What Am I Doing Here? (Part 2)

This is the second installment of three accounts of my time in Iraq. Only the names of those involved have been changed to protect their identities.

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     40 Commando had secured a disused concrete cattle holding pen as a Headquarters just outside of the northern town of Zakho in the Dahuk Governorate. It smelled of s**t but at least offered some form of cooling shade from the sweltering Iraqi sun. We had managed to purloin some cots or �clicky-beds� from the US Marines a few kilometres to the west of us, it was way more comfortable than the foam roll mat that I had had to become used to. I was relaxing on my clicky-bed and thumbing the pages of a book when there was a commotion at the pen entrance. I noticed the familiar bald head of a guy called Yani, a USMC medic, or Corpsman as they are known. We had frequent interaction with the Yanks, or Septic Tanks as we knew them, as they seemed to have more kit than you could shake a s****y stick at. Yani had been amazed when I revealed that I, as the sole medic, had just one 3�x 4� box of medical stores for 300 men. In addition to full medical facilities, they also had hot and cold running ablutions, satellite TV, a shop or PX as they called it and a wagon that mass-produced burgers � I was still eating out of �boil in the bag� ration packs and hadn�t been able to s**t for a fortnight.
     �Doc! Doc!� I was up off my bed and across the pen almost before I had realised it. Yani was speaking rapidly into his radio. Sergeant Stone jabbed a finger at me, �get your med-kit, the septics have a couple of casualties up the road.�
     My heart was thumping in my chest as I grabbed my med-kit, webbing, helmet and rifle. I followed Yani and climbed into the back of the short wheelbase Land Rover. Yani was in his late-twenties and from South Carolina, he had the measured southern drawl associated with that region and that had led some of the British lads to think that he was a little slow. I just hoped that Yani was every bit as switched on as he should be as we thundered along the dusty track towards the scene of the incident.
     �Word is!� He shouted back at me as the wind and sand bit into our faces, �is that we got two Marines gone an� done stand on an anti-personnel mine.�
     Prior to my deployment to Iraq I had spent the months taping up blistered feet and treating coughs and colds; the worst I had seen was a broken ankle. I started to try to force as much medical knowledge through the sieve of my mind as I could; of a year�s medical training, I could recall almost nothing. We arrived at the scene all too soon.
     Yani knelt beside the fallen Marine and I heard him saying, �f**k no, no, no, no�� Words that meant nothing but that would stay with me forever.
     I immediately went to the second Marine and dropped to my knees placing a hand on his chest, �it�s ok mate�� I started and then stopped.
     �Christ�� Gibbo muttered behind me, he was a Royal Marine�s Corporal and our driver. The first rule of checking over a casualty is the primary survey; airway, breathing and circulation. There was nothing to check, the young man�s face and throat was gone and his chest was a pulpy mass of crimson and pale bone. I pressed shaking fingers just below what was left of his lower jaw, to the carotid pulse at his neck, nothing. I attempted to clear what I could of the airway, the tongue was a bitten-off, purplish stump and the back of the throat was full of dark blood. What skin, that was not blood-smeared, was grey or mottled blue. Priority 4: Dead or unsalvageable.
     �Move on Doc,� the Sergeant said gruffly, �the Yank needs a hand � me and Gibbo will square this bloke away.� Gibbo went to fetch a body bag from the rear of the landrover.
     Yani glanced up at me as I joined him, his mouth opened and his eyes shifted to where the lads had gathered round the second casualty. I shook my head.
     �F**k it!� Yani spat. �Okay, okay, we got a guy with a traumatic amputation to the right leg above the knee, amputations to four fingers of his left hand and the pinky off his right.�
     It seemed strange for a moment to hear the word �pinky� amidst such carnage; it was a word my Aunt used to use, an absurd sliver of normality in a world of blood and s**t.
     �He has multiple shrapnel wounds to his neck, arm and face but he�s conscious and breathing��
     Conscious? For the first time I looked at his face. He seemed dazed, his pale blue eyes staring out from a tattered mask and his mouth flapped open as he breathed. He looked almost drunk as he squirmed and tried to prop himself up onto his elbows. �I�m �k� I�m �k�� He assured us, spitting blood. I noticed that the name tally at his left breast read Castellano.
     �We need to secure that airway,� Yani said rummaging in his bag. It�s a common misconception that even if a guy is talking that his airway is clear.
     �It�s okay mate,� I said to him, �the Medics are here and we�re going to sort you out.� I turned his head to the side and hooked out a thick globule of bloodied tissue with my fingers. �Don�t worry you�re going to be fine, just keep spitting out the blood.�
     Yani and I exchanged glances as we cut away the sodden material to expose the leg wound. Ordinarily with a clean traumatic amputation, the thick muscular wall of the arteries will contract and stem the flow of blood; this wound was not as clean as we�d hoped, it was ragged and haemorrhaging badly. �The leg is f*****g shredded,� Yani said grimly and leaning heavily on the Marine�s groin to compress the pressure point there, �you gotta clamp those major blood vessels.� My fingers were slick with blood and the popliteal artery quivered and slipped in my fingers as blood pulsed steadily from it. I think now that it was more good fortune than judgement that I was able to retrieve it and clamp it off. I successfully clamped the other vessels and the bleeding slowed.
     �S**t, he�s still f*****g slipping, Howie,� Yani said, his eyes wild and sweat pouring down his cheeks. Castellano�s face was ashen and his bright blue eyes were rolling back in his head as his breathing began to accelerate. Yani reached for a wrist and felt for a pulse.
     �He�s bleeding from somewhere else,� I panted cutting into the rest of his combats with my scissors and searching for other injuries.
     �I�ve lost his radial pulse,� Yani whispered reaching automatically for the Marine�s neck. This meant that his blood pressure was dropping rapidly and before long his heart would stop. �He�s tachycardic.� I knew that this meant that he was losing blood and that the heart was working overtime in order to pump oxygen around the system. �His pulse is about one forty.�
     Gibbo, who was First Aid trained, set up two intravenous drips and run them through ready to go. �We�ve got to force that blood pressure up,� Yani said fastening a tourniquet around Castellano�s upper arm whilst I did the same to the other.
     �He�s too far gone,� I said, �everything�s shutting down.� Castellano was going into hypovolemic shock due to massive blood loss and his extremities were closing down to focus the main blood flow to the major organs.
     �F**k it! F**k it! I can�t get a vein either.� Yani angrily threw Castellano�s arm back into the dirt and spat. �F**k you Castellano, don�t you f****n� die on me!� He stared at me, his mouth a tight line. �Can you do a cut down?�
     I wiped some of Castellano�s blood off my face, it�s coppery taste in my mouth. �F*****g hell, I�ve only ever seen one done on a hospital ward.�
     �Well that�s one more than me.� Yani admitted darkly.
     S**t. �Gibbo, hold his leg still, get the skin just above his ankle bone tight.� I ploughed into the contents of my med-kit, my mind reeling. Come on, come on. Taking my scalpel I began to gently tease the skin apart over the saphenous vein that ran down and over the ankle bone, my hands shook and the scalpel blade was greasy in my hands. Focus, focus. Yani handed me a set of forceps, it was scant relief to see that his hands were trembling too. Holding my breath I slid the blunt end of the forceps under the blue-green vein that I had exposed and held it free of the skin so that Yani could slide the needle home.
     We forced through 2 litres of saline whilst we waited for the helo� to arrive, squeezing the bags of clear fluid to bolster Castellano�s blood pressure. The Marine slipped in and out of consciousness as we worked but never once complained of any pain. We managed to regain a pulse at the wrist; a good sign that his blood pressure was rising, also his breathing and heart rate had started to slow. During his seemingly more lucid moments he actually tried to give me the thumbs up. I forced a smile in return and offered some words of comfort but felt suddenly sick to my stomach when I realised that he was staring right through me.
     It was a fifteen minute flight to the Field Hospital at Kani Masi in Dahuk, northern Iraq. I kept the oxygen mask clamped firmly over his nose and mouth, staring into his distant blue eyes. Don�t die, don�t die, don�t f*****g die. His pulse was weak and thready, but it was there and that was what counted. He reached up at one point and squeezed my forearm with four of his good fingers and I swore I saw the corners of his eyes crease slightly as if in a smile. Then his eyelids fluttered and he was gone again. Stick with me mate, stick with me.
     The fast, low level flying of the helo� made us all feel queasy as it stuck to the contours of Iraq�s arid terrain and on more than one occasion I saw Yani spit a mouthful of vomit out of the cab door. I closed my eyes and drew hot air through my nostrils � what am I doing here?

     An hour later, Yani and I sat cradling a couple of bottles of cool water outside the surgical unit of the Field Hospital, our faces, hands and clothing still filthy with blood and dirt. �You the guys that bought the L/Cpl in?�
     A US Army surgeon stood before us, a towel hanging loosely in his hands, we hadn�t seen him approach. We both stood.
     �Sir?�
     The surgeon gave us a curt nod, �you did a good job there; he should have been dead long before he got here.�
     Yani and I exchanged silent glances.
     �How is he now, Sir?� Yani asked, drawing a hand over his tired features.
     The surgeon blinked and cast his tired eyes into the approaching dusk. �L/Cpl Castellano suffered severe internal injuries resulting in non-compressible exsanguination,� he paused as we stared back blankly. �He suffered a fatal cardiac arrest after bleeding out on the operating table. I�m sorry. You did all that you could��

     For:
     Lance Corporal. James Arthur Castellano � aged 26.
     Private First Class. Aaron Josef Delagdo � aged 20.
     And my friend,
     Hospital Corpsman. Yani Janowski.

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What Am I Doing Here? (Part 3) A Story by Howie { Remixing & Reposting }

Reviews

[.Bunnie.]

"Doc! Doc!" I was up off my bed and across the pen almost before I had realised it. Yani was speaking rapidly into his radio. Sergeant Stone jabbed a finger at me, "get your med-kit, the septics have a couple of casualties up the road."

[Vesa Lee]

Amazing. Brilliant. Phenomenal.
The words sound cheap when used to describe this piece.
I'm at a loss of words...and maybe that's how it's meant to be.
Maybe one should be silenced.
Thank you for sharing this.
Thank you for being there.
And I really mean that...

[A sea person]

My mother is a LtCol nurse in the Air Force. She was deployed overseas during Operation Enduring Freedom. I still haven't the courage to ask her of the things she's seen.

God bless you and keep you, physically, mentally and emotionally.

v.r.
Ryan

[dawnsue541]

Okay, so now I know why I was worried about you. I am afraid to read part three.

[Phillip J Clayton]

very raw bro, hey life has it's own gore, but this is not of evil but a reality that exist, awessom stuff bro...now to part 3.

[Narnie]

I am again touched by the raw intensity of this story. You tell it well as your emotion is checked but not panicked... it's more of a resignation to the whole thing. I wish wish wish that this stories like this would land on the powers-that-be tables every bloody morning so that they could see the reality of what their signature on a piece of paper has done to young lives. Im not saying that there are not just causes.. just that there has to be a better way in some cases and that maybe the stark reality of war should be an essential read before any suited official makes the decision. Your writing here is powerful Howie. Really powerful.

[Richard McLin]

This is a Great Piece of writing. This was a great blend of different styles, and I salute you for it. Great job.

[C.m.v]

Well, damn! I wanted them to live...I was hoping you and Yani saved him. How awful. I dont know how you did that. How you could stay calm...its admirable, for sure.
The description was amazing...you have a great talent for this. I was making faces and going "eew!" out loud on my break here at work, and people were like "Whats wrong?"
So, obviously your writing is very effective and I envy the talent for the way you describe scenes. I realize these things are probably still very vivid in your mind, so its not hard to recall details, but the way you write it really draws the reader into it. The expressions, the minute details and even the medical stuff your average person wouldnt know..its all told perfectly.
Normally, this isnt anything Id read. I mean, I love Horror, but not the real human kind, if you know what i mean. But you're writing draws me in. I really respect everyone serving the country
but I just dont know how you endure it all. I've imagined in my mind how tough and awful it all must be, but now that Ive read this, its even worse--worse than any horror movie or story I could ever fictionalize. Sorry you had to go through it all. I feel awful for those marines. Shoot, Im depressed now! What Im trying to say is, great job! If your intent was to affect the reader and make them understand the chaos, panic, gore and bravery associated with being in that situation, you succeeded beyond amazingly.