Wednesday, August 8, 2012

The Hard Choices a Medic Will Face

 He was laying face down on a backboard, soot all over him.  Most of his clothes were cut away except for his boots and t-shirt.  I told him, "hang on this is really going to hurt."  And then I started shoving kirlex in the halfdollar sized exit wound in the back of his leg.  A .50 cal round had "cooked off" and gone through his leg.  The second I did, he started squirming and screaming writhing in pain.  At first he just screamed then he started saying things.

"Oh God!  Stop!  Please!  Stop Doc!" he screamed.

I grit my teeth and tried to ignore his piteous pleas.  You have to plug this wounds.  A  tourniquet simply won't do it.   Plugging it will prevent infection, it will speed the healing, and is one of the quickest wats to start clotting in such a wound, but it will hurt so much.  And so on this day I put a man through unbelievable amounts of pain to save him.

"I can't man I've got to do this"

If you can imagine, an abrasion that's getting cleaned, but far worse because its inside your body.  I put half a roll into his leg which probably only took 15-30 seconds.  But its 15-30 seconds that are seared into my memory.  It wasn't the first or the last time I had done such things.

Once I had to help set a man who'd broken Radius and Ulna.  The Orthopedics doctors had given him locals, and he was on some pretty heavy Opoids, but he still cried out.  It was just a simple break or he would have been put under.  I'm here to tell you the sound of bone grinding on bone is something you'll never forget.  You have to put it out of your mind or you'll never get the job done.

The one of the worst things to treat are burns.  That stench of burnt hair is something you never forget, neither do you forget burned skin, or muscle.   The worst part is the pain.  You simply can't touch their pain.  Every touch gives them pain, and it is not a good option to simply put them under.  You have to bandage the wounds, you have to, their skin is compromised and if you don't clean and debreed the wounds quickly they will get infected.  But oh, the pain that causes them.  it is not something I would wish on anyone.  Three times in my life I've treated 3rd degree burns, experiences I would rather leave in the dust-bin of memory, but they, like most of the other cases are pretty vivid in my mind. 

But by far the worst thing every medic is trained for, but truly dreads can simply be labeled as The Choice.  There is no formal name for it, aside for a french name that somehow doesn't relay the horror of what is before you.  Who lives, and who dies.  One look from a trained Medic is usually all it takes to know that a man is far beyond help.  The burns will be too bad, or the wounds in the wrong place.  They will scream and holler, call for you beg and plead but you simply can not help them. 

The responsibility to a 19 year old that is crying piteously for his mother as he slowly bleeds to death from a wound to his leg that tore into his pelvis.  You simply can't plug a hole that big.  You can give some half measure to help, but there is usually never one casualty, so you can not "waste" your time on a man you simply can't save.  These decisions are made in a heartbeat, in the time it takes to look a person up and down.  Your platoon sergeant and leaders may call for a 9-line medivac, their battle buddies will stay with them try to tell them it'll be alright, but you know.  You know that it will not be alright.

I have heard men ask me "am I going to be ok?"

You never say no.  You never tell the truth.  Sometimes you don't speak, but more often than not you have to lie.  You can not tell a man whose scared to death that he has only a few minuets to live.  You have to force a smile and give them as much comfort as you can.  Later this moment will haunt you.  It will haunt you that you lied, and you will wish that you could somehow have made those words true.  You send him off to whatever lies after death, with a lie.  But it is better you tell this lie, than a poor young man spends his last minuets in abject terror.

Thankfully I have only had to lie to a person in this manner just once, though the person I told was not the one dying.  In every war where there is medical support, there will be moments like this.  Rare is the heart that is so hard that does not break at such moments.  you hold onto your composure as much as you can in those moments, you use your mind as much as possible to keep yourself rational, but you always feel for them.  Later, in the quiet moments, then it'll all come back, with a vengeance.  It is hard to show mercy in war.  But this job is vital.  You must have the will to overpower revulsion, and do what is your duty.

There will be times you must treat men and women that moments before were trying to kill you.  There will be children who have the misfortune to be in the wrong place at the wrong time.  You must somehow give the same dispassionate care to these as you would yo your own soldiers that you've lived with ate with slept with and generally suffered with.  The life of a Medic or Corpsman is not an easy one, indeed it is one of the most taxing, emotionally speaking, of any job in the military.  Only commanders have more responsibility, but their burden is lightened by the distance they keep from their troops.  Truth is, there is not a Soldier, Marine Airman or Sailor out there that isn't eternally grateful that their Medics and Corpsmen will risk their life and come running when they give the cry.

Before God, Before their Mothers, they call for me.  I am the Medic, and I will always come for you.

30 comments:

Anonymous said...

With my son deploying in the near future, I hope and pray the medic with his group is as good and compasionate as you. God bless you and thank you.

Spockgirl said...

Thank you Doc, for being who you are.

Anonymous said...

Thank you, Doc. For doing what you do, for what you have done for our soldiers. God bless you.

STxRynn said...

My CMB son told me how many quarts of "liquid" the abdomen can hold without showing. And he told me how he knew and what he did for the man. He mentioned how the brain turns dopamine loose at times like that. I don't know how he does it. But he is amazing at what he does.

Good on you Doc.

Anonymous said...

Thanks for being with us! Medics like you are our best back up. Bless you.

Anonymous said...

From one to another god bless and thank you.

Doberman Dad said...

Well Said !

Anonymous said...

I am a man with countless family at war I wish I was there even after reading this war is ugly but you still save lives for that I thank you they call you not God because god is with you either way remember that. At that time you are the had of God .

Anonymous said...

Doc... thank you for having the courage to put this up for the world to read. I am a prior service US Army Flight Medic so this really touched home. Most of us keep it bottled up and will never talk about it again. Thank you my brother!

Anonymous said...

I myself was a Combat Medic in the war and this hits really close to home. Even when ones own life is in danger there's absolutly nothing else on your mind but of that person calling for you.

Anonymous said...

My dad was a Medic during WWII, he never told me what he saw and did. But only could imagen the horrors.

Uncle Sam's Mistress said...

I have heard those very lies being told in nightmares. I witness the effort my husband gave to some in sleep walking and night terrors. I knew that it was bad, but you just opened up a new world for me of understanding the demons that haunt him now. My husband served OIF, AR Ramadi, Iraq 15 months as a Combat Medic. Thank you so much for sharing your stories, insight and for speaking up. I am very grateful for finding your blog! Thank you sincerely from one medic's family to yours. I have shared your blog on my FB page in hopes that other medics might find you. God Bless. Uncle Sam's Mistress @ Living with PTSD and TBI www.armyreservistwife.blogspot.com

Alishia said...

As a Navy Doc's wife, I hear what you have written in the screams during his nightmares. I realize that being medical in a combat zone is the toughest job. Thank you for sharing your story!

Anonymous said...

It is a special person who will kneel beside someone who is suffering so much. A special person that can put aside the fear they feel to deal with someone elses. It is a special person who will run into anything for their comrade to save them and even more special to do it for someone you don't know and just moments before tried to kill you and your friends. God bless these medics, as every soldier knows, they are indeed very special.

Anonymous said...

the pain and suffering that you are around in a trauma setting are terrible
God bless and ease the burden of those that do what few can

Click Here said...

Hi There, I just spent a little time reading through your posts, which I found entirely by mistake whilst researching one of my projects. Please continue to write more because it’s unusual that someone has something interesting to say about this. Will be waiting for more!

Anonymous said...

Well said Doc, our title is earned in the heat of conflict. I too am a combat medic and know all to well what you are going through. God bless you. 91B/68W HHC 1-504 PIR 82ND ABN DIV

Josh Orth said...

thank you

Anonymous said...

From a fellow "Doc", very well said. I don't regret anything from my time as a combat medic, I am honored to have been able to be there for my Joe's and many others. But the images never leave you, it's a lot to carry sometimes. But it's also who we are, can't change it if we tried. I tried - ended up a paramedic on the civilian side. Keep your head up bro, there are a lot of us out here who know what you're goon thrum and got your six. And keep writing, it's good for the soul. SSG B, 68W/EMT-P

St Louis Medic said...

Wow, I never thought about it before but as a combat medic most of the "pt's" you are treating are your friends. As a medic in a very violent city, daily shootings are something that you deal with and don't get you emotionally upset anymore. However if every shooting call I ran on was a friend I don't know if I could handle that stress. Thank you to all of our soldiers, and a special thank you for your job.

D.J. Mattsen said...

Thank you for this blog. The scenes described here are spot on. I shared this page with my girlfriend of 3 years to try and explain why I am always "on edge", "moody", and "restless". I am hoping that it helps her and all of the other families out there to understand that we, the combat medics, and veterans, aren't crazy or "psycho". Its sometimes overwhelming when these memories intrude on everyday thought and during everyday life.

Thanks again...hooah!

lynbpickel said...

Thanks for sharing your experiences. I am a published author who plans to write a book documenting the firsthand experiences of combat medics. My son will be returning home after 8 years as a combat medic, having served in both Iraq and Afghanistan. After all that he has seen and done, you will understand when I tell you that he suffers from PTSD and TBI (as well as injuries to his back, arm and hand). Thank you for all that you do. If you ever feel like it, I'd like to hear more of your experiences.

Anonymous said...

thanks for sharing.

Anonymous said...

Thank you...you've inspired me

D. Wolf said...

You are amazing! I'm also a combat medic and I have many times tried to put pen to paper and write about my service. I could never find the word to describe it or my feelings. The only ones I could talk with about it at all were the guys I served with or other medics. After many years I gave up trying.
I found your blog and read all and cried through most of it and I felt a kind of release, thank you very much.

ditchdoctor said...

I am a civilian paramedic. I understand all to well what your are referring to. I have told those lies numerous times. Thankfully only twice to people I knew and cared for.
Thank you for putting into words the things that are hard for me to explain to people about what I, we, do.
Thank you for your service and for my freedom.

"Ditchdoctor"

Anonymous said...

As a "Doc" in an airborne infantry platoon I couldn't of said it better myself. Knowing that your best friend is bleeding internally and there is nothing you can do but lie and tell him it will be all ok. Or running a half a mile up a road just to find a friend shot in the head, dead by the time you reach him. That is more than any 20 year old (like myself) should ever have to go through. But just knowing that all the others that made it home to hug their moms and kiss their wives because you were there for them on the worst day of there life makes the job worth it. I wouldn't trade it for the world! "So that others may live!"

Anonymous said...

Thanks For Your Service, I'm Retired Navy and have a CMB who my Wife and I consider a Son who has just arrived in Afghanistan. I know that he is well trained and will be looked after very well by his Brothers, such as the Seals & Marines look after their Corpsman. Thank You to all of you Combat Veterans for your Service and Sacrifices. Praying for all of you Stay Strong and God Bless !!!

Anonymous said...

Great post, I am enlisting hopefully as a 68W and would like to talk more about the life.
nastrup2@gmail.com
Thank you for your service.

Anonymous said...

Thank you for what all that the Combat Medics and Navy Corpsman do. I am a Marine Corps vet. and I know that the words a Marine doesn't want to hear is" Corpsman up!!" or the yell for "DOC".. But it is sure a beautiful site to see and know that the "Doc" is coming to get you no matter what is going on or how bad the firefight is... I loved my "DOC". We all did. Little did I know that years later Doc and I would work as Officer's for the same Police Department...We were back together once again. My 21 year old son is a Combat Medic and I am so PROUD of what he does. Thank you all for your compassion and putting yourselves in harms way to save the lives of others!!