Navy Doc's Memoir: 'On Call in Hell'

DATE May 28, 2007 ACCOUNT NUMBER N/A
TIME 12:00 Noon-1:00 PM AUDIENCE N/A
NETWORK NPR
PROGRAM Fresh Air

Interview: Martha Raddatz, news correspondent and author of "The
Long Road Home," on the situation in Iraq, the frustration of
being an on-site journalist, and families dealing with war deaths
TERRY GROSS, host:

This is FRESH AIR. I'm Terry Gross.

Black Sunday, as it came to be known, was the start of the battle in Sadr City
in which the First Cavalry faced Iraqi insurgents and had more casualties than
any single day since Vietnam. My guest, Martha Raddatz, has written a book
called "The Long Road Home" that reconstructs this battle which began on April
4th, 2004. Her book is based on interviews with the American soldiers who
were ambushed by insurgents. She also interviewed their families back home
about what it was like when they got news of the battle. Raddatz is the chief
White House correspondent for ABC News and formerly served as ABC's senior
national security correspondent. Before joining ABC, she was NPR's Pentagon
correspondent. Raddatz has been to Iraq 13 times since the start of the war.

Martha Raddatz, welcome to FRESH AIR. Why is this battle considered a turning
point in the war in Iraq?

Ms. MARTHA RADDATZ: I think it's the first time that the US military
realized, `There are people here who don't like us.' There had been sporadic
and very violent attacks, a few of them. There had been a few suicide car
bombings before that, but never such a wholesale assault on the US military,
and particularly in an area where the US military thought they liked us. This
was Sadr City, this had been under the thumb of Saddam Hussein for so long
that the military and civilians assumed that everyone would greet the military
with open arms. It's the thing you've heard over and over again. But this
city, this slum, personified that because they felt that they would believe
that the US military would come in there as saviors, and that day it was clear
they were not.

GROSS: What did they face? What did the platoon face in Sadr City that made
them realize this was an insurgency?

Ms. RADDATZ: Well, it all started out very quietly. They'd been patrolling.
It was a morning where they'd done sewage patrols, "honey trucks," as they
call them. The Iraqis would drive around and suck up sewage. There's more
sewage, raw sewage in the city than you can imagine. And they had been
escorting these trucks and they realized, first of all, that the truck
drivers, the Iraqi truck drivers, were starting to get taunted by some of the
people on the street for even being with the Americans. And they didn't think
much of that. And then, really, just very suddenly, they started being fired
upon. And it grew in intensity, and there were RPGs flying. This platoon, 19
soldiers out there, and an Iraqi interpreter, were under fire, pinned down.
They were in four humvees. Two of those were completely disabled and burning.
And the crowds grew. It wasn't just the Mahdi militia, Muqtada al-Sadr's
army. It was civilians. There were women. There were children. It grew
from hundreds to thousands of people on the street. And every rescue attempt,
there were more and more people attacking those rescue squads.

GROSS: The soldiers thought this was going to be a peacekeeping mission.
They thought it was a kind of routine patrol. How were they unequipped for
the insurgency that they faced?

Ms. RADDATZ: They were equipped for a peacekeeping mission. The Army--the
Pentagon decided that it would be bad to bring in a whole lot of tanks, a
whole lot of Bradleys, because then you look like an occupier. Those are very
bad in such a dense urban environment, and if you open fire you're bound to
have what they always call collateral damage, which means you can kill a lot
of innocent people. So when this platoon came under assault, when these men
were out there, they were in unarmored humvees. Some of them just had canvas
tops, and they were in open trucks. It's really extraordinary when I see
these trucks--in fact, when I was just back there a couple of weeks ago I saw
one of them, they're called LMTVs, and they're basically supply trucks, carry
troops around. But they are wide open. It is like a giant pickup truck. And
these soldiers hopped into these trucks to try and rescue this platoon in this
wide open truck.

GROSS: So what were the Mahdi militia's tactics in fighting the American
military during this battle in Sadr City?

Ms. RADDATZ: I think the oldest tactics that these soldiers--and some of
them were sitting in their vehicles thinking, `Oh, no, I've read about this.
I've seen this in the movies. This is horrible'--the tactics were often to
put children out in front.

There was a point when these soldiers were in this alley. They'd been pinned
down for about an hour. They'd taken refuge in this alley, and on either side
of this alley--and it was about 10 feet wide, lots of small concrete houses,
and they'd taken refuge in one of the houses with humvees parked in the
alley--on either end of that alley, they saw hundreds of Mahdi militia and
civilians lining up. And they would line up in tiers, and at the very front
they had children. Behind them, they had old people. Behind them, they had
teenagers. And behind them, they had the Mahdi militia. And the Madi militia
were firing over the heads of the children as they approached further and
further down the alley.

And Lt. Shane Aguero, who was the platoon leader, watched them, and he, in
his mind, calculated at what point his men had to open fire no matter what,
and--because he felt they'd be overrun. And he watched those children--he has
children of his own--most of the men looked at the children aghast, but at
some point they just started firing. They had to because the Mahdi militia
was firing at them. And the descriptions of what happened in that alley and
what was left in that alley are horrifying. They felt...

GROSS: Tell us a little bit about what did happen.

Ms. RADDATZ: There were, Lt. Aguero told me, probably 100 bodies on either
end of the alley piled on one another. Piles of shoes, piles of clothing, a
bloodbath in that alley. And Lt. Aguero and some of the other soldiers just
said, in their minds, it was kill or be killed at that point. Again,
horrified that they had to shoot children. But, at the same time, they knew
those were the tactics that often the Mahdi militia or other insurgents had
used over the years.

There was another tactic that some of the insurgents had used, and, you know,
Terry, I find myself here the same problem here of what to call the enemy in
Iraq since it's changed so many times, but we'll call them insurgents at this
point. And they would put a gun out--they would put an AK-47 out on a string
and they would pull the gun back to themselves, grab the gun, run out into the
alley and shoot at the soldiers. Or they would get children to stand out in
the alley and point out where the soldiers were firing from. They call those
kids "peekers," and they started saying, `There's a peeker over there,'
because the little kids would run around the corner and point at the soldiers.
They did not shoot those children because they were not armed, but they
would--if the insurgent would come around the corner, the Mahdi militia would
come around the corner and fire, then the child would usually run back.

GROSS: So those AK-47s on the string, was that meant to be a decoy, to like
deflect attention to the wrong spot while the real action was going to come
from someplace else?

Ms. RADDATZ: Actually, there was probably that, but it was also a way, if
the shooter was killed, they'd still have the weapon, and that they could pull
the weapon back.

GROSS: Another tactic the Mahdi militia used, which isn't as horrifying in
the sense that it didn't take advantage of children--it didn't abuse children
for this, but they would haul objects into the intersections. And talk a
little bit about this tactic.

Ms. RADDATZ: Well, that was what was astonishing. I've driven down these
streets in Sadr City so many times, and there are usually these lively markets
and they're selling vegetables and fruits, they're selling hubcaps; they're
selling almost anything you could possibly think that any human being could
sell. You have to imagine this, too, because it's absolutely lined with
sewage. And, I mean, you can smell the city from miles and miles away because
of the raw sewage. But the markets are out there.

The day of this battle, the day of this ambush, the entire town shoved
everything into the road as an obstacle course. It was a flaming obstacle
course within about 20 minutes after this platoon was pinned down. They had
piles of hot dog stands and--or what looked like hot dog stands, big metal
stands that we can identify from streets of big cities. They had kitchen
sinks. At one point, they had a giant metal staircase blocking one of the
routes. And basically what this did was block off any kind of rescue because
they would have these main routes on the streets blocked with all of this mess
that they pulled down from the markets.

GROSS: How did this battle in Sadr City finally end?

Ms. RADDATZ: The real battle there didn't end for 80 days because at the
same time that they pinned down this platoon, they took over--the Mahdi
militia took over every police station in the city. So as soon as they were
finished rescuing this platoon--and they lost eight soldiers that night, and
they had more than 70 wounded--as soon as they managed to get that platoon out
of there, they had to go try to re-occupy the police stations, take that back
from the Mahdi militia. But 80 straight days they fought to get those police
stations back, to get the city under control. They got it under control for
about a month, and violence broke out once again. And they fought for another
60 days, and look where we are today in Sadr City. It is a long way from
being solved.

GROSS: What is it like now in Sadr City?

Ms. RADDATZ: You can't go in. I was there two weeks ago, and it's the first
time--I mean, think about this and how long we've been there, how long ago
this battle was. It was not safe for anybody to go in. The military wouldn't
take us in, and it is such a political firestorm there right now, as you
probably know, that the Maliki government has been accused of being in bed
with Muqtada al-Sadr. He is now in the political arena. But he controls that
town without question.

GROSS: Al-Sadr controls the town?

Ms. RADDATZ: Al-Sadr controls that town without question. The last time I
went into Sadr City in August of last year, you could see Mahdi militia
members along the streets still toting AK-47s. We went in there very quickly
and got out of there quickly. I went back to see the alley again, which is a
place I like to see to sort of get a feel for what's going on in Iraq, is to
return to that alley as often as possible. But this time there was no chance
we could go in there.

GROSS: My guest is Martha Raddatz, ABC's chief White House correspondent.
Her book about the battle of Sadr City is called "The Long Road Home." We'll
talk more after a break. This is FRESH AIR.

(Announcements)

GROSS: Martha Raddatz, White House correspondent for ABC News. She's been to
Iraq 13 times since 2003. Her book "The Long Road Home" is about the battle
in Sadr City that was a turning point in the war in Iraq. It was the first
sign that there was a major insurgency against American troops.

Did the families at home hear about the battle first through cable news or
through calls from the military?

Ms. RADDATZ: The families--there's something called a Family Readiness
Group--and the Family Readiness Group, the brigade commander's wife, the
battalion commander's wife, LeAnn Volesky and Connie Abrams both first started
hearing about the battle from calls from Baghdad. They didn't know who had
been killed, and it came as, `Two dead, four dead, get the care teams ready'
who would go out and help take care of the families.

But the notification comes from the knock on the door. The notification
always comes from the knock on the door. People had probably started hearing
a few things about a battle in Sadr City. I know Cindy Sheehan heard about
the battle in Sadr City, and she immediately said, `Casey's dead.' And her
husband said, `No, no, no. There are 160,000 troops over there. There's no
way he's dead.' And by the time the notification teams got there, she was
convinced that he wasn't. But when the knock on the door came--that's how
they do it. They only do it before 10 PM and after 6 AM. They won't do it in
the middle of the night, and the reason they don't do that is they don't want
military families to go to bed thinking they could get a knock on the door in
the middle of the night because they know no one would ever be able to sleep.

GROSS: Colonel Abrams, who commanded the division's 1st Brigade in Sadr City,
was the son of General Creighton Abrams who was in Vietnam, and the Abrams
tank is named after him. But although Colonel Abrams had been in the military
for about 22 years, until Sadr City, you say he'd never heard a gun fired in
battle. How is he changed--you know, this person from an illustrious military
background--how is he changed by actually being in battle?

Ms. RADDATZ: Colonel Abrams, who I describe as a--his soldiers joke that
he's a natural born killer, given his family history--is the most
straight-ahead, salute-sir colonel you've ever met. Always the colonel. He's
a wonderful, warm guy, but he is very military. I talked to Colonel Abrams in
Sadr City. They were just about to go back home. And he was, you know,
ramrod-straight posture in his uniform and practically saluting me, and I ask
him a very simple question. I said this: `Tell me what your year has been
like.' And the division, by the end of the year, had lost 168 soldiers either
in battle or through accidents, and Colonel Abrams started talking, you know,
very clipped sentences, and then he said, `It's been hard on our families,'
and he could not continue. He burst into tears.

And he was so upset by this that, as soon as we finished, he was calling me
saying, `I can't believe I did that. I'm totally humiliated. You're not
going to use that, are you?' And I said, `Colonel Abrams, it is a lovely,
lovely tribute to your family and to the military, and yes, I am going to use
it. And I promise you it'll be used tastefully.' And he, later that evening,
e-mailed General Peter Chiarelli, who is the division commander, who's in
Baghdad--they're all in Baghdad still, and I am too. And General Chiarelli
did one of those great things, which is, he forwarded me this e-mail
unbeknownst to Colonel Abrams, who he later told--we both told--and the e-mail
said, `General Chiarelli, I try to make the division proud, but today I let
you all down. I was interviewed and got emotional when talking about our
families. I'm sorry to let you down, sir.' And General Chiarelli wrote back
and said, `You would have let us down if you'd done anything else.'

So, to me, to see how heartfelt and how much pain these soldiers have from
this--and their families--but that they go back and do it the next day--I
mean, the next day--they were fighting for 80 straight days. And the 1st
Cavalry division is back in Iraq now.

GROSS: Why did you use that scene of Colonel Abrams breaking down and talking
about what his family had been through? Why did you use it after he asked you
not to?

Ms. RADDATZ: He never frankly said, `Don't use this; you can't use this.'
But I think he understood how powerful it was, too. I think it's good for
Americans to see that our military has heart, has suffered in this battle,
gets up every day and does it again. I mean, to me, when I see someone like
Colonel Abrams and I see the pain, the depth of pain, it is remarkable to me
that people don't understand, or that none of us have paid enough attention to
this conflict.

I went through a period where I would tell people, `Please, please, just when
you read the paper, read the names of the dead. Do that. It's the least you
can do.' None of us have paid any price for this war, outside of those who
have family members there or who have served. None of us. Yeah, people can
put up a yellow ribbon, but you still go shopping every day, you still go out
to dinner, you still mow your lawn, and you don't think about it.

There is a greatest diversity in the military community and in their families;
you can't imagine it. Their families, they're like us, but they have
experiences unlike those we will ever have. And it is important for us to
connect with them, to somehow know what they're going through and not just
say, `Aren't they great?' as if they're our, you know, hometown football team
and go on and do whatever we do.

GROSS: As the White House correspondent for ABC News, what's it like for you
to hear often pretty upbeat press briefings from the White House about how
we're doing in Iraq and what the outcome is going to be when you've been there
and you've seen and heard really gruesome things? You can't even get into
Sadr City right now. Is there often a real disconnect between the briefings
that you get and what you see when you're in Iraq?

Ms. RADDATZ: Oh, is there ever! And believe me, it can drive me crazy. And
there've been a couple of times when I've just been back--and, in fact, the
president had a briefing just a couple of days after I got back from my last
trip, and he actually--he knows I go. He asks me about the trips. He's
pretty respectful of it, and he also knows I know what's going on there. And
I think it is an advantage for me, because they know I know. I feel like I
can ask better questions at some of the briefings, but here's the problem: It
doesn't mean you get better answers.

And I think the press corps in general is getting far more aggressive about
saying, `Wait a minute. That's not really what's happening.' I mean, I
remember the day that they came out and glowingly said they're going to start
all these provincial reconstruction teams around the country and they're going
to double the size and asking, `Well, wait a minute. They can't even staff
the ones they've got. They're not working. You've got a few people. You've
got some unqualified people. The military is filling all the bills because
you can't get civilians from the State Department to go over there. How on
earth are you going to double the size?' And it was just sort of, `We are, we
are.' I mean, I know, I've been there. I've seen it.

It is actually disturbing to me--when I first started covering the White House
and I first started hearing this, I thought, `This is difficult. This is
really difficult because I know what's going on.' Now I've also listened for
years and to years of Rumsfeld saying it was the media's fault and we're not
reporting the good news. I mean, the truth is, we're there. We are covering
that story because the US military is still there after four years and because
it is still not under control. I mean, I heard General Casey say in one of
his last hearings, Americans would not be safe walking around 50 percent of
that country, and that's very true. It might be more than that.

GROSS: Martha Raddatz, thank you so much for talking with us.

Ms. RADDATZ: Thank you.

GROSS: Martha Raddatz is the chief White House correspondent for ABC News and
NPR's former Pentagon correspondent. Her book about the battle in Sadr City
is called "The Long Road Home." Our interview was recorded in March. I'm
Terry Gross, and this is FRESH AIR.

* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *

Interview: Dr. Richard Jadick talks about his deployment as
battalion surgeon during the battle of Fallujah in Iraq in 2004
TERRY GROSS, host:

This is FRESH AIR. I'm Terry Gross.

In November 2004 US troops launched a full scale siege in the Iraqi town of
Fallujah. My guest, Dr. Richard Jadick, was in charge of medical treatment
during this month-long urban battle against an estimated five to 9,000
insurgents. Instead of setting up the medical aid stations safely behind the
front lines, he set them up in the middle of the fighting to get to the
wounded quickly. His battalion, the 1st Battalion, 8th Marine Regiment, had
21 men killed in action. That fell below the 30 to 40 percent casualty rate
predicted for the battle. Commander Jadick received a Bronze Star with a
combat V for valor.

Just before deploying, Jadick had been working as a surgeon with the Marines
at Camp Lejeune. When he heard that there was a shortage of military doctors
going to Iraq, he volunteered, even though he was 38, older than most
battalion surgeons, and his wife was about to have a baby. After returning
home from Iraq, he was the subject of a Newsweek cover story. He's written a
memoir called "On Call in Hell: A Doctor's Iraq War Story."

Dr. Jadick, welcome to FRESH AIR. Would you describe what the American
soldiers faced in the battle of Fallujah in 2004?

Dr. RICHARD JADICK: Sure. I think every American soldier, Marine and sailor
who went in was really looking at a well-dug-in defensive system of insurgents
who had been there for quite some time. Fallujah was never really occupied or
patrolled very seriously by the American forces before any of this, and then
it became a hotbed of insurgency. So the insurgents had their way, throughout
the city, to dig whatever defensive systems, perimeters, set up makeshift
hospitals, that kind of thing, for a long time. So we were looking at a
well-entrenched urban fight that, I think, really kind of, as you look at
weapons systems, takes away some of the technical advantage that our military
has.

GROSS: Now, you basically set up aid stations in the heart of the battle of
Fallujah. You were working under enemy fire. Why was it important to you to
set up aid stations in the battle, as opposed to doing it more safely in the
rear, which was typically what's done?

Dr. JADICK: Well, when I began looking at the plan--and I really, I looked
at, every time we went out on our operation or some sort of patrolling system
where we had our troops somewhere, I always looked at it as to how was the
best way for me to care for the Marines that were out there. That's my job,
so it made sense for me to really analyze this urban battlefield and figure
out how can we get the Marines most efficiently to medical care. And what
made sense to me, and what has always made sense to me was not trying to bring
the Marine to the medicine, but bring the medicine to the Marine.

And when I went, initially, prior to the battle--we went on a recon--I went
with the command element, and we went out around the perimeter to draw fire,
it was obvious to me that this was a long drive from there back to the
surgical hospital to get any kind of real treatment, and once you got into the
middle of the city, you never knew how long it was going to be from getting a
Marine from the point of injury back to any kind of care. So my thought, and
when I presented it to the colonel, the thought was let's get our people as
far forward so that there's only a five minute difference between the time
they're injured and the time they get some significant medical care.

GROSS: So what kind of places did you set up your aid stations in?

Dr. JADICK: Well, we set--and, really, it was two aid stations. I set up a
very full, robust aid station at the--really at the forward edge of the battle
area, what we call the FEBA. We had an assembly point just behind the FEBA.
I set up with the second physician--there's two physicians in a battalion--and
he ran most of the corpsmen. I took six other corpsmen into downtown Fallujah
at the government center, and in a little prayer room inside that government
center, we set up our second aid station. And what that did to us was give us
one aid station that would cover the whole southern end of the battlefield and
one aid station that would cover the northern end. So it really was, you
know, five minutes from point of injury to a physician or a significant
provider with trauma experience.

GROSS: What were the typical wounds that you saw in the battle of Fallujah?

Dr. JADICK: The typical wounds, because of the body armor that we all wore,
were extremity wounds. We saw a lot of, you know, arm, leg wounds, and some
significant head wounds. The wounds, though, that we saw that were really
concerning were anything that got in between the plates in the upper body
armor, which didn't happen, really, too often. I had a couple of shots to the
chest, but the other one that was very life threatening was there was a lot of
wounds to the inner groin area that became--that became the wound that was,
really, the most concerning. Because all the vessels that are packed in
there, and the difficulty it is. You can't put a tourniquet around it, you
have to really just put your hand in there and pack it. So those were the
wounds we saw, and we learned very quickly how to deal successfully with the
groin and kind of chest wounds.

GROSS: Well, why were there so many groin injuries? Was there no body armor
in that area of the body?

Dr. JADICK: There is not. You know, it's a joint. It's very difficult to
put any kind of armor in there. You know, you could armor a--you could put a
Marine in complete armor, but then he doesn't move around very well. So
there's trade-offs. You need to armor as much as you can, however you don't
want to--you're giving a guy an extra 12 pounds of body armor, as well as a
very large contingent of ammo and the gear he's going to need to be through
the city and live for anywhere from two to four weeks. So adding more armor
makes it difficult. I thought--I took it as our challenge was to figure out
how to save those people who were shot in those areas, and I think, you know,
that we were very successful with that.

GROSS: What was it like the first time you treated a severe groin injury,
before you figured out how to treat it?

Dr. JADICK: I'll never forget, the first time was the day after the battle
kicked off, and we had gone into the city. And once in the city, we got a
call. I was in the ambulance, and we were taking one Marine out who'd been
shot in the chest and--actually it was a Navy corpsman Force Recon kid. And
we got a call to go into the middle of an ambush area, so we moved the
ambulance down there, and that's when I saw my first groin injury, and it was
Sergeant Lonny Wells. And he came over and--it was relatively chaotic, but I
did everything I could. I packed that wound, I tried to stop the bleeding and
I couldn't. And I had six other wounded Marines, so triage became what I had
to do, very dirty work sorting out and moving on. And as I rode back in the
ambulance, I played this over in my mind a million times, what did I do or
didn't do that could've changed this course of events for Sergeant Wells.

And Sergeant Wells became a pivotal point where I realized that we were there
pretty quickly, and I got to him before he lost all, you know, before he
passed on us. But I didn't do the right things to save his life, and I wasn't
sure why I wasn't able to pack that wound tighter or make the move to change
the course of events. So when we got him out of there, I really thought about
it for about an hour, because that's all the time I had before PFC Volpi came
in with the same wound. He had the same wound, he was unconscious, and pale
as a ghost, and in shock. And he came in, and I realized that I didn't pack
tight enough on Sergeant Wells, and that I needed to put my hand in there and
grab everything I can and just keep as much compression on his vessels. And
that's what I did, we pushed some fluid in. The outcome was a lot different
for PFC Volpi.

After that, as I sat down and kind of reworked this thing, I knew that we had
to be as close as we could, because these kids will bleed out in five, 10
minutes. And I also knew that we were going to need to really be aggressive
in treating any kind of bleeding, with tourniquets and compression and IV
fluids.

GROSS: How do you do triage in the middle of a battle?

Dr. JADICK: You look at your wounds, you look at what's around you, and you
assess. Really, my triage was, `Who can I get to and save their life within
the next three minutes by some sort of intervention? Anybody who's going to
require more of my time than that, I don't know if I can spend that much time
with them.' And that's it. I mean, there's NATO and US triage categories, but
I really didn't use many of those. I used those who aren't going to die no
matter what I did and they were just wounded, those who were going to die if I
didn't do anything, and those who were going to take too much of my time that
the others may pass away because I spent too much time with them.

GROSS: My guest is Dr. Richard Jadick. His memoir is titled "On Call in
Hell: A Doctor's Iraq War Story." We'll talk more after a break. This is
FRESH AIR.

(Announcements)

GROSS: My guest is Dr. Richard Jadick. He's written a memoir called "On
Call in Hell" about being a doctor during the battle of Fallujah in 2004.

There were things that you learned to improvise in Fallujah, like warming IV
fluids by taping them to people's bodies because it would get cold sometimes,
and the cold IV would be very bad.

Dr. JADICK: Right.

GROSS: So what are some other things that you learned to improvise with
experience?

Dr. JADICK: Everything we do out in the military seems to be improvisation.
You've got a certain amount of gear, but there are other things that you can
utilize. We improvise every day by trying to figure out where are we going to
set up our aid station. Our aid station happened to be a perfect place
with--you have to think about access to it, you have to think about putting
stretchers in it and getting gear for it.

We improvised. When it got cold, we improvised with the fires. We had the
engineers kind of open up some holes in the wall, and we built little
fireplaces in the wall. And when we knew that casualties were coming, we
always had embers burning in there and then we'd stoke them up because it got
very cold. It got to 25, 26 degrees after Thanksgiving. So when that
happens, you can't--you're going to--what you're going to wind up doing is
bring a patient in, taking their clothes off, and figuring out where their
wounds are and trying to plug these holes, but you're going to make them
hypothermic. So we had two fireplaces going in our second aid station that we
would just kick up, and you would sweat in the room when those things were
going. So it really did work.

And innovation is not--certainly wasn't my innovation. It was the corpsmen's
innovation. They would come up with things that, you know, transfers of
patients into the ambulances; and how to use a loading dock was key, because
we could move patients in and out faster when we had that set up. So we
looked at everything out there as the opportunity to kind of improve your
situation.

One of the corpsmen came up with, you know, we have to make latrines when we
go out, or what we call in the Navy "heads," and he came up with just a
fantastic way to make heads out of sandbags. And it made it a lot more
comfortable for anybody who had to use one.

GROSS: Now, you were talking about how a lot of the injuries that you dealt
with were bleeds, and what you did was often like pack the wound or apply a
tourniquet. But some of the injuries you saw were brain injuries. How do you
deal with those? Like, a tourniquet isn't going to do the job?

Dr. JADICK: Yeah, you just--for the most part, for brain injury, you're
bandaging the head and sending them out and trying to stabilize them as best
you can. And I look at, you know, their airway, their circulation, whether
they've got any other bleeds going on. But I will tell you that, in triage,
if, on the battlefield, somebody is displaying brain tissue or gray matter,
then there's very little you can do for them, and for the most part, comfort
is what you give them. And we did that on occasions.

GROSS: Were you able to call in medevacs? Were they able to arrive quickly
for the injuries like brain injuries, where there wasn't much that you could
do?

Dr. JADICK: There were no helo-evacuations out of the city, which is kind of
where my--as the plan was being put together, we thought about, `Hey, where
are we going to have a helicopter support?' There really wasn't any way they
were going to let helicopters fly over the city where they didn't know what
kind of weapons and RPGs were going to be involved in all these rooftops. So,
because they were really trying to prevent a "Black Hawk Down," and I can't
blame them for that, we, on the ground, had to be more innovative about our
evacuations.

So I evacuated--we did all self-evacuation. Everybody I had who was wounded
and in the 1st Battalion, 8th Marines, went back to an ambulance exchange
point, which was way back about a mile and a half from my forward aid station.
But a lot of times it was through Indian country, so there were--and the roads
weren't good, so I wanted to make sure that my guys were very stable before
they made that trip, and then once they got back there we'd exchange them with
an ambulance that would take them into the combat surgical hospitals, or Bravo
Surgical, which happened to be the surgical company that was taking care of us
in Camp Fallujah.

GROSS: Was it difficult for you to decide--I assume it was like your job to
decide when a Marine should be sent back into battle, if their wound was
manageable enough that they could return to battle. Were those hard decisions
to make?

Dr. JADICK: They are. It is my decision. It was never a decision I took
lightly, and I will tell you that, on one occasion, I had a Marine come in who
had been shot through his helmet and he just walked in with his helmet under
his arm and said, `Doc, I really--my head's killing me,' and we looked at his
head, and he had taken a sniper round that grazed the top of his scalp. He
had splayed it open, but it didn't go through the bone. So he was probably
the luckiest man I'd I've ever seen. The decision that day was, `You need to
go home. At least take the next couple days off and come rejoin the group
after you get that thing washed out.' So we sent him home.

Unfortunately, most of the Marines wanted to go back very quickly, and I
treated, that same day, a young lance corporal, Demarkus Brown, who just
really had a lip laceration. And one of the corpsmen sewed it up, and he
wanted to get back out there. And so we let him go, and his wound was pretty
minimal, and our job is really to maintain the fighting force. That's what we
need. We need people who are putting rounds down range, and my job is really
to make sure that that's happening and that people aren't just leaving. And I
never had that with the 1st Battalion, 8th Marines. People did want to leave,
and Demarkus Brown wanted to get back to his unit. So we sent him back out.
Unfortunately, Demarkus Brown came in the next day with a chest shot and
didn't make it.

GROSS: Sometimes the Marines who you saw were so mangled you couldn't tell
who they were until reading their dog tags, and because some of these men were
men who you'd known and already worked with, that must've been pretty
upsetting.

Dr. JADICK: Yeah, it was. It's extremely upsetting. I think, for me, as an
older person, it was something I really did compartmentalize and didn't deal
with until I was gone. But I knew that the corpsmen who live with these guys
and knew them well, there was a moment, on almost every Marine, because they
came in very--even if they were OK, they were beaten up, they were bloody and
they were dirty. They were covered in mud, and if they came in and they
weren't with us anymore, if they were not alive, then there would certainly be
some very serious wounds that were going on, and nobody really would
understand who the Marine was until we started really look into finding the
dog tags. And there was this, what I call the moment of realization, and it
was sad to watch. Because people didn't know, and all's they knew was they
had a Marine there, and then they would realize that that Marine was somebody
they might've lived over top of them, somebody that they had gone out and
drank beers with back at Camp Lejeune. And it was always a difficult thing to
deal with for these kids, as they would have to put them in body bags and we'd
have to evacuate them out of there.

GROSS: My guest is Dr. Richard Jadick. His memoir is titled "On Call in
Hell: A Doctor's Iraq War Story." We'll talk more after a break. This is
FRESH AIR.

(Announcements)

GROSS: My guest is Dr. Richard Jadick. He's written a memoir called "On
Call in Hell" about being a doctor during the battle of Fallujah in 2004.

In addition to treating Marines in the battle of Fallujah, you treated some
civilians. You also treated some insurgents. Why did you treat insurgents?
And what do the rules of war have to say about treating the enemy?

Dr. JADICK: Well, the rules are that you're supposed to treat everybody
that's out there on the battlefield. First of all, you know, I'll say that
because of my Hippocratic Oath, the oath that I've taken to become a
physician, I was going to treat everybody anyway. I didn't have a problem
with that. I was able to come to terms with the fact that, you know, if
they're insurgents, I am--it's not my job to judge what--who lives and who
dies. It's my job to put my skills to effectively treat and manage their
wounds.

Now, there were some bad men that came through my aid station that I treated,
and the way I discussed it with my corpsmen who were having problems with it
was, you know, these are guys who--they wanted--they stayed because they
wanted to become martyrs, to become a martyr they have to die, and if we can
keep them alive, then that takes away the only reason they were here. So it
was a little reverse psychology, but in reality our job was, on top of that,
to provide a healthy patient to the intelligence people so they could talk to
them and try and get some sort of information out of it, so that in the future
they--we can save our own, you know, our Marines, our lives.

And then there was always the fact that sometimes a poor guy came in that may
have been caught up, may have not--may be an insurgent, and I just didn't
know, and I wasn't there to make that determination. So I treated everybody
very equally. I never had the situation where I had to make a choice between,
`Do I treat a Marine or do I treat an insurgent?' It was always at an
appropriate time that I could treat either one equally.

GROSS: What about the security aspects of the insurgents in the same aid
station as the Marines were, and did you have to worry about security even
though the insurgents were wounded?

Dr. JADICK: Absolutely. No insurgent came into the aid station without
having two Marines on him and having been completely strip-searched. Even
then, I had probably four or five known Iraqi insurgents that they had dug out
of a house, and they came into us, and one was sitting on the ground,
blindfolded, hands tied behind his back and he bit into one of my corpsmen.
So even then safety--I mean, you always have to be on guard, and we always had
a very well-trained force of Marines who would stand off and watch us treat
the patients because the last thing I wanted to do was have my corpsmen with
weapons trying to do that and treat a patient and then the insurgent can
actually get a hold of a weapon. So we were very thorough in how we dealt
with insurgents who came in, and always concerned, paramount over everything,
was the security of ourselves, and the Marines did a very good job of that.

GROSS: So when you were treating insurgents who knew that you were an
American doctor with the Navy, did they look at you like they really would
prefer to kill you, or did they look at you with gratitude for treating them?

Dr. JADICK: There was never--and it was different with different people.
The hardcore insurgents never looked at me with gratitude. They hated
everything I stood for, everything I was about. But, you know, hate's a
painful thing to carry around with you, so I tried very hard not to have that
with me. I wanted to get rid of it, do what I had to do and be proud of what
I did and not walk around with this significant hate that would eat me up
inside. That's what these guys had. I mean, they had a burning hate.

There were quite a few kind of lower-tier insurgents, guys who probably didn't
think that we'd actually come through, who were paid to stay in town--not paid
a lot of money but more money than they'd probably see ever in their lives,
and these were guys who did feel relief that they had been captured, relief
that we were treating them and, hopefully, when they go back and they're
offered a couple hundred bucks to do the same thing again, they think about it
and say, `Well, I don't know. It doesn't make sense.' So that's what we did.
We worked hard at treating them all the same.

GROSS: Well, I want to thank you very much for talking with us and wish you
good luck. Thank you.

Dr. JADICK: Well, thank you very much. It's been great to be on the show.

GROSS: Dr. Richard Jadick's memoir is titled "On Call in Hell: A Doctor's
Iraq War Story." Jadick received a Bronze Star with combat V for valor for his
work during the battle of Fallujah.

(Credits)

GROSS: I'm Terry Gross.
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