One

Sitting in EVAC with Tim watching the Buick Open on the Armed Forces Network. Not a big golf fan, but I'll take any distraction at this point.

"Just past midnight. We finally hit one July."

"Yeah. The month you're in doesn't count, and the month you go home doesn't count either. Guess that means we only have one month left in Iraq?"

Tim's laughing and not quite agreeing at the same time. Either way, we both herald the disappearance of June as we crawl one month closer to home.

"Four casualties inbound. Mikes unknown; still engaged in a firefight." says one of the EVAC platoon medics.

"Army or Marine?"

"Army."

Tim and I walk out to patient receiving. Waking up some key staff, including some surgical teammates. Hospital CO is up as well as the XO. 3rd ID Sergeant Major drives up; his men have been ambushed and are taking a beating. The unit is having a hard time getting them out of the fight.

Finally, a humvee guns up to Charlie Medical out of the dark. One out of four casualties arrives so far. Soldier with gunshot wounds to his extremities. Medics, corpsman, and physicians go right to work; no surgical intervention needed, and he will be fine. Humvee looks worse than the soldier: turret is torn to pieces, but the gunner is OK. Two more casualties finally arrive via Humvee...also OK. More gunshot wounds, but all stable. No surgery needed; we start making arraignments for MEDVAC.

Fourth casualty is critical. GSW to the face and no way to safely get him to Charlie Medical by road. A decision is made: one of the Apache gunships providing close air support will touch down, the gunner will get out, and we will just airlift him in the Apache. Effective; and a first for anyone present.

He has some facial damage and airway swelling. In the OR, Bob does an awake intubation to protect him from continued edema (swelling). Mark flies all four patients to Balad, and they do well.

9 AM we get a detainee from last night's firefight. Both feet shot, the surgical team takes him to the OR for debridement and a complete washout. After post-operative recovery, the detainee is taken, complete with security entourage, to a detention center in Baghdad with an attached hospital.

1 PM finds Jason and I trying to figure out another detainee's injuries. Initial chest film looks good, but the patient's oxygen levels aren't "quite right" and he seems to be guarding a mystery injury. Tim and I are in the x-ray room 5 yards away, and I'm right in the middle of looking at the detainee's chest film, when a detonation and subsequent deep bass of the concussion wave knocks the wooden window covers back. My initial thought: "mortar attack was pretty close." Jason and I both look at our patient and immediately request he be put in patient hold for observation. We need the trauma bay cleared out...as in right now. All staff immediately start pulling down litters, setting up triage stations, and the trauma bay jumps to life as all stations are manned with medics and corpsman.

"VBIED" cracks over the radios. My initial thought was wrong, but somehow doesn't matter when the results are the same: casualties. Snap a quick picture from Charlie Medical on my way to Tactical Command, only a few short steps away. Truck-borne IED has taken out a local bridge. Small arms fire coming from the back gate. The few remaining staff running to Charlie Medical from church service and the barracks.

New insurgent tactics recently include attacking Anbar infrastructure. This is the second local bridge targeted over the past few weeks. A communications tower was targeted last month. This attack was coordinated with several others in Anbar throughout the day, including another bridge in nearby Fallujah.

A shift away from local civilian populations, as the insurgents found that Sunni leaders have united against outside aggressors and are now working directly with U.S. and Coalition authorities under the Anbar Salvation Council.
Radios continue to stream information: two casualties inbound. Both Iraqi civilian. They weren't close to the blast, and only have some superficial scraps and soft tissue injuries.

The rest of the afternoon was spent on standby as more casualties arrive. Another abandoned VBIED was blown up by an Explosive/Ordnance platoon near the bridge. Not sure if the driver was found, or what happened to him.

Midnight. An Angel ceremony for the fallen. The entire Army unit is in formation, and the surgical team falls in off to the side. We get word that the men lost today were the heart and soul of their platoon. Tragic beyond words. In formation, it's just an unspoken rule that no one talks. Thirty minutes of silence amongst one another. Each man left to his thoughts and prayers for the fallen and the families and friends left behind. Yet in the silence, we all feel so connected...we stand as one collective Spirit to honor those who gave all. 200 silent salutes in the night as an H-46 lifts them gently Home.

One July. One 24 hour period; midnight to midnight.

One day that couldn't go fast enough.

One day that I will never forget.

http://uk.news.yahoo.com/rtrs/20070703/tpl-uk-iraq-clash-43a8d4f.html