Greetings all from hot, hot, hot Iraq,

We are short indeed...although not quite as short as we had originally thought...our flight home has been posted and is showing up 3 days later than planned.  The good news is that we leave in the middle of the night and arrive (all admin complete, including turning our weapons into the armory) ! around dinnertime at Pendleton on the same day we leave (11 hrs time difference).  The other good news is it appears we've got commercial contract air carriers taking us we don't have to worry about sleeping on the cold steel deck of an Air Force C-17.

So...we turned over authority of the surgical company last week to our replacements, who had a serious trial by fire here in multiple ways, including multiple traumas, surgeries, increased risk to their personal safety, power outages, water outages, and camel spiders in the hospital...all in their first 4 days.  But a few days ago, we heard the helicopters coming and knew they were dealing with multiple traumas, several of which were going to the OR...and we sat in our barracks and waited for them to call us if they needed us.  They never did.  Last week was the ceremony to mark the official end of our role here.  Now we just wait.

As the days move very slowly by, just! waiting, I decided that one of the things I should work on for my own closure and therapeutic a list.  The list would be a comparison:  "Things That Were Good" about Iraq and being deployed with the Marines as one of the providers in a surgical company, and "Things That Were Not Good."  Of course, it's quite obvious that this list will be very lopsided.  But I thought I would do it anyway, hoping 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.  Interestingly, it sort of turned into a poem.  To be expected, I guess.

Most of all it's just therapy, and by now I should be relatively good at that.  Hard to do for yourself, though.

So here reverse order of importance...

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 passes by say "Hoorah, Ma'am..."

Having them tell us, one after the other, 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 could 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, laid 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 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 lifelong 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 last, but not least...

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 leischmaniasis

132 degrees

Wearing long sleeves, full 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 could 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 would soon follow

The cracking 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 treat the ones who were not so lucky...

Watching the helicopter with the big red cross on the side landing at our pad

Worse...watching 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 Marine with three Purple Hearts...and listening to him weep because he felt ashamed of being afraid to go back

Telling a room full 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 could, 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 who 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 could see his eyes go dull when he couldn't fight any longer...

And last, but not least...

Holding the hand of that dying Marine.

Lieutenant Commander Heidi Kraft, MD, USN
A member of Alpha Surgical Company, 1st Med Battalion, 1st MEF.

This email is from a good friend of mine who is a Navy psychiatrist and former flight surgeon who is currently deployed.  She has been sending periodic updates that have been very well-written and poignant.  She was the doc who stayed with PFC Phelps (recommended for the Medal of Honor for jumping on the grenade) before he was shipped to Germany and then the US where he died in route.

Otto Lehrack