Angel of Mercy (5 page)

Lieutenant McKay was assisting Captain McGuire in a thorough examination of the wound area. In a perfect world, the medical team would have had access to a triple contrast CT scan to determine the precise mode of treatment, but since such a thing wasn’t available the lead doctor and head nurse were doing things the old-fashioned way. Chelsea was monitoring the patient’s vital signs. The signs began to point to things not going well.

“B.P. 80 over 18 Captain McGuire, he’s crashing!” Chelsea shouted as the young man’s blood pressure headed south in a hurry.

“I see it. There’s an internal bleed somewhere,” Captain McGuire said in a calm, yet urgent voice. “Get me three units of plasma, stat! I’m going to try to find the bleed, but if I can’t immediately we’re going to have to fill him up!”

Private Dale Bostic came quickly with the requested plasma. He was brand new to the war zone, and his face looked as white as the sand that Chelsea could see behind him. She gave Private Bostic a quick nod as he placed the pouches of plasma where Captain McGuire could reach them quickly if need be.

The makeshift operating theater fell silent as Captain McGuire, using his years of experience and channeling them through his fingers, searched for the vein that was leaking so profoundly into Akhmar Abaallabad’s chest cavity. Chelsea watched the young man’s blood pressure drop. She didn’t want to break the silence, but if the patient’s diastolic pressure dropped below 10 she would have to tell the doctor. Chelsea had been taught that, while most people concentrate on the systolic (or higher) number, the key was the diastolic number and the gap between the two. Right now Akhmar’s gap was fine, but his diastolic was becoming critical.

Just as the young man’s BP showed 69/11 Captain McGuire said, “Got it.” He pointed to where he needed help from Lieutenant McKay. The bleed was coming from the back side of the patient’s spinal column. Captain McGuire knew that time was of the essence. The buildup of blood or fluid can press on the spinal cord and damage it.

“I’m going to put my finger on the artery. You tie the artery off,” he said to his head nurse.

“Yes sir, Captain,” Lieutenant McKay answered as she went to work with the silk thread used to tie off arteries.

Within seconds, the offending artery had been secured, and Akhmar Abaalabad’s blood pressure had stabilized, soon to be on its way to a healthier set of numbers.

Once the medical team determined that patients who could be treated and released were able to leave, and the patients who needed transport (and were safe to transport) the 15 clicks back to Kabul were prepared for the journey, they loaded the trucks for the half hour trip back to camp. Chelsea sat beside Private Bostic on the bouncy ride back to town.

“You did fine today. How did you feel about it?” she asked the young nurse.

He shook his head and rubbed his cheeks with his hands.
Poor kid looks like he hasn’t started shaving yet,
Chelsea thought. “I guess I did okay, but it all goes so fast. I worked in the E.R. for a spell back home in Omaha, but it was never like this.”

“You’ll get used to it,” Chelsea said in a comforting tone.

And I guess he will,
Chelsea thought to herself
. I never thought it would happen, but today just seemed like another day at the office to me.

Back in Kabul, BSP (Base Support Personnel) unloaded the gear while the medical staff dealt with the patients. Chelsea and Private Bostic waved across the road to each other as they retired to their separate CHUs. For the first time since she had arrived, Private First Class Chelsea Bannister felt less like a fish out of water, and more like someone called to do a job in a difficult place, and under difficult circumstances. She slept well that night.

Winter landed on Kabul harder than usual. Everyone knows about the searing misery of the desert summer, but few realize that the winter is harder to endure than the heat of July and August. Every winter the infrastructure of this rapidly expanding city struggles under the weight of the severe weather. There are regular power cuts, roofs collapse and children are at risk of dying from the cold.

Back in 2002, US President George W. Bush vowed to rebuild Afghanistan with a modern Marshall Plan—a program devised to help lift Europe from the ruins of World War II. But as the temperatures in Kabul drop to well below freezing during the night and people struggle through another winter houses often have no running water or sanitation and there is a limited electricity supply. The gas generators businesses use during blackouts and the wood-burning stoves that heat homes only add to the thick pollution that hangs in the air.

Solving these issues is difficult, partly because of graft in the public sector. The United Nations has stepped in with some aid to communities ravaged by the seemingly endless winter. Certainly, the government has also tried to emphasize its role in these efforts. As well as sending supplies to rural communities, the Afghan National Disaster Management Authority offers compensation to people affected by avalanches, landslides and floods.

Money, often in excess of $500, is offered to the family of someone who is killed. Smaller amounts are provided for property damage. Money from the same pot is occasionally delivered to civilian victims of violence brought about by warfare. However, decades of conflict and unrelenting poverty have left a lot of people devoid of hope.

The medical staff of Chelsea’s unit worked hard to try to alleviate some of the suffering. Trucks bearing warm clothing, blankets, and hot food were dispatched to the center of Kabul. Preventing frostbite at the source was easier than trying to treat it when it was in full control of someone’s feet. Children, dressed in rags and covered up with scraps of newspaper, crowded around the truck. Old men tried to push through to get their share of the largesse from the American service men and women.

Chelsea was at the tailgate of the first truck into the area. She was handing blankets out of the back of the truck as quickly as possible. Just when the crowd threatened to overwhelm the truck, a figure stepped into the fray from the street. Chelsea sensed the presence of a uniform more than saw who was wearing it.

Chapter Four

Corporal Timothy Giacomo was on a three-day liberty into town. He worked in aircraft maintenance at the Air Base. In the summer, Corporal Giacomo fought a pitched battle against sand. Sand in the radiators caused overheating. Sand in the manifold caused engine miss, and eventually engine failure. Sand in the fuel injectors caused planes to fall out of the sky. Corporal Giacomo swore that, when his hitch was over, he would never visit a beach again.

The winter brought about different issues. Most of his winter days were spent trying to keep the anti-freeze in the aging C-130’s from freezing. Most people didn’t know that, in spite of its name, anti-freeze can freeze under the harsh conditions in Afghanistan. Airplane de-icing equipment works really well to 160 degrees below zero. To the layman that would seem sufficient.

Many of the planes under Corporal Giacomo’s care saw wind chill of less than 200 degrees below zero on a winter night flight. Aircraft maintenance personnel fought the ice and the cold weather decay just as hard, or harder, than they did the sand in the summer.

Corporal Giacomo had noticed Chelsea from a distance, but had never had a chance to strike up a conversation. Today, when he saw that she was struggling with the philanthropic task before her, he rushed over to help. He shouldered the heavy blankets and got the line moving in a smoother fashion. After delivering 200 blankets to the freezing masses, Chelsea and Timothy had a chance to catch their breath. They worked together to bring the canvas back on the truck down and fastened securely.

“Hi, I’m Tim Giacomo,” he said, holding out his hand. “I work in the garage on base and thought that you needed a hand.”

Chelsea laughed as she noticed the rank insignia on his arm, “Well, hello Corporal Tim Giacomo. I’m Chelsea Bannister. As you can see,” she said indicating her attire. “I’m a nurse on base.”

“I have seen you, but our paths haven’t crossed at least until today. So…where’s our next stop?”

Chelsea glanced at the route sheet printout that was on a clipboard on the side wall of the truck. “The Artreaton Senior Center,” she read aloud. Then Al-Aquiffa School, and we will be done.”

“Okay, I’m in,” Tim said, leaning back against some of the blankets that were going to the senior center.

Chelsea smiled. “I appreciate the help, but you must have been on your way somewhere. People don’t just walk around taking the air on a day like this.”

Tim said, “Well, Chelsea, I’ll allow that what you say is true. I was going back to my hotel where a cup of hot chocolate and a good book was waiting for me. But then I saw you folks, and what you’re trying to do and I remembered what another good book had to say. In the real Good Book, it says, “When I was hungry you fed me and when I was naked you clothed me.” Well these folks aren’t naked, but they might as well be. I think I will help y'all rather than drink hot chocolate.”

It took the better part of the next two hours to finish distributing blankets at the next two stops. During that time, Chelsea and Tim Giacomo got to know each other. She told him about her nursing school and how the loss of a good friend and the determination of another had-brought her to this point in her life. He told Chelsea about his wife Anne, and their two children Josh and Maranda. He told her about his twin brother Gerald, who was also serving in Afghanistan, but as an infantryman. Tim and Chelsea became good friends faster than good friends can be made under normal circumstances. When they parted later that afternoon it was with a promise to get together soon for coffee on base.

“The coffee there is pure swill, but I can put up with it if you can,” Tim said with a laugh as he jumped off the truck and headed up the street to his hotel.

As the frigid days of January and February gave way to the only slightly less chilled days of early March, Chelsea and Tim became close. They discovered a shared interest in art, both creative and performing versions. They listened to similar music, though Tim preferred his music with more of a country flavor than did the city-bred Chelsea.

Chelsea and her roommate developed a close friendship as well. Long forgotten was the first impression that Chelsea had of Lisa Glenn. The often irreverent Boston native of Italian extraction provided a sense of fun that lightened the mood, whether in the CHU or at work. Deep down and under the gum-snapping, wisecracking exterior, Lisa had a true heart for her wounded patients and a healthy distaste for war in general.

Far from the gung-ho days of early enlistment, combat nurses often develop an intense disgust for the activities that provide so many of their customers. Chelsea and Lynn spoke at length about the absurdity of war and the carnage that it took on the young lives with whom they came into contact. Tim Giacomo sat in on one of the young women’s discussions.

“You two sound almost like the war protestors that lined up in front of the recruiting center in Omaha. The recruiters brought big dogs to work, so the protests never got very far, but you guys sound just like them,” Tim said one evening while relaxing in Chelsea and Lisa’ s CHU. Lisa responded, “I’m not a pacifist or anything like that. I believe that our country has a role in the world as the last great superpower, but God Almighty Tim. You should see what we see! You should see the mangled bodies and the shed blood. It’s not nauseating anymore because I’m used to it but it still seems…” Lisa’s voice trailed away.

Chelsea spoke up. “It seems like a waste, is what she’s trying to say. Young, torn-up bodies that we can only try to make better. But a lot of these folks are never going to be whole again, or anything like it. We patch them up and if they’re lucky they go home with a limp or scar or something wrong with them that can’t be seen from the outside. If they’re not lucky they go back to it and we just have to pray that we don’t see them again.” Tim rubbed his head.

“I get it, but I’m fourth generation Army. My great granddaddy fought in the Spanish American War. My grandpa landed on Omaha Beach. Serving the country is no different in my family than going to high school is in some families. It’s just something that we do.” Lisa Glenn put her hand on Tim’s leg. “We’re not judging you, Tim. It’s something that everyone has to think about on their own and come to their own conclusion. Chels and I aren’t going to desert and run off with a Jeep like some kind of Army Thelma and Louise.

“We just need to blow off some steam once in a while, and this is a better way of doing it than knocking down the cooking sherry, falling in a heap on the floor and cracking our damn fool heads open.”

Tim laughed ruefully. “I wouldn’t be no help if you did that. I can fix the timing chain on a Rolls Royce plane engine and change the tires on the landing gear, but I’m no account at all when it comes to patching heads.”

Though the day to day activities of a combat nurse have changed some in the last 20 years (downloading the latest education in treatment techniques into the unit’s ASUS All-in-One hard drive being a relatively new example) one thing that has never changed is the thrill a soldier gets when a letter from home arrives. Once in a great while service men and women are able to have a video chat but those are always too short and subject to the needs that the rest of the unit had for broadband space.

A letter was another matter entirely. An old-fashioned on paper letter was something that those in the service of their country cherished, carried on their person, and reread until the ink faded. Then they would read it one more time since the contents were committed to memory anyway. Chelsea got just such a blessing from home one early April day. Her mother wrote and told her about life stateside. In the letter, she shared some exciting news.

Dear Chelsea, How are you, honey? I just wanted to tell you that I miss you and to tell you some of the things that are going on around here. Your brothers are fine. Thomas is completing his first year at Penn State. Nathan is finishing high school and looking forward to graduation next month.”

Chelsea put the letter in her lap. Was that even possible? It seemed like just yesterday that the boys were playing with Legos. Chelsea read on,

“I am doing great. I met a gentleman when I was a chaperone at Nathan’s Winter Ball. His name is James Edward. He is sweet and kind and everything that I need at this point in my life. We love spending time with each other, and I’m very happy. I know that you’ll be happy for me as well. I love you, Chelsea, Mom.”

Chelsea read the letter twice and put it on the table beside her bed with a happy smile. She was happy for her Mom. The speed bump, significant as it was, that was created by Chelsea’s father seemed less daunting now.

Summer came to Afghanistan again, and with it a heat that seemed to punish the landlocked country for the winter just past. Searing heat that appeared to have a personality of its own rolled through camp. Temperatures that topped a hundred degrees Fahrenheit pummeled Kabul. As much as possible, the scheduling clerk tried to set the medical staff up with tours that were four hours on and four hours off because of the dreadful conditions.

Any longer than four hours and the mind didn’t work as quickly as these finely tuned, highly trained, minds needed to work. Chelsea was two hours into a tour in surgery. Six soldiers were brought in by helo after taking fire from the side of the A01 just outside of town. The casualties were evenly split between minor shrapnel wounds, severe injuries from fire or non-lethal gunshot wounds, and critical cases.

Chelsea had been tasked with caring for one of the casualties that fell into the middle category. She was treating Staff Sergeant Joseph Cole, who had suffered second degree burns over about a third of his lower body. Unlike medical centers in the outlying areas, Kabul Air Base had a burn center.

Upon admission to the burn center, severely injured patients are admitted to a private area known, somewhat euphemistically as intensive care, which is managed by a team that comprises a burn surgeon and ophthalmologists, as well as Chelsea and other nurses, respiratory therapists, and nutritionists. Everyone on this team must collaborate. Chelsea was in charge of doing most of the main debriding of the affected area. SSgt. Cole had been given an anesthetic to keep him as comfortable as possible while Chelsea trimmed the dead skin away in hopes of saving the presumed healthy skin underneath.

When she was finished, Ssgtt. Cole was wheeled away. In a stateside hospital, a burn unit included a cooling unit that helped with the immediate retardation of the burn. Unfortunately, at Kabul Air Base there was no such relief area to be found. The burn unit was just a different area of the central facility.

Second Lieutenant Dr. William Bradford was new to the base and to this particular unit’s method of operation. He had already proven himself to be more than a competent doctor. The nursing staff was instinctively responsive to his needs, and he to the needs of the many patients that came through the medical facility. Chelsea saw that one of Dr. Bradford’s nurses was showing telltale signs of reeling a bit in the heat. It was Wendy Shafer who was struggling a bit. She had been on duty for a little less than five hours and was showing the mileage in her body language.

Chelsea stepped over to the table and quietly spoke to Lieutenant McKay. “I think Wendy is about done in. Do you want me to step in?”

Lieutenant McKay glanced over at Corporal Shafer and saw the same thing that Chelsea had seen. Wendy Shafer’s face was ghostly white, and her hands, usually firm and sure, had a small quaver that only another nurse was likely to notice. “Why don’t you, Bannister? Thank you.”

Chelsea stepped over to the table just as Lieutenant McKay spoke up. “Shafer! Go home for a little bit!” Then more gently, “Bannister is going to step in. You’ve done your share today.”

For a moment, Wendy Shafer looked blankly at her superior officer. It was as if Lieutenant McKay spoke a different language. Finally, and only when Chelsea touched her elbow, Corporal Shafer stepped away. Three steps toward the makeshift doorway of the burn unit area of the medical facility, Wendy Shafer collapsed to the floor.

Lieutenant McKay secured the new dressing on the patient in front of her and stepped away. She took vitals of her young nurse. “Pulse 121, BP 132/89. She’s going to be okay. The heat just got to her.” Lieutenant McKay checked Wendy for contact injury from her fall. Finding none, she put the young lady’s head in her own lap and stroked the back of the fallen nurse’s neck. Seconds later, Private Shafer opened her eyes. What she said then was going to keep her friends ribbing her until she went back home.