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Authors: Dave Hnida

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The doctor with the highest military rank was a crusty character we called Charlie Brown, an affectionate nickname that evolved from his real name of Robert Blok to Blockhead to Charlie Brown. Charlie was a full-bird colonel, one step below general. He seemed to know every rule and regulation ever invented by the Army, including the recommended distance from tent to latrine. I'm sure he even counted the steps. He was our anesthesiologist, and was in charge of a group of four nurse anesthetists who would accompany us to the CSH, the combat support hospital.

As we talked, I discovered I had the least amount of military experience in the group, a relative baby with just over three years in the service. But I did have one bit of priceless experience none of the others did—combat. I didn't know what the conditions would be like when we finally got into Iraq, but I knew, as physicians, we wouldn't be allowed “outside the wire,” meaning allowed off base. Physicians, especially surgeons, were in short supply, so it was a rare doctor who was allowed to travel around unencumbered like I did three years before. Hell, I doubted we'd even be allowed to dip a toe into the sand outside the fence.

As we lounged in our tent, I offered one piece of what I hoped was sage advice: don't talk politics. I had a feeling the group was fairly split when it came to conservative versus liberal, with me sitting smack dab on the center post of the political fence, but I knew the minute we started talking politics, we would implode as a group. We all agreed to put political opinions to pasture for the duration.

Weather in Iraq seemed to be a big issue—sandstorms were walloping the country, grounding a lot of aircraft, especially those transporting fresh troops into the war zone. After close to a week of false
alarms, we got word we'd join a larger group on an eight o'clock evening flight to Tikrit. So, in a classic hurry-up-and-wait, we packed our duffels yet again and chain-carried them to the loading area at 2
P.M.
The staging terminal was actually several miles from the airfield, and in some ways reminded me of an overcrowded Greyhound bus terminal. It was open-air, with separate roped-off areas under thin corrugated metal roofs that seemed to magnify rather than protect from the rays of the sun. Penned like cattle, we found scores of roasting soldiers lined up for the day's flights: Baghdad, Mosul, Taji, Q-West, and many more destinations; some names I recognized, others seemed completely foreign, which was appropriate considering they were foreign, at least to us tourists.

Our group sat until 5
P.M.
behind the chalkboard that said “Tikrit” and were thankful when we were finally herded onto a bus that took us straight to the airfield and our C-130 sitting on the tarmac. We were told to drink as much as we could, use the porta-johns, then hold tight. The “hold tight” part lasted more than two hours as the plane sat and repetitively revved its engines. Finally, an Air Force guy walked over and gave us the bad news: no flight, engine problems. Sorry, fellas.

Bummed out, we filed onto the bus and headed back to the terminal. At the halfway point, the bus unexpectedly pulled a multi-
g-force U-turn and zoomed back to the airfield. Problem solved, the flight was a now a hurry-up-and-go. We once again formed our weaving antlike procession, and funneled onto the plane through its rear ramp door.

On board we found we had more people than seats, but flying the friendly skies of the U.S. Air Force meant you never had to worry about being bumped—the human shoehorn technique worked for them. The inside of our C-130 was like any other, a dimly lit tube with two long parallel aisles, sort of like narrow hallways, where the web seats faced each other. It was a claustrophobe's nightmare: our knees touched the knees of the people across from us and we had to twist our shoulders at a weird angle so we'd all fit. The overbooking also
meant your butt didn't exactly fit into the natural groove of the webbing; instead most of us were treated to metal support rods trying to give us a rectal exam through our uniforms. As the ramp of the plane closed, applause and whistles traveled up and down the line of seats. But the cheers dissolved into grumbles, then curses, as we continued to sit on the tarmac for another hour feeling the coarse vibrations of the engines being tested and retested by a sadistic pilot.

Problem solved my ass. If it was 120 degrees outside the plane, it had to be 30 degrees hotter inside. And we were in full battle rattle with Kevlar helmets, flak vests, and combat gear—to say nothing of the overstretched bladders from all the water we were told to drink. We wanted to document our suffering for some complaint-to-be-filed-later to the secretary of the air force, but the pictures we took didn't come out—it was so hot and humid in the flying oven, the lenses of our cameras fogged over. The sweat ran like a broken faucet from inside our helmets and poured off our chins. When a few of the guys started getting lethargic and began to heave, we knew heatstroke was imminent and this playing with the engines bullshit had to stop.

A young crewmember in a brown jumpsuit came back and said it would just be a few minutes more; his open mouth was met with the threat of a bullet to the head if the ramp wasn't opened—
now.
There was no way we were going to keel over from heat injury because of some asshole jerking around with the engines. It was shit or get off the plane. At first, I don't think he believed his passengers were serious, but we were already in group protection mode. None of us was going to sit quietly as one of our own collapsed from heatstroke. Wide-eyed, the airman watched as a hand reached toward a holster, only to be saved by a sudden jerk forward that told us we were either on our way to Tikrit … or the nearest jail.

The flight took less than an hour. Since C-130s aren't insulated, we shivered most of the trip as our sweat turned to ice water when we reached flying altitude. A few of the guys said the hell with it, and simply pissed their pants to relieve bladder spasms and abdominal pain.
No bag of peanuts and a soft drink on this flight. Deliverance came with a landing that was different from any other I'd done before in the Army—rather than spiral in from ten thousand feet in a stomach-dropping free fall to avoid an enemy rocket, we skimmed the treetops at high speed for miles before the wheels kissed the pavement. Cramps were rubbed from muscles and wobbly knees gingerly tested before we filed off into the night and re-formed as a group. Once again, we stood and stared like lost children, wondering where we were and who would help us. The questions were answered quickly as a group of brand-new black Chevy Suburbans appeared from the darkness—it was a group from the hospital sent to fetch us and our belongings.

It seemed like we drove forever. The hospital was located within the confines of cavernous COB Speicher, with the COB standing for “Contingency Operating Base”—the military's new term for huge, monstrous, and probably-going-to-be-here-forever base. The COB was home of the 82nd Airborne's and 25th Infantry Division's main operations, with the 399th combat support hospital a flyspeck, but an important flyspeck, on its periphery. And as the former home of Saddam's Air Force Academy, there were a few concrete buildings left standing after the intense bombing raids of the war's first days. And we lucked out; one of those intact structures was to be our barracks. It wasn't much to look at. Pockmarked by bullet holes and shrapnel, the building was the same dull brown that seemed to be the color of paint the entire country was dipped in.

To our delight, we were handed new, unopened packages of sheets and pillowcases along with room assignments. To my further delight, I was bunking in what was called the “Love Shack,” the largest room in the building, and the only one making up the third floor. By American standards, the “large” was relative—most of the other guys doubled up in plywood-sided rooms the size of a typical bathroom; mine was the size of three bathrooms. My roommates were my fellow ER doc Mike Barron and surgeon Ian Nunnally. As we walked through the door, our sleep-deprived brains blurrily did the math: three guys plus two
beds equals a big problem. Our eyes twitched back and forth, and to each other—seeing who was going to blink first. Jarhead Mike solved the dilemma. Spying a homemade plywood table, Mike plopped his sleeping bag down and was snoring in less than a minute. He slept on that rickety platform every night for the next three months.

4
PARADISE GENERAL HOSPITAL

T
HE FEW HOURS
of sleep I got that night were edgy—
helicopters zipped through the night skies over Camp Speicher with an unpredictable regularity—each angry whirl of the blades kept me from fading into a much-needed sleep. I was disoriented but knew the hospital was close—and it seemed like every copter was making a drop-off outside my window. They must have had a busy night. All too soon, it would be my face waiting at the end of the line as the birds carried in their bloody cargo.

I pulled on my uniform and decided to make my way over to what would be my workplace for the next few months. Breakfast was out of the question—acid had eaten a hole in the lining of my stomach and I had a bad case of the jitters. As I opened the door on to the gravel-covered compound, the heat struck like a torch and the explosive rays of the desert sun took my vision away.
Jesus, don't forget to keep water with you all the time. And get some good sunglasses.
Several soldiers stared at me as I tentatively staggered across the blinding landscape. To them, I must have looked like a lost sheep searching for the rest of
the flock.
Must be one of the new doctors
, their faces said.

I swallowed my embarrassment and decided to ask for directions.

“Morning, how's it going, guys?”

“Just fine, sir. Another day in fucking paradise.”

“Can you tell me where the hospital is?”

“Just behind those walls, sir.”

I mumbled a thanks and stared at the huge blast walls less than fifty yards away.

The short route was covered with gravel—in fact, the whole camp looked to be landscaped with the chunky gray rocks—and even at 7
A.M.
the heat radiating off the gravel felt as if it were melting the rubber soles of my boots.

As I neared the hospital, another group of soldiers came by, snapping salutes as they passed.

“Morning, sir!”

I saluted back as I crunched along, “Hi, guys, how's it going?”

In unison, they answered, “Just another day in fucking paradise. Thank you, sir.”

It was a phrase I would hear repeated several times more that morning, as well as every single morning for the rest of my deployment: “Another day in fucking paradise.”

Bingo! We now had an official name for our new workplace: Paradise General Hospital.

I wasn't sure what to expect when I saw Paradise General for the first time. I knew it wasn't going to look like Johns Hopkins, but I wasn't ready for a group of shabby tents hidden behind the blast walls. It made the grounds of the 4077th MASH on TV seem like that of a major medical center. Out of the five combat support hospitals in Iraq, all had regular buildings and hard roofs except one. Ours. The bulk of our hospital was made up of a group of huge green tents with an occasional connection to an old building or to some trailers you'd typically see on the back of a semi, all surrounded by ten-foot-high, three-foot-thick blast walls to protect us from the rockets and mortars
the insurgents would lob onto our laps. The support staff of more than two hundred had already been in country for a year and gone through three rotations of doctors—we were their fourth and final group—so they probably were elated to see us, even if they didn't know or trust us.

It was key I got off on the right foot at my new workplace; instead, I stepped in a verbal pothole and fell flat on my face. As I continued my openmouthed wandering, I realized another soldier was passing as I entered through a break in the blast walls. I spied a colonel's rank on the cap, which meant I needed to offer a salute and a greeting. Yet this superior officer had a few strands of long hair sticking out of the cap. Was this colonel a he or a she? It was like Vegas in Iraq, with 50—50 odds I'd guess the correct gender. I took a shot and bet on the hair.

“Morning, ma'am,” I said with a confident air of respect and courtesy.

The stunned, pissed look told me I had rolled snake eyes.

A deep masculine voice replied, “Good … mor-ning …
Ma-jor.”

Shit!

He was one of the main bosses of the hospital. And it took less than ten seconds to get on his personal shit list thanks to my blurry-eyed gender confusion. I quickly mumbled an incoherent “Sir” and took off, stumbling past a collection of dusty tents. I had just had my initial encounter with an “administrator”—which in this camp was a four-letter word, especially one small group in particular, whose specialty was manufacturing misery for the medical staff.

The sign on the door of the ER said, “STOP! AUTHORIZED PERSONNEL ONLY!” in oversized block letters. Was I now authorized? Or did I have to wait until I went through my orientation and became official before entering the no-man's-land of the emergency room? I took a deep breath, rolled the dice again, and pushed through the doors. It was like stepping from a serene forest into a multicar pileup. Blood, screaming, and a kaleidoscope of chaos.

“Can I help you, sir?”

Help me?

“Ah, well, I'm one of the new docs.”

“Welcome, sir, we heard you folks got in last night. Get you a cup of coffee?”

I snuck a peek at the sergeant's nametag—“Courage.” He was the NCOIC of the ER—the noncommissioned officer in charge. And I could use a dose of his name right now. He sat calmly at a desk despite the yelling and screaming that peeled the paint off the walls. A bloody stump of an arm hung off one stretcher, while on the next one over a Niagara of blood poured onto the floor as a group of medics struggled to cinch tight a tourniquet around where a leg used to be. The other leg pointed oddly at a right angle away from the body at the knee.

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