Somber Note From A Combat Surgeon

  • October 14, 2013

I was deployed in Afghanistan for 17 months, came home, and then went back for an additional 2 months. For a short time while there, I published a blog.

In light of closure of national monuments honoring our Fallen Heroes, I have here re-published a particularly moving guest article; it is a letter home from a combat surgeon, and lays out vividly the mental, physical, and emotional toll on our fighting forces in harm’s way.

As Originally Published: I am very honored to be allowed to post (below) a letter home from a combat surgeon. He gave permission to put this on my blog on condition that I remove identifying information. Otherwise, it is just as he wrote it. Keep in mind that this was written by a very tired man who takes care of our kids when bad things happen in combat:

Dear DadI apologize for not writing sooner. But having said that . . .

Halfway Point. Well here it is. The halfway point in my deployment in Afghanistan. I spent so much effort to get here and now I am halfway through. We were VERY busy last night. Many operations, many injured and no sleep. I am never really told when the injured will come but they make an announcement over head just like in MASH when the character Radar would announce that helicopters where arriving. The injured come by Hummer/MRAP ambulance, helicopters, and transport. I head down to the ED and find organized chaos but they know what the are doing. They are so young . . . The good news is that the American and coalition service personnel get “patched up” by us and then are flown (out). I don’t know if you will remember the several weeks I spent at (the) Regional Medical Center as a surgeon. That is where we would work on them some more before being sent back home. For lack of a better term, this is bloody work, Dad. May be I should have become a Cardiologist. (Jets are taking off overhead – something is up). The Americans then fly home to … or … or … or if burned to … There are also a lot of elective cases like laparoscopic appendectomies, gallbladders, hernias, etc. I find that we do a lot of elective cases here as well. However, I am sure that the Vietnam physicians and surgeons saw a hundred times more. Their numbers were staggering with many more dead. Either we have become better or the warfare in Vietnam was hell. I do not mean to minimize the other doctors work here in Afghanistan, but Vietnam and the lessons learned there still reverberate in the halls of our hospital.

The helicopters also bring in EPW’s (Enemy Prisoners of War) or really Enemies of Peace as they are now being referred to. [Deleted (sic)] They get the same care as the coalition troops. Don’t worry. I carry a shoulder holster (lent to me by my friend and LTC in the US Air Force) with a 9 mm at all times. My friend and combat medic, Lt. X, taught me how to use it well enough plus before I left I took a bunch of classes at Shooter’s World. We don’t (talk about it much) as it is serious business here but you know this from when you were overseas. I take my 9 mm even to the shower. I remember as a child the story of a US Air Force hero and (my friend’s) uncle, carrying his gun to the showers which saved his life. He is a Vietnam vet. Anyway, [Deleted (sic)], I am planning on coming home . But weariness, long hours, and lack of sleep, take a toll. I find church and sleep are my only reprieve. I am feeling all the years of my age.

The weather is getting warm so action is picking up. We were treated to a dust storm here that obscured the tall mountains around us. The winds felt like they were going to blow down our huts they were so strong. The dust is everywhere and you constantly have the taste of dirty in our mouth when outside or smell it in the air. You wash your hands about one thousand times a day.

As for the people, it is like everywhere. Some are good leaders and I love working with them in fact it is a pleasure. Others are just bad. But I feel that many of the times people are just inexperienced and make up for it by acting tough or hard, etc. Or perhaps they think they need to do so for their superiors for a promotions. All I see is fear in them and their lack of experience but hopefully in time they will learn that being a good leader does not have to be conveyed with hostility, anger or cold toughness. I remember what you and mother used to say about “winning more flies with honey than with vinegar”.  You both were correct. She was a wonderful women and not a day goes by that I remember some lesson she taught me. I miss her.

I am learning several of the languages here. Well, kinda sorta! Just some phrases but mostly have interpreters speak to my patients. I spend some amount of time telling the captured that they will be alright and that I will fix their wounds or their injuries and to trust me. I tell them that I care for them and that we will fix them. Once you gain their trust and they see that you do not mean them harm they are generally friendly back to you. But this cannot be taken for granted. I have no illusions that My kindness and caring will win this war. The horror stories of what brought them in or what they did to our troops or their country men are for another day and not for e-mail. [deleted (sic)] Actually, I think I will just as well forget all of that as it does no good to hold onto the memories of such events. I just do what I can on a daily basis and pray for the best.

American medicine is great. This country has nothing like the United States. Even our little hospital does its best but we must send the injured Americans on for higher level of care. The local hospitals in Afghanistan for the local nationals are nothing more than places for people to go and if sick enough to die. The seriously injured or sick all want to come to us as to stay there means months of care, poor care and / or possibly death. Families constantly try to bring their loved ones to us. It is heartbreaking. Often triage is done by a marine or soldier at the gate. Many times people are turned away. We just cannot open our base to the masses of sick and injured otherwise we would never be able to care for our troops or the coalition troops and other priority peoples like those friendly Afghans injured by the enemy or the enemies of peace. I will never again complain about not having something or about some resident or nurse or anyone’s lack of experience or poor judgment. You have to leave the United States to see just how lucky and privileged we are at home.

Home. I miss home. I want to come home. There is no place like home. Home is where the heart is. I speaking about the heart of the matter, I want to get home to see my true love and you and all of my friends. I know it is halfway through this rotation but it is hard. Anyway, I suffer from lack of sleep and not speaking to my wife for 48 hours. I miss you and I love you dearly and hope to see you in a very few weeks.

Your son,

More articles from my Afghan blog may be seen at