Paradise General: Riding the Surge at a Combat Hospital in Iraq
Format: PDF / Kindle (mobi) / ePub
In 2004, At The Age Of Forty-Eight, Dr. Dave Hnida, a family physician from Littleton, Colorado, volunteered to be deployed to Iraq and spent a tour of duty as a battalion surgeon with a combat unit. In 2007, he went back—this time as a trauma chief at one of the busiest Combat Support Hospitals (Csh) during the Surge. In an environment that was nothing less than a modern-day M*A*S*H, the doctors’ main objective was simple: Get ’em in, get ’em out. The only Csh staffed by reservists— who tended to be older, more-experienced doctors disdainful of authority—the 399th soon became a medevac destination of choice because of its high survival rate, an astounding 98 percent.
This was fast-food medicine at its best: working in a series of tents connected to the occasional run-down building, Dr. Hnida and his fellow doctors raced to keep the wounded alive until they could be airlifted out of Iraq for more extensive repairs. Here the Hippocratic Oath superseded that of the pledge to Uncle Sam; if you got the red-carpet helicopter ride, his team took care of you, no questions asked. On one stretcher there might be a critically injured American soldier while three feet away lay the insurgent, shot in the head, who planted the Ied that inflicted those wounds.
But there was levity amid the chaos. On call round-the-clock with an unrelenting caseload, the doctors’ prescription for sanity included jokes, pranks, and misbehavior. Dr. Hnida’s deployment was filled with colorful
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
screwed the pooch on this one.” “Just stop for a minute and look at one thing. We’ve got a guy who should be dead, but he’s not. So you didn’t make any fatal errors. Just go over your protocols until you can do them in your sleep. And be the boss. It’s your ER when you are at the head of the stretcher.” “Thanks. And sorry.” “There’s nothing to be sorry about. That’s why it’s called the practice of medicine. And at least you give a shit.” With that, Twomey abruptly spun on his heels and headed
temporary control, but the bone splinters lying upon a blood-saturated sheet were a magnet to the eyes. Reciting my lessons aloud to Major Twomey, I followed the trauma protocol to the letter. A. Airway intact and open. No obstruction. B. Breathing—good breath sounds bilaterally. Trachea midline. C. Circulation—skin warm. Heart sounds are clear. Capillary filling less than two seconds. D. Deficits to neuro are none. Patient alert. Glasgow Coma Scale 15 of 15. The voice coming from my mouth
might have fifteen minutes to isolate and stop the pulsating flow of blood from multiple wounds. Take sixteen minutes and your patient dies. Someone’s brother, sister, mother, or father is gone because you were one minute too slow. Our surgeries tend to be a sprint rather than a marathon. I’m adjusting okay to life in the desert, just mainly trying to get used to the heat. We hit anywhere from 120 to 135 degrees every day. But at least it’s a dry heat. Then again so is a microwave. We’ve also
base. Our shared misery also found solace in the uniquely male world of ballbusting. The initial July 4th target was anesthesia. The tussle sounded just like the civil wars in hospitals back home: “In this corner, trying to put people to sleep while staying awake themselves: anesthesia. And in the far corner, a masked man with a sharp knife and giant ego: the surgeon. Let’s get ready to rummmmm … ble.” It was no different here; surgeons and gas passers took special pleasure slicing each other