At one point during the evening, Kristen and Dino got up and took the mike. They made a toast, asking everyone to raise their glasses in a tribute to their two friends who could not be at the wedding because they were serving their country. One of them, they said, was flying Hornets off a carrier in the Persian Gulf, and the other was caring for U.S. Marines in western Iraq.
There was not a dry eye at our table. We are all so proud of you, Heidi.
You were missed.
The List
In some ways, this early September morning was a carbon copy of every other morning in Iraq. I arrived at Jason’s room just after 0730, and we walked to breakfast together amid rapidly increasing temperatures. But today was different. For the first time in more than seven months, there was no 0700 OIC morning meeting to attend before I retrieved Jason. Those meetings were over. Our replacements were in charge of the hospital now.
Jason, Bill, Steve, and I planned to watch the final episode of The Sopranos that night. For 220-something days, every Tuesday and Sunday night we escaped to the violent and humorous world of that endearing HBO New Jersey crime family and salivated as they ate delicious-looking Italian food on screen. When we first arrived in Iraq, we careful1ly planned a schedul1e to ensure that we woul1d view the finale on the night before we went home. Finale night had arrived at last.
Jason and I rounded the corner from our barracks onto the long, narrow road to the chow hall. Countless people in tan utility uniforms with rifles over their shoul1ders or pistols strapped to their legs moved in both directions around us. As we navigated around holes in the broken concrete, a group of Marines passed on my right and I said good morning. Several of them shouted in response, “Ooh-rah, ma’am!”
I had to smile.
“Aren’t you going to miss that?” I asked Jason.
“Miss what?”
“As we walk to the chow hall each day, nearly every person who passes by says ‘good morning’ or ‘ooh-rah’ to us. You have to admit, there aren’t many places where that happens.”
“Any Marine base in the world, Heidi.”
“You know what I mean. It is really cool. I’m going to miss it.”
“Okay,” said Jason wryly, grinning sideways at me.
“I think I’m going to write a list,” I announced as we reached the chow hall and got in line. “It’ll have two columns — things that were good about Iraq and things that were bad.”
Jason and I stepped up to the line of sinks in the chow line and turned on the water.
“That will be a pretty lopsided list, don’t you think?” he asked, squirting a large amount of industrial-strength hand soap into his hands.
“Sure.” I ripped a piece of paper towel from a gigantic roll. “But I’m going to do it anyway. For instance, Marines saying ‘ooh-rah’ as I walk to chow; that’s something good about Iraq. I think it’ll be good therapy for me. Call it closure.”
We each asked for pancakes and two hard-boiled eggs. That morning I realized that Jason and I had eaten pancakes every single morning for more than seven months. Of course, on those happy occasions when the food trucks brought fresh eggs, we considered it a great treat to add the hard-boiled eggs to our trays.
Over the course of our deployment, we often commented on good-egg days, on which our eggs peeled easily and the whites looked smooth and perfect, and bad-egg days, which usually involved an inordinate amount of time peeling tiny cracked pieces of shell and ending up with a mangled mess of an egg.
This was a good-egg day.
With no responsibilities at the hospital, Karen and I went to the gym in the late morning and then returned to our room to watch a few episodes of Sex and the City. She then donned her headphones, stretched out on her cot, and began writing in her journal. I started typing my list. It was easier than I imagined.
I walked to the Internet café that night and sent the list home with an accompanying e-mail to a few family members and friends.
We are almost on our way. The good news is that we depart in the middle of the night and arrive (all admin tasks complete, including turning our weapons in to the armory!) around dinnertime at Camp Pendleton — on the same day we leave. The other good news is it appears we have commercial air carriers taking us home, so we don’t have to worry about sleeping on the cold steel deck of an Air Force C-17.
We turned over authority of the surgical company to our replacements, who had a serious trial by fire here in mul1tiple ways, including casualties, surgeries, increased risk to their personal safety, power outages, water outages, and camel spiders in the hospital — all in their first four days. But yesterday, we heard the helicopters coming and knew they were dealing with the traumas. And we sat in our barracks and waited for them to call us if they needed us. They never did.
I decided one of the things I shoul1d compose for my own closure and healing was a list: Things That Were Good about Iraq and being deployed with the Marines, and Things That Were Not Good. My hope is that somehow the trauma, the fear, the grief, the laughter, the pride, and the patriotism that have marked this long seven months for me will begin to make sense through my writing.
So, here goes . . .
THINGS THAT WERE GOOD
Sunset over the desert . . . almost always orange
Sunrise over the desert . . . almost always red
The childlike excitement of having fresh fruit at dinner after going weeks without it
Being allowed to be the kind of clinician I know I can be, and want to be, with no limits placed and no doubts expressed
But most of all,
The United States Marines, our patients . . .
Walking, every day, and having literally every single person who passed by say “Ooh-rah, Ma’am . . .”
Having them tell us, one after another, through blinding pain or morphine-induced euphoria . . . “When can I get out of here? I just want to get back to my unit . . .”
Meeting a young Sergeant, who had lost an eye in an explosion . . . he asked his surgeon if he coul1d open the other one . . . when he did, he sat up and looked at the young Marines from his fire team who were being treated for superficial shrapnel wounds in the next room . . . he smiled, lay back down, and said, “I only have one good eye, Doc, but I can see that my Marines are OK.”
And of course, meeting the one who I will never forget . . . the one who threw himself on a grenade to save the men at his side . . . who will likely be the first Medal of Honor recipient in over 11 years . . .
My friends . . . some of them will be life-long in a way that is indescribable
My patients . . . some of them had courage unlike anything I’ve ever experienced before
My comrades, Alpha Surgical Company . . . some of the things witnessed will traumatize them forever, but still they provided outstanding care to these Marines, day in and day out, sometimes for days at a time with no break, for 7 endless months
And finally, above all else . . .
Holding the hand of that dying Marine
THINGS THAT WERE NOT GOOD
Terrifying camel spiders, poisonous scorpions, flapping bats in the darkness, howling, territorial wild dogs, flies that insisted on landing on our faces, giant, looming mosquitoes, invisible sand flies that carry leishmaniasis
132 degrees
Wearing long sleeves, ful1l pants, and combat boots in 132 degrees
Random and totally predictable power outages that led to sweating throughout the night
Sweating in places I didn’t know I coul1d sweat . . . like wrists, and ears
The roar of helicopters overhead
The resounding thud of exploding artillery in the distance
The popping of gunfire . . .
Not knowing if any of the above sounds is a good thing, or bad thing
The siren and the inevitable “big voice” yelling at us to take cover . . .
Not knowing if that siren was on someone’s DVD or if the big voice woul1d soon follow
The cracki
ng sound of giant artillery rounds splitting open against rock and dirt
The rumble of the ground . . .
The shattering of the windows . . .
Hiding under flak jackets and Kevlar helmets, away from the broken windows, waiting to be told we can come to the hospital . . . to treat the ones who were not so lucky . . .
Watching the black helicopter with the big red cross on the side landing at our pad
Worse . . . watching gray Marine helicopters filled with patients landing at our pad . . . because we usually did not realize they were coming . . .
Ushering a sobbing Marine Colonel away from the trauma bay while several of his Marines bled and cried out in pain inside
Meeting that 21-year-old Corporal with three Purple Hearts . . . and listening to him weep because he felt ashamed of being afraid to go back
Telling a room ful1l of stunned Marines in blood-soaked uniforms that their comrade, that they had tried to save, had just died of his wounds
Trying, as if in total futility, to do anything I coul1d, to ease the trauma of group after group . . . that suffered loss after loss, grief after inconsolable grief . . .
Washing blood off the boots of one of our young nurses while she told me about the one who bled out in the trauma bay . . . and then the one she had to tell, when he pleaded for the truth, that his best friend didn’t make it . . .
Listening to another of our nurses tell of the Marine who came in talking, telling her his name . . . about how she pleaded with him not to give up, told him that she was there for him . . . about how she coul1d see his eyes go dul1l when he coul1dn’t fight any longer . . .
And finally, above all else . . .
Holding the hand of that dying Marine
The Beginning,
Part II
The men and women of Alpha Surgical Company returned as a unit to Camp Pendleton on a chartered (and patriotically decorated) American Airlines jet. Mike came to San Diego to meet us and cohosted a homecoming celebration with my sister, Steph, and my dear friends Alli, Margy, and Colette. I moved, trancelike, through the wonderful party, frankly stunned at every turn by everyday details: fresh air, fragrant tropical flowers, and colorful hot-air balloons that hovered over Alli’s backyard. Color and sweet smells; two things that Iraq simply did not have.
Mike returned to Florida after the party, and my comrades and I spent eight days returning gear and attending debriefs at Pendleton. The majority of people from Alpha Surgical Company belonged to the naval hospital in San Diego. I had spent seven months telling Marines it would be important for their mental health to stay together as a unit upon return.
And then, after all my gear was turned in and my party was a memory, I boarded a plane by myself to return to Florida.
My husband, my children, and my parents met me at the airport. In my neighborhood in Jacksonville, yellow ribbons embraced our trees and mailboxes. A huge silk-screened American flag that said WELCOME HOME, MOMMY hung over my front door.
BETTE SQUIER
I was home.
Before returning to the hospital, I took three weeks of leave. Over the next six months before I left active duty, I struggled to reconnect with my family; jumped at every car backfire, popped balloon, and firework; lost my appetite and ten more pounds; and battled bizarre nightmares.
Through it all, my return to seeing regular patients at Naval Hospital Jacksonville could only be described as torture.
My first day back in clinic after leave, I found myself sitting at my desk at 0730, staring blankly at a stack of charts that contained six new evaluations. After providing patient care every day of the week for seven months, I now felt strangely out of practice and incompetent.
While I procrastinated going out to meet my first patient, a large metal storage rack that was being moved on the floor above us crashed to the deck. The sound was deafening, a terrible crack of metal and concrete that caused my window to shudder in its sill.
I froze.
My heart seized. I clutched the medical chart I was holding so tight that my fingers blanched. I darted looks out my window at the blue fall sky and up at my white ceiling. I stood and walked to my open doorway, looking into the hall for signs that anyone else had heard the crash. Our doctors, corpsmen, and admin staff moved through their morning routines as if nothing had slammed into the ceiling above our heads. I bit my lip, battling tears of frustration. I knew it was just me. I knew it was the war, still with me.
HM3 Betancourt, a relatively junior psychiatric technician who had deployment experience with the Marines, saw me in the doorway and stopped. He moved toward me cautiously.
“Hey, ma’am. You okay?”
“Oh, sure,” I said, not making eye contact and moving back into my office, looking at my feet. He followed me, closing the door behind him.
“Dr. Kraft?”
I looked up.
“It’s okay if you’re not okay.”
Two big tears slid down my face.
“I’m not,” I whispered, sinking to the couch my patients used and covering my face with my hands.
HM3 Betancourt sat in my chair.
“I know, ma’am.”
Ten minutes and very few words later, I shook his hand and strode out my door to wash my face and then retrieve my first patient from our waiting room.
And so I returned to life as a clinical psychologist in a peacetime hospital. Despite my clinical knowledge that each individual’s suffering is real and important, I often found myself openly staring in disbelief at patients. I could not fathom the crises that my patients made out of their life events, nor could I empathize with the petty relationship, work, or financial stressors that brought them to tears in my office.
Only months before, I had held the hand of a twenty-two-year-old hero who gave his life to save two of his men. I had witnessed courage in the face of injury and pain, loyalty in the face of grief. Everyday psychological problems not only paled in comparison, they struck me as frankly absurd. Despite the personal toll seven months of war had taken, I found myself wishing I worked on a Marine base. At least then I would know what to say to my patients.
Over the months, I spoke with HM1 Botkin, our Leading Petty Officer in the psychiatry department, about some of my conflicts. When the referral to treat Corporal Paulsen came across his desk, he did not hesitate over which psychologist to assign. To this day, I appreciate his insight — he knew that not only did this patient need me, I needed him.
Corporal Paulsen’s battalion was still in Iraq when he came to my care. He had been injured several weeks before and was sent home by medevac. He was allowed to visit family on leave, and his doctor asked us to look after him during that time. In her consult she stated that the corporal displayed total paralysis of his legs — with no medical indication for it whatsoever.
When I entered the waiting room at our first appointment, the young man with the blond high and tight saw my dark green Marine Corps utilities and desert boots, wheeled forward, and shook my hand firmly.
“You have no idea how great it is to see that uniform, ma’am,” he said with a grin.
We entered my office together. Knowing that I would need to start slowly, I pulled my chair up next to his wheelchair and leaned back. Before I spoke, I noticed that he was looking at the pictures from the war on my bulletin board. Most were of people — Bill, Steve, Jason, Katie, Karen, and Cat. One, taken by Bill, beautifully framed the decrepit mosque on our base within multiple circles of razor wire. The corporal seemed focused on that one. I waited.
WILLIAM REYNOLDS
“That’s Al Asad!” he exclaimed. I nodded. He looked at me.
“So, ma’am . . . you were there.”
“I was there.”
He knew that his doctors could find no objective reason for his inability to move his legs. “It’s called conversion disorder,” he told me expertly. “I guess it means that my mind is fucking with my legs.”
I smiled. He was right. That was exactl
y what it meant.
He started talking. He told me of the closeness of his unit and of his tremendous guilt about being home while they still fought in Iraq. He told stories of literal hand-to-hand combat, of the day he killed a man with his Ka-Bar when he was too close to use his rifle. He described the day he was shot.
“We were on the roof of a building. I was standing next to my lieutenant. I don’t really know what happened, just this huge impact. And I fell.”
“Off the top of the building?”
“Yes, ma’am. A bunch of rubble fell on top of me, and I was pinned. My rifle fell away during the fall, and when I could see through the dust, I realized I was stuck and couldn’t reach it. I couldn’t actually see the bad guys, but I knew they’d be coming soon.”
I stared. “What happened?”
“I yelled up to my platoon to get their asses down there — and they yelled back for me to hold tight. It was pretty fucking scary, ma’am — pardon my language, ma’am.”
“No problem. So obviously they got down to you.”
“Yeah, they did. You know what’s amazing? You know the body armor we wear? It stopped two AK-47 slugs. They’re actually stuck in the plate. I asked if I could have it back, and they said I could.”
“That is amazing.” I made a note to go back to that story another time. I noticed that his skin was graying and beads of sweat forming on his forehead.
“Anyway, I guess I passed out, because the next thing I remember was the CASH.”*
“No damage to your spinal cord? After a fall and having something land on you that was heavy enough to actually pin you.”
“That’s what the MRI says, ma’am. See for yourself. They sent it. Says my back, legs, neck — everything — are fine. Guess it’s just my head that needs help.”
“You know, combat can be really traumatic. People who have been through it sometimes experience a slow recovery from that trauma. It’s pretty normal.”
Rule Number Two Page 15
