Three Thunderous Knocks

Three thunderous knocks struck my door; it’s 1:20 AM.  My startled eyes opened and my mind went into a state of daze.  Sergeant M’s voice cut through the door “Doctor Duber Trauma, ETA 20 minutes”.  I wearily climb down from my bunk get dressed and head to the FST.  I’m informed one U.S. soldier is being medevac to us via Blackhawk after falling down the side of a mountain.  The only medical information is that a spine injury may be involved.  20 minutes blooms into 2 hours and the “steel angel” finally arrives.  Charlie Co. meets the bird and transport not one but three U.S. soldiers to the FST.  Fortunately two of the three soldiers walked in under their own effort; the third on a gurney. Mike M and I immediately begin triaging the patients.  I focused on the two ambulatory soldiers and Mike the gurney bound.  The soldiers apparently were in the process of setting up a new outpost in a high altitude mountainous area within our medical territory when one of them slid 50 feet down an embankment. The operation was at night so lack of visibility was likely involved.  The two ambulatory soldiers were injured in the rescue effort.  After a thorough evaluation no surgical injuries were present. I released the two ambulatory soldiers back to duty and Mike M determined the gurney bound soldier would be medevac to Baghram for advanced spinal imaging; our suspicion for spinal injury was low but we don’t take chances based on past experiences. The clock now read 4:20 AM and I made a STAT consult with sleep.

My alarm blared at its usual time waking me up; the lack of respect.  I arrived for morning report tired and ready to return to the comfort of my bed.  My bed would have to wait; we have a VIP visit tomorrow and we needed to prepare. The brigade commander and his staff were present for the meeting to make sure everything goes as planned.  Tomorrow appears to be busy now; I’ll take it.

Following our meeting I helped Charlie Co. with an orthopedic consult and then headed back to my shack. As my door shuts three more knocks blast through as if timed. One of the NCOs informed me that the Special Forces unit just brought in a trauma and they were hit by a vehicle.  I quickly headed back; excitement filled me as this mechanism usually meant surgery. As I entered the FST four “Bearded Ones” stood before me.  The patient they brought to me was an Afghan contractor who was directing traffic for them when a car travelling about 40 MPH struck him.  He was lucid, had a deformed left lower leg, multiple abrasions and lacerations.  Our interpreter “Rocky” was present today for traumas today; helping as usual.  Our Afghan patient did not want fluids during his resuscitation as he was under “Ramadan” until 7 PM; he was stable and we respected his desires.  Joey T evaluated his head and abdominal issues while I focused on the extremities.  Amazingly his only significant issue was the fractured left tibia. I found it very humorous that the whole team was on me to externally fixate (EXFIX) his leg, and although I was just as excited as them the facture did not dictate it; their sad faces were priceless.  I splinted the patient instead and we ended up transferring him to a regional Afghan trauma hospital for definitive treatment and follow-up. 

The Afghan sun is starting to heat up my world and with it my motivation.  I find my position here personally awkward at times.  Just like the infantry want to complete their next mission I want to be in the operating room fixing and saving lives, but it’s at a cost.  These lives can be U.S. soldiers and coalition troops so I have to moderate my emotional drive to be busy and recognize being slow means were succeeding and our troops are returning to their families unscathed; just like I want to return. 

It’s that time my friends. Give your significant other a hug today; god knows I wish I could do the same too my wife.

M