by John McCain
In all, three families were notified of their loss in this manner, crying out in anguish at the news, while the other families sat gripped by terror waiting for the messenger of death to signal to them. The last was Beverly Clark’s family. Her shattered mother wailed, “She was my baby.” Finally a chaplain convinced the army to halt the dreadful proceedings. The families were escorted home, where they waited to be notified in the appropriate manner: the dark sedan rolling to a slow stop in front of their house, two men in green removing their caps on their doorsteps before they unburdened themselves of terrible news and offered the president’s condolences.
The survivors waited in a tent city in the desert for ten days, unfairly stricken with guilt for not being among the dead, and then finally they too were escorted home. They arrived first to a solemn welcome at Fort Lee, and then the next day to a tearful and relieved homecoming at the little airport in Latrobe, where a news photographer snapped a picture of Rhoads hurrying toward the open arms of her husband and daughter. She was happy to be home, of course. They all were. But they would not easily recover from the wounds they bore. They had returned too late for the funerals or the big memorial service the governor and secretary of the army had attended, where the letter of condolence from President Bush was read. But there would be a memorial service every year on the anniversary, February 25, and an appropriate monument raised to the fallen. Rhoads would bring a white teddy bear with her to the memorials.
She returned to her job with her leg in a big white brace. She was eager to get going; she wanted her life back. Something was wrong, though. She had frequent nightmares; she lost her temper. She used to shrug off the kids who hassled her and called her names for giving them a parking ticket; now she got into it with them, right in their faces, daring them. She wasn’t herself. She froze once while directing traffic when she heard an emergency vehicle’s siren. Then she started getting really sick.
Chronic vaginal bleeding resulted in a hysterectomy. She had her gall bladder removed and her appendix. Stomach ailments, headaches, sinus troubles, and serious difficulty breathing brought her to Walter Reed Army Medical Center in Bethesda, Maryland, then the hospital in Brownsville, Pennsylvania, the VA hospital in Pittsburgh, then back to Walter Reed and again to Pittsburgh. Doctors discovered precancerous cells in her esophagus. She developed liver disease. And she suffered such terrible acid reflux it necessitated a Nissen wrap, a procedure named for the doctor who invented it, in which the upper part of the stomach is wrapped around the lower part of the esophagus and stitched in place.
These and other ailments were attributed to the mysterious malady that afflicted many Desert Storm veterans, called Persian Gulf War syndrome. None of the doctors Rhoads saw in Bethesda or Pittsburgh could figure out what was making her so sick. She was becoming almost completely incapacitated. She worried the doctors were using her as a guinea pig, unable to diagnose the cause of her illnesses, offering no cure and giving little hope. Her sister, Kathy, beat on doors for help: the VA, the army, local officials, anyone she could reach. She was a tireless advocate. Scott Beveridge and another local reporter, Connie Gore, took a genuine interest in her case and wrote about her often. Her local congressman, Frank Mascara, and his aide, Pam Snyder, got involved and pushed the VA to recognize that whatever its cause, Gulf War syndrome was real, and it was destroying the lives of people who had risked everything to serve their country and who deserved their government’s attention to their service-related illness. Their persistent appeals on her behalf resulted in a full disability pension, one of the first awarded to a sufferer of Gulf War syndrome. She gave testimony to the Senate Veterans Affairs Committee in 1991 and traveled to Washington in 1995, while very ill, to testify to President Bill Clinton’s Advisory Commission on Gulf War Illnesses. Congressman Mascara began his statement in a hearing at the House Veterans Committee by invoking her as the poster child for Gulf War syndrome.
When word got around about his successful intervention on Rhoads’s behalf, Mascara’s office was swarmed with calls from veterans around the country, who like Rhoads were plagued by numerous illnesses since coming home from the Gulf. No one has yet to establish a cause or causes of the disorder that appears to weaken the immune system, making its victims susceptible to multiple illnesses. There are many theories—fumes from the oil well fires, reactions to inoculations, Iraq’s undetected use of chemical weapons, Scud warheads carrying biological agents, combat stress—but none have been proven. Whatever its cause, thousands of Gulf War veterans suffer chronic and multiple illnesses attributed to it. According to a congressionally mandated advisory committee of independent scientists, at least a quarter of the seven hundred thousand Gulf War veterans suffer from a disorder that “fundamentally differs from trauma and stress-related syndromes described after other wars.” Beveridge’s newspaper conducted a survey among the 14th’s surviving members and found that seventeen of them had ailments that could be linked to Gulf War syndrome.
After her testimony to President Clinton’s advisory commission, Rhoads dropped out of public view. Beveridge wrote that he had received “anonymous hate mail” attacking Rhoads for publicizing her suffering and condemning the deployment of women to war theaters. It appears she heard some of the same criticism. She might have been estranged, for a brief time anyway, from a few others in her unit. When asked, she said the 14th was like a family, and like all families, they have their squabbles and then make up. “We love each other,” she maintains.
She volunteers at a care facility that treats veterans but spends most of her time these days caring for her husband, who is also in ill health. Her own health continues to be precarious. She has had mini strokes and two small heart attacks in the past ten years. She lost a lot of weight and has persistent breathing difficulty. She admits to having a rough time emotionally during the first three months of every year, the months when the 14th had been mobilized for war. She still has survivor’s guilt. She still misses Bev Clark. But she possesses a naturally cheerful personality, which seems irrepressible even in the most trying of circumstances. “I’m still on my feet,” she laughs, “which is a good thing.” Her daughter is trying to have children, and she’s excited about becoming a grandmother.
She was not able to attend the past two memorial services for the eleven men and two women in the 14th Quartermaster Detachment who gave their lives for their country. Her husband was too ill. But she intends to go next year, no matter what. She’ll greet old friends and shed tears for absent ones. She’ll carry old wounds earned in service to her country and a white teddy bear for her friend.
Combat medic Specialist Monica Lin Brown stands a post at FOB Salerno in Eastern Afghanistan.
CHAPTER TWELVE
The Job
Monica Lin Brown, a frontline medic in Afghanistan, risked her life to save others in an ambush.
“YOU’VE BEEN TREATED LIKE A superstar, really. And you’re just a kid,” the reporter observed.
“Yeah, I’m just a child,” the soldier agreed.
MONICA LIN BROWN WAS decorated for “extraordinary heroism,” which she plays down as her training taking over. “Robot mode,” she calls it. There isn’t a trace of false modesty in her self-effacement. Throughout all of it—the 60 Minutes interview, the Washington Post story, the visit with the president—her humility appears as genuine as her courage. An observer gets the sense it is the source of her courage rather than a separate virtue. She calls it “duty,” one of the “Seven Army Values” she was trained to uphold. But it is humility that makes the duty binding, that holds the “job” above self. It is humility, as much as training and courage, that compels combat medics and corpsmen to do their job, to run toward danger rather than take cover. It is humility that makes them heroes.
“Doc” is a hard-earned title of respect in the military, an expression of the trust a medic or corpsman has earned from soldiers who have come to believe Doc will be there for them in the very worst circumstances. To a scared and ble
eding soldier, Doc might be an agent of deliverance who will get him home, if not intact at least alive. Or Doc might be the last human face a dying soldier sees. Neither job can be refused. Imagine soldiers on the beaches of Normandy or marines at Okinawa taking temporary shelter from a curtain of fire in a shell crater or behind the hulk of an armored vehicle. Maybe they try to return fire from their position, or maybe they just need a minute to steel themselves to their duty in the knowledge they are likely to die. They hear the cries of a wounded soldier. Maybe they go to him or at least try to, but the fire is just too hot to brave right then. Maybe all they can do is join the chorus of “Medic!” or “Corpsman up!” Only Doc answers, no matter what. Only Doc must go and do what can be done: stanch the bleeding, relieve the pain, hold their hand. That’s the job.
There aren’t many jobs that are more important, more dangerous, or more critical to the morale of a platoon. Medic, or 68W, is the second largest occupation in the army, right after infantry rifleman. Soldiers place immense value on having a medic or a corpsman they can count on and will take risks to protect him. And they hold few soldiers in greater contempt than the medic who doesn’t do his job, whom they cannot count on. What is often observed about soldiers in battle is more true for medics and corpsmen than others: their greatest fear is not of being killed or wounded by the enemy, but of being unreliable under fire.
Seventy-five medics and corpsmen have received the Medal of Honor, most posthumously. Over two hundred have been killed in Iraq and Afghanistan. The most decorated American in World War I was not Sergeant Alvin York, as is popularly believed, but Private First Class Charles Denver Barger, a stretcher bearer. In addition to the Medal of Honor and more than twenty other decorations, Barger earned a Purple Heart with nine oak clusters, signifying that he was wounded on nine separate occasions. His Medal of Honor citation reads in part, “Learning that two daylight patrols had been caught out in No Man’s Land and were unable to return, Pfc. Barger and another stretcher bearer, upon their own initiative, made two trips 500 yards beyond their lines, under constant machine gun fire, and rescued two wounded officers.”
Not many soldiers in France would have expected to survive a five-hundred-yard excursion into no-man’s-land. Only a medic would have tried it twice. The accounts of the sacrifices medics and corpsmen have made to answer their summons are gripping to read and some of the most astonishing examples of battlefield heroism.
Specialist Edgar Lee McWethy from Denver, a combat medic in the 1st Cavalry Division, was wounded four times coming to the aid of soldiers caught in a North Vietnamese ambush in Binh Dinh Province in June 1967. After crossing a “fire-swept” field to dress his platoon leader’s wounds, McWethy was wounded in the head and knocked down as he tried to reach other wounded men. He got up and continued to make his way to the wounded but was brought down again by a wound to the leg. He was wounded a third time as he crawled toward another bleeding rifleman. “Weakened and in extreme pain, [he] gave the wounded man artificial respiration but suffered a fourth and final wound.”
Medics usually carry a rifle along with their aid bag. They have received combat and weapons training and are expected to fight when taking lives takes priority over saving them. Staff Sergeant David Bleak, a high school dropout from rural Idaho, was serving as the medic on a patrol into Chinese-held territory in Korea, when the patrol suddenly encountered an intense barrage of fire from entrenched Chinese. Bleak treated the wounded before rushing toward the enemy trench and killing five Chinese, four of them with his bare hands.
Since they are usually the only medical professional on the scene, and in earlier wars often the only one a wounded man was likely to see for quite some time, medics were sometimes expected to undertake responsibilities well beyond those they were trained to perform. In World War II a twenty-three-year-old corpsman aboard the submarine USS Seadragon, Pharmacist’s Mate Wheeler Lipes, was ordered by his skipper to perform an emergency appendectomy on a sailor. Before Lipes deployed, a prescient navy surgeon had him assist in operations at the base hospital, including several appendectomies, to prepare him for such an eventuality. But onboard the submarine Lipes didn’t have surgical instruments, equipment to deliver anesthesia, intravenous fluid, or an operating table. Instead he used kitchen cutlery sterilized with torpedo alcohol and placed the patient on the wardroom table. The skipper dove the boat to 120 feet to escape the ocean swells. Lipes covered the patient’s mouth with a mask made from a tea strainer covered in gauze, had an assistant drip ether onto it, and then cut through the stomach muscles. He located the nearly ruptured appendix, removed it, careful not to puncture it and kill the patient, sprinkled ground-up sulfa tablets on the area to disinfect it, and sewed the wound closed.
Doctors at the navy’s Bureau of Medicine and Surgery were apoplectic when they learned a corpsman had performed surgery, but what choice did the corpsman—or the patient—have?
When Lipes left the navy, he received letters of commendation praising his bravery in combat actions, but none mentioned the appendectomy. “Not that the incident in itself was so important,” he conceded. “It was my job to do anything I could to preserve life and, really, I didn’t deserve special credit or recognition for doing that.”
The vocabulary of the medic and corpsman is identical in most instances to the language of civilian medical professionals. Considering the conditions in which they work, familiar terms such as health care specialist, the army’s official title for a combat medic, primary care providers, and patients sound almost as if they’re meant to be ironic, as does the army’s posted job description for a health care specialist:
• Administer emergency medical treatment to battlefield casualties.
• Assist with outpatient and inpatient care and treatment.
• Prepare blood samples for laboratory analysis.
• Prepare patients, operating rooms, equipment and supplies for surgery.
AMONG THE SKILLS THE army considers “helpful” to a combat medic are the desire to help others, an attention to detail, and an “ability to communicate effectively and work under stressful conditions.”
Consider the reality behind the anodyne descriptions. Health care professionals wearing body armor and a vest with a full combat load of ammunition, carrying an M-4 rifle and possibly a 9 mm Beretta, lugging at least forty pounds of medical gear in addition to other equipment might have to run hundreds of yards under fire to the aid of a wounded soldier. They examine the patient quickly to ascertain the location and severity of the wound or wounds. If there is more than one wounded, they do rapid triage. They instantly decide on a course of treatment to stabilize the patient and give him the best chance of staying alive long enough to be airlifted to a hospital. They might have to apply a tourniquet to stop massive hemorrhaging or insert a chest tube to drain air from the space around the lungs or perform a tracheotomy to let the patient breathe. They could be under fire the entire time. The enemy might specifically target them because their death would demoralize the platoon. But they can’t lose their focus on the patient, on the life-and-death decisions they must quickly make and execute. You can see why an ability to “work under stressful conditions” would be helpful.
Modern combat medics are highly trained paramedics who carry an astonishingly varied inventory of medical equipment into battle. They are perhaps the biggest reason the mortality rate for wounded soldiers has greatly declined in America’s wars in this century. In World War II a soldier had a less than 75 percent chance of surviving his wounds. In Vietnam the rate improved to a little better than 80 percent. Today more than 90 percent of soldiers wounded in Afghanistan survive—this in an age when the weapons of war have never been more accurate or lethal.
Since most soldiers who succumb to their wounds do so before they reach the hospital, it stands to reason that the higher survival rates are mostly attributable to major improvements in the training, skills, and equipment of the combat medic, as well as better body and vehicle armor. Th
ose improvements were initiated after the Blackhawk Down disaster in Mogadishu, Somalia, in 1993, when fourteen soldiers died from their wounds for lack of adequate care and equipment.
It’s an exaggeration, but only a slight one, to claim medics are now equipped better than entire field hospitals were in twentieth-century wars. They certainly bring to the battlefield considerably more resources than the equipment medics in past wars carried, which wasn’t much more than a first aid kit and morphine. Today medics select the equipment they will carry into battle based on the length and kind of mission they are going on. A typical aid pack includes a set of surgical instruments, IV fluids, tubing and needle sets, catheters of various sizes to use as chest tubes and in tracheotomies, a nasopharyngeal airway or nasal trumpet to open a patient’s nasal passage, tourniquets, pressure bandages, dressings for sucking chest wounds, burn dressings, coagulant agents, assorted gauze bandages, ace bandages, splints, morphine, a drug to counter the morphine, antibiotics, antinausea medicine, drugs to counter severe allergic reactions, syringes, alcohol, iodine, tape, scissors, stethoscopes, blood pressure cuffs, thermometers, gloves, surgical sponges, and various other items.
That medics can competently use all this is a tribute to the training they receive today. The army puts about seventy-five hundred prospective medics a year through advanced individual training (AIT), a demanding, sixteen-week course of instruction at Fort Sam Houston outside San Antonio, Texas. The first part of the AIT is essentially an emergency medical technician course, at the end of which students are required to pass the national EMT test. The rest of the training is in combat medicine. In a change from practice in previous decades, most instructors are now veteran medics, not nurses who may have had experience in field hospitals but not in combat. Much of the training focuses on controlling bleeding, the most critical element of trauma care. Students are taught how to apply a tourniquet in under sixty seconds and how to stop hemorrhages in areas of the body where a tourniquet can’t be used. They’re also taught how to clear airways, seal a sucking chest wound, and treat other trauma. They’re taught how to triage mass casualties, how to treat casualties on patrol, how to serve as the sole medical professional on a forward operating base, and how to provide rudimentary medical care to local communities.
