lrd
03-17-2006, 11:27
God Bless all you docs and medics out there.
On Call in Hell
By Pat Wingert and Evan Thomas
March 20, 2006 issue - Then I heard the voice of the Lord saying, "Whom shall I send? And who will go for us?" And I said, "Here I am. Send me!"
—Isaiah 7:8
Richard Jadick was bored. The Navy doctor was shuffling paper while Marines were heading out to Iraq. Once, many years before, Jadick had been a Marine officer, but he had missed the 1991 gulf war, stuck behind a recruiter's desk. Now he was looking forward to leading a comfortable life as what he called a "gentleman urologist." Jadick, with a Navy rank of lieutenant commander, was 38—too old, really, to be a combat surgeon.
But then a medical committee searching for help came knocking on his door. Because of an acute doctor shortage, they were having trouble finding a junior-grade Navy doctor to go with the First Battalion, Eighth Marine Regiment (the "1/8"), to Iraq. Jadick at the time was one of the senior medical officers at Camp Lejeune, N.C. "Who could we send?" they asked. Jadick thought for a moment. "Well," he said, "I could go."
His friends told him he was crazy, and his wife, a pediatrician nine months pregnant with their first child, was none too happy. But in the summer of 2004, five days after the birth of his child, Commander Jadick shipped out for Iraq. On the plane, he sat behind a gunnery staff sergeant named Ryan P. Shane. A 250-pound weight lifter, the massive Shane turned in his seat to look at Jadick. Slowly taking the measure of the 5-foot-10, 200-pound Jadick, the gunnery sergeant said, "So you're our new surgeon. That's one job I wouldn't want to have with the place where we're going." That night Jadick e-mailed his wife, "What have I gotten myself into?"
The place they were going was Fallujah. In Sunni territory west of Baghdad, the city seethed with insurgents. Jihadists had strung up the burned bodies of American contractors in the spring of 2004, and chaos had reigned ever since. By November, the United States was tired of waiting for the enemy to give up or clear out. "Over the past five months, [we] have been attacked by a faceless enemy. But the enemy has got a face. He's called Satan. He lives in Fallujah. And we're going to destroy him," said Marine Lt. Col. Gary Brandl on the eve of the attack. Jadick's regiment, the 1/8, was ordered to take what was, in effect, the Main Street of the city. For Jadick, who speaks in a gentle, matter-of-fact voice, occasionally strained by memories of the men he saved and lost, it was to be a journey to the other side of hell.
The night before the assault, Jadick hopped into a command Humvee taking a reconnaissance mission from the headquarters base outside the city. He wanted to see what he was up against. In treating traumatic injuries, there is something known as the golden hour. A badly injured person who gets to the hospital within an hour is much more likely to be saved. But Jadick knew that in combat the "golden hour" doesn't exist. Left unaided, said Jadick, the wounded "could die in 15 minutes, and there are some things that could kill them in six minutes. If they had an arterial bleed, it could be three minutes."
Jadick knew that helicopter evacuations were out of the question: there was too great a risk the choppers would get shot down. Casualties would have to be driven out of the city. It took Jadick 45 minutes to drive from the base hospital, where he would normally be stationed, to the city. Not close enough. Jadick wanted to push closer to the action.
Jadick, along with 54 Navy corpsmen, his young, sometimes teenage medical assistants, moved to the edge of the city as the assault began; the night sky was lit by tracers and rocket fire. The next morning a call came over the radio. A Navy SEAL with a sucking chest wound needed evacuation. A weapons company was heading in to rescue the man. Lacking much military training, doctors normally stay back in the rear area. But ex-Marine Jadick decided to go to the fight. As shots rang out around them, the weapons company ran and dodged down narrow alleyways toward the building where the SEAL lay wounded. Jadick was armed only with a small 9mm pistol. He thought: "If anyone actually gets close to me, I'm going to have to throw it at him." He felt slightly ridiculous, remembering a "MASH" episode in which Alan Alda tried to scare away the enemy.
In the rubble of a shot-up building, he found the SEAL conscious but bleeding badly. "Get me out of here," the man said. Helping to carry the man on a stretcher down the stairs, Jadick could hear rocket fire and shooting. The air was thick with fine dust and a familiar smell: cordite, from gunpowder. He had smelled cordite before at rifle ranges, but never like this. "It just hung in the air," he recalled.
The radio squawked. Two Marines had been wounded in an ambush in the center of the city. Jadick wanted to get his wounded SEAL back to base camp. But the voices on the radio were insisting that the two men down in the ambush were in even worse shape. It was Jadick's call. He loaded the SEAL into an armored ambulance and set off in the vehicle toward the scene of the shooting. He could hear the firing intensify. Jadick wondered, anxiously, if a rocket-propelled grenade could punch right through the ambulance's metal sides.
The ambulance stopped and Jadick peered out at the first real fire fight of his life. There were not two wounded men, but seven. As a middle-class kid growing up in upstate New York, Jadick had avidly read about war, and even applied to West Point. But he flunked the physical—poor depth perception—and went to Ithaca College on an ROTC scholarship instead. He had served as a communications officer in the Marines, but left the corps after seven years, bitter that he had been left out of the fighting in 1991. Attending medical school on a Navy scholarship, he had never seen or experienced real war—the kind of urban combat that can leave 30 to 40 percent of a unit wounded or dead.
"I can't tell you how scared I was," he recalled. "My legs wanted to stay in that vehicle, but I had to get off. I wanted to go back into that vehicle and lie under something and cry. I felt like a coward. I felt like it took me hours to make the decision to go."
But he got up and went. He felt as though he were "walking through water." Desperately seeking cover, he ran to a three-foot wall where the most badly wounded soldier lay. He lifted the man over the wall to safety. "I put him down on the ground, and he was looking at me," Jadick recalled. The man had a gaping wound in his groin. Jadick tried to "pack" the wound, stuffing sterile gauze packages into the hole torn by an AK-47 round, but he couldn't stop the bleeding. Jadick was forced to make the first of a thousand wretched decisions. "I knew I had six other people that I had to work on. So I don't know ..." Jadick paused in the retelling. "I stopped and went on to someone else." It was Jadick's first experience in battlefield triage—forget the mortally or lightly wounded, save the rest—a concept easier to philosophize about than to practice.
Bullets were hissing around him. Afraid of dying, more afraid of failing his comrades, Jadick managed to treat the wounded, to stabilize them and stop the bleeding. As he began loading men into the ambulance, an RPG screamed in—and glanced off the roof without exploding. A second RPG slammed into the wall next to them; it didn't go off, either.
One of the wounded was Ryan Shane—the massive gunnery sergeant Jadick had met on the plane. Shane's abdomen was all shot up. Jadick was unable to lift him, so the sergeant had to crawl into the ambulance by himself. "I made room for him underneath the stretchers," Jadick recalled. But he had to turn away another Marine who had been shot in the foot. There was no more room.
As a urology resident at an inner-city trauma center in Baltimore, Jadick had spent a three-month rotation handling gunshot wounds. But the inside of the darkened ambulance, bathed in red light and blood from the wounded, echoing and rattling with the combat close by, seemed far away from the sterile, scrubbed world of a hospital ER. Working with a medic, Jadick pumped Hespan (a clear blood expander) into veins and tried to pack wounds. One man was dead already. His body, on the top rack, was bleeding all over the patients below him and Jadick, too—"down my neck, everywhere," Jadick recalled.
Jadick was covered with gore by the time the ambulance reached a transfer point. People standing around the medical tent were staring at him, so he rubbed sand on his uniform. "It made it go dark," he said.
It was not yet noon on Jadick's first day in combat. A Humvee rolled up and a big, husky young Marine from Louisiana, Joel Dupuis, jumped out and began rambling on that his friend, Pvt. Paul Volpe, was going to die. Jadick ran with Dupuis to find a young Marine slumped over on the back hatch of the Humvee. Hit in the thigh, Volpe was "fluorescent-light white," recalled Jadick. His pulse was thin and weak; shock was setting in. Jadick figured the Marine had lost more than half his blood.
Jadick looked at Volpe and thought of the Marine who had died and bled all over him. "I can't let this happen again," he thought, "or there's no point in me being here." Turning to a young Navy doctor, Carlos Kennedy, Jadick instructed, "Pack him like you've never packed a guy before." Kennedy used his boot to stomp in the gauze stuffing. Meanwhile, Dupuis, who was a corpsman, found a vein to insert an IV, and a liter of Hespan started pumping into his unconscious friend.
"All of a sudden, it was the most amazing thing," recalled Jadick. "It was like Frosty the Snowman come to life." Volpe opened his eyes, looked up and asked what was going on. When he saw Dupuis's anxious face, he joked, "I'm all right, I can see your ugly-ass face."
continued
On Call in Hell
By Pat Wingert and Evan Thomas
March 20, 2006 issue - Then I heard the voice of the Lord saying, "Whom shall I send? And who will go for us?" And I said, "Here I am. Send me!"
—Isaiah 7:8
Richard Jadick was bored. The Navy doctor was shuffling paper while Marines were heading out to Iraq. Once, many years before, Jadick had been a Marine officer, but he had missed the 1991 gulf war, stuck behind a recruiter's desk. Now he was looking forward to leading a comfortable life as what he called a "gentleman urologist." Jadick, with a Navy rank of lieutenant commander, was 38—too old, really, to be a combat surgeon.
But then a medical committee searching for help came knocking on his door. Because of an acute doctor shortage, they were having trouble finding a junior-grade Navy doctor to go with the First Battalion, Eighth Marine Regiment (the "1/8"), to Iraq. Jadick at the time was one of the senior medical officers at Camp Lejeune, N.C. "Who could we send?" they asked. Jadick thought for a moment. "Well," he said, "I could go."
His friends told him he was crazy, and his wife, a pediatrician nine months pregnant with their first child, was none too happy. But in the summer of 2004, five days after the birth of his child, Commander Jadick shipped out for Iraq. On the plane, he sat behind a gunnery staff sergeant named Ryan P. Shane. A 250-pound weight lifter, the massive Shane turned in his seat to look at Jadick. Slowly taking the measure of the 5-foot-10, 200-pound Jadick, the gunnery sergeant said, "So you're our new surgeon. That's one job I wouldn't want to have with the place where we're going." That night Jadick e-mailed his wife, "What have I gotten myself into?"
The place they were going was Fallujah. In Sunni territory west of Baghdad, the city seethed with insurgents. Jihadists had strung up the burned bodies of American contractors in the spring of 2004, and chaos had reigned ever since. By November, the United States was tired of waiting for the enemy to give up or clear out. "Over the past five months, [we] have been attacked by a faceless enemy. But the enemy has got a face. He's called Satan. He lives in Fallujah. And we're going to destroy him," said Marine Lt. Col. Gary Brandl on the eve of the attack. Jadick's regiment, the 1/8, was ordered to take what was, in effect, the Main Street of the city. For Jadick, who speaks in a gentle, matter-of-fact voice, occasionally strained by memories of the men he saved and lost, it was to be a journey to the other side of hell.
The night before the assault, Jadick hopped into a command Humvee taking a reconnaissance mission from the headquarters base outside the city. He wanted to see what he was up against. In treating traumatic injuries, there is something known as the golden hour. A badly injured person who gets to the hospital within an hour is much more likely to be saved. But Jadick knew that in combat the "golden hour" doesn't exist. Left unaided, said Jadick, the wounded "could die in 15 minutes, and there are some things that could kill them in six minutes. If they had an arterial bleed, it could be three minutes."
Jadick knew that helicopter evacuations were out of the question: there was too great a risk the choppers would get shot down. Casualties would have to be driven out of the city. It took Jadick 45 minutes to drive from the base hospital, where he would normally be stationed, to the city. Not close enough. Jadick wanted to push closer to the action.
Jadick, along with 54 Navy corpsmen, his young, sometimes teenage medical assistants, moved to the edge of the city as the assault began; the night sky was lit by tracers and rocket fire. The next morning a call came over the radio. A Navy SEAL with a sucking chest wound needed evacuation. A weapons company was heading in to rescue the man. Lacking much military training, doctors normally stay back in the rear area. But ex-Marine Jadick decided to go to the fight. As shots rang out around them, the weapons company ran and dodged down narrow alleyways toward the building where the SEAL lay wounded. Jadick was armed only with a small 9mm pistol. He thought: "If anyone actually gets close to me, I'm going to have to throw it at him." He felt slightly ridiculous, remembering a "MASH" episode in which Alan Alda tried to scare away the enemy.
In the rubble of a shot-up building, he found the SEAL conscious but bleeding badly. "Get me out of here," the man said. Helping to carry the man on a stretcher down the stairs, Jadick could hear rocket fire and shooting. The air was thick with fine dust and a familiar smell: cordite, from gunpowder. He had smelled cordite before at rifle ranges, but never like this. "It just hung in the air," he recalled.
The radio squawked. Two Marines had been wounded in an ambush in the center of the city. Jadick wanted to get his wounded SEAL back to base camp. But the voices on the radio were insisting that the two men down in the ambush were in even worse shape. It was Jadick's call. He loaded the SEAL into an armored ambulance and set off in the vehicle toward the scene of the shooting. He could hear the firing intensify. Jadick wondered, anxiously, if a rocket-propelled grenade could punch right through the ambulance's metal sides.
The ambulance stopped and Jadick peered out at the first real fire fight of his life. There were not two wounded men, but seven. As a middle-class kid growing up in upstate New York, Jadick had avidly read about war, and even applied to West Point. But he flunked the physical—poor depth perception—and went to Ithaca College on an ROTC scholarship instead. He had served as a communications officer in the Marines, but left the corps after seven years, bitter that he had been left out of the fighting in 1991. Attending medical school on a Navy scholarship, he had never seen or experienced real war—the kind of urban combat that can leave 30 to 40 percent of a unit wounded or dead.
"I can't tell you how scared I was," he recalled. "My legs wanted to stay in that vehicle, but I had to get off. I wanted to go back into that vehicle and lie under something and cry. I felt like a coward. I felt like it took me hours to make the decision to go."
But he got up and went. He felt as though he were "walking through water." Desperately seeking cover, he ran to a three-foot wall where the most badly wounded soldier lay. He lifted the man over the wall to safety. "I put him down on the ground, and he was looking at me," Jadick recalled. The man had a gaping wound in his groin. Jadick tried to "pack" the wound, stuffing sterile gauze packages into the hole torn by an AK-47 round, but he couldn't stop the bleeding. Jadick was forced to make the first of a thousand wretched decisions. "I knew I had six other people that I had to work on. So I don't know ..." Jadick paused in the retelling. "I stopped and went on to someone else." It was Jadick's first experience in battlefield triage—forget the mortally or lightly wounded, save the rest—a concept easier to philosophize about than to practice.
Bullets were hissing around him. Afraid of dying, more afraid of failing his comrades, Jadick managed to treat the wounded, to stabilize them and stop the bleeding. As he began loading men into the ambulance, an RPG screamed in—and glanced off the roof without exploding. A second RPG slammed into the wall next to them; it didn't go off, either.
One of the wounded was Ryan Shane—the massive gunnery sergeant Jadick had met on the plane. Shane's abdomen was all shot up. Jadick was unable to lift him, so the sergeant had to crawl into the ambulance by himself. "I made room for him underneath the stretchers," Jadick recalled. But he had to turn away another Marine who had been shot in the foot. There was no more room.
As a urology resident at an inner-city trauma center in Baltimore, Jadick had spent a three-month rotation handling gunshot wounds. But the inside of the darkened ambulance, bathed in red light and blood from the wounded, echoing and rattling with the combat close by, seemed far away from the sterile, scrubbed world of a hospital ER. Working with a medic, Jadick pumped Hespan (a clear blood expander) into veins and tried to pack wounds. One man was dead already. His body, on the top rack, was bleeding all over the patients below him and Jadick, too—"down my neck, everywhere," Jadick recalled.
Jadick was covered with gore by the time the ambulance reached a transfer point. People standing around the medical tent were staring at him, so he rubbed sand on his uniform. "It made it go dark," he said.
It was not yet noon on Jadick's first day in combat. A Humvee rolled up and a big, husky young Marine from Louisiana, Joel Dupuis, jumped out and began rambling on that his friend, Pvt. Paul Volpe, was going to die. Jadick ran with Dupuis to find a young Marine slumped over on the back hatch of the Humvee. Hit in the thigh, Volpe was "fluorescent-light white," recalled Jadick. His pulse was thin and weak; shock was setting in. Jadick figured the Marine had lost more than half his blood.
Jadick looked at Volpe and thought of the Marine who had died and bled all over him. "I can't let this happen again," he thought, "or there's no point in me being here." Turning to a young Navy doctor, Carlos Kennedy, Jadick instructed, "Pack him like you've never packed a guy before." Kennedy used his boot to stomp in the gauze stuffing. Meanwhile, Dupuis, who was a corpsman, found a vein to insert an IV, and a liter of Hespan started pumping into his unconscious friend.
"All of a sudden, it was the most amazing thing," recalled Jadick. "It was like Frosty the Snowman come to life." Volpe opened his eyes, looked up and asked what was going on. When he saw Dupuis's anxious face, he joked, "I'm all right, I can see your ugly-ass face."
continued