On Feb 23, 1991 at 1502 hours, I crossed the border into Iraq. I had just invaded my first country. War was no longer a threat; it was a reality. I was attached to the 3rd Squadron, 2nd Armored Cavalry Regiment. Our mission was to spearhead the 7th Corps through nearly 200 kilometers of Iraqi desert, find the Republican Guard, engage and hold them until the rest of the corps came through to destroy them. A mission of this nature had never been attempted before, but those in charge believed that it could be accomplished and it was our job to prove them right. It was hard to believe that the waiting had ended. Five months earlier, I didn't know who Saddam Hussein was; nor did I care. Now I was part of a force that would dismantle his military might, liberate the world from his egomaniacal rule and free the Kuwaiti people from his terror. This venture promised to be costly both in men and equipment. It was estimated that 220 casualties would come from our squadron of 1200 men, including 40 men who were expected to die. We were expecting to lose one of our tanks for every four of theirs. We faced not only conventional weapons but also the very real threat of chemical weapons. Were we ready for this mission? I was confident that the scouts and tankers were ready. The command was ready and, of course, America was ready: But as a Physician Assistant (PA), I had never been faced with a mass casualty situation. In practice scenarios I had always performed well, but that was practice and this, real. I had never had patients that I was responsible for die. Would I be able to deal with that? I didn't know and it was too late to back out now. There were many firsts in this conflict. European units were deployed for the first time since World War II. PAs for the first time would be filling positions normally held by physicians. National Guard and Army Reserve units were activated for the first time in years and many technological advances in weaponry would be tested. There were many aspects to the war fought in Iraq. One was witnessed daily on CNN; precision guided missiles, spectacular explosions, the burning skies of Baghdad. The another was the 100 hour ground war, where not only was I impressed with what modern weaponry can inflict on the human body, but how much damage the human body can withstand. The last is the battle of the mind; the emotions, the fear, the anger, relief, the guilt. This is the aspect of the war I describe daily in my journal. This book is an important reminder of what soldiers face on a personal level when combat is inevitable. With the political tone today, this book is timely.
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26 February 1991 Excerpt from the Ground war
Last night we were placed in a hasty defense with an easterly heading. TheTawakalna Division was heading directly for us. We waited. There were some vehicles fired on during the night, with secondary explosions. We treated no enemy wounded because the lines had not advanced to collect them.
The news at 0500 today said Saddam had ordered his troops out of Kuwait and that they would be back in Iraq by the end of the day. Our response was, they may leave but the vehicles and rifles stay in place. So the war continues.
After yesterday, I had seen all the trauma I wanted to. I was ready to end this thing and go home. By this morning the adrenalin was gone and the realization that humans were being dismembered and killed became apparent.
Just after 0500, we received word that five EPW's were on their way to the aid station. These men had been wounded during the sporadic fighting during the night. The call came in as we were preparing to move out. The white team was designated to treat the casualties while the rest of the combat trains advanced. LT Starrs who had been monitoring the battle, stopped at my vehicle and told me the White Team needed help. I jumped in his vehicle with my aid bag. We drove to Steve's aid station where I prepared to go to work.
Only a few minutes had past when the casualties arrived. The first casualty had a partial amputation to his right arm and multiple shrapnel wounds to his lower extremities. His arm had been packed with 4x4 gauze and wrapped with bandages. The bleeding was under control and he had a large bore IV started and was stable. The rest of the men had wounds to their legs except one who had lost a large section of his gluteus.
All these men were stable and were being cared for by the medics when we got a call that four Americans and one EPW were on the way. We instructed the medics to bring them to the white aid station since we were already set up to receive casualties. We continued packaging the enemy soldiers for transport. Choppers were on the way. Luckily the weather had partially cleared. Before the medevac arrived, we received word that the American casualties had been taken to the Blue Team (my aid station) and were on the ground.
By now my aid station was three to four kilometers away. I jumped in the HUMVEE with LT Starrs and moved out, leaving Steve to finish with the Iraqi's.
We had preached over again and again that patients would be treated at the working aid station. One of the medics asked us what to do if the ambulance came in and the medics insisted that the patient be treated at their aid station. They simply would explain how the patients will be treated faster if they take them to the "working" aid station. Obviously, this time it didn't work.
On the way, I kept thinking that I was about to treat "our guys". I had taken pride that treating enemy soldiers I had given them the best care possible and tried to put behind me the fact that the were "the enemy". Suddenly I realized what a crock of shit that was. Treating your men, people who were injured for our just cause, had top priority. These men would get the best I could give them. But unlike the Iraqi casualties, there was an emotional bond that tripled the stress I had felt earlier.
When I arrived, SSG Dowridge had triaged the patients and they were being unloaded from the ambulance. The patients were seriously injured...
28 March 1991 Excerpt of our Humanitarian Mission
I wonder just how much good I'm doing for these people. I know that many people who need to be here cannot cross the road blocks and that hundreds of people are dying. I would like to make a difference, if not for many, maybe for one. A prime candidate came in this morning.
She was brought in on a Bradley. She was orphaned last night when the building she and her mother were in exploded. Her mother was killed. Her father died at the governments hands a few days ago. She was scared, alone and looked as if she had eaten very little these past days. She had jet black hair dark brown eyes that were filled with pain, fear, and tears. She dared not cry aloud, but the tears were streaming down her face. She knew that her country was just at war with us and that until proven otherwise, we were evil. Instead of the ribbons that most little girls at home would wear, her hair was decorated with thousands of lice. Her clothes were tattered and bloody. She had a puncture wound to her back just under her scapula. The wound wasn't deep and I was convinced that there was no lung damage. Her lungs were clear and she had no apparent tenderness when I compressed the lateral aspects of her thorax. The wound was old. I could not suture it for fear of infection. I cleaned her wound. Knowing that I could have sent her back with the young man who brought her in, I opted instead to send her to the hospital where she would be deloused and properly fed.
This little girl had touched me emotionally. She was all the proof I needed that wars are not only fought, and felt, by soldiers. She had no future. Her government was broke and I doubted there would be much humanitarian support for the kids. I hoped that by keeping her in our system, she would be sent someplace where there were people who could care for her.
My brown-eyed girl was not my only patient. We treated a twenty five year old man who was hit in the lower leg by an RPG. He was lucky. The round did not go off and he only received an open fracture of his tib-fib. A fourteen year old boy lost most of his right hand to a round from an AK-47. We had our second open mandible fracture in as many days. A thirty year old man with a through and through bullet wound to his left thigh escaped fracture but he began bleeding from the wound and my medics had an opportunity to stop bleeding and start an IV. Another young man had an open fracture to his patella. All these patients were sent to the hospital at the base camp, which was overwhelmed but had not yet closed its doors to those who needed to be there.
Many told us of how it looked like Saddam's troops would be in total control by dark. They were leaving their homes and all their worldly possessions; just trying to get out with their lives. The towns have been declared unclean and the Iraqi army has been ordered to purge those left who are above twelve years old.
Because of the uncertainty of our stay here and the questionable supplies that will be available to us, we have been ordered keep all food and water for ourselves. We can not share with the starving people that trickle into our camp. This order was especially hard to follow for one of the scouts today. He walked over to my tent. I could tell something was bothering him; something other than being thousands of miles from home. Something other than pulling guard, and deciding who could come in and who would have to remain outside the safe zone. I waited. He looked at me misty-eyed and told me that an Iraqi family, a man, his wife, and five children were walking by. The man stopped and whispered in the little girl's ear. She shook her head and then reluctantly walked over to him. He was sitting on the tail gate of the Bradley eating his noon MRE. The little girl motioned to him that she was hungry and thirsty and asked for food and water. He was determined to follow orders and refused the little girl. She kept asking and he kept refusing until she finally ended the confrontation of wills but did not end the torment. She left with muddy streaks on her face, a mixture of dust and tears.
There were no words to console the soldier.
2 April 1991
The fighting has intensified this evening. There are many fires in the towns on the horizon. The silence is eerie. There are no reports after the explosions. Perhaps it's because of the wind. It's blowing towards the towns. The wind will help me get some sleep tonight. I wonder how long it will be before the people in these towns will get to appreciate the calming effects of the wind, or how many will still be alive tomorrow with the promise of another torturous day at the hands of Saddam's faithful followers.
There were more tracers and more explosions in the towns nearby most of the night. We were told that the Iraqis had been re-supplied and were not wasting any time using their new found treasures on their civilian enemies. I guess that probably explains why I haven't seen a patient all day. The atrocities described by the refugees are so gut-wrenching that they are unbelievable. The Iraqi soldiers are not only killing men and women but they are stealing what little dignity they have and attacking their sexuality. Women are tied up in the town square, stripped naked and are disemboweled, or their breasts are severed; leaving them to die slowly. Men are treated similarly except instead of breasts, they loose their genitals, dying then from exsanguination. We were also told of a woman running down the street with her baby in her arms. The Iraqi soldiers waited until she was almost exhausted from her flight and then cut her in half with an RPG, killing both her and the child she so desperately tried to save. The lifeless power lines are now used as gallows as dozens of people are executed at a time. And there is nothing we can, or will do, for those on the wrong side of the fence. We are here merely to bide time while the 18th Airborne Corps deploys back to the states. Every day, it gets harder for me to justify our inactions.