Armed and Dangerous

Hi guys,

A cool event happened last night. We have been teaching Special Forces medics to intubate and use various intubating devices. The surgeons also let them scrub-in and perform various surgeries; all in effort to help them keep up their skills. These are real high speed guys, as you can imagine. So as payback they took some of us out to the special ops firing range and gave us familiarization training with various weapons. I got to fire the full auto M240 7.62 cal. machine gun and the 5.56 SAW. These are belt fed baby! Full auto, tearing it up just like Rambo. We also got to fire full auto AK 47s and HK submachine guns. They had a whole arsenal of captured weapons we could handle, play with, and fire. We shot from 9:00 until midnight. The big machine guns are like handling a jackhammer. We got to do all kind of special-ops firing like moving and running with the weapons. To top it off helicopters were flying by after a mission and popped flares as they passed. It was really spectacular. I was so tired the next day but it was worth it. I’ll never get to do that again in my life. I’ve included a pic of me with a captured AK47 all chromed out Gangsta style. Even in Iraq the insurgents have to show off the bling.

I almost forgot. Here's a link to a video article from The Detroit Free Press about medical care and AirEvac from Balad. I haven't seen it myself because of bandwidth constraints so let me know if it is good.
http://www.freep.com/apps/pbcs.dll/article?AID=200660326004

Greetings from Balad,

It has been along time since I have written, I know, I know! My audience has suffered. I have been busying myself at work, and off; with other projects to keep busy. I’m pretty settled in my temporary lifestyle as of late, and it may come as news to you that I have passed the halfway point in this deployment. As I write this I sit at 57 days until I leave Iraq.


I tried to give a gift of medical supplies to the hospital in the city of Balad as a humanitarian gesture but bureaucracy stymied me. I had about one thousand dollars of equipment that was of no use to us. It’s not that it was expired or useless but just that it didn’t mesh well with our anesthesia practice. I met and spoke with the head MD from the hospital, and he was very cordial. H aid he would be glad to receive the supplies; and at that point I should have given him the stuff. But I decided to do the right thing and file a request and pass it through Logistics. Whatever, I may as well have burnt the whole pallet of junk and let the smoke waft out over the city for all the good it did. Now the supplies have to be entered into a database to see if anyone in the DoD wants the stuff first, And once I declared it “excess” Logistics took possession of it. It disappeared into their warehouse never to be seen again. I knew not to go through channels; I knew it in my heart. But I did anyway, and got burned.

Despite my humanitarian endeavor falling through, things have been OK here. I instituted a policy for the administration of blood to trauma patients upon arrival, in the Emergency Dept. We used to have to wait for a paperwork shuffle to be completed before we could get emergency blood products. I determined that this might have contributed to a poor outcome for some patients. I spent about a week steering my policy through several departments to get it implemented. The funny thing about it is that all it says is that the blood bank needs to bring two units of un-crossmatched O+ blood to any and all traumas. Nothing fancy, if we don’t need it they walk back the thirty feet to the fridge and put it away. So simple, but I’m convinced that just by having it on hand the Emergency docs are more likely to administer it right away instead of waiting for the anesthesia department to do it during the surgery. So many of our casualties have already bled-out in the field that when they get to us they are very nearly ex-sanguinated.

J. Stormo and I got a Humvee the other day and ‘went-a-four-wheelin’ across the base (rebel yell goes here). We drove down to see the remnants of Saddam’s airforce.
Picture a long dusty road strewn with junk; the unsalvageable parts of wrecked weapons systems. Midway down that road lie about ten wrecked fighter jets, all soviet made; Covered ignominiously in American graffiti. We climbed around them for a while and took some pictures. Air force specialists tried to fire all the ejection seats, about a year ago, but stopped when one airman lost some fingers. Stormo and I wisely stayed out of the cockpits. Further down that road we saw the place where we store wrecked vehicles of our own. Bradleys, Humvees, and up-armored trucks, all the elements of our convoys blown apart with such violence you could hardly imagine. I saw the armor of a Bradley fighting vehicle melted like candle wax and dripped down across steel tracks in shiny silver rivulets. I counted at least five medical vehicles destroyed. I know they are medical because of the huge red crosses painted on them, but our enemies targeted them anyway. Two of the destroyed vehicles were the ubiquitous blue Air force ambulance buses many of my readers know from flying air-evac. These buses were totaled. One had a huge crater blown up through the floor and its heavy I-beam chassis was twisted and broken. Stormo and I were pissed.

It was a good day anyway, despite what we saw. The smoke from the burn pit was drifting away from the base and we took that hummer through dirt, mud and gravel burning up both rubber and fuel before stopping at Popeye’s for chicken and biscuits.

I know, it’s a strange war experience for those of us at Balad.

NPR and the latest from Iraq

Well I finally heard the NPR story done about the AFTH (Air Force Theater Hospital), here in Balad. I like NPR, despite the fact that some of my politics are so right wing as to make Sean Hannity look like a commie. The Republicans don’t always have the moral high ground. I think it takes both extremes to help keep America on course. The constant push and pull of the two sides steer us down a moderate course and keep us from investing ourselves in some of the more dangerous political adventures that have been problematic for other western nations. So I listen to NPR. They cover such a wide variety of news topics from around the entire globe. Many other news outlets are so America focused that I only get some of the picture. It just may be entirely possible that France has the right approach to something. But I’d never know if all I listened to was Bill O’Reilley (sp.?). I believe the French got wine and cheese correct; Oh! and art. So diatribe aside let me give you the link to the story:

http://www.npr.org/templates/story/story.php?storyId=5298089

If that didn’t get you there go to the NPR home page and click on archives. The story will be found on the March 23rd page, under “All Things Considered”.

The story is pretty accurate. All the surgeons are USAF, with the exception of the neurosurgeon, he is in the Army as stated. In addition, the Lt.Col. interviewed is a Nurse Anesthetist not a Nurse Anesthesiologist. She is also my boss. In the picture I was standing just to the left of the doctor with his back to you. That’s J. Stormo, MD. He’s a buddy of mine from Wilford Hall (USAF Hospital) in Texas. Almost everyone in the picture is a friend of mine. Patients go to an Intensive Care Unit, not internal. I guess these are just quibbles. In reality this story captured a lot of what it is like here. But nothing short of coming here can do it justice.

I still believe that despite our best efforts and examples we will never install a true democracy here. Islam, and years upon years of factionalism will prevent it. Until our president is able to truthfully articulate to the world the evil that is Islam, no good will come of this conflict. No one is ever remembered for heroic diplomacy.

Me at Work
copyright2006

It begins with my correspondence from Balad Iraq

Letter Number One

Hi everyone!

I’m fine here in Iraq. I’ll get straight to the good stuff; yes, there are mortar attacks on this base but almost all are inconsequential. When they do detonate, they usually destroy a patch of dirt and nothing more.

I have been thrust right into the operating room, and I began doing cases immediately. Those already here have a vested interest in training me so that I can replace them. In fact my guy has already stopped taking his shifts and left them to me. That being said, I am doing fine with the cases presented to me. I am quite confident in my trauma skills from all my years of experience when I was an RN; plus my school was very trauma focused (being in the ghetto). The rest of the cases are really mundane as our primary patient population is composed of young healthy guys. Lots of orthopedics and kidney stone extractions are on the schedule each day.

I live in a small not so insulated trailer with another officer. It’s like a college dorm room situation except our toilets and showers are about 300 yds away, and it is cold here, like a cold Spring day. Actually it’s more like the Unabomber shack but with 220v outlets.

We had dust storm last night, which limits our visibility, and the choppers are hesitant to fly. The dust storm makes everything really weird looking. The sun dims so that it looks like the moon, and the sky turns a bloody orange color. All that coupled with the diesel smell of the burn pit and the smell of the dust in the air give the worlds a hellish appearance. I kept expecting “Charlie” to come out of the bush. Which makes me wonder do we call the Iraqi insurgents anything similar? Muslim Insurgent would be “Mike India”; maybe “mike” will come out of the dust cloud and I‘ll have to off him with my stethoscope and ballpoint.

The Army dudes, even the nurses and docs carry weapons all the time. By a fluke I am actually in posession of my weapon, but since no other AF officer in my hospital carries theirs, I keep it locked up. All Army personnel are here for at least a year, compared to my five months that is quite a sore spot between the services. People joke about it but you can tell it bugs the Army people. My feeling is why should I have it worse just because you do. Stop worrying about how good I have it and start by fixing your end.

Letter Number Two

Hi everyone, Greetings from Babylon,

Today is the 22nd and today my predecessors are going home. They bequeathed me an extra fridge, a microwave, a chair, shelving and a Huffy bike! Yes you heard right; a real Huffy brand mountain bike. It’s a couple of years old but it makes getting around a whole lot easier. 20-minute walks become short 5-minute excursions. I am very grateful. The stipulations are that I give my stuff to the next anesthetist to replace me, and I don’t charge. To remind myself to comply I labeled everything with indelible ink, and wrote 332nd EMDG Dept. of Nurse Anesthesia on all the stuff. Which is my little subset of my unit here. My other compatriot received the TV and DVD player. I brought a DVD playing laptop courtesy of my dad and I can always go to other people’s hooches to watch the game.

Slow day in the OR so I have been annotating a book on Islam I found in the ‘free for all’ bookshelves at work. It excludes any of the more unpleasant aspects of Islam. So I’m mentioning them in the margins. On the free note I also went to the ‘Wal-Mart’, which is big shipping container full of sundry items sent, by boy scouts and churches, so if you are thinking of sending yours-truly (or anyone here for that matter) things like baby wipes, games, deodorant, toothpaste, etc. don’t. There is enough for the next year at least. I picked up some Motrin for this tendonitis I have developed in my Achilles’ Tendon. PT/OT gave me orthotics to ease it but I think I need more definitive care. Monday, if it hasn’t improved they’ll refer me to orthopedics. All of which is so weird b/c I work with orthopedics on a personal level everyday. But I felt it better to go through channels than be seen to use my status to get preferential care.

I’m sending pics with this one. Most are self-explanatory. Pay attention to the main gate pics and the 250yd wired kill zone around the base. There is one of the hospital from above. Also there is Coke Light? I guess it has less alcohol and calories than those other beers. Apparently Richard Simmons is some sort of magic nut vendor to these people, which you’ll see in one photo. In addition check out the pic of my ride, and the American infidel and his canned swine. There was going to be the obligatory pic of me with some heavy firepower, but there was an event last night and the security dudes are all really irate and jumpy. I think it wise not to bug 18 y/o angry dudes with 50cal. weapons so I’ll get that one later.

I have to go now because the rain has driven the mice into my walls they’re making loud peeping noises and I need to drive them out before nighttime or I won’t be able to sleep. If I get plague you’ll know why.

Letter Number Three

Greetings from Iraq,

I’m still alive and enjoying my “Babylonian Captivity” here in the land of Nebuchadnezzer and Abraham. I’m about 15 minutes from The Tigris River, and the land shows it. The soil is silty, like dry river mud; which I suppose it is. 100,000-year-old silt from Anatolia. The little bit of countryside that I have seen is covered with rushes and willow trees. It is probably pretty in some places but not here on this base. Here is a hive of military and logistical activity. Trucks, and HumVees swarm the ground like ants and Blackhawk helos swarm the skies like big buzzing horse flies. Then above all that are the thunderous fighters going and returning from missions all over the theater.
You have to wonder why anyone and I mean anyone would go tete ‘a’ tete with the US military. Only a fraction of our forces are deployed in this country, and a fraction of those, here in Balad. Even I find the immensity of it frightening. Insurgency is the only option left to the desperate or misguided few that oppose us.

I work in the Air Force Theater Hospital, staffed by 332nd Expeditionary Medical Wing, and elements of the 207th Head and Neck Team (US Army). What does that mean? It means we are the final receiving hospital for all of Iraq and Afghanistan. We’re the biggest, with the most capability. In Tikrit, Baghdad and elsewhere there are smaller Army Surgical Hospitals, who stabilize patients and send them on to us.

Most casualties are Iraqi, from both sides, and there are striking differences between the two. The insurgents can be old or young. The older ones are usually Saddam supporters; they may have been officials or the better-off. The older ones to my surprise speak English in varying degrees. Our interpreters say this is because they were the privileged classes who went to schools or studied abroad.

The younger insurgents don’t speak English; I know less about them because they are usually more injured. I’m guessing that due to their ages they weren’t born in a time conducive to the study of English. I know some of these are also religious fanatics and foriegn radicals.

The Iraqis on the side of the new government are less likely to speak English and although are nominally our allies they are still eyed suspiciously by us. This is because we don’t always know who is who after a conflict or IED explosion. Recently we had an Iraqi policeman on the ward where we keep the “bad guys”. This ward is heavily guarded and many of the patients/inmates wear blindfolds and earplugs 24/7. His family found him after a lengthy search and provided papers vouching for him. The command staff was apologetic, and all was forgiven.

Americans are usually less injured and receive most of our attention when we have them. Americans also have a better chance to fully recover. An Army Anesthesiologist related a story to me about Iraqi medical care. He said that the local ambulance attendants were taking patients out of his facility to assume care for them at Iraqi hospitals. One attendant would get in the back to assist the patient with an AMBU bag and the other would drive. As soon as they rounded the corner, out of sight from the Army hospital, they would stop and the guy in the back would get back in front and they would drive away. When confronted about this they were not chagrined, as one would expect, they said if the person was to die it was the will of Allah. Besides, they don’t have ventilators. So ever since then the Army won’t provide more care to the Iraqis than they can provide for them selves. It is futile.

The Air Force has been slow to learn this lesson. We have many gomers hanging around in our ICUs. I voiced concern that we may have to take some of these people back to the USA, as no one here can care for a paraplegic. If you doubt me, remember Christopher Reeve. He had more money and access to healthcare than many of us, and he died of pneumonia. I could say more but I might labor the point. Let’s just say that many of us here are voicing concerns to the surgeons that this is not supposed to be a humanitarian mission.

On a personal note the police stopped me the other morning. The cop asked if I valued my life (insert your own joke here), because it was dark and foggy and I didn’t have a light on my bike. So now I have a light, but they still won’t issue me bullets. Everywhere are eighteen year olds with some of the most awesome firepower ever devised and this guy was worried about the 36-year-old geezer on a bike. Now I’m a big illuminated target cruising slowly by on two wheels. I’m like a duck in a shooting gallery. PING! 50 pts. for the American medical officer. You win a stuffed camel Mohammed. Congratulations!

I want to provide a disclaimer; all the pictures I send are copyrighted by me, Chris Kuennen, 2006. They are for your personal perusal but are not to be duplicated or transferred to others than those to whom they are addressed. I know many of you are medical, military, government, and nursing professionals, so please understand the possible sensitive nature of my correspondence. Not that it’s classified, but I would hate for the good we do here to be exploited for prurient purposes. That being said I have more photos. Many of them are of helicopters, and those are for my neighbor’s boys who requested them. The ones with the guns are Apaches, they escort the Blackhawks, which carry the medics and wounded. I have two shots of the ER/receiving area, one out outside and one inside. Note the huge amount of stretchers. Finally, I have included some pictures of the devastation inflicted by IEDs on Iraqi bystanders. Mind you, Americans are not getting hurt as frequently as the poor Joe Blow who is just trying to live his life. The insurgents don’t care. Life is cheap in Iraq.
One more thing, just so you know, despite the somewhat somber tone of this letter I’m a currently doing exactly what I love to do, and what I have labored so long in my career for. I love emergency medicine and surgical trauma. The grim nature of my job is not lost on me, I just happen to have the temperament for it. If it weren’t for the separation from Kim and the kids I’d be here a lot. (many photos I mention in my letters I cannot post here)

Letter Number Four

Hi everybody!

I’m still alive despite the efforts of the disgruntled elements of Muslim society.

Last night at the DFAC, which is Army-Speak for Dining FACility, I got caught in an alarm red condition. Sirens sounded shortly after we heard the silverware rattling blast, and we all took cover under the table. It is so silly to do so. Usually, only one mortar is lobbed at us, and it is all over. If that mortar had hit the facility you wouldn’t get this message until I was able to walk again (after my rehab, provided you got it at all). I took my tray with me and continued eating on the floor. One and a half hours later an all clear was sounded and I was able to get home.

Mortars are really loud. The other day they hit approximately 700yds from my hospital and they shook the place. I thought they hit right outside, but people who have been closer to them say that the shock wave would cause the tent structures to collapse in and then billow out. When this happens the ever-present dust is sucked in and clouds up the entire facility. Ah! Iraqi fecal matter in the air, can you smell it? I’m sure you can.

The dust in the air causes all sorts of minor respiratory trouble for our people. In addition to being over worked and under appreciated, almost all the nurses have kennel cough. I feel for them all, and I’m so glad I’m out of that racket. They are short staffed and few of their patients speak English to any useful degree. The patients are as a whole are infected, smelly, poopy, misogynistic, and show little desire to participate in their own care (it’s women’s work). They will scrupulously shave their pubes and pits, but have no concept of deodorant. I’m working on a program where I apply deodorant to them when they are anesthetized and can’t fight it. One of the techs asked me what we must smell like to them. I replied, “Flowers.”

Which brings me to Kissy Guy. He’s the guy from some of my more graphic pictures who blew his right arm and leg off. He is very grateful. And he is always trying to hug and kiss us. The other day he gestured to me to come over, and he grabbed me and kissed both my cheeks. Muslim style. Then he said, “Thank you, thank you, Sidiq”. Sidiq means ‘Friend’. I blushed in front of all these young girls nurses and techs, which sent them a twitter. “Ooo, Captain Kuennen, he likes you.” “Yes”, I said, “That’s just their culture. It’s like shaking hands for us”. But later when I thought about it none of the other dudes were getting the same treatment from him, and none of the other Iraqi dudes had attempted to kiss me. Damn! The girls were right. Curse my fair skin and inability to grow a beard. I probably look like his cousin Fatima or something.

You may also know that I’m now a minor celebrity. You all have heard of the reporter from ABC and his cameraman who got blown up. Well guess who did the anesthetics and subsequent ICU life support, that’s right yours truly. You may have seen me in the footage displayed on all the major news outlets, rendering care to Doug Voght. Who was the least injured of the two. I also made Armed Forces Network and was spotted by everyone on the big screen TV, at dinner last night. I’m getting my SAG card any day now. The ironic twist to that story is that 2 hours previously I worked to save a 26-year-old guy who had an injury to his neck and will be paralyzed for the rest of his life. No reporters came to see him; no cameraman cared to film me at that time. Only this guy’s First Sergeant showed to provide some meager comfort. This young dude will go home to momma’s trailer and a motorized wheel chair, if he’s lucky.
There is always more to tell but it’s late and I want to describe to accompanying pictures. I’m sending some shots of the ICUs, of which there are four. They are divided by type of patient: Friendly, American, Unfriendly, and overflow. We also have five step-down units, and several outpatient clinics.

Letter Number Five

Hi everyone!

Despite what you may have heard; the rumors of my death have been greatly exaggerated. I have now rotated to a swing shift schedule which means I do a few nights them I’m off, then a day or two, and then I’m off again. Which sounds worse than it is. Days off mean I can get my laundry done and go to the gym. Working at night means I can call my parents and my family, and type lengthy e-mails for you folks.

So many things have happened since I last wrote to you; I‘ll have to collect my thoughts before I begin.

Two nights ago we had the largest attack on the base since I’ve been here. There were some powerful booms echoing around the base. Which I took to be mortars impacting. Then our guys ripped off tracer fire into the night. The machine guns that are used to defend the base are huge belt fed 50 cals Gattling Guns. They fire so fast they sound like a huge fart fed through a PA system. Make a raspberry sound with your mouth right now, go on do it, now imagine it over an amplifier. Yep, sounds just like that.

For those of you who don’t know tracers are the bullets that glow after they have been shot out of the gun so you can actually see where they are going. The ones I saw were red, streaking through the night sky to literally rip apart somthing. 50cal. bullets are about the size of a grown man’s thumb and the shell casing that contains the explosive is as big as … aw hell, it’s about 2.5 cm in diameter by 6in. in length. (Ladies don’t trust the man next to you, he’s lying. Go look at a ruler.) So when they hit a human, they have little chance to survive the impact.
Following all that we began bombarding the areas where the attacks came from with 155mm self propelled guns, which are cannons on tracked vehicles. I have been told that we can, with radar see where the mortars are launched from and respond in timely fashion to destroy those responsible. I hope that is true. I’d hate to think we were just firing off into the night sky, but something tells me that firing into the night may be just what we are doing.
After the war died down, the wind and weather picked up. It rained for two days straight without stopping. The wind gusts were in excess of 50 mph. Our sand bag walls collapsed, and our living area was flooded about a foot deep in the shallower areas. I never left my trailer all day Friday. That night I got called into the OR. Two American dudes got hit. Both had minor injuries, relative to what we usually see, but needed surgery anyway.
These guys were real special-ops, maybe SEALS or Delta-Force. Because they had ‘handlers’ with them during the anesthesia, in case they divulged anything. Also they had huge beards and native clothing, to blend in with the Iraqis. I’d really like to tell you more about the incident, but I can’t. That is not an exaggeration.

Ok final story then I’m going to try to sleep. So I was able to get from my hooch to the Porto-san today, with my feet dry. I live in the French Quarter; my not so lucky friends live in the 9th Ward. I currently have a ½ inch of water on the ground around my trailer. My buddies have about nine inches. So really I’m not so bad off. Anyway, I was able to step on spots of high ground, and by swinging myself off a concrete bunker casing I could jump over a really deep puddle in the road to reach the outhouse. The outhouse sits by the side of a road. The road due to the rainfall was about 11in. deep with mud water. So I’m in the john doing what comes naturally when I heard the diesel engines, and I heard them about one sec. too late, as a torrent of biblical proportions raged into my Porto-san. Brown mud water swirled about my ankles with each passing truck, of which there were so many I lost count. In addition the waves were so powerful I was worried that the whole thing might get knocked over, and that’s one kind of ‘brown water’ I didn’t want swirling anywhere. After about what seemed an hour, when the torment subsided, and I had washed my tears away. I went home and thought how good it was to be alive. Alive and free of poop water.

So long for now, I write later and let you know about my humanitarian project if it comes to fruition.

Letter Number Six

Hi everyone,

All remains well here in Iraq. I’ve entitled this one ‘Groundhog Day’ because each day has become a routine. I wake at 5, either pm or am it doesn’t matter, and get showered, if there is power. If no power I wash out of a tin cup, on my front steps; then I go to eat. After chow, I go to work. When I get home I read or play on the Internet. Lately I have borrowed a few DVDs to watch (South Park and Family Guy) then I try to sleep.

Lather, Rinse, Repeat.

On my day off I met some friends from another squadron. They are CCATT personnel. CCATT stands for Critical Care Air Transport Team. They are the guys who provide care on AirEvac missions for those soldiers who are so badly injured that they need to be kept on ventilators and monitoring equipment for the flight. They took James Stormo (Anesthesiologist from San Antonio) and I for a ride around the base perimeter.

I saw some of the coolest stuff. There was a whole graveyard of Saddam’s destroyed tanks, planes, and trucks. We drove up to the burn pit, where we burn all trash and refuse. It looked like the fires of Gehenna. Melted plastic, twisted metal glowing hot even in the daytime with the most toxic stench you could imagine. The workers all wear respirators. The body parts of Iraqi insurgents are burnt here as well as their corpses if they’re not lucky enough to live. I’ll go back later and get photos. My friend was too scared to stop or slow for most of the trip, and not because of the enemy but because of the Army, he’s a major too. Docs don’t earn their rank through years of service, it comes very easily for them, and so they either abuse it or under utilize it.

We drove on to several areas where you could see the locals farming. Their houses are made of cinderblock and mud brick. Most have tin roofs, and all have a satellite dish. Grapes grow on trellises around the houses and oxen plow fields. I saw little boys herding goats around big bushy palms. They whacked them with sticks to move them along. It was all very pastoral. The area I’m in is so flat I find it hard to give you an adequate description. It’s just level, level earth for as far as I can see. Palms and willows spring up periodically on the landscape, and you can see the rushes from the irrigation canals blowing in the dusty wind, but you never see a natural hill or a hummock, rise to break the vista.

Two days ago I met Omar. Omar is three. He lost his mother and aunt in an attack on his car. The car he was in approached an American convoy, and was fired upon. Omar wasn’t shot but he got 2nd degree burns on about 40% of his body. We are grafting his skin and caring for him. His father stays with him, Omar will be lucky because his grafts have taken well and are not infected. His predicted outcome is good he’ll have some scarring but full function of his hands and such. His face was unaffected. He walks around the hospital with his dad. I find it hard to look at him sometimes because I think of Lauren and Bridgie and all the little toddlers in my life. I love them so, and I find my mind wanders and I picture them burnt as well.

We all chipped in and bought him a DVD player, so now he can watch cartoons. I’ll bet this DVD player is worth at least a month’s salary for his dad. We collected enough for it in a couple of hours. I just have to wonder what the common Iraqi thinks of all this. I suspect many want us to leave simply because our existence here must remind them of their society’s collapse and failure. Our prosperity must be an affront to the false promises of Mohammed that they have repeated for generations. The poorest Airmen here live like kings compared to the mud hut dwelling peasants of Iraq.

I wanted to launch into my insights into Muslim fatalism here but I could just picture everyone glossing over this part, so I’ll spare you. Suffice it to say that Iraqis are fatalistic in their outlook. Everything is ‘The Will of Allah’.

Letter Number Seven

Hi everyone!

Livin’ Large here in Iraq. Here’s the next installment in my ongoing attempt to keep occupied during my down time.

I’m really anxious to go home. I have been here long enough to get a feel for the place and now I’m ready to go. Lauren’s birthday is coming up and I’m going to miss it. The thought of missing it makes me sad, so I went shopping for her today. The pickings are slim for a three-year-old American girl.

I can get the locals to embroider a child’s size desert hat (like Daddy’s) with her favorite cartoon character. Dora seems to be the most popular. Or I could send her various types of animal figurines, camels and such. I don’t think the woven carpet will go over well, but there are a lot of hookahs. There are all shapes and sizes with ceramic bodies and brass bowls. Multiple hoses wind their way out of the water-chamber to bring the cooled apple-tobacco smoke to your lips. It’s all quite artful. I’m contemplating the hookah for Lauren. She can always use it when she gets to college.

Despite all the commotion out in the countryside after the Samarra mosque destruction, things have been peaceful here. We had some attacks over our north gate the other night, but no casualties. We could hear the machine guns rocking with that rapid pop-pop-pop-pop-pop, followed by the crack of rifles. These attacks are always short lived and you really get complacent about them. The reality is if you’re going to get hit you probably wont even see it coming, so why worry. It also gives us some excitement during the long night.

Speaking of complacency, I’m not getting used to the casualties. I have 8 years of nursing experience, most of that spent doing emergency/trauma nursing. I thought I had seen some horrendous things in my career. But I had never seen them at this volume. In the city you see some really disturbing stuff. Maggots in wounds, OD’d corpses, charred firemen. But it comes in fits and spurts. Here in Balad we see mutilated young men and women every day and night. Mutilated beyond what seems possible. Wounds that appear barely survivable are extant on alert soldiers and POWs. Some wounds that seem so small are devastating to the recipient. Two cases: one a US soldier, hands gone, legs gone, eyes gone; talking to me, survives and is sent on to Germany; another, a Marine 2nd Lt. with a pinhole at the base of his skull dies on me. His brain swelled, and despite our ministrations he couldn’t be saved. I used to not care about gore and death, but for some reason since I have come here, I care. I’m pretty sure that when I go civilian again, I’m going to find a nice plastic surgery center somewhere and do boob jobs until I reach old age.

We also get torture victims that the Special Forces bring us. Our guys aren’t the ones torturing. The Iraqis do torture, however. I’m told it’s usually Shi’a vs. Sunni vs. Kurd. Sometimes the special ops guys rescue them, and bring them in. They are electrocuted and beaten, and we treat their burns and bruises and let them rest before the US assumes custody. I really don’t know what to say about that. No one here, and I mean no one, is innocent, maybe just the babies. But they’ll suffer and die too. I don’t believe in nation building anymore. It’s a lie. War should be total. If we wanted to attack Iraq, then it should be total. Armies are for destruction, not for policing or peacekeeping. It could have been quick and more merciful if we had just used the 300k troops Shineseki requested and demolished the place. Instead, Iraq is dying by degrees.

I got to take a little road trip two days ago. I went to the hospital motor pool and requested a vehicle. Now remember that there are many, many vehicles to choose from. Humvees, big deuce-and-a-half trucks, five tons’, and Chevy suburbans with bullet proof glass, all available. Also remember that I’m probably the only one of the 150+ people in the hospital who is licensed to drive any of these. Hell, unless it has tracks I’m qualified to drive it. So as the motor-pool man sized me up and down I was sure to receive that up-armored Hummer with the 50cal. mount on top. But Noooo, I smiled and showed the braces like dork and got handed the keys to . . . a Dodge minivan. I guess despite the uniform and weapon, despite the calloused hands and muddy boots, despite the badges and official paperwork that say otherwise; you can see the white bread, collegiate, suburban dad I am. People can smell a nerd.

Now for the pictures: There is one of me in the OR, one of a brain surgery, a series of a fantastic facial reconstruction that is gory but must be seen, one of a self-propelled gun, one of a camel spider (looks gross but is harmless), one of an F-16, an overhead shot of the hospital (ORs are on the left), our T.I. expounding on the differences between being a hard charging Marine and an Air Force weenie, Sergeant Baby exhorting us to get off our asses and unload the helicopter, and a CT scan of a bullet in a brain (one of the most common injuries we see). I’ve got more of me to come but other people shot them and I have to get the pics from them.

Well bye for now, I miss you all. If you know of someone who wants to get this letter and doesn’t please forward a copy to them. Don’t send them the surgical pictures if they will be disturbed or not know how to take them. But otherwise pass it on.