G. Richard Holt, MD, MSE, MPH, is Professor and Program Director of the Department of Otolaryngology-Head and Neck Surgery at the University of Texas Health Science Center in San Antonio.
Colonel, Medical Corps, Flight Surgeon, Texas Army National Guard, Brigade Surgeon, 36th Combat Aviation Brigade, Camp Anaconda, Iraq
This is a short narrative of the experience of this otolaryngologist, who was deployed to Iraq to participate in Operation Iraqi Freedom. My experience was somewhat different from that of Colonel Brennan, but not uncommon to generations of otolaryngologists who have served in a war or conflict in a position other than this specialty. Individuals such as Drs. Jack Hough, Ted Cook, Roger Crumley, and Christopher Post come to mind as examples of dedicated otolaryngologists who were at war in another position—I cannot list all those who have served.
Like Dr. Brennan, I have been a flight surgeon in the military (he in the Air Force, I in the Army) for several decades. In this capacity I have served with airborne and special forces units, medevac units, the US Space Command, and NASA. When I was recalled to active duty in the summer of 2006 and mobilized for duty in Iraq, I had no misgivings about the mission, but was sorry that my family and my colleagues would have to carry a heavy load in my absence. They helped me tremendously, and I publicly acknowledge my appreciation to them.
I was assigned as the Brigade Surgeon for the 36th Combat Aviation Brigade, a unit of the 36th Infantry Division. I had no prior contact with this unit, but understood it had been significantly augmented to a force of nearly 3000 airmen and soldiers from 44 states. It would prove to be an interesting challenge to organize and manage the medical assets of so many diverse units and personnel. Although the brigade composition was like a patchwork quilt, the brigade commander, an aviator and attorney, was a strong and competent leader and unit cohesiveness was achieved.
I met the brigade in Kuwait—at a staging camp there. The bulk of the brigade had been training at Fort Hood, TX, for six months prior to deployment, so I needed to get up to speed quickly with the others. In Kuwait, we experienced one of the hottest locations on earth—138 degrees and sunny! In fact, it felt like a blast furnace, and I never got used to it. The sandstorms were so forceful that my protective goggles were pitted by the particle blasts. It was there that I became acquainted with the flight surgeons, aeromedical physician assistants, and the flight medics whom I would need to bring together into an efficient and effective medical asset team.
Our flight from Kuwait to Iraq involved an interesting, corkscrewing approach to the airfield to avoid SAFIRE [small arms fire]. The military airfield in Balad, Iraq, is the busiest military airport in the world now. It is divided into two sides—one for the US Air Force and one for the US Army aviation assets. The US Navy and Marines had a few helicopters on the Army side, as well. My brigade was composed of attack, air assault, and medevac helicopters with quite a variety of missions. My job as brigade surgeon was to organize and manage the medical assets of the brigade as they were needed on the various missions, as well as to be responsible for the overall health of the brigade personnel. I also advised the brigade commander on health issues and flight medicine issues that could affect the missions.
I was in charge of an aviation medicine clinic, which was primarily to care for the aviation crews and keep them flying, but also to care for the rest of the personnel in the brigade. I regularly cared for patients with a wide variety of problems, including dislocated joints, cardiac events, renal stones, reactive airway disease, lacerations and fractures, GI epidemics, and other minor emergent conditions. I was also involved in medical evacuation and casualty recovery missions, primarily through our air ambulance battalions.
Young men and women who were injured in a firefight or involved in an explosion (usually an IED) required immediate air evacuation, no matter what the circumstances—day or night, or even if the firefight was still going on. I have the greatest respect for the flight crews and medics who voluntarily went to these sites, even though dangerous, and extracted the wounded soldiers for transfer to the nearest combat hospital. There, my colleagues in otolaryngology would often be involved in their care, particularly with respect to head, face, and neck injuries.
I cannot emphasize too strongly the dedication, selflessness, and bravery of those men and women who each day would go out on convoys, travel on dangerous roads, fly over enemy territory, and put themselves in harm’s way, to do their job for our country. They are all volunteers and some of the finest young people I have had the pleasure of knowing. It was very sad to see their broken bodies after their injuries, but these fine young people never complained about being in a war that was not popular at home. Even the most seriously wounded, if they were able to speak, asked when they could return to their fellow soldiers.
I was honored to be able to participate in a small way in the medical care of such individuals, and pray each day for the safety of each remaining behind in Iraq.
©2007 The Triological Society