The two sides of luck
November 11, 2013
NANGARHAR PROVINCE, Afghanistan (October 28, 2013) -- At this phase of the Afghanistan Campaign, the most common method the enemies of Afghanistan use to attack Coalition Forces is indirect fire, launching mortars or rockets at their bases. Forward Operating Base Fenty has received these kinds of attacks.
"I was sitting in my room when the blast hit," said Private 1st Class Nathan Lenard, Troop C, 4th Squadron, 9th Cavalry Regiment, 2nd Armored Brigade Combat Team, 1st Cavalry Division, "it kind of knocked me down. I … held there until the blast was over and everything stopped shaking."
Whether or not an IDF round hits anyone is a matter of luck and luck can go both ways.
"At that point I grabbed my aid bag and the rest of my gear and put it on. I started running outside," said Lenard, a combat medic, "as soon as I got outside, I couldn't see anything because there was smoke everywhere. I started to go to the bunker … the smoke started to clear up."
During this attack, one U.S. Army Soldier experienced both types of luck.
"I saw someone [lying] on the ground," said Lenard, a native of Becker, Minn., "when I got closer, I realized that's exactly where the blast hit. When I came up to him I realized that it was one of my [sergeants]."
This time the enemies of Afghanistan had gotten lucky with one of their IDF rounds. The round landed near Staff Sgt. Joseph Gavin as he was running for a nearby bunker. Gavin, a mortarman, Headquarters and Headquarters Troop, 4th Sqdn, 9th Cav. Regt., 2nd ABCT, 1st Cav. Div., was seriously injured.
"He was bleeding from every extremity," said Lenard, "I jumped onto his left leg and started strapping on a tourniquet."
Gavin's luck had changed, this time for the better.
"My other medic ... Spc. [Kyle] Waldera ... he was running down [the stairs and was] putting a tourniquet on his own arm ...and was coming to help me," said Lenard. "He ran over to Gavin's right arm and started working on him."
It was the sound of the blast so close to the barracks that alerted other Soldiers that their battle-buddies might be injured.
"We were told by a cavalry Soldier that the barracks got hit," said Maj. William Vanasse, a native of Milwaukee, Wis.
Vanasse, chief nurse, 759th Forward Surgical Team (Airborne) had been playing volleyball with Dr. (Maj.) Weichen Chen, orthopedic surgeon, 759th FST, and Sgt. Tommy Chavez, operating room non-commissioned officer, 759th FST. The three Soldiers ran toward the sound of the blast. Vanasse estimated that they were on scene in less than two minutes.
There were now five medical professionals working on Gavin. While each of the men was working on the wound in front of him, Vanasse realized that Waldera was having trouble.
"I was telling him to tighten the tourniquet," said Vanasse, "I pressed on his [Gavin's] femoral [artery] … In the moment you're like 'come on' … hurry up."
It wasn't until later that Vanasse and the others realized that Waldera's arm had been broken when he was struck by the shrapnel. With an open fracture of his arm, Waldera continued to work on Gavin in an attempt to save his life.
"I was still packing him [Gavin's wounds] up," said Lenard, "they [the other medics] were … cutting [his] shirt … working on chest wounds, he had maximum facial trauma … some arm wounds; both of his legs had arterial bleeds."
Since he had been discovered, Gavin had been silently laying on the ground.
"We couldn't get communication with Staff Sgt. Gavin at all. We kept calling his name. At that point, I really didn't know if he was alive or dead," said Lenard. "When I was packing the [leg] wound, he screamed 'OWWWW.' That was the best thing I could have heard all day…that means he's alive, he feels pain."
Gavin's streak of good luck continued when a group of Soldiers who had been issued their own vehicle showed up and offered to quickly transport Gavin to the base medical facilities.
"After the IDF went off, we had him in the [aid station] … within 10 or 15 minutes," said Dr. (Maj.) Chan Webster, commander, 759th FST, "which is very fast."
"The expeditious transport was vital," said Dr. (Maj.) Kelly Lesperance, general surgeon, 759th FST, "it probably saved his life."
Several Soldiers were injured in this attack; however Gavin was by far the most serious.
"War injuries are very different. They can affect more than one body part … and they can be more severe. I work at Landstuhl [Regional Regional Medical Center in Germany, the largest Department of Defense military hospital outside the U.S.], where I'm deployed out of; we see all the injured Soldiers … they all come through Landstuhl. [Gavin had] one of the most severe injuries I have seen. He sustained several injuries from shrapnel and blast effects." said Lesperance, a native of Pensacola, Fla., "He was in severely critical condition … on the verge of death."
The medical facility on FOB Fenty is comprised of medical personnel from two units; the 759th FST and Company C, 94th Brigade Support Battalion, 4th Brigade Combat Team, 10th Mountain Division.
Due to the severity of his injuries, Gavin needed a lot of attention; the 759th was able to devote its entire 21-Soldier surgical staff to his case. The 94th treated the rest of the injured.
Gavin was rushed into the operating room where the doctors began to treat his injuries; most importantly they had to stop the bleeding.
"I remember looking into his eyes," said Lesperance, "seeing that look of … he's on the verge of death … and thinking … his family might be down one son this Christmas."
The surgeons were not about to give up on Gavin.
"All of our surgeons were working on him," said Webster, "we're going to [do] everything we can to save [his] life."
When supplies of Gavin's blood type began to run low, the 759th was forced to request an emergency shipment be flown in by helicopter from the hospital on Bagram Air Field. It was still not enough.
"About two hours into the surgery is when we activated the walk-in blood bank," said Webster, "because we only had to focus on him [Gavin], we only had to ask for his blood type."
The walk-in blood bank is just what it sounds like; the service members on the base walk in and donate their blood.
"They asked for his blood type over the [base] intercom," said Webster, "we had lines and lines of people who wanted to donate. We had more people than we really needed. We had to turn some people away."
Each person donated a pint of blood.
"We ended up giving [Gavin] 25 units of that whole blood," said Webster. "He definitely received more blood products than we've ever given to one individual. He received 100 units of blood products."
In addition to the 25 units of whole blood that his fellow Soldiers had donated, Gavin received 75 units of blood that the aid station had on hand; a combination of pre-packaged blood, freeze dried blood, plasma and platelets. Some of this has been treated in such a way that it made it difficult for the blood to clot.
"When you give blood to someone who is hemorrhaging and they don't get the clotting factor," said Webster, "they just continue to bleed out."
This made the whole blood that Gavin received from his fellow servicemen even more critical. This blood still had all of its clotting factors and Gavin desperately needed it. Even with the blood and its clotting factors helping, the surgery itself was not a quick process.
"He was initially on the [operating] table for 5 hours, which is very long for a trauma surgery," said Lesperance, "but considering how many injuries he sustained … and how many procedures we had to accomplish to get him stabilized … it was appropriate."
With the 94th collecting and screening the blood, as well as treating all the other injuries, the 759th was able to dedicate itself fully to Gavin.
And by all accounts they did.
"We had our surgeons almost passing out in there, because they were so dehydrated," said Webster, "we tried to rotate them out and to feed them and get them water. The surgeons were definitely putting all their efforts in there. They were with him the whole time he was in surgery."
Eventually the surgeons were able to stop the bleeding and get Gavin stabilized, before moving him into the recovery area. But the doctors were not done yet.
"We had to take him back into surgery again because he started hemorrhaging again [from] the leg," said Webster, "In total, surgery time was … eight hours."
Gavin's streak of good luck continued; there were no more trips to the operating table.
"Our team feels pretty good about it," said Lesperance, "There were so many factors that fell into place to allow him to survive. It was a very severe injury and we were lucky that everything fell into place."
Eventually Gavin was sent to the hospital at Bagram Air Field.
Currently Gavin is hospitalized in the United States where he is still undergoing medical care. He has had several procedures to remove debris that the blast embedded in his body. He has also received additional blood transfusions. According to doctors this is quite normal for Soldiers who have been exposed to blasts. It will be a long slow progress, but the doctors are confident he will recover from his injuries.
Waldera is also back in the United States; he took some leave before continuing with his rehabilitation and physical therapy.
"I feel good. I was able to do my job. I was able to do what I signed up for," said Lenard, "I got to help someone go home to their [family]."