On Memorial Day....(Thoughts from Afghanistan)

Trigger warning...for those with PTSD.



The air reeks of an acrid odor that will never come off your clothes or possessions. A smell so bad that your wife will swear you shipped home a dead animal in your footlocker. A smell that you'll come to loathe and yet, at times, you'll open that footlocker and dig through the gear and take a big smell of the contents, just to remind yourself. That overwhelming acridity would follow every action and move you made in country. You can't forget the first time you smelled it as you landed in that C-17 from Kyrgyzstan, the flight where you noted the beautiful Himalayan mountains in the winter. It would follow you from the rear base, appropriately named Camp Leatherneck, until you reached your destination, God knows how many clicks away at the furthest reaches of NATO lines. Your home for seven months would be a small prison, except with the sentry guns pointed outward. You'd be warned of snipers looking to take shots at you as you attempted to exercise in your down time by running around the flightline. Yet, the smell of the country would persist. Despite the raw beauty of the sunsets, the brutal sandstorms that battered your every movement without warning, or even the ever welcomed shower, nothing would rinse that smell away.

I can still see, in my minds eye, our first multiple amputee. I had been awoken by the duty corpsman who got word over comms that we were getting a triple amputee. It was an ungodly hour and I was immediately pulled from sleep to wake with such a fury that the distance from my tent to the STP/FRSS tents was little more than a blur, that's Shock Trauma Platoon/Forward Resuscitative Surgical Services...think M*A*S*H but more austere. Our corpsmen struggled to bring him into the triage area, not because of the weight, but because of the unnatural act of carrying a grown man on a cot that has lost both legs and half an arm. The young marine looked up like a pale ghost with the look of recognition on his face that he was in the hands of friendly medical personnel, and he collapsed. We opened his abdomen to control the blood vessels running down to his bloody stumps of thighs before he had even been put under anesthesia...he wouldn't remember and the catecholamine rush would help his heart restart. After getting in and clamping the pelvis vessels, we got a pulse back. Blood flowing...fluids running...we left the clamps in place and placed a temporary covering on the abdomen. We weren't there to do definitive surgery...our job was to stabilize and send them on to a real hospital...one where sweat wasn't dropping into the wound, or the talcum fine sand that covered everything. After placing the covering over the abdomen, we did our best to clean up the thigh wounds that extended up to the groin and the arm wound that sheered all portions of what could be considered normal anatomy from his right hand except for the skin, leaving behind a ghostly glove of a forearm and hand, the fingers nothing more that a skin silhouette with fleshy bone fragments attached.

That marine would go on to have five times his blood volume transfused, he'd survive the visible injuries, but would ultimately die from the brain injury he endured from the initial blast, but not before his family had the chance to be by his side one more time and say their goodbyes.

We would care for and operate on many more casualties during our time in Afghanistan. Locals, Marines, NATO forces....if I close my eyes, I can see their faces, relive their cases....in my darkest moments, I can still smell the blood on my hands, mixed with that damn acrid desert air...even now, six years out.

We would be given accolades for our trauma care, we'd write articles about how to manage multiple amputees, we would share our experiences far and wide and yet...the details, the horror, the trauma, would only be shared amongst those of us who were there, who knew what we saw, who laughed and cried and fought over what we did...even as we transitioned home, some of our fellow medical personnel had no idea what we had experienced. Sure, they empathized, they listened, but they didn't know....

Even now, six years out...I wake up at night reliving that time...I dream of those we cared for...I still see their faces...I can smell their blood on my hands...and that desert aroma still shrouds my every move.