30 OCT Mischief night

30 OCT Mischief night

The night before Halloween will always be mischief night. I don't know if it is a national holiday, but in 1970's Connecticut we celebrated it as if it was. It almost felt like a social obligation to roam the streets of our quiet suburb in gangs of adolescents and TP anything with limbs. Of course we would tell our parents that we were going outside to defend our homes from being the target of someone else's attacks. We would meet up in the woods between houses. One would bring the TP and another would have nabbed a can of shaving cream. Rivals had been selected ahead of time through careful deliberation on the school bus. The uniform was work boots, Wranglers, and a navy blue hoodie over a baseball T-shirt with white chest and team colored arms. Back then a hoodie was called a hooded sweatshirt, ya know. Mischief night wasn't about the vandalism and littering, that was just a by-product. It was about being part of a crew and sticking it to someone else's crew. I wonder if my children will match our foolishness?

It doesn't feel much like Mischief night in Iraq. Recently, I have been pleased to see a reduction of violence in our microcosm that mirrors the recent trends in all of Iraq. It has been happily boring some nights. The calm was broken this afternoon when a helicopter brought three troops that had been struck in an IED attack. They were riding in a Bradley fighting vehicle when they felt an tremendous explosion. After dismounting and calling in, they waited for dustoff when they got hit by a second IED. They were wheeled into the ER and our crew flitted from gurney to gurney, measuring vital sighs and removing clothing. All three were awake and had little more than scratches on their bodies. Two had been knocked out during the explosion and were still a little punch-drunk, but were regaining their orientation. On first glance, they would seem to be fine. Time will tell if there are any lasting effects of the two explosions. As we learn more about the late traumatic brain effects of the many explosions affecting our troops, we have struggled to keep up and are getting better at detecting the damage. These troops will be evaluated before they leave our hospital.

Around the same time, we received three Iraqi troops injured in an IED explosion. Two were breathing with the help of tubes in their throats. The third had a patch over his eye where a fragment had torn the skin of his forehead into bloody ribbons. Again we made our rounds, checking wounds, taking x-rays and examining the men for hidden wounds. I took one man to the operating room to cut dead muscle away from a hole in his leg that looked like a shark had taken a bit out of it. Deep within his thigh we found a jagged chunk of metal the size of a matchbook. It had torn through his flesh and created this crater. Orthopedic surgeons H. and E. washed dirt and bone fragments from his broken shoulder where another fragment had done its damage. We were relieved to find that no major arteries had been severed. His hands and feed seemed to be receiving good blood flow. While we worked, ophthalmologist H. worked on one of his comrades to remove an eye that had been destroyed by a piece of shrapnel.

We were disappointed today when one of our patients slipped from our grasp. He was the man who had been planting a bomb when it detonated and drove a length of rebar into his leg. We had urgently returned him to the operating room today when an examination revealed signs that an infection was creeping through his burned and battered tissue. We cut away layers of skin, fat, and muscle, trying to remove all of the dying material, but it was too late. The infection had spread throughout his body and even with powerful medicines his heart gave out. It didn't change his care that he had hurt himself attempting to plant a lethal device. His bomb might have killed someone we knew from a base back home or from training. It might have ripped through a family vehicle, maiming and killing children. In spite of this we still felt a defeat because he had made it to our door alive and we hadn't been able to beat back death. Many of our team had taken part in his numerous procedures, and the nurses had spent round-the-clock hours at his bedside administering treatments. Sure, we knew the severity of the explosion and his proximity made it a far shot to save him. We still gave it our best. Whatever judgements we might have made in our hearts, they mattered little when it came time to treat him.

So there you have it. No one here gets out unscathed. Even I, safe in this well defended base and fed hot meals three times a day, know that I will carry these faces with me. But there is no way to face the bad but to hold onto victories and rally for more. A few days ago the burned boy went home in good health. I am so excited to see him at the next Iraqi clinic. I'd be willing to bet that a little time at home already has him walking strong and upright and that fearful look has been swept from his face. He must have something important to to do have made it through.

Perhaps there is a little mischief to be found. Surgeon S. arrived in the locker room one morning to find that someone had written two mysterious "T"'s on the toes of his boots in Sharpie. We still haven't solved the mystery of the T-bandit, but since then I have taken the opportunity slip papers with "T" written on the into his locker and his files. Another morning, Orthopedic surgeon H. discovered that someone had stuck multi-colored smileys all over his uniform. Maybe it was the T-bandit. It's impossible to remove them all on one sweep. I'm sure he was finding them for the next couple of days, like the thousands of size stickers that the Gap insists on plastering on all their items.

All things considered, I think I'd rather be home TPing the neighborhood. Next year, my friends, next year.

Happy Halloween!

Chris