Monday, September 06, 2004

My Three Terrorists

Contributed by LTC Cindy Clagett.

"Rituals help us all cope with this environment. Most we make up ourselves. Some find us. Every night around 10 or 11, I make evening rounds in the Iraqi detainee ward. This is a medical and surgical ward that is guarded and contains bad guys who, if they were otherwise healthy, would be in Abu Ghraib or some other prisoner of war camp. Most of the patients located there have come through the ICU at one time or another so I sort of know them and their stories.

Some I have told you about before. There was the 60 year old, shot three times in the groin as he was charging a machine gun position. He had a massive heart attack. The definitive care is us (the CSH). We do not evacuate POWs back to the for advanced medical care. The way it was explained to me was that getting captured did not result in a health care plan for life.

Another is a kid, maybe 17 who was shot in the arm and both knees while he was, high as a kite, lobbing grenades at a check point. Another young guy, also was shot in the gut, chest, leg, calf and arm as he almost suicidally charged a position. I know these patients because they all spent a lot of ICU time with me. Once conscious and aware that they were in the care of the infidels, they were, shall we say, less than polite. It probably didn’t help that the day shift played Madonna’s “Like a Virgin” and “Material Girl” over and over on the CD. The older guy expressed his displeasure in a particulary noxious way by depositing his scat on the floor every time he wiggled his hind portion over his cot. The others would slap at us, spit, bite and kick, pull out IVs, chest tubes, drains, bandage packing and foley bladder catheters (only once though after they discovered the internal bubble was not deflated).

I really had only two words for these men then…’Scheduled Haldol’. That stopped the physical abuse. The fecal man kept up with the other antisocial behavior until we caught on to suppositories to better empty his arsenal on our schedule.

Every morning we make mass doctor rounds. But every evening, I go into the Iraqi Ward alone, sneaking in treats from my care packages. The young men like the Oreos. Of course my heart attack guy wants anything with salt in it, which I cave in to and compensate with his blood pressure medications. (Like he is ever going to get the heart healthy low salt diet anyway).

I make a big show of listening with my stethoscope and bring cool towels and alcohol wipes. I lean over them and look them directly in the eyes. At first, none would look back. Now we have a kind of visual arc. I perform no real medicine, but tuck them in, act like I have seen God when they give me a good strong cough, and otherwise wish them goodnight. Most of this is in mime. My big fear is that the thumbs up or OK sign is an insult. I used to do a lot of fanning my hands over my chest and taking in a really big breath, pulling my cupped palms down to my navel to get them to breathe deeply. I could not get these guys to follow along with what I thought was a fairly obvious pantomime. This was until the translator told me he thought I might be giving a somewhat provocative impression. Given that they usually don’t see women uncloaked let alone running around in a sweaty, wet t-shirt, the emphasis on expansion of the chest could, I suppose be taken in other ways.

I know they are bad guys. I know they are responsible for probably innumerable deaths. But I kind of like them now. We have a gentle relationship. They are no longer on haldol and the floor no longer reeks of crap. I feel they really smile when we see each other. I have learned other methods to signal them about the breathing thing. We have worn each other down. It is a mutual Stockholm Syndrome. They are trapped by their injuries and the MPs. I am trapped by my gratitude that they responded favorably to therapy.

There is some degree of ribbing I get from the staff and the MPs who watch this interaction and probably want to vomit. I counter with the very practical explanation that if the bad guys’ buddies ever overrun us, I would stand the greatest chance of survival.

When the day is done, all I see is a frightened older man and two young boys who have all suffered and survived mortal wounds. They like Pringles, Oreos and Bigelow Orange Spiced Tea. The three of them are parked in a row on one side of the ward. They are my three terrorists. And for better or worse, I am their doctor."


Anonymous said...

You are amazing! It would seem difficult at best to feel kindness toward someone who would just as soon kill you as to look at you. You have transcended their hatred and cultural differences by caring for human life first, then for their individual lives. It is touching to see he blend of professionalism and love for another. I hope that these people leave your care with a different view. If so, it was YOU that made that happen. God bless you!

Anonymous said...

Hey Cindy Clagett,
I saw you on CNN tonight while on call in Fayetteville, NC. Would love to get in touch with you. I'm now a PA in OB-GYN and have been for the last 6 yrs. My office address is 1320 Medical DR. Fayetteville, NC 28304.
Cindy Wrenn