Trauma over the last two days has been non-stop; some serious and others not. The missions in our region have increased at a rapid pace as well as the injuries associated with them. One specific area seems to be the hot bed and the unit attached there has taken the brunt of the trauma. We have seen probably 20 soldiers from that unit in the last month and unfortunately more than 1 has been KIA (killed in action), including a U.S. soldier from yesterday. It pains me and the rest of our team every time we see soldiers from this unit because we can only begin to imagine the mental and emotional turmoil they must be facing. There’s no stop button on this game called life and sometimes when there is no reprieve it can overwhelm you; something were getting used to seeing on the faces of our heroes.
Yesterday started like any other and our team would never have known what was coming our way. The morning started with an easy 3 soldier IED trauma where the injuries were back pain and mild TBI (traumatic brain injury). We combed through the patients with our multi-point trauma resuscitation protocol and found most were well with the exception a few obscure findings which necessitated two of them to be transfer to Baghram for advanced imaging. A medevac Blackhawk eventually made it to transfer these patients and then members of our team began the process of preparing their stations for the rest of the day.
Two hours later we received a call that a large IED hit an MRAP with 6 U.S. soldiers and they were going to be medevac to our FST; ETA 30 minutes. After 10 minutes we received notification that 3 of the soldiers had orthopedic injuries, 2 were TBI/spine, and 1 soldier was KIA; these soldiers were from the ravaged infantry unit we have reluctantly gotten to know too well. About a minute from landing the beating props of the Blackhawk could be heard and we all put our game faces on. Once it landed Charlie Company met the bird and transferred the soldiers to the FST. The door of the Humvee swung open and the soldiers were quickly brought inside. All three general surgeons and myself began evaluating the patients. My attention was focused on one soldier who had an obvious deformed open facture of his distal tibia. My initial exam showed very weak pulses in his foot so once anesthesia gained IV access and pushed some sedation I realigned his leg and put a better temporary splint on; his pulses were regained and his dusky foot became pink. I then bounced to the other patients to do my orthopedic evaluations. Two other soldier had a concerning orthopedic injuries. X-rays were done on all the patients then I reviewed them. My initial patient had the most significant injuries and it was clear I would be taking him to the operating room to externally fixate his leg and wash his large open wound out. He also had a significant pelvic fracture and various other fractures. While he was headed to the OR I splinted fractures of the other soldiers and then made my way to the OR. Once in the OR I went to work. I washed the soldiers open leg wound used x-ray to realign his leg then externally fixated it. After 2 units of blood and other biologic resuscitation products the soldier was stable and transferred to recovery maintained in an intubated state. After all the patients were deemed stable Baghram was called for medevac and a “Steel Angel” was sent. 1 hour later we loaded them on the bird and off they went. The U.S. soldier who was KIA was transferred to the morgue when he arrived to FOB Fenty. We were informed his body would be sent to Baghram on a “Hero Flight” at 11P.M.; the second one for the FST. The whole FST would be there and unknown to us; other friends.
8:00 P.M. arrived and with it a medical joint special operations command (JSOC) surgical team. Some type of special operation mission was going down tonight and they were here for their medical support. The only thing other than our FST resources they needed was an orthopedic surgeon; their orthopod left the day previously and I was obviously excitedly obliged to help if need be. This was not just any JSOC medical team but rather this was the team that responded to the Seal Team 6/special operator Chinook attack; when 39 heroes and a special operations pup died. It was obvious after discussion about their experiences in Afghanistan they were physically, mentally and emotionally drained. Their stint here was overwhelming and tomorrow they were leaving for home after tonight’s mission. We hung out with them to raise their spirits and when it was time for the “Hero Flight” they joined us.
It was a warm moonless black night. At least 150 active uniformed U.S. soldiers lined a walkway from the morgue to a helipad where a “Steel Angel” would arrive to take our fallen hero to Baghram and then to his family. After a longer than expected amount of time a Blackhawk could be heard in the distance; blades beating to the rhythm of our hearts. Once it landed it slowly taxied to the ramp loading area at the end of the lined up soldiers. After about 5 minutes when the crew of the bird was ready for the transfer all the soldiers in the formation were brought to attention and then to salute. The hero’s body was slowly wheeled down the walkway toward the Blackhawk; shrouded in a brilliant American flag. Sobs of soldiers could be heard all around me; tears rolled down my face the second he passed me. The hero was moved inside the bird and after a minute or so the “Steel Angel” disappeared into the darkness of the night. Goodbye my friend.
Fortunately the JSOC mission went off flawlessly and my services were not needed. The team spent the night in our FST and then left this morning. I shook all of their hands and commended them on a job well done; a smile of relief exuded from all of their faces knowing home and their families were only days away.
P.S. I love you Melissa, Turin, Talon, and baby Myla. I’ll be home soon as well.