By Lennox Samuels
The young man in the gauzy yellow jumpsuit sits motionless in a
reclining chair at the edge of the ward, his knees drawn up in a
near-fetal position. His face is puffy from his wounds and he exhibits
the stillness of someone who is blind. Indeed, the thick white bandage
over his eyes seems to confirm that he is. But a second look takes in a
light-brown leather strap that tethers him to the chair, and an
American military officer confirms that he is a detainee. There’s
nothing wrong with his eyes. The oversized bandage is there to make
sure he won’t be able to identify anyone after he is released.
Apprehended because of his actions fighting Coalition forces in Iraq
(Only captured or suspected insurgents face such restrictions), the man
is a patient at the U.S. Air Force Theater Hospital at Balad Air Base.
He is an emblem of the facility’s policy of treating anyone, friend or
foe, who arrives there needing medical help. The care is world-class at
the hospital, which is renowned for its trauma treatment and the skill
of its doctors. "For us, if you’re a military physician and come to
Iraq and practice medicine, this is the Super Bowl,” says Colonel
Patrick R. Storms, commander of the 332nd Expeditionary Medical Group
and the hospital’s boss. A soldier brought to Balad, however badly
injured, has a 99 percent chance of surviving. The one percent who die
essentially are beyond saving because they have suffered extreme
traumas such as loss of brain substance. The survival rate for Iraqi
patients is 91 percent; they don't do quite as well as the Americans
because they lack the soldiers' protective gear and are unable to heal
as quickly since their bodies are often not as well nourished.
Saving lives is a reversal of roles in the building, which had a far
more sinister function during the Saddam Hussein regime. “There used to
be torture chambers in the basement, which boggled my mind,” Storms
says. “Now the place looks a lot like a hospital. We’ve kind of lost
that MASH feel.” Like the surgical hospital in the classic TV medical
drama, the Air Force facility used to be housed in tents. Now it is in
a 63,000-square-foot building outfitted with an overhead mortar
protection field – a wise addition in this area, 42 miles north of
Baghdad, where Iraqi militants regularly fire rockets and mortar onto
the sprawling base. The patients, about half of whom are Iraqi and half
American, are in the hands of a staff of 380, among them 17 surgeons.
Not surprisingly in a war zone, the hospital’s priorities are to save
lives and clear beds. American patients stay a little more than a day,
on average. “It is not unusual for someone to be in Walter Reed within
72 hours of his injury,” says Storms, referring to the Army medical
center in Washington. Iraqis typically are discharged after about six
days.
Many hospitals in the United States treat perhaps three or
four trauma patients a month. Balad handles 246 monthly, with 150
evaluated for traumatic brain injuries, from admissions totaling 500.
“Traumatic brain injuries are the signature injury of this war,” Storms
says. With suicide vests and IEDS now the favorite weapons of Iraq’s
insurgents, he and his team are seeing more and more patients with a
combination of blast and burn injuries. “There’s no parallel
stateside,” he says. “We’re talking about blast, burns, penetrating
injuries.” Among the worst cases he’s seen is one in which 23 car
bombing victims were brought in; 22 had life-threatening injuries.
Storms says 8 to 12 percent of admissions are children. “The injuries
have been horrific, devastating. Monstrous stuff, like some sniper
shooting a child through a window just because they can.” Further, he
says, while a doctor in the U.S. might remove one or two eyes in his
career, Balad physicians extract about 70 damaged eyes in each 120-day
rotation.
Reservists Lt. Colonel Peter Sorini and Lt. Colonel Jim Budny
are among the doctors on the current rotation. Both are struck by the
severity of the trauma cases. In the U.S., trauma injuries tend to be
related to events like car accidents. “It’s the depth and breadth of
the injuries you see here that’s different from back home. I don’t
think I saw a penetrating wound to the head in Montana in 10 days. Here
you see them every day,” says Sorini, of Butte. “The big question to me
is what kind of person would do this to another person,” adds Budny, of
Buffalo, N.Y. “There’s no limit to their cruelty.” On a light day,
surgeons at the Balad hospital log a total of around 20 hours in the
operating room. A heavy day pushes that number to 80 hours. Storms says
he has jammed as many as 21 patients into the emergency room at the
same time, in “a ballet of chaos.” Even with that many people, he
strives to keep the place clean, making sure no blood or drip
accumulates on the floor “so the next casualty coming in has no idea
there were casualties before. That’s good for morale. “
The hospital was completed last July, with the medical staff
working through construction. “We didn’t say 'stop the battle,'” says
Storms, a doctor of gastroenterology and aerospace medicine. The
hospital is known for neurosurgery; treating head and neck as well as
ear, nose and throat cases; and for oral and face reconstruction. It
also handles general surgery, internal medicine and a range of other
maladies. But it is best know for its trauma work. Most trauma patients
arrive by helicopter and are on an operating table within 30 minutes.
Wounded troops are rushed from the landing pad to the OR, passing along
“Heroes Highway” through a tent whose ceiling is a large American flag.
“They’re on their backs and they look up and see the flag and know
they’re in good hands,” Storms explains.
In the intensive care unit, a GI sleeps in a bed, recovering
from a gunshot wound to the chest. An Iraqi man in his 30s is in
isolation, injured in his stomach and arm by an IED. A one-year-old
Iraqi boy is receiving a skin graft, his donor arm still attached to
his face. He bit into an electrical cord and was grievously injured.
Capt. Brian Caldwell, of the 4th Brigade, 2nd Infantry Division, lies
in a bed nearby, awake but slightly groggy. He had been walking at
Forward Operating Base Warhorse when an IED exploded. “They threw me in
a vehicle and brought me here,” he says. “All I remember is reading the
word ‘Phillips’ – on some kind of CAT Scan.” Caldwell appears to have
been lucky. He is being evaluated for a concussion and depending on how
he responds, will be sent either to Germany for further treatment or
back to his unit in Iraq.
Down the ward from Caldwell, a few curtained partitions over,
the Iraqi detainee doesn’t stir. People walk to and fro, paying him
little attention. “Insurgents flow through from time to time,” says
Captain Brian Caruthers, the hospital’s executive officer. “It’s great
to patch them up. They’re actually vital, in a way, because we get a
lot of information from them that helps the war effort.” Just so they
don’t expect to see their surroundings, or anyone in them.
