The List

Things That Were Good

Sunset over the desert...almost always orange
Sunrise over the desert...almost always red
The childlike excitement of having fresh fruit at dinner after going weeks without it

Being allowed to be the kind of clinician I know I can be, and want to be, with no limits placed and no doubts expressed

But most of all,
The United States Marines, our patients...
Walking, every day, and having literally every single person who passed by say "Ooh-rah, Ma'am..."
Having them tell us, one after another, through blinding pain or morphine-induced euphoria..."When can I get out of here?  I just want to get back to my unit..."
Meeting a young Sergeant, who had lost an eye in an explosion...he asked his surgeon if he could open the other one...when he did, he sat up and looked at the young Marines from his fire team who were being treated for superficial shrapnel wounds in the next room...he smiled, laid back down, and said, "I only have one good eye, Doc, but I can see that my Marines are OK."
And of course, meeting the one I will never forget…the one who threw himself on a grenade to save the men at his side...who may be the first Medal of Honor recipient in over 11 years...

My friends...some of them will be lifelong in a way that is indescribable
My patients...some of them had courage unlike anything I've ever experienced before
My comrades, Alpha Surgical Company...some of the things witnessed will traumatize them forever, but still they provided outstanding care to these Marines, day in and day out, sometimes for days at a time with no break, for 7 endless months 

And finally, above all else...

Holding the hand of that dying Marine

Things That Were Not Good

Terrifying camel spiders, poisonous scorpions, flapping bats in the darkness, howling, territorial wild dogs, flies that insisted on landing on our faces, giant, looming mosquitoes, invisible sand flies that carry leischmaniasis

132 degrees
Wearing long sleeves, full pants and combat boots in 132 degrees
Random and totally predictable power outages that led to sweating throughout the night
Sweating in places I didn't know I could sweat...like wrists, and ears

The roar of helicopters overhead
The resounding thud of exploding artillery in the distance
The popping of gunfire...
Not knowing if any of the above sounds is a good thing or bad thing
The siren, and the inevitable "big voice" yelling at us to take cover...
Not knowing if that siren was on someone's DVD or if the big voice would soon follow

The cracking sound of giant artillery rounds splitting open against rock and dirt
The rumble of the ground...
The shattering of the windows...
Hiding under flak jackets and kevlar helmets, away from the broken windows, waiting to be told we can come to the hospital...to treat the ones who were not so lucky...

Watching the black helicopter with the big red cross on the side landing at our pad
Worse...watching gray Marine helicopters filled with patients landing at our pad...because we usually did not realize they were coming...

Ushering a sobbing Marine Colonel away from the trauma bay while several of his Marines bled and cried out in pain inside
Meeting that 21-year-old Corporal with three Purple Hearts...and listening to him weep because he felt ashamed of being afraid to go back
Telling a room full of stunned Marines in blood-soaked uniforms that their comrade, that they had tried to save, had just died of his wounds
Trying, as if in total futility, to do anything I could, to ease the trauma of group after group...that suffered loss after loss, grief after inconsolable grief...

Washing blood off the boots of one of our young nurses while she told me about the one who bled out in the trauma bay...and then the one who she had to tell, when he pleaded for the truth, that his best friend didn't make it...
Listening to another of our nurses tell of the Marine who came in talking, telling her his name...about how she pleaded with him not to give up, told him that she was there for him...about how she could see his eyes go dull when he couldn't fight any longer...

And finally, above all else...
Holding the hand of that dying Marine