Sunday, April 15, 2007
Staff photo by Shawn Patrick Ouellette
Capt. Brian Landry of Turner, who runs the patient administration department at COB Speicher's Combat Support Hospital, remembers in particular four burn patients. They were Iraqi policemen wounded by an IED. Two died.
Staff photo by Shawn Patrick Ouellette
Spc. Jesse Burke, a 25-year-old from Fryeburg, worries about how his experience in Tikrit will affect him when he gets back home. "I feel like I won't think about it -- but I don't know."
Staff photo by Shawn Patrick Ouellette
Sgt. Brandan Gerry remembers an Iraqi family that lost three of eight children, including one in utero, to an IED explosion. His wife, Spc. Jossary Gerry, admired a soldier she called "Sgt. Gator," who was determined to return to his "guys."
Staff photo by Shawn Patrick Ouellette
Maj. Sherryl Kempton of New Sharon holds one of the teddy bears she gives to patients who come through the Army Reserve's 399th Combat Support Hospital. Her unforgettable patient was a soldier suffering not from wounds, but cancer.
Staff photo by Shawn Patrick Ouellette
Spc. James Elliott recalls the death of one young soldier with a head wound the staff could not treat, and the pictures of the man's wife and three children. "We wrapped him up in the body bag," he said, "and left one arm out so his friends could hold his hand."
TIKRIT, Iraq - The motto, written in block red letters, sits atop the patient tracking board inside the 399th Combat Support Hospital's patient administration department.
It says, "Get 'em in. Get 'em out." If it sounds a tad impersonal, its intent is anything but.
"What it means is that we want to get them in here as soon as possible to start care for them," said Capt. Brian Landry, 32, of Turner, who runs the department. "But we also want to get them out as fast as possible to get them to a higher level of care."
In other words, many patients don't stay here long -- particularly American soldiers who often end up in a stateside military hospital within two or three days of being wounded. Iraqi soldiers and civilians have no such "echelon of care," Landry said, and thus tend to stay longer.
But however long they stay, as the ambulances and helicopters bearing wounded arrive day after day, week after week, month after month, it soon becomes impossible for the 399th's staff at this hospital, which includes 24 Mainers, to remember each patient.
Over time, the snapshots of trauma since the 399th arrived here at Contingency Operating Base Speicher last September have blurred into a montage of blood, fractured bones, severe burns, scissors cutting through clothes and sprints to one of the hospital's two operating rooms.
But then there's "the patient." That one person who, for reasons even the soldiers can't easily explain, will stay in their minds forever.
Ask almost anyone here about "the one you can't forget." They'll nod knowingly, stop what they're doing and, sometimes with tears in their eyes, tell the story as if it happened only yesterday.
"Mine were four burn victims," said Landry, whose department is charged with removing all personal items from patients the moment they enter the emergency medical treatment unit. "They were all Iraqi police and they got hit by an IED (improvised explosive device)."
The bomb had been set alongside a volatile "accelerant," Landry said. "It can be anything -- gasoline, kerosene. It's basically stuff that sticks to you and burns a lot longer."
One of the police officers died soon after his arrival. Another was "expectant," meaning he, too, would not survive.
"All we could do was make him comfortable, but we knew he wasn't going to make it," Landry said. "You try to keep him stable and comfortable."
The two other Iraqis survived.
So why can't Landry forget them?
"The smell," he replied. "It's a very unique smell when you have a burn patient. You don't forget it."
Spc. Jesse Burke, 25, of Fryeburg, knows the feeling. As a radiology technician, one of his jobs is to rush to the emergency room when a trauma patient arrives and take internal pictures with his portable X-ray machine. Usually, the patient is on his back -- the optimal position for an abdominal X-ray. But two months ago, a middle-aged U.S. soldier came in on his stomach.
"He had burns all over his back," Burke recalled. "And I had to wait until they could put enough drugs into him so they could roll him onto his back."
It wasn't the delay that bothered Burke. It was the soldier's screams.
"It was probably the worst screaming I've ever heard in my life," Burke said. "It was heart-wrenching to hear him. It was almost like I could feel his pain. The way he was screaming, you knew he was in a lot of pain."
Burke's experience here has taught him that the "war fighters" -- U.S. soldiers who patrol outside the protective wire of COB Speicher -- are a tough bunch.
"One guy walked in one day holding his own IV bag that his medic gave him," Burke recalled. "He's saying, 'Yeah, I need to get seen. I got shot today.'"
All the more reason to wince when a soldier is in real agony. And all the more reason to remember.
"I worry about when I get home, how it's going to affect me, if I'm going to think about it a lot," said Burke, who hopes to find work at a hospital. "I feel like I won't think about it -- but I don't know."
Sgt. Brandan Gerry and Spc. Jossary Gerry, a married couple who work as respiratory therapists both here and at Maine Medical Center, have two sets of memories that will follow them back to their home in Standish.
For Brandan, 28, it's the family of Iraqis that was hit by an IED last fall. Two of the seven children died instantly. The other five were severely injured, as were both parents.
And the mother was nine months pregnant.
"We took her in the OR (operating room) for a Caesarean section," Brandan said. "But the baby didn't make it."
There was no time to reflect on the young life that ended before it had a chance to begin. The mother still needed treatment, as did the father and the five children -- all of whom survived and soon were transferred to an Air Force hospital in Balad.
Brandan let out a long sigh. He can still see the frightened, injured children, desperate to be with their parents.
"That was a helluva night," he said.
Jossary Gerry, 23, will never forget "Sgt. Gator."
"He was from Florida, and he loved the Florida Gators," Jossary explained with a smile.
The sergeant had severe chemical burns on his back and hands from an IED. But his airway was fine, freeing Jossary to comfort him and keep him awake while doctors and nurses administered morphine and worked on his burns.
"We talked about his kids. We talked about his family back home," she said, smiling again.
Then Jossary turned serious.
"You know, we're here (inside COB Speicher). We're pretty safe," she said.
"But these guys go outside the wire every day. And the thing that impressed me the most was that Sgt. Gator didn't want to go home. All he wanted to do was make sure we got him taken care of, stable enough so that he could go back with his unit."
Jossary remembers gently advising the sergeant that he had a long journey ahead, that burns like his take time to heal. He'd need to be patient, she told him.
He understood all that. But still, he wasn't satisfied.
"Ma'am," he replied, "just make sure I get back to my guys."
At 60, Maj. Sherryl Kempton of New Sharon is a mother figure not only to the young Mainers here -- they call her "Mama" -- but also to the 20-something soldiers who show up daily at her acute-care clinic.
"He was 21, maybe," Kempton replied when asked if she has "a patient." The young soldier was a sniper, meaning long nights spent out in dangerous areas trying to see and not be seen. And, when he showed up at Kempton's clinic a few months ago, he was dog-tired.
"He blamed it on being up all night with his job," Kempton said.
But Kempton's seasoned nurse practitioner's eye quickly spotted the swollen lymph nodes in the soldier's neck. Off he went to the doctors and then to radiology for a CT scan.
The eventual diagnosis: Hodgkin's lymphoma.
"I can still see his face," Kempton said. "He was so strong when we told him. So calm."
The soldier was evacuated to the Army's Landstuhl Regional Medical Center in Germany, and then on to Walter Reed Army Medical Center in Washington, D.C.
"I don't know what happened after that," Kempton said. "That's the hardest thing -- not knowing what happens to them after they leave here."
She paused as soldiers, some young enough to be her grandchildren, came and went around the 399th.
"You don't expect to be seeing kids with cancer over here. You just don't expect that," Kempton said. "So thank God for us, huh?"
Not all patients depart to such state-of-the-art treatment.
Memories of a less fortunate bombing victim still keep Spc. Tim Verreault, 30, of Auburn awake at night.
"A poor Iraqi lady," Verreault said. "She was burned. She was infected. Her trach was infected. Her skin grafts weren't taking. She had no more sites to take skin from to cover the burns."
The woman had been transferred here from another combat support hospital. The 399th's job was to stabilize her and pass her on to the Iraqi medical system -- in these parts, the under-equipped Tikrit Teaching Hospital.
"She was basically going there to die," Verreault said. "And this poor girl -- her eyes were so expressive. She would communicate with us through blinking -- one for yes, two for no. We were managing her pain and just trying to keep her comfortable -- we had her for, I don't know, maybe a week or so."
The day finally came for the young woman to leave. Verreault helped pack her into the ambulance.
"Watching her eyes looking out at us -- that's one that's going to haunt me for a long time," Verreault said quietly. "Knowing we sent her out to die where she might not have faced that if she was an American."
Then there's the one case everyone in the 399th knows about, but few can talk about.
"He was a U.S. soldier," said Spc. James Elliott, 25, of Bangor, who works in the hospital's emergency medical treatment unit. "He came by Chinook (helicopter) and the medic who was with him was covered from head to toe with blood."
The 23-year-old soldier had a massive wound on the right side of his head from a roadside bomb. Elliott began working on him, looked at the medic and asked, "Are you hurt, too?"
"No," the medic replied. "It's his blood."
Outside the Army Reserve, Elliott attends nursing school at the University of Maine. There, he once learned about "agonal respiration," the body's last-ditch attempt to take in air just before death.
"I'd never actually heard it before that day," Elliott said. "And it was pretty horrific."
It was a no-win situation: The soldier needed a neurosurgeon, which the 399th doesn't have. Nor was he stable enough to be evacuated to the Air Force hospital at Balad, where all neck and head traumas are treated.
"He'd lost so much blood that we put blood products in -- and all the blood products just came out the back of his head," Elliott said. "So the doctor said there's nothing we can do for him. They gave him some pain medicine and we all just kind of stepped back and let him go."
Elliott paused to compose himself.
"We closed the curtains around him, washed his body, wrapped his head up as much as we could," he continued. "We tried to leave one eye open so when his friends came in, they could see him."
Friends from his unit, based here at COB Speicher, did come.
"Then we wrapped him up in the body bag and left one arm out so his friends could hold his hand," Elliott said. "We wheeled him over to the chapel and his unit came over and saw him. Then we wheeled him out to the front of the hospital."
An alert had gone out to the 399th's entire 217-member staff.
As the covered gurney approached the base mortuary vehicle, the doctors, nurses, technicians and support personnel stood in a large circle. Simultaneously, they raised their hands in final salute.
"Then we put him in the back of the mortuary vehicle and watched as it drove off," Elliott said. "It was a bad day."
Inside the hospital, soldiers gathered their fallen comrade's belongings.
Someone opened his wallet. Staring back at them, all smiles, were the young man's wife and three little children.
"I'm going to remember that for the rest of my life," Elliott said.
It will be five more months before the 399th packs up and comes home. More helicopters will land, more ambulances will speed down the access road in a cloud of desert dust.
And while one war goes on outside the wire, a quieter, equally challenging one plays out here each day.
Most lives are saved. A few are lost. And memories -- to the extent that it's possible -- are held at bay.
Spc. Burke, the-25-year-old radiology technician, spoke for all when he reflected this week on all that's happened here -- and all that still awaits the 399th.
"Seeing all this stuff can blow your mind," Burke said. "We're seeing things that people aren't supposed to see."
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