IT had been five years. Five years since my last Thanksgiving in Baghdad. The years for me have been more kind than cruel. They have, as they always do, simply rolled in to one another. I am back home in Vermont, though not for long. I will leave for Afghanistan in November. Last time I could not help comparing the war to home, the grass versus the sand, but this time I cannot help comparing this most recent deployment to my last. I spent Thanksgiving of 2006 in Bagdad; exactly five years to the day I was back in Bagdad. A few weeks later I was home wondering if these points in time drew circles or lines or simply random dots in the sand.
In 2006, during the surge, I was also an Army anesthesiologist in Baghdad. It was, at the time, the busiest penetrating trauma hospital in the world. This time was different. My operating clogs did not rot from standing in blood. This time I simply waited for something bad to happen as the war wound down. It was a call night that stretched for months. Disasters lurked outside the door but I tried to sleep between watching the clock and the pounding on the door screaming “we have patients”. I was a doctor with few patients, waiting squeezed between the routine of meals and sleep and meetings. Waiting for the war to end.
I ran into another physician who had been at the same hospital; we talked about 2006. We talked about people and personalities. Who was just crazy versus really crazy. A surgeon who threw things versus the mortuary officer who stopped eating because she grew tired of stacking the dead. We laughed at some of the shared lunacy and silliness. I had forgotten about the colonel and the kangaroo. Forgotten about the robot in the ER. We mentioned a few patients. She reminded me that I wanted her to stop working on one patient but she would not. He died in the ICU minutes after leaving the operating room. We stop talking then. Oddly, I do not remember much about our patient. I do not know if time or sorrow has blurred my memories. I remember it was bloody. It was bad. We both agreed.
Beyond that there were few reminders of last time. An Iraqi custodian at the hospital recognized me. He commented that my hair was whiter and I commented that his belly was bigger. He told me that his family and country were well. I hope he is right. The mess hall had a picture of one of my previous patients who did not make it home. It was strange to see her every day. By and large the days were uneventful and the desert sky was often clear and beautiful at night.
There is a strange symmetry to witness a war from start to finish. Early in the war I took care of service members burnt beyond recognition. Later, in Iraq, during the surge, I saw a constant stream of casualties, American and Iraqi, many missing limbs. This time I saw troops packing up years of struggle in shipping containers, but few casualties. There were still random acts of violence. They were blissfully less frequent though equally felt. The lieutenant killed by a sniper’s shot. The last US casualty who ran over an improvised explosive device. He died on our table weeks before he was to go home. A soldier’s suicide a month before he was to go home. The car bomb against worshippers. The occasional public announcement, affectionately known as the giant voice, booming incoming, incoming, incoming as mortars fell.
I have seen the whole nine year arc of the war and still do not have a good perspective. Perhaps one day. As a scientist I know my perspective is biased. Can those who have served, who saw awful things, whose loved ones gave their last full measure, ever give an unbiased view? If I say it was worth it do I dismiss the inconceivable suffering? If I say it wasn’t worth it do I dishonor the dead?
Just because the war has ended does not mean it doesn’t go on. Thousands of widows and orphans struggle on both sides of the Atlantic. The human cost is beyond reckoning. Afghanistan stays dangerous and bloody. Even if that war ended today there are thousands dead, tens of thousands wounded. I am lucky. I got to go home whole and intact. Many do not. I went home to a loving family and a good job. Many do not. Hundreds of thousands bear seen and unseen damage and scars. Soldiers and families bear heavy and grievous burdens. I wonder who will speak for these people? Who will remember them? Who will give them jobs? Who will be kind to them? Who will say thanks?
This, like other Thanksgivings, I gave thanks for the all those things I had, even on the far side of the world. I gave thanks for a bountiful table. More food than I could possibly eat though I invariably tried to squeeze in another piece of pie. I watched some football. I gave thanks for my good health and fortune. Mostly, at least this Thanksgiving, I gave thanks that I was bored.
© 2012 American Society of Anesthesiologists, Inc.