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In preparation for his second tour of duty in Iraq, retired Army Reserve Lt. Col. John Burson reported to Fort Benning, Ga., for a physical and two-week refresher course in July. "When I signed in, the sergeant major looked at me funny and asked me how old I was," the 73-year-old Burson recalled. "He was 50 and proud that he was the oldest soldier in the unit. I told him I had children older than him."
In the fall of 2005, Burson, ChE 55, MS Met 63, PhD ChE 64, responded to a call for medical reservists to temporarily relieve active duty doctors. An ear, nose and throat physician in Villa Rica, Ga., Burson cared for wounded soldiers and civilians at a combat support hospital near Baghdad. He returned to Iraq in August.
My billet is a two-man room with a young dentist who has been here a year and is getting ready to go back to Germany. I have a nice bed with a real mattress, a small nightstand and a locker for my stuff. The latrine is just a few doors down the hall. All in all, more than I expected or could ask for.
Both my battle buddy and I are attached to the 31st Combat Support Hospital for our duty assignment, but the 535th is responsible for our administrative stuff. This is potentially a very good situation because neither unit really knows where you always are nor what regulations apply to you, and this can sometimes be an advantage.
Most of the soldiers here wear individual body armor, a backpack, a weapon and a soft cap and usually carry their Kevlar helmet as well. All this stuff is awfully hot and heavy in 130-degree heat.
Since my unit is not yet officially here, there are no regulations as to what I wear to work, and there is wide variation among units. So, I wear my ACUs, a soft cap and my weapon. I will don the more stringent stuff when I am instructed to do so.
The natural question arises: Are you adequately protected with what you are wearing? I think so. We get a mortar round or two most every day, but getting hit by one is about the same risk as getting run over when you cross the street.
The 31st Combat Support Hospital is a relatively small hospital, much smaller than the one I was dutied to on my previous tour. Since I am a board-certified surgeon with previous trauma experience at the 10th CSH, one would naturally expect me to be attached to the surgery staff. Not so. Instead, my battle buddy was assigned to the ER and I was assigned to the detainee medical center.
The hospital side of the CSH takes care of both Americans and Iraqis, but the DMC takes care of only detainees, the proper term for prisoners. I take care of detainees and operate on occasion when they need me.
The DMC has two main functions. On one day, there is a wound-care clinic where all the shot-up detainees are brought in and their wounds evaluated with dressing changes, etc. After this, rounds are made in the security holding unit. This is a series of solitary confinement cells for bad actors with a small subunit for those with tuberculosis. Medics screen the individual cells for medical problems and the MDs evaluate those with complaints. Detainees with a death sentence already rendered by their courts have a red band around their nametags so we can keep a close watch for suicides among them.
If they have a problem, which is usually a headache or sore throat, we usually give them a single pill and move on. There are about 60 or so cells and it takes about two hours to make the rounds. If a patient needs follow-up care, we make a notation and schedule them for the DMC clinic.
In the afternoon, we have general sick call for detainees and any that have been designated for follow-up care. We have a lot of middle-aged Iraqis with chronic diseases in the camp, so there is a regular clinic for those with high blood pressure and for diabetes.
We have about 3,000 detainees here including some really bad guys, deck-of-cards types. There is a much larger camp south of here at Bucca. There are about 30,000 detainees there and there is a lot of transfer activity between here and there.
All holding areas here, even the tents, are air-conditioned. For the most part, these guys have much better surroundings than they do in their home villages. They get little or no medical care in their villages, so there is a real incentive for sick guys to get captured and detained where they can get medical care.
Every morning on my way to work, I see about four to six full-size buses roll in with new captures from the night before. When there is a sweep through a village with suspected or actual insurgent activity, usually all the adult males are gathered up and brought in for questioning. About 90 percent are Sunnis and the majority are 20 to 30 years old, with a fair number of older guys (the oldest so far being 77) and a sprinkling of juveniles.
If there is a fire fight, we bring in the ones we shot the night before and expend a lot of resources in getting them well so they can fight us again. Such are the contradictions of war.
Many of the young docs here are just out of residency and are using the prisoners to hone their skills in clinical care. I have no problem with that.
So, that is a typical day at the DMC. On every other day, we have what is called the IHA (Incoming Holding Area). Here, the fresh captures are given a medical screening and those who may need continuing medical care are identified.
We usually see about 100 to 150 captures per day. My fellow physicians usually take about 15 minutes per detainee for evaluation, whereas it takes me about 1.5 minutes to screen one. So, I have become very popular with the enlisted medical folks who have to man this clinic — we usually finish about two hours earlier than they did before, and I usually wind up seeing about 70 percent of those seen. You've got to be pretty sick to get a follow-up visit to the DMC from me.
Don't get me wrong. I am not ignoring real medical problems, I am just making sure that I am not providing what I consider as unnecessary care for them. I am trying to adopt the Mother Teresa attitude — that is, they are all God's children and I don't do anything as an act of commission or omission that would harm them (even though they may have set off an IED and killed fellow GIs the night before). Not being judgmental is not always easy.
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