Trial By Fire

Yesterday afternoon, in a brief informal ceremony, we took over responsibilities as the Forward Surgical Team for FOB Lagman. Afterward, we moved into the quarters we'll be living in for the next 6 months. It was nice to unpack knowing it will be the last move for a while. We had a quiet evening with plans for a single team trauma drill this morning and a Sunday without any responsibilities.

This morning we awoke, ate breakfast, and met at the FST to perform morning equipment checks and have our trauma training for the day. It's a beautiful day with not a cloud in the sky and the temps around the mid-seventies. We made it through a small portion of the scenario when we were informed that we had incoming patients from an IED blast. We quickly ended our training and began to prepare for our first patients to arrive.

The initial report we received was that an IED blast had killed two Afghan nationals and wounded several more. We would be getting four patients with varying injuries. After the story changed several times ranging from us actually being bypassed and getting no casualties to us getting four, the MEDEVAC helicopter landed and the truth began to spill out. In total, we received, and cared for, seven patients. Our first trauma call was officially a mass casualty.

The first patient through the door was a badly injured young teenage boy. His elder brother was accompanying him and waited outside while we worked to save him. We gave him what would be considered the "full court press" in the States but, in the end, his injuries were more severe than we could correct. He died from massive hemorrhage and, most likely, a severe closed head injury. We cleaned his body and he, along with his brother, were provided transportation back to their village. Welcome to war.

In addition to the teenage boy we cared for a 2 month old infant, two women, and three men. All were Afghan nationals. By the time we loaded the last patient on a helicopter, cleaned the FST, and debriefed it was 3:30 PM.

Today's events brought the reason that we are here into sharp focus. Before today, all the training, talk, and supposition about what FOB Lagman would be like was an abstract idea individualized to each of us. Now, just over 24 hours into the real job, it's become a harsh, ugly, shared reality.