We are approaching day 30, one-third of the way through the tour. I am stationed at Al Asad in Anbar province, which is in the western desert of Iraq. It is a large base that supports several forward operating bases throughout the western part of the country.
My departure on Jan. 26th was emotional — the Blue Star Mothers arranged a surprise send-off for me and were at the airport pre-dawn with a group of supporters. They presented my mom with a Blue Star flag.
First stop was Fort Benning, Ga., for in-processing. For the first time, the harsh reality of this adventure sank in — the briefs on improvised explosive devices (IEDs) made the hair on the back of my neck stand up. It’s amazing how many ways the insurgents have found to turn ordinary looking items into deadly weapons, and how many ways they have developed to detonate them. Casualties from IEDs are the greatest threat right now.
Next was 20 hours of flying to get to Kuwait, where the clock started for my 90-day tour.
We spent another five days reviewing what we did at Fort Benning. (You know the Army, if they don’t tell you the same thing at least three times, they haven’t told you.) But I was glad to get another briefing on IEDs.
Finally, I got to my duty station at Al Asad. I am working in a combat support hospital as the chief of emergency services. We have an emergency room with trauma capabilities. Fortunately, it is fairly slow in the ER, which means the good guys aren’t getting hurt. We see a fair number of minor-moderate illnesses and injuries, which is fine.
The Army Medical Department’s motto is "To Conserve the Fighting Strength," so getting these troops with minor-moderate ailments back into the fight is priority No. 1. We also see quite a few civilians and Iraqi army, which is all part of the mission to "win the hearts and minds."
But we have had some major trauma as well. Feb. 21 was a terrible day. We received a radio report that the medevac was inbound with a Marine who sustained a gunshot wound to the chest.
We got our team ready and were waiting for his arrival. Then we got word from the helicopter that they were five minutes out and they just lost a pulse. I felt my heart drop. As soon as they landed and we got him inside we worked him hard. We did things that would have been considered heroic and "last-ditch" efforts in the States, but we decided before he arrived that we would do everything humanly possible.
Unfortunately, we couldn’t save him. I was crushed. This 20-year-old kid looked like he could have been on the Marine Corps recruiting poster: rugged face, chiseled body, blond hair. You could just tell he was a Marine’s Marine. The entire ER staff became somber and sullen. Without a word, the charge nurse and two of my young medics began to clean the body to remove the blood and grime. Then, without anyone saying anything, these two medics spontaneously carefully draped the body with an American flag and took up positions at the foot of the gurney, standing at parade rest — "never leave a fallen comrade" — until the mortuary affairs team came to retrieve the remains.
I was never, simultaneously, more proud and heartsick — proud of my medics and their actions, yet heartsick over the loss of this Marine. He was the first combat trauma that we received since our arrival in theater, and we lost him. His face and name are etched in my brain forever. I have lost many patients in the ER back home, but this one was different. And it affected me much more than any other patient I have lost.
About 30 minutes after we finished that case, we received another call that we were getting a detainee who was shot. Incredible, I thought to myself, we just lost a Marine to insurgent actions, and now they are bringing us an insurgent.
He sustained a gunshot wound to the buttock that went into his abdomen and required surgery. From the time he hit the ER door until the time he was in the OR was 20 minutes — a feat that many U.S. hospitals cannot achieve. He survived, and was nursed back to health by the fabulous nursing staff and then sent to the detainee facility. We learned later that he was from a separate incident where he and three other insurgents were placing IEDs. His comrades were killed.
A few days later, we had a mini-mass casualty incident when a building collapse from poor construction resulted in five Iraqi army casualties. One was dead at the scene from head trauma, and the other four were brought to us. Most of the injuries were broken bones, but there were some abdominal organ injuries as well. They have all done well.
On the personal side, it is tough being away from the family, as you can well imagine. Especially my 10-year-old son — he started playing lacrosse this year and I helped coach before I left, but the season will probably be over by the time I get home. Internet access is pretty good, so I am able to e-mail with them and I get to call every so often.
Things have settled into a routine, as much as that is possible. There is not a whole lot to do when you are off shift, although I am on call 24-7 for trauma.
I am hoping to start flying with the medevac crews shortly. My secondary military occupational specialty is as a flight surgeon, so I would like to get outside the wire and fly a little while I am here.
We are succeeding in our goals for the Iraqi people. Unfortunately, only the violence is covered in the media and not the humanitarian progress that is being made. Many of the workers on the base are Iraqi nationals, and they are very grateful that we are here and have liberated their country. They are constantly expressing their gratitude.
Our troops are remarkable, which is something I have always felt, but have now seen. They believe in the mission and morale is high. There is no griping or complaining. They are the consummate professionals, just getting the job done.Editor’s note: Army Reserve Col. Joe Heck is an emergency room physician from Henderson who left McCarran International Airport on Jan. 25 for deployment in Iraq. In civilian life, he also is a Republican state senator. Here is the first of a series of dispatches on his experience with the 325th Command Support Hospital in Anbar province.