Copyright 2006 U.S. News & World Report
All Rights Reserved
By NANCY SHUTE
U.S. NEWS & WORLD REPORT
As an orthopedic surgeon at the 86th Combat Support Hospital in Baghdad, Army Maj. Merritt Pember saw his mission as keeping grievously wounded soldiers alive until a medevac could fly them out for further treatment. Baghdad ER, a documentary that premieres on HBO on Sunday, May 21, details the experiences of Pember and his colleagues. U.S. News spoke with Pember, 33, now at Fort Hood, Texas.
You chose orthopedics, which is not a specialty for the faint of heart. How was your first day in the emergency room in Iraq?
As strong as I thought my stomach was, I don’t think that anything can prepare you for the first patient in a war zone. The velocity of the wounds over there is just so much more dramatic. It creates devastating injuries. The first patient I had was a double amputee; he lost a leg and an arm. The other leg had a compound fracture of the femur, and the other arm had a terrible wrist fracture. Just the look of it makes you step back. As the war goes on, unfortunately, you get used to what rolls in the door day after day.
People think of amputations as a primitive form of medicine. Had you done them back in your hometown of Lubbock, Texas?
Yes, but the majority I’d done in the civilian world had been on diabetics. As for traumatic amputations in young people, it’s an extremely rare event. But in Iraq, probably 80 percent of the injuries involve orthopedics, because you have the body armor and the helmet, and what’s left unprotected are the extremities. It’s not a clean cut; they’re shredded and as dirty as dirty gets. You can’t make the leg look nice and pretty. The dissection is unfortunately already done for you, and you have to decide how to make it as best you can.
That’s got to be hard.
It’s certainly depressing. There was a 19-year-old marine I remember well. You amputate both of his arms, and you watch him walking out of there without both of his extremities. I suppose that’s better than being dead, but it doesn’t leave you feeling that you’ve done him a great service.
The survival rate in this war is the highest in history, largely because of improved body armor. But in fact, many of your most valuable tools in Iraq were surprisingly low-tech. Why?
Tourniquets are incredible lifesavers, especially with already amputated extremities. All the medics have them, and all of us have them. It’s a quick fix, and that’s what you need to get someone to a combat support hospital. We didn’t have the fancy new tools, but you don’t necessarily need them for acute care. You need a “squirt gun” to wash the dirt out, and a knife and a saw.
You often treated Iraqis, even if they were insurgents who were injured while fighting Americans. What was that like?
Anybody we injure, we take care of them as well. You’re obligated to treat them the same as anyone else. Once when I was working in Mosul, the enemy was rushed over. We performed heroic measures to save him; he actually coded a couple of times and survived. He woke up and was irate — and still hated Americans. It’s frustrating to go through all that and know they still hate you. But I think it speaks volumes about Americans that we treat them better than they would be treated in their own country. It was a challenge, but they got outstanding care, whether they deserved it or not.
Was there a toughest day?
It’s strange — they all kind of blended together. We called it “Groundhog Day,” because each day was like the next. I was there six months, and it never once rained. You see the same injuries come in the door every day. One day, I did four or five amputations; that was the worst. You know that you have to do the amputation because you can’t repair it, but it’s not feel-good surgery. It gets old.
That had to be physically and emotionally exhausting. What did you do for a break?
We had cigar night every night on the hospital roof. That was a big stress reliever. There were several groups that would go work out. There was a pool you could go to. Outside of that, there was not a whole lot you could do. Nonalcoholic beer and stogies were the main thing. It’s not the place to go for entertainment.
You signed up with the Army to help pay for medical school, way before the Iraq war started. Was this more than you bargained for?
I have no regrets. Back then, the timing looked better. But you never know. Deployment in a war zone is a life-changing experience for the better, if you survive it. Everything is sweeter when you come back — to see how life is in other places and to see how lucky you are to come back with all your parts. You realize the more important things in life, like family.
Do you have a family?
My wife’s expecting our first child in August.
The documentary producers followed you and your colleagues for two months. Do you think they captured your experience accurately?
I haven’t seen the film yet, so I don’t know how it comes across. It certainly shows there’s a high price to pay for war. That’s the take-home point. The question is, is it worth it? I don’t think that answer will come for generations to come. I can only hope that the sacrifices in life and limb being made by Americans will be worth it, that their sacrifices will save hundreds of thousands of lives down the line, in a more stable Middle East.