God Bless Our Soldiers

The first rule of war is that young men and women die.

The second rule of war is that surgeons cannot change the first rule.

We had already done around a dozen surgical cases in the morning and the early afternoon. It is not boastful or arrogant when I tell you that some of the best surgeons in the world were present - I have been to many institutions and I have been all around the world, and at this point in time, with this level of experience, the best in the world are assembled here at Balad.

The call came in. An American soldier had been injured in an IED blast north of here, and he was in a bad way with head trauma. The specifics were fuzzy, but after three months here, what would need to be done was perfectly clear - the 332nd Expeditionary Medical Group readied for battle.

All was ready, and we did not have to wait very long. The approaching rotors of a Blackhawk were heard, and Chris and I moved forward to the ER followed by several sets of surgeons' eyes as we went.

They wheeled the soldier into the ER on a NATO gurney shortly after the chopper touched down. One look at the crew's faces told me that the situation was grim. Their young faces were drawn and tight, and they moved with a sense of directed urgency. They did not even need to speak because the look in their eyes was pleading with us - hurry. And hurry we did.

Max called out the injuries as they were found, and one of the techs wrote them down. The chest was auscultated as the ET tube was switched to the ventilator. All the wounds were examined and the dressings were removed except for the one on the head.

The two neurosurgeons came forward, and removed the gauze covering the soldier's wounded head, and everyone's heart sank as we saw the blossom of red blood spreading out from shredded white and grey matter of the brain. Experience told all the surgeons present that there was no way to survive the injury, and this was one battle the Medical Group was going to lose.

But he was American, and it was not time to quit, yet. Gentle pressure was applied over the wound, and the patient went directly to the CT scanner as drugs and fluids were pumped into the line to keep his heart and lungs functioning in a fading hope to restore the brain. The time elapsed from his arrival in the ER to the time he was in the CT scanner was five minutes.

The CT scan confirmed what we had feared. The wounds to the brain were horrific and mortal, and there was no way on earth to replace the volume of tissue that had been blasted away by the explosion. He had no hint of respiratory activity, his heart that had beat so strongly early in the day ceased to beat forever, and he was pronounced dead.

I am always surprised that anyone still has tears to shed here at Balad, but thank God they still do. The nurses and techs continued to care for him and do what they could. He was silently placed in the body bag when mortuary services arrived as gently as if they were tucking him into bed.

Later that night was Patriot Detail - our last goodbye for an American hero. His duty was done he had given the last full measure, and he was on his way home.

The third rule of war should be that we never forget the sacrifices made by our young men and women, and we always honor them.

We honor them by finishing what they came to accomplish. We remember them by never quitting and having the backbone and the guts to never bend to the yoke of oppression.


This account of the Brotherhood of War was exerpted from a letter by Col. Brett Wyrick commander of the 154th Medical Group, serving as a surgeon in Balad.

Thanks to Gen. Paulson for sharing it with us. The full letter is available for the asking.