No Place to Hide Read online

  Still dressed in my dirty DCUs, I put on my boots and stepped outside to search for the nearest facilities. I walked down the sidewalk in a monochrome world. Everywhere I looked, I saw one hue — brown. Brown dirt, brown buildings, brown vehicles, and brown uniforms. The constant desert wind carried blinding sand, hiding the green of scattered trees and patches of grass and frustrating the dawn sky’s attempt at blue. If this was the place God chose for the garden of Eden, why was the predominant color so boring?

  Three blocks later I found the shower trailers. Two rectangular cubes sat on wooden decking, one marked “Males” and the other “Females.” A huge plastic drum sat between them, connected to the trailers by pipes. Foot-high block letters warned us that this was “Non-Potable. Do not drink.”

  Signs inside the trailer reminded me I was in the desert, and water for showers was in short supply. I was to use the water for no more than sixty seconds at a time. This is known as a combat shower. I shaved at a sink with two faucets, one of which had a sign, “Do not use this water for brushing teeth.” I wondered what types of bacteria were found in water deemed safe enough to wash with but not to have in my mouth.

  A few minutes later I emerged from the trailer, shivering in the cool morning air and smelling more like myself. I managed to find my way back to my room, where I put on a fresh uniform, ate two candy bars I found in my backpack, and opened my laptop computer to write about my journey so far.

  A knock on the door announced the arrival of the sergeant; it was time to formally check in at the hospital. When I asked about email, he said, “It’ll take about three days to get your account set up — I’ll take care of it.”

  We walked the one hundred yards to the parking lot and his Humvee. Along the way, he pointed out a long, rectangular row of concrete tubes, about five feet high and four feet across. “The bunkers,” he said. “You’ll find them all over the base. When you hear the Alarm Red sirens, put on your gear and head to the nearest bunker until they sound the All Clear.”

  Just past the bunkers were sand-covered blue Porta-Potties and a trailer marked Laundry. “Take your dirty clothes there. The Filipino contractors will do them for a couple of bucks.”

  I thought, I have a laundry service in Iraq. I didn’t have a laundry service in San Antonio.

  Since last night’s Alarm Reds hadn’t amounted to anything, as far as I could tell, I was about to ask the sergeant if the bunkers were really necessary. Before I could speak, he pointed to a trailer just past the laundry — still standing, but mostly destroyed. “A mortar hit there last week in the middle of the night. No one was killed, thank God.” He continued, “Most of these mortars have about a thirty-foot kill radius.”

  We were about fifty yards from my room.

  I looked at the laundry, where twenty or so people stood in line for their clothes. All of them were within thirty feet of the blown-up trailer, meaning that if the mortar had landed in the daytime, many people would likely have died. I checked the strap on my helmet, but it didn’t make me feel any safer.

  We climbed into a Humvee for the five-block drive to the hospital. As I looked out the window, the sergeant played tour guide, pointing out items of interest. Balad was a bustling, noisy military city of over thirty thousand people, ten times larger than my hometown of Broken Bow, Oklahoma. I saw defunct Iraqi tanks, rusted airplanes, concrete bunkers everywhere, and a huge airfield. The sergeant explained that Balad was Iraq’s largest air base under Hussein’s rule, and now LSA Anaconda was the Army’s major supply and distribution center for the war. Convoys left here every day to carry the goods of warfare to the troops — convoys that would face IEDs and other perils along the way. I didn’t know it yet, but the attacks on those convoys would supply me with many of the patients I would treat, and many of the nightmares I still have.

  We pulled up to the hospital and I stepped out of the Humvee, excited about starting my new job as a combat brain surgeon — an excitement that was equal parts fear and anticipation. The morning sun cut through the sandy haze in the sky, slightly diminishing the monotony of the one-color world in which I now lived.

  How could I feel so blue in such a brown place?

  CHAPTER 3

  EVERYWHERE I LOOKED, I SAW DIRT

  Here you go, Major. Good luck.”

  The sergeant dropped me off at the gate to the 332nd Air Force Theater Hospital and drove away with a wave. A guard checked my ID and waved me through. I remembered how I felt when my mom left me at kindergarten on the first day — how I had watched her leave, wondering what would happen. I’d felt scared, excited, and a little tearful — just as I felt right now. But today I thought, Shake it off, Lee. It’s showtime.

  The walk from the gate to the hospital was about a hundred yards. I looked around the compound as I walked and felt like I’d stepped onto the set of the television series M.A.S.H., complete with a jeep-turned-ambulance with a red cross on its sides and a canvas stretcher leaning on its hood. A couple of nurses stood around a trash barrel, smoking with a group of weary-looking soldiers. A signpost held markers labeled Balad 3 Miles, San Antonio 7,400 Miles. Another sign said Days Since Last Mortar Attack — 3. The word Days had been scratched out and replaced with Hours.

  A Humvee was parked inside the gate. A soldier stood on its roof, working on the machine gun mounted in a turret. Another soldier was leaning on the open door with his head hanging down. A can of Coke sat on the roof above his head. As I approached, the private on the roof jumped down. He landed facing me. Our eyes met, but he looked right through me.

  “Hello, Private,” I said. “How’s it going?”

  He shook his head as if I’d startled him. He felt his chest and then his helmet with both hands.

  “We hit an IED a few minutes ago.”

  I stepped closer to him and noticed for the first time that the side of the Humvee contained hundreds of little dents in its armor. There was blood on the turret where the private had been standing.

  “Are you guys okay?” I asked.

  He looked at the ground. “Our sergeant was in the turret. He’s in surgery right now. We just got this new armor last week, or we’d all be dead.”

  I didn’t know what to say, so I just stood there for a second as the reality of what he’d said penetrated my brain. It was the first time I truly understood that just a few hundred feet away was a gate that led out into the real war. These young men had been not far from the base when they were attacked.

  “I’ll go check on your sergeant,” I said. The private thanked me and leaned back against the Humvee, digging in his pockets. He produced a cigarette and lit it. I noticed a little twitch in his right eye.

  His partner was still leaning in the Humvee’s open door, looking down. He never turned around.

  I stepped around the Humvee and headed to the hospital.

  The noise level increased, and it occurred to me that I hadn’t heard silence since I’d arrived in Iraq. Wind, the distant whump of an approaching helicopter, the roar of a passing transport plane overhead, Humvees in the street — all these sounds jumbled together to provide a soundtrack to life in the war.

  I studied the hospital as I approached it. It sat on a square concrete slab about two hundred feet on each side. The complex was composed of several tents arranged around a central, larger one. These were not little Boy Scout camping tents — they were about ten feet tall and built on wooden frames, like houses with canvas walls. The tents were connected by short walkways made in the same way, so you could go from one tent to another without going outside. At several points around the compound I could see short metal cubes that looked like my quarters, only sturdier. The tent hospital seemed to engulf the front end of each of the cubes, like someone had cut a doorway from the side of the tent and attached the cubes. I passed one on my way in and saw CT SCANNER, FIELD, PORTABLE, US ARMY written in black stencil on the side.

  The emergency department was in the large central tent, and its double doors were marked with r
ed crosses. It sat at the end of a wide concrete walkway connected to a helipad large enough for several helicopters to land at once. Two teenaged airmen played Frisbee on the sidewalk. I watched them for a moment, suddenly surprised at the ability of kids to relax in any situation. One of the airmen made a wild throw, and the Frisbee flew over his friend’s head toward me. I bent to pick it up and noticed that the concrete was stained in several places. Dark red trails along the sidewalk told the tale of other days, when the pathway served a much more somber purpose. I flicked the Frisbee back to the airmen and walked into the hospital.

  The six beds were empty. Clean white sheets gave no hint of the wins and losses those beds had seen before. I wondered what had happened to 1856.

  “Good morning. You smell better.”

  I looked up and saw Pete. He shook my hand. “Glad you’re here. The Australian you replaced left five days ago, and I’ve been on call ever since.”

  He looked like it. “Hey, do you know what happened to the sergeant they just brought in?” I asked.

  “The IED attack?”

  A surgeon walked toward us, blood on his scrubs, his mask hanging in front of his chest. Pete said, “Hey, Vic, how’s that gunner doing?”

  Vic stopped, pulled the cap off his head, and looked sideways. “Lost him. I’m going out to tell his squad now.” He walked toward the door.

  I wondered what I would say when it was my turn.

  After breakfast and a brief introduction to the hospital commander, Pete took me on a tour.

  The first stop was a dirty tent containing a desk with a computer, a couple of chairs, and a worn-out couch currently occupied by a snoring man wearing hospital scrubs.

  “This is the surgeons’ lounge. You can check email, hang out, crash on the sofa,” Pete said.

  “I could never sleep there,” I said, thinking of the neck ache that poor guy would have when he awoke.

  Pete laughed and punched my shoulder. “We’ll see.”

  Next to the couch was a scraggly plastic Christmas tree, complete with blinking lights and tinsel. The walls were adorned with numerous crayon-drawn posters from elementary schools back home, thanking us for taking care of the troops and reminding us we were all heroes. A television set in the corner tuned to CNN was broadcasting a story about the developing problem of improvised explosive devices in Iraq. I thought of the dead sergeant and the shaken-up soldiers in the parking lot and wondered how Vic’s conversation had gone.

  Pete introduced me to several other members of the team hanging out in the TV area, about to watch a college football bowl game. There were five general surgeons, two chest and vascular specialists, three orthopedists, an ear-nose-and-throat doctor, an ophthalmologist, and an oral surgeon. Overall, we had something like thirty doctors, fifty nurses, and another hundred or so technicians and support personnel.

  The urologist I’d met over 1856’s bed was there too.

  “Hey, Bob. How’d it go with 1856?”

  Bob looked away from the television and raised his left eyebrow. “Who? Oh, the guy from the other night. He’s okay, going to Abu Ghraib soon.” He turned back to the TV.

  I nudged Pete and said, “Abu Ghraib? Isn’t that the place where — ”

  “Yeah, the prison you heard about last year. When the bad guys are well enough to leave here they go to prison, usually Abu Ghraib.”

  The scandal at the prison had been world news in early 2004, less than a year ago. Horrible abuse of prisoners at the hands of poorly trained and undersupervised guards had led to several US soldiers going to prison themselves, and at least one general officer had been stripped of command and demoted. Ironic, I thought. Iraqi terrorists blow something up, get arrested, wind up in prison, are mistreated by their captors, and the story of their abuse becomes fuel for the recruitment of even more desperate insurgents from all over the world, some of whom end up in our hospital and eventually at Abu Ghraib. A cycle of sorrow that starts and ends with hate. I remembered Jesus’ words: Love your enemy. If anybody in that cycle had tried that, maybe some of these guys wouldn’t be here.

  Pete sat at the computer to check his email. I sat on a chair and tried to strike up a conversation with the other surgeons. No one was very talkative. I felt like a replacement soldier in an old war movie: A few of the squad’s veterans are killed in battle. In the next scene, rookies arrive to replace the fallen men, and nobody talks to them. The seasoned troops are suspicious of the newbies, afraid to get close to them.

  When the surgeons around the TV said something to each other, I felt their camaraderie and brotherhood. These guys had been through a lot together, saved and lost lives together, been there for each other. And they were going home in a few days. I was an outsider to them. They were the seniors about to graduate, and I was the pesky freshman who’d somehow made the team. Pete was different. Maybe it was his personality, or maybe it was because we shared a specialty, but he accepted me and took care of me.

  From the surgeons’ lounge, Pete walked me into the central area of the operating room. Plywood panels framed the thresholds between the lashed-together tents. I suspect that my jaw dropped when I saw the area in which I was supposed to perform lifesaving brain surgery. A forty-foot square contained several desks and computers, shelves full of surgical supplies, refrigerators storing IV fluids and medicines. In the corners were four simple foot-controlled washbasins. These were the scrub sinks where we would wash our hands before surgery.

  Everywhere I looked, I saw dirt. Dirt on the walls, on the floors, on the desks. How could I possibly operate here without infecting all my patients?

  Pete pointed out the heavy plastic sheets hanging like drapes in each doorway. Their purpose, he said, was to keep the dust and sand from blowing through the hospital, keeping the air cleaner. “You should have seen this place before we took it over from the Army,” he said. “We’ve cleaned it up a lot.”

  The Army had run a combat support hospital (CSH) at Balad until the Air Force was assigned to take over the bulk of the medical mission for Iraq in the fall of 2004. The Air Force assigned the 332nd Expeditionary Medical Group (EMDG) to turn the CSH into the 332nd Air Force Theater Hospital, a small part of the 332nd Air Expeditionary Wing. The 332nd had a history dating back to World War II. The famous Tuskegee Airmen, the “Red Tail Fliers,” were the first all African-American fighter units. They painted the tails of their P – 51 Mustangs red, and had the best record in history of protecting bomber pilots on raids over Germany. We were now standing in Iraq, in a tent hospital bearing the same insignia, part of a legacy of people assigned to save others; we were the Red Tail Medics. Pete was the first Air Force neurosurgeon deployed to the war. I was the second.

  “Come on, let me show you where the action happens,” Pete said. I followed him through another threshold into a twenty-foot-square metal box that contained two surgery tables about five feet apart, with two anesthesia machines, two sets of surgery lights, X-ray boxes, and IV poles. Although most of the hospital was made of tents, the operating rooms were hardened, designed to withstand mortar attacks. With four of these ORs, we would be able to operate on as many as eight patients simultaneously.

  Walking around the hospital with Pete, my inner camera lens began to zoom in a bit, and I noticed that this place was highly organized. Once I got past the austerity and un-hospital-likeness of the environment, I could see that everything here was carefully thought out.

  In one low-ceilinged metal cube, I saw racks of neurosurgery supplies. We had to anticipate needs, Pete said, because it would take a week or more to receive new items after we placed an order. If we ran out of something, we would just have to make do until the next airplane arrived.

  In San Antonio, I could demand a particular brand of gloves if I didn’t like what was available, and someone would scurry around until they found what I thought I needed. A three-ring binder on the shelf at my hospital, labeled “Dr. Warren’s Preferences,” contained detailed instructions and specifics on what I us
ed for every type of surgery I performed.

  I came by it honestly; neurosurgeons are famous for being prima donnas in the operating room. We throw fits if we don’t have a particular instrument available right away. In fact, some of my colleagues have been known to toss instruments across the room if they don’t work properly or aren’t what the surgeon had in mind. At a hospital cafeteria in Pittsburgh, I once overheard a group of scrub technicians discussing the worst experiences they’d ever had in an operating room. One of them laughed and said, “Working for those perfectionist neurosurgeons, hands down.”

  When Pete showed me the instrument sets we would use in surgery, I realized that a prima donna, perfectionist attitude would not work in Iraq. There were only four sets of sterile brain surgery instruments available, the contents of which had been chosen by a surgeon years before and had been sitting in a warehouse waiting for a war ever since. It took three hours to clean, process, sterilize, and repackage the instruments for their next use, and we didn’t have backups for most of the instruments. So if multiple patients arrived at once, so that several operations had to be done in rapid succession, we could run out of sterile brain-surgery-specific tools. I would have to learn to work with whatever was available.

  In the middle of the hallway Pete led me down next, a low spot had standing water, and on either side of it were muddy footprints. There were water stains on the walls. We were in the Iraqi rainy season, Pete explained, and when it rained, as it had two days before, parts of the hospital flooded.

  Just past the mud hole in the hall sat the intensive care unit. This tent featured parachute cords stretched along the walls. These cords replaced the fancy racks and poles found in more upscale ICUs, but held the same monitors and IV infusion pumps we’d had in the ICU back in San Antonio.