Medevac Missions

By U.S. Air Force Reserve Captain Ed Hrivnak

Our patient load is 11, 7 and 2 and a duty passenger. That means 11 litter patients, 7 walking wounded and 2 attendants. Some can take care of themselves, some need lots of help. All have been waiting for us for a long time and need pain medicine and antibiotics. The patients include: gun shot wound to the stomach, partial amputations from a land mine, open fractures secondary to gun shot wound, head injury-struck by a tank, blast injuries, shrapnel injuries, and dislocations. The patients are mainly from the Marines and 101st Airborne Screaming Eagles. Many were involved in ambushes.

I've noticed that the most seriously injured are the youngest. The older, experienced soldiers do a better job of staying alive and avoiding the flying metal. One soldier I'm treating looks like a young boy. We talk for a bit as I assess him. I medicate him for his pain.

The morphine is not working, but it's the strongest stuff I've got. At some point during these adjustments I accidentally dislodge a Hemovac suction unit from one of his infected wounds. Foul smelling, reddish-yellow fluid drains from the tube and drips off the litter. I start looking at his bandages to find the other end of the tubing. I open one bandage and find sand fleas where his toes use to be. I try my best to keep a straight face, but the sight nauseates me.

We finally get this soldier comfortable. Because we moved him so much, I decide to reassess his extremities. I know there are parts of his leg and thigh missing from reading his medical record, but I can't tell from the thick bandages. The wounds were left open to allow them to drain. The dressings are wet and covered in a light layer of sand. I ask the soldier to wiggle the toes he has. On one side his toes move fine; on the other side there is no movement. What is left on that side is cold and hard to the touch. He looks at me and our eyes are locked. His eyes say, "Tell me I'm going to be O.K. Tell me that I'm going to be fine, tell me I'm going to be whole again…" These are some of the longest seconds of my life because I know he is counting on what I say to him.??I bend down below the litter to break eye contact. I act like I'm adjusting some of the medical equipment attached to him. My mind is racing. I have always been honest with my patients. Do I lie or tell him the truth? The seconds move so slowly as I fight my internal battle on what is right. I stand straight up and there are his eyes. I'm at the end of the litter and with the noise of the plane there is no way he could hear me speak. We are now communicating solely with our eyes and facial expressions. I'm sure less than two seconds passed before I gave him a big smile and a thumb's up. Those two seconds felt like an hour. He broke into a big smile of relief and I felt broken for lying to him.

He motioned to me and I walked to the head of the litter. I leaned in so he could yell into my ear over the jet noise. "Why do my feet feel so cold?" he asked.

I yelled back, "There is a lot of swelling in your feet and the blood circulation is not so good because of the swelling. It is way too early in the game to tell how well you are going to heal. The swelling is going to affect your senses and ability to move." These were all true statements. I felt reassured with my answer. It is too early to say how this soldier will recover. But I still felt bad about lying.

What does the future hold for these men who go home to their families mentally and physically different? And what of the critically injured who have a long future of VA hospitals followed by VA disability? How do they cope? How do they adjust? I feel obligated to stay out here and take care of the wounded. I want to do all I can to help them.

Copyright Ed Hrivnac. All Rights Reserved. This excerpt of "Medevac Missions" from Operation Homecoming, edited by Andrew Carroll, is reprinted by arrangement with The Random House Publishing Group.