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Letter from a father: The war in Balad

Since I was about four years old, my Dad has worked part time in the Air National Guard. His full time job is at Paoli Hospital Emergency Department as a physician assistant.

Last November, he was deployed to Balad-a large base in Iraq-to work in the ED there. He was only gone for about two months, but that was possibly the longest two months that my family and I have ever lived through.

While he was in Balad, he and the team of doctors, physician assistants, nurses and technicians worked to save the lives of both American soldiers and Iraqi civilians.

This is an email he sent home to explain his experience with the war. Whether you approve of this war or not, I think it is important to move away from the politics that surround it and really listen to what the people who are living it have to say about their experience in Iraq.

Some of you have emailed asking how the war is going from my perspective here in Iraq. Difficult question. Balad AB is a thoroughly Americanized piece of Iraqi real estate, and I can’t see more than about 100 yards outside the wire into the “real” Iraq.

For obvious safety reasons, we aren’t permitted to go outside the gate, so contact with the locals is very limited. I rarely interact with an Iraqi who isn’t a patient.

I watch the same news as you do. The American Forces Network brings us CNN, MSNBC and Fox News, so I see the daily display of car bombs, revenge killings and the Iraqi government’s impotence or indifference towards these events.

I watch the talking heads debate whether this is civil war (what a term, how much more un-civil could this be?), or just “sectarian violence.”

You might think that, by being here, I might be privy to all sorts of information that isn’t available in the States, but the fact is that nobody tells us medical types anything.

We learn more from CNN than from official channels. So, although I’m right here in the middle of things, it seems that sometimes my view of the war is even more limited than yours at home.

To be honest, I don’t know how we’re doing. It sure seems like chaos out there, and I don’t know whether we are making things better or worse. I certainly don’t know how to extract American forces and leave a stable and peaceful government.

I find that my perspective has narrowed drastically, and the only war I can impact or care about goes on in the large tent that is our Emergency Department.

Here our enemy is death and suffering. The enemy doesn’t discriminate by age, gender, nationality, religion or combatant status.

Neither do we. You might think that there would be some preferential treatment of American wounded, that limited resources would go towards our own, but that isn’t the case.

Even captured insurgents get full care; they also get an armed guard at their bedside.

So for eight hours a day, this is the battle: breathe for the patient, stop the bleeding, put the blood back inside where it belongs, reverse the gains that the enemy has made and discover the secret physiological flanking maneuvers and the hidden traumatic time bombs that, if not found, will change the battle to a futile struggle against the downward spiral of failing cellular respiration.

We are well armed for the fight. Our main offensive weapon is a seemingly unending supply of blood and blood products.

I am amazed at how our enemy flees in the face of “2 & 2,” two units of packed red blood cells and two of fresh frozen plasma. The blood pressure normalizes, the pulse rate comes down, and the pallor of near death is replaced by a healthy pink blush.

We have powerful defensive weapons as well. Our patients are saturated with antibiotics to ward off the insurgency of infection that would otherwise strike days after the main battle has been won.

Although it can’t be measured in grams and administered through a syringe, the tender care provided by our nursing staff allows the wounded to regroup and keep up the fight.

Radiology and lab are our Intel sections. Coagulation studies and blood pH tell us how well we are doing against the enemy and what further resources should be committed to the battle.

The CT scanner lets us look into our foe’s order of battle and assess the damage done and plan the surgical counter attack. If the ED is the Cavalry, making initial contact with the enemy and getting the lay of the land, Surgery is the armored counter punch, pushing the enemy back and reclaiming territory lost to trauma.

Most of the time, we win. Especially with our guys, our capacity to continue the fight to the end, by evacuating them to Germany and on to the States for rehab, is more than the enemy can withstand.

For the Iraqis though, we often fight to a draw. We have halted the advance of the enemy, and he won’t claim a total victory, but there isn’t the capacity to completely vanquish him either.

There is a steady stream of very alive Iraqis who are missing limbs and eyes and children who will go through life with physical and emotional scars.

I wonder, what does a former Iraqi policeman with amputations of all four limbs do when he leaves us? What future is there for an Iraqi child who is now paralyzed below the waist?

Sadly, I don’t know the answer to these questions, not in my theater of operations.

So, how is the war going from my perspective? Well, it’s like the proverbial knife fight in a telephone booth: tough, very personal and you get some blood on you. I think though, we’re winning.

Rachel Lambert is a junior at Eastern University who is majoring in English.

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