5 Things You Learn At A Hospital In An Active Warzone
War, huh. What is it good for?
Fucking people up, for one. It's super good at that. And where there are war zones, there are hospitals full of hardworking people putting those victims back together. What you may not have realized is that medicine often doesn't discriminate -- these guys will stitch together comrades, enemies, and civilians all in the same shift. That right there can make for some awkward goddamned moments.
We talked to "Jim," a mental health specialist, and "Sara", a medic in Camp Bucca Iraq. We also spoke with "Bill," a nurse in Afghanistan. They said ...
It's Their Job To Make The Enemy Feel Better
Ronald Bucca was a New York City Fire Department marshal who died on 9/11, after running into one of the towers and climbing all the way up to the blazing impact site on the 78th floor. For some reason, the military decided to honor his memory by naming a prison camp in Iraq after him. Tens of thousands of insurgents and suspected insurgents, including the current leader of ISIS and most of his top men, spent time at Camp Bucca.
Like the state pen and prison gangs, but on an international scale.
Jimothy McFakename (Note: Not his real name) was a mental health specialist at Camp Bucca: He took 19 weeks of specialized training to be able to help counsel his fellow soldiers ... and also, any insurgents the U.S. military captured. Yes, a big part of Jim's job was providing therapy to the enemy. So it's theoretically possible, albeit unlikely, that Jim was at one point the official government-mandated shoulder-to-cry-on for Abu Bakr al-Baghdadi.
So, what kind of patients did Jim deal with on a day-to-day basis? "We had a guy who got his arms blown off once trying to plant an IED [improvised explosive device] not far outside the prison. He'd actually been released from there recently. ... [He had] wired his personal telephone up to the IED he was planting when someone called him. Blew off the side of his head, a chunk of his shoulder, and both his arms, and he lived." It became Jim's job to talk to his guy, to try to lift his spirits. "He was suicidal due to him failing to kill any of us. I literally had to hold back the laughter as he wild waved his stumps around while my interpreter informed me he was demanding to be released or he would kill himself."
If you want to be taken seriously, maybe don't act like a Monty Python character.
Suicidal thoughts were a fairly common complaint among the visitors to Camp Bucca. Sometimes they were despondent over the state of their lives (a guy usually doesn't wind up there because his life has been a string of unbridled successes) or were afraid they would be locked up with a member of a rival sect. "They would rather die than suffer at the hands of their enemies. Hence the one guy who managed to get a hold of a pencil and gouge both of his eyes out to keep from going into a rival compound," Jim says.
For others, he says, a suicidal cry for help was just a strategy. "A majority of my detainee patients [faked being suicidal] in hopes of being released or getting special treatment or just a change of scenery for a day or two."
They Counseled Insurgents Next To The Men They Wounded
War zones are notably lacking in functional, well-staffed hospitals. So when, say, a U.S. Marine and an insurgent are horrifically wounded in the same firefight, there's a good chance they'll both wind up in the same place. So sometimes Jim would get called in to counsel some depressed insurgent next to a man the insurgent had blown up. "We were supposed to go out and try to be compassionate to these people, make a 'positive difference in their lives.' That's admirable and all, but it was a little beyond me. But I figured ... I'm here, so I might as well do what I'm here to do. I tried. I really did," he says. "On one occasion I wound up counseling a wounded American infantryman with no lower extremities -- he'd lost them in an attack. And while I was gently introducing him to this new fact about his life, one of the insurgents responsible for the attack was across the room in another bed. They were only separated by a sheet. That guy wanted to talk, too. I won't claim he got my best."
A little hard to work up the effort to give a hand when he took your guy's legs.
Our other source for this article, Bill Evenfakername, was a licensed practical nurse working at a detention facility in Parwan Province, Afghanistan. He points out that sick locals sometimes posed as terrorists just to get their hands on some of that sweet, sweet Western medicine:
"I had to deal with a guy who was diagnosed with Stage 4 colon cancer. He actually pretended to be a terrorist just so that he could receive treatment (that was the story the Afghan National Army told us, anyway) because he was dirt poor. He couldn't believe that there was nothing we could do about it. They have such a high opinion on what Western medicine is capable of. He was maxed out on pain killers and took an exceptionally long time to die. By the time we got him, though, the cancer was already metastasized to his liver, lungs, and brain. He thought we could cure him and was convinced we were letting him die on purpose."
Yeah, when it comes to culture shock, you really can't beat a war zone.
They Get A Close-Up View Of How Ugly -- And Weird -- Extremism Can Be
On one occasion, Bill says, he "had to observe a man who had tied a plastic bag around his scrotum and penis and tied it off with string. ... Honestly, I have no idea why 'numb nutz' (as I called him from that point forward) tied his junk up with string and a plastic bag. From what I gathered from the translator, the guy was tired of having to clean himself after taking a piss, which is a custom in the Muslim faith, so he tied his junk up to prevent any dripping."
"OK, for you I'll give my best counseling."
Huh, that's ... not where we thought that story was going. Many of Sara's patients were, well, less amusing. She sometimes wound up "shooting the shit" with violent radicals, asking one man, "What would you do if your sister went to the market by herself to buy fruit?" He responded, "I'd probably cut her legs off." Sarah says, "Just matter-of-fact. His family strongly believed a female had to have an escort, and that's how he'd treat his sister."
And he was saying that to a female who was in the process of treating him. Yeah, the kind of guys who wound up in a POW camp didn't tend to be on the more moderate end of the faith. "When they came in, they had two armed guards and were blindfolded and shackled. They were some of the scariest-looking people. When you took their mask off to put them to sleep, the look they gave you as a woman caring for them ... I had a lot of those people give me looks of death."
She's not your sister. You come near her feet, she'll break them off in your ass.
We asked her what precautions you take when getting fist-deep in the butt of a high-ranking Al Qaeda operative. "You take your rank, name tape off -- the people working in our hospital, housekeepers, would hide. They didn't want these people recognizing them."
Keep in mind, one of the big problems inside the detention facility was detainees attempting to murder each other -- and sometimes succeeding. According to Jim, they called them "blanket babies." He explains: "Fights would break out or someone would feel insulted and would murder the other 'tainer (our slang for 'detainee'). They would then pile the body onto a blanket and drag it up to the fence and act like they had no idea what happened. No evidence, no witnesses, no convictions. Or while they were trying to tunnel out to escape they would dig a side tunnel and stash bodies. We'd find them after the tunnels were discovered or collapsed, and we'd dig them up. There was no real middle ground. If someone was angry enough to punch you in the face, they usually jumped to slitting your throat."
Sadly, they never discovered any ice cream or candy tunnels.
Like inmates everywhere, the prisoners of Camp Bucca eventually figured the rules out well enough to exploit the shit out of them. "As an act of compassion, guards were at times ordered to transfer 'tainers to different compounds if they had family members there," Jim says. "Well, if Timmy the 'tainer from Compound 15 found out someone he had a beef with was in Compound 28, he would work out a way of getting someone in 28 to vouch for him and get him transferred.
"We had a guy that found out the sniper that killed his brother was in another compound. He notified some friends via chai-mail (they made rocks out of their tea and attached notes to them, then threw them into adjacent compounds, or at our faces) and had the guy killed. He was stabbed hundreds of times, his arms were broken and sliced open, the bones removed, and his trigger fingers were also removed," Jim says.
It's An Incredibly Busy Hospital That Sometimes Explodes
As we mentioned, Sara worked as a medic in Camp Bucca's trauma ward. As you might have guessed, there is stress involved in that job. "It was one of the most fast-paced work environments I've ever been in. You get a call that a trauma is coming in, and they have to coordinate pick-up by helicopter. If they're close enough to the hospital they just haul ass to the facility, 1.5 miles each way was the green zone. So everything outside was a combat zone. So these guys would get into a firefight or blown up. ... Once you get that call, it's just coordination between a surgeon, the medics downstairs. ... My first case I thought it was insane. After 1.5 weeks there, you get used to it and you kinda live off of that adrenaline," she says.
Most of what Sara dealt with were bomb victims. "Ninety percent of cases were IED blasts. Lot of shrapnel wounds. They were the worst wounds, because ... when it blows up it sends pieces of metal into the person, so a small hole on the outside wreaks havoc on the body. You put in a lot of time X-raying, trying to stop the bleeding. It was just devastating."
And when you're done you get to clean it up.
She continues: "By the end of the year into the spring, we started seeing EFP, explosively formed penetrators -- they put them in barrels, copper on top, explosive charge through a ball of molten copper. They hit the trucks a lot. But the armor wouldn't stop the copper. So even the Bradleys, pretty tough vehicles, or the MRAPS, it'd go through them like butter. And when it hit a soldier ... it would take everything off, rip an entire arm or a leg off. That was a lot easier than spending eight hours digging around in someone's stomach. But it was a lot more stressful for the soldier."
Medics still have nightmares every time they see a penny.
And on top of all that, Sara was regularly being shelled while trying to, y'know, perform fucking medicine.
"We got mortared a lot. Whether it was close or not it's still pretty scary. Alarms go off to let you know one's got up. We got shelled on my first day there. I was walking home from dinner. The mortar alarm went off. I was walking back ... and I hear it. And these guys pull me into this bunker like, 'What the hell are you doing?'"
They Also Treat Wounded Civilians, And It's Horrifying
Obviously, American soldiers and insurgents opposing them aren't the only people who get/got killed/horribly wounded in Iraq/Afghanistan. Some estimates say more than a million people have died in Iraq since the invasion (5 percent of the population) and more than 220,000 people in Afghanistan, most of them civilians. Regardless of whether or not you agree with the wars, on the ground, it is a shitstorm of human misery. Our sources saw it up close. "The hospital wasn't supposed to serve the local Iraqis," Jim says, "but the physician in charge basically said, 'Fuck that, of course we're going to treat these people.'"
"Let's just hope they're not scared about getting dragged into a prison camp."
Sara had one nightmarish example: "We had a kid that came in early in deployment. The story ... kept changing, but the one that stuck around was that her family didn't want her anymore, 10-year-old girl, so they doused her with kerosene and set her on fire. And we got her 10 days after she was set on fire. And she was still alive. But her family decided to take her to an outlying American hospital. Dunno where she was from in Iraq. Probably 85 percent third-degree burns.
"They brought her straight to the OR, and we had this great burn doctor. He and I debrided everything, shaved her hair because of the lice. We tried to scrub her as much as we could. Did surgery to relieve pressure from swelling muscle tissue. We sent her up to the ICU, and I came up after and talked to nurses a bit ... but she came back the next day and her tissue and her legs were dead. Just totally dead. So we ended up amputating her legs from the knee down. Over the course of her time in the hospital, she got better. Everyone loved her. She was really witty, and if she didn't like something ... we spoiled her. She had so many stuffed animals, Disney movies, they set up a TV for her, and she wound up being our little mascot."
That's our last amputation story, we promise.
Holy shit. So how in the hell do you live through that kind of thing, day after day? Well ...
"Suicide was a worry with a lot of the soldiers there," Jim says. "I had to talk people out of porta-shitters with a rifle in their mouth ready to pull the trigger. People got alcohol in; one civilian huffed air dusters so much he barricaded himself in his trailer and we had to cut a hole in the wall to get him out. He got sent home."
For Sara, well, it was the little things: "There were a lot of palm trees and date trees. Not a lot of grass. I remember specifically the contractors on the outpost next to us planted a patch of really soft green grass. There was no grass anywhere around us, but we just had this little patch, and I miss walking by it," she says. "That little patch of grass was my favorite thing to walk by."
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For more insider perspectives, check out 5 Harsh Truths You Learn As A Doctor In The Third World and 5 Things You Learn Hanging With The Taliban.
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