“You do not have time to cry, you do not have time to feel. You basically put those feelings in a box and you put them over on the counter,” says Air Force Lt. Col. Sherry Hemby, a 19-year veteran who went to nursing school and then joined up.
At the behemoth Bagram military base in Afghanistan, medical transport planes — essentially flying trauma centers — slam fast on the runway, always after dark, trying to avoid enemy attack.
On a recent fall night, the huge hold of an Air Force C-17 was filled with stretchers stacked three-high. There was just enough room for doctors and nurses to squeeze between life-support equipment and severely injured patients bound for Landstuhl Regional Medical Center in Germany.
For 10 years, aeromedical evacuation crews like this one have been ferrying war casualties out of Iraq and Afghanistan.
Lt. Col. Trisha Fulton, chief flight nurse, has made hundreds of these trips. She was waiting for her latest group of patients.
Some walk on crutches. Others are carried on stretchers.
The most critically injured are sedated and cocooned in life-support equipment. They are brought aboard last, accompanied by a critical care transport team consisting of a doctor, a nurse and a cardiopulmonary technician.
By the time the severely injured, some of them amputees, get here, they have been stabilized at Bagram’s field hospital and prepped for flight.
At Landstuhl, the receiving point for tens of thousands of wounded soldiers and Marines, surgery or rehabilitation awaits.
Those too badly hurt to be redeployed will go on to the burn unit at the Brooke Army Medical Center in San Antonio, Texas, or to a veterans hospital near their hometown.
Back at Bagram, at 2 a.m. the buses that transported the injured pulled away. There was a hydraulic whine, and the C-17’s gaping rear door thuds to a close.
With that, the aircraft took off into the night. The roar of jet engines consumed the hold.
People who have been thrust into each other’s lives by the consequences of war began a wordless eight-hour relationship of necessity.
Fulton, the chief nurse, gently took the pulse of a deeply sedated, wounded medic.
He was attached to a network of drip and drainage tubes and blinking heart-monitoring equipment.
Fulton moved from suspended stretcher to suspended stretcher, monitoring vital signs, communicating through headsets with her crew of 10 or so doctors, nurses and technicians.
The medic was blasted by an IED, or improvised explosive device, while he was running to help a soldier felled by another roadside bomb.
Gunnery Sgt. Troy Ruby, a combat photographer for the Armed Forces Network, shouted above the jet noise, “Those medics are the bravest guys out there. When one of them gets hit, it really pisses us Marines off.”
The unidentified medic’s legs and face were shattered. Dried blood was caked under his nostrils. He stayed alive because body armor protected his core, the doctor tending to him said.
He’ll need reconstructive surgery on his face, and months, if not years, of rehabilitation.
Fulton considers him one of her own.
“When he’s on this plane, he’s mine. I treat them like my own kids,” she said. “I don’t want to lose them.”
But war-weary doctors and nurses who ferry the maimed and wounded can’t really put their emotions in a box. Not for long.
“We do hurt. We do feel. We see these young men and young women and we see what war has done to them,” said Hemby.
“And it’s hard.”
She gives hula hoops to the men and women service members who serve under her. She organizes water-balloon fights — silly things to release the surreal workplace pressure and to ease the heart and mind.
But sometimes the kids get to her. The really young men and women ripped apart by war. Speaking of them, her emotions spill out of their box and onto her cheeks.
“They’re so resilient,” she said, wiping away tears. “You would be amazed at the folks that say, ‘When am I going to get better? I need to get back to my men and women, I need to get back to my troops.’
“The camaraderie here, the dedication, is phenomenal,” Hemby said.
Unlike the Vietnam War, when it took an average of 45 days to get the wounded airlifted out, the fallen in Afghanistan and Iraq can be on their way to Germany within hours of being hit — and sometimes hours after being rescued by medical helicopters escorted by attack aircraft into the middle of combat zones.
Despite those advancements, dying is an ever-present event, its permanence always felt and always looming in the shadows.
“It hurts a lot, to not be able to save those soldiers,” said Army Col. Michael McFadden, who works on the rescue helicopters. “But every mission is a new mission. And that’s the way we focus on it. Everyday is a new day ... We save those who we can and we try like hell for those who we couldn’t.”
To Hemby, it’s about giving back.
“I am serving my country and taking care of these young men and women,” she said. “They’re taking bullets for me. They’re getting blown up for me. For my freedoms. They’re out on the front lines ... And we’re going to take care of those men and women.”
Tim Malloy is journalist in residence at the School of Communications, Quinnipiac University in Connecticut.