A Nurse in Wartime
On the seventh anniversary of the Iraq invasion, a New Mexico nurse discusses her service
By Whitny Doyle, RN
When people hear about nurses serving in war, they probably picture a woman in white tending to wounded soldiers on the battlefield. Modern American military nursing, however, goes beyond providing comfort to our uniformed service people. Nurses may dress the wounds of the enemy. They may deploy to New Orleans to salvage lives in a temporary hospital. Some military nurses may get the chance to share their skills and knowledge with Iraqi women in makeshift classrooms. Others may find themselves witnessing history firsthand as Saddam Hussein’s guilty verdict is being read.
Amy (a pseudonym) was 25 during that first helicopter ride to the now infamous Abu Ghraib prison in Iraq. As a newly deployed Army nurse, her mission during her yearlong service was to care for wounded Iraqi detainees at the Abu Ghraib hospital. It was April 2006, and nearly 2,500 U.S. troops had been killed in Iraq. Abu Ghraib itself had suffered heavy mortar and rocket attacks. But if Amy was concerned for her own safety, photos of her during that initial helicopter ride don’t reveal it. The genuine smile on her young face appears oddly incongruent with the fatigues she’s wearing and the weapon she’s clutching.
In person, Amy is the portrait of the wholesome American nurse. Blond hair reaches the middle of her back, and long eyelashes graze her cheeks when she blinks. She radiates kindness, though her sweet nature is generously laced with a dry sense of humor.
Anyone familiar with bad television can’t help but associate a pretty military nurse like Amy with the new medical television drama “Mercy.” The show's main character, a similarly blond nurse named Veronica, has returned home from Iraq. “Mercy” chronicles the estrogenated yearnings of Veronica and her other hot nurse friends amid the dramatic backdrop of her post-traumatic stress disorder.
If you’re looking to “Mercy” for a deep or complex treatment of the war in Iraq, you’ll be disappointed. In the show, Iraq primarily serves as a plot device to flesh out a clichéd romance between the vulnerable yet tough-as-nails Veronica and one of the conveniently hunky doctors she meets in the war. In contrast, Amy’s experiences in Iraq illustrate the enormous gulf between prime time television’s sexified, pixilated representation of war and the real world of hard work in a foreign desert. And besides, Amy points out, “Deployment relationships are about as real as calorie-free tiramisu.”
After being commissioned as a second lieutenant in the Army, Amy cared for wounded American soldiers at a military hospital in Europe. She then deployed to Abu Ghraib in Iraq. A few months into her deployment, Abu Ghraib closed and Amy was transferred to Camp Cropper in Baghdad. During her time there, Saddam Hussein’s trial and sentence were carried out. The compelling narrative behind Amy’s experience puts TV’s fictitious world of libidinous nurses and endearingly quirky patients to shame.
The following dialogue occurred during one five-hour, face-to-face conversation and numerous e-mails over the course of a week.
Why did you volunteer to go to Iraq?
The soldiers [in Europe] could tell by my uniform that I had never deployed to Iraq. My inability to really understand the environment they had come from limited my ability to care for them as fully as they deserved. Some of them said, “How can you understand how I am feeling when you haven’t been there?” So I went.
You took care of wounded Americans before deploying to Iraq. Tell me about the differences between caring for people on your own side and caring for detainees in Iraq.
I talked to some of the other nurses working at the hospital in the Green Zone, where they cared for wounded American soldiers. Most of them didn’t want the detainee mission. Caring for wounded American soldiers is rewarding. But I think that caring for “the enemy” takes a certain kind of person. I believe all human beings deserve care and compassion. I wanted to show them that Americans are good people. I guess you could say our unit's mission was to "do the right thing," and my mission, along with my ward's mission, was to "do the right thing and make it better." We made it our mission to win the hearts and minds of the detainees.
What did you learn from working with the detainees in that way?
I’m confident that we provided some of the best medical care available in the world today, and I poured my heart and soul into my patients, to the point that I was left depleted and depressed by the end [of my deployment]. But my time in Iraq taught me how much bigger this is than me.
In retrospect, I think that the effort to win their hearts was more symbolic than anything else. But I hope it had a lasting impact. That was one of the motivating factors in our care. Some would tell me I'm naive for that, but I found it most effective to approach their care in this manner.
“One thing I learned about serving in a war is that everyone has a breaking point.”
How did you feel about having to transfer your patients to the detainee camp?
I believed that they were being sent to one of the safest place in Iraq. Before being released to the camp, my patients would ask me where they were going. I learned how to respond “five-star hotel” in Arabic. At the camp, they received the absolute best medical care possible, got "three hots and a cot," which was more than they got on the outside, and enjoyed many of the freedoms our prisoners in America get (mail, visitors, newspapers and religious freedom). As far as the prison camps, the command separated detainee business from the medical business, which is the law in the Geneva Conventions. So I didn't see daily operations in the camp. My opinion is based on what I learned working with the detainees.
What I know for sure is that the medical care was some of the best in the world, and the hospital was safe. Very ill patients would be “compassionately released” into an Iraqi hospital, and some begged us to stay. Depending on their religious orientation, they knew they’d be killed as soon as they were no longer in our system.
But I also realize that we were releasing our patients to a prison, not a five-star hotel. Shiites and Sunnis were thrown together into a prison environment, which has been criticized as creating a breeding ground for terrorists.
Did you ever become attached to any of your patients?
Of course. There are several I distinctly remember. They would arrive to us feeling scared and extremely distrustful. I don’t care who you are or where you come from; I think all human beings come equipped with certain defense mechanisms to cope with a situation like the one that the detainees were in. It’s called “prisoner mentality.” With prisoner mentality, you withdraw, you wait and watch and test the system. But sometimes the prisoner mentality would melt away, and the person’s unique personality would emerge.
How did the language barrier affect the attachment process?
We had awesome translators. Our translators were often Iraqi doctors or veterinarians who were risking their lives to work with us. So the language barrier wasn’t as significant as the cultural barrier. This is a society in which women have no power, and here the detainees are in a situation where a woman is telling them when to eat, when they’re allowed to pee. ... It was very difficult, and I learned that culture can be impermeable, so the interventions should be compatible with the culture.
Did the knowledge that some of your patients may have killed Americans affect your ability to care for them?
I remained deliberately ignorant to the charges made against the detainees. I felt this would allow me to give them care consistent with my philosophy that they're all God's children, and I need to treat them as such.
Were you able to conclude anything about why some of the people you cared for were there?
I don’t want to get into the motivating factors for the detainees because I don’t fully know. And it’s impossible to cast judgment on an entire culture. Personally, I don’t believe that the majority of detainees are evil or anything like that. They just weren’t on our side. But if, say, my brother had been killed in Iraq, I might feel differently. It’s a touchy subject.
Did you ever feel like your own safety was at risk while you were there?
I felt safe on base. The greatest threat to my safety was the random mortar and rocket attacks we received. I’m thankful that no one was injured during my deployment. There was also the possibility of harm from an escaped detainee, which didn’t happen either. Keep in mind I was never allowed to go into the Red Zone, where the real danger was. Nurses were protected, and much to our dismay, we were over-protected. But in retrospect I’m thankful for it.
You mentioned that the mission to win the hearts of the detainees might have been more symbolic than anything else. Were there any projects that you felt went beyond symbolism and impacted Iraq positively?
Yes! There is so much horror to war that it’s easy to overlook the positive things that happen or to dismiss positive efforts as some sort of PR ploy, but there was one project I was involved in that I think represented a genuine and successful effort to begin rebuilding Iraq.
I got to teach health courses to Iraqi women for the Preparatory Iraqi Nursing Course in Baghdad. These Iraqi women were risking their lives to attend these nursing courses. The courses were offered with the intention of empowering women and rebuilding Iraq’s nursing force. Normally, there are about four nurses per doctor. In Iraq, the numbers are closer to 100 doctors per nurse ... because women aren’t supposed to work outside the home. So I feel like nursing courses like the ones I was involved in were needed and quite successful. It was a wonderful experience for me.
Post-deployment PTSD and suicide seem to have skyrocketed in the military. Do you have any experiences with these?
One thing I learned about serving in a war is that everyone has a breaking point. My breaking point came a little later than some of the others [in my mission], and it took the form of depression. My self-esteem plummeted. Maybe that’s just the nature of war.
I didn’t do a good job setting boundries. I was so concerned with convincing them that Americans are good people, I exhausted my reservoir.
But now Army nurses and doctors deploy for six months instead of a year, and I hear that’s really helped people cope with the experience. Because by the time I finally made it home after a year, I felt totally isolated and worthless. Normal people on the street had no idea what I’d been through, so I felt alone. I struggled with depression and sought counseling.
The counseling has really helped me because I now realize that, like a lot of nurses, I will give of myself until nothing is left. And with the work demands and backdrop of war, I think that limiting someone’s exposure to six months will help minimize the strain.
A few of the people I worked with attempted suicide. A medical service officer I lived with made the national news when she took a psyche nurse hostage with her gun and eventually shot herself in the stomach. And I think my mission had a 75 percent divorce rate. But, in my experience of a woman who never left base, the time factor played a crucial role. The first few months of deployment are exciting, but continued exposure is draining. Unfortunately, the new six-month timeframe only applies to nurses and doctors, not to everyone else.
What’s the most important take-home lesson from your deployment?
My experience in the Army has shaped who I am, and I still feel that it’s the best decision I ever made. I feel deep gratitude for the experience, for life, for our freedom. I feel I am one of the luckiest women alive. And now, after a couple of years to decompress and reflect, I am able to say this is my official opinion of my service to my country.
Writer Whitny Doyle is a registered nurse and a family nurse practitioner graduate student. She writes the Miss Diagnosis health column for the Alibi .
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