Camp Dwyer Medical Staff story...

Registered nurse Lt. j.g. Phyllis Dykes records doctors notes while staff members of the

Combat Logistics Battalion 8 Surgical Support Team examine a new patient, July 8.

Editors note: The Jerry Bland mentioned in the story is a fellow Everett Silvertips fan. (Hockey team in the WHL)

Emergency Medical Staff Saves Lives With Controlled Chaos
Regimental Combat Team 3
Story by Gunnery Sgt. Christopher Cox Date: 07.20.2009 Posted: 07.20.2009 10:28

CAMP DWYER, Islamic Republic of Afghanistan – Chaos theory is the study of order within seemingly random arrangements. By looking closely enough, scientists can find patterns. The resulting theory being that there is likely no such thing as random events – at least in the study of physics.In the middle of this barren and unforgiving environment that the locals call the "Desert of Death," a perfect example of controlled chaos outside of a laboratory is embodied by the doctors, corpsmen and Marines at Combat Logistics Regiment 2's Bravo Medical Company.
THE LAYOUT Four tents make up the living quarters and work spaces for the 87 Sailors and Marines who make up the staff of the Shock Trauma Platoon and the Forward Resuscitative Surgical Suite. The STP is one possible stop for seriously wounded Marines after the "line corpsmen" provide immediate care to stabilize their vital signs enough for helicopter transport. The line corpsmen live and work with the battalions and are with their Marines every dangerous step of every operation. The other U.S. military hospitals are at locations throughout Afghanistan, but sometimes they're too busy, or there just isn't enough time to get a patient there.In those cases where patients are in dire enough straights to necessitate immediate surgery, they come to the FRSS. Even though the staff has the capability and equipment to conduct major surgery, the FRSS is no TV operating room. Two long-legged, black, mesh cots are the operating tables. All the gloves, medicine vials, IV bags and the rest of the tools and supplies are in open, stacked weather-proof boxes. There's no need, and no room, to unpack. They need to be ready to move on short notice. Additionally, all the electricity to power the lights, monitors and machines comes from generators, so ensuring they remain fueled is a job for the Marines
The Marines: "They call us 'The Marines,'" said Lance Cpl. Alan R. Davis. The good-natured 21-year-old from Ballston Spa, N.Y., and the eight other Bravo Medical Company Marines were picked from the motor pool at Marine Corps Base Camp Lejeune, N.C., and attached to the surgical team about three weeks prior to deploying here. All of them are motor transport operators by trade. Spending their first deployment outside of an all-Marine environment, these young men are like Labrador puppies – trainable, full of energy and loyal."Here we're the drivers, security, triage – I don't even know what that word means – but we bring the most injured person first," Davis said. When a call comes in at any hour, the Marines are among the first to respond. They receive the call and within two minutes are geared up, in the ambulance – a medically modified mine resistant ambush protected vehicle – and, with a corpsman, are on the short dirt road to the helicopter pad. They always wear their flak jackets and helmets and are armed when they move, but even in the flurry of initial activity to get their wounded brothers to the docs, their focus is intense."It's kind of hectic," Davis said. "We get real close to the helicopter, grab the litters and run. If there's two guys, we'll put both of them in the back, but it's a little more time consuming."Sometimes a doctor will go with us," he continued. "They'll grab their med bag. I never see what goes on in the back after we start driving."
The New Guy: On every military deployment, there is a mixture of experience in the group. From those with years of expeditionary practice to those on their first tour, every Soldier, Sailor, Airman or Marine has to start somewhere. One of those in the shock trauma platoon here is Seaman Jerry J. Bland who is about as far from familiar surroundings as his home of Everett, Wash., is from the desert he's living in now. When he rides in the ambulance with the Marines, he is one of the first corpsmen here to take stock of incoming patients."It was a drastic change," the 23-year-old said comparing his duties in the States to those here. "The medical aspect of things didn't catch me off guard. The only thing it couldn't prepare me for was the shock of actually seeing it." Bland earned the title of corpsman in February last year, transferred to Marine Corps Recruit Depot Parris Island, S.C., and worked mostly around routine "sick call" injuries and illnesses for the recruits and permanent staff there. For him, coming to Afghanistan to work in the emergency room was like being thrown into the deep end when you've only seen pictures of a swimming pool."It's basically like anything you haven't done before," he said. "Your heart is racing and your senses are whacked out, but then your adrenaline pumps and everything gets taken care of." Most green-side corpsmen, as those who are attached to Marine units are called, experience everyday life as a Marine – eating, sleeping and working in the most austere and demanding conditions. Working in the surgical trauma unit is different."When I learned I was deploying, I asked other corpsmen what to expect," Bland said. "I now know what I was told by line corpsmen was not a description of the environment the surgical team is living in. I was expecting to be sleeping on the ground, but here we have cots and A/C."Temperatures reach the 130s on some days and air conditioning is a luxury that not all the Marines in the area have. It's a symptom of the logistical challenge faced by Marine Corps planners who have to keep up with the necessities of war. Even so, triage – or attention based on necessity – is recognized and practiced by logisticians. Those who need air conditioning, get it."It's definitely important to have those amenities," Bland said. "We're on 12-hour shifts. If you can't get any sleep when you're off, you'll be complete garbage on the next shift."
A Special Place: Since corpsmen are the first aid wounded Marines receive in a combat zone, they hold a special place among them. All Marines share the bond of brothers in arms, but the "docs" save their lives. Over time, corpsmen eventually realize why their special place in the pecking order is unique when compared to their peers in other military services."The Air Force and Army are very specialized in this job description," explained Petty Officer 1st Class Christopher V. Daily. "FMF [Fleet Marine Force] corpsmen provide a higher level of care."Shortly before this deployment, the Bravo Medical Co. STP and FRSS as they are today did not exist. With only a few weeks notice, the call went out for specialists who could fulfill the predicted need here. In answer to that call, doctors and corpsmen came from medical facilities all over the world. The resulting unit is made up of sailors and Marines from California, North Carolina, Hawaii, and even Japan. "We're really using the world as a surplus of skilled professionals to serve together in this AO [area of operations]," said Daily. Daily, who hails from Downingtown, Pa., is the unit's medical regulator and mortuary affairs director. Since his earliest days as an emergency medical technician on ambulance calls in the suburbs of Philadelphia, the tall Sailor has born the burden every emergency medical practitioner carries, painful memories of trying to save people in horrible condition. "Over time, you get numb," he said. "It's good because you're more level headed, but I wish I could forget some of the things I've seen."What makes Daily and the rest of the staff rest easy at night is not the hard work or a feeling of pressure to perform, but simply being there for those who need them. And the thought of those patients' loved ones who appreciate what they do, even though they don't even know Bravo Medical Co. is here.
The Real World: Unlike their civilian peers, military medical practitioners in a combat environment have a much clearer picture of why they do what they do. Doctors in big cities face traumatic injuries that are sustained under less than honorable conditions on a regular basis. For the docs here, there are no doubts about their patients."In the civilian world, normally you're taking care of people who are hurt acutely, but they're not always pleasant," said Lt. Cmdr. William Brown, an emergency medical doctor and assistant officer in charge of the STP. "You get people who are shot, stabbed or blown up in a meth lab. These are people who are sometimes shady. "When I run into a guy who just got wounded out here, and I'm able to let him know he's in a safe place – that's what keeps us going," he said. "When he looks up and sees your face and the uniform, you can see the relief on his face." Civilian doctors also may not constantly worry about lawyers' opinions, but the concern over potential law suits over educated judgment calls made during touch and go situations influences how they handle their business, according to Brown who professionally cross-trains in civilian hospitals each year. In the civilian world, doctors worry about people who want to take advantage of them, so they order an extra test just to be sure of the most appropriate course of action – to marginalize the possibility of an honest mistake, says the doctor from Charleston, S.C. This sometimes causes delays, self-doubt and disenfranchisement with a system specifically created to care for people."Here, I know that guy just wants me to be the best doctor I can be," he said. "I can't think of a better way to use my skills than to take care of these kids who are going above and beyond."
Controlled Chaos: From May to mid-July, the Bravo Medical staff saw 75 patients with problems ranging from heat exhaustion to catastrophic injuries. All of them either went directly back to their units or were transferred to a facility with longer-term intensive care accommodations.At any time and with little-to-no notice, this group of individuals can go from the daily grind to a fully functioning surgical facility where patients are literally brought back from the brink of death. Bullet wounds and improvised explosive devises injure military members and local residents alike. This collection of skilled professionals drawn from all over the world is solely focused on devoting the time and attention to ensure the victims of these events survive.Together, they turn what could be a chaotic end to a random event into the rest of someone's life.