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By jtallenmd
September 6, 2006

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Family physicians often use the phrase "from womb to tomb" to describe the broad spectrum of care provided by members of our specialty. During my residency at Fort Bragg, and later in my practice at Wuerzburg, I had more than enough opportunities to experience the "from womb" end of the spectrum. However, because I have dealt largely with a young, healthy population for most of my career, I have not had significant occasion to deal with the other end of the spectrum. This deployment has changed that.

I am assigned to 1 / 32 IN of the 3rd Brigade, 10th Mountain Division. Our area of responsibility (AOR) covers a wide region in northeastern Afghanistan. There are two airfields in our AOR. One is close to the front lines. It is there that the Forward Surgical Team is located and that the majority of the wounded and sick are taken.

The other airfield is remote from the front lines, but is the preferred refueling point for non-urgent missions because of its relative safety and it's location in relation to Bagram and the Combat Support Hospital. It is here that the majority of the fatalities from our AOR are taken as they wait for further transportation to Bagram. This is where I serve.

Soldiers' families cannot be notified until each person has been officially declared dead. Since there are only medics at the front line and, since I am the only doctor at this location and, since this is usually the first stopping point for the KIA's en route to their final resting place, the duty to declare them dead has fallen to me.

The majority of those who have come to me for this duty have been strangers. I don't know their names nor their faces. However, a few have been people I have known. One was a flight medic whose equipment failed as he tried to extract a patient from a mountainside. Two more were medics attached to 1 / 32 who were together in one vehicle when it struck an IED.

It doesn't really matter whether they are strangers or acquaintances. In either case, I choke back tears as I perform the task at hand. I think about the mothers that sit at home, peacefully unaware of what has happened to their son or daughter. I think about the spouses who will have to pick up the pieces and begin life on their own. I think about the children who will not have the privilege of knowing the great individuals that were their father or mother.

After having performed this task for the umpteenth time, the chaplain comes to me with concern on his face. "Are you sure you're alright? You carry a great weight in your face." I smile and tell the chaplain that I have been sustained by remembering one of my favorite scriptures. I find it somewhat ironic that a doctor would be quoting scripture to the chaplain. I tell him that the scripture is 1 Cor 15:19-22. He asks me to recite it. I stumble and say that I don't know it by heart, so he pulls out his Bible and starts to read

19 If in this life only we have hope in Christ, we are of all men most miserable.
20 But now is Christ risen from the dead, and become the firstfruits of them that slept.
21 For since by man came death, by man came also the resurrection of the dead.
22 For as in Adam all die, even so in Christ shall all be made alive.

He nods and accepts (I think) that, even though my heart is heavy, there is a hope in Christ that burns deep within.

I also speak briefly with the battalion commander. He has seen far too many of his men cut down in battle. He has also lost a dear friend in an unfortunate accident at the front lines. A couple of times he has said to me that he thinks I have the toughest job. I graciously accept his thanks, for that is how I interpret his remarks, but I know that my job is not the toughest. The toughest job is done by those at the front line. They are the ones who have watched their buddy fall, but do not have time to grieve nor to comfort one another. There is a more pressing duty at hand, so they push their emotions to the back of their minds and focus on more immediate concerns. They are the ones that put their lives in danger every day. Yes, it is they who have the toughest job.

By comparison my job is relatively easy. My job is to "mourn with those that mourn" and to "comfort those that stand in need of comfort". My job is also to honor the memory of those who have given all.

As I stand side by side with my infantry brethren, the chopper carries these fallen comrades into the air and one step closer to home. That comrade may have been just a Private, a Specialist, a young NCO, or a junior officer, but rank doesn't matter. Two Lieutenant Colonels, two Majors, a handful of Captains and Lieutenants, two Sergeants Major, the First Sergeant, my medics from the litter team and many soldiers from the unit, soldiers of higher rank or lower rank than the fallen, soldiers of the same rank as the fallen--all stand, choking back tears, and show our respect and honor for these brave young men and women through a simple military gesture. We render a salute.

Farewell, my brother. Farewell, my sister. May this hope in Christ of which Paul spoke burn deep in the hearts of your families and loved ones. Our thoughts and prayers are with them. May God be with you 'til we meet again.

We hold our salutes until the helicopter is no longer in sight.

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