166 Days: My Journey Through The Darkness (19 page)

8 September 2008

This was a much needed good day for me. Clinic was actually a positive experience; far from the norm I had grown to expect. For the first time I saw a husband who appeared to genuinely care for and love his wife. She was seven months pregnant and complaining of low back pain. After ensuring she was not in labor I talked with them about the low back pain that can come with pregnancy. As I gave them educational information on how to relieve her pain, I realized they probably had never seen anyone before for prenatal care. “Would you like to listen to the baby’s heartbeat?” I asked. I watched their eyes light up with excitement as they heard the interpreter translate my question. They both nodded enthusiastically. They held hands as I put the gel on her belly and put the Doppler on her skin. At that moment the baby kicked and I watched the man squeeze his wife’s hand. When I located the baby’s heartbeat I watched them both smile from ear to ear. What a huge moment it must have been for them both, especially considering the region we were in and its lack of medical care. They both thanked me profusely for the rare opportunity.

As I walked the couple out of the clinic, I saw an old man with two walking canes, his ankles splinted in permanent braces suggestive of a neurological disease such as cerebral palsy or a similar condition. As I walked up to him I said “Shalom (Hello in Dari),” as I did with every patient.

And much to my surprise he replied back in English, “Good morning, how are you doctor?”

“Well! Good morning to you sir!” I said, pleasantly surprised to hear him speak English, as I always was with any patient there I could speak directly to. We talked about his medical complaint, which was an infection in his prostate and when I finished discussing the treatment plan with him, I asked, “Is there anything else I can do for you today?”

He looked at me and said, “Yes doctor. Now I will ask you a favor.”

“Ok,” I said, skeptical of what he would request.

“I am on a quest,” he explained. “You see, once I learned to speak English it became my mission to teach it to as many children as I can.”

“Wow, that’s incredible. Are you teaching students now sir?”

“Yes doctor, I have fifteen pupils now. My problem is that I don’t have any supplies to teach with, and that is my request of you.”

“What do you need?” I asked eagerly.

“If you can spare some pencils, paper, and any other school supplies I would be so grateful,” he said as he put his hand over his heart. As I listened to his request, my heart filled with respect for this man. It was so rare to see anyone in that area with much education and even more unusual to meet someone who wanted to have a positive impact on the youth.

“Wait here, let me see what I can do,” I replied. I hurried up to the OpCen and asked for help from the guys who were ultimately responsible for that sort of thing. I walked with them over to the connex, where they kept their humanitarian aid, and made sure the man got as much as we could spare. When we gave him the supplies, I could see the gratitude in his face.

“My heart is filled by your kindness,” he said as he started his journey home with his two canes and bags full of school supplies on his back.

“Tashikor,” I replied and bowed my head.

I also got to see a little boy for the very last time that I’d been treating for several weeks for a partial finger amputation. He was about five years old and was working at home and got his little hand caught in a grinder, resulting in his almost losing several of his fingers. I had to actually remove the end of one digit because it was so mangled. I instructed him come in every day for dressing changes saying, “Now listen sweet boy, I need you to come back every day and let me change your bandages. But, you have to keep this clean ok?”

“Yes doctor,” he would say. Like clockwork he returned every day, covered in dirt. He did what he could to follow my directions, but he couldn’t avoid his living circumstances. Thankfully, with the daily dressing changes and antibiotics we were able to keep the wound clean. He was very sweet and seeing him became one of my only things to look forward to in clinic. I would watch him march up to the clinic in his bare feet holding his hand up as if he was trying to prevent it from getting any dirtier than it already was. He would see me and wave with his good hand and smile. As we changed the dressing each day, I could see it was painful, but he did everything he could not show that it hurt.

“Do you need me to stop for a minute?” I would ask, as he winced in pain.

“No doctor. I can do it. I’m strong man,” he answered. He was indeed a strong little man and I would miss him. As I said goodbye to him the final time I gave him as many things as I could to help him; toothbrushes, toothpaste, soap, a winter hat and coat, etc. I would never forget his courage; he never once complained, so very brave.

Lastly, I saw a very interesting Dermatology case that was worthy of writing a case study about when I got home. After I got as much information as I could from the patient, I researched my differentials of diagnosis as much as possible and sent an email with pictures to my friend Chad, a dermatologist I met in my training. I truly found the case fascinating and was excited to proceed with my plan of care for the patient. I hoped I would see him throughout the course of treatment before I had to say goodbye to the clinic and firebase for good. It felt so good to be excited about medicine again. For the first time in several weeks I felt a piece of
me
was still there, and that was a great feeling.

Unfortunately, after several days of searching, the Aussie who returned to retrieve their missing bomb dog, Sarbi, had no luck in finding her and sadly he had to leave without their teammate. I prayed that night for the dog, that if she was alive, she was not in harm’s way.

10 September 2008

It had become significantly obvious that Becky and I were no longer the scared, naïve, and sheltered women we were when we first came to the firebase. We’d become something I never thought possible; numb. We were sitting down in the clinic after we had finished seeing our patients talking.

“I feel like we’re so removed from everything and everyone,” Becky said.

“We are. I really don’t care anymore Becky.”

“I don’t either, what’s the point?” Before Rod’s death we couldn’t wait to get back up to the OpCen with the team and be a part of the group, but now we didn’t want to be involved with anything. By sitting in the clinic we were trying to get away from it all by talking, laughing and sharing stories of home. As we sat, we heard the all too familiar “boom” of an attack. The Becky and Jenn we used to know would’ve jumped in shock and fear as we heard the sound, scurried up to our positions, and waited for further instruction; the two hardened ladies we’d become sat in the clinic and barely flinched.
Who cared?
What can they possibly take from me that they haven’t already?
We knew our place during any attack was to be in the OpCen, while the team took the wall and defended the firebase…but we sat.

“You think we should check and see what’s going on up there?” I asked.

“I guess so,” she answered. We eventually opened the clinic door and looked up toward the OpCen and saw the majority of the team standing on the roof looking off into the distance. The attack was occurring at a checkpoint just outside our firebase.

We both sat and watched in our detachment; neither one of us cared. At one point as the booms continued, I opened the front door to the clinic that the patients normally enter through, and stood outside with my arms in the air with clenched fists. “Come on God! What’s next? Bring it!” I shouted. I was daring Him to take me. I didn’t care what happened at that point. I’d officially shut down.

When the attack was over, and it was deemed safe to exit the clinic, we went back up to our rooms and Hal told us that one of our ANA soldiers at the checkpoint had been killed. The Jenn I used to know would’ve been upset, shaken, and saddened by the loss. I didn’t know who that person was anymore; she was gone. I listened to him tell me the news. When he was done I nodded, gathered my things, went to my room, closed the door and went to bed. Sleep would make it all go away. It was the only thing that could.

11 September 2008

On September 11, 2001 the most horrible terrorist attack on American soil occurred, and we were all never the same. I, like every American citizen who was old enough to remember, will never forget where I was that day. I was a young Airman working on the Medical/Surgery (Med/Surg) floor at the Nellis AFB hospital, having served just over one year of active duty time. For some reason around 6am PST (9am EST) I couldn’t sleep so I called my friend Ron to talk. Ironically he was up as well. We made small talk and then I turned on my television; we both fell silent as we watched the second plane hit the World Trade Center. I couldn’t believe what had just happened. I hung up the phone, put on my uniform and rushed into work. We all gathered in our break room and watched the rest of the horror unfold on television. After several hours those of us who were not scheduled to be on shift, were released to go back to our dorm rooms if we lived on base. We agreed to get ready in case we were needed to help in whatever ways we could in New York. There were specific disaster teams that were in place in the event something like this were ever occur; the members trained frequently on scenarios that would require an immediate response for assistance, but there was no way to prepare for this type of tragedy. Being as young as I was in my military career, I had not been assigned to such a team, but the majority of my colleagues were.

I remembered the drive back to my dorm as if it happened yesterday. Lines upon lines of vehicles were stopped at the gate to the base due to the lockdown. As I sat in traffic I stared out the window at the other drivers and watched their faces. They were all the same; wide-eyed and distant gazes of shock, horror, and disbelief. None of these people were speaking; everyone was looking straight ahead in silence. That night I tossed and turned in bed. I’d laid out my uniforms and my go-bag was ready. I wanted….
needed
to go with the disaster team to help, so I stayed up that night writing a letter pleading to my flight chief to let me be a part of the disaster team. The next day I reported directly to his office, letter in hand, and tears in my eyes begging to go. I felt that I
had
to help.

“Sir! I know I’m too new to be on a team, but please consider me as a volunteer willing to step in if I’m able. I will take anyone else’s spot who doesn’t want to go. Please…I am begging you.”

“I appreciate your heart, Airman” he replied, “I will keep you in mind if any opportunities open up on the team.”

“Thank you, sir” I said and walked away. It was in that moment I felt for the first time that my purpose in the military was bigger than me and my selfish reasons for joining. Despite being ready and able to help, the disaster teams Nellis AFB staged to depart at a moment’s notice were not needed.

I sat on the roof of the OpCen and reminisced about the eager and motivated Airman I was on this day seven years ago. Now here I was in Afghanistan feeling completely defeated and numb to the violent world around me. That fire, that heart, that motivation to make a difference, was all in my far distant past. I wished I could meet that young naïve person and spare her heart from the harsh and brutal realities of war, but I couldn’t. Instead I knew I would live those realities for the rest of my life.

September 11, 2008….so what? Just another day in this hell.

15-18 September 2008

As the days passed, it became clear the firebase family had fallen apart. It was very tense and everyone seemed to be on edge. I found myself withdrawing more and more and spending every day preparing myself to leave. No one wanted to talk about feelings and seemed to avoid addressing the issues at all cost. Many attempted to go on as if nothing happened; pretending not to have suffered from the loss that we all shared. Becky and I got word we were on the next ring flight out of the firebase which couldn’t have come at a better time, I was emotionally exhausted and felt all the joy of my job was now gone. It was time for me to get the hell out of there.

The six members that recently joined us from the other Green Beret team were very helpful; one of them, named Chase, was a medic. He was a nice guy; someone I wished I could’ve worked with the majority of the time of my deployment, instead of Kyle. He had a good head on his shoulders and not overly cocky like Kyle. All the same, I was ready to leave. I was realizing every day that passed I was shutting down. The night before I was so tired I lay down early but I could hardly sleep at all because I couldn’t stop thinking about all of the bad things that had happened. It actually scared me; I’d become so
consumed
with these horrible thoughts that I couldn’t sleep. I wondered;
Am I going to be ok after this?
I knew how fortunate I was to have such a strong support system at home, but still I wondered. I knew I’d changed and realized now it was up to me on how I
dealt
with the change.

Ben’s condition continued to deteriorate. Apparently there was much more to the injuries he suffered when VICTOR-1 hit the IED that threw him from the vehicle. While he was at KAF he didn’t tell the whole truth about his symptoms. He wanted to get back with his team, so he managed to get on one of the medevac flights the night of the mass casualty. He was the weapons sergeant for the team, which was a job that required lifting and maintaining heavy weapons throughout the day. He began to notice he couldn’t perform his duties and went to Hal for help. Hal then came to me.

“Hey Jenn, you got a sec?” Hal asked.

“Yeah, what’s up?” I replied.

“Listen, I need your help. I just talked to Ben and I’m real worried about him.”

“What is it? What’s wrong with him?”

“Well, he told me that since he got back he’s had weakness and numbness in his left hand. He said he’s having trouble lifting things.”

“Are you serious? How long?” Ben was the typical SF guy; nothing but muscle, spending the majority of his time in the gym. Weakness was never a word any of us would have used to describe him.

“Since he got back a couple of weeks ago Jenn. What do you think it is?” he asked, genuinely concerned.

“It could be serious Hal; he could have a severe neck injury. I need to evaluate him right now,” I got up and started to the door.

“Jenn! No! Wait! He told me that in confidence. He’d be so pissed at me if he knew I came to you,” he pleaded.

Normally that wouldn’t have fazed me in the least, but this was a different situation. I thought about the determination Ben had to get back to his team despite his injuries. They were family to him. I had to respect that bond; but at the same time he needed attention. I wrestled back and forth with what to do for several minutes.

“Ok, I get it Hal. I do. I will teach you how to do a neurological exam on him, but you have to
promise
me if there is anything at all that you see, that looks abnormal, you have to come and tell me immediately. Do you understand?”

“Absolutely….Jenn, thanks. I promise. I’ll take good care of him,” he said as he walked out of my room.
Ugh! I hope I made the right call with this,
I thought. I would give them the space they needed, but I had to stay on top of it. It took a couple of days of Hal treating his symptoms before Ben would actually let him do the exam, but he finally did. When Hal came back to me and reported the results they were not good.

“He gets medevac’d now Hal,” I insisted.

“Yes ma’am, I’ll make the call,” Hal said, “I think he’s expecting it.” He left on the next flight out and returned to KAF for further evaluation. As he was loaded onto the Chinook it dawned on me how much certain individuals can influence a group. He was a great guy and an amazing and dedicated soldier. I thought about the rest of the people who were no longer with us. It seemed the people who’d impacted us in the most positive way, with the exception of Hal, were the ones that were now gone, leaving remaining skeleton of a team in a word - “broken”.

When he arrived to the treatment facility, more tests were run and it was discovered he had both a skull fracture and - what I was concerned about - a fracture to his cervical spine. He’d been walking around with a broken neck for almost a month! He wanted so much to be with his team that he put himself at great risk to do so. Luckily, he suffered no permanent damage.

September 18th was my last day of clinic. As I stood in the place that had been my life for three months, I felt sadness. Despite all of the tragic things that occurred right where I stood, I still had some fond memories of the place. I would miss our interpreters and Hal dearly. Hal had come in to his own as a medic in the short amount of time that we’d shared. After everything we’d faced together, he’d become a good friend, one I would never forget. Becky and I shared this sentiment and tried to make the most of our last day. We drank chai one last morning with our friends and tried to have some laughs about some of the memories we shared in the clinic. The interpreters had gotten into the habit of bringing us chai every morning and they knew that this would be our last so they also brought us some cake. They’d given us each an Afghan name; mine was “Nazanin,” which meant darling. I thought it was such a nice name to give me so I began writing “Nazanin” on my cup every day instead of “Jenn”. On that day, as one of the interpreters poured my chai, the other handed me a marker and nodded to my cup and said, “You will write Nazanin Yes?” I looked at him and smiled nodding my head as I took my cup and wrote my given name one last time.

As we stood together for the last time in our clinic, I looked around at the walls of the building that had become one of the most significant places I had ever been. The few short months we spent there would be in our hearts forever. We found a marker and we each signed the wall with our names and the dates we were there, along with the slogan we’d picked up from the t-shirts they made for us back at BAF,
Good
Medicine in Bad Places
. The clinic had left a permanent mark on who I was, I hoped I’d done the same - beyond what I wrote on the wall that day.

Several weeks ago Becky received some pictures that some children from back home had drawn and sent to her. One was of two girls in a field with flowers and trees on a sunny day with two airplanes flying over. We’d hung it, and the rest of the drawings all around the clinic, but that one was our favorite. As soon as we hung it we wrote our names above the little girls and it made us smile every time we looked at it. We decided to take a picture by it, and hoped it would continue to make many more people smile as much as us.

As we closed the clinic door one final time, I thought of all the people I treated successfully and all the people I had to turn away because I didn’t have the capability to help them at that facility. I’d learned more in that place than every book I’d read in school and every patient I’d seen back home; both about medicine and myself. I was thankful for the lessons and the people I met, but as I walked away and back up to the OpCen I didn’t even think about looking back.

The interpreters and the local labors had worked with us every day and when they heard we were leaving they decided to throw us a party. It was such a thoughtful gesture and they spared no expense. They purchased fresh grapes, watermelon, vegetables, and soda. The cook prepared a delicious chicken curry and rice; a luxury for the region we were in. When we arrived at their hut, I was amazed at the trouble they’d gone to; all of the food was displayed so nicely. I was truly touched by the gesture.

They even went as far as to hire a local musician to play music while we ate. As we listened to him play his instrument some of the ANA soldiers got up and left the room. They returned shortly with their own “instrument”; an old wound irrigation bowl and a lid to the sterilization kit that we’d thrown away in the clinic. They had taken those pieces of our “trash” poked some holes in the lid, tied a piece of wood and string to it and made a guitar.

They sat and played the homemade instrument with the hired musician, while one of the interpreters, Anwari, turned over a water cooler and made it into a make-shift drum. They laughed and played the music while others got up and danced. It was nice to sit and laugh with them as they sang and danced. I would never forget them and how they touched my life.

The next day was to be our last day on the firebase. I was looking forward to a month back at Bagram to unwind prior to going home. I was excited, yet found myself having trouble believing it was truly over. Surely something would happen to ruin it, right? As I lay down to sleep that night tears of mixed emotions streamed down my face. I prayed to God for our flight to go as planned, and to actually leave the scariest place I’d ever been within the next forty-eight hours.