Working with the Wounded: Tired, But not Numb

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Commentator Ian Black, who is Chief of Anesthesia at the 28th Combat Support Hospital in Baghdad, says he is tired of seeing wounded Americans and Iraqis. Reflecting on Christmas, Black says that he hopes at the end of the day, it will be the people — not the injuries — that he will remember.


This holiday season has been busy, and that means relentlessly bloody for Dr. Ian Black. Listeners to this program first met Dr. Black this past July in stories from the Brook Army Medical Center, or BAMC, in San Antonio, Texas, where he's the chief of anesthesia.

BAMC has the military's only burn center, treating those injured in Iraq and Afghanistan. Dr. Black talked to us about the burn patients who do pull through.

Dr. IAN BLACK (Brook Army Medical Center): These are incredibly stoic guys. I mean, they just want to be functional. I mean the difference between having all their fingers cut off or amputated and having a little bit of a nubbin so that they're able to button their shirt and go to the bathroom is enough to - that's what they're worried about. To be functional enough that they can take care of themselves.

BLOCK: A few months after we met, Dr. Black was sent to Baghdad. He's now chief of anesthesia at the 28th Combat Support Hospital there, inside the green zone. They're the front line of treatment for U.S. service members, employees and contractors. They also treat Iraqis who are in danger of losing life, limb or eyesight.

Ian Black took some time between surgeries to send us this essay about his experiences treating the wounded in Baghdad.

Dr. BLACK: It is Christmas, but I am tired. Tired beyond words, tired beyond measure. I'm not complaining. I have it easy. I have gifts from family and friends. I sleep on a bed and get warm meals. I'm inside the wire. I don't have to go outside the relatively safe green zone. I don't have to ride in the gun turret or kick down doors or go to the market and wait for a blast or bullet to rip me to shreds. I'm a soldier. I'm also anesthesiologist at the busiest U.S. military hospital in Iraq.

I just wait to see if there is anything to fix after the blast, after the bullet, after the crash. I'm tired of all these soldiers, all these people, dead and maimed beyond recognition, tired of wearing galoshes in the operating room because the blood is so deep. I'm especially tired of the wounded women and children.

Family and friends, even reporters, ask me what I think about all this. I do not answer, not because I have the good sense to self-censure, rather, I don't think about the larger picture. It seems a luxury. Perhaps, I will years later. For now, there are only the daily realities - my job, eating, sleeping, my colleagues and always the injured.

The wounded arrived day after day. The sound of helicopters is incessant. The injured are missing one, two or three limbs. They have bullets that have traversed every cavity from head to toe.

Some are lucky. The girl with a bullet lodged behind her heart. We cracked open her chest expecting a catastrophe, only to find a bullet that has inexplicably curved around her heart. She walked out at a hospital two days later. It is one of the many small miracles among the suffering Iraqis and Americans, friends and foes.

Some are not lucky. The soldier with the lethal head wound. The staff and his comrades stood to vigil in the ER. There was nothing we could do besides make him comfortable and offer a prayer. Here's how we say goodbye to a dead U.S. soldier. Suppose we're not busy, we'll stand along the helipad. We stand at attention and salute their broken body, salute a comrade we did not know, and then they will begin their long trip home.

It's not just the U.S. service members who are unlucky. There is the Iraqi official's wife whose eyes were shot out during an assassination attempt on her husband. There is another poor soul who was lit on fire. There is a contractor who had two arms blown off while shopping in the green zone, supposedly the safest area of Baghdad.

I feel embarrassed that after a few months, I've already forgotten so many patients, those who have been comforted and cured and the many who will die or bury their wounds for the rest of their days. What I hope I will remember most vividly are the people, not the injuries. I'm grateful to work among soldiers who go back into burning vehicles to pull their buddies to safety. I'm grateful to work with doctors, nurses and other medical staff I'd entrust my family to. I'm grateful to work among Iraqis who day after day take care of those around them, families and strangers.

But I wonder, I wonder why among all these brave, committed and intelligent people, the helicopters and wounded keep coming. I wonder if peace on Earth will ever mean the same.

BLOCK: Dr. Ian Black is chief of anesthesia at the 28th Combat Support Hospital in Baghdad. He will be there through March.

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