Our Tank


This is an Abrams tank:

This is a United States Marine:

This is what an Abrams tank can do to an automobile:


Imagine what an Abrams tank could do to a Marine. Gruesome, eh? But maybe you don’t know Marines like we did in Navy Medicine. Maybe you never met our Tank.


Tank arrived at the National Naval Medical Center in Bethesda, MD in the very first wave of injured Marines from Operation Iraqi Freedom in the spring of 2003. Tank was not his real name, but it’s how we came to know him, and how we introduced him to the CommanderinChief when he visited his wounded Marines. Among the early American heroes from that conflict, Tank epitomized the toughness and resiliency of the men who had gone into harm’s way.

We named our poster Marine  after the U.S. combat vehicle that caused his injury. During a short break from sustained operations, Tank dozed against a mound of warm Iraqi sand. By design, his desert camouflage uniform blended into the terrain. The driver of the maneuvering vehicle never saw his comrade in arms. As one track of the Abrams ran over Tank’s body at pelvic level, the sand absorbed enough of the crush that he sustained only reparable injuries, a fractured pelvis and ruptured bowel.

Thanks to emergency surgery on the battlefield and in forward deployed hospitals, Tank survived the initial trauma. Just a few days after the mishap, he arrived at Bethesda with a repaired bowel and temporary colostomy, bedridden from the fractured pelvis.  Physically and emotionally, he remained in combat. 

This indomitable Marine did not wallow in his rack. He soon overcame the restriction to bed, got up on crutches, and made daily rounds on the ward where about 30 wounded Marines recovered from a variety of injuries. “Oo-rah, Marine,” he would say. “Look at me. If I can survive, and walk, so can you!”

In the nearly ten years since Tank returned from the battlefield, thousands of Marines and soldiers did survive their wounds, and got on with their post-traumatic lives attacking their disabilities with the same spirit as they did the enemy at arms. 

Military medicine rightly touts the advanced trauma care and sophisticated technology that have resulted in the best survival rates of any modern war. In truth, those are just adjuncts to the primary healing force we saw on that ward: Tank and other Marines who refused to quit, refused to consider themselves disabled, and rallied each other to health.

I recall another recovering young Marine’s immediate response when asked where he wanted to go for convalescent leave upon discharge from acute care in the late spring of 2003:

“Bagdad!”

Semper Fi, Marines!

Tank

The President of the United States didn’t really bestow the nickname, “Tank,” on the young Marine, although that made a good story. POTUS did meet Tank at the National Naval Medical Center, and he took an immediate liking to the charming young man. But he didn’t coin the nickname. In typical Marine camaraderie, Tank’s fellow wounded combatants bestowed the moniker.

Tank arrived at NNMC Bethesda in that first wave of injured Marines. He was a victim not of enemy fire, but an equally dangerous threat called “DNBI,” for “Disease/Non-Battle Injury.” Simply defined, DNBI is death or disability that we inflict on ourselves. Looking at any conflict in our history you will find that DNBI usually exacts a larger toll on battle effectiveness than does any enemy action.*

A U.S. Abrams tank caused the non-battle injury to its namesake Marine. In the heat of sustained combat operations, Marines rest when and where they can. Tank dozed with his back warmed by the Iraqi sand. By design, his desert camoflague uniform blended right into the terrain, and the driver of the maneuvering vehicle never saw him. One track of the Abrams ran over Tank’s body at pelvic level. If laying on asphalt or concrete, he would have been killed almost instantly. But the soft sand absorbed enough crushing pressure that he sustained reparable injuries, a fractured pelvis and ruptured bowel.

He came to Bethesda with a repaired bowel, temporary colostomy, and still bedridden from the fractured pelvis…physically and emotionally still in combat. His indomitable spirit rapidly overcame the restriction to bed. No wallowing in the rack for this Marine! Before we knew it, he was up on crutches. Every day he made his own rounds on the ward where about 30 wounded Marines recovered from a variety of injuries. He exhorted them, cajoled them, encouraged them. “Oo-rah, Marine,” he would say. “Look at me. If I can do this, so can you!”

Most of those wounded Marines did survive and got on with their post-traumatic lives, in or out of the Marine Corps. But in truth, our advanced trauma care and sophisticated technology were merely adjuncts to the primary healing force on that ward: Tank and other Marines like him who simply refused to quit, refused to consider themselves disabled, and rallied each other to health.

I recall another recovering young Marine’s immediate response when asked where he wanted to go for convalescent leave upon discharge from acute care in the late spring of 2003.

“Bagdad,” he said.

Semper Fi, Marines!

*In my early flight surgery days I did a little study demonstrating how injuries sustained in hangar bay basketball games and other recreational sports negatively impacted the medical readiness of an aircraft carrier’s crew. The conclusion asked for improved safety measures, not cessation of these important recreational outlets for deployed sailors.

…Fi!

The two Latino-Americans grew up in the Texas Hill Country, not far from each other.  Roughly the same age, they both entered military service soon after high school. Staff Sargeant Alameda, USMC, and Hospitalman Alvarez, USN (not their real names) met and became good friends when both were assigned to a Marine Corps Logistics unit shortly before Operation Iraqi Freedom (OIF). Staff Sargeant Alameda was a regular Marine. Hospitalman (HN) Alvarez was a Navy hospital corpsman assigned as medical support to that Marine unit.

Navy Medicine provides health care to the Marine Corps, which owns no intrinsic medical assets. Many Navy doctors, dentists, nurses, medical service corps officers, and hospital corpsmen are assigned to the Marines over the course of a career. They wear Marine Corps uniforms, drill and exercise with their Marines, adhere to the same physical standards, and otherwise become an integral part of the units they support. Above all, the relationship of a hospital corpsman to his Marines is the most important and revered. Every Marine depends on his “Doc” for his life, and he knows that the Doc is prepared to make heroic efforts to save the life or limb of a Marine.

So there they were, in the early days of OIF traversing southern Iraq, miles behind the initial assault. The unit had stopped for rest and chow. Diving into his MRE, Staff Sargeant Alameda strolled around near his vehicle. A sudden, deafening explosion disrupted the tranquility of the place, quickly followed by a primal scream. The young Marine had stepped on a concealed Iraqi land mine. He lay in agony on the sand, bleeding profusely from the remant stump of a leg blown off.

“CORPSMAN UP!” came the immediate call. Hospitalman Alvarez, as any corpsman would do, rushed to the aid of his fallen friend and comrade, mindless of his own personal safety. As he knelt beside the victim, another explosion unexpectedly scrambled the scene. The ensuing primal scream came from HN Alvarez himself. He had knelt onto another concealed mine, whereupon he suddenly became not the rescuer, but the second casualty. And he too had lost a leg in the detonation.

Thanks to the most sophisticated and capable field trauma care in history, both amigos were rapidly medevaced to a nearby emergency resuscitative surgery site, where they underwent immediate life-saving operations to control bleeding from their traumatic amputations. They were then air lifted out of Iraq to the Landstuhl Regional Medical Center in Germany where they received their secondary definitive surgery. Within three days of the initial explosions, the two comrades in arms arrived at the National Naval Medical Center (NNMC) in Bethesda, MD. They were two of the first four OIF casualties received there.

Even though they were now safely ensconced in a hospital room thousands of miles from the war, emotionally and physiologically they were both still in combat. The support they gave to each other in those first few days, and that given and received from fellow Marines, made a huge difference. Both survived their initial wounds and ultimately wore state of the art prostheses. If you passed either of them on the street six months after their injuries, you would not recognize either one as an amputee.

Once he recovered from his injuries, newly promoted HM3 Alvarez elected to stay in the Navy and requested orders to NNMC Bethesda. He wanted to continue caring for wounded Marines.

The year after his knee hit that land mine he and his spouse were honorees at the annual Hospital Corpsmen Ball. They seemed ill at ease sitting at a head table with a Navy Medical Corps Captain and his equally uncomfortable spouse.

The HM3 didn’t feel particularly worthy of all the honor and attention. He never considered himself a hero. He was just the Doc taking care of a wounded Marine.

Similar scenes have occurred thousands of times since OIF began in early 2003, and will recur as long as this or any conflict involves Marines going into harm’s way. It’s what Hospital Corpsmen do. It’s what all of us in Navy Medicine do when called the serve the Marines.

We remain supremely honored to do so.

Semper Fi, Marines!