Looking for Lazarus

Kandahar, Afghanistan

I walked my colleague Jon out to the flight line.  I wanted to get a photo of him in his garb.  I think we look slightly bad-ass in our helmet and flak waiting for the SH-60 helo to come pick us up.  Some people wait for trains or buses.  We wait for a 20 ton, gunsmoke grey chopper.

We had gotten another call right at our change of shift - the calls seem to always come right at noon.  Someone was very sick at a FOB 45 chopper minutes away and they needed medical assistance that couldn't be provided by the EMT level care which is assigned to the helo detachment.  Today's patient is a closed head injury who has already blown a pupil - that means his brain is swelling and pushing on the cranial nerves which regulate pupil size.  It's dire.  It's the 21st call our Enroute Care team has gotten in the past 40 or so days.  We getting fully utilized these days after a slow start.

My last trip was over a week ago.  I was called to pick up an adolescent local Afghani who had been bitten by a bee near his mouth.  His throat had become swollen and he got intubated at the distant FOB, i.e. had a breathing tube placed.  His lungs started to bleed and he was in shock.

This day I was picked up by our Air Force brethren - we ride with either Army or Air Force helos.  Air Force likes to keep the helo doors open until we get our patient aboard.  I hadn't had a ride like this.  I was sitting about two feet away from a gaping hole in the helo, a 6 ft by 8 ft hole.  I was strapped in around the waist.  We flew low and fast across the countryside.  I could see villages filled with mud huts below me. I imagined I was Jesus walking through the countryside two thousand years ago.  Did Lazarus' house look like the ones I was seeing below me?  Could this really be the 21st century?  Dirt roads, no cars, little vegetation.  Desolate.

I was wearing our new helmet which allowed me to hear the banter of the pilots and gunners.  Each side of the helo was equipped with what looked to me like a 50 cal machine gun.  Every so often I'd hear "Suspicious contact, 11 o'clock!"  The gunner would swing his machine gun to the azimuth of interest.  It was usually a shepherd or something completely benign.

We landed and picked up our patient.  He seemed stable at the time, but as Murphy's Law dictates, he would crump before the trip was over.  About 10 minutes before landing his blood pressure tanked and his oxygen saturation dipped.  I gave life supporting medications, one dose after another.  Blood began to pour out his endotracheal tube, frothy, like strawberry soda.  My blood pressure rose commensurately.  We successfully bagged him by hand and finally got his vital signs to normalize, but not without 10 minutes of hair-ball maneuvers.  I almost forgot how queasy I get on the ride back, with the helo racing, dipping and diving.  Almost.  I think I lost 5 pounds of sweat on that particular ride.  I felt very mortal.  I was exhausted and wrung dry.