Caring for those who bear the fight

  • Published
  • By Master Sgt. Tom Allocco
  • 439th Airlift Wing Public Affairs
Westover Air Reserve Base, Mass. --  Three medical professionals of the 439th Aeromedical Staging Squadron served four months in a place where theories and abstracts give way to tangibles as real as the shriek of a mortar alarm and the smell of burnt explosives, propellant and metal.
Lieutenant Col. Robert C. Dorman, Maj. Robert D. Rostedt, and Maj. Maureen A. McCann treated physical and mental casualties north of Baghdad at Balad Air Base, part of the complex spread over 15 square miles known as LSA (Logistics Support Area) Anaconda. Among the approximately 30,000 Soldiers and 3,000 Airmen, the alarms and aftermath of mortars are routine enough to keep alive the three-year-old moniker "Mortaritaville" for LSA Anaconda.
In the course of their tour, they experienced the gamut of emotions - - admiration for the selfless troops they served, leaden exhaustion, pride when they won and frustration when they couldn't do more amid pain and loss.
As a mental health nurse in the 332nd Contingency Aeromedical Staging Facility (CASF), Major McCann's job was to treat the stresses of life in a combat zone before they build to a breaking point, which can be as simple as lack of sleep.
"It can start with working long hours, maybe the hut air conditioner is not working and you can't sleep, or off duty there is an attack...it's enough to keep you awake," she said.
"There is an alarm red, an alarm yellow, you have to call in for accountability, you're standing in heat waiting in line to call in.
"Until you haven't slept 48 hours, you don't really know what lack of sleep is. It's a pretty powerful stressor. Everyone's symptoms are different, but like any symptoms, if stress is untreated, you're just not functioning at 100 percent. It can be debilitating," Major McCann said.
"You can train for it, but you don't internalize it until you really live it," she said.
Colonel Dorman took leave as a Veterans Administration physician to go to Balad.
"As a VA physician, I saw Iraq and Afghanistan veterans. But in Balad it was different. We saw them immediately after IEDs (improvised explosive devices), young amputees. Some of the burns were worse than the IEDs...people with lung injuries on ventilators," he said.
His job included flying missions in an Army C-21 at 180 feet off the ground, at times attracting AK-47 gunfire.
Working 24-hour shifts as a physician in the CASF, preparing casualties for evacuation to Germany, Colonel Dorman came home with what he described as a profound admiration for the wounded and injured men and women.
"They are always worried about their friends, always worried about others more than themselves. They're not typical patients. I think that's one thing I took away from Balad...the young people I saw there are the bravest, most selfless people I've ever run across," Colonel Dorman said.
A civilian emergency room nurse, Major Rostedt served in Balad as a critical care nurse at the Air Force Theater Hospital. Patients included Americans, Iraqi soldiers and police, and Iraqi civilians.
"The mission is to care for Americans, but if a civilian is caught in crossfire, or if we are the only ones who can help, we will try to help. (Sometimes) the Army and Marines will call and say they need help for civilians," Major Rostedt said.
"A three-year-old was burned, her mother killed and her father wounded. Once they land we are going to take care of them," he said.
"Some are purely humanitarian missions. Two 10-year-old boys were flown to Balad when they fell off a truck and hit their heads. The only two neurosurgeons in the country were American," he said.
The medical teams were not immune to frontline stress that comes from experiencing victories and defeats.
"After an IED blast, we replenished the blood supply of two Marines more than five times each. One died before he left the hospital. I remember his name. I saw his name in a Doonesbury list of casualties," Major Rostedt said.
"The other gentleman, we were able to save and send to Germany. We were successful," he said.
"There was an Army lieutenant with massive head trauma. We knew he wasn't going to survive. We worked to get him to Germany to be with his family. He deserved that.
"We learned he died three days later and his family was with him. You feel honored to be able to do that, to give him the dignity of being with his family," Major Rostedt said.
The reality of modern, rapid aeromedical evacuation is that bonds are quickly formed and broken, leaving the caregiver in a kind of limbo.
"One convoy left Balad, got five minutes off base and was hit by an IED. A driver was pulled out of his burning vehicle by one of his buddies and four to six hours later he was on his way to Germany," Major Rostedt said.
You work to stabilize patients, you see a change, and then they are gone," Major McCann said.
"And then there is a new group," Colonel Dorman said.
"The injuries are so ferocious, you don't know how they will do...it could go either way. You have no idea," Major McCann said.
"That's the bad part because you like to think they are getting care and getting their lives back together," Colonel Dorman said.
"Every once in a while I'd read in Stars and Stripes that someone died and maybe remember him from the hospital," Colonel Dorman said.
"For a lot of the patients you don't know how they will do for a year or two...if they will recover and have a future in society, be able to have a relationship with their families," he said.
Colonel Dorman, Major McCann and Major Rostedt came home with no neatly-wrapped conclusion to their experience.
"There was a desire to make a contribution, but also a sense of frustration because there was so much that was needed," Colonel Dorman said.
"Sometimes it takes years for an underlying psychiatric disorder to manifest itself. We don't know yet the full effect of what's happening.
"I talked to a 23-year-old, and this was his third tour, and you may see a cumulative effect," Major McCann said.
The three ASTS medical members were in Iraq as Memorial Day approached, prompting Major Rostedt to send an e-mail to family and friends.
"As I get ready to leave Iraq, Memorial Day has taken on a new meaning for me. It will remind me of the men and women of our military that have made such great sacrifices for our country... Remember, freedom is never free and they are paying the price for freedom. God Bless America."