Doctors with orders — for Iraq

Michael Moran Senior correspondent

It was 3 a.m. when Dr. Tamarin McCartin’s pager went off.  Three severely injured children, the survivors of an Iraqi family ripped apart by mortar fire the prior evening, had been driven around the dangerous, post-curfew Iraqi night by their teen-aged brother for more than seven hours in search of urgent medical help. Eventually, having been turned away from several facilities and the Syrian border, the boy convinced an American unit to break Army regulations and arrange helicopter transport to the U.S. Army’s 228^th Combat Support Hospital in Mosul for his dying siblings.

“The three children that were here were a 14-year-old girl, a 12-year-old boy and a 7- or 8-year-old boy,” says McCartin. “I took care of the girl because at the time I was the only female physician in our [hospital].”

The girl was awake but strangely quiet, perhaps because she had seen her father and a brother blown to pieces earlier that night, McCartin says.  Metal shards studded the back of her legs, back and buttocks, and one large piece lodged dangerously close to her bowel. She also had a broken back. After hours of surgery, the girl was stabilized. The two boys, injured even more extensively, also survived surgery, and within a few days all three had been transferred to an Iraqi children’s hospital in Mosul.

“As far as I know, they all lived,” McCartin says. But, like so many things in Iraq, there is no way to be sure.

Deploying obstetricians and pediatricians
An obstetric gynecologist from Honolulu, this is hardly the life Tamarin McCartin had foreseen when she elected to go to medical school on an Army scholarship. She and her husband, another Army OB/GYN, practice at Tripler Army Medical Center on Oahu, a great pink wedding cake of a hospital with Pacific vistas that is one of the most sought after postings in the U.S. military.

“This is very unlike anything I do at my job at Tripler,” says the doctor, who deployed to Mosul in June and spoke with MSNBC.com via email. “All of the surgery and trauma I’ve done with the exception of one teen-aged Iraqi girl has been on men, and has ranged from chest tubes, central lines and orthopedic procedures like skin grafts and wound care.”

McCartin is hardly alone. Throughout the vast Army Medical Command, an agency with a budget of $9.7 billion in 2005, doctors, dentists, physicians' assistants, lab technicians and nurses on active duty in the reserves or National Guard, are finding themselves opening old notebooks and straining to remember things they have not done since their medical residencies. The wars in Iraq and Afghanistan have created an urgent appetite for battlefield medical specialists. The situation is much the same at the Navy’s Bureau of Medicine and Surgery, which handles Marine Corps casualties, and the Air Force’s system.

“Frankly we’ve had a large number of pediatricians deploying as battalion surgeons,” says Lt. Gen. Kevin Kiley, the Surgeon General of the Army. “We would like all of our physicians to deploy and serve in combat ops. It may not be what they did in peacetime, but all of them know that the Army’s main job is saving the lives of our soldiers.”

One of those pediatricians is Dr. Charles Garbarino, a neo-natal specialist who practices in West Orange, N.J. – about 13 miles from New York City. Dressed in a blue jean shirt emblazoned with the characters of A.A. Milne’s colorful Winnie the Pooh, Dr. Charlie, as he likes to be called by his diminutive patients, seems anything but battle ready. But he, too, is heading for the front, starting his second tour in as many years on August 11 in Southwest Asia.

“I’m scared out of my wits,” he says as his wife, Lydia, listens nearby. “Reality is setting in. I went out and bought a holster for my sidearm this weekend. But I’m also planning to bring a lot of lollypops and spend time in Iraqi clinics with their children. If you can make even a little bit of a difference, I think you should. But in the end, I do it for the soldiers.”

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