The team just walked back to the hospital from lunch.
"Patient coming in 10 mikes (minutes)." says one of the Army staff.
As we quicken our pace, we ask what happened so we can anticipate what we will need.
"Not sure, it was a roll-over accident. A Marine."
We are already at the receiving area, and wait for the patient to arrive. After a few minutes, I wander around the corner and see some of the Army staff running to the front of the hospital. Instincts kick in, and I'm right behind them. Sure enough, a few humvees come to a halt in front, and 8 Marines scramble out and put one of their own on a litter and make a run for the front door. We direct them to the trauma bay and quickly triage him straight to the OR.
"We don't think he's breathing" He had a nasal breathing tube placed in the field at the point of injury, but it comes out from the frantic activity. Eric places another within seconds. Checking for a heartbeat-just can't tell from all the confusion, but skin is dusky and pale. I start chest compressions while the surgeons start cutting. Instruments are flying off the sterile field, thorasic cavity is clamshelled and held open with rib spreaders. We find bleeding everywhere-thorasic cavity, retroperitoneal, and abdominal. Walking blood bank is activated as we pour lifesaving and oxygen-carrying hemoglobin into him. No idea, however small, is spared for saving a life.....desperation is in the anesthesiolgist's and surgeon's voice. Despite herculean efforts, we lose a Marine. He was the turret gunner. Another fallen Angel......
Just finishing some dinner when the radio blurts out gunshot wound just arriving in the trauma bay! Almost finished trays are thrown towards the side as the team runs next door to the hospital. A SF soldier on base is hit by a stray round from a firefight on the perimeter. He's wisked to the OR as we intubate and start the thoracotomy within minutes--all staff on hand and running around the room scrambling for supplies and sterile instruments for the second time in hours. The bullet rips through a lung and lodges in a vertebra. Bleeding is quickly controlled, so we close his chest, stabilize him, place double chest tubes on the affected side, and I fly him to Al Asad. He took the flight well, and I was able to give a liberal amount of pain and sedation medications to keep him comfortable.
The blackhawk finally gets me back to Ramadi after 11 PM, and we planned an Angel ceremony for the Marine lost today. After midnight, we line the route from the hospital to the helo pad with glow sticks and line up to pay our respects for a fallen comrade that was taken too soon. The desert winds kicks up and sends a sharp chill though my spine as I think about the fallen and my own mortality. As the H-46 gently lifts our Angel back to his family, we all gently lift up our prayers for him, his friends and unit, and especially his family.

Update: the SF soldier I flew to Al Asad had the breathing tube removed and he was talking to his buddies today.......prayers answered.