Authors: Jackie McCallister
“Mommy?” she said to Lieutenant McKay.
The head nurse looked into Wendy’s eyes, checking for signs of a concussion. What she saw was a young lady, not concussed, but desperately in need of rest. “No, Corporal Shafer. Not Mommy.” Two other people came to Wendy Shafer’s side and helped her up and toward her CHU. Wendy was given something that was a true luxury, and only possible because the flow of casualties slowed. She was given a full day off.
Meanwhile, Chelsea stepped into the spot recently vacated by Wendy Shafer. Once she knew that her friend wasn’t seriously injured Chelsea didn’t notice what else happened with her. The patient in front of her had taken severe shrapnel from his groin down past his knees on the left side, and slightly less of the same on his right side. He hadn’t been a part of the group that had taken fire. His were the injuries of the roadside bomb.
The bleeding had been somewhat contained as this is the first thing that must be done in the case of shrapnel injury. Captain McGuire was carefully removing the larger metal pieces and closing the wounds as he went. Chelsea glanced to the side and saw that Captain McGuire had probably removed ten pounds of metal fragments from the young man already. He was lucky to be alive.
Chelsea looked toward the young man’s face and was going to tell the still partially conscious soldier exactly that. When Chelsea saw whom the patient was she almost went the route so recently traveled by Corporal Wendy Shafer and hit the floor herself. It was Tim Giacomo.
Chelsea had been trained to act quickly during a time of crisis. That’s why she tore her eyes away from the face of the patient and began dealing with the blood that was still draining from the young soldier’s wounds. As she deftly and expertly went about her task, Chelsea’s mind pored over the fact that her friend had been injured.
The last time Chelsea had seen Corporal Giacomo was…when? As Chelsea’s hands moved over the patient’s body, she worked her way backwards over the last several days in her mind.
Today is Tuesday,
she thought.
I haven’t seen Tim since…last Thursday I guess. He said that they were all putting in serious overtime to keep the planes in the air. One had limped home on one engine and with broken landing gear at the beginning of last week, and this wasn’t tolerated by the brass. Nor was it tolerated by the mechanics themselves.
Chelsea put aside what she had heard about the intense pride that the aircraft maintenance crew had in their job. “What about Tim?”
Tim Giacomo hadn’t told Chelsea anything about having to go out into the field, but that wasn’t surprising. If an aircraft had landed at another of the battle zone’s airfields and had mechanical difficulty, it would have been the crack mechanics from Bagram Air Base that would have been called in to do the repairs. Each base had its own mechanic shop, but everyone knew that the best wrenches in this man’s Army were wielded by the men and women at Bagram.
In fact, Michelle Sarnosky, one of the first female aircraft mechanics in the service, was considered one of the finest at her craft. She worked closely with Tim on some of the intricate parts of the maintenance task. Chelsea had gotten to know and like Michelle as well.
Regardless of the when’s and the why’s, Tim had been wounded on some kind of repair job. Chelsea was doubly concerned for her friend because, though he was heavily sedated when she had first come to his side, Tim had been conscious enough that he should have recognized Chelsea. There hadn’t been a hint of recognition in his eyes as they drifted closed. Chelsea prayed as she aided Captain McGuire in his task.
Dear Lord, I know that your ways are Holy and that my ways are just human, but please be with my friend Tim. It may be selfish of me, but he’s a wonderful man with a wonderful family who need him so much. Help Captain McGuire and all of us work with sure hands. In Jesus name, Amen
Just as Chelsea concluded her inner dialogue with the Almighty, Captain McGuire took stock of the situation.
“We have him stabilized. We’re going to have to get some images of his insides to see if there is any further damage, though. Walter?” Captain McGuire shouted, calling one of the transport medics. “I need you to make a run to Glynnis with this young man.”
Glynnis was the name given to the Nuclear Medicine and Imaging Unit of the medical facilities at Bagram Air Base. Located about 75 yards from where the patient was currently located, Glynnis (named when it was first built after the actress Glynnis O’Connor. The name, for no apparent reason, stuck) was a little slice of the famed Mayo Clinic in the middle of the God-forsaken desert. Complete with CT, nuclear medicine, large bore MRI, and the latest in healing technology for neuroblastoma tumor cells brought about by exposure to high temperature burns. The latter, known as positron emission tomography (or PET) was second to none in the world.
Today, the patient was going to be transported to Glynnis while under sedation to make the trip that much more comfortable. He would be restrained during the testing procedure. That would ensure that the resultant images would be as clear as possible. Rather than waiting days to determine if there was any hidden damage to his internal organs, Captain McGuire would know by early this evening.
The triage area of the medical facility was mercifully and for one of the few times lately, empty of incoming casualties. Chelsea asked if she could accompany Tim to Glynnis. Lieutenant McKay, with a puzzled expression that Chelsea couldn’t decipher, agreed.
Chelsea caught up with Private Walter Beauregard who, along with Pfc. Clayton Adams was carefully transporting Tim Giacomo’s sleeping body across the smooth sidewalk that connected the main medical facility to Glynnis. About a third of the way there, someone new fell into step beside Chelsea and asked, “How is he doing?”
Chelsea turned to answer and saw that the question had been asked by Corporal Tim Giacomo. Chelsea went pale as she looked from Tim to the patient and back to Tim. Suddenly it all came clear to the young nurse.
The patient hadn’t recognized her because he didn’t know her. Lieutenant McKay was puzzled by Chelsea’s request. As far as she knew, Chelsea had never seen this patient before. Tim asked how the patient was doing because the patient was Tim’s identical twin brother, Specialist First Class Gerald Giacomo.
Tim quickly realized what Chelsea had been going through for the last half hour. As concerned as he was for his brother, Tim put his arm around his friend and said, “I’m right here. I’ve been right here all along.”
Chelsea felt faint. Of course, the boy on the transport table was important to her, but to know that it wasn’t her dear friend brought about a guilty moment of pleasure. It was a moment that she quickly squashed.
“We think that he’s going to be fine. He’s been terribly cut up, though, and some of the wounds are pretty deep. He has movement to all of his extremities, though. We’re going to get him looked at in Glynnis.”
Tim’s eyes clouded over as he looked at his sleeping brother. It is said that twins have a unique sense when the other half of the same fertilized egg is in distress. That was certainly true for the Giacomo twins. Once, when they were in elementary school, Gerald had been on the losing end of a fistfight. Tim’s nose had started to leak a little blood just as Gerald had taken a right cross across the bridge of his nose.
All today, Tim had been in a state of mental and physical distress, and he couldn’t explain any of it, until now.
The small medical entourage arrived at Glynnis shortly thereafter. Gerald Giacomo was wheeled into the testing area for further evaluation. Tim and Chelsea waited in the adjoining area where coffee, water, and snacks were provided.
Tim gulped two cups of coffee and sat down, having found himself suddenly weak in the knees. Chelsea sat down beside her friend, and said what she could in an attempt to allay his fears.
“Captain McGuire felt good about his chances of full recovery when he sent Gerald away. He didn’t say it just like that, but I’ve gotten so I can tell what he’s thinking about the patients and he had an okay look this time.”
Tim thanked Chelsea with his eyes. He respected her skills, not only as a nurse but as an observer as well. He had grown to appreciate her compassionate heart, and sense of humor. She was one of his best friends at the base, and he had written letters to his wife where he talked about her. Far from there being any romance at all in their relationship, Tim considered Chelsea to be just a great friend, and he wanted his wife to know about her and that their relationship was on the up and up.
For her part, Chelsea appreciated Tim as well. For a while, she couldn’t figure out of whom he reminded her, but there was something about him that recalled someone else. It was the way that he held his head back when he laughed, or a turn of phrase that he occasionally used. One night, when she was almost asleep in her CHU, Chelsea realized that it was her friend Guy Harris that was recalled when she was around Tim Giacomo.
Even now, sitting on the hard plastic chairs in the waiting area inside Glynnis with a worried expression on his face, Tim had an expression that was reminiscent of Guy Harris when he was concentrating hard, or was worried about an upcoming exam or skills test.
Chelsea had liked Guy but had never felt attracted to him beyond that. She felt the same way about Tim.
He is a really great guy, though
, Chelsea thought.
His wife is lucky that she fell for him. There is a lot about Tim that a woman could grow to love.
After about an hour, Master Sergeant Barry Blakeley came into the waiting area and asked to speak to Tim in a private room. Tim asked if it would be all right if Chelsea accompanied him. MSgt. Blakeley nodded his assent. They processed into the only cubicle in the front end of Glynnis that had a door that would close for privacy purposes. Tim and Chelsea took a seat in front of the desk facing MSgt. Blakeley, who directed his words to Tim.
“First of all, Captain McGuire did his usual magnificent job on your brother. We could tell that as soon as the shrapnel had cooled to the point of it being safe to remove, that’s exactly what was done.”
MSgt. Blakeley glanced quickly at Chelsea, “Some of what I’m going to say will be overly simplistic to you, but the patient’s brother isn’t in the medical field, I understand.”
Chelsea said, “Please, tell him what he needs to know in ways that he can understand. MSgt. Blakeley turned his attention back to Tim Giacomo. “The injuries that your brother sustained were from what we call an L.E. That stands for low-order explosives. It appears that the patient ran up against a pipe bomb of some sort. Don’t get me wrong, though.
“The term low order doesn’t mean that it isn’t a dangerous piece of work. It only means that the explosive didn’t have a significant amount of liquid as part of the propellant process. The planes that brought down the World Trade Center towers on September 11th were low order explosives as well, just because the damage was primarily done by a solid rather than a liquid. Are you with me, so far?
Tim nodded, taking it all in. MSgt. Blakeley, satisfied that his words were being comprehended to this point, continued.
“The first thing that we have to be concerned about from a bomb like this is what we call primary blast injury. The respiratory system can sustain substantial injury as a consequence of supersonic pressure triggered by the blast wave. Pulmonary contusion is most common and generally occurs on the side of the body that was closest to the explosion. Signs and symptoms can be delayed up to 48 hours after the event.
“So, while I can tell you that your brother appears to be doing well at this time and that we see no sign of this kind of traumatic injury, we won’t be able to know for at least a couple of days if that continues to be the case.
“The bomb that impacted your brother today had a deadly mixture of bolts, nails, and glass in the recipe. That creates an additional concern going forward.”
MSgt. Blakeley started to rise. It looked as if he was about to conclude with his last statement, but something bothered Chelsea.
“Doctor, you said that there were two concerns that you had about this patient in particular. What is the second one? I mean besides the dangers inherent in secondary explosions.”
The doctor nodded in Chelsea’s direction. “I’m glad you asked, but it’s not a concern unique to this patient. I’m sorry if I have given either of you that impression. It’s just that infection is almost a given in the case of shrapnel injury. The detritus that the attacker puts into the bomb is filthy, and if it isn’t filthy naturally, the attacker makes it that way by adding dirt to the mix. I’m sorry to say that, while the care that your brother has gotten today has been superb, infection isn’t a matter of if but of when and where it strikes.