Air Force Lt. Col. Jeffrey Bailey, 332nd Expeditionary Medical Group, leads the morening rounds with fellow doctors in the intensive care ward of the Air Force Theater Hospital Oct. 13, 2007, at Balad Air Base, Iraq.Bau
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In what are often considered less-than-desirable conditions, military doctors are performing incredible feats, and with little fanfare. These are the stories of some of the military doctors that have set up practice in the midst of a war zone. This is the fourth article in VFW’s medical series.
by Janie Blankenship
Doctors have it tough. Military doctors have it even worse. While they are in the business of saving lives, they also must deal with the aftermath of those who can’t be saved.
In just a single day in Iraq and Afghanistan, surgeons might be responsible for amputations, brain surgery or artery repairs. They are faced with telling young Marines and soldiers when they have lost limbs or soon will. These same doctors feverishly work over victims for hours only to lose them to death.
At day’s end, there is no time for decompression because they must prepare for the next round of wounded troops that could hit at any minute.
Doctor Earns Bronze Star for Valor
In his first firefight (which is unusual for a doctor) in Iraq, Navy surgeon Lt. Cmdr. Richard Jadick had seven wounded men in a matter of minutes. He did what he could to forget the mortally wounded and save the rest. Inside a full ambulance racing through the streets of Fallujah, Jadick scrambled to pack the gaping wounds of the Marines.
In his book On Call in Hell, Jadick recalls how the Marine on the top rack died en route to the aid station on the edge of the city. His blood was dripping onto the patients below him as well as Jadick. “I had it down my neck, everywhere,” he wrote.
Serving with the 1st Battalion, 8th Marine Regiment in November 2004, Jadick knew there would be bloodshed—that’s why he volunteered to be the unit’s surgeon. Armed with only a 9mm pistol, Jadick didn’t imagine he’d be in the midst of a firefight.
Because most doctors don’t have much combat training, they usually stay in the rear at the aid stations or base hospitals. But Jadick, a former Marine, knew that if he could get closer, it might mean saving more lives.
After unloading the dead and stabilizing the wounded before getting them on to a hospital, Jadick knew that with the types of wounds he was seeing, mere minutes could make the difference between living or dying.
He and his men loaded up two armored ambulances and convoyed back to Fallujah, where they established an aid station in the prayer room of an old government building.
They took metal plates from the street, cleaned and covered them with sterile gauze and used them as trays for Jadick’s scalpels.
By morning, the casualties began arriving. The surgeon said that at times he couldn’t sterilize his instruments fast enough.
“You’d just have to throw some alcohol on the stuff and use it again,” he wrote. “I didn’t get a chance to wash my hands a lot. I wore gloves as much as possible, but they’d get all torn up and my body would just get covered in blood.”
For Newsweek, Jadick described the one Marine who is always with him to this day. Lance Cpl. DeMarkus Brown was treated after a piece of shrapnel sliced his lip. A few days later, he was back in Jadick’s front-line emergency room and didn’t appear to be badly wounded.
However, a major blood vessel had ruptured inside him and he died as Jadick pleaded with him to hang on.
“To this day, he’s the kid I can’t get out of my head,” he said. “It was just one of those things.”
For 11 days, Jadick and his crew worked around the clock in Fallujah. Some 53 Marines and Navy SEALS died. But of the hundreds of men treated by Jadick in the makeshift ER, only one died after reaching a hospital.
“I have never seen a doctor display the kind of courage and bravery that Rich did during Fallujah,” said Jadick’s commanding officer, Lt. Col. Mark Winn.
Jadick was awarded a Bronze Star for valor, the only doctor from the Iraq War to receive this honor. He is credited with saving an additional 30 men.
“Being a battalion surgeon is one of the greatest jobs there is,” says Jadick, who is now a urologist at the Medical College of Georgia in Augusta.
‘These Guys Come in and They Just Die’
For seasoned surgeons like Army Lt. Col. Joseph McClain, trying to save lives in the midst of war never gets easier.
A heart surgeon who served six months with the 10th Combat Support Hospital in Baghdad in 2005-06, McClain previously worked seven years in trauma surgery at Brooke Army Medical Center in San Antonio and then three years as a cardiac surgeon at Virginia Commonwealth University in Richmond.
“Everyone thinks, ‘Oh, he’s a cardiac surgeon, he’s tough,’” McClain told Army Times during his time in Iraq. “But the fact is that the cardiac patient death rate is less than 3% … I gotta tell you, man, here these guys come in and they just die. They’re blown apart.”
But McClain admits that the hospital in Baghdad had all the necessary equipment he needed to perform comprehensive surgery, like the removal of a lung.
McClain recounted a day in ICU when he was trying to determine the best course of action to save a wounded soldier’s leg.
“He couldn’t talk,” McClain said, “so he writes me a note and it says, ‘Please save my leg,’ and it just killed me.”
McClain saved the soldier’s leg.
Another experienced surgeon, Army Col. Richard Briggs, also served at the Green Zone hospital known locally as Ibn Sina.
The reservist from Knoxville, Tenn., has seen a lot in his 25 years of trauma surgery. While in Iraq, Briggs and his fellow surgeons averaged 17 major trauma surgeries per day.
“You are dealing with human tragedy constantly,” Briggs told the Los Angeles Times. “All these are young people in the prime of their lives.”
The Army reports that ranked by the number of trauma patients treated, the Ibn Sina emergency room is the third-busiest in the world after Cook County Hospital in Chicago and Ben Taub General Hospital in Houston.
“The typical gunshot wound you see in an emergency room back home is what we call a ‘recreational wound,’” Briggs says, “compared with what we see here, which the damage is caused by high-caliber bullets, rocket-propelled grenades and flying metal shrapnel.”
At Balad Air Base, the hospital is the medical receiving center in Iraq for all head and neck wounds sustained by U.S. troops. Maj. Hans Bakken, a neurosurgeon serving at Balad in 2006-07, said he saw about six gunshot head wounds in six years of practice. But in Iraq, he handled one or two penetrating brain injuries a day.
“I think we provide Level 1 trauma care comparable to any center in the United States,” Bakken told The Washington Post, while still in Iraq.
He gave up his private practice at age 37 to join the Army specifically to serve in Iraq.
Age Doesn’t Stop Two Doctors
When Bill Krissoff lost his son, Marine 1st Lt. Nathan Krissoff, in Iraq in 2006, he made a decision to join the military. After meeting with Navy officials and even President Bush, the 61-year-old family man boarded up his Truckee, Calif., office and moved with his wife to San Diego.
He is preparing to deploy to Iraq as an orthopedic surgeon with the 4th Medical Battalion, 4th Marine Logistics Group.
While Krissoff is 19 years over the Navy’s official age limit, he will serve three years as a surgeon. Early in his career, Krissoff was an emergency room doctor, so he says he’s confident he can deal with what is surely to come when he goes to war.
“My interest in Navy medicine was because they take care of Marines,” Krissoff told the Sierra Sun (Truckee). Krissoff’s youngest son, Austin, also is a Marine.
While meeting with the Krissoff family last August in Reno, President Bush asked members if there was anything he could do for them (because of the death of their son). Krissoff told the President that he wanted to serve.
Bush asked Krissoff’s wife, Christine, who said she wholeheartedly supported the decision.
Krissoff told the President, “Sir, I’d like to serve, but they told me I’m too old, but I’m younger than you, sir.”
Within two months, he got approval to enlist.
According to Lt. Cmdr. Lisa Braun of Navy public affairs, 53 personnel older than 60 years old are serving throughout the armed forces.
“It’s more common than you would think,” Krissoff’s Navy recruitment officer, Lt. Cmdr. Ken Hopkins, told the Sierra Sun. “They reach the top of their professional career and they are looking for a new challenge. And they have a desire to serve.”
One of those is Army Reserve Col. William Bernhard, who at age 75 went on his third deployment to a war zone in 2006. He served in Afghanistan with the Oregon Army National Guard’s 141st Support Battalion as a surgeon.
The year before that he was in Iraq with the Mississippi Army National Guard’s 155th Brigade Combat Team. He described to the American Forces Press Service an incident that occurred on Nov. 23, 2005, while guarding a bombed-out building on the Euphrates River about 85 miles west of Baghdad.
“I was the one with the shotgun, so I had to cover the little alley coming down behind us,” he said. “We got in a firefight for about 10 hours that night. A patrol coming down got within a quarter of a mile of us, and the insurgents ambushed them. They killed one of my medics that night.”
Bernhard first joined the military as a Marine in 1950. He was discharged following a knee injury. He then joined the Navy as an anesthesiologist and served 10 years combined on active and reserve duty, then moved to the Army Reserve for 22 more years.
Thanks to the National Guard’s “Boots on the Ground” (BOG) program, Bernhard came out of retirement. BOG strives to find doctors for field hospitals for 90-day rotations.
“I know what I’m doing because I’ve done it so many times before,” Bernhard told the Washington Times. “I figure while I’m in good enough physical shape to go and support these young soldiers, I might as well.”
Growing up in Connecticut, Bernhard served in the Navy during the Vietnam era, which he said helped him improve his medical skills.
Prior to his deployment, he said he was not nervous about going back to Afghanistan (it was his second deployment there).
“Do I get scared? No. I get mad when my guys die,” he told the Washington Times. “When I’m talking to a guy in the morning and by the evening he’s been killed, it makes me mad.”
Thriving Amid Chaos
While most military doctors are likely to say they don’t have it nearly as bad as the troops out doing the fighting, the stress of trying to save lives and the gruesome images of mangled body parts are a lot to carry.
Working as a surgeon in Camden, N.J., sometimes known as the “murder capital of America,” Army Reserve Maj. Donald Robinson didn’t expect to be taken by surprise when he got to Baghdad in 2005.
“When I got there I was taken aback,” Robinson told Stars and Stripes. “This was penetrating trauma to the nth degree. It was massive. The tissue destruction was like nothing I’d ever seen before.”
On his first day as the chief of surgical and critical care for the 86th Combat Support Hospital, Robinson was introduced to IED victims.
“In all honesty, it just looked like destruction,” Robinson recalled. “Blood everywhere. People were screaming. It was chaos.”
Throughout the next seven months, the doctor operated on nearly 400 patients—70% of whom were IED victims. About 80% of all patients were Iraqis.
He said it really hurt to see wounded Americans, and occasionally the frustration would mount to the point he would punch a wall. And when a patient died, he wanted to be left alone.
While he talked with young medics and nurses about how they were coping with the rigors involved with severe trauma victims, he never thought about how he was handling it.
Once he came home, he began having vivid dreams filled with pain.
“It was almost like you know you can help the person, but it’s the intensity of what this person has gone through and will have to live with,” he said. “I would go to sleep, and I would see that.”
Navy Cmdr. Erin Moore said he, too, experienced a lot of similar emotions such as frustration, anger, helplessness and a sense of loss.
He recalled a young Marine who was brought to the operating room at Al Taqaddum Air Base with a sniper round to the stomach. With three surgeons operating on him, he still could not be saved. Eventually, Moore was forced to pronounce him dead.
“It was hard to even call it,” he told Reader’s Digest. “I’m tired of putting kids in bags and knowing within a few hours someone will get a call back home.”
Air Force Col. Jack Ingari performed 530 surgeries on 270 patients during his nearly five-month tour in Iraq at the end of 2005. He said the toughest part for him was telling young troops when he would not be able to save a limb.
Stationed in Balad with the 332nd Expeditionary Medical Group, 332nd Air Wing, Ingari said that one of the most traumatic events occurred when the hospital received 39 patients in 90 minutes following a bombing in Balad. He added that everyone on base pitched in. Pilots were mopping the bloodied floors. There were so many blood donors that people had to be turned away.
“It was the highest of highs and the lowest of lows,” he said. “But when you can sometimes save a limb after a soldier is told it has to be amputated, that’s the best.”
Editor’s Note: VFW magazine art director Robert Widener contributed the interview with Air Force Col. Jack Ingari. This completes our four-part series: previous articles covered medics/corpsmen, nurses and air medical evacuation crews.
Sidebar: State-of-the-Art Hospital Opens in Afghanistan
For the doctors serving at Bagram Air Base in Afghanistan, things are looking up thanks to the year-old Craig Joint Theater Hospital. With shining white floors and a sterile environment, the 38-bed facility is like being back in the States.
The hospital, which opened in March 2007, treats about 2,200 outpatients and performs about 150 surgeries each month. With an advanced lab for blood work and surgical specialties like facial reconstruction surgery, the hospital is the most advanced in all of Afghanistan, according to Air Force Col. Bart Iddins, hospital commander.
Named for Army Staff Sgt. Heathe Craig, a medic killed in Afghanistan in 2006, the hospital is the first major Air Force medical facility in the U.S. Central Command theater to be housed in a permanent hard structure.
The previous hospital was nothing more than plywood, which let the dust seep into everything.
“In the old facility, the dust was a big problem,” Iddins told Air Force Times. “A lot of the equipment was not able to stand up to the dust load.”
The staff of about 200 doctors, nurses, technicians and other personnel has a small dining facility with a full kitchen and a seating area with a television.
“There aren’t too many clear, bright places to work while you’re on a deployment in Afghanistan,” Lt. Col. Jeffery Jones, the hospital administrator, told Air Force Times. “The staff truly appreciates what they have here and it shows in their morale and the care they provide.”
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