These days most NATO forces in Afghanistan rarely, if ever, leave the secured perimeters of their bases. While safer, life on base produces a complicated proximity to the realities of war — we’re both close and far away. At Bagram Airfield north of Kabul, the line between life and death is often clearest in the largest American hospital in the country, Craig Joint Theater Hospital.
The Air Force-led hospital’s primary mission is to treat injured or ill NATO personnel, and despite decreased volume of battle injuries due to the drawdown of troops, the facility remains busy. But now, it’s mostly a steady flow of Afghan trauma and humanitarian patients punctuated by sporadic coalition casualties, such as the wounded from the attack that killed Army Maj. Gen. Harold Greene in August.
Sometimes the contrast between hope and despair, between smooth recoveries and catastrophic battle injuries, comes into focus within minutes.
July 22 was supposed to be the last day in Afghanistan for Air Force Lt. Col. Jason Williams, and he wanted an easy morning to pack, tell friends goodbye and perform a final check-up on a special patient. But a suicide bomber in Kabul changed those plans. Instead, the 38-year-old cardiothoracic surgeon was in an operating room scrambling to save six gravely injured Nepalese security contractors.
More than a dozen doctors, nurses and technicians attended to one man who spent five hours in surgery. Maj. Jon Forbes, a neurosurgeon, worked on a severe brain injury while Colonel Williams and a trauma surgeon, Maj. Jason Pasley, tried to save the man’s arm.
“We’re on our last unit of B. I’m going to activate the walking blood bank,” the anesthesiologist, Maj. Scott Jensen, said as he set a cooler with the last of the hospital’s B-positive next to a pile of empty blood bags.
“Jon, do you think this guy’s survivable?” asked Major Pasley while suturing a hole in the man’s radial artery.
The answer came in a series of dire descriptions of the damage. The man’s middle cerebral artery had been shredded and the left hemisphere of his brain was functionally dead. That would leave him paralyzed on one side of his body and unable to speak or understand language.
“O.K.,” was all Major Pasley said in reply.
Colonel Williams’ camo-patterned Crocs made footprints in the blood pooling on the floor as he and Major Pasley bandaged the man’s arm. Major Forbes continued his quiet work on the man’s brain. Wisps of smoke rose from his cauterizer. The hiss of his suction seemed amplified against the heart monitor beeps and an iPod playing Blake Shelton’s “Boys ‘Round Here.”
A few minutes later, in sweat-drenched green scrubs, Colonel Williams flung open the operating room door and stepped toward the locker room shaking his head.
“That poor guy’s probably going to die,” he said while changing scrubs. “Busy day. Let’s go see the little girl.”
Down the hall, in the hospital’s waiting area — a fluorescent lit, white-tiled room lined with American flags and images of troops who died in the facility — 12-year-old Zuhal and her father, Ahmad, waited to see Colonel Williams. They were the only civilians in the room, and their soft conversation was largely drowned out by the chatter of troops with machine guns and a television tuned to the Armed Forces Network.
A month earlier, the colonel removed a lobe of Zuhal’s lung that had been strangled by a plum-sized cyst. Colonel Williams, a native of Fayetteville, Ga., said the growth was likely the result of a parasite or possibly a congenital problem that put Zuhal at risk for life-threatening chronic infections that could prevent her from developing normally.
Zuhal’s path to treatment took more than a year, but the surgery went well, taking just two hours.
She spent a week and a half recovering at the hospital. Several Afghan security forces healing from amputations and gunshot wounds occupied the neighboring beds, and as the only child in the hospital at the time, she garnered a lot of attention from the staff.
Zuhal and her father smiled when Colonel Williams entered the small exam room. A World War II “Rosie the Riveter” poster with the words “We Can Do It!” hung above her, the riveter’s blue shirt mirroring her own bright blue shirt and eyes.
“So, I’m very happy with how well you’re recovering. You’ve done a great job since surgery,” Colonel Williams said. “This should never come back and should never be a problem again.”
“I’m very happy that we brought her here and you were here,” Ahmad said to the colonel. “She was lucky that you took care of her.”
Zuhal had just one question: “What can I eat?”
“Whatever you want,” the colonel replied.
“I have five kids, and my oldest daughter is your age, and I’m going home tomorrow to see them,” Colonel Williams continued. “You remind me of my daughter.”
As the father and daughter departed, a linguist gave Zuhal some Girl Scout cookies and a juice box. But Colonel Williams’ work was not done: He donated a pint of his B-positive blood for the man he’d just operated on, joking with the lab technician and looking away as the needle went in.
“At some point we’re going to have to leave, and our humanitarian mission is not going to be as robust, or it won’t exist at all,” he said in the operating room lounge while cleaning the dried blood from his Crocs. “When we leave, either some other organization is going to have to come in and take over the humanitarian role, or these folks aren’t going to be cared for as well. There’s a huge medical need here, and there will continue to be for many years to come.”
“I feel like we’ve done some good things here,” said Colonel Williams, who deployed from Travis Air Force Base in California. But, he added, “I’m ready to go home to my family.”
The wounded contractor died that night. The plane carrying his body to his home country left just before Colonel Williams’ flight out of Afghanistan.
Colonel Williams is home now coaching his son’s football team and riding the California highways on a Harley-Davidson that he custom-ordered while at Bagram. Zuhal started seventh grade this week.
Air Force Maj. Brandon Lingle is currently deployed as a public affairs officer at Bagram Airfield, Afghanistan. He has previously served in Iraq and Afghanistan as a public affairs officer. His nonfiction was noted in “The Best American Essays 2010″ and again in the 2013 volume, and he is an editor of “War, Literature & the Arts,” published by the United States Air Force Academy. You can follow him on Twitter.
The views expressed here are those of the author and do not reflect the official policy or position of NATO, the United States government, the Department of Defense or the Department of the Air Force.