Dave Williamson, emergency medical technician, army medic
Interviewed in Tyler, Texas, December. 10, 2007
Born: 1982 in Shreveport, Louisiana
“Knowledge studies others, Wisdom is self-known;
Muscle masters brothers, Self mastery is bone;
Content need never borrow, Ambition wanders blind;
Vitality cleaves to the marrow
Leaving death behind.”
— The Way of Life According to Lao Tzu: An American
Version, chapter 33
translated by Witter Bynner, John Day Company,
1944.
DW:
My introduction to emergency medicine was very flawed. I had absolutely no aspirations of going into the field of medicine. I didn’t ever plan on having anything to do with medicine, and it wasn’t because I was scared of blood or anything, it was that before I enlisted into the service, I planned a career based around either mechanics or criminal justice. I have always been fascinated by the field of criminal justice.
Well, I am colorblind which left me with, like, 5 career options in the military. I didn’t want to sit behind a desk, which left me with about 2 options. One being a radio operator — they call them RATS in the army, short for Radio Teletype Operator — and the other was a job where I would be put in a garrison environment and wear a suit all day. I had absolutely no interest in doing either, but I was offered an $8,000 bonus to go into communications. At the time I was 18, and if you dangle $8,000 in front of any late-teen they’re going to jump at it. So I jumped at it, went to school, and I became a radio teletype operator.
When I came out of high school I also never anticipated ever going into the army. Even up to the point where I graduated from Basic Training I thought that the army life just had to suck. You know, you just sit out there and train for 10, 12 hours, and too many people yelling and screaming. I had no interest in it whatsoever, but I came home and did my research and found out what an average day is like in the military. At the time I was in the Louisiana Army National Guard and had already finished up my training by graduating Basic Training and Airborne school at Fort Benning and Combat Radio Operations at Fort Gordon. I looked at the benefits of active duty, and everything I had already accomplished, and I said, “This is fantastic.” This is something I want to pursue.
When I went to MEPS (Military Entrance Processing Station) to figure out where I was going they told me that I’d be assigned by the needs of the army, and that I had no say in the matter. The contract was entirely up to them because it was my choice to go into active duty. They told me that my first duty assignment was going to be Korea, and that I’d be shipping in September. I was not looking forward to being in Korea in the middle of winter and I said, “No, there’s no way. I’m not going to Korea.”
They said the only way that you can get out of your duty assignment of Korea, is if you reclass your MOS, which is Military Occupational Specialty. So I said, “Well, what are my options?” And they said, “Per needs of the army, your only other option is 77-Lima”, which is a PAC clerk…a paper pusher. And there was no way; I was not about to be a paper pusher. I was an ASE certified mechanic before I went in, and I always enjoyed working with my hands and taking things apart but even that was not open to me because of my colorblindness.
I’ve got to pause right there and go back in my story. When I was at Fort Benning for basic training almost the entire company, 250 to 300 people strong, were going to Fort Sam Houston to become combat medics. In fact I was one of three people in a platoon of 65 that was not going to be a medic, I was going to go do radios.
Lincoln, I’m not going to lie to you or church this up to make it sound glorious, or that I did it because I wanted to go and save lives, because that was the furthest thing from my mind. But at the time I was 18 years old, and the female to male ratio at Fort Sam was 7 to 1, and I was single with no dependents.
So I said, “I’ll give this combat medic thing a shot. It’s a field job, it goes hand in hand with all the other work that I had enjoyed. That’s what I want to do. I get to work with the infantry, and I’ll be a combat medic.” But my sole motivation of going to Sam Houston was because there was a lot of females there.
LS:
Was this just general basic training?
DW:
No. Fort Sam Houston was the AMEDD … the Army Medical Department Center of Schools, or something like that. It’s a block away from Brooke Army Medical Center, which is the leading burn hospital in the country, if not the entire world. It’s way, way up there. So they had a lot of officers and a lot of people who were very good at what they did. As far as medical anything for the military, not just the army, it happened at Fort Sam Houston.
So I said, “OK, I’ll be a combat medic. This is going to be great!” But I had absolutely no interest in becoming a medic. And I didn’t think I was going to be any good at it. I was nervous, I didn’t want to have that much responsibility — I already knew radios — and I especially didn’t want to go down there and train for 22 weeks.
When I got there I was really looking forward to it, but I was really just looking forward to the females. By the time I graduated I came to feel that it was something that I was really, really good at. Not only was I really good at it, but I was really interested in it.
LS:
This was now 22 months later?
DW:
22 weeks.
LS:
Pretty quick training.
DW:
It was like taking a drink from a fire hose. It was, “We’re going to give it to you, and it’s up to you to learn it.” Now here’s something that I know you’re going to love to hear. To this day I have lived my entire career by this philosophy. There was an instructor, his name was Sergeant First Class Cook, and he was a real down-to-earth guy, and he’d talk to us like people first, and NCOs (Non-Commissioned Officers) second.
Well, we were being, … uh … we weren’t holding ourselves accountable for our own actions. We thought that since we were all prior service we were special, and Sergeant Cook told us one day — he never really yelled, he never got upset — he told us, “In no other job that you ever have does it matter if you sit through the class, day dream, doodle, or what-not, but if you don’t remember this stuff then somebody dies, and it’s your fault because…” — and he wasn’t saying it to me, he was generalizing — “because you didn’t want to pay attention. This truly does matter. This is life or death. No other job you have had has been a matter of life and death and this entire career field is a matter of life and death. And if you remember, then you’re not even doing something that fantastic; you’re just meeting the standard. That’s what we’re teaching you here: how to meet the standard.”
Ever since then, when it came to medicine, if I heard it, then it clicked. It was almost at an autistic level, but if I heard something that had to do with medicine, then it clicked. You could have told me one thing 5 years ago, and if it pertained to medicine then I would remember it to this day.
I’m not going to say that I grew up in a troubled home, but my Mom pretty much considered me a lost cause. She put all her time and effort and money into my sister — my parents were divorced — and just considered me to be this great, giant, enormous screw-up. Even when I did something right I was still a screw-up. So when I did something right it didn’t mean that much, I considered that I was doing something my sister was doing all along. So it wasn’t anything big to me. It wasn’t a big deal.
It wasn’t until later on that I figured out that — and I’m not trying to boast — it wasn’t until I started doing medical work that I realized how good I was at it. And it wasn’t by my own admission because I had doctors and surgeons and nurses and PA’s (Physicians’ Assistants) asking me, “How do you know all of this stuff? This is medical school stuff?” Well, I’d just tell them the story about Sergeant Cook, and tell them that the stuff just sticks. I don’t really know how to explain it.
So that’s how my job in the medical field — which I’m absolutely in love with — came to pass. I know a lot about a lot of stuff, but I’m not truly great in any one field. After Fort Sam I took off to Fort Campbell, home of the 101st Airborne Screamin’ Eagles Air Assault division.
LS:
Where’s Fort Campbell?
DW:
Well, it’s shaped like a “U,” and the upper half is in Kentucky, and the lower half is in Tennessee. When I first got there I was assigned to a divisional command, which was a pretty high honor for a person of my rank. When I first went there Major General Turner was the General,,… uh, as you were… the first General — I went through three Generals — the first General was David Petraeus, so I actually served under General Petraeus who, you know, now is the MNFI (Multi-National Force-Iraq) Commander, and then it was Major General Turner, and then it was another guy. I don’t remember his name because I wasn’t in the army for very long after he took command.
My position was interesting because not only am I working with the people that run the division, they run the entire post. There were a lot of people rubbing elbows with really High Brass, the folks in Washington, and all that stuff.
They put me in the 801st Main Support Battalion. I’m not sure how familiar you are with the military but breaking it down — and this is very important to understand what I did — breaking it down you have brigades within divisions. A division usually consists of 3 to 5 brigades. Within each brigade you have 3 to 5 battalions. Third brigade was called the Rakasans. The Rakasans were commanded by Colonel Steele, Colonial Steel was Captain Steele in Mogadishu, during the conflict portrayed in the movie “Black Hawk Down.”
So you have the three brigades and HHD, which is Headquarters and Headquarters Detachment. And we have 1st Brigade, 2nd Brigade, and 3rd Brigade. All four of them are infantry, but HHD has the motor pool, and the HHD guys that are in charge of the whole brigade.
Within every infantry brigade you have the Ground Pounders that lob the mortars and shoot the rockets and pound the ground and do all that stuff, and then you have the forward support battalion. The people that are not on the line with these guys in the infantry battalions are support: PAC clerks, finance, quartermaster, transportation, all that stuff. And medical.
Now, if you were a line medic with the infantry you fell in under HHD and they would assign you out to different companies. But for a forward support battalion, line medics can’t uphold higher echelons of care, whereas a forward support battalion can set up their own aid station that has more capabilities than the infantry medical aid station such as X ray and lab capabilities. Every brigade has a forward support battalion. Now, you take all these brigades and they fall-in under a division. Just like a forward support battalion is to a brigade, a main support battalion is to a division. Does that make sense?
LS:
I guess so.
DW:
I was assigned to division command. Main support meant that we were supporting the divisional command, we were supporting everybody. If one of the medics in the line units die, get sick, or go home, or if they need another medic for this or such and such, or anything, they can draw from the main support battalion, because that’s what we’re there for. That’s where I stayed for about a year.
LS:
Isn’t that sort of an office job?
DW:
Very much so, very much so. It kind of fell apart, and I was really upset because my skills were just steadily going down the drain. I was wasting away. You have so many people that are so eager to get just a little bit of patient contact, and here I am where my skills are useless.
The Department of the Army announces that they’re forming a new division, the 506th. Now the 506th is the same brigade that was the “Band of Brothers.” But I stayed in the same spot and I was getting really upset. I started to kick up a stink because I felt that I would be a greater asset to be an infantry medic with the training I had already received. And at this point I knew I was good at what I did. People had told me, and it was apparent when I did get to work. They knew that it just came second nature to me.
So I took it to my rear detachment commander and I said, “Look, all we do is sit in an office until lunch.” We literally did nothing! We watched TV until lunch, and lunch was about two and a half hours, and then at around 1600 we’d empty out the trash and go home. Naturally, I’m furious. So I said, “There’s got to be something you can do so that I can keep my medical skills up.” And he said, “Yes!”
They sent me to work in the clinic. The clinic was a TMC, Troop Medical Clinic, and there I picked the doctors’ and the PAs’ brains all the time. Picked their brains, I mean it was to a point where the docs would come find me and say, “OK, this is really rare.” They knew that I’d remember it.
I worked there for a little bit, and I met a PA whose name was Lieutenant Patton-Curry, we’ll call her Vickie. Vickie was so completely blown away by my skills and talent that she was rallying with my command to send me to PA school.
LS:
What’s a PA do? Do they work directly behind the doctor?
DW:
They can pretty much practice by themselves. As a PA I would have gotten my commission, I would have been an officer, and I’d be working on patients all the time. But in the mean time I had to start taking classes. My command said, “No, you’re not doing it.” They decided that since I was so advanced they’d pull me out of the clinic and put some of the less advanced medics into the clinic in order to learn stuff. And I said, “That’s ridiculous! I’m getting really good at what I’m doing and just because I’m getting really good you want to pull me? That’s not fair!” Well, the army’s not fair.
I picked up a slot for EMT (Emergency Medical Technician) Intermediate School. I went and passed and everything like that, so now I’m an EMT Intermediate, which pretty much establishes that, yes, I do know what I’m doing, I’m good at it, and I’m shit-hot.
Well, after that they refused to do anything with me. They said, “You’ve got all the training that you need, and you’re really good at what you do.” And I said, “So that’s it? I just wait ‘til we deploy and that’s it? I keep on doing the petty stuff? That’s not really fair.” Once again, the army’s not fair.
Turns out that I stepped on a lot of people’s toes doing what I did next. There was another PA that I worked for named Lieutenant Scranton who was a Special Forces PA, and he was impressed by my PT scores. And there was another PA named Major Briley, also a Special Forces PA. I worked hand in hand with the both of them.
Major Briley and Lieutenant Scranton took me up to SF (Special Forces) Recruiting and didn’t tell my unit. They both believed with my knowledge in the medical field and my motivation, that I would excel as a Special Forces medic and convinced me that I had what it took. One morning I went to the clinic while everybody else was going to PT, but when I got there they took me up to SF Recruiting so I could take my PT (Physical Training) Test. I passed it with flying colors and was given orders to go to Special Forces selection. When I took it back to my unit, they got furious.
LS:
Because you didn’t follow the standard procedure?
DW:
I didn’t go through my chain of command, and they’d already told me I’d had all my training, and I was weakening the unit strength. Plus, I was their showcase EMT Intermediate, their resident subject matter expert on combat medicine who taught the combat lifesaver program for the division’s different units which was like saying, “Look at our guys!” I wasn’t about to be a statistic.
Around Christmas time of that year I get a phone call — I was home on leave — and I get a phone call from my old platoon sergeant. The platoon sergeant that I met when I went to Fort Campbell, and who managed to stay with me all they way through my army career — and I went through 7 different units — he was always my platoon sergeant. He would move into a new unit, and two weeks later I would move into the same unit. It just magically seemed to happen. So he knew me really well.
He called me up and said, “Come Monday morning you’re not going to fall-in with the 801st any more.” I’m thinking this is my big break, this is great. I’m not going to be in support anymore and I will finally have some line time which is where I should have been all along. I said, “Well, where am I going?” He said, “Me and you have an interview.” I said, “Interview for what?” He said, “Some of the doctors and nurses up at the hospital have put you in for the forward surgical team selection-assessment.” I didn’t want to do that. I did not want to do that. A forward surgical team is very small. I knew very little about them, but I knew that they did nothing…or so I thought.
The med director board review was pretty much, “So, what do you know? What have you done?” They looked at my training records and they asked me basic medical questions and stuff like that. As opposed to answering them on the level that they expected a medic to answer, I answered in the most detailed and specific manner I knew how. There was certain stuff that they were asking that, quite frankly, I had no business knowing. They weren’t expecting a direct, straight to the point, and guided answer that leaves no room for error.
Needless to say, about two days later I got picked up. I was upset. I was very angry. So I fall-in with the forward surgical team. After that my career absolutely sky rocketed. It just took off. I found out that to be assigned on the forward surgical team you have to be in the top 1% out of every medic in the army. Not just out of every medic of your rank, out of every medic period.
To get on a forward surgical team is very, very, very elite because you’re working hand in hand with the doctor, and you’re essentially using your doctor’s license because you’re not bound by any license of your own.
LS:
So were you wrong when you said that they didn’t do anything?
DW:
No, I was not. There was a Major that joined the team that knew how to get stuff done. And our commander was probably the smartest man I ever met, and he was very socially… I mean I love that man to death, and he’s just the greatest commander I’ve ever known, but he was a nerd.
He pretty much gave us the go-ahead to do anything that we wanted, and Major Morton, the Major that came onto the team, he is blowing the roof off the budget. As a matter of fact, about 9 months before combat he got us a one million dollar grant for us to do whatever we wanted to.
Our forward surgical team had 20 people on it, six were enlisted and the rest were officers. There were specialized nurses, like an OR (Operating Room) nurse, a nurse anesthetist, a flight nurse, a trauma nurse. The lowest ranked nurse in our team was a Major, which is pretty high, and the highest rank was our commander who was a Colonel, and as far as the enlisted members our highest rank was a Master Sergeant. To work hand in hand with a Master Sergeant and a Colonel every single day,… I mean in bigger units the Colonel is God. Colonel Steele, who’s commanding an entire brigade of close to 4,000 people, was the same rank as my commander Colonel Gross, who was commanding 20.
So Major Morton — I don’t know how he did it but I’m glad he did — ends up finding us ways to do all sorts of stuff. We end up going to Special Operations Combat Medic School in Miami. We got to work at Vanderbilt, and we got to work at St. Judes.
And since we had so many people that worked in the hospital on a regular basis it was just kind of like going to work with Dad. I mean everybody had a chance to do whatever they wanted to and learn how to do procedures or anything that interested them. I went from having to all but beg to have any sort of patient contact, to them teaching me everything that they knew. I was like a sponge. I soaked it all up. I loved it. I was so enthusiastic!
Our team graduated with the highest cumulative average from the Emergency War Surgery course. Graduating from a course in Emergency War Surgery didn’t mean that I knew how to hit the books to get the right answers, it meant that I could now do these life-saving surgeries, because I’m not bound by license, and in combat it doesn’t matter. We were out there to save lives using whatever means possible.
Now I’m going to put the story on pause here and go back to tell you how a forward surgical team works. A forward surgical team is primarily designed for Special Operations use so naturally, with the training I had already received and excelled at, I fit right in and loved that aspect of the unit. They take this forward surgical team and throw them way, way, way out in front of the line, so that if somebody was injured… Have you ever heard of the “golden hour of care?”
LS:
No.
DW:
The golden hour of care is from the moment of injury, to sustain life for one hour until they can get into surgery. After that one hour your chance of survival drops something like 10% every minute. It’s insane. Our job was to extend the golden hour to a golden eight hours.
Our team was broken down into four 5-man teams. On each of those teams you had a medic, a surgeon, an OR nurse, a nurse anesthetist, and a flight nurse. So I kind of went from a combat medic to being a combat surgeon of sorts.
The way that we’re supposed to operate is, from the moment that somebody gets injured we can pull them into cover and start surgery right away. Everybody carries their own gear, the surgeon carries his gear and the OR nurse carries his gear, and it’s all specific to what you’re doing in the field and your role in the life saving surgeries. The OR nurse carries a bunch of tools and sterile packs. The doc carries books and gowns and stuff that he needs, and I carry everything for immediate trauma. So you get the picture.
We’d go out with Special Forces, the people who were, like, “You must be mistaken, we were never there” types of people. That’s what a Special Forces Surgical Team is designed to do.
So in the time that someone would otherwise die in transit, we would operate. And this isn’t an operation where we stapled their bellies shut and said, “Fine.” This was like exploratory laproscopic surgery. It was pretty intense.
As a graduate of the Emergency War Surgery Course it meant that I could do whatever was needed if shit really hit the fan, the reason being that just because someone is a doctor doesn’t mean that they’re immune to getting shot. So pretty much we could do whatever we wanted to. I was doing stuff as a combat medic that some people had never heard of. I mean never heard of.
So we go back to Fort Campbell after Miami and we all knew that deployment was on the horizon, we just didn’t know how soon it was going to come. It was August 2nd. We’re all sitting in the office waiting on the commander to show up, and the commander’s never late unless he’s in surgery. Our master sergeant wasn’t even there. The door opens and in comes our commander and we called everyone to attention. They pulled us all in and were issued our FRAGO (Fragmentary Order), we got our OP word to go to Iraq, and it was about 4 weeks away.
From August the 2nd to August the 12th we were pretty much closing down our lives states-side. A lot of us were nervous — I can’t speak for everyone else, I can speak for my own behalf — I was nervous that I was not adequately trained. I was nervous that I was not ready for this, where everybody on my team was unrivaled. There was no medic, ever was or ever will be, as advanced as I was, but I was still — and I guess this goes back to my Mom — worried that I didn’t know it all. I should know more.
I wasn’t nervous that we were going to get shot, or that we were going to die, I was nervous that I would freeze up, or that something was going to happen to the tune of, “I don’t know what to do now.” Because when everything starts coming at you there is just too much to think about, there’s just so much going on.
On August the 12th I had moved out of my apartment, I had everything up in storage, and I came back up to Shreveport for block leave. That’s when I told my parents and they didn’t really know what to say, but they were really, really, really scared. Really scared. On September 9th 2006, at 1215 in the afternoon, we boarded a DC-8 and headed for Kuwait. On the way to Kuwait we stopped at Rhine main, in Germany. That was our only stop.
We land in Kuwait, and it’s 118 degrees. At lot of people have asked me, “So, how did that feel? How does 118 degrees feel?” When I got off the aircraft I got out on the aft, starboard side. I got off right behind two gigantic jet engines. What do you call it when you open up the stove and all that heat rushes out at you…? Back draft! The back draft was insane.
We had to get all of our gear together and we had a little formation. The most miserable, absolute sheer misery of my entire tour, wasn’t the heat or the fact that my life was constantly in danger, none of that compared to the misery of movement. Movement means organizing how to get in or out of the country, or going from one place to another.
I failed to mention this, but when we went over there we didn’t have a definable mission. To be 100% honest nobody, nobody knew why we were over there and, quite frankly, we really didn’t have a place to stay. We didn’t have a mission, we didn’t know where we were going. I was told so much crap.
See, Major Morton — and I hate saying this about a United States Army officer — he was a pathological liar. He is a great, great guy and he always looked out for the troops but,… he had is grubby little fingers in a bunch of grubby little pies that didn’t belong to him.
When we got there, he pretty much set all this stuff up, and the only reason that we were over there was — it was never proven but I didn’t fall off the turnip truck yesterday — was so Major Morton could put a combat patch on his shoulder in an attempt to hype himself and his ORB (officers record brief) up and say that he had been in combat with the 101st Airborne Division. That’s at least my opinion. So ultimately Major Morton knows what’s going on and nobody else has a clue.
I remember staring at the aircraft thinking, “Those after-burners, it’s a good thing we shut them off when we did because it’s really, really hot up here.” And I was standing maybe 20 to 25 feet away from the aircraft and we’re all getting our gear together and we basically had 15 or 20 minutes of down time because we’d just been up in the air for 22 hours. We were all just shell-shocked. We don’t know what to think or what to do.
The plane leaves. I was so naive and I guess you could say ignorant, as to why it was still hot. It never really registered to me that that it was not the back draft from the after-burner, it was the heat of the desert. And it was! It would be like you were pulling steaks off a grill, and you pulled the top of the grill up and it all went whoosh! It’s like that, except that it never stopped. I remember this so vividly.
I think the part that sucked the most was that everybody was responsible for their own weight. Now, Lincoln, if I told you to pack all the stuff up that you’re going to need for the next year and a half, pack it all up but you’re only allowed this much. You need to pack up not only things that I tell you to, but you’ve also got to pack up the things that you think are going to make your life more comfortable. I had 2 rucksacks, a patrol pack, two duffle bags, and a Pelican box, which is a bullet-proof, polyurethane box on wheels.
You can imagine how big of a cluster it would be if you took 323 people and called out their names one at a time to come get their multiple bags. So instead they had a baggage detail and threw everybody’s junk in the middle of this huge pile. It was just a free for all: just go find your stuff. That was insane. From that point on, everywhere we went we were dragging our gear. It was miserable, absolutely miserable.
I lose my temper very quickly when I don’t know what’s going on, when I don’t know what we’re doing, and when there is no game plan. I have to have some sort of order and structure in my life so that I can maintain a sense of accomplishment, dedication to the mission, and focus. I need to know, “This is what’s going on.” We didn’t have it.
I found out later — and this is factual — that Major Morton was flying by the seat of his pants the whole time. He was coming up with idea after idea, talking to people and making deals; it was insane. He was making deals for us to deploy and I found out all he did was get us on the plane into Kuwait and that was it. After that we were homeless, had no support, no mission, and we did not know where the gear we had already sent to Iraq was. Our unit was too small to operate as a single unit, but too large to piggy-back with another unit. We essentially had to wait for someone to say, “You can stay with us here at this place and if we have any work for you there you are welcome to it.” We were stuck between a rock and a hard place. I was so angry when I found all of this out. That is piss poor management and planning all so that one selfish officer could put a combat patch on his shoulder.
Major Morton knew how monotonous everything was inside of Kuwait so he gave us the chance to go out and do stuff, to get equipment. We went over with no medical supplies. It all would have expired, it wouldn’t have made it through the flight, or it wouldn’t have maintained sterility, so we had to go and get all of these medical supplies in Kuwait. And that just made more gear that we had to hump across the berm. I know now that the reason we did this in Kuwait was because we had no means to get any supplies while we were in theater because we had nowhere to go.
That was when I got to see the Persian Gulf that’s south of Kuwait, and I got a chance to get out and see the country. The biggest thing that I wanted was to see a camel. I wanted to see real, true-to-life wild camels, and I did, I saw a bunch of them.
We stayed in Kuwait until September the 10th. No, as you were, the 12th. We stayed there ‘till the 12th. And on the 12th of September we got orders that we were going across the berm. I had a small sense of relief, and at the same time, followed very abruptly by a sense of, “This is going to suck! We’re moving into another country, again!”
We were able to get our own C-130 into the country, which was extremely lucky for us. A lot of our gear had been palletized, which was good because it was at the end of the aircraft, but bad in the sense that if things when terribly wrong we’d have to cut sling load, which means that our gear goes completely out the back of the bird, and we’d have to jump.
I don’t know if you’ve ever jumped out of an aircraft, but there’s already a lot of things going on when you have to jump, and to cut sling load and see it wheel out the back, and then everybody has to rig up their ‘chute, hook up to the static line, and come flying out the back, all the while you’re crash landing and the bird’s going to the ground, that’s not necessarily a good thing (laughs), or easy, or anything like that.
What made it worse was that you can only fly by cover of darkness. That’s the only time that you can fly, at least something like a C-130. To make things even worse, the C-130 doesn’t have any windows. It’s got two in the front, and that’s about it. I was a little upset by this because, while flying doesn’t bother me and closed spaces don’t bother me, the people around me didn’t feel the same way.
We did a combat dive into BIAP (Baghdad International Airport), and I don’t care how strong a stomach you have, or how well you can maintain yourself… You’re flying and you hear the engines kill, and the nose dives down and it sloops… like it’s flying straight one moment and then they kill the engines. The tail drops down first, and then the nose drops down like this (Dave gestures with his hands.) and they swing high up to the left — almost 90 degrees like it’s a pendulum — and then all the way to the right, and then it levels out about 5 seconds before it hits the ground. So you never know if you’ve been shot down, or if they’re doing a combat dive. The reason that they do this is to evade surface to air missiles. Because by doing this any surface to air missile would be hitting behind the plane, as opposed to hitting the actual aircraft.
So we land at BIAP and what do we do next? We hurry up and wait. We unpalletize the gear, we take accountability for ourselves and our equipment. Major Morton goes off again to beg, borrow and steal from,… anybody to get what he wanted and to see if he could pawn off our small unit onto a larger one and get us a mission. Like I told you, Major Morton really looked out for the troops. And he could get things done.
Still, nobody knows what’s going on. Major Morton is the only one that thinks he knows what he’s doing, but he doesn’t. He doesn’t have a clue. It got to the point where the Master Sergeant was getting pissed because we had all put our trust in Major Morton, who is not getting anything accomplished. And there are helicopters landing and taking off, landing and taking off.
Finally we had these two Chinooks (helicopters) come to pick us up. Thank god! We were using one Chinook for cargo, and one Chinook for personnel. We landed in BIAP at 0515 that morning. At 2245 that night the Chinooks rolled up. We hadn’t been indoors yet, we hadn’t eaten, we hadn’t slept. We’d been awake now for going on 30-something hours.
We repalletize all of our equipment and go and sit on these Chinooks. Mind you, we are not fortunate enough to have air conditioning. So I’m sitting in all of my combat gear, and my combat load weighs 49 pounds and includes my helmet, and my flack jacket, and my rounds, and all of that. We sit there for a couple of hours and finally the crew chiefs shut down the turbines, get up and say, “Every body has got to get off. We can’t take the aircraft anywhere.”
So around 2300 we were literally spending the night on the runway. We had taken all of our bags and made a circle, we were using our rucksacks as pillows, laying out there hoping to get some sleep. We weren’t allowed to sleep because every half hour to 45 minutes Major Morton thought that we had a lead, or a jump on something.
Around 0145 or 0200 the next morning here comes a Rhino, which is an armored bus. So we’re taken to an airport called Washington LZ, which is a hub for helicopters and that’s all: you can’t land anything bigger than a helicopter on it. Then we climb on the back of a 5-ton and we’re taken to the combat support hospital and my thoughts were, “You have got to be kidding. We went from working in a hospital in the states to prepare for working on the fields of combat in Iraq to working in another hospital that already has all the doctors, nurses, and medics that they need. What are we here for?”
We’re given rooms and everything like that. We unpack our stuff and by the time we were all done and my room was ready it was time for breakfast. Our building was mortared twice while I was trying to sleep. And I was like, “If this is how life is going to be, then I’m going to be hating it.”
The next day Sergeant Crosby, the same NCO who was my squad leader the whole time, told me that me and him were scheduled to start working the next day, but he didn’t want the rest of the medics to start working yet. He wanted me to go in there and get my feet wet so that I could go back and tell the troops. He was pretty much using me to test the waters. I worked under cover, without anyone else besides Sergeant Crosby knowing that I was working, for about a week. That is when I saw my first patient.
My first patient was an E4 who was riding in a track vehicle, an APC (Armored Personnel Carrier), when they hit an IED, which is an Improvised Explosive Device. There were six people in the APC: one was DOA (Dead On Arrival), one death later on due to injuries, and then you had four patients.
Just to give you an idea of how messed up trauma is, one of these guys had a scratch underneath his eye, the guy next to him was decapitated, and the guy next to him on the other side had two or three traumatic amputations. Sitting directly across from him was a guy that was about to die, and the guy sitting next to him was fine. It’s just weird how stuff rolls out.
My first patient came out of the APC and he didn’t have any noticeable signs of damage. We rolled him inside and he was CPR (Cardio-Pulmonary Resuscitation) in progress, he didn’t have a pulse or anything like that. This was the very first patient I ever touched in the combat zone and he didn’t have a pulse, which is not good. So he dies.
I had to wheel his body to the morgue past his entire unit, and they’re all looking at me like I failed them. They’re all looking at me, like, “Why did this happen?” They’re all looking at me like it’s my fault; like I personally had failed them.
We get to the morgue and were still not sure how this man had died, and had died so quickly, so we were going to examine him further to find a cause of death. We take him out of the body bag and he has a hole about the size of a dime that’s right underneath his navel. I said, “Doc, I think I found the entrance wound.” The doc says, “Let’s get ready to roll him.” I put my hand up underneath his right arm and below his left buttocks, and I crossed arms with the NCO next to me, just like we were supposed to. I immediately, after placing my hands on his back, said, “I think I found the exit wound.”
When we rolled him over we see he was filleted open and from the top of his buttocks up to about his C5 (cervical vertebrae, his neck), it was blown wide open. His lungs and his intestines stayed on the gurney, and we pretty much rolled him out of his insides. I knew there was one of our guys who would have lost it. This kid was unstable as it was. I knew that he would start crying.
LS: He wasn’t there.
DW:
No, no. And this was the biggest reason that Sergeant Crosby pulled me in first. He knew that I could handle dead people, he knew that I could handle all that stuff. The people who we were relieving thought that we couldn’t do anything right, and that we didn’t know what was going on. They had no idea that we had all graduated from Emergency War Surgery and Special Operations Combat Medic School. We just kept to ourselves. We let them act like they were the Cocks of the Walk, just let them act like they were something special and in all fairness, they had been there almost a year and dealt with this stuff day in and day out.
LS: You were
replacing these people?
DW:
Yes, it was the end of their tour. We were going to be a transition force from one unit to another. One combat support hospital was leaving and another was coming in, we transitioned two months before they were supposed to leave so that when the new one came in we’d have enough experience under our belts to “right seat, left seat” them, and they could concentrate on other stuff.
The kid that I was telling you about, that was not mentally stable enough to handle this, he was a combat medic but this just wasn’t his gig. We put him on the ICW, which is Intensive Care Ward. Basically he was changing sheets and bedpans and putting diapers on people that were conscious but unable to care for their daily life needs. There was no way that he’d ever be able to handle it in the ER. We just left it at that: out of sight and out of mind. You can change diapers and never know what goes on inside the ER, and that’s fine.
There was another one, his name was Matt Mitchell. Me and Mitchell were best friends; best, best friends. And the night that he was first supposed to go to work he asked me, he said, “Dave, how is it in there?” And I said, “Look, it’s not pretty. It’s not something that you want to be a part of. It’s not something that you get really good OJT (On the Job Training).”
The one that really got to me — and I remember this to this day — was a 17 year old Lance Corporal who got a waiver to get in to the Marines, got a waiver to come to war, and was riding along in a Humvee. The Humvee hit an IED and it came straight up from underneath him and completely shredded his legs.
When we moved him from one bed to another his calcaneus fell out of his foot, which is your heel bone. His calcaneus fell out of his foot and hit the ground, and you could hear it, and it was just unnerving. That was the first and last time I let a patient have a personal impact on me. When his heel fell out of his foot I’m thinking, “He’s never going to have a normal life. He’s not going to be able to play soccer with his kids.” He’s 17 years old. I went back to the barracks and I cried about that one.
We finally brought Mallard down to the ER. Lincoln, this kid just didn’t fit. I mean he just did not understand emergency medicine; he just didn’t get it. We all felt bad for him, but at the same time he brought it on himself because he’d lived such a sheltered life. His parents made all the rules and all the decisions for him. We can’t change him any more than he’d already been changed. Bless his heart he tried, God he tried, but he just didn’t get it.
I really got to shine over there because I had, on average, about 28 patients a day. Out of those 28 patients a day I learned just about everything you could learn. I also noticed that the stuff we learned in Miami did not hold a candle to the stuff that we were doing in Iraq. That was mainly because in Miami we dealt with a lot of thoracic and core trauma, but in Baghdad they’re all wearing flack jackets. It was all extremity stuff. They weren’t teaching anything based on military experience.
As far as decision making in Iraq, everything worked as a fine oiled machine. Our surgeons were always up on the OR (Operating Room), and I very rarely saw anybody from my team, other than Matt who was my best friend, me and him worked on the same shift. Sergeant Crosby worked on the shift after us, and we worked 12-hour shifts, 6 days a week, for a year and a half.
The best way I can explain it is,… let’s say I drive a Porsche, and the doc drives a Lamborghini, and the nurse drives a Koenigsegg CCR. They’re all phenomenal vehicles and they all have their own pro’s and con’s. I can go from 0 to 60 in 4 seconds, the Lamborghini can go from 60 to 120 in 4 seconds, and the Koenigsegg can go from 120 to 196 mph in another 4 seconds. All told we have 12 seconds and 196 miles an hour. In other words, I do my job and everything that I’m capable of doing, and when I finish my job the doc picks up right where I left off, or the nurse does. And where the nurse stops, the doc picks up.
After the kid that lost his feet I never took anything personal. Instead, I would do exactly what I was taught, exactly what I was trained: concentrate on the job at hand, and the job in front of me, as opposed to the grand scheme of things.
Anyone who is going to get caught thinking, “Oh my God, he’s missing both of his legs! Crap, what do I do?” And then get all in a frenzy, while the guy not only doesn’t have a pulse, but hasn’t been breathing for the past 25 minutes. You’re working on a dead guy. So keep a level head, and know what you’re doing, and know how to do it well. That’s about all that you can do.
As far as my decision making goes, just like it says in the newspaper article here, no matter who the patient is, I treat them all the same. And I treated them as though they were somebody’s brother, or father, or son, or grandson, or daughter, or grand-daughter, or whatever, because they were. They were somebody’s kin. I did what I knew how to do and not until later, when I looked back on it, did I realize that I had his life in my hands. Mallard walked into every situation saying, “I’m going to screw this up” and he would. He screwed up everything.
I had a sense of urgency for everybody that came through that door. If they came through the door, they don’t have to ask for my help but they’re going to get it. No one comes in there and says, “Please save my life.” You don’t have to beg with me to do the obvious. That’s my job. It would be the same as if I said to one of them, “Hey, please protect my life.” For the most part my decisions were based on morals, what I believed was right.
It got to a point where it was almost muscle memory, I knew exactly what to do. It got to a point where I was doing chest tubes, intubating patients, ordering drugs. The nurses are bound by their licenses, but I’m not bound by anything. I’m bound by what the doctor knows I can do.
It’s kind of a double edged sword because if the doctor knows I can do it, and I haven’t done it, or failed to do it, then it’s going to come back on me, not on him. The doc’s going to say, “Why didn’t you do it? You recognized it? I had to stop my procedures, and my critical care, to go back and cover for your mistakes. I have to downshift from 196 miles an hour all the way back to 60 because you dropped the ball while you were changing gears.”
And I knew it. So before I would take my hands off the patient I’d say, “I’ve checked, and double-checked, and triple-checked,…” And if the doc came to my patient he expected a report: he expected to know what interventions I’ve done, what drugs I’ve given, what X rays I have ordered, and a full report of his injuries. He wanted to know exactly what was going on so that he could pick up from my work, instead of starting off at zero and going all the way up.
Like I say, it was muscle memory. I recognized things that needed to happen and I did ‘em. The biggest thing — even to this day — is: “Failure to act is unacceptable.” Don’t sit there and do nothing, at least do something. Even Mallard, the kid that was good at computers, would do something. It was so completely off-the-wall that it had no bearing on what we were doing, but at the very least he was doing something. I taught him that so I could feel better about having a loose cannon in the ER.
LS:
Tell me, did this whole experience change you for the better? How have you taken this experience for the better?
DW:
Professionally it altered my career and sky rocketed me to levels I never thought possible. Personally, it had a very adverse reaction on me because when I came home I was still in survival mode, and to this day I’m still in survival mode, and I’m trying to get over it.
LS:
What’s it mean to be in survival mode in terms of living around here?
DW:
When I drive down the street and I see a trash bag on the side of the street, I’ll stop and back up and find another way to go down the street. It’s like I got blinders on to the world. Through one eye I see everything from the combat medic perspective, and in the other eye I see what I know to be the civilian world.
My biggest challenge since I came back home is people not understanding, and to make matters worse they can’t understand. They’re not capable of understanding. I could sit there and try to explain it to them all day long, but until you’ve been there and done it you just don’t understand.
There are some outstanding medics in the army that do great things for the country, and great things for the military, but when that first patient comes in missing every single one of their limbs and they can’t control the bleeding,… they go home in a nut wagon. They can’t handle it. They don’t know what to do. Drugs is a very real thing over there…
LS:
You mean for your own medication.
DW:
Yeah, a lot of people taking sleeping pills, a lot of people are abusing sleeping pills. There’s a case of a guy that was given 30 vials of morphine a week and he couldn’t keep them in his aid bag because he’d shoot up before he’d go out on a mission.
As far as changing me, it’s the best thing that’s ever happened to me, ever. It’s made me a better medic. There isn’t an injury I’m going to see in Shreveport, or Bossier, or Miami that I have not seen before.
You know, coupled with Vanderbilt and the burn ward I did there, and the pediatric patient accounts I did at St. Judes, and the rescue and EMS I did in Miami, and then my trauma rotations in the Miami trauma center, and everything I did in Iraq, I’m at the top of my game. I can go into any situation with a cool, calm, and collected head and know that I’ve already seen it before. There’s nothing that I’m going to see as a paramedic now that I haven’t already dealt with. It’s very easy for me to approach a trauma scenario. Somebody that’s gotten nailed by a train, or someone that’s been in a head-on collision, or a motorcyclist that’s gone down, even though I never saw a motorcycle accident in Iraq, I saw his injuries. It’s the best thing that’s ever happened to me.
But personally it’s had an adverse reaction on me. I’ve got to start weaning myself off of ideas like, “You don’t have to turn around when you see a bag of garbage in the street, and you don’t have to drive over the median, and you don’t have to go into a situation thinking that this is one of your own guys.”
It was the greatest honor of my entire life, but it’s hard, because when one of your coworkers sheds blood for your safety he becomes your brother, even if you never see him again. He’s still your brother, and he’s your brother for life. And even though I’m not in the military there’s still plenty of people that consider me their brother. There are plenty of people — I know this for a fact — that would take a bullet for me. Did you know that 60% of all Medal of Honor recipients are either medics or people that died trying to save the medics? Sixty percent.
The Ground Pounders think that doc is God. There’s a lot of them that are just so obtuse, and so ignorant, that they honestly believe that if doc sees me get shot in the head it’s going to be fine because he’ll save my life. There are some of them that are so naïve that they think that when I take their friends off in a helicopter, and they’re in a black bag, that I’m keeping them warm because of their blood loss, and they’ll see them again when they get back home. “Good job, Doc!”
What kind of a bearing does that have on me? You know? I don’t tell them, “Hey, sorry but Joe Snuffy died enroute, or Joe Snuffy was dead when he got shot.” I can’t tell them that. It’s hard for me when they think that everything’s going to be OK, and it’s not. I haven’t lied to them, I didn’t tell them a story, but I didn’t tell them the truth either.
LS:
So you’ve got a new problem, a new issue. You’ve got to shift gears to take the best of what you know and jettison the baggage that’s not helping. How are you going to do it? Is there anybody to help you?
DW:
Not now, no. I’m torn between two things Lincoln. I think when I tell you the latter of the two, you’re going to look at me like I’ve been huffing paint for the last 6 or 8 months, but I’m stuck between two things. One of the two is going to be my ultimate career goal, the one I’m going to stick with for the rest of my life. I’m either going to take my MCAT and go back to school to be a doctor — I’m two years away from my Physician’s Assistant in Emergency Medicine — or I’m going to be a Wildlife and Fisheries Agent, because I enjoy guns and I enjoy the outdoors.
I know that I’d be extremely good at being a doctor, or a physician’s assistant. I know that it would be a cakewalk. It would be easy for me because I’m interested. But at the same time, as a Wildlife and Fisheries Agent I’d get to be on a boat, get to be in a 4-wheel drive, have a gun, have authority — it’s all based on wildlife conservation — and being out in the woods is where I’m truly happy.
I never want to forget everything that happened in Iraq, ever. But at the same time not all of those memories are pleasant ones, and not all of those memories are easy to deal with. There are some memories that are very, very difficult for me, but I have to remember them. I have to remember them, and make sure that they stay a part of my life, so that they continue to have a positive impact on my life.
I know that may seem just absolutely absurd, but in order for me to sustain the level of professionalism I have to remember: A, where I came from; B, what I’ve made of myself; and C, what I’m capable of doing in the future. Between the three of those it looks like I’m taking the back door out by going Wildlife and Fisheries, but that’s something that I want to do. And also, if it’s something that I want to do, and I’ve proven myself already, nobody can ask anything more of me.
I served my country and I saved lives. I’ve had people come up to me and recognize me as the person that saved them, and I have no idea who they are. Even to this day I don’t see any particular way that I’ve saved anybody’s life, because everything that I did somebody else could and would have done in most cases. It might be me being modest, but I just don’t see it as anything heroic or fantastic, I just see it as how I was trained. This was my job.
There were several occasions where somebody was “expectant,” which means they’re not going to make it. You can’t admit them to a ward when they’re essentially already dead, because you need the bed space, so I was put in our specialty room. That was where we stacked up all the dead or expectant. I’d sit back here and pump them full of morphine and valium until they passed naturally. You know, I don’t consider it euthanasia, and I don’t consider it killing or mercy killing somebody, but at the same time I don’t know what to consider it, because that’s exactly what it was.
I saw some pretty traumatic stuff. I worked hand in hand with a guy named Colonel Wood. Colonel Wood was the brigade commander of an MP (Military Police) brigade and we knew about 90% of their unit on a first name basis. They brought in 3 or 4 injured people every night, and about every other night we’d lose at least one of them. Colonel Wood presented us with a Certificate of Appreciation and a Commander’s Coin for our outstanding service in support of his unit while they were there. He presented us with this two days before he left country.
That night Colonel Wood came in, and he came in in two different vehicles. They flew his lower half in on a helicopter, and his upper half was driven in. The guy was going home in less than 12 hours and you sit back and think,… I mean I’m a Christian, can’t say I’m a practicing Christian, but I am a Christian,… and you sit back and think, “How is this fair? This is not fun. I’ve got all the experience that I need so just quit, just stop giving me patients. I’m sick of seeing it. I’m sick of dealing with it.”
LS:
Did you feel like that, or did it just cross your mind?
DW:
It was so fleeting Lincoln, I didn’t have time to think about anything while I was over there. Taking time to think about things, that takes precious seconds. I had the option of going home and thinking about it when I was off-duty, but who wants to think about it then? I went home and played X-box, or read magazines, or worked out, or something, but I don’t want to think about that. I don’t want to put it at the front of my mind and go, “I’m going to think about and get all emotional about all the things that happened to me today.”
Mallard was the complete opposite. He would go home and intentionally think about it. He’d always ask me, “Dave, how come you come home and you leave everything in the ER? Those guys died tonight!” “OK, well would you rather them died, or you died?” “Well, I’d rather that neither one happened.” “Well, you know what? Life isn’t like that. It happened. Somebody died. You can’t get it back. Leave it in the ER, don’t bring it home.” He just didn’t understand.
LS:
The inescapable truth is that your experience is unlike other peoples’ experience.
DW:
That’s correct.
LS:
The people that I’m interviewing are mostly normal kids that are growing up in society. What would you advise? If you could tell them something that’s important in terms of getting their lives together, what would it be?
DW:
In numerous different occasions I was put in a situation where it was all or nothing: “Learn all about this. This is what you’re going to see. This is what you’re going to be doing.” But when game-time came, I didn’t see any of it. But regardless, I knew it and was ready for it when it did come. Anyone can diagnose and treat the stuff that comes along all the time in civilian hospitals, but that is not how we were trained. We were trained for the freak accident, the one-in-a-million, worst case scenario type stuff.
I’m not the type to sit and throw my cards down and say, “Oh, now I give up. I’ve spent the last year and a half of my life trying to figure this out, and I’m not able to use any of this, so I’m just going to suck at what I’m doing.” No, I said, “OK, I obviously need to learn what I’m doing now, and be good at it.”
But truth be told Lincoln, what I have to say is this: “Don’t do whatever you like, like whatever you do.” If you find something that you’re interested in, and this is what you want do, then do it. But you’ve got to understand that it’s not a hit or miss situation. You can’t learn everything there is to know, but that doesn’t mean that you have to stop trying.
People will tell you, “You can’t do this because you’re not allowed to know this.” Or, “This is too advanced for you.” When someone said that I couldn’t do something, or when somebody told me that it’s too advanced for me, that was fuel to the fire. I wanted to prove to them that they were so wrong.
Respect and knowledge: all of that is earned. When you start learning something, do everything you can to learn about the subject. And if it’s not something that you want to do, then reevaluate why you’re in it.
Just because a teacher tells you something, that this is what you’re going to see or do,… no, medicine doesn’t work like that. Life doesn’t work like that either. You will most likely see the complete opposite. And what are you going to do when it comes around? Are you going to say, “Oh, well I never learned that.” Or are you going to say, “OK, I acknowledge that I don’t know that, and I’m going to take it upon myself to make sure I don’t look like a blubbering idiot next time that rolls around.”
You start with a foundation and you build on it. After you’ve built on that, another problem arises and you build on that, make that problem your cornerstone and keep building,… and build, and build, and build. I don’t let a problem arise where I would say, “Oh well, crap, I don’t know what to do, so I’m just going to leave this alone.” No, I get in there and I engage. I make sure that I have some sort of understanding about what’s going on. There is no excuse, no excuse for failure to engage. Failure to act is unacceptable.
When push comes to shove it’s your own damn fault if you don’t know something. This day and age everyone has the means and the capabilities to have the whole world at their fingertips and the answer is out there. You just have to dedicate yourself to finding it. And the next time it happens and you still don’t know it — and it doesn’t have to be in medicine — you just look like a fool. Someone is going to be there to point out, “You’ve seen this before, and you didn’t know what was going on then. Why don’t you know what’s going on now?”
