Later that night

I continued to reunite with old friends.  Jeremy, a trauma surgeon, and I had worked together at Wilford Hall in San Antonio. He graduated from the Air Force Academy and had completed most of his training at a civilian hospital, as I had.  He shared his observations.  This was his 3^rd deployment also, and his second to Bagram.  However, he would be leaving in a few weeks, back to San Antonio.

Later I met with Mike.  Mike is a specialty surgeon.  He’s about 10 yrs older than me.  We have overlapped twice in Iraq during our deployment rotations.  We shared stories of our previous deployments, some comical and others humbling.  We attached most of them to the ethos that the soft walled tents of Balad Hospital in Iraq created.  Bagram was new for both of us and he had arrived 2 weeks before me.  Later, I met with Jeff.  Jeff is a Colonel and a trauma surgeon. We also had met over the years.  He was in charge of the entire Theater Trauma System in Afghanistan and Iraq, a daunting task.  He was handpicked to improve our trauma care built on blocks from the last 9 years at war.  We chatted about Balad.  It was like therapy.  Most who have never worked there do not understand. There is an emotional attachment to “the tents” and the care we provided.  That hospital tent received more casualties than any since the Vietnam War.  It the hub for casualties for all of Iraq and we worked there during the busiest time of the war.  We likely we never see that volume of casualties for another generation.  A replication of Trauma Bay 2 is in a Washington Museum and the USAF Surgeon General has a picture I took in 2007 posted in his Pentagon conference room of the ER the day before it closed.  Jeff and I chatted about how busy it was and he enlightened me to the character of the Bagram Hospital (Craig Joint Theater Hospital – CJTH).  While CJTH is one of the busiest and will be so as the Operation Enduring Freedom surge begins, it’ll never reach the volume of Iraq, which is a good thing.  However, the temperament of the combat hospital was different, slower, and more patient.  They had the right to be as the trauma system was more mature, the communication from facilities better, and the smaller facilities better equipped.  At CJTH we typically get warning of patients arriving and with the mountainous terrain and mercurial weather, the flow patients is staggered, so we are not typically overwhelmed.  This contrasted with Balad where, like the TV series MASH, Blackhawk Helicopters would fly in with 1-2 minutes’ notice, often with 2-8 critically ill patients.  Nonetheless, the care delivered at Bagram was remarkable and rivaled or left behind US civilian trauma centers.  The US trauma centers still seek new lessons we are learning to apply to their institutions.  Jeff said he would be travelling to forward operating bases (FOBs) for most of his tour, but would be here once a week.  As we ended our conversation, I felt relieved, like I had therapy.  Someone else resonated my experiences and validated them. I was ready for the next few months.