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.