just to let you know
They're Burned, or Blinded, or Sparring with Death
By Matthew Mcallester
Newsday
Monday 27 September 2004
The story of the military hospital where there's no escaping the horrors of the
fighting in Iraq and Afghanistan.
Landstuhl, Germany - The medical team that accompanied the soldier on the Thursday morning
flight from Iraq had worked the whole way to keep him alive, his body burned and lacerated by the fire
and metal of a roadside bomb.
They were low on oxygen by the time the green military ambulance reached the front door of the
hospital.
"Get me more O2," shouted out a visibly upset nurse, Maj. Pat Bradshaw. She had been up and
working for 28 hours, ferrying the wounded out of Iraq.
"She's stressed," said Capt. George Sakakini, a physician in charge of the team that greets the
wounded. He watched from the curbside through the early-morning drizzle, keeping an eye on his
highly trained squad of doctors, nurses and chaplains. "Someone's trying to die on her."
Full green oxygen tank in place, its contents filtering into the unconscious man's lungs, the team
lowered the soldier on his stretcher to the ground. His scorched face was a painter's palette of the
colors of pain: yellow, mauve, bright red.
In the intensive care unit, nurses quickly worked to make sure his wounds were as clean as
possible. An infection could kill him. A couple of rooms over, more nurses worked on another young
soldier, also unconscious, burned and sparring with death. Another roadside bomb victim. Dabbing
gently, they spread thick white antimicrobial cream on the raw flesh of his forearms. Twenty percent of
his body was burned.
It was an average morning at Landstuhl Regional Medical Center, which has become the American
military's museum of pain and maiming, doubt and anger. The planes from Iraq land every day,
sometimes two or three of them.
Like his staff, who brim with frustration at what they see as the irresponsible disinclination of the
American people to understand the costs of the war to thousands of American soldiers, the hospital's
chief surgeon feels that most Americans have their minds on other things.
"It is my impression that they're not thinking about it a whole lot at all," said Lt. Col. Ronald Place.
As he spoke, the man who has probably seen more of America's war wounded than anyone since the
Vietnam War sobbed as he sat at a table in his office.
First Stop for Injured
Nowhere is it less possible to escape the horrors of the war in Iraq for American soldiers than
Landstuhl. Nestled among the tall trees of a forest on the outskirts of this small town in southwestern
Germany, the largest American military hospital outside the United States is the first stop for nearly all
injured American personnel when they are flown out of Iraq or Afghanistan. Dedicated and
compassionate doctors, nurses and support staff push aside curtains of fatigue and what the hospital's
psychologists call "vicarious trauma" to patch up and tend to soldiers before they fly to the United
States for longer-term care.
This month, politicians focused on the unwelcome tally of the 1,000th American soldier to die in
Iraq. Landstuhl has its own set of figures, numbers that flesh out the suffering occurring on the
battlefields of Iraq and in homes across the United States.
Since Sept. 11, 2001, more than 18,000 military personnel have passed through the hospital from
what staff refer to as "down range": Iraq and Afghanistan. Of those, nearly 16,000 have come from Iraq.
Last month, 23 percent of those were casualties from combat, slightly higher than most months;
the rest had either accidental or disease-related complaints.
Thirteen have died at the hospital.
Each day, an average of 30 to 35 patients arrive on flights from Iraq. The most on a single day was
168.
More than 200 personnel have come in with either lost eyes or eye injuries that could result in sight
loss or blindness.
About 160 soldiers have had limbs amputated, most of them passing through the hospital on their
way home to more surgery.
And it's not just their bodies that come in needing fixing. More than 1,400 physically fit personnel
have been admitted with mental health problems.
Then there are the Pentagon's figures that touch on all casualties from the war in Iraq: 1,042 dead;
7,413 injured in action, including 4,026 whose injuries have prevented them from returning to duty. In
Afghanistan, there have been 366 injuries and 138 deaths.
One other number tells a slightly different tale, a story of selflessness in the face of suffering: one
third. That's about how much money surgeons at Landstuhl make compared to what they could make
if they chose to work in the civilian world.
"There is nothing more rewarding than to take care of these guys," said Place, the skin around his
eyes reddening with the tears that he failed to hold inside. "Not money, not anything."
Every day starts in the same way at Landstuhl. The staff get up early to greet the buses and
ambulances that come from nearby Ramstein air base, where the planes from Iraq touch down as
early as 6 a.m. Most soldiers can walk off the buses, with broken bones or noncombat illnesses. But
those who come in ambulances, like the two blast-injured soldiers, go straight to the ICU.
On Thursday morning, the 20-bed ICU was a busy, but not rushed, place. As so often these days,
the staff there were dealing with the effects of roadside bombs rather than bullets. That means taking
care of scorched, lacerated bodies that may have less obvious internal injuries.
Col. Earl Hecker sat outside the room where nurses were applying the white antimicrobial cream to
one of the burned soldiers. Twenty-seven-years-old, Hecker remarked, looking at the patient's notes.
(Hospital officials were not able to get these patients' consent to be named or photographed because
of their medical conditions.)
Hecker, at 70, is a few generations older than his patient. A surgeon who had retired from the
Reserves but recently rejoined, he has forsaken his private practice in Detroit for now to help at
Landstuhl, working past his assigned 90-day tour to stay nearly 150 days.
This experience "has changed my whole life," he said, his jovial demeanor fading to introspection.
"I'm never going to be the same."
The day before, Hecker had been taking care of an 18-year-old soldier who, thanks to an Iraqi bullet,
will forever be quadriplegic.
Hecker sat gazing through the window at the burned soldier and thought of the kid he had sent off to
the States the day before. "Terrible, terrible, terrible," he said, staring into the distance. "When you
talk to him he cries."
A month ago, Hecker took four days off to fly home to see his family. He needed a break. They
went out for dinner at a nice restaurant. Hecker realized during dinner that he was suddenly seeing the
world differently. He looked around at the chattering people, eating their fine food, drinking good wine
and he thought to himself: "They have no idea what's going on here. Absolutely none."
He doesn't think people want to see it. He thinks the nation is still scarred by Vietnam and would
prefer not to see the thousands of injured young men coming home from Iraq.
"I just want people to understand - war is bad, life is difficult," he said.
Maybe it was the stress, maybe it's because Hecker has no military career to mess up by speaking
out of line, but it just came out: "George Bush is an idiot," he said, quickly saying he regretted the
comment. But then he continued, criticizing Bush as a rich kid who hasn't seen enough of the world.
"He's very rich, you'd think he'd get some education," Hecker said.
"He's my president. I'll follow him in what he wants to do," he continued, "but I'm here for him."
Hecker leaned forward and pointed through the glass at the unconscious soldier fighting for his life 2
yards away.
'It's Just Not Right'
Not all of the staff can get away with criticizing their commander-in-chief or his decisions, but many
use more opaque ways of communicating their unease.
"It's not right," said Maj. Cathy Martin, 40, head nurse of the ICU, when asked how she felt seeing
so many soldiers pass through her unit. She paused. "It's just not right."
She declined to elaborate on what exactly she meant. Comments such as Hecker's about the
president can lead to severe consequences for those with careers ahead of them. But Martin did add:
"People need to vote for the right people to be in office and they need to be empowered to influence
change."
What she did feel comfortable saying, echoing the head surgeon, Hecker and others, was that
people back home just don't get it.
"Everyone's looking but no one's seeing," added Staff Sgt. Royce Pittman, 32, who works with her.
"I had no idea this was going on. ... What we see every day is not normal. There's nothing normal
about this."
In private, some hospital workers said they wished they could openly air their feelings about the
war. And if reporters could somehow quote people's facial expressions, a number of those staff
members would probably be facing disciplinary hearings. Only one staff member interviewed expressed
solid support for the war.
"I do believe, I truly do believe that those that are fighting and defending for liberty and freedom ...
that that is a truly worthy cause," said Maj. Kendra Whyatt, head nurse of inpatient orthopedics.
Is it all worth it? the head surgeon was asked. "That's not for me to say, but I'll be here for them,"
Place said.
The staff do talk among themselves, said Maj. Stephen Franco, chief of the clinical health
psychology service at the hospital. He recalled one doctor's comments after attending a memorial
service for a young soldier who had died. "I wish some of the lawmakers could attend some of these
more often so they can think a little more about their decisions," Franco recalled the doctor telling him.
But like all the staff in the hospital, politics comes second to healing with Franco. He has a lot of it
to do.
"It's probably the biggest challenge to mental health since Vietnam," said his boss, Col. Gary
Southwell, chief of psychology services.
Soldiers come in carrying guilt about leaving their unit behind, haunting visions of seeing friends
dying, nightmares, frayed nerves and deep anxieties about their future, Franco said. Place noted that
for a single man facial disfigurement, for example, can be particularly traumatizing. Who's going to
want someone with a face like this? the young men wonder.
Care Taken Not to Sugarcoat
Franco and his colleagues - the number of psychologists and psychiatrists has doubled since the
Iraq war began, reflecting large staff increases throughout the hospital - make a point of visiting all new
patients to see how they're doing.
"We provide assurance, look to the future," he said. "We're careful not to sugarcoat anything."
Franco doesn't attempt quick miracle fixes for traumatized soldiers, most of whom are flown to the
United States after a few days. "When your world is rocked like that it's not a smooth process
necessarily to get that to make sense," he said.
On Sept. 18, Army Sgt. 1st Class Larry Daniels' world was rocked. So was his wife's.
With other men from his platoon, Daniels was standing on a bridge over a highway near Baghdad
International Airport while an Iraqi contractor fixed a fence by the side of the road. Daniels, 37, was
waving Iraqi vehicles past the three American Humvees while the contractor worked as quickly as
possible to fix the wire fence.
An orange and white Chevy Caprice, a type of car usually driven as a taxi in Baghdad, veered
toward the soldiers. It exploded; a suicide car bomb.
"I felt my body went up in the air," said Daniels, in his Texas drawl. "I was upside down looking
back at where the car had been and landed on the ground. Three seconds later it hit me what
happened."
Lying on the pavement, Big Daddy Daniels, as his men call him, had the presence of mind to keep
ordering his soldiers around, even though he couldn't move. Another unit arrived soon and ferried the
survivors to safety. Two were dead.
Two days later, Daniels was flown to Landstuhl. Both of his arms have multiple fractures. Steel pins
and thick casts keep his bones in place. Part of his hand is missing. And as he puts it, he's got "holes
from my ankle to my ear." The doctors have taken some of the shrapnel out. Some fragments are still
there.
Wife's Opinion Has Changed
Daniels is an experienced, professional soldier. He's been in the Army for 17 years. His dad was a
draftee in the Vietnam War. He can trace his family's military history back to the Civil War. So perhaps
it's not surprising that he says he wishes he were still in Iraq with his men.
His wife, Cheryl, has had enough. While the staff at Landstuhl move the injured on, usually after five
days, the families of the wounded have to face up to the long-term consequences of the violence in
Iraq. Many are embittered.
From a military family herself, the mother of two had been changing her mind about a lot of things
even before her husband became so badly injured that he can't do even the most basic of tasks for
himself.
She supported the war and voted for Bush. Now, she says, she wants to pull the troops out of Iraq.
"I will vote for Kerry. Not because I prefer Kerry over Bush but because I don't want Bush back in
office."
Her 12-year-old son has been saying he wants to go to West Point. Her 8-year-old daughter wants
to be a military veterinarian. She's stopped encouraging those ambitions.
Speaking alone, without her husband, she said she knew that the Army wasn't going to like what
she had to say. Like Hecker, she hasn't got much to lose by speaking her mind, which she did, calmly
and thoughtfully.
"I don't feel we have any business being there," she said Friday. "I think this is an area of the world
that has been fighting for thousands of years, and I don't think our presence will change anything. If
anything, we've given them a common target to focus on. Rather than fight each other, they're fighting
us. I don't see why my husband has to lose two soldiers or question why he's here or see his other
guys that are hurt. The minute we pull out, things will go back to the culture that is established."
Cheryl Daniels is looking at a tough future. She has to parent her kids, hold down a job at Fort Hood
Army base in Texas, where the family lives, and finish the management degree she is studying for at
night. Soon her disabled husband will be home, and she finds it hard to believe, as the doctors have
told her, that "in a year or two he's going to be back to normal. I can't see that right now because he's
got nerve damage in his arms."
She doesn't feel that her country, her military, is giving her enough support. She had to pay her own
way to Germany and her own way back. The Army was doing almost nothing for her, she said.
"I feel like we've paid our dues," she said. "And I'm done." |
