Balad ER: A ballet of chaos

AVIANO AIR BASE, Italy -- Since my arrival at Aviano, I've been asked on several occasions to describe what it was like to spend a year as the commander of the Air Force Theater Hospital at Joint Base Balad, Iraq. Many of those reading this article have deployed in support of Operations Iraqi Freedom and Enduring Freedom or both. You all have your own stories, usually starting with "there I was ..." and sharing them is an important part of bringing the message home to loved ones and co-workers. 

As with any military success, it all boils down to people and to the leaders at every level required to make the mission happen. Three recollections come most immediately to mind: 

I had the chance to work with four group superintendents during my time at Balad. All were superb, but one was simply a force of nature. He engaged with each medic, eyeball to eyeball. He coached, he railed, he hugged, and he worked side-by-side with our medics in the emergency room, and at all levels within the facility. As importantly, he engaged with our Army partners, working within the group of Army sergeant majors to open lines of communication, work common problems, and create an environment where joint operations were truly joint. 

The second recollection that comes to mind is when a group of biomedical repair and facility technicians decided we needed a common area for relaxation/celebrations and took it upon themselves to gather materials and build an impressive oasis for all to enjoy. The work was backbreaking and done just as the heat started to become a real issue. It was also done off duty in an environment with precious little free time. These medics made considerable personal sacrifices to craft something that benefitted almost 800 personnel and became a focal point for unit cohesion. 

Lastly, on our deployment, volunteers were huge contributors to our success. They would often work their own 12-hour shift, then come to the hospital and spend several hours doing all sorts of work: loading and unloading patients onto helicopters or ambuses, working as couriers, serving as non-medical attendants, or just folding scrubs. It was common to see a volunteer spending an entire day off at the hospital, sacrificing their down time for the care of our patients. 

On one occasion, I saw a fighter pilot washing blood off of stretchers with a pressure washer. When asked why he'd selected that volunteer duty, he simply replied, "It helps give me some perspective," and kept on washing. 

These are only three short descriptions of remarkable people doing remarkable things in a hostile environment. Here are a few of the common characteristics these medic leaders displayed: initiative, energy, focus, and a commitment not only to our patients, but to one another as medics. 

I described the ER at Balad as a "ballet of chaos," in which dozens of people swirled around dozens of casualties, doing God's work in a noisy, disruptive environment where the stress level was high and adrenaline output was set to the max. We were entrusted with the lives of our injured warriors, and the work of creating and sustaining teamwork, while cultivating individual excellence set the stage for the clinical successes we enjoyed. 

The leadership themes described in these stories are not medic-specific, and invite reflection from all as we consider our many and varied
experiences.