My Day Off

Expect the unexpected when ‘off duty’ as a Medevac pilot in wartime

This is the second in a series of three stories by the author. Currently serving as a medevac pilot in Bala Morghab, Afghanistan “the middle of nowhere, northwest side,” Paul Graham, 35, lived in the Sacramento region from 2000 to 2005 until he was deployed to the Middle East as a combat engineer. He now lives in Reno, Nevada with his wife Holly and their four children, Keenan, 15, Jonas, 10 McKenna, 8, and Ava, 6. Graham—a surgical technologist in the civilian world in addition to being a helicopter pilot in the National Guard—hopes to return from Afghanistan in time for Christmas.

I’m off the flight schedule, so this means that I can finally relax completely. It’s June 16 around 9 a.m. I’m standing, leaning over my bed. My rucksack is empty and I’m wondering what I should pack in it for the upcoming trip. See, I’m going to stay in Shindand for a couple of weeks when I come back from leave, and I’m not sure what I’ll need down there.

Socks. Check. Captain America boxer briefs. Check.

I go outside and smoke. It’s hot. Bernie put an Air Force cargo pallet down between the Tactical Operations Center tent and my tent. There’s 15 feet between the two Quonset hut tents and they face each other. He did a good job on the pallet. It’s level and solid … way better than standing on those freakin’ river rocks. But, sadly, it’s made of aluminum, and I’m getting 120 degrees from both sides as I’m smoking.

I pull the cigarette away from my lips and look at it with a confused look on my face, the way a dog looks when it cocks its head to one side.

“Why the hell are you smoking again,” I mutter to myself. “I can’t believe you.” I shake my head and put the cig back in my mouth. I’d quit for two-and-a-half months. Then they wouldn’t let us launch a few days ago—we lost one of our own—and it broke me. I always think of exercising when I smoke: 300 sit ups; 300 push ups; 3 mile run; 30 dips; 30 lunges, and 30 pull ups … everyday. “If I did that, then I’d be in great shape,” I think to myself. Of course I never do it. I’ve made it to 200 sit-ups, 100 push-ups, a 3-mile run. And the other stuff … I did do 30 of ’em … once … not everyday. So I smoke in a fog, and think to myself that after I pack, I’ll workout. Why am I so stuck on threes? Weird … cig’s done.

I walk back inside my tent. It smells like feet and Febreze. Its dark in here and I feel my way down the odd hallway. There’s a heavy layer of talcum power-fine dirt that puffs from under my flip-flops. My room is the fourth one down on the right. I found some linoleum about a week ago in what we refer to as “The Dump.” So now I have a high class 6-by-6 room with linoleum that looks like hardwood. I track some of the dust in as I sweep the curtain out of the doorway with my right arm.

I’m putting off packing, standing next to my desk, staring at a postcard I got from my newly acquired sister, Sylvia. Napoli Coast … I want to go hiking there some day.

“Medevac, Medevac, Medevac. Five cat Alphas,” It doesn’t matter that I’m off duty until I get back from leave. The hairs on my arms are standing on end and waves of nervous tension course through me. My breathing is heavy, and I don’t know what to do with myself. I’m a trapped animal, pacing back and forth in its small cage.

Wait a minute! Did they say five cat Alphas? There are different categories - triage codes, if you will; Alpha is urgent. It requires a Forward Surgical Team within an hour. The helicopter has to be off the ground in less than 15 minutes. Five Alphas! They can.’ hold five Alphas on one Blackhawk!

The First Up crew bolted out of the tent 30 seconds ago, so I make my way to the TOC (a fourth of one of these Alaskan Tents with a couple of computers, a couple of phones and a big map on the wall), my flip-flops clapping as I walk. I walk in and look at the Lieutenant who’s just taken over. The Captain left just yesterday on leave. He says, “I’ll race you for who gets dressed first.” I look at the computer screen showing where the incident was, and run out the door. Flip-flops, shorts and dog-tags is all that I’m wearing. I kick off the flip-flops and drop my shorts; now I’m just in my dog tags. “Bernie, Dan … we got one! Get your clothes on,” I’m yelling as I pull on my pants.

I run into the TOC and sling my gear over my shoulder, “Hey, I’m ready,” and look to the Lieutenant for approval. I’m poised, as if waiting for the start of a cross country race. He comes through a curtain and pushes his hand toward the door. “Go, Go!”

I’m off like Seabiscuit, smashing though the door. First Up and Chase are just pushing the engines to fly (full throttle ready to go) as I awkwardly trot by. This gear is beating the crap out of me. Without a belt, my pants are falling off. Since they’re already half off and I’m not wearing any underpants, I push ’em down a little more just as I’m in front of Chase, and make a little dance to the side as I jog by, mooning them. I don’t look to see if they’ve noticed. I’m the first one at the spare aircraft. I drop all my stuff and I climb up on the side of the bird, pulling the engine intake covers, then the pitot tube covers, and finally the gust lock. Dan and Rip just showed up and I’m buckling my seatbelt, throwing on the P. Since I don’t have a t-shirt, underpants or socks on, the sweat is running down the full length of my body and pooling in my boots. I look up and there’s Bernie walking all nonchalant with a small ice chest. He just strolls up and hands the chest to Rip, and starts putting his gear on. I give a little wave to get his attention. He looks up at me, bent over, clipping the leg straps of his survival vest. I’m smiling and I point at the starter. He does a little nod with the corners of his mouth turned down and goes back to his business.

Bernie climbs in just as I’m pushing to Fly. This is not normal practice. Just as I lock the engine Power Control Levers (PCLs) into fly, we get word that we’re approved single ship and that the other birds can launch. They take off and we’re still cleaning up the cockpit (making sure all the switches, knobs and radios are all set correctly and operating).

We launch in … well under 15 minutes. I’m cruising in what I think is the right direction, from what I remember from the glance at the computer screen. Bernie is loading the GPS. I don’ see the other birds even though they took off only two minutes before us. I’ve got her pegged out and we hit some fairly moderate turbulence, the kind that flips your stomach.

Bernie says, “It’s up.” I look down and I’m perfectly on course. Bernie doesn’t let on, but he knows I’m Arnold-flexing in my brain right now. Hoo-Ah!

The cockpit is quiet … well, except for the didgeridoo trance music performed by the engines and blades.

“Uh-Oh. Crap,” Bernie says. Both in surgery and in a helicopter you should never say

“oops” or “uh-oh.”

“My door came open,” he says. I immediately start slowing back. I know a door being open doesn’t sound that bad, right? At the speeds we’re going, it can get ripped off and go into the tail rotor. Mess with the big fan or the little fan and you’re gonna have a bad day. The doors on the Blackhawk are crap. We’re use to it, so it really isn’t a big deal. I come to a stop. It takes me a little longer than it probable should’ve. We’re 1,000 feet above ground level (AGL) at a hover and Bernie slams his door. I pull in power and dip the nose forward.

I see Chase circling in the distance. Dan says, “You want to start slowing back?” What the hell? Why is the Crew Chief asking me about my flying? I bite my tongue. Then I remember that I’d just written a story and, since he was featured in it, he was one of the first to read it. In the story I made a point of saying how embarrassing it was that I came screaming in and had to circle around to land. He’s just lookin’ out for me and I’m really glad I didn’t bite his head off.

We get a little closer and see the First Up aircraft on approach. I come over the rolling hills and take a hard right, coming around behind them. I’m talking about everything that I’m doing … crew coordination. One of our last classes in the primary section in flight school was called Crew Coordination. The class consisted of a guy with a strong New York accent playing death tapes of helicopter crashes that involved lack of crew coordination. That was all I needed.

So I talk … a lot.

After discussing it, we decide to hold off landing until First Up leaves. Instead of dodging Chase in their pattern above, we hold hover at 150 feet and 200 yards back. We’re beneath the tops of the hills and Chase has free rein. After a few minutes, First Up is loaded with their three critically wounded and takes off.

It’s dusty. We’ve been kicking up a cloud behind us while hovering. There’s a large area for landing, so I keep her fast and we roll out 15 or 20 feet. No dust. Chase stays overhead, protecting us while First Up heads for home to Bala Morghab (BMG).

I’m looking at the large armored vehicle that was hit by the Improvised Explosive Device. It’s on its ass end, pointing straight up in the air. We’re talking about it, like it’s an exhibit; not indifferent, but as if it isn’t real … like it’s a Hollywood movie.

I can’t speak for anyone else, but I’m not scared. Oh, I know I should be. Hell, I want to be! But in this moment, I’m just hot. The sweat is now stinging my eyes, so I transfer the controls to Bernie and start wiping my face with a cloth. There’s so much sweat. Dan and Rip are running around getting the patients. I can see them loading the first; then run back off to get the next one.

Bleeding all alone in the back of a helicopter … waiting … and hoping you survive. Still nothing.

The weird thing is you could come up to me and start telling me about when your kid-brother skinned his knee riding his bike, and I’d get sympathy pains up and down my whole torso. Does my brain just turn off my emotions? You can’t handle this. Click!

“We good, everyone secure?” I ask. Then up we go! Chase says, “See ya,” and they go

after First Up. We climb above the hills and turn the opposite way, toward Qual-i-Naw.

Qual-i-Naw is the small town where we do our patient transfers. This country is beautiful at 1,500 feet. It’s a geologist’s wet dream. I’m flying toward Qual-I and thinking about the naughty Skype that I had with Holly last night. Within the next week it’ll be for real … God I want her!

I’m slipping around in my shell of a uniform, trying to get comfortable. The Spanish ground commander for the guys we have in back thanks us over the radio in very broken English. There are so many countries here, all working together. It’s so cool to be alive at this point in time. I think it’s remarkable that we’re all so connected.

Qual-i is a short ride from where we picked up the Spanish soldiers. We land and it’s weird sitting there on the apron, all by ourselves. Single ship just doesn’t happen. It takes special approval. While we wait for the guys to get here from Herat, I drink the water that Bernie brought, leaning my head back and crushing the bottles. There’s a waterfall off my chin, down my chest and over my stomach. I’m more animal than human.

“Do those guys give a crap about anyone?” I say about our sister ships from Herat. They just yank up on the collective when they’re right next to us and knock us all over the place. We reposition and get gas, then try to get a hold of the TOC back at BMG. I swear to God, our long-range radio was invented by ET … an umbrella, record player, rake, and the Fisher-Price animal wheel. Turn the umbrella a little … try the pig instead of the cow. Crap! Nothing is working.

“SHHHH back. SSSSHHH ship.” Did they say, “Come back, single ship?”

I’m hovering at 20-ish feet, looking down the runway and there’s this kid in the middle of it. He’s just standing there, gawking at us like we’re from outer space, holding a rope connected to a donkey. The kid’s maybe 8, but he wouldn’t know that one way or the other. No one knows their birthday. You were born when it was hot; it’s been hot quite a few times since then. I suddenly feel like the kid is right. We really are aliens here.

We’re getting ready to take off when we hear First Up talking to tower (a guy with a hand held radio who doesn’t know much English). Oh, I guess they didn’t say to “go back single ship.”

We get off of the active, land on the apron and wait.

Our Chase crew is awesome. They love to fly and not only are they willing but they’re eager to protect us. Their personalities fit with ours. Their Crew Chiefs challenge ours to a dance off at Qual-e. They “get down” underneath the spinning disc and we’re all laughing and commenting on their sweet moves.

On our way back home Chase plays music over our internal radio and I hope the guys from Herat aren’t listening in. The Divinyls’ “I Touch Myself” plays over the scratchy secure net and we smile.

Just as we drop into the Morghab River Valley, Bernie asks for the controls and I give them up. I’d been flying very conservatively since I hadn’t flown formation in six months … we’re always out front. Bernie tightens the formation up, and then starts bouncing from one side of the aircraft in front of us to the other. He isn’t thumbing his nose at me. He’s just showing me that I need to become more comfortable and get better.

The blades are spinning down, I pull my armor (ballistic plate) back and open my door.

There’s a little breeze. That feels great. There are spider webs of sweat attaching me to my helmet as I pull it off.

I can’t help but think of my helmet from flight school. Fort Rucker is very humid, we flew everyday, and after a few months of that, the helmet smelled like sour milk. I remember trying to clean it and dry it out before the next day of flying. I was standing there in our bathroom, hairdryer in hand, stinking up the entire house. I clearly remember Holly with a disgusted look on her face saying, “You’re gonna have to do that somewhere else.”

The lieutenant walks up just as I’m turning off the P.

“Hey, there askin’ for you in surgery,” he says in his slight New England accent.

“I think I’ll put some socks on first,” I reply with a grin, my boots are soaked through the leather.

“Oh, so that’s how you beat me,” the lieutenant smirks.

I walk into surgery after a quick shower; I’m wearing my favorite tan, plaid shorts and a Flogging Molly shirt. I immediately get to work. The OR looks like they had a blood-filled water balloon fight. They just completed an above-the-knee amputation, and there’s another patient on deck. There’s no one in the OR tent and it’s a disaster.

There are no orderlies or sterile processing people in the Army. There are just scrubs, and my pampered Renown Hospital ass can’t take it. My brain switches from Warrant Officer mode to Sergeant. I look around and see these three guys, standing at the Hesco (a huge wall made from metal mesh and burlap/cotton wrap that are filled with dirt to create a barrier).

They’re smoking and joking around. I walk up to them with this I’m-gonna-eat-you look on my face. They know who I am. I’m the easy-going pilot who sometimes scrubs. Back home I’m the scrub who sometimes flies. It’s so weird being in the National Guard. Today is my day off, so I’m not going to mop and scrub the tables while these privates smoke and giggle. They can read my expression, put out their smokes and get to work before I can reach them. I work alongside them, mopping and working at dried-on blood. I look over and see Foreman, the FST’s scrub, working with us. He asks, “You want this next one?”

“You think I’ll get to sew?” I reply. He just shrugs and we both continue working.

Amputations are one of my least favorite surgeries. It’s right up there with perirectal abscess. You’re not fixing anything.

I’m set up and turn toward the patient in my surgical gown, hat, mask, glasses, and Asics. I’m distraught. It’s a young Spanish woman, early-20s covered in dirt, about to lose her leg. There’s a reason it took so long for women to be on the front lines in the military, and right at this moment I’m still not sure it’s a good idea. The surgeons slice, clamp, tie, and burn. Then they pack and dress it open. I guess there’s no sewing for me. Kevin scrubbed in. It’s the first surgery he’s ever been in, and I’m happy I can show him a few things. I still get excited when it’s new for someone. I can’t stand incompetence, but I love smart eagerness.

I help clean the room, then go and clean the instruments, my payment for scrubbing.

The “sink” is two large metal basins. I pour five water bottles in each and some soap in one of them. The autoclave and basins are in a shipping container next to the OR tent and there isn’t air conditioning or even a fan.

It’s either clean and sterilize the instruments or chop up the legs. If the pieces of flesh

Aren’t small enough then the burn pit won’t consume them. Animals will be running around with half-burnt limbs hanging from their mouths. I finish with the dishes and wrap them and put them into the autoclave.

I’m heading back to my room. Crap! I got blood on my favorite shorts and, as I’m going through the OR, I look at Kevin and Foreman. They’re making the most out of their shitty job of cutting up the legs and are doing an anatomy lesson with each other. I’ve now missed breakfast, lunch, and dinner, all by choice. I’m not hungry, but I know I need to eat. In the FST I find some pasta with a prosciutto cream sauce that had come from the

Italian dining facility (DFAC). It’s cold but still delish.

It’s 10:30 p.m. and I’m sitting in Reggie’s, finally relaxing, watching a movie. Oh, crap, I’m scheduled to cover operations tonight from 11 p.m.’til 7 a.m. I’m still not packed. My flight out of here is sometime early tomorrow afternoon. OPS isn’t hard. My challenge will be staying awake. I’m feeling sorry for myself and wishing I wasn’t the only one.

When key words show up on the computer, such as “Medevac” or “9-line,” it announces them with a song. Our computer plays, “Bad boys, bad boys, what ’cha gonna do, what ‘cha gonna do when they come for you?” I’ve joked that when I’m home and the show “Cops” comes on, I’m going to run outside, start the car and drive off before I realize what I’m doing.

It’s 7 a.m. and I’m a zombie. It doesn’t matter if I leave with nothing. I’m not packed, but I’m going to sleep and I’m getting on that chopper.

“Graham, You in there?” I hear a voice from the ether and my eyes pop open.

“Huh,” is all I’ve got.

“Dude, your flight is 30 minutes away.”

Like a gymnast I swing out of bed and stick the landing. “Goin’ home, suckas.”