A Dark Day in Baghdad

by Ashley Bohn

On May 21, 2009 I woke up, put on my uniform, grabbed my weapon and made my short trek to the hospital. It was the same routine I had kept every day for 6 months as a surgical tech in the United States Army. I was attached to a combat support hospital called Ibn Sina, an Iraqi-built, American-run hospital in Baghdad, Iraq. I spent most of the morning taking inventory in the 3rd floor operating room and launching myself down our long hallway on a rolling stool. Around 11 a.m we, the operating room, got a call from the emergency room downstairs. When the OR nurse answered the phone, the look on her face told me all I needed to know: it was time to get ready.

An American convoy had been conducting patrols in a part of Baghdad that lay outside the confines of the Green Zone, a 3.9 square mile checkpoint controlled area of the city. As the patrol vehicles were rolling through a popular outdoor market, an assailant triggered a suicide vest next to an armored vehicle carrying five National Guard soldiers. Three soldiers died in the blast: a major, first lieutenant and sergeant. Two of the other occupants,- the gunner, a specialist and the interpreter – were rushed to our hospital for emergency surgery. By the grace of a high-power, the driver escaped serious physical injuries. Other soldiers injured in the blast, around twenty, were treated in our ER.

The blast was just miles from the hospital. Emergency personnel jumped in the patrol vehicles that hadn’t been effected and quickly drove the injured soldiers to our combat support hospital. This was unusual as most of our patients came in by a medical evacuation helicopter. From the roof I could see the vehicles pulling onto the small road leading from the hospital checkpoint to the ER. Out of those vehicles came body parts, bodies, and survivors. It was chaos.

I ran inside and took a call from the ER. They needed internal paddles. I knew that meant a soldier downstairs was barely hanging on to life. I hurried down the three flights of stairs that separated me from the emergency room. As I rounded the corner I was shocked to see how many soldiers were filling the hospital hallways. Dirt, dust and blood covered the men and women who had been in the immediate area of the blast. These soldiers now stared blankly into space, waiting their turn for medical attention.I handed the paddles off to a waiting medic and ran back upstair to prepare for the long day ahead. I heard the elevator doors open outside the operating room and I got ready.

The interpreter came into the operating room I was working in. I immediately noticed that he had bilateral traumatic arm amputations. Where once strong biceps were, there was now a giant void with a tiny bits of muscle connecting the severed arms to the body. He had extensive shrapnel injuries to the lower half of his body with wounds bleeding faster than doctors could fix them. Once I gowned the five surgeons, I spread the basic instruments they needed on a tray within reach. They buzzed around the lower half of his body trying to stymie the bleeding. I was shoved in a small space between his armpit and his waist with my table of instruments , my space limited by the four surgeons, two nurses, anesthesia provider, and other support staff in the room trying to save the interpreter’s life. I passed the doctors clamps to close off bleeding vessels as fast as I could. The key to saving his life was to stop the bleeding as quick as they could.

I measured each wrenching minute by the number of drops of sweat I felt running down my back. The normally chilly operating room was now a stifling 102 degrees. Bright lights, stifling gowns and gloves warmed us even more. Doctors, nurses and assistants running in and out with coolers of blood made our OR feel like the pit of hell. To this day I get anxious when I am too hot. It got to the point that I stopped sweating. My body slowing down from dehydration. I tapped out and asked for a break. The door hadn’t stopped swinging behind me when the nurse screamed for a crash cart. To make room for it I pulled the x-ray machine out into the hallway amidst all the chaos. The anesthesiologist was able to push a medication that stabilized him. The whole room collectively let out a sigh of relief.

One of my hardest jobs in the OR was delivering amputated limbs to the morgue refrigerator. I fell into that job reluctantly. No one wanted it, but I knew the procedures for turning over the limbs. The bags were heavy, but that wasn’t the burden I felt. It was the heartache of knowing someone’s life was forever changed and I was throwing a piece of them away. The route to the morgue took me straight through the main hospital hallway and outside across the small street that lined the side of the hospital. The freezer was a large refrigerated shipping container that sat outside of the morgue. That day I carried two bags: the leg and two arms of the interpreter. I tried to keep my eyes down in the packed hallway, walking as fast as I could to the freezer. I can still see the shocked look on the soldiers’ faces when they saw the two clear red biohazard bags in my hands.

The shipping container was locked so I went next door to the morgue to get the key. When I opened the door, bags in my hand, the hospital chaplain was finishing Last Rights on a soldier killed in the blast. Officers were speaking softly, their faces solemn. This was the first time during the deployment I had seen a dead soldier. I don’t think I will ever forget that moment, paying respect to a brave soldier who lost his life too soon. The morgue attendant stepped away to help me. His eyes darted to the red bags in my hands. No words were needed. The pain and understanding when we locked eyes were in that moment were enough.

I headed back to the OR to see what else I could do to help. My next mission: running up and down three floors to deliver life-saving blood. I was not the most athletic soldier in our hospital, but that day I ran like a track star. The adrenaline never stopped flowing and for that I was grateful. After an hour of running blood we got word that one of the soldiers, the gunner, was declining. He needed to have surgery to open his chest and remove the clots hindering his lung from expanding. I volunteered to help. I pulled the instruments and supplies needed for the surgery and I got to work setting everything up. The chaplain came into the room and asked if he could stand and pray while we worked. I had never seen the chaplain in the operating room before, but w. Through the whole surgery he stood quietly praying. I am not a religious person, but that day I prayed quietly with him.

When they brought the gunner in I noticed a large Batman tattoo across his chest. Something about that tattoo and the events of the day has stuck with me. I never look at that symbol today and think of the comic or the number of actors who have played Batman. I see the soldier’s face, the unscathed tattoo in the middle of a body cut and burned from the bomb blast earlier in the day. The surgeon came in and we started the surgery. It was gruesome. Doctors cut a space in his ribs. I got to see his living breathing lung and his beating heart. The surgeons removed his clots and placed tubes in his chest to drain the excess fluid. Slowly we worked to close his chest. I passed the instruments and sterile wire to bind his ribs back together. We moved in a steady cadence, marching towards the end of the surgery.

Once we were done, the chaplain thanked us and left the room.As they readied to move him to the ICU, his heart stopped. Over the monitor I heard the doctor scream, “Fuck.” Moving with a quickness he leaped on the bed and started compressions. I held my breath. After a couple of compressions his heart started again. Once that beautiful beeping noise returned, I exhaled.

It was almost 7 p.m. when I looked at a clock, finally gaining a sense of time in that hectic day. I pushed the bloodied instruments back to the sterile processing sink. There were pans upon pans of dirty instruments. My co-workers gathered in the back of the OR to wash, rewash, assemble, wrap and sterilize all of the instruments we had used in that day, Everyone else, who had the day off, had come in to help in the chaos. They took one look at me and told me to go back to the barracks for the night. My shift was over. I changed out of scrubs and OR shoes. I put on the camouflaged uniform I was so proud to wear. Next to me changing was one of the nurses I had worked with all day. We decided to go upstairs and see Batman.

He was hooked up to a machine that helped him breathe. There were tubes in his chest draining the fluid from his lungs. I took his hand in mine and I put my other palm on chest, pleading with him to fight. I knew he had friends and family back home. I prayed that we had done enough to help him survive the long trip home to them. I said a quiet prayer, sent it to the heavens and I left. The next day the army flew him back to the United States start his journey towards recovery.

I got sent home a month later. A shoulder injury ended my deployment and I flew back to the States. I faced my own war when I returned. The weight of what I had seen in Baghdad almost drowned me. I tried taking my life a number of times. I felt unable to handle the burden of my memories, the brutality I witnessed in combat and the sickening feeling that I had abandoned my unit by coming home. Without my unit, my living spaces felt empty. I felt that I had failed as a soldier, that I had failed my unit and the Army. I left Baghdad with nothing but the clothes on my back, whatever I could fit in my backpack – and the gaping void of abandonment.

After I returned from Iraq I battled with severe depression and anxiety. I didn’t know at the time what PTSD was. I had convinced myself that what I had seen in Iraq wasn’t bad enough to effect me, and that mentality sent me into a tailspin. When I tried talking to my chain of command, my first sergeant recommended that I choose a medical chapter, and get discharged from the Army. His words crushed me. He reminded me that I was taking the spot of a healthy soldier, making me feel like I was something that could be thrown away and replaced. After that meeting I lost all desire to live and the overwhelming depression that I was gripped by took all the fight I had left away.

I tried taking my life 4 months after I returned from Iraq. I spent a total of 12 months in an intense inpatient PTSD treatment program. The program I attended was run by civilians but paid by the military to treat soldiers coming back from Iraq and Afghanistan. In that program I worked through the 6 months of trauma that I had witnessed with writing as the main outlet. Writing helped me work through the experiences that haunted me after I returned. While I was in treatment my unit transferred me to a Warrior Transition Battalion and once I was discharged from treatment I started my transition out of the military.

Six years after my deployment to Iraq I still battle with anxiety, depression, and insomnia. I was lucky enough to be accepted into a pilot program that honestly saved my life. It allowed me to take a step away from the military, even though I was still actively serving, and understand how my deployment overseas had effected me. Even though I hit rock bottom I have slowly worked my way out and I am glad that I survived. In the end, the gunner we saved did not. Batman survived the blast, recovered fully from his injuries and had hopes of becoming a Special Forces recruit. The military healed his physical wounds, but failed to address the psychological scars from not only the trauma he experienced that day in May, but also the loss of his three brothers-in-arms.

Twenty-two veterans commit suicide a day. We might survive combat overseas but the biggest fight we have is the war of coming home, an invisible war that no one sees but everyone talks about: PTSD. It’s unacceptable that the military doesn’t do more to acknowledge and de-stigmatize PTSD as well as notice the destructive high-risk behavior and silent cries for help soldiers make when they start to lose their personal war with it.

I have spent a lot of time thinking about why, out of all the patients I worked on, the gunner stayed with me. That was the day the last part of the old me, the part of me who had never seen war, died. That day I witnessed hatred and suffering on a scale that eclipsed anything I had seen in Baghdad. I also witnessed the beauty of resilience in the face of death. The gunner fought a battle in the OR that day and he won. When I was at my lowest point back home, weighed down by all of the guilt I felt, I saw him in my dreams. I remember resting my hand on his chest, over his tattoo, pleading with him to fight. I knew that wherever he was he would want me to fight, too. It’s because of him that I fought, and it’s because of him I won. He is my superhero.

Ashley Bohn is an Army veteran who deployed to Baghdad and worked as an operating room specialist in a combat support hospital. She now lives with her wife in California and continues to work in the medical profession as an EMT.