May 2007

D

r. Jose Rodriguez, a Manhattan orthopedic surgeon, joined the Army National Reserve in 1990, during his medical internship, because he believed then, and still does, that some form of service to his country was the right thing to do.

After the World Trade Center bombings on Sept. 11, 2001, he knew it was likely that he would be deployed and that he would have to leave his family and his Lenox Hill Hospital medical practice. What he didn't anticipate then was that he would serve in Iraq not once, but twice, putting his life at great risk. He also didn't foresee the thorny moral issues he would face when he provided medical care to both Iraqis and Americans.

2003

In May 2003, Rodriguez, 39, received notice of his imminent deployment to Iraq. His wife reacted badly to the news. "She was very unhappy because my official Army commitment ended in 2001. So, theoretically, I could have been out of the Army in 2001. But this is why I joined — to contribute in a meaningful way," Rodriguez said in an April 2007 interview.

He tried to reassure his family, packed up the few belongings he was allowed to take — his clothes, laptop, photos of his wife, 15-year-old son, and 12-year-old daughter — and left. He spent four months working in the forward surgical unit serving Camp Warhorse, now renamed Camp Freedom, in Baquba, northeast of Baghdad. The surgical unit’s goal was resuscitative surgery — emergency stabilization treatment for patients, who were then transferred as quickly as possible to more fully equipped combat support hospitals. 

Moving medical care closer to battle sites in Iraq has made it possible to treat the wounded more immediately and save more soldiers’ lives. But the new strategy has also exposed doctors and other medical personnel to greater combat danger than they have traditionally faced.

Insurgents launched mortar attacks on Camp Warhorse and planted explosive devices under its gate and trucks. Children tossed grenades at the soldiers. Rodriguez, like most of the other soldiers, kept his family’s pictures in a plastic bag inside his helmet, which he wore almost all the time.

"I was constantly confronted with death," Rodriguez said about his first tour. "Death in the people that I dealt with and the threat of my own death."

Rodriguez sent home emails and kept a journal about his experiences in Iraq. He wrote about heat, sand and homesickness. He mused about the war, Iraqis and human suffering. He also described the disturbing ethical dilemmas he confronted in Iraq.

Treating the enemy…

In August 2003, a medic was placed on Rodriguez's operating table. The medic had been riding in an armored vehicle, but a rocket-propelled grenade with a delay mechanism had penetrated its defenses and detonated. The bones in the medic’s hand and arm were shattered; his blood spurted out of a severed artery.  The medic told his fellow soldiers where to place a clamp to stop the bleeding and succeeded in saving his own life. But his injury was the worst destruction that Rodriguez had ever seen in a limb. As Rodriguez amputated the young man’s arm, he mulled over "what I would do to that muther fkr that did this if I had his ass in front of me right now,” according to his journal.

The next night, he found out. The culprit, an Iraqi teenager, was placed on his operating table. The boy had been turned in by his father, and his wound, from a 9-millimeter bullet, was minor.  Rodriguez cleaned it, then showed the boy the images on his laptop of the medic’s shattered arm. “Goodbye, God be with you, because only he can love you now,” he thought when the boy left the surgical unit.

Grievous wounds with the prospect of a challenging recovery…

In September 2003, a young American soldier, a specialist, waited uncomplaining and steadfast for Rodriguez and his operating team. The soldier’s lower leg was attached only by the skin above his knee. “I’m gonna make it,” he told the surgeon before he was anesthetized and Rodriguez had to amputate his leg and perform a colostomy to remove the shrapnel that had ripped through the soldier’s lower body. Presumably, he had considered the possibility of death when he volunteered to serve in the Army, but his injuries left Rodriguez wondering in his journal: “The specialist was prepared to die, but was he prepared to live with the residuals of war?”

In October 2003, Rodriguez headed home. He wept for relief when he reached Kuwait and quietly rejoiced back in the United States, where autumn’s damp smells, the feel of his daughter’s hug and the taste of his wife’s salty tears blurred his memories of Iraq.

2005

In 2005, Rodriguez was deployed again. He was part of a special team of doctors and anesthetists selected to be sent to the Abu Ghraib prison hospital. They would treat detainees flown in from all over Iraq. Their mission’s motto, after the 2004 Abu Ghraib prison torture scandal, was “Restoring America’s Honor.”

Rodriguez’s wife, who is also a doctor, sought counseling to help cope with his second departure and absence.

Rodriguez spent four more months in Iraq, performing mostly orthopedic surgery, mostly amputations. During this tour, insurgents attacked Abu Ghraib and a bomb exploded at its gate.  “Fourteen of our boys dead in front of me.  Their beautiful temples disfigured and defiled by the depth of hate that surrounds us.  Each time, I walk away with their no longer life-giving blood soaked onto my clothing and my soul indelibly,” Rodriguez wrote. Blood is one of the themes Rodriguez returns to again and again in his emails and journal.

“So much carnage and death. Day after day. Sunnis and Kurds, Shiites and Turkomen, children and grandfathers, Marines and Infantry, men and women have all come through our OR. Some have lived, many have died; all are patients, all human, all hurt, and all have bled, and the blood runs together, pooling where gravity takes it. And I carry it with me, in my heart, and on my shoes.  …  I stare at them to gather strength and perspective as I breathe, to search for hope in my own soul, and pray that something good and lasting comes of all this.”

Postscript: Rodriguez is now in the process of resigning from the Reserve.  He feels he has fulfilled his duty to his country.