19 OCT Nowhere to hide
Good evening. I can think of little today except the young boy who died this morning. He was one of the two boys I have been treating for serious burns. I left the hospital at 1300 this afternoon, but now I'm back at 2200 because I couldn't sleep in my hooch. I'm sorry to share bad news, but that's the only news I got. We all knew he had little chance of surviving the day he came to us. Even his father told me that he had thought he would die when we spoke today after his son's death. He had stumbled into a pile of burning leaves. His clothes ignited and severely burned his skin, turning it to a thick charred leather. For over a week now our staff has worked night and day trying to save him. The nurses put in such long hours at his bedside and it is so emotionally demanding to care for a burned child. I tried to choose the right course of therapy and timing of his operations but in the end I failed him. It just makes me feel empty. All last night he was struggling to get oxygen through his swollen lungs and his immune defenses began to fail. I visited him this morning. He was so ill that I cancelled the surgery I had planned for him. I didn't think he could make it through the day. He couldn't make it through the morning.
I was in surgery when he died. I was washing dead tissue away from an Iraqi soldier's leg stump. His leg had been blown off in an explosion two days ago. His body was peppered with small wounds where fragments of metal had entered his skin. His wounds were clean and he appeared to be healing. After surgery I found the boy's father. I spoke words to him. Interpreter J. translated them. The words didn't change anything. I had watched this man dying a little every day as he watched his boy's body swell, tubes coming out everywhere. When there were little victories, we shared them. One day his lungs worked better. Another his fever broke. Day after day I cleaned his burns and removed dead skin but found little sign that his whole body was improving. Now it is over. The father has gone home to his family with five other children. I think there is no escaping the fact that there will always be a hole where that beautiful little boy used to be.
Last night on backup call I had little to do. I spent the day working on men and women of various ages with wounds on various parts of their body. One boy had open wounds on his legs where the muscles had been to swollen and I was able to close them. Another boy was in the operating room for 13 hours while four different surgeons took their turns to remove his shattered eye, evacuate blood from around his brain, rebuild the fragments of his face with delicate metal bars, and painstakingly reconstruct the jigsaw pieces of his skin. I helped Oral surgeon L. reconstruct the tube in his cheek that made saliva. When the long marathon was over, he still was swollen, but his precious little face was whole again. His mother had been pacing and seeking updates on his condition for many hours. His whole family had been injured together. His father wasn't clear on what had happened. He told us that they had been away from home for several months. When they opened the front door of their house it was as if the entire house exploded into them blowing them backwards. They were seen at a forward base and rapidly flown to us in helocopters.
After finishing my operations, I sat around the hospital. People passed by me this way and that. Many asked me for directions since the surgeons' desk looks so much like an information desk. I worked for a little while on my MBA assignment on the Norwich University website but the connection was slow. People said hello but I didn't have much to offer. I wanted to be alone so I went back to my hooch. I skipped dinner and watched "The Fifth Element". Lelu multipass made me smile. Sleep didn't come. There was no hiding from my thoughts. So now I'm here. It honestly feels a little better to write this down even if it is a one way conversation and I'm dumping on you. Pain shared is halved and joy shared is doubled. I'll look for some joy to share next time. Tomorrow I'm operating on a boy who has had a stoma bag for 5 months after being shot in the belly. He has grown healthy enough to get rid of that colostomy and be made whole. that's a reason for joy, even if the recovery will hurt a little.
I miss you.