Video: On the medical frontline

By Correspondent
NBC News
updated 1/1/2004 12:50:12 PM ET 2004-01-01T17:50:12

American medics with the Forward Surgical Team attached to the 2nd Armored Cavalry Regiment in Baghdad are working day and night to save the victims, both American and Iraqi, caught in the cross-fire of the ongoing war in Iraq. Although more and more of those brought into their mobile surgical unit are Iraqis, the doctors don’t ask questions as to whether their patients are the victims or the aggressors of the guerrilla war. The doctors just continue to do what they do best: save lives.

U.S. Army Maj. Peter Allen, a 37-year-old Walter Reed Hospital-trained general surgeon from Washington D.C., thought it would be a ‘’fairly exciting way to serve my country’’ when he learned, about a year ago, that his medical unit was deploying to Kuwait and then, most probably, into Iraq.

As a member of a 20-person Forward Surgical Team, he knew his unit would be moving with U.S. combat troops — much like M.A.S.H. units in the first Gulf War, but even lighter and more mobile. As he understood, his primary mission would be to treat U.S. soldiers who were critically injured in the thick of battle, a kind of “rapid reaction” surgical force. Now, one year later,  Allen’s team is set up as a “stationary’’ field hospital in three compact rooms within Saddam Hussein’s former Military Academy in central Baghdad. And Allen’s primary mission seems to have taken a radical shift — eight out of 10 of the patients the surgical team treats these days are Iraqis.

Allen calls his work “damage control’’ — stanching bleeding and stabilizing patients just enough so that they can be transported to a combat support hospital for further treatment. “Many of the patients brought here — Iraqi patients — have been taken out of a combat zone,” explains Allen. Often, the victims, with blast or burn injuries, come from both sides of the conflict.

One night as Allen and his team prepared for surgery on a group of three detainees rounded up by U.S. soldiers and one pro-U.S. Iraqi soldier who had just arrived in the unit, he explained how politics stayed outside the operating room. “It doesn’t matter to us,’’ he said.  “Our goal when they bring the patients to us is to treat them all the same — U.S. soldiers, Iraqi soldiers, Iraqi prisoners, or simple civilians caught in the wrong place — we don’t worry about that. Different people worry about that. We worry about taking care of the patients.’’ 

Sophisticated care
The care is remarkably sophisticated  for a field unit. What was designed to be contained within three large tents is now a trauma resuscitation room, an operating room with two complete operating tables — a first for this kind of unit — and an intensive care unit as well. Three general surgeons and one orthopedic surgeon work in 12-hour-on, 12-hour-off shifts, seven days a week. Lights are portable and generator-driven. The operating tables weigh only 50 pounds (not 700 pounds, like the ones at Walter Reed Hospital back home) and allow for rapid transport. Vital-sign monitors, measuring pulse and blood pressure, are state-of-the-art. Ventilators are only half size, and oxygen supplies are about 60 percent of standard civilian operating rooms.

Even with limited anesthetic, Allen has seen the rewards of their work many times over. “When you see the Iraqis coming in, they have confusion and fear written all over their faces — they have no idea what is going to happen to them. But when they leave the other side, when they leave our ward, they have smiles on their faces — they realize they’ve just been taken somewhere where people are actively trying to help.’’

Depending on the source, anywhere from 10,000 to 14,000 Iraqis­, many of them civilians, have been injured in this conflict, so far. Only a tiny fraction of the worst cases pass through Allen’s hands. But, for him, as well as the nurses and technicians who make up his unit, every life saved is a victory. And every life lost — and there are many — is a source of collective anguish, just as it would be in the operating room back home. “Most of us are disheartened when we see that,’’ explains Allen’s boss, chief surgeon Col.Tim McCorerie. “Many of us here say prayers for the patient who died, even if he is the enemy.’’

Working against time
The real enemy in the surgical unit is time. Usually, there are only minutes between survival and death. It’s one reason why niceties are left outside the premises, just like the politics. Following the arrival of the four Iraqis, there are piles of crushed plastic bags, used syringes, and bloodied bandages strewn across the floor as a reminder that this is a combat unit. Procedures are often too rough for the unaccustomed to watch, and injuries are unlike any sustained — or treated — in the antiseptic civilian world.

Another Iraqi patient arrives. An accompanying soldier from the 1st Armored Division briefs the surgeons in the resuscitation room as other medics prepare the operating room.  “He apparently was running away from the scene of a car bomb when the car exploded.’’ Shrapnel wounds covered the patient’s naked body. Within seconds, a portable X-ray machine scanned the Iraqi’s bloodied chest while a nurse attached an IV drip. The surgeons washed their hands, a medic slipped a ventilator into the Iraqi’s mouth, and yet another medic read out blood pressure numbers: “110 over 65 and dropping.”

The surgical team responded to the frenzy methodically, knowing exactly what to do and when to do it. And, even if they thought it, no one questioned aloud whether this Iraqi individual — now precariously balanced between life and death and in the best care the U.S. Army could offer — was either an innocent victim of a car bomb, or, himself, the insurgent who planted the bomb hit by his own evil deed.

For the men and women of the 2nd Armored Cavalry Regiment Forward Surgical Team, those questions don’t matter.

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