I read a recent comment from a fellow blogger who mentioned she read my other blog, Downrange Mama. Since I had not looked at it in a while, I decided to swing back the doors of time to check it out. It has been 2 years nearly to the day where I was getting ready to leave the hottest and dustiest place I have ever had the good/bad fortune to set foot.
2 years ago… I was getting ready to leave Kandahar after finally completing a very quick turnover of my nighttime duties to my relief. We had just made it through a relatively quiet Ramadan season and then all hell breaks loose. Literally.
So what happened? Backstory…I had just had lunch with a buddy who was a medic with one of the units ripping out and some of his fellow medics in one of the few air conditioned eateries in the airfield. We were all getting ready to redeploy: them, after a full year and me, after about 6 months boots on ground (counting that awful week of waiting in Kuwait). It was a nice visit with “Z” and his fellow medics. Who could have imagined that I would see any of them again at work? They were all starting to decompress as they prepared to leave the warzone.
That same night, I was on duty and training my relief, Dave, for the 1st time. We only had a couple of shifts before I was supposed to be wheels up and on the way back to Kuwait before heading straight home to God’s country, Texas.
Sand, sand and more sand Well, we had been in a couple of days of sand storms, the kind that creates a spooky, Stephen King “the fog” mood in the middle of the day and that grounds all kinds of flights like, oh, medevac flights. The worst part was that we still had folks getting injured but no way to fly out for higher level of care. So by the time I came on shift, there were a handful of serious injuries, Alphas, throughout the area and the medics and docs on scene were maintaining as best as possible. (in peacetime it is akin to making lemonade of lemons… In war, it is embracing the suck)
Whence the recovery flight would have taken less than 30 minutes there and back, the pilots were likely very frustrated by the lack of windows of opportunity to get up in the air. But the worst was still yet to come.
Our hospital was in the midst of a major staff turnover so we had a good number of staff available should a mass casualty occur. But the challenge in handling a mass casualty is the sheer simple management of events beyond your control and resources which you don’t own but which relationships established over time prove mighty valuable.
You see sometime in the evening, before my shift, a handful of soldiers were involved in what’s called a dismounted IED, meaning they were not in a vehicle when someone or something hit a mine or IED. Normally, the birds would already be enroute and Joe Soldiers would be in the Trauma Bay within minutes, considering how close they were to “us”. However, Murphy ruled that night and no helos were flying. Too dangerous. They could go up but couldn’t guarantee that they could land safely. What to do, what to do???
Well, that really wasn’t all the trouble. The injured belonged to the unit that I had lunch with earlier in the day. So I knew that the majority of medics were already out of the Argandab Valley and awaiting transport off KAF so there was a skeleton crew of medics taking care of 5 injured soldiers. And no air support in sight.
But Americans are far from down when the going gets rough. The solution came in the KISS format. The ingenuity of the medical liaison and others was critical in this case. We had the best medical care waiting for the patients and every hour outside the golden hour was heartwrenching. Plus I had to time the mass casualty call for staff support. No need to wake up the trauma teams hours ahead of time. It is best to let them sleep as long as possible.
So what was the solution? Get the injured into armored vehicles, in this case MRAPs, and start heading down. Since the roads around Kandahar City aren’t the safest in the world for man and beast alike, that meant a road trip that would be at least 3 hours in the middle of the night. That’s compared to a 10 min flight! Now if you’ve got injured soldiers, their unit commanders crowding the trauma bay entry and a new crew turning over in the trauma bay, that heightens the overall stress factor. What a way to train my relief on how to manage the scenario!
Now add another 3 or 4 injured coming from another direction also via MRAP and then there’s a mass casualty experience like none other for new and old crew. So my last mass casualty was just as busy as my first with one significant difference: 8 MRAPs pulling through the Role 3 driveway all at the same time vice a Chinook or Blackhawks careening through the night sky. What a way to get training and turnover for the new crew, by the firehose! Although it was purely by chance, it turned out best to have a mass casualty happen while the old crew was still around. I heard that a few days later when we were already decompressing in Kuwait that they had a mass casualty during the day and the other TOC who I didn’t train and frankly, rubbed me the wrong way, didn’t call the trauma team at all so when the ambulances came back from the flight line full of injured soldiers, the teams weren’t ready and waiting. We all make mistakes in the beginning but since he didn’t want to listen to his predecessor, his turnover was severely stunted. Yikes!
back to my last mass casualty…Thankfully we didn’t lose anyone that night, but my relief didn’t like the sight of blood so I was thankful he didn’t lose his midnight rations! (I heard through the grapevine that he was the best TOC of his rotation so hopefully I prepped him well. He also took my advice and stayed on nights throughout his stay there… Makes being a deployed parent and calls home easier with the time difference).
Why on earth am I reminiscing about this tonight? I am thinking of the folks there now and although I consciously avoid reading the news about Afghanistan much nowadays, I do empathize with the numerous caregivers and support staff there at the Role 3. They pour their hearts and souls into their work. They sleep little, eat some and hopefully relax some too. Some will passionately become social butterflies and cheerleaders for those who get the Blues with a capital B. Others will avoid close relationships with coworkers. And still others will make friendships that last a lifetime.
They are an incredible bunch of folks, of that I am certain. I pray they all return home safely and with their spirits intact.