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He was shot; four months ago—nearly to the day—in a stinging attack that caught the American soldiers driving Humvees through Mosul. But Command Sergeant Major James Pippin realized they were in a “nearside ambush,” and ordered his driver to assault directly into the RPG and machine gun fire. Riding the offensive momentum, the American soldiers dismounted their Humvees, moving into the attack, disorganizing the ambushers. Pippin shot one in the face. Then a bullet found him.
As supersonic rounds snapped through the air, one bullet tore through Pippin’s right calf before it smashed into his left leg. His tibia shattered, Pippin fell to the ground as the firefight raged on around him, bullets popping off the Humvees. While their buddies continued to fight, American soldiers and an Iraqi interpreter pulled Pippin from the open into a Humvee.
Pippin’s attack into the ambush had broken the enemy effort, but he was bleeding all over the Humvee. Humvees are terrible for medevac; there is no way to lay a soldier down. Sometimes, when the bullets are still flying, the best option for wounded soldiers is to stick the wounded and any disassembled parts inside the Humvee and race to a hospital. Pippin was driven to one of the nearby “Combat Support Hospitals” (CSH).
I was in Anbar when word came that Pippin had just been shot in Mosul. I remembered our first encounter. Pippin didn’t have much use for the press, but through time he eventually invited me to cover his soldiers. I’d spent about five months in Mosul in 2005, at a time when we had about 9,000 Stryker soldiers there. When I returned to Iraq’s third-largest city in early 2007, we were down to a single battalion, or roughly 700 servicemen and women, of which maybe 400 were actual fighters. I spent about a month with Pippin and his soldiers, writing about their efforts to hold fast against any erosion of gains, as Iraqi security forces increasingly carried load.
Soon after my embed with the 2-7 CAV ended, I made one other visit to a CSH. Among the many wounded was one soldier who had been terribly maimed by an IED during an ambush. It is hard to describe the extent of his injuries. These CSHs host a daily array of gunshot wounds of every description, traumatic amputations, and severe burns, but his wounds were horrible even by those standards. As blood soaked through his bandages, a pretty young nurse walked out into the hall and burst into tears. A doctor called the soldier’s father, and gravely related the truth: the staff would try to keep him alive until Germany, so his family could be there at the end.
After some time, a C-17 was ready and waiting to make the “Mercy Flight.” This particular plane had been arranged into a sort of flying clinic.
Still wearing full combat gear, some of his buddies were there to see him off from the CSH. Other off-duty soldiers were there to help load the wounded onto the buses, which drove us all to the C-17 parked on the tarmac. We roared into the night, heading to Landstuhl, Germany. During the flight, the nurses steadily checked the patients, especially the dying soldier, farthest back on the plane. While this flight was very unpleasant, there are worse: the “Angel Flights,” as the soldiers call them, are for soldiers who return home in flag-draped coffins.
I’d seen Pippin and his soldiers load comrades onto Angel Flights in Mosul. In those cases, an aircraft goes to the major bases, picks up the coffins and flies home. Many soldiers’ hearts make it to Landstuhl before finally succumbing. After their Angel Flight home, it’s often one last flight to the airport nearest their hometown before being laid to rest under the cracking of rifles and the stirring flare of final taps.
After some time in the back of the C-17 sitting with patients, I went to the cockpit to talk with the pilot, looking at glowing instruments, occasionally seeing another jet streak by in the night, its ice trail glistening off the moonlight. Peering out the windows at the stars above, I remembered reading once that on a clear night a naked eye can make out roughly 2,000 individual stars. I wondered if it were true.
We glided down through the German night, where a large group of staff waited on the tarmac to load the patients into buses. During the bus ride to the hospital, electronic monitors beeped, IVs dripped, and the patients’ litters were jostled by the road. The ambulatory among us steadied the patients, to protect them from further pain.
Once at the hospital, the back of the bus was opened and we handed down the patients to volunteers and medical staff. Those sick and wounded who were able to communicate were greeted by liaison representatives from their service branches. Over the next couple of days, I saw these liaisons doing exemplary if inglorious duty, completing the paperwork that attends any and all aspects of military existence, making sure patients understood their options and advocating for services or resources.
The system for treating wounded soldiers and civilians is an example of the military at its best: the CSHs around Iraq, the “Mercy Flight” to Landstuhl, and then the Landstuhl staff itself, was among the best. It always amazes me that a soldier who is wounded in some strange Iraqi village in the morning, through a system of fast ground transport and aircraft, is in a top medical facility possibly before midnight on the same day. The first-class treatment and service for the patients, at every step of the way, has long been a source of both pride and controversy. It framed more than one dispatch, including Gates of Fire:
It was near 10 PM when the airplane that would start their journey back to America landed outside, its engines rumbling the hospital floor. The terrorist who shot Kurilla, and who was now a eunuch in a nearby bed, might well have been the same terrorist who, after being released, shot Lama and Thompson and others. Kurilla could see Khalid Jasim Nohe, but made no comment.
As Captain McGrew and I drove through the dusty darkness back to the Deuce Four, the Commander and SGT Lama, along with other wounded and dead soldiers from around Iraq, began their journey home.
. . .
Over lunch with Chaplain Wilson and our two battalion surgeons, Major Brown and Captain Warr, there was much discussion about the “ethics” of war, and contention about why we afford top-notch medical treatment to terrorists. The treatment terrorists get here is better and more expensive than what many Americans or Europeans can get.
“That’s the difference between the terrorists and us,” Chaplain Wilson kept saying. “Don’t you understand? That’s the difference.”
Over the next couple of days in Landstuhl, dozens of wounded soldiers told their stories, and although soldiers can complain about most anything, no one had a single serious complaint about the treatment they’d received from the medical teams.
Everyone, it seemed, felt cared for, including the families who swarmed in from America and other places. The airplanes kept coming from Afghanistan and Iraq, seven days per week, and many families were there to greet wounded soldiers. While these journeys are most often a source of comfort for patient and family alike, they also can be cauldrons for stress. One mother cried hysterically despite her family’s efforts to quiet her. Another mother and daughter-in-law got into an emotional dispute about where to bury the dead soldier who was once both the mother’s son and the wife’s husband.
The soldier who had been ambushed by the IED in Iraq was expected to die very soon. I was a few feet away when a call came in from a close family member. The family member did not inquire about his condition or what happened. This family member only wanted to know when the soldier would die, and who would receive his death benefit. In less civilized times, people like that roamed the battlefield with tools to pry gold teeth from the jaws of fallen soldiers, but it was distressing to imagine that a family member would do the same.
For the wounded, the medical staff and liaisons kept the focus on the needs of the patients. For the family members, there were civilian groups like Soldiers’ Angels and Fisher House providing comfort and succor.
Once back in America, the quality of care is apparently not as consistently excellent or compassionate. I get frequent and disturbing reports from veterans that the strained if not broken system tends to be uncaring and often is just flat incompetent. It seems counterintuitive that the system would break down, not under the stress of combat conditions, but back there on stable American soil. Yet, I hear versions of this same scenario all the time.
Long after my trip to Landstuhl, and four months after CSM Pippin caught the bullet that got him his seat on a Mercy Flight, he recounted similar experiences with the treatment-train. When he got shot, and evacuated to Landstuhl, Pippin eventually flew back to Texas where, predictably, the system started to fail. I saw the x-ray of his shattered tibia: the wound was serious. But after only four months, Command Sergeant Major Pippin fought through the system, got his own care where possible, and was yearning to return to his soldiers and the battlefield in Mosul.
I had just landed in Kuwait on 23 September 07 for my latest embed with combat soldiers, and within a couple of hours was standing in line to manifest on the flight to Iraq. A soldier stood in line in front of me, and from the back he looked familiar. He looked just like Pippin. The resemblance was uncanny. He hadn’t seen me, so I glanced at his nametag. Sure enough: PIPPIN.
Well I’ll be.
“Sergeant Major Pippin!” I said, and gave him a bear hug. We talked for a long time and I promised to come back to Mosul. He said he couldn’t stand being away from his soldiers while they were fighting. Every time I’m ready to throw in the towel, soldiers like Pippin come to mind.
It’s been many months since the soldier was killed with the IED, and the subsequent call asking who would get the money for his death, and then his organs were harvested. I think about him often, even though we never met until his brain was dead and his body was only barely alive. The impact of his life and death might seem like a tiny, twinkling star in the heavens: so dim, most people would never see it; or if they did, it might not seem so memorable arrayed against so many other faint specks of glowing dust. Like the dimmest stars to our straining eyes, his life might seem distant and his death irrelevant to people searching for meaning in the loss of yet another soldier.
That obligatory Army-issue newspaper announcement might be the only formal recognition he will ever get for dying in service to his country. But it won’t be the greatest one, not by far. And not for those who saw the young nurse crying for him, or the stoic wash of tears that stained the battle-weary faces of his buddies, gathered in combat gear to see him off.
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