties inbound. Urgent surgicals. (Are there any other kind?)
It was the Army this time. Seems the 506th and the Marines 3/7 trade off fights. Us, we're on call 24/7. Great if nothings going on but really wearing in the long term.
Stagger out of the rack, pull on BDU bottoms and boots, walk outside.
They come in. Dismounted patrol ambushed with an IED initiation. 2 DOA. Cracked both chests on the stretcher...we ALWAYS do a full court press. No joy. One's aorta was gone from arch to diaphragm...that was probably an instant killer. The other, just general massive thoracic wounds.
The third, "Mike", was awake and alert. Missing right foot and right hand, but awake and alert, and (amazingly) cracking jokes. He didn't know about the other guys and as far as I know, still doesn't.
Me: What's your name.
Mike: Mike.
Me: how old are you, Mike?
Mike: 20....20 today.
Me: Happy f-ing birthday, guy.
Mike: Yeah, happy f-ing birthday to me, doc.
I took mike off to sleep. Intubated him and placed a central line as the 2 surgeons scrubbed and started on his leg. He must have stepped on the IED. Foot was gone and the tibia was completely exposed. They controlled the bleeding, removed the non-viable tissue and a portion of the tibia while I was pumping in the O neg. Then to the arm.
Once he was stablized, and his wounds covered, we called for air evac to the 10th CASH. He left intubated and sedated with our evac nurse, Dave, at his side. I usually give Dave a few drugs and instructions: BP goes up. give this. Goes down, give that. He moves, give this and that. Mike gets a ride in style: sole patient on a blackhawk with a cobra escort. (When Dave gets back, he has an exciting story of somebody shooting at the helo on the way out).
All said and done, we come out of the OR to face the new sun rising over AR Ramadi. It's already getting hot and the wind kicks up some sand.
Our OIC, a trauma surgeon who resembles (both in appearance and sense of humor) Jim Belushi and will retire from the Navy on 1 Dec (also my birthday) says that he feels that he is stuck in a bad MASH episode. We begin to talk about the night. The general consensus is that it was a bad birthday for the kid. One of the Corpsmen, a 1st class with 10 years in, makes a pretty telling comment...sort of along the lines of how many brand new 20 year olds would be able to keep up his spirit in the face of those severe injuries.
We got to talking about that. We see 'em come and go. 18, 19, 20 year old (not kids) but men. A 20 year old at school, worring about his date for the frat formal is a kid. A 20 year old 11B in Iraq is a man, years above his peers in character and fortitude....nothing like the whining kids I see back in the states. They should take a lesson from such men as Mike.
This is why I went to medical school.
Well, I'm going to crash while I have the chance.
Another day in the life of the Forward Resuscitive Surgical Team here at AR Ramadi, Iraq.
"Cheaters of Death."
Happy Birthday, Mike of the 506th.
It was the Army this time. Seems the 506th and the Marines 3/7 trade off fights. Us, we're on call 24/7. Great if nothings going on but really wearing in the long term.
Stagger out of the rack, pull on BDU bottoms and boots, walk outside.
They come in. Dismounted patrol ambushed with an IED initiation. 2 DOA. Cracked both chests on the stretcher...we ALWAYS do a full court press. No joy. One's aorta was gone from arch to diaphragm...that was probably an instant killer. The other, just general massive thoracic wounds.
The third, "Mike", was awake and alert. Missing right foot and right hand, but awake and alert, and (amazingly) cracking jokes. He didn't know about the other guys and as far as I know, still doesn't.
Me: What's your name.
Mike: Mike.
Me: how old are you, Mike?
Mike: 20....20 today.
Me: Happy f-ing birthday, guy.
Mike: Yeah, happy f-ing birthday to me, doc.
I took mike off to sleep. Intubated him and placed a central line as the 2 surgeons scrubbed and started on his leg. He must have stepped on the IED. Foot was gone and the tibia was completely exposed. They controlled the bleeding, removed the non-viable tissue and a portion of the tibia while I was pumping in the O neg. Then to the arm.
Once he was stablized, and his wounds covered, we called for air evac to the 10th CASH. He left intubated and sedated with our evac nurse, Dave, at his side. I usually give Dave a few drugs and instructions: BP goes up. give this. Goes down, give that. He moves, give this and that. Mike gets a ride in style: sole patient on a blackhawk with a cobra escort. (When Dave gets back, he has an exciting story of somebody shooting at the helo on the way out).
All said and done, we come out of the OR to face the new sun rising over AR Ramadi. It's already getting hot and the wind kicks up some sand.
Our OIC, a trauma surgeon who resembles (both in appearance and sense of humor) Jim Belushi and will retire from the Navy on 1 Dec (also my birthday) says that he feels that he is stuck in a bad MASH episode. We begin to talk about the night. The general consensus is that it was a bad birthday for the kid. One of the Corpsmen, a 1st class with 10 years in, makes a pretty telling comment...sort of along the lines of how many brand new 20 year olds would be able to keep up his spirit in the face of those severe injuries.
We got to talking about that. We see 'em come and go. 18, 19, 20 year old (not kids) but men. A 20 year old at school, worring about his date for the frat formal is a kid. A 20 year old 11B in Iraq is a man, years above his peers in character and fortitude....nothing like the whining kids I see back in the states. They should take a lesson from such men as Mike.
This is why I went to medical school.
Well, I'm going to crash while I have the chance.
Another day in the life of the Forward Resuscitive Surgical Team here at AR Ramadi, Iraq.
"Cheaters of Death."
Happy Birthday, Mike of the 506th.
