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Mar. 10, 2008
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Word From War Zone

Doctor-legislator says reality of Iraq conflict sets in quickly

By JOE HECK
SPECIAL TO THE REVIEW-JOURNAL

Nation at War

Editor's note: Army Reserve Col. Joe Heck is an emergency room physician from Henderson who left McCarran International Airport on Jan. 25 for deployment in Iraq. In civilian life, he also is a Republican state senator. Here is the first of a series of dispatches on his experience with the 325th Command Support Hospital in Anbar province.

Joe Heck, an Army Reserve colonel stationed in Iraq's Anbar province, left Southern Nevada on Jan. 25. The Republican state senator is the chief of emergency services with the 325th Command Support Hospital.
Photos courtesy of Joe Heck

Army Reserve Col. Joe Heck stands in the trauma room of a military hospital at Al Asad, Iraq. He is serving a 90-day tour.

Click image for enlargement.

We are approaching day 30, one-third of the way through the tour. I am stationed at Al Asad in Anbar province, which is in the western desert of Iraq. It is a large base that supports several forward operating bases throughout the western part of the country.

My departure on Jan. 26th was emotional -- the Blue Star Mothers arranged a surprise send-off for me and were at the airport pre-dawn with a group of supporters. They presented my mom with a Blue Star flag.

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First stop was Fort Benning, Ga., for in-processing. For the first time, the harsh reality of this adventure sank in -- the briefs on improvised explosive devices (IEDs) made the hair on the back of my neck stand up. It's amazing how many ways the insurgents have found to turn ordinary looking items into deadly weapons, and how many ways they have developed to detonate them. Casualties from IEDs are the greatest threat right now.

Next was 20 hours of flying to get to Kuwait, where the clock started for my 90-day tour.

We spent another five days reviewing what we did at Fort Benning. (You know the Army, if they don't tell you the same thing at least three times, they haven't told you.) But I was glad to get another briefing on IEDs.

Finally, I got to my duty station at Al Asad. I am working in a combat support hospital as the chief of emergency services. We have an emergency room with trauma capabilities. Fortunately, it is fairly slow in the ER, which means the good guys aren't getting hurt. We see a fair number of minor-moderate illnesses and injuries, which is fine.

The Army Medical Department's motto is "To Conserve the Fighting Strength," so getting these troops with minor-moderate ailments back into the fight is priority No. 1. We also see quite a few civilians and Iraqi army, which is all part of the mission to "win the hearts and minds."

But we have had some major trauma as well. Feb. 21 was a terrible day. We received a radio report that the medevac was inbound with a Marine who sustained a gunshot wound to the chest.

We got our team ready and were waiting for his arrival. Then we got word from the helicopter that they were five minutes out and they just lost a pulse. I felt my heart drop. As soon as they landed and we got him inside we worked him hard. We did things that would have been considered heroic and "last-ditch" efforts in the States, but we decided before he arrived that we would do everything humanly possible.

Unfortunately, we couldn't save him. I was crushed. This 20-year-old kid looked like he could have been on the Marine Corps recruiting poster: rugged face, chiseled body, blond hair. You could just tell he was a Marine's Marine. The entire ER staff became somber and sullen. Without a word, the charge nurse and two of my young medics began to clean the body to remove the blood and grime. Then, without anyone saying anything, these two medics spontaneously carefully draped the body with an American flag and took up positions at the foot of the gurney, standing at parade rest -- "never leave a fallen comrade" -- until the mortuary affairs team came to retrieve the remains.

I was never, simultaneously, more proud and heartsick -- proud of my medics and their actions, yet heartsick over the loss of this Marine. He was the first combat trauma that we received since our arrival in theater, and we lost him. His face and name are etched in my brain forever. I have lost many patients in the ER back home, but this one was different. And it affected me much more than any other patient I have lost.

About 30 minutes after we finished that case, we received another call that we were getting a detainee who was shot. Incredible, I thought to myself, we just lost a Marine to insurgent actions, and now they are bringing us an insurgent.

He sustained a gunshot wound to the buttock that went into his abdomen and required surgery. From the time he hit the ER door until the time he was in the OR was 20 minutes -- a feat that many U.S. hospitals cannot achieve. He survived, and was nursed back to health by the fabulous nursing staff and then sent to the detainee facility. We learned later that he was from a separate incident where he and three other insurgents were placing IEDs. His comrades were killed.

A few days later, we had a mini-mass casualty incident when a building collapse from poor construction resulted in five Iraqi army casualties. One was dead at the scene from head trauma, and the other four were brought to us. Most of the injuries were broken bones, but there were some abdominal organ injuries as well. They have all done well.

On the personal side, it is tough being away from the family, as you can well imagine. Especially my 10-year-old son -- he started playing lacrosse this year and I helped coach before I left, but the season will probably be over by the time I get home. Internet access is pretty good, so I am able to e-mail with them and I get to call every so often.

Things have settled into a routine, as much as that is possible. There is not a whole lot to do when you are off shift, although I am on call 24-7 for trauma.

I am hoping to start flying with the medevac crews shortly. My secondary military occupational specialty is as a flight surgeon, so I would like to get outside the wire and fly a little while I am here.

We are succeeding in our goals for the Iraqi people. Unfortunately, only the violence is covered in the media and not the humanitarian progress that is being made. Many of the workers on the base are Iraqi nationals, and they are very grateful that we are here and have liberated their country. They are constantly expressing their gratitude.

Our troops are remarkable, which is something I have always felt, but have now seen. They believe in the mission and morale is high. There is no griping or complaining. They are the consummate professionals, just getting the job done.

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Please enter your name Name: Please enter your email Email: Please enter a comment COMMENTS : (word count limit is 300) You have reached the maximum number of words allowed Current Word Count: Note: Comments made by reporters and editors of the Las Vegas Review-Journal are presented with a yellow background. micheal jackson wrote on April 08, 2008 08:00 AM: i love the kids of the world Mallard wrote on March 19, 2008 03:13 AM: To Mr./Mrs 'The Truth on Heck ', You are a whine baby who obviously didn't get some sort of workman's comp for a fraudulent injury. There are very few people who don't care for Mr. Heck, but your rantings show there is indeed an ulterior motive, and it isn't just because you are probabaly a Demorat. The article was outstanding and brings the harsh reality of something most of us will never know firsthand, thanks to men and women like him. It must be so hard to be so hateful and miserable because of your own doings, and so easy to hold someone else responsible that's an easy mark. For God's sake, have a little decency. The man is helping to prevent another 9/11 in the way he was trained- saving the lives of wounded soldiers so they can continue their mission. Quite whining, learn some respect and be responsible for your actions instead of trying to blame someone else for your misfortunes. People like you make me sick. I could have guess you were a gov. employee- always wanting the pie in the sky. Smithy wrote on March 10, 2008 11:34 PM: Hooah Col. Heck- make us proud!!! Emily wrote on March 10, 2008 11:26 PM: My only problem with Col/Dr/Sen Heck is that he's gone. He is a wonderful man, legislator and physician as well as a father and husband. If he ever did decide to run for Governor, I will be by his side knocking on doors. He is just what this state needs! As a nurse who worked with him in the Emergency room, I can tell you he is one of the best I ever worked with, and one of the most respected. ANd I have been a trauma nurse for 27 years. They are lucky to have him. Jen wrote on March 10, 2008 11:22 PM: To robert miles : May you be protected and thank you for your continuous service. I thank my lucky starts every day our soldiers are proficient in many aspects- ground support, medical, linguistics, cooks, you name it. Everyone can't be playing in the dirtbox or there would be no one to keep order outside the box. God bless you and I hope you never have to meet Col. Heck face to face. But if you do, let him know we pray for him here are are very proud of him as we are you. Edwin wrote on March 10, 2008 11:05 PM: Don't know the man (Heck), but I respect what he is doing. I doubt he had the choice of not going. Call me silly, as a veteran of Vietnam, but I think you go when the big guy, Uncle Sam, calls. I think the hint that it is political in nature is a result of an uneducated, non military person who wishes he were Heck. Heck, I wish I were Heck. He's a good man. God speed Col Heck- let us hear from you again! Michael P wrote on March 10, 2008 10:59 PM: what a great and uplifitng story! Thank you to Col. Heck for being there abd for keeping us updated in ways no newspaper or news station could. I am a registered Democrat but this is the man I want representing me and protecting my life. To you other bums who only have bad to say, there's an Army signup station on East Sahara- I suggest you grow some hair first or you won't last long. Tina wrote on March 10, 2008 10:53 PM: For Mr. Joke: I don't think Dr. Heck is puffing his chest out- I think he is so proud to serve, it just happens. Have you ever been that proud? Probably not since you are writing form Las Vegas and not Iraq, and whining about someone not wiping your butt! Dr. Mark wrote on March 10, 2008 10:49 PM: To my fellow soldier Chris--- As a physician who has been to Iraq, I find it amazing you critisize the one person who you should respect the most. To answer your question of "why only 90 days" my friend, we have practices in medicine that when we leave, we have no billable hours and many patients that depend on us here. When we answer our call to duty, we do it in 3 month increments so we don't lose our practices and livlihood. We do not have cushy jobs- we deal with things no one should have to see- we work hard to save lives and cry when we can't- for people like you. You want us out there in the dirt with you? Well, who takes care of your sorry butt when you get shot or blown up, if we are by your side? Docs aren't suposed to be leading the search for IEDs- we are there to attend to the wounded so you don't die. Which is it gonna be- by your side in the dirt, so we have no medical personel to help when you get wounded, or in the hospitals so we can do what we are trained for, for fools like you? Get off the politics and have some respect man. It might be your life he saves if you're lucky enough. Sam wrote on March 10, 2008 10:38 PM: Regarding publicity4campaign's comment- it must be so easy to write your garbage about one of Nevada's soldiers from your comfy living room where you have no possibility of being attacked, no possibility if getting shot by a sniper, no possibility of having to airlift a patient out and getting shot down, no possibility of an Iraqi insurgent of coming into the hospital as a 'patient' and setting a bomb off (which they are now doing in American military hospitals)no possibility of missing your family, no possibility of not making money for 90 days, except your military pay. Yeah, you're right, Heck's got it easy. That's why you're not over there, huh??? 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