Mass Casualties

I cannot speculate on what exactly caused the incident. I will tell you that 13 bodies came in at once.

I was sitting in the sparrow’s nest at the gate with one of the designated marksmen toying with my new camera when the call came over the radio that I was needed up to the front. I ran down two flights of stairs and into my ambulance. As I was pulling up the lane to the front of our gate I could see two gun trucks escorting two pickup trucks. In the beds of the pickup trucks were probably 4-9 Iraqi townspeople standing around.

I pulled my ambulance way off to the side and all of the people had exited the beds of the trucks. I could hear the townspeople wailing, but my attention was immediately diverted to what was remaining in the pickup trucks. 13 bodies were still in the beds of the two trucks; some of them not moving. I ran up and started to try and figure out what to do. I made a quick count. “I’ve got ten patients down here and some DOA.” I didn’t have a clue if I was right, but I knew that we needed more help. Soldiers from the gun trucks had started to help people out of the vehicle beds and on to the ground. One of the soldiers asked where the litters were. I started to tell people to pick a person and treat. I dumped my aid bag onto the ground in between the tailgates of the two trucks. “Take what you need and do what you can!” I ran over to a child and started to assess him for a second. A call came over the radio asking for the names and ages of the patients. A Lieutenant from the gun trucks, god bless him, said, “This is a triage situation right now!” I snapped my self away from the child.

I had fallen into that old medic trap of wanting to jump in and treat. But in a mass casualty event, the only medic on scene has to work as a command and control. I started to order more people to treat and tell me what they had. “I got a baby with bleeding from the head! Probably a fractured skull!” I looked for the best turn around for an ambulance. “Ok. Put them over there! Our worst go over there!” I could hear several people yelling, “Doc”, but it all seemed to sound like gibberish. I went to the next soldier. “I have this lady and she’s got shrapnel all over… I can’t even move her without her screaming in pain.” She got put on the stretcher face down and moved to the urgent pile. “Doc, this boy is going down fast!” I looked at him and he was covered in blood and shrapnel holes. I could hear the sirens of other emergency vehicles coming down the lane. “Do what you can.”

I went over to the first pickup truck where there were bodies, but no one really treating. There were five kids, all about 7 or less piled in like sandbags. They were all ashen. I could see a golf-ball sized hole in one’s back. Bone and meat were showing. Another had legs that were mush below the mid-femur. I moved in closer and could see the eyes of two of the other ones had glazed over. They were looking at each other in a sad puppy dog expression. I walked over to the right side of that truck bed and felt down for a carotid pulse. I don’t know why I did it. It was obvious that all of these kids had died. I looked right into the dark eyes of the small girl. I could see that there was blood on her clothes, but I could not tell where she had been hit. Her mouth was open as if she was stopped short in saying “ow”. Her eyes gave a sad wincing look of pain. Her lips and face had specks of dust that seemed to match her ashen appearance. Her lips were even on off-white. There was no pulse, no life.

The sound of sirens coming closer drew me out of my trance. I ran over and started guiding the emergency vehicles into place. I guided the ambulance to the set of 4 urgent patients. Two medics hopped out and started to move the litters by themselves. I grabbed the first people I could find and told them to start help in moving patients. I told one of the medics to back off the litters and direct patient flow. I ran over to the ambulance and started undoing the top berths. (The patient berths are where the litters slide into.) I helped in the ambulance with the loading of the four critical patients and then looked over at people trying to shove more patients into my ambulance. I told them to hold up and I had to ask, “How many patients were left?” “Just these three”, responded one of the guys. “OK, I guess I’ll take ‘em.” I had planned to stay just in case we had more patients, but I quickly changed my mind. We took a woman with a penetrating back wound, a boy with a penetrating wound to the arm and pain in one of his femurs, and a girl with a penetrating injury to the femur that had already been dressed.

On the way in, I felt kind of guilty. I’m pretty sure that the other ambulance had only one medic in back with 4 critical patients. My guilt was re-enforced when I saw his face at the hospital. I opened the doors on his ambulance and he was visibly frustrated. I dumped my three patients after his and I drove back to the gate. I sped so fast, that I almost flipped the ambulance on some loose rocks about ¾’s of the way back. My ambulance started to shift to the left and I did an awesome power-slide. Two officers saw the whole thing from about 100 feet away and threw their arms out at me.

They looked a little less than thrilled with me. So I did what anyone would do. I honked my horn twice, waved, and kept on towards the gate. No one else came in, but I was informed that there were 6 dead on arrival. The incident had hit a single family. The father had survived unscathed and he was taken to the hospital. He had lost his grandmother, wife, and many of his (and his extended family’s) children. I talked with everyone that I could about what they had done, and how things were. No one seemed really phased. (I guess, time will tell.)

The pickup trucks left while I was at the hospital and went to bury their dead. We could hear their gunfire at the cemetery. I guess there was a fear that they were going to organize and mob the gate. My fear is that there will be some serious mortar fire coming in for the next few days or a increase in IED’s.