Paradise General: Riding the Surge at a Combat Hospital in Iraq

Paradise General: Riding the Surge at a Combat Hospital in Iraq

by Dave Hnida
Paradise General: Riding the Surge at a Combat Hospital in Iraq

Paradise General: Riding the Surge at a Combat Hospital in Iraq

by Dave Hnida

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Overview

Dr. Dave Hnida's devastating and inspiring account follows a group of brilliant and committed doctors who staff a combat hospital in Iraq and achieve an astounding survival rate as they forge deep and lasting bonds based on friendship, good humor, and fidelity to the well-being of the American soldier.

IN 2004, at the age of forty-eight, Dr. Dave Hnida, a family physician from Littleton, Colorado, volunteered to be deployed to Iraq and spent a tour of duty as a battalion surgeon with a combat unit. In 2007, he went back—this time as a trauma chief at one of the busiest Combat Support Hospitals (CSH) during the Surge. In an environment that was nothing less than a modern-day M*A*S*H, the doctors’ main objective was simple: Get ’em in, get ’em out. The only CSH staffed by reservists— who tended to be older, more-experienced doctors disdainful of authority—the 399th soon became a medevac destination of choice because of its high survival rate, an astounding ninety-eight percent.

This was fast-food medicine at its best: working in a series of tents connected to the occasional run-down building, Dr. Hnida and his fellow doctors raced to keep the wounded alive until they could be airlifted out of Iraq for more extensive repairs. Here the Hippocratic Oath superseded that of the pledge to Uncle Sam; if you got the red-carpet helicopter ride, his team took care of you, no questions asked. On one stretcher there might be a critically injured American soldier while three feet away lay the insurgent, shot in the head, who planted the IED that inflicted those wounds.

But there was levity amid the chaos. On call round-the-clock with an unrelenting caseload, the doctors’ prescription for sanity included jokes, pranks, and misbehavior. Dr. Hnida’s deployment was filled with colorful characters and gifted surgeons, a diverse group who became trusted friends as together they dealt with the psychological toll of seeing the casualties of war firsthand.

In a conflict with no easy answers and even less good news, Paradise General gives us something that we can all believe in—the story of an ordinary citizen turned volunteer soldier trying to make a difference. With honesty and candor, and an off-the-wall, self-deprecating humor that sustained him and his battle buddies through their darkest hours, Dr. Hnida delivers a devastating and inspiring account of his CSH tour and an unparalleled look at medical care during an unscripted war.

Product Details

ISBN-13: 9781439100400
Publisher: Simon & Schuster
Publication date: 04/27/2010
Sold by: SIMON & SCHUSTER
Format: eBook
Pages: 304
File size: 2 MB

About the Author

Dr. Dave Hnida is a family physician and medical commentator. He has worked as a local and national correspondent for NBC and CBS, and has made appearances on the Today show and The Early Show. He lives with his family in Littleton, Colorado.

Read an Excerpt


I’M NOT A SOLDIER BUT I PLAYED ONE IN IRAQ

THE LAST TIME I talked with my dad was on a sweltering April evening in 2004. It was a lopsided conversation. He had died of a heart attack almost thirty years earlier. But he was one of the main reasons I was hiding in a sandy ditch in the middle of Iraq, and I had some things to tell him before I died. My dad was a good man, although up until a few days before his death, I didn’t always think so. A hard-toiling factory worker, he drank a fifth of cheap whiskey every day, was a mean drunk, and always left me searching for the answer to why any man felt the need to retreat to the safety of the bottle. I had my hints and theories, but never walked in his shoes, or in this case, his Army boots. It took three hours in a ditch to get a firsthand revelation about why the liquor cabinet was permanently open while I was growing up.

As a twenty-three-year-old infantry lieutenant at Anzio in World War II, my dad sent a number of other young men into battle and could never forgive himself for the ones who didn’t return. This member of the “Greatest Generation” was silent about his war until he abruptly and permanently corked the bottle in late 1975, when I was a senior in college.

We were driving from Newark to Philadelphia down the Jersey Turnpike when he threw a couple of quarters into a tollbooth, saying, “That’s not much of a toll in this life, Dave.”

I wasn’t sure what he meant until a painful flood of war memories suddenly spilled from a place deep in his soul. He had never told anyone, including my mom, about any of his wartime experiences. I was the typical college kid who thought I could handle anything the world dared throw at me, but was humbled into silence as each mile marker brought a new and horrible description of the savagery of war.

In a calm and measured voice, my dad told me about being hit with flying body parts as German artillery shredded the men next to him in a foxhole; driving a knife into the throat of a wide-eyed enemy soldier no older than himself; then sending out on patrol a man, no, a boy, really, who had saved his life in an ambush only the night before. A boy whose machine-gun-riddled body my dad dragged back to American lines a few hours later. Finally came the worst story of all: the fear. The fear of failure. The fear of letting your fellow soldiers down. The paralyzing fear of fear itself. Fear was my father’s lifelong bartender.

The drive ended in exhausted silence an hour later when he dropped me in front my apartment at the University of Pennsylvania. His voice was steady for the entire trip but as the car braked to a stop, his eyes were damp. With the exception of drunken bursts of anger, it was the most emotion I had seen from my father in my twenty-one years. We shook hands, said our goodbyes, and that was it. Almost. As he rolled up his window, my dad quietly said, “I’m sorry, Dave. I hope I wasn’t a bad father.” He died of a heart attack four days later.

I think my dad died a more peaceful man, but for me, his stories of war delivered anything but peace. I tried to make sense of the things he had told me in the hour-long monologue, wondering how his experiences shaped him and—as a result—me. And I simply couldn’t shake the last words I would ever hear from him, a questioning statement that was almost a plea for forgiveness. How could I think of him as a terrible father after what he’d been through? I saved myself from a lifetime of regret when I answered with a smile and a quick thumbs-up as he pulled away from the curb.

As the decades following that car ride melted away, the stories did not—they seemed to be on a constant simmer below the surface of my life. I went on to medical school, got married, and started a family. Yet as I watched my own four children grow, there was always a sober thought that the only way to learn what made my father tick was to leave them, and go to war myself.

NOW, IN A classic case of be careful of what you wish for, I found myself lying in some nameless ditch along the side of a nameless road outside a village whose name I couldn’t pronounce. It was a beautiful desert night, with a sparkling sky and a moon so brilliant it made me the perfect silhouette.

“Doc!” The voice came from behind in a stern whisper.

“Get your ass down and make yourself small!”

A wiry young sergeant had silently wiggled up beside me.

“You’re going to get us all killed unless you get the fuck down and eat some sand, sir.”

He was right. Here I was, a forty-eight-year-old doctor, well schooled in medicine but clueless in the ways of war. And fortunate to be getting lessons from a twenty-three-year-old tutor carrying an oversized M4 automatic rifle. Christ, this kid is the same age as my father when he crawled around Italy in 1943.

My night in the ditch had actually started hours before the sun went down. We were on our way back from convoying a wounded Iraqi insurgent from our aid station to a British combat hospital. I was nearing the end of my deployment and had been through a few close calls. Now I needed my luck to hold out for just one more ride. I stared out the small window of our Humvee as we weaved and dodged well-hidden IEDs, trying to make sense of why we were risking our skins to save the life of an insurgent who had cursed and spit on us as we loaded his stretcher into the ambulance.

Along the route, our convoy picked up a number of stragglers, vehicles whose drivers knew there was safety in numbers. Among the group of wheeled hitchhikers were a number of fuel trucks, appetite-whetting targets for anyone with a rocket-propelled grenade. The convoy hauled ass toward our base, making good time until one of our Humvees unexpectedly let out a series of groans and weakly chugged to a halt in the middle of the road. The breakdown left us no choice but to sit and wait for help. And wait we did, watching the sun disappear, and darkness creep up.

It didn’t take long for word to make its way to the wrong ears that an American convoy was stranded on an isolated road. At first we could vaguely see, then only hear, scrunching footsteps in the darkening fields and groves that ran along both sides of the road. The contractors from the fuel trucks huddled as the soldiers set up a protective perimeter around the dead convoy. I settled into my spot in a ditch that was two feet deep, cradling an M16 rifle, and waited. And listened as the scrunching slowly and steadily got louder. I’m a doctor. What the hell am I doing here? And what will my kids do when they get the news I was killed?

AS MY FOUR children grew, I made sure their world was different from the one where I grew up. They would never never worry about their father stumbling around drunk in public or throwing an empty booze bottle at their heads. And they’d never cower in a corner waiting for the alcohol to trigger an artificial slumber.

Though I worked hard, I tried to make it home early every day to have a catch in the backyard or help with homework. And despite offers of more money to work in New York or L.A., I realized the way to have more was to take less, and the best place to raise a family was at the foot of the Rockies in the tight-knit community of Littleton, Colorado.

Life in Littleton, in fact, seemed to revolve around kids: My family medicine practice was more pediatric than grown-up; I coached Little League baseball, basketball, and football; and I volunteered as the team physician for so many schools, there were days I didn’t know who to root for. Life was good and I was content. I had even made peace with my children’s grandfather—telling my kids the stories of the good times of my childhood, while leaving out the bad.

Then came two events that shattered my world, and started the wheels that would take me to the ditch.

The first happened in 1999, a seismic blast that shook the country, as well as my life—the Columbine High School shootings. My office was literally a stone’s throw from the high school; I knew most of the students, parents, and teachers; and most importantly, of the thirteen who died in the shootings, nine were patients of mine, some of whom I had cared for since the day they were born. And as they fell, so did I.

Soon after, my daughter Katie made history at the University of New Mexico as the first woman ever to play and score points in a major college football game. But her groundbreaking journey was a long and painful one. Katie was originally recruited as a placekicker by the University of Colorado, but a coaching change right before arriving on campus abruptly chilled the atmosphere for a female playing a traditionally all-male sport. It was clear the new head coach, Gary Barnett, didn’t want Katie around and a few of the players picked up on the unwelcome message. The harassment started the first day she stepped onto the field, and never let up. She was cursed, groped in the huddle, and had footballs thrown at her head as she practiced her kicking. Soon after the season ended, the nightmare of every father took place: Katie was raped. He was a teammate she considered a friend, the last guy she ever thought would harm her.

It would have been easy to quit, but she never considered it. Katie left Colorado and found a home at the University of New Mexico where she played for a team that accepted and encouraged her to make history. I was proud beyond words the day she trotted onto the field to kick against UCLA on national TV.

She had accomplished her goal, and went on to play in another game the following year at New Mexico. Despite her successes, Katie still had days of darkness, and with them came a struggle I woke to each morning—one inner voice goading me to kill the guy who had raped her while another mocked me as a failure for not protecting her.

My life became a bottomless well of guilt and it seemed the only way to lift myself out was to serve penance: do something to protect, help, save the young people of the world. Memories of my dad’s experiences resurfaced, and suddenly I knew where I was needed, where I could help, where I might find peace. That place was war. Tonight, though, I wondered if I was just plain stupid: dying in a ditch wasn’t going to fix the world or explain the meaning of life.

NOW WE COULD hear whispering and muffled voices in the fields around us. All of the noises were magnified, and my heart thumped like a runaway bass drum. How long was I in this same spot? The cramps in my legs answered forever. It was time to move. No one had ever taught me the proper Army techniques of a “low crawl” or “high crawl”; I just slithered along the sandy ground in a way I remembered seeing in war movies. I was surprised at how hard and rocky the ground was; I thought sand was supposed to be soft and friendly, just like at the beach. Jesus, I miss the beach. Every year or so we took the kids to Disneyland and the beach in California, but that was the extent of our travels. Not much of an adventurer, I had never even been out of the country until my plane landed in the middle of a war zone just months before.

An odd light caught my attention as I settled into a new position. A red beam from about thirty yards way—it had to be from one of my guys. The beam narrowed to a dot and danced back and forth across my face, then slowly moved to a spot directly over my heart. Shit, was I a target? The dot then jerked back and forth from me to the ground. I flattened my body like a pancake into the hard sand.

This time I heard the young sergeant’s movement before his voice.

“Sir, you’ve got to move. You’re right between that .50 cal and the hedge. They come through there, your head is going to get blown clear off your neck.”

I swung my head around and saw a .50 caliber machine gun on top of a Humvee pointed directly at an opening to the fields. And I was exactly between that opening and the gun. I murmured a sorry and asked where I should go.

“Back to your position, sir. We need you there. Not here.”

So much for knowledge of defensive perimeters and tactics. This wasn’t what I had in mind when I joined: I was expecting to take care of soldiers, not be one.

WHEN THE WAR erupted in the spring of 2003, the decision to join was far from automatic. I was not some Yankee Doodle doctor who wanted to make the Middle East safe for democracy. I possessed no secret clues about elusive WMDs. And though I loved my country, the start of the conflict didn’t infect me with a sudden bout of acute patriotism. But when I heard the Army needed doctors, the deal was clinched. It was all about the kids; maybe not my kids, but someone’s kids. Across America were families who went through the motions of life by day and paced the floor by night while their imaginations terrorized their hearts with worry.

So at an age when people retire from the military, I pulled the trigger and became the Army’s newest recruit. They even handed me the rank of major, pretty good I was told for a forty-eight-year-old whose military experience consisted of watching Saving Private Ryan.

I should have known better. The transition from a comfortable civilian life to instant soldier was my personal version of shock and awe. I was simply too old to enter a world of saluting, marching, or giving orders. And I really hated being ordered around, especially when that order was punctuated by a raised voice. I realize a fighting machine isn’t built on etiquette, yet I never yelled and expected the same courtesy in return. I got pissed when a pimple-faced instructor more than twenty years my junior called me a “clueless asshole” during basic training. The fatal infraction: a loose thread on the shoulder of my uniform. Christ, the way he screamed you’d have thought I had left a scalpel in him during surgery. When I flicked the thread in his direction and told him a deep, dark anatomical place to stick it, I thought his head would explode. And was disappointed when it didn’t.

The brave new world of military courtesy was especially foreign to me: I liked to be called “Dave,” not “Sir.” Plus, I preferred a “hi” and a handshake when I met someone—a neighborly friendliness that didn’t go over very well the first time I met a general. My outstretched hand was greeted with a stunned look, then livid laser beams shooting from his eyes.

NOW I CAUGHT a whiff of tobacco smoke from beyond the hedge. They were closer. Would they try to kill us or capture us? An intelligence briefing said there was a price on our heads—the insurgents were offering cold hard cash for an American taken alive: a captured enlisted soldier was worth $2,500 cash; an officer, $5,000. My crew had made a death pact weeks before during a road trip to Baghdad: we’d fight to the next-to-the-last bullet, then use that last bullet on ourselves to avoid capture—there was simply no way we were going to become stars on an Internet throat-slitting video. As the highest-ranking officer, I would make sure the deeds were done, and then pull the final trigger. I wondered if it would come to that tonight.

THOUGH THE ARMY was quick to snatch me up and start yelling at me, it took more than eight months to get my orders to Iraq. It was January of 2004, less than two weeks before my newly assigned unit departed—and I only got the job because their doctor dropped out at the last minute. Things happened so quickly, there wasn’t time to reconsider the leap to war. My kids were torn; on one hand worrying I was going to be shipped home in a casket, on the other, proud I was taking the risk to help soldiers who were, in many cases, the same age as they. We talked a lot about the importance of serving others—being a doer, not just a talker. I hoped I was setting a good example instead of playing the over-the-hill fool.

My new title was “Battalion Surgeon.” I was officially attached to the 160th Military Police Airborne Battalion, a reserve unit out of Tallahassee, Florida, which in turn was attached to the 16th MP Airborne Brigade out of Fort Bragg—a unit tasked with security and detainee care around Baghdad and southern Iraq. I was a little confused about where a battalion fit into the scheme of things, but soon found out that their surgeons were typically young, spry, and sharp in military medicine. I was none of the above.

The night I met my new boss, Lieutenant Colonel Izzy Rommes, the first words from his mouth didn’t exactly make me feel like a first-round draft pick. After a full thirty seconds of a cold stare from a hard face, he finally drawled, “You sure are one old fucker for this job.” Then he stuck his hand out, smiled, and said, “Welcome aboard, Doc. We sure need you, thanks for volunteering.”

My new unit quickly took me under their collective wing and led me through the maze of the military, schooling me in the best ways to keep my ass intact. When we arrived in Iraq, their first tasks were to scrounge up scarce body armor, find me an M16 rifle, and make sure I could shoot it without hitting them, as well as teaching me hand-to-hand combat and self-defense.

The war was quiet when our boots first hit the ground, but within weeks the insurgency came out of hibernation. We were a full eight months from the infamous “Mission Accomplished” moment, now we we had shifted into the “Holy Shit” mode. I spent my deployment carrying an M16 or a shotgun in one hand, medical tools in the other. The months that made up the spring of 2004 were among the bloodiest of the war.

My greeting card to war was a split-second whoosh of air accompanied by stinging shards of glass hitting my face. We were convoying outside Baghdad when someone decided to take a potshot at a moving vehicle. My moving vehicle. We later calculated that the bullet missed my head by little more than an inch. Only weeks before, my biggest enemies in life had been insurance companies who wouldn’t approve tests for my patients.

But that was just the beginning. Not only did I get shot at, I was mortared, rocketed, clubbed, and almost stabbed by a group of insurgents, while logging more than two thousand miles convoying the highways and byways of a very pissed-off country. My best stop was Saddam Hussein’s palace outside Baghdad; the worst was the infamous Abu Ghraib prison.

The palace was massive and gilded with gold, with the piÈce de rÉsistance its bathrooms—beautiful rooms with elegant fixtures and real flush toilets. It had been months since I had had the luxury of using real plumbing, and as I stood over the bowl taking a wicked pee, I pictured Saddam reading the Sunday comics while sitting on the fancy porcelain. Ever so grateful for the facilities, I was even courteous enough to put the seat back down when I was done. But I got a post-pee shiver when I walked over to another structure on the palace grounds—Saddam’s so-called party house, a building with a stone etching of Saddam’s face on the head of the serpent, handing Eve the apple of sin. The man was truly nuts.

He was also our most famous, and secret, prisoner. Captured a little over a month before my arrival in Iraq, Saddam was hidden away at the High Value Detainee Center at Camp Cropper. As the world was playing a game of “Where in the World Is Saddam?”, he was right under everyone’s nose at a camp in Baghdad just a few miles from the Green Zone. Like many older Iraqi prisoners, this self-proclaimed strongman wasn’t very strong when it came to health: Saddam suffered from high blood pressure, a chronic prostate infection, and was the owner of the largest inguinal hernia in the Middle East (which the Army fixed months later). He was also an obsessive neat freak with a fanatical love of Cheetos and Doritos, neither of which helped his blood pressure.

Abu Ghraib was a creepy place filled with ghosts of the tortured. The prison was best known for the detainee abuse that had taken place less than a year before, yet it was hard to ignore the souls of the tens of thousands of Iraqi citizens murdered at the prison by Saddam and his henchmen. The soldiers and marines manning the prison lived in the old cells behind sliding bars. Decorated with American flags and posters, it was impossible to hide the Saddam-era bloodstains on the walls or the hooks once used as tools of torture. Whenever our unit stopped at Abu, I begged off the offer of a guest cell, choosing instead to sleep under the chassis of a truck parked in the courtyard. It wasn’t the most comfortable place to spend the night, especially when a rocket landed and bounced me into the undercarriage, but it was still better than sleeping inside the house of horror.

THE EXOTIC VOICES from the fields were getting louder. Too many voices. I took a quick look at the fuel trucks, knowing they’d be hit first, and wondered if I’d get a shot off before being burned to a crisp. Whispered orders made their way among us. Lock and load. Safeties off. Here we go. I thought of my family, my dad, my stupidity. Had I really accomplished anything? Without warning, a growling thunder erupted from down the road, steadily overtaking the noises from the hedge. The ground began to shake and I thought my world was coming to an end. I was wrong. While it wasn’t a true John Wayne moment with gunshots and fireworks, it was John Wayne enough for me. Our cavalry came rumbling to the rescue: a half a dozen heavily armed gun trucks with a massive tow truck bringing up the rear. We cautiously got up and moved toward our rescuers, grins of relief splitting our faces. I was scheduled to go home in three days and now it looked like I’d live to make the trip.

THE CONVERSATION WITH my dad that night took place in bits and pieces over the course of three long hours, more time than I had with him on the ride to Philly. The words were never spoken aloud, yet I felt sure that he knew that I had just learned his bitter lesson of war: fear. Sure, I was scared of dying—it’s hard not to think that way when you are lying in the dark … waiting.

But worse was the fear of leaving my loved ones behind and the pain they would feel with my death. Then came the fear of screwing up and causing the deaths of my fellow soldiers. Unforgivable.

As I walked with shaking legs to my Humvee with my wiry young sergeant, I apologized repeatedly for screwing up as we’d hid for our lives in the ditch.

“Hell, I didn’t know what I was doing back there. I could have gotten us all killed. Man, I am so sorry.”

It wasn’t until our Humvee was headed toward the safety of our base that it hit me, three long decades after a car ride down the Jersey Turnpike. The young sergeant had answered with a smile and quick thumbs-up.

© 2010 David William Hnida

Table of Contents

1 I'm Not a Solider but I Played One in Iraq 1

2 Which End Do the Bullets Come Out? 13

3 Camp Boring 29

4 Paradise General Hospital 41

5 First Day of School 55

6 Hot Tamale 67

7 The Tug-of-War 77

8 "A Picture Is Worth a Thousand Tears" 91

9 Dear Kids 115

10 Rebels with a Cause 129

11 Anatomy of a Trauma 139

12 Sick Call Sunday 151

13 Dante's Infirmary 163

14 Death of an American Soldier 175

15 Family Ties 185

16 Suicide Isn't Painless 195

17 Blursday 203

18 The Guns of August 215

19 The Wounded Wore Aftershave 223

20 Tale of Two Brothers 235

21 You Shoot 'Em, You Own 'Em 243

22 Dog Kennels 253

23 Last Tango in Tikrit 267

24 Hero's Welcome 275

Epilogue 281

Author's Note 285

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