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Authors: Dave Hnida

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“I don't think we need to call a mascal until we get more info—sounds like it's a question mark if we're even getting anybody.” Mascal stood for mass casualties, a situation that required all hands report to the hospital.

“I know, but you know what fifteen wounded would do to this place if they all fall out of the sky at once.”

“Agree. But let's wait a couple,” he answered.

So we sat and squirmed. The Styrofoam containers with our lunches got tossed into big plastic trashcans and some of the medics started to make up the trauma bays—putting out IVs and trauma packs. Nervous stomachs and anxious bladders sent a few off to the latrine. The slow tick of the wall clock could be heard above the low growl of small talk in the room.

The door swung back open.

“Number now at fourteen. Destination unknown. Could be us, Balad, or Baghdad, or none of the above. There's a lot of chatter on the line. But they're starting to move some people out.”

I walked over to Roger.

“I think maybe the compromise is a heads-up. No one needs to come over but it might be a good idea to just let people know there's a possibility. Maybe hold off a nap or a workout for the next half hour.”

Roger slowly nodded. “Okay. I'll put out pages to everyone. Tell them NOT to come, but there is a small chance we could be real busy soon. But let's play it safe and let them know we'll page them again when we hear more.”

The surgeons, backup docs, respiratory therapists, nursing staff, X-ray, lab, adminsitrators all got paged to be available. The text on the
pager was clear:
Potential mascal. Do not come. Repeat, do not come. Expect zero to fourteen patients. Further info to follow.

The clock continued to tick slower than our hearts. I realized I was in a T-shirt with a joke nametag. The tape that said “Dr. Fran-kenstein” got crumpled and tossed in the trash.

Ten long minutes passed when the doors finally banged open again.

“Stand down. No casualties coming our way.”

Roger quickly sent out a page telling everyone to relax. But within minutes, a three-man parade of stooges began.

One by one, the administrators marched in. Each red-faced and spewing venom. Their separate speeches had the subtlety and tact of a hand grenade.

“What the hell are you people doing! You can't scare the hell out of everyone for something that's not going to happen.”

Followed by: “Are you people stupid or something? You don't call a mascal when no one comes. You're wasting my time.”

Followed by: “I can't believe what just happened. You page every goddamn person in this place for something that's not happening. We came running over from lunch because of these pages. You better get some counseling on why and when to page personnel.”

A few poison stares came my way, but most of the hatred was pointed at Roger. He sputtered out a few words of reason, but I think he was caught off guard by the viciousness of the attacks. The diatribes only lasted a few minutes, but each violated a cardinal rule of command: never embarrass an officer in front of his troops. And Roger went down hard in front of a large group of medics and nurses. I sat by quietly—too quietly—as the scenes played out. I should have stuck up for Roger—after all, I was the one afraid of a deluge of wounded, but failed him by staying silent.

As the last screamer left, I meandered over to Roger and asked if he'd step outside for a second.

The wind was starting to whip up, the tongue of fire sandblasting
our faces as I apologized.

“I should have spoken up. It was me who asked you to page everyone. I just don't understand why they went nuts—it was only a heads-up.”

The Zen-like officer gave me a serene look.

“We did the right thing. You know, Jack Twomey would have done it, too. One thing he taught me was to drill and be ready. And never take chances with the troops. If it was his son coming in, he'd say we did right.”

“What do you mean?”

“Jack's son is a marine. And he's here in country right now. Heaven help us if his kid ever came in, but we'd be ready because Jack has been saying since we got here that we
had better
be ready in case
his
kid ever does come through the door. That's why we were ready today. If it wasn't his kid, it was someone else's kid. So screw those guys—they don't know anything about patients.”

Now things made sense. Jack Twomey was a quiet man—often quiet to a point where at times I felt uncomfortable. But if I were in his boots, I'd be quiet and serious, too. Unlike those who sat and worried at home thousands of miles away from their child in the war, Jack was right next door, and it would be horrible to be notified that your son had been wounded by personally seeing his face lolling on a stretcher. Christ, he must swallow his heart every time the radio squawks.

Roger's words and demeanor lowered my temperature a few degrees and the steam from my ears slowly dissipated into the desert heat. But I was still pissed at the Three Stooges who had yelled at us, and wondered if there was a path down the road to payback for Moe, Larry, and Curly. I didn't need to worry about getting my hands dirty, though. As I walked back into the ER, one of the medics pulled me aside and said, “Don't you worry, sir. Those guys have been dicks all year, and a bunch of us figure it's time to have a little fun. You watch, sir.”

I sighed and shook my head—sometimes you wondered which side of the war some of the administrators were on. I'd step back and
let medic-karma take its course.

At the stroke of seven, Mike marched in to take over the reins. I grabbed my weapon from the lockbox and headed to dinner. The bulk of the group was already there but mostly quiet, with little of the usual mealtime banter. Last week was a bugger; this week hadn't started any easier. Everyone looked tired. Our mood was further soured by the news that some of our friends, active duty doctors from the 82nd Airborne, had just been told to unpack their bags. Originally slated to head home in a few weeks, the group's homecoming was now delayed to October. Another twelve-month deployment extended to fifteen. The stress on the troops was reaching epic proportions.

We took a nighttime walk back to the hospital to check e-mail and give a quick call home. All quiet on that front. As we felt our darkened way across the gravel back to barracks, Rick said, “You know, I didn't think you could do it. Looks like I owe you twenty bucks.”

“Keep it,” I said. “There's nothing to spend it on, anyway.” I think I had gone through a whole $4.32 at the PX since we arrived, mainly on shaving cream and deodorant. “You can buy me a beer when we get home.”

Two tired men made their way up the stairs that night. I'd flip a movie into my computer and Rick would read another book. At least until I snuck down a flight of stairs at five minutes to twelve. I banged on Rick's plywood door like the barracks were on fire, and then hid around the corner. When he barged out of his room in bare feet, he never saw the slippery tray of onion-filled foods I had retrieved from the trashcan in the ER. He slipped and slid like a man doing a drunken jig.

“Shit. Bastard. Damn. I'm going to kill you, asshole.”

I just calmly turned and walked down the dimly lit hallway.

“Hey, Oklahoma boy. Watch your mouth, it's still Sunday. But I gotta admit, I do love the way you dance, honey.”

As his scowl melted into a grin, I tossed him a final good night.

“Sleep well, onion-head.”

13
DANTE'S INFIRMARY

(They picked him up in the grass where he had lain two days
in the rain with a piece of shrapnel in his lungs.)

COME to me only with playthings now …

A picture of a singing woman with blue eyes

Standing at a fence of hollyhocks, poppies and sunflowers …

Or an old man I remember sitting with children telling stories

Of days that never happened anywhere in the world …

A
FRIEND FROM MY
Reserve unit back home e-mailed me a poem from Carl Sandburg the week before. It was written during World War I and described a soldier who was wounded, taken to a field hospital … then dreamed of only beautiful and peaceful things as he awaited surgery and transport home. It's called “Murmurings in a Field Hospital.”

The poem made me think of how frightened the wounded were when they came in—you could always see it in their eyes—as well as how frightened we were to take care of the wounded. I wondered if they could see it in our eyes. I wondered if they heard the murmurings in a combat hospital, like we did.

As I read the e-mail, I was scraping small bits of flesh off my pants legs near my ankles and getting ready to pour a bottle of peroxide on my boots to dissolve away the bloodstains. Even when clean, I
wondered how much gore, and memories of gore, I would bring home with me.

I was finally at a point where I wasn't too worried about my skills, whether it was caring for a guy whose limbs had been shredded or whose eardrums were ruptured and bleeding thanks to an IED. But when done … Jesus. You were forced to watch a mental rerun of your every move and decision, and your movie snack wasn't popcorn, instead an overflowing tub of adrenaline-soaked fear.

The night before, I thought a lot about breathing, not a subject I would even consider worthy of a fleeting thought back home. A gunshot wound made me think about all the ways we talked about “a breath.” You take one, you lose one, steal one, hold one, waste one, save one, run out of … the combinations went on and on. And those combinations dominated a corner of my mind as I watched a young soldier heave for air after being shot. As I did my exam, I couldn't shake the thought of what his lungs were trying to do. A simple act that we don't think very much about. Yet for this kid, I prayed he'd take another. And another. And another. And he did.

Funny, I don't think my heart started galloping, at least to where I noticed it, until I sat down after the case had been handed off to one of the surgeons. Did I do well? Did I screw anything up? In most circumstances, I would never know. In fact, a good outcome was when we saved a soldier and shipped him out within twenty-four hours—never to hear about him again. I was just one blurred face in a bustling mix of people who would care for him over the next months or years. I had simply been one of the first, and probably one of the forgotten. But I could live with that—as long as he lived long enough to have a chance to forget me.

The wounds of this war were certainly vicious, but no worse than the ones my father witnessed, or the ones suffered by the soldier who lay in a field for two days during World War I, or for that matter, any war since someone decided to invent war.

I knew people back home saw and heard about the deaths and the
wounds, but on a screen or in writing it was all sanitized and sterile. Just numbers. Statistics often selfishly used, by some, for political arguments about the rights or wrongs of this war. They didn't see, feel, or smell what a broken body is like up close and personal. And they didn't have to make the decisions we did. Save the arm? Save the leg? Save the soldier?

We had only seconds to decide what would define the rest of someone's life, and in turn, the lives of the loved ones who would care for them. With all of the advances in military medicine, we played by a new set of rules, and with them came a new set of dilemmas. We saw soldiers who would have quickly died on the battlefield in wars past; in Iraq they came to us maimed, blinded, or with traumatic brain injuries. Save them with their horrific injuries or let them die peacefully? For us, the dilemma was no dilemma: the unspoken rule was save them every time. And we would work ourselves to the grave if it meant getting them home to family.

As for the war itself, we didn't have arguments or discussions. There was no desire, or for that matter, energy. We were too busy trying not to slip and fall in the bloody puddles on the floor. And when our workdays were done, we sat together like a family at dinner and talked about beautiful and peaceful things. Two months into our time here at Dante's Infirmary, and there hadn't been one single hot word between us. We often would speak of family, baseball, a frosty cold beer spilling over the lip of a tall glass.
Bring us playthings
. We were wounded by what we did and what we saw.

But no more than those we cared for. A few days before, I was talking to a grimy sergeant who accompanied a wounded soldier from a firefight in Baquba. I looked at his arms and legs and realized he had tourniquets loosely in place around all four limbs. So did the rest of his squad.

“Doc, we know we're going to get hit one of these days. Better to have the tourniquets on ahead of time. All we've got to do is tighten
them up if something bad happens.”

He chuckles grimly. “Might save you some work, sir.”

This kid was a war machine who lived by the
Be Prepared
credo of a Boy Scout.

All I could do was shake my head at him, and at the others. Many others.

There was a group we'd come to know well on the night shift. We called them our “frequent fliers.” It seemed like they came in at least once a week after being blown up. They were a convoy security team who weaved in and out of slow-moving trains of supply trucks. The team had high-tech equipment to detect roadside bombs—maybe that's what kept them from hitting the big ones—but it seemed like they had hit more than their share of little ones lately. One guy had been in six times within the last month, three times within the last ten days. Not a scratch, just nagging headaches.

“Buddy, you are an IED magnet. Ever thought about taking a little break?”

“No can do, Doc. Not enough people. Can't stay home while the rest are riding the roads.”

“One more visit and you've got enough points for an upgrade to first class and a nicer stretcher.”

We gently touched each other on our sleeves and said no more.

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