Journal of a front Line Surgeon: Part II

Aussie,
The following are excerpts from my journal:
Dr. G

MORTARS

Ear drums burst
the death spray comes
warriors fall...uniforms smolder

Healing hands work fast
to late for some
furrowed brows and sweat stained foreheads
play the ultimate tug-of-war with death

Time stands still...
eyes glaze over
limbs tremble as life's essence
ebbs into the sand.

I look into this warrior's eyes
his color darkens and he begins
the journey across the river Hades
as soldiers shout "hang in there... don't give up on me!

Doc G


Sgt A...
I've lost count of the casualties we've treated today, or how many hours Ive been in the O.R. My legs ache, and I feel like I could sleep for a week. My surgical scrubs are covered in sweat and my hands are showing that slite tremulousness of fatigue and hunger, but there's no time. We have a report of 3 more soldiers coming in, victims of an IED, we don't yet have an updated report on the extent of their injuries. The trauma surgeon, Dr. S and I quickly down a bottle of water as we help clean and re-prep the OR and regown.

As I quickly reglove, they bring a young Army Sergeant to the table. His eyes are wild with panic and his mouth drawn in pain. My medics have done an excellent job in containing the bleeding and there are dressings and splints in place to all his extremities. Dr. S and I separate as two other surgeons join us, (there's a surgeon at each extremity now)unwrapping dressings, hanging blood, assessing vital signs, examining for wounds.

The soldier begins speaking in spanish, and answers alll questions in spanish. The anesthesiologists and other surgeons look at each other,an then at me. I make my way to the head of the bed and begin to speak softly to him in Spanish. I explained that we have 4 surgeons at his side who will help take care of him. The sound of someone speaking to him in spanish has a calming effect as the anesthesiologist administers a sedative.(His medical history, medications,allergies, etc have all been obtained my very skilled medics) and we're ready to proceed.

I end up evaluating his left arm with Dr. M, our orthopaedic surgeon. As I remove the wooden splint, my heart sinks as his forearm bends in half at mid shaft. Arterial blood spurts out and venous blood begins to ooze as the bandages come off. I see a macerated stump with two jagged bones standing sentinel at mid forearm. It's apparent that his forearm is held together by a thin, single strap of skin from his upper forearm. We quickly apply a pneumatic tourniquet and I look over at Dr. Metz who shakes his head "no" (signifying that we can't save this arm). I ask for the bone cutters and begin the process of converting the skin and bones into a viable flap.

I feel a rush of emotion come over me as we amputate the arm, and I want to burst into tears and sob uncontrollably as I look at this young soldier's face. I can't help but think of all the challenges he'll face in life when he wakes up. I try to focus and avert my gaze, trying to concentrate on the task at hand. I'm hoping that no one has noticed my tears.

Despite his many injuries, the young Sergeant lives, and will be air-evac'd as soon as he's comes to. I wait by his side until he opens his eyes and gains recognition. The only remaining task is for me to break the news that we had to take off his left arm...

Doc G

Check out the rest of Dr G's Journal on my second blog, frontlinesurgeon.blogspot.com,
SSG Oz
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