This is how we roll

My day typically starts in the afternoon, and carries on until the job is done. Our first patient arrived around 3 PM: multiple penetrating trauma from IED blast. By the time we got him off the helo and scrambled to shock/trauma, he was unresponsive......and pulseless. Our first clamshell (cracking the chest open to access great vessels and the heart quickly) of the day....and it was futile.
6 PM: We put the call out for all medical personnel-mass casualty inbound in 15 minutes! Two helos land simultaneously with four patients. Does anyone have to guess IED's at this point? Two more clamshells and 20 minutes later; two more fallen angels. My patient was devestated, but alive. Multiple penetrating trauma to his abdomen with fragments blown out his back.....legs flopping around from shattered femurs. His left hand? Nothing left. He came in initally responsive, and the surgeons wisked him first to surgery within 10 minutes (we already completely exposed, lined (large bore IV's) him, and intubated him within 2-3 minutes). Three hours later, and we had initiated the walking blood bank not once...but twice. For those in the know, I give you the following: He initially got all the packed RBC's we had (10 units). Following that, he received an additional 36 units of whole blood (this is not a typo: 46 total units of blood). We also gave two doses of factor VII (rapid acting clotting factor). In no way can I describe how tenuously he clung to life......our flight nurse just got back from taking the patient to Balad, and said he never worked so hard to keep a patient alive in his life..........
It's 4 AM and winding down. I'll be up at 7 AM for laundry turn-in (of all things). Formation at 8 AM for weapons and flak/kevlar accountability. Then a few hours after that: we roll all over again. Shock/Trauma goes back to work....
Can I just say that nothing, I repeat nothing, would have fully prepared me for this. The chaos, the mayhem, the disorientation of so much devastation pouring in with such regularity.