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Ground Zero, Iraq

"Ground Zero, Iraq" Continued...

Issue: "Lord of the Rings," Dec. 20, 2003

The EMT ward clears slowly but the mood changes instantly. The medical team is sober and curt. "It is very, very hard when we lose three guys," explains nurse Capt. Shirley Daniels. "No one takes it well. We've been doing it for nine months. And it's getting old."

Central Command said attacks on coalition forces across Iraq averaged 50 a day at the height of bombings in November-the worst casualty month yet for U.S. forces in Iraq. Last week they said attacks had fallen to about 20 a day.

The slowed tempo is welcome news here. But it doesn't change the toll for the military's caregivers. The camp itself comes under attack too. Overnight, two artillery rounds are unloaded against suspected insurgents.

"It's hot and cold. You can have 28 attacks and only four wounded. Or one attack with 28 casualties," said Maj. Douglas Boyer, an internal-medicine physician.

Most here are seeing combat duty for the first time. And most will be around well into next year. March is the earliest anyone currently on duty is likely to go home. "There is a lot of trauma here. A lot of trauma," said Col. Carol McNeill, deputy commander for nursing and a 23-year Army active-duty officer. "We see multiple amputations, eye injuries, bellies opened up-the kind of things that stay with you."

The bombing of UN headquarters in Baghdad sent 24 trauma victims to the 21st, including a man with a 5-foot metal window-frame rod protruding through his skull. Technicians had to saw the rod in order to carry him through the trauma unit doors. He survived, but lost an eye.

Trauma victims instantly marshal these hospital workers, but the seriously wounded rarely make headlines. During the first week of December, arriving combat casualties averaged about three a day. A soldier came in with the lower part of his face blown off. His vehicle hit an improvised explosive device, or IED, just outside the camp. When the convoy slowed after the explosion, an attacker shot him in the face.

A severely wounded soldier was driven up to the gate in a Bradley after he was hit by an armor-piercing artillery round. Medics worked to revive him, but he died in the trauma unit.

In another recent case, about 60 hospital personnel volunteered their own blood for a severely wounded soldier after failing to stop near-fatal bleeding. He needed 21 units of whole blood before surgeons located and fixed a contracted vessel from a leg amputation.

The hospital has two recovery units set aside for Iraqi prisoners of war.

"Sometimes they will bring in an American soldier, and right behind him the insurgent who shot him," said Col. McNeill. No one anticipated the hospital would take on prisoner patients, but they have to be completely healed, according to Col. McNeill, before they can be moved to a detention facility. "We treat the patient, regardless of nationality," said Maj. Boyer. But the prisoners have a separate ward guarded by military police.

Defense officials are continuing the embed policy for journalists (which put a BBC camera crew and WORLD in the trauma unit on Dec. 8), but medical personnel here are frustrated by the way news media are covering casualties. Capt. Troy Smith, a respiratory therapist, says reports should not distinguish between "war" casualties before the official end of hostilities and current casualties.

Those reports may exact political damage on President Bush for declaring an end to hostilities last May, but to the staff here, the slant makes it look like the military isn't up to the present threats. "This never was a major conflict; it was a guerrilla war from the outset and it still is. They are trying to maim our soldiers, and that's our whole focus out here," he said.

Dec. 8 may be the only reprieve combat hospital workers have for awhile. The following day the radio was crackling early with reports of bombings at both ends of the sector: A car bomber had driven up to a checkpoint in Mosul and detonated himself among U.S. troops, and soon after there was another explosion in Baquba. None of the wounded showed up at the 21st until sometime after lunch, when one of the Mosul injuries just suddenly appeared at the tarmac. He had already been operated on at a smaller hospital in Mosul, then flown here.

One of the medics who flew with him produced a baseball-sized piece of shrapnel covered in blood. He had saved the chunk, which had wedged itself into the soldier's face. Gauze draped the young man's lower face, but bleeding from his facial wounds continued and some of his vitals were wavering. Scanning his paperwork, one of the nurses noted that yesterday was his 18th birthday. Doctors readied him for X-rays and more surgery, before he would be sent up to Germany.

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