10 NOV 2007 A little more coffee

Good Morning! It is 0500, and I’ve got to bear my burden of being the SOD (that’s surgeon on duty) for only a few hours more. It’s too short of a time to get any meaningful sleep, so I’d like to sit a spell and write to you.

How many times do I have to say it was a bad day? I don’t know, I guess until I get home! I was working with an anesthetist who has a tour three times as long as mine and I told him. “If you hear me complaining, slap me!” He’d have an unfair advantage, because once I scrubbed in and my hands were sterile, I couldn’t hit him back! Maybe that is why surgeons throw things in the operation room when they have a temper tantrum. Oh no, it isn’t always professional calm and cool in there. We get along well here, but the truth is, our little crew hoed a tough row last night.

At least I’ll start with some good news. I operated on the boy with the colostomy to reconnect his intestines, and he has done very well. I visited him where he was recovering. He was drowsy, sore, and irritated by the tube in his nose, but he looked like a healthy little boy and could respond to us. A few days rest and I’ll have him running around the ward. I found out that the woman with him is actually his aunt. “But where is his mother?” I asked. She was at home. She was injured in the same explosion that resulted in this boy’s colostomy. She was still too weak to travel, and had to take care of a younger child. Doesn’t that just sound like a mother’s lot? Recovering from a serious injury and still turning in the work to care for a baby. I tell you, if it wasn’t for mothers, I’m sure fathers would just let all the children of the world grow up wild like feral cats.

This boy does look well, and I’ll do what I can to get him home quickly to his mom. He can celebrate the loss of his colostomy by using the toilet again. Ah the simple pleasures. I guess that’s a little task that can be taken for granted until it is rudely taken away.

I have had such a smooth run of luck on my call nights. Sure when I was paired with Vascular surgeon M., I took the heat of a busy night, but I blamed him for that! I must sheepishly admit that the black flag was flying on my watch yesterday.

Our little family here is recovering, it’s clear, but what hit us so hard yesterday is that we lost the life of a US troop. I know that each and every medic in this building will quickly tell you that every life is precious and that we will sweat blood to keep anybody alive. The fact remains that we feel downright low when we lose one of the troops. I can’t justify or fully explain why this is. It is true that it is our primary mission to rescue the lives of combat wounded US troops. We know this, so it feels like the greatest failure when a soldier dies on our watch. We are so fortunate to have the resources and personnel to also care for the Iraq troops, civilians, soldiers from third party nations, and detainees, but we are only granted this expanded mission because we have ensured that we are prepared to care for US troops.

The troop who died was young, and it was a blow to all of us that we couldn’t manage to keep this patient alive. We did emergency lifesaving procedures, and we got the patient to the operating room.  The team performed the necessary operation and all the while the anesthesiologists were intensely trying to recoup the deficit of lost blood and shock. This young patient, with the typical strength and reserves of the young, died slowly in little steps, fighting to the end.

We gave the troop military honors. The troop’s body was cleaned and all medical tubes were secured in place. The body was gently slid off of the operating room table and into a thick black bag with a long zipper running up the side. We lined the walls of the operating room facing the body. Our nurse in charge of the operating room called out “Room, attention.” We snapped to attention, heels together, backs straight, and arms at our sides. The bag was zipped shut. The patient movement officer and the mortuary affairs representative presented a flag folded into a triangle. They carefully unfolded it, suspending it in the air between them over the dead troop. They folded the flag in half once, the long way, with the stars on blue field showing. They lowered the flag to cover the body bag with the stars over the troop’s head, red and white stripes stretching down over the feet. They tucked the ends and sides of the flag between the body bag and the stretcher. I sniffled. Others did too.

The circulating nurse called out “Present arms.” We saluted, arms bent at the elbow, hand and fingers straight and flat, index finger just touching the outside edge of the right eyebrow. The patient movement officer and the mortuary affairs officer grasped the handles of the NATO gurney, one at the head, and one at the foot. They each kicked up the folding legs at their respective ends of the litter stand. The springs flipped the legs up with a snap of metal on metal. They pivoted the gurney and wheeled it between our ranks and out the operating room door. The circulating nurse called out “Order arms.” We dropped our salutes to a position of attention. Some rubbed their eyes, some cried, and some swore. We thought of the fallen troop’s family and missed our own.

I returned to the ER continued to receive patients through the night. We cared for men and women from the USA, Iraq, Australia, and Fiji. Most lived, so did we. I'm going to get a little more coffee before I present the the list of patients I treated to my colleagues at morning clinical openers.

Love life,

Chris

LTC Christopher P. Coppola, USAF
332 AEW/EMDG/OR
APO AE 09315-9997

Christopher.coppola@blab.centaf.af.mil

DSN 318-443-2925