The text of this piece is an excerpt, slightly adapted, from Ann Jones's new book They Were Soldiers: How the Wounded Return from America's Wars—The Untold Story, just published by Dispatch Books/Haymarket Books
In 2010, I began to follow US soldiers down a long trail of waste and sorrow that led from the battle spaces of Afghanistan to the emergency room of the trauma hospital at Bagram Air Base, where their catastrophic wounds were surgically treated and their condition stabilized. Then I accompanied some of them by cargo plane to Ramstein Air Base in Germany for more surgeries at Landstuhl Regional Medical Center, or LRMC (pronounced Larm-See), the largest American hospital outside the United States.
Once stabilized again, those critical patients who survived would be taken by ambulance a short distance back to Ramstein, where a C-17 waited to fly them across the Atlantic to Dover Air Base in Delaware. There, tall, multilayered ambulances awaited the wounded for the last leg of their many-thousand-mile journey to Walter Reed Army Medical Center in Washington, DC, or the Naval Hospital at Bethesda, Maryland, where, depending upon their injuries, they might remain for a year or two, or more.
Now, we are in Germany, halfway home. This evening, the ambulance from LRMC heading for the flight line at Ramstein will be full of critical-care patients, so I leave the hospital early and board the plane to watch the medical teams bring them aboard. They’ve done this drill many times a week since the start of the Afghan War. They are practiced, efficient and fast, and so we are soon in the air again. This time, with a full load.
Two rows of double bunks flank an aisle down the center of the C-17, all occupied by men tucked under homemade patchwork quilts emblazoned with flags and eagles, the handiwork of patriotic American women. Along the walls of the fuselage, on straight-backed seats of nylon mesh, sit the ambulatory casualities from the Contingency Aeromedical Staging Facility (CASF), the holding ward for noncritical patients just off the flight line at Ramstein.
At the back of the plane, slung between stanchions, are four litters with critical care patients, and there among them is the same three-man CCAT (Critical Care Air Transport) team I accompanied on the flight from Afghanistan. They’ve been back and forth to Bagram again since then, but here they are in fresh brown insulated coveralls, clean shaven, calm, cordial, the doctor busy making notes on a clipboard, the nurse and the respiratory therapist checking the monitors and machines on the SMEEDs. (A SMEED, or Special Medical Emergency Evacuation Device, is a raised aluminum table affixed to a patient’s gurney.) Designed to bridge the patient’s lower legs, a SMEED is now often used in the evacuation of soldiers who don’t have any.