I Couldn't Save Him

[The following is a piece I wrote while deployed with an Infantry Battalion to Iraq. One of the most trying experiences of my life, writing this was highly therapuetic.]


“I couldn’t save him.”

These are the words I had to say out loud to my wife a couple weeks ago. After a week of agonizing soul searching, I finally found the one thing that bothered me the most. The words suddenly came to me as I was saying them, and it was a moment of pure elation to finally say that out loud. For a brief phone call, I had dropped my guard and let it out. This bothered me. This was on my mind. This caused me pain.

It happened while we were out on (yet another) operation performing reconnaissance and interdiction operations across an area highly suspected of being used as a staging point and transit area for insurgents and oil smugglers. The previous operations had all been smooth – we had rounded up a handful of oil smugglers, a few possible insurgents, and had discovered a decent amount of weapon caches. It was just another operation. On one routine morning around 0700, we were settling down to our breakfasts, falling back asleep or just getting into a book while the platoons were heading out for their operations. We heard the words “Contact, Contact, Contact” frantically spewing across the radio waves. Within minutes we had loaded up into our vehicles and were on our way to the platoon’s position. Mere minutes thereafter we arrived at the scene, and the First Sergeant turned back to the Senior Line Corpsman and me and said “3 Urgent Surgicals”. I remember these words as if they were just said to me today. I can still see his three fingers in the air. I can still see his face. I paused for a brief second as it hit me, then dismounted the vehicle with our med bags in tow.

I came upon the most critical Marine first. He was barely conscious, had a gunshot wound to his left upper and inner chest, and another to his left upper and inner arm. His upper left arm had swollen up to twice its regular size due to massive internal bleeding, his respirations were barely distinguishable, and his general appearance was something I’ve never seen before. I’ll never forget that look on his face. For those first few seconds, I honestly could not believe this was happening. As a last ditch effort to control the bleeding in his upper arm, I had a Corpsman place a tourniquet, knowing full well that it wouldn’t control it due to the large shoulder joint it had to be placed over. I couldn’t use Quick Clot, as there was very little bleeding outside the wound. It was all internal and inaccessible. I had them place a breathing tube, and had to move on to the two other patients while they tended to him.

The remaining two casualties were close together, with the platoon Corpsman working on one while guiding his Staff Sergeant and another Marine as they tended to the other one. One had a gunshot wound to his lower abdomen with what appeared to be exposed intestines and minimal bleeding. As I had the Staff Sergeant quickly expose the wound, I only had a brief moment to look at it before they quickly resecured the dressing. Later I found out that it was actually his scrotum and testicles that had been shot, but they had been pulled up onto his abdomen as a result of the applied dressing. Nonetheless, it was a fairly minimal wound, and in light of the severity of the other casualties, my concern was also minimal. One foot away was the platoon Corpsman, Hospitalman [deleted name], working on a Marine who had been shot through the left side of his neck, with an exit wound on his right middle back. Here was another critical Marine. HN [deleted name] had bandaged him up exceptionally well, but due to the course of the bullet and location of the wounds, I was extremely concerned about his prognosis. Despite the gravity of his wounds, he was remarkably stable. It was the Corpsman that was having problems. He was crying. He kept looking over at the Marine teetering on the verge of death, and the guilt of having to move onto the other injured Marines was too much for him at this time. I told him he did everything he could, and when my couple comforting sentences fell seemingly on deaf ears, I hastily kissed him on the top of his head, and told him he was doing everything right.

I rushed back over the most critical casualty. He was almost gone. I placed both my hands on his chest to assess for a punctured lung. Seconds passed as I waited for one side to rise and the other to stay flat (a tell-tale sign of a punctured lung). Nothing. His respirations were too infrequent and lacked enough depth to accurately determine this life-threatening condition. I tried it one more time, as I silently prayed to God. Again, nothing. As he had been shot into his left chest, I had a Corpsman place a needle into his lung area to relieve any trapped air. I placed my cheek over the hub of the needle and waited for a rush of air. Nothing. I placed another needle into his chest at a different location, hoping that the lack of muscle overlying this second area would yield an adequate penetration of the lung cavity, and relieve the potentially trapped air. Helplessness at a level I have never experienced before suddenly hit me as no air rushed up to meet my cheek, and he stopped moving seconds later. For 15-20 seconds, I checked for a pulse. The enormity of it all weighed heavily on me, and I prayed to God that I did the right thing. After reluctantly determining that there was no pulse, I directed CPR to begin. They began. The Casualty Evacuation helicopters did not show up for another 40 minutes; during this entire length of time, the Corpsmen and Marines working on their fallen comrade did not pause whatsoever. I knew it was a futile effort. I didn’t order it to be done to save him. I ordered it for the benefit of the watching Marines. We wouldn’t give up, no matter what.

Damn, this is tough to deal with. I never thought it would be this hard. I’m not sure what’s affecting me right now – is it just the funk of being here for 6 months, or is it deeper than that? If it is the loss of a Marine that’s on my mind, I’m afraid. I’m afraid it will continue when I get home, and life will lose the tasteful flavor that it has always held for me. I’ve treated too many patients with depression and PTSD, and I’ve seen how desolate and painstaking their lives have been. God, I hope not.

I’m afraid for my happiness. I’m afraid for the happiness of those around me.

Although exceptionally trying, I’m hoping this experience will further develop me into a better leader, Sailor, and man. I’m hoping that I can continue to enjoy life and the company of friends and loved ones. The above may be my fear, but this is my hope.