Thursday, September 23, 2010

The Stan Part I

Life is an interesting thing. We live it every day and yet so many are always trying to find the meaning of it. Other people would never spend their time consumed by such poetic and wasteful thought. Life is just a way to get ahead or to end up on top. Either way, you walk out the door everyday living it. Sounds kind of redundant doesn’t it? Here I am just living life. For what is life if not to be lived? I guess it’s a circular discussion once you get right down to it. He believes in this religion and so it’s this way, he doesn’t believe and so it must be something different. Let’s all agree on one thing here shall we? We all have a right to life and to live it. I’m not talking about consequences of choices here either. Some do things in their lives that change that right to live life. Let us keep this simple in those regards. Mr. Jones down the street works an honest 9-5 with a typical 2.5 kid family. He has the right to live life doesn’t he? The same goes for you and me.

I know that I probably seem to be rambling about who knows what, but I promise you that there is a point. I am going to apologize up front because this is going to be a lengthy expression of the heart, but these thoughts keep me up at night. I just hope that getting them down on paper will release my mind. There are a couple of stories that prod these thoughts and emotions out of me. I’m not trying to be political in my telling of these stories, but they are my stories. My opinion is going to come through.

There was this little local national girl that was injured in a fight between Taliban, Afghan Army and us that came to our FST (forward surgical team). She was perhaps five years old maybe six. I say perhaps and maybe because the typical Afghan doesn’t really know their age. They just guess at it. She had been hit by an RPG that the Taliban fired errantly into her house. The explosion killed two of her sisters. She lost a leg, but she lived. This isn’t the only child I’ve seen come through our doors thanks to the Taliban that claims to be fighting for them. There was a young shepherd that lost both legs and an even younger boy that lost his life. If it wasn’t for our team all of them, not just the one, would be dead now. I’m not tooting my team’s horn or anything, but it’s the truth. I can’t say how happy I am to have the opportunity to help these people. We’ve saved so many lives here that I think it’s appropriate to feel good about what we’re doing.

You know, it’s a funny thought that keeps coming to me when I get to this point of the story in my head. It’s usually about midnight by this point, but it’s only 8:30 right now. My heads clearer so now I can address this funny thought. Many people who would read the thought bubbles floating above my head would scoff at this little story. If we weren’t in Afghanistan then none of these kids would need our help in the first place. There wouldn’t be Taliban killing children while trying to kill American troops. I’ll tell you why this is a funny thought. It’s going to get political though.

While preparing to come over here my unit was required to take some cultural sensitivity classes. What we learned was almost sad more than anything else. The doctors that were schooled under the Taliban government only received the education that our third year medical students receive. I’ve worked with third year medical students and I promise you that as a lowly Army medic I know more than they do. You can’t learn anything spending three years in a classroom about how medicine works, only about how it’s supposed to work. The rest of the schooling these doctors received was purely from the Quran. Am I saying that religion is a bad thing to learn? I spent two years of my life teaching nothing but religion. I would never say it’s bad. What I am saying is that the suppression of knowledge and learning to save lives as a profession in order to learn religion is wrong. What scholars and doctors were experiencing under Taliban rule was akin to what was experienced in the dark ages of European history. It was even worse than that though. A seven year old girl was hung for going to school. Mutilation of women’s genitals was common practice as was public executions if a woman spoke her mind. Free thought, education, even the right to live life was suppressed and taken away by this system. What I am saying is that it’s a shame that it took a terrorist network killing thousands of Americans before we decided to do something about the Taliban and their buddies. The reason why the thought from the previous paragraph is funny is because those that would say we’re at fault for the deaths of those children would be the loudest calling for us to put an end to the atrocities that were a daily event in this country.

All of this wouldn’t keep me up at nights if it wasn’t for the last tale to tell. I’ve struggled with how to put this part down on paper. So much of it swirls around in my head and I wonder at times how much I have a right to the feelings that I have about it. I guess the conclusion that I came to is that who has the right to tell a man what and how he can feel? Not even God takes that upon Himself and if you don’t believe in God than think of it as freedom of speech.

I don’t remember the call, but I remember standing around trauma bed one. This is the bed that the most seriously injured come to and in a war zone that can mean some bad stuff. This time the word is that it is one of those bad ones. A vehicles’ armor had been penetrated by an IED and it was U.S. Soldiers hurt. I’ve been in numerous traumas already. I’ve seen things that normally are only in books and movies. The point being traumas had stopped making me nervous. Those butterflies had been beaten and now I was a somewhat seasoned medic with a job to do. This time it was different though. I felt those butterflies again as soon as I heard that they had started chest compressions on one of the patients.

Somewhere in time somebody decided that trauma was sexy. Maybe it was the adrenaline or that morbid fascination people seem to have in blood and carnage. M.A.S.H. was a huge hit in its day and ever so manly George Clooney and ER were very popular. The thing is with those shows is that typically you get a close up of Clooney doing chest compressions with the sweat dripping down his face. Somebody yells, “CLEAR!” and then there’s the shock. Everybody stares at the monitor praying for that beep that says there’s a heartbeat. When there’s not Clooney calls for this drug or that drug in whatever amount. Tension builds and when it seems that all is lost we hear it. Beep, beep, beep. Everyone breathes a sigh of relief and they start patting each other on the back. With all of that tension and sweaty close ups what’s not to love?

The sad reality that those in the medical world are faced with is that if it comes to chest compressions you’ve probably already lost. I can attest to that, I’ve done chest compressions on three people in my life and worked on a couple others where it was done. Out of all of those, not one walked out of that hospital. These are the thoughts that course through my mind as I can feel my heart begin to race. Those thoughts feel dirty and sick to me like death overtaking a once healthy flower in the face of winter. I should be positive. They’re American Soldiers and I’m an Army Medic. By some miracle we’ll save this guy I tell myself. No matter how hard I try there’s still a dark mocking voice that continues to taint my thoughts with reality. I can feel my throat and chest tighten. I continue to remind myself that I’ve done all of this before, but doubt nags at me like the beating sun in the heat of summer with no shade in sight. The world comes crashing into my inner struggle tearing all of these thoughts apart as the sounds of the approaching ambulance reaches my ears. I am a medic and I have a job to do.

I wish there was a way to paint a mental picture of a real trauma. The sights and sounds. It is a child’s breath away from sheer chaos at times and as smooth as a waltz at others. The concept is simple though. Everyone has a job and the surgeon leads the team assigned to that table. There is an airway to secure and IV access has to be gained. Wounds have to be uncovered and bleeding controlled. There are drugs to be pushed and bandages to be placed. Don’t forget to get that patient off of the litter and cover him with a blanket. When its severe trauma like this was, people are calling out for a hundred different things and you have to be able to do all of them at once.

The litter team came in at a near run through the double doors at the end of the trauma bay. There is no time wasted getting the soldier onto the bed and it all starts. I’m the right medic for this trauma and all I’m thinking about is that I’ve got to get an IV started on this guy. Somebody has already cut his shirt open and I grab hold of his arm. It’s warm to the touch… That must be good... I can’t see any obvious veins… this is going to be a hard stick, but there’s one IV in… “KC the doc said to start chest compressions”… why are we checking for breathing again… something about his eyes doesn’t look right… oh good, KC nodded at me so that means he heard… why in the world does somebody want to change the airway? If it’s in place let’s use the damn thing… good, he’s starting chest compressions… once things calm down I’ll get an IV started in this other arm… what is that look in his eyes… wow there’s a lot of blood on his legs. I need to get that uncovered… why are we stopping chest compressions? Doesn’t the doc know we already checked for breath sounds… what did the doc just say? He’s what? Gone?

Have you ever heard silence before? I know it’s a funny thing to ask. How can you hear silence? Might as well see clear right? I’ll tell you what silence sounds like, it sounds like death. In that trauma room standing over that soldiers’ body I heard silence. With a trauma bed with another soldier being worked on it perhaps 5 feet behind me, I heard it. With people calling things out and near chaos reigning there was complete and utter silence. That’s when I knew what that look in the soldier’s eye was. Sometimes our bodies are referred to as tabernacles of clay. Something built to house something greater. That look was emptiness. It was like looking into an empty container.

I still have work to do and it must be done. I’ll need to gather all of his personal gear and keep it together. We’ll need a body bag and the proper forms for the soldier’s body. I’ll need to get some form of identification off of him. My mind tries to run down a mental list as I numbly begin the process. Thinking that I have his dog tags I cut the tag tied around his neck. It’s not his tags and so I set it with his other gear for the moment. I find his tags looped through his belt loop and then tucked into his back pocket. I find it interesting since that is the way I carry my dog tags. It’s just more comfortable that way.

Not much longer after that our other soldier has made it into the operating room. He’ll lose a leg, but he’ll keep his life. I realize at this point that he doesn’t know that his battle buddy didn’t make it. We’ve reset the trauma bay in case more patients come. That is always a priority. The dead soldier’s body is placed in what we call a refer unit until we can start it on its journey home. The refer unit will keep it cool until then. I gather up the few things that haven’t been sealed in a Ziploc or in the body bag with the dead soldier. I find the dog tag that I cut off of his neck earlier and take a moment to look closer at what it is. “WC, May the Lord bring you back to me. BC”. I sat there and read it over and over seeing the initials of WC and BC stands out like a light in the darkness. I knew without having to be told that these were the initials of our dead soldier and the girl he left at home. My wife’s face flashed through my mind repeatedly as I sat absorbed in this moment. I was startled to realize that I was holding back tears and with some effort I was able to rip my mind and emotions away from the moment.

In this life we all endure hardships and joys. Nobody can sit back at the end of their days and say that they had no joy or no pain. The two emotions are tied to each other and are of an eternal nature. Joy is made all the sweeter by those painful experiences that we endure. We just have to hope that the joyful moments outnumber the painful ones. Most of these we will forget. They will simply become part of the collage of emotions and experiences that make up life. Some of them will never go away. They are seared into our minds like brands on the flesh never to be removed. Every now and then we realize that we are having one of these moments which only heighten the sensation being experienced. We even tell ourselves on days such as our wedding day or the birth of a child that we will never forget that day. I will never forget that day. I knew as I stood to get on with my duties that I had had a moment that will forever impact me, a moment to be remembered.

As I was saying earlier, life is an interesting thing. How often do we take it for granted? I’m not talking about our climate controlled houses or the cars we drive 2 blocks to the corner mart for a soda. I’m just talking about that simple right from before, the right to live life. When is the last time any of us feared just to walk across the street or to let our kids stand in front of the window? I can’t seem to recall ever having those fears. That’s actually part of why I’m here in fact, to keep those fears out of my country, my neighborhood, my family. I just hope that the lesson learned here sticks with me throughout the rest of my life. I hope that each of us can feel pain for what is happening a world away, but feel joy that it’s happening a world away.

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