And the Carnage Continues

Being in the field does funny things to people. I started the morning with a bloody nose, and the discovery that the drippy moulage blood tastes like peppermint when it seeps down your septum and into your lips. In related news, Tyler Powell started the morning with broken fifth metacarpals, almost exactly like Major Burns's during train-up week. It was rather unfortunate that we had to report to the same sick call, but at least Jaime Piercy, who had woken up unable to see, was there between us to distract us at first. By the time we arrived at the EMED, even that was unable to keep us apart, and we started to fight again. I probably called him some names that I would have regretted in the future, except that he deserved them. By the time the MS-4s running the EMED had pulled us apart and restrained us in zip ties (not an easy process, I assure you), my nose really needed attention, so they brought me in for an eval. Pressure didn't stop the bleeding and I squirmed too much for silver nitrate, so they had to un-cuff me to lie me down and give me IV morphine. Which was a bad idea because as soon as I laid down, the blood started filling my throat, and I started coughing and choking, a hacking fit so violent that I currently have a real-world bruise on my cheek from hitting it against the metal side of the litter. They finally sedated me (that seems to happen a lot on this deployment), anesthetized me, and cauterized my bleeding septum. It came out in the history that I was taking enormous doses of asprin to control headaches, and no amount of pressure would have made my blood clot. Also, that Tyler and I were fighting because he had slept with my boyfriend and I had threatened to out him. And we were battle buddies, too. The traitor. The punk. I can't believe he would do that to me. Even the morphine didn't really get rid of my rage, though it did take the edge off. Apparently such skirmishes were happening at sick calls all over the deployment that day.

I wasn't back on duty long before I was thrown from an exploding car and sustained a closed-skull fracture. It looked so horrible that the medics left me for expectant the first four times someone passed by me. They even left with the ambulances with me still on the ground. Nobody even bothered to examine me--they would have found me responsive to at least painful stimuli. So I had to break role and start screaming to get their security guard to notice he had left me, and then go back into my mostly-unconscious state.

It was the kind of day that reminds you of the Chinese curse "may you live in interesting times." Loren Walwyn-Tross was attacked by ninjas who almost killed him had he not been able to stumble into the BAS with the ninja star still embedded in his forehead. Later on in the day, I found his face spattered with bullets. Seamus Cobb got circumferential burns all across his torso, mere hours after an explosion that blew open his skull so bad that brain matter and bone were sticking out. The same explosion knocked out my hearing, forcing me to yell all communication to the doctors and their assistants. The burns got Dan Brennan and Scott Story also. An unexploded ordinance, part of Marion Keehn's rogue model rocket project, embedded itself in Robert Fenequito's head, which forced his eye to dangle out its socket by its nerve and artery. He was barely back at work when an explosion burned him all over the face. Kevin Gray lost an arm and had to go all around the woods looking for it. I still don't know what happened to the arm Greg Nishimura lost. Frances Rosario got an open fracture to both her radius and ulna. Nicole Baker was hit by rectal bleeding, which looked pretty similar to Jaime Piercy's exploded bladder. Dan Bailey's foot was badly mangled. Chris Oching was impaled with a chest. I was shot in the left chest on two separate occasions, once leaving me with a tension pneumothorax that took three decompressions and once leaving me with an open pneumothorax that became a tension pneumo once occluded. I was gasping from the time they appeared within hearing distance until they finally successfully treated me and just the hyperventilation was making my arms and feet tingly and numb. Jesse Giffhorn's forearm was mangled. Tara McClusky's was in a different car accident, which snapped her forearm, leaving a huge bone sticking out. She took it better than Seth Olchese, who did the same thing. Fred Nielson, may he rest in peace, lost several inches of gray matter when his head split open. Liz Miller got cuts all over her face. I didn't get all the details, but the rumor is that she provoked whoever did it. Aubry also had cuts accross her cheeks. I never found out if the two were related. Muoy Lim lost a finger, as did Heather Scheibe. Robbie Wetzler, after remaining in tact all of yesterday, was peppered today with fragments of something all over his face and arm. And John Gillis--I'll miss him. By the time they found him, he was so red and black and blistered with burns that he looked like Darth Maul in his impressionist phase. Eric Abdul threatened to kill his commanding officer because he wasn't given emergency leave to deal with his encarcerated wife. Amy Alexander's arm was pretty much destroyed. Fred Nielson's OCD hit a stage where he wouldn't even go into the commander's office because of its decor; then to top it off, he was shot in the buttock. Andrew Fisher chose the wrong time to have his bowel eviscerated--right when all the rest of us were hit by a car bomb--so whatever chance he might have had to be evacuated within a reasonable window of time to save him was lost.

For forensic purposes, I documented many of these injuries photographically. It would be disturbing and beyond the bounds of good taste to make them available here, but, if we get approval from our chain of command, we'll try to set up a restricted, by-invitation blog or photo album for the photos that would be way too grafic to leave open to the public, and those who want to see will be able to just request to be given access.

There's only so much people can take before they start falling apart, especially when they're feeling like no one is attending to their needs. When the medic finally decompressed my first pneumothorax and I could breathe again, I started to cry, and crying became wailing. I didn't want to die. I was in pain. I didn't want to leave my baby, who needed her mama. I wished I had listened to my dad and joined the Air Force instead of the Marines. I didn't want to be in this horrible country with its horrible food where people kept stepping on me and shooting at me. I was sick of being shot and blown up. And I needed pain meds. Somehow, inexplicably, giving me pain meds always diminished the wailing and screaming.

We can feel the tension building. We're trying to keep up troop morale, but we keep getting injured, which then really beats on the morale of the medical staff. You can sometimes feel their agitation. There are rumors of more car bombs tomorrow. The smoke machines and Saving Private Ryan soundtrack that come on every time Jazeeris blow up cars make it even harder for them to come rescue us. By tomorrow, we might all reach our saturation point.

We hear word of political debates on whether or not we should still be in Fort Indiantown Gap, Jazeeristan, Pennsylvania. The public is suspicious that we always seem to think going to war is worthwhile when there are penutbutter cups involved. I don't know enough about the big picture to say yes or no. On one hand, a shortage in peanutbutter cups and subsequent spike in peanutbutter cup prices would send our economy into a vicious spiral. And it's really a peacekeeping mission. On the other hand, despite our best intentions, it's not even always clear they want us here.

Tomorrow should be very telling.

I Would Like to Thank the Academy

That glorious sensation of clean from yesterday didn't last long. Yes, we have achieved a relative steady-state of non-stinkyness, but today we added a whole new level of mess--moulage. Moulage is French for "big, simulated-bloody mess."

Our mission for today was to get hurt. And sick. And unstable. And occasionally die. All in the name of helping the rising MS-4s practice how to deal with hurt, sick, unstable and dead people. We bussed out to the central moulage site and deposited our stuff on a series of cots under the holding area tent. We then dug through old donated cammies and each found suitable ones to evolve into bloody messes. I pulled a set of soft green Marine digies belonging to someone named Evans that looked a little bit like pajamas on me. Command Central, starring Tim Gotham, Rebecca Hardy, and Mike Cullen, would recruit us in teams of two to eight, and hand us all cards with a set injury or illness on them, including relevant medical history, precipitating factors, vital signs, and what would reasonably be expected from an MS-4 treating us. If that injury involved diarrhea, out popped a baby suction bulb and some carmel-colored dyed applesauce. If the injury involved a scrape or fragmentation wound, out popped the scar wax and small silver wads of gum wrappers. If the injury involved an arterial bleed, out popped an IV bag with a control valve filled with super-saturated red cool-aid. Then Ben Nye make-up, fresh scab, and stage blood were layered on for color blending.

But, really, an injury is only as good as the Oscar-caliber theatrical performance behind it. Which was why I was terribly disappointed that my first card was to report to sick call with ear pain and itching. But then the first set of MS-4s upon whose camp we were assigned to stumble were dreadfully disorganized, having just arrived and set up their gear when Nicole Baker with back pain, Jen Nuetzi with blaster diarrhea, Anthon Lemon with an asthma attack, Kevin Gray with alcohol-induced gastro-esophageal reflux, and I arrived on the scene. Their lack of organization slowed them down, and in short order our whining had escalated. They were still in the process of slowly attempting to effectively treat our maladies when Loren wandered up with two large bleeding wounds on his shoulder to report that he, Jaime Piercy, Andrew Fisher, and Tara McClusky had been badly injured in a firefight. Nicole and I had already turned up the griping big time because of the wait, but this time we saw our chance to put something Oscar-worthy on the table and tried to run to Loren and help our friends. They tackled me. It took two of them. Anthon would have helped me out if he weren't in the middle of his asthma attack. On top of the huge collection of meds they had already given for my ear, they sedated me and strapped me to a litter. By the time the ambulance came to pick up Anthon and me, they realized that they couldn't give away a litter to send me, so they lowered the previous dosage of sedatives until I was capable of walking. Which meant I was conscious enough for another round of freaking out when the ambulance landed at EMED. There, they seemed to have a little better idea of how to calm down a hysterical patient (or, at least, in my Method acting, I wanted to calm down because of their treatment of me, whereas the other group's had only encouraged me to escalate). Finally, they just let Anthon come and keep an eye on me, until headquarters demanded we be evacuated and returned to come be patients again.

I was quickly turned around into the moulage station, where a series of gum-wrapper foil fragmentation wounds were waxed into my shoulder and covered in stage blood. Yummy. Chris Oching had been similarly pelted, Andrew Fisher was burned all over his face and hands, and Anthon was hit in the calf. Our scenario was that we had been caught in a firefight, and were found on the battlefield. Vivina McGintley won the Oscar on that one with massive abdominal injuries. I have to say, after all our tactical movement work last week, the MS-4s come off as pretty pathetic at it. They didn't have much of offensive line, so Anthon and I, as marines, kept asking for a weapon after our initial care under fire so we could get back in the fight and fend off the punks who had attacked us. Finally, one of the MS-4s gave Anthon his rubber duckie (a big no-no), and another one gave me a 9mm caliber stick. While they ran around like crazy trying to litter-carry ambulatory patients, we fended off hostile action closing in. But as soon as they brought me back into the camp in my triage area, someone who had been on the staff at the morning's sick call took away my stick-gun because she thought I was way too unstable to be carrying one. Which left no one guarding 180 degrees of their perimeter, a fact that upset me a ton more than it upset them. My bleeding wasn't serious, so they put a clean dressing over it and gave me morphine and a pre-emptive low-dose sedative--this time not taking any chances. They didn't sedate Chris, but he also would have grabbed any weapon lying around to pull security had he had the chance.

This time, I was evacuated back to the moulage tent get a skull fracture, with drips of blood oozing beside my nose and down my cheeks and eyes. Our Humvee had hit an IED and I was thrown from the vehicle onto my forehead. With pupils dilated and unreactive, I had a hemorrhage compressing my midbrain, and had no chance of ever regaining consciousness. They triaged me as expectant and got to me last. I have to say, the secondary survey the first medic performed on me included a whole lot more hands on breasts than the one we were taught. I was torn between staying in character within my coma and reminding him that he'd already checked there. A lot. Since I was the only patient left, they intubated me, but not until after a relatively long ethical deliberation. But once intubated, then they had to deal with me, so they sent over the chaplain, who kept trying to give me a poncho. After last week, the little trickle of rain was hardly even worth noticing. He then quizzed me--in my comatose state--about what the process is to return the body of a fallen American serviceman to his or her family. "What do you make sure to include in the bag with the body?" "Air freshener."

When I was finally evacuated, I came back to find that Anthon had been sent to the real-world medical tent because he was having a reaction on the tops of his feet to the make-up remover solvents. I grabbed his stuff and Sergeant Flores and I escorted him back to the dorms. Even though I came back in time for my next assignment--loss of hearing subsequent to a cold--they had already passed it on to someone else, so I got...arterial bleeding. Yay! A spurter, with it's own little squeeze-activated release mechanism. It also came with the bonus of altered mental status. This time, rather than belligerent, I went with loopy. It didn't make them freak out nearly so much. They got a tourniquet on me right away, and were the first of three groups to see me bleeding who actually bothered to cover the wound. In a series of progressively more pleasant and competent MS-4s, I was swept up through triage, initial eval and treatment, and orthopedic surgery, which was held in this beautiful inflatable clean plastic tent.

Here at Bushmaster, they seem so much more paranoid about our safety than they were at Kerkesner--we aren't to walk through the woods without chem lights and k-pots in the dark and they are attempting to enforce hydration. And then they go and pile sixteen of us on the back floor of an unmarked white van to drive on a highway. They are also beyond paranoid about making sure they have an accounting of every body on the exercise, having us check in and out of every area we use. One gets the suspicion they've lost people before. One also mourns a little that we can't have Major Burns running this by our year--he would remember to treat us like grown-ups, and would not let us get away with some of the slackage we've seen.

After my post-op evacuation, I had a few minutes to scarf some food before I was at it again, this time with a dry cough. That one was painful to simulate, and doing it too much brings on dizziness. The faculty and fourth years kept coming back to me to tell me I could drink water. Jen got bloody diarrhea, Seamus Cobb had a spontaneous pneumothorax, and Brian Pomerantz got to attack somebody. We could see how the length of the day was beginning to wear on them. It's been kinda fun to listen to the dialogues between the faculty and students about best course of action with our various complaints. It makes me excited to start getting into Pharmacology and Pathology and clinical rotations, and not just so we can show them up in two years.

When we arrived at the barracks, there was a mad rush for the showers. We're not quite ready to sacrifice that whole clean thing so quickly just yet.