On the Front Lines

A day in the life of a combat ER.

Tough Decisions

The temperature is near 130 degrees on a July day at TQ Surgical. Staffed by Navy physicians, nurses, techs and corpsmen, this trauma center at Al Taqaddum Air Base is between Fallujah and Ramadi, west of Baghdad. The Marines arriving here with combat injuries have been fighting insurgents in Al Anbar province, a desert expanse the size of North Carolina. The crew at TQ Surgical cares for these patients, binding their wounds and sending them back to their units or on to other hospitals. And all too often they line the halls, “manning the rails,” to honor those who have fallen. Waiting for the wounded to arrive is nerve-racking, relieved by some easygoing banter. Then, with a mix of dread and relief, they hear the beat of helicopter blades.

As soon as the bird lands, the Navy corpsmen race to the flight line in a Gator to transport the wounded. “These are kids. Some survive because they’re young and strong. If you can turn them around, the successes can be miraculous,” says Comdr. John Deordio, director of Medical Services and the Shock Trauma Platoon. The flight medic updates the physician on the condition of the two men while the patients are cleared of ordnance: bullets, weapons, grenades. Both have lower-leg injuries. One, Staff Sgt. Garth Lindelef, smiles in relief and flashes the victory sign. His injuries are not life-threatening. But his buddy has suffered grievous wounds and is crying out, “Please, can I have something for the pain? This is awful!” Amid a barrage of voices, talking over vital signs and orders, the wounded are settled as gently as babies on the beds.

“Labs! I want blood right now!” yells Deordio. The Marine has lost a lot of blood. The X-rays show a right leg with badly broken bones. Worse, the knee is shattered, there’s no pulse in the major artery, and the sciatic nerve is damaged.

Before taking him to the OR, Lt. Comdr. Harlan Taliaferro tells the Marine there’s a chance he’ll lose the leg. “You never want to have a guy wake up and discover he doesn’t have a leg,” Taliaferro says. In the OR, he performs the amputation above the right knee. “It’s not easy, but this was the right decision.”

The day gets worse fast. A Marine has taken a sniper round to the belly. He’s getting CPR on the bird, never a good sign. Minutes later, the helo’s blades beat the air. The physicians stand at the door, and within seconds the Marine is swept into a bay prepared for thoracic surgery.

• Military
• • Iraq War
• • International Issues

• The Mental Anguish of War
• Sometimes the battle takes a greater toll on the mind than the body.
• 
• Best Search and Save
• Navy medic Chris Walsh heard a woman's cry for help -- then took on a risky new mission.
• 
• Semper Fido
• One scruffy puppy in Baghdad. One hardened Marine who couldn't leave him behind.
• 
• Beyond the Battlefield
• During hazardous duty, a U.S. Marine and his Iraqi interpreter forge an unbreakable bond.
• 
• Destination: Iraq
• He was working as a second-grade teacher. Then came word that his Army Reserve unit was moving out.
• 

• Be Inspired
• Meet a 12-Year-Old Making a Difference
• Help Prevent Teen Car Crashes
• Meet 6 Incredible Individuals
• PLUS:
• Quiz: Match the Celebrity With the Cause

During my shift as a customer-service agent at Detroit Metro Airport, I was approached by a woman who was so upset that I thought maybe she had missed a connection or lost a child. "I left a book on the plane!" she said frantically. I assumed this had to be a rare first edition of some kind. "Okay," I said, "just tell me the title of the book." Don't Sweat the Small Stuff, she replied.

-- Kevin Ramsdell