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I know I haven't been such a good correspondent lately, but this is sometimes a very sad place to work. I go to the ICU or the OR almost every day to answer some urologic question from the general or trauma surgeons. The unit is almost always full, and the injuries are incredibly bad. Boys who never would have lived long enough to make it to a hospital in Vietnam routinely are kept alive long enough for them to make it as far as Germany. That's because of the body armor which protects the head, chest and abdomen. But it leaves their arms and legs vulnerable to tremendous blast effects, and often involves the loss of one or more extremities. I've rounded on boys with only one arm and no legs. Missing eyes, missing genitals. No amount of surgical experience can prepare you for the shock on walking into an operating room to see the remains of a body so fileted, between the amputations, the incisions for exploration, and for decompression of compartment syndromes. I address the urologic issues, and sometimes stay to assist the general surgeon explore the abdomen or close a large incision. I never saw the survivors in Iraq, longer than to pack them up in a medevac helicopter. But here, the hospital is full of destroyed flesh. It's very sad. In Iraq I worried about my physical safety; here I worry about my mental health. On top of all that, lots of babies are born here every week, and each time a baby is delivered, the public address system plays Brahms' lullaby, "Rock-a-bye, rock-a-bye, rock-a-bye little baby." And all the doctors and nurses go, "Oooooooooh, isn't that nice," while they go on debriding some loose muscle that once was an arm or a leg. |