06 March 2002 – Cole Range, Fort Benning, Georgia
Jeff’s arms shook while straining to hold his fifty-pound rucksack over his head. The assigned task wouldn’t be difficult on a regular day, but this wasn’t a regular day. The cadre at the Ranger Indoctrination Program had driven the candidates hard for the twenty hours they’d been awake so far. The three days since Jeff’s class arrived at Cole Range were sharp departures from the first week of RIP. Those first days ended at 1700. The candidates slept in barracks. But if the cadre here stuck to the pattern he’d seen over the last few days, Jeff’s class wouldn’t get to sleep until sometime after midnight and then only for two or three hours at a simulated patrol base.
Ten candidates dropped out after the first day. The original class of one hundred sixteen candidates dwindled rapidly, more so when Cole Range began. Soon, just fifty-nine remained.
“Why don’t you just quit, old man? There’s a nice warm fire over there. We’ve got burgers and dogs waiting for you, too.”
Through the screaming pain and numbing exhaustion, Jeff recognized SGT Biggs’ voice – one of the RIP cadre – as he stood behind Jeff, out of view. SGT Biggs wasn’t the only member of the cadre trying to plant the kernel of doubt in his mind. They targeted everyone. In that there was no discrimination.
The RIP cadre’s job was to weed out those who couldn’t push past their limits. They delighted in telling candidates there was no quota. In fact there were times when no candidates graduated from from an RIP class. Jeff knew that the entire course was a giant mind game – they were testing him and his classmates. There was no way he was going to quit, however, no matter how inviting Biggs’ question sounded or how good the food smelled. Even as in-shape as Jeff kept himself, the combination of three endless days of physical exertion, of expending more calories than he took in, was starting to chip away at him. His internal struggle whether or not to quit troubled his mind. Although the voice urging him to quit was faint, it was there. It nagged at him. After two hundred four-count flutter kicks the cadre released the class for their evening meal of MREs – the burgers were for the cadre – and a nap. Jeff woke at 0530 the next morning mostly rested.
“How you holding up, old man?” Jeff’s current Ranger buddy, SGT Todd McKnee, asked.
Buddy assignments shifted to keep the pairs in alphabetical order after voluntary withdrawals and cadre drops. McKnee entered RIP to rejoin the Rangers. He was part of 2d Battalion from 1996-2000. He too reenlisted after the 9/11 attacks, but he refused to sign his contract until he was guaranteed another shot at the Regiment. He and Jeff were the only two candidates with prior military service, and the only two sergeants in their class.
“As the SEALs like to say, Todd, ‘The only easy day was yesterday.’ We can only suck it up and drive on until they let us sleep again,” Jeff muttered while they shaved.
The morning and afternoon passed in another blur of PT and ‘hitting the wood line,’ repeated half-mile sprints to the woods and back. RIP was to be endured to reach his final goal: a tan beret and a scroll-shaped Ranger unit patch. The men in charge at RIP were those who’d been there and done that. Jeff once smelled the smoke and saw the elephant too, but not as a Ranger. When he passed RIP he was sure he’d be in the best shape of his life.
That night the instructors put Jeff’s class through a new evolution: night land navigation. He did well at land nav earlier in the week, despite being a decade out of practice. His skills returned with a quick review. Everything else so far at RIP was done with a buddy, but students were sent out for night land nav alone and ordered not to speak to anyone. Jeff suspected the instructors would somehow try to confuse and test them while they searched for their waypoints. At the command to start he shut out the distractions and concentrated on his task. He was acutely aware that hunger and fatigue caused careless mistakes. Being able to perform while hungry and tired was a necessary skill in the Rangers.
All that mattered to Jeff was finding the waypoints on his card. Voices called out to him while he searched the forest for points. He ignored them. Jeff was the fifth or sixth person to finish which earned him almost a half-hour of rest. Todd finished right behind him. They watched another six soldiers pull themselves out of the class. Jeff figured they decided that RIP wasn’t for them, or perhaps they felt they committed some honor violation.
Some of the candidates prepped their rucksacks and other equipment Friday morning for an eight-mile road march. These men hadn’t kept pace with the RIP cadre on the six-mile road march the previous week. Four men dropped out before the march. Todd and Jeff had kept pace. They enjoyed another morning of sprints and upper body-focused PT at Cole Range instead. While the road march group trudged through their evolution, the RIP cadre surprised Jeff’s group with a lunch of flame-broiled burgers, chips, and soda to celebrate completing their week at Cole Range.
“Men,” SGT Biggs said while they ate, “you’ve earned this little shindig by being in the first group on the road march last week and by making it through this week. You’re halfway through RIP but you’ve still got critical evaluations ahead of you over the next two weeks. Don’t slack off. After lunch, police up your things and get ready to move back to the barracks. Use any slack time to check your equipment. When the road march group gets back and they’re squared away, we’ll head back.”
Jeff and Todd weren’t class leaders or subordinate leaders that day but they were always expected to set an example as NCOs. They made sure their gear was squared away, helped the rest of the winners group check theirs, and helped with the road march group’s gear when they returned. Forty-five men boarded the bus back to the barracks. Then three more dropped out.
The final week of March found Jeff enjoying early spring weather in Central Massachusetts. A delayed fifth birthday party for the boys doubled as a welcome home party. Jeff would be home for one week before reporting back to Fort Benning. The 3d Ranger Battalion would be his new unit after they returned from their current deployment and he completed the Special Operations Combat Medic course at Fort Bragg.
Jeff’s combat medic course wasn’t scheduled to start until July 1st. His friend Donal waited for his RIP class to start on April Fool’s Day. Assuming Donal graduated, they’d travel to Fayetteville together. The six-month SOCM course would finish by the end of the year. They’d complete a compressed version of paramedic school, along with extra training, and would complete clinical rotations at a Level One trauma center. When finished, they’d have a knowledge base equivalent to that of a nurse practitioner or physician’s assistant.
Jeff experienced another moment of déjà vu standing on a porch in Greenwich, Massachusetts during the middle of his week home. He visited with his friends Kathy and Jack earlier that morning before driving to this house after lunch. He tapped the brass knocker to announce himself as he’d done here so many times before. He smiled at the person who answered the door.
“Hi, Jeff,” Jane Donnelly said, wrapping her daughter’s longtime best friend in a hug.
Jane was first among his friends who told him he was crazy to rejoin the Army when he had a young family to look after. She’d been among the first, however, to also call and apologize.
“Hi, Mom,” Jeff joked before kissing her on the cheek.
Jane hugged him harder. He and Heather considered themselves siblings at one point so they had called both mothers ‘Mom’ for a while. Jane still thought of him as him her adopted son.
“Thanks, Jeff,” Jane sniffed, wiping a tear from her eye.
He kept an arm around the shorter blonde woman while she led him into the living room. There a white-haired copy of Jane rose from the couch to hug him. Every time he saw Alice Cavanaugh Jeff thought Jane and Heather owed their good looks to her.
“Hi, Jeff.”
“Hi, Alice. You haven’t aged since the day I first met you.”
“I should hope not! I’m still twenty-nine!”
“HEY!” barked the other occupant of the couch. “You muscling in on my girl, Airborne?”
“That’s ‘Ranger’ now, Colonel,” Jeff replied, shaking hands with Tom Cavanaugh.
“Congratulations, Jeff, but no more of that ‘Colonel’ nonsense, okay? You’re not that scared nineteen year-old kid I found standing in my office anymore.”
Jeff first met Jane and Heather in December 1988 when the former piloted his plane home from North Carolina. They then gave him a ride from Westover Air Force Base in Chicopee to his family’s annual Christmas party in Dana. The ladies enjoyed four hours at the party, then invited him to dinner at this very house the following week. Once here Jeff learned that Tom Cavanaugh was an Army vet, a former commander of the parachute infantry regiment he served in at the time. Between Tom and Alice they nearly scared the crap out of him that night.
“Roger that, Colonel.” Tom wagged a finger in warning. They shared small talk until Alice asked the question Jeff expected.
“Jeff, still no word from Heather?”
He sighed and shook his head. “I’m afraid not, Alice.”
“I have no idea what’s wrong with that girl,” Jane muttered.
“It is what it is, Jane. When she and I decided that we’d be better off as brother and sister than boyfriend and girlfriend, I told her I’d be her brother for as long as she’d have me. Maybe that’s run its course? I can’t force her to talk to me, and I’m not going to her house to pound on the door! I’d like to be part of the Ranger Regiment for a little while before they toss me out for conduct unbecoming.”
“What she’s doing is wrong!”
“She feels what I’m doing is wrong, Jane. That’s her reality, whether we agree with it or not. If I push, what happens then? I don’t see too many people afraid to speak their minds in this room and I know the apple didn’t fall far from the tree with her. I want my friend back as much as you want her to talk to me again, but it has to be her choice, Jane.”
“Good morning, sir,” the young woman at Brophy EMS said when the visitor stepped into the lobby. “How may I help you?”
“Is Sean Brophy in?”
“Do you have an appointment with Mr. Brophy today?”
“No, not today.”
“I will have to see if he’s available to meet with you in that case. If you’ll give me your name I’ll see if he has time to see you, sir. Feel free to have a seat while I do so.”
Jeff nodded and sat where he waited for his first interview with Seamus Brophy in 1993. Like that day he didn’t have to wait long. Within a minute of the receptionist’s call to his office, Sean burst into the lobby. Jeff rose to meet him. Sean ignored his outstretched hand and embraced his friend.
“Holy shit, are they feeding you cement?” Sean asked, squeezing Jeff’s bicep.
“The workouts got a little intense during Ranger Indoctrination.”
“You think?”
“Are you going to say hi to me, or just ignore me for the rest of your visit?” a different voice asked.
Jeff looked behind Sean to see another of his former partners, Shawna LeStrange, smiling at him. He hugged her, too.
“I expected to find this misplaced Southerner here, but this is an added bonus, Shawna. How have you been?” Sean McNeil Brophy was born and raised in Clinton, North Carolina and earned a business degree at Duke before moving to Boston.
“Before you guys start catching up, let’s go to my office and let Terri have the lobby back.”
Those who worked in the Malden office before Jeff’s departure for DMD two years ago sprang up to greet him. Walking to Sean’s private office took almost twenty minutes.
“So you’re a Ranger now?” Sean asked once his door shut.
“Well, I’ve made it to the Regiment, Sean. They say that it’s harder to stay there.”
“Like that’ll be a problem,” Shawna snorted.
“I’ve still got probably a year of training before I make it to being an official Ranger medic, Shawna. I have to make it through both upcoming courses. Then I have to get up to speed to be a useful part of my unit once I get there. Training is constant in the Regiment. Even more so now. I’ll have to meet and maintain the standards.”
“You’re still not done with training?” Sean asked. “Does that add time to your enlistment?”
“No, I signed a four/four contract – four years active duty and four years inactive reserve. I’m headed to my Special Operations Combat Medic course in July. That’s six months of training. Ranger School after that is another two months of training. Depending on their class schedule it could be close to a year before I’m finished and at my unit. The time spent training won’t add time to my enlistment unless I have to repeat part of either course. I owe the Regiment twenty-six months once I finish SOCM. Anyway, how are things here?”
“Good, despite a gaping hole in one of our divisions’ management team.”
“Come on,” Jeff replied. “It can’t be all that bad, can it?”
“It’s okay,” Sean admitted. “I’d be happier if you were still out in Shirley running things. Your team’s taken up much of the slack out there and Dad and I are about ready to name an interim operations manager. We forget how nice it is to have someone else looking after all the daily details until they’re not.”
“I’m sure it’ll be fine.”
Sean looked at his friend from across his desk. “There are no guarantees in life, remember?”
Jeff’s brief visit back to the civilian world ended before he got the chance to fall back into that life again. In a way it was a blessing. He wouldn’t have to re-acclimatize himself to the military like in October. His week was long enough, however, to let him catch up on the happenings around the country.
Jeff learned the administration was trying to link other countries in the Middle East to the September 11th attacks, more specifically Iraq.
“Which is crap,” he muttered to Keiko while they watched the news the night before he returned to Fort Benning. “The Iraqis couldn’t find their asses with two hands and a flashlight right now! They’ve only just poked their heads up after a decade-long civil war! There’s no ‘government of Iraq’ to have ties to Al-Qaeda or Bin Laden!”
“I do not see how they are drawing these conclusions either, Jeffrey.”
“At least the President made the effort last year to distinguish between the terrorists and the typical followers of Islam. I don’t think even the mullahs in Tehran would go so far as to side with those thugs. They may call us ‘The Great Satan’ but openly siding with terrorists would be beyond the pale.”
Keiko hugged Jeff harder. “Your class will not finish until the end of the year?”
“If the coursework doesn’t kill me before then. It’ll be the equivalent of half of medical school condensed into under a year, if you count the clinical rotations.”
Keiko shivered at the phrase ‘kill me.’
“And then?” she asked.
“Sorry,” he said in response to her shiver. “Ranger School. That’s another two months, if it fits into 3d Battalion’s combat rotations. I don’t hold an infantry MOS any longer but I am an NCO, so I think that means I’ll go before I report to my company. I’ll find out for sure when I get back to Georgia.”
“Will you be allowed visitors?”
“I should be, at least while I’m in the classroom portion of the training. I hope to be able to stay in contact better than during RIP, too.”
They sat in silence for a moment.
“Each day that passes brings you closer to the day you will go to war,” Keiko whispered.
“I can’t promise that I won’t get hurt, Keiko, but the guys I’ll be with are some of the best in the world at what they do. I’ll be as safe as I can be in that environment.”
Keiko burrowed further into her husband’s arms. Taking care of the kids and focusing on her class lesson plans helped keep her mind off where Jeff was headed. The quiet times were when the worries about the dangers he faced crept in.
Keiko fell in love with Jeff the moment they met in his barracks room at Fort Bragg. Her brother Ken told his family how Jeff became his friend within days of reporting in, and soon became his best friend. Then his roommate and Keiko fell hard for each other the weekend she visited. At that point Jeff still had two years to go on his enlistment. Keiko had just finished high school and would be at the University of Virginia until 1994. Years of separation, other relationships, and even Ken’s death hadn’t kept Keiko and Jeff from marrying in 1996, only two years after reconnecting.
Jeff was Keiko’s life partner in every way. She could no more imagine her life without him than life without the children. Wrangling three children under five years old by herself wasn’t any fun, but having her parents next door made things so much easier. The children were showing themselves to be the product of their parents’ guidance, love, and attentiveness even at their young age. Keiko hoped his reenlistment would not cause Jeff’s influence to diminish.
Keiko knew she came unhinged the day of the September 11th attacks. Her behavior that day still surprised and concerned her. Since her parents’ safe return that dark day she’d held herself together. The exception to that was when Jeff announced he would return to the Army. Her friends and family knew Keiko as a tough, strong woman. While this was true something she recently heard was also coming true: “She’s strong but she’s tired.” She had no choice but to remain strong for her family especially with her partner absent. She couldn’t afford to let her fears and weaknesses show right now.
Jeffrey, bless his heart, sees the strain I am already feeling, Keiko thought. He spent as much time as possible with her and the children while he was home. The little things he always did for her became even more apparent once he wasn’t around to do them. To have them return with her husband gave Keiko a small measure of comfort.
Despite all her fears, Keiko truly knew the man she fell in love with and married. She knew that he would reenlist after 9/11. His desire to join the Rangers dated from high school and wasn’t surprising. His drive to succeed, to be the best at whatever he attempted, propelled him to a senior management position in EMS by the time he turned thirty-two. Now it motivated him to join one of the most elite and demanding special operations units in the Army. Nothing would stand in his way.
“I know you will be careful, Jeffrey. I do not want you, however, to hold back during your training. I want you to kick ass.”
“Keiko?” he chuckled. “That’s not something you’d usually say. Normally you would say ‘I wish for you to expend maximum effort in your endeavors,’ or something like that.”
Keiko poked him in the ribs. “Do not think for one moment that I will not give you a sound thrashing, Jeffrey. The men you are training to join are the best at what they do, but I will still kick your posterior.”
Jeff tickled his wife, drawing a rare giggle from her. “It’s good to hear you laugh, Keiko. I worry about you and the strain my decision’s putting on you.”
“I cannot say that this is not difficult,” Keiko sighed, “nor that it will not get more so, but I know the man I married. Jeffrey, we spoke of this in a limited way before you reenlisted. You and I are in agreement in that we feel there is a significant threat to our nation, one that is more obvious than the long-simmering Cold War. We are in agreement that we should confront that threat at its origin, not here at home.” She sighed again. “‘In good times and in bad,’ Jeffrey.”
“Your strength continues to awe me, Keiko, but don’t be afraid to ask for help. Our families, including our Army family, are here to support you.”
“The children and I have begun their introduction to karate here at home. We are on the mat every day after I pick them up from Big Steps. All three of them appear to enjoy it, particularly Sabrina. It is helping us maintain our bond and focus.”
“Sabrina, our little ninja,” Jeff chuckled. “What did you decide about the dojo?”
“Regrettably, I decided to scale back on my teaching there. I will only teach the Saturday intermediate class for now.”
“Is that Emily and Ben’s class?”
Emily Daoust started watching the children for them when the boys were six months old. She was the youngest daughter of their sensei. Ben Mattson, another student at their dojo, was her boyfriend of over four years.
“Yes, husband, it is. I suppose I am playing favorites but I seem to derive the most pleasure from teaching their class at the moment. I have enjoyed watching their growth through the years.” Keiko wormed her way out of Jeff’s arms and off the couch before pulling him to his feet. “You are leaving in the morning. Let us go make some more memories.”
Memories crashed over Jeff while carrying his duffle bag into 3d Ranger Battalion headquarters to report in. For a brief second he was eighteen and reporting to the 82d Airborne. He saw another soldier approaching and reached out to hold the door open. The soldier jogged to the door.
“Thank you,” he said, stepping through. He saw the rank on Jeff’s Class-A sleeves and snapped to parade rest. “Thank you, Sergeant!”
“As you were, Specialist,” Jeff replied. “You’re gonna hurt something snapping and popping like that!” he grinned. He extended his hand. “Jeff Knox.”
“Good to meet you, Sergeant. I’m Specialist Benny Montoya, company clerk for Headquarters and Headquarters Company, 3d Ranger Battalion.” Montoya saw the combat star on Jeff’s jump wings and scanned his ribbons. “Panama?”
“Right,” Jeff confirmed. “Back when I was young, dumb, and full of ... well, piss and vinegar.”
“That’s not usually how that saying goes, Sergeant.”
“I’ve got three small kids at home,” Jeff shrugged. “I had to censor myself during my leave last week and I haven’t shaken the habit yet. Anyway, I’m here to report in.”
“Well, let’s head into the office and get you squared away, then.” Once in the battalion office, Montoya muttered while reading Jeff’s file. “You’re here until 25 June and then you’re off to Bragg for SOCM. They’ll get you trained up on part of your battalion duties while you’re here, but the bulk of your training will come when you get back from Bragg.”
“Am I looking at Ranger School at that point too?”
“As an NCO coming into the Regiment, yes. The battalion just deployed. They’ll be two months from rotating back from the ‘Stan by the time you return from SOCM. I’d guess you’ll be starting Ranger School just before they return. We won’t deploy again for at least another nine months after that from what we hear, if not longer, so you’ll have time to finish up.”
“How’d you get stuck here while the rest of the battalion’s on deployment?”
“It was my turn,” Montoya shrugged. “I was on the battalion’s deployment right after 9/11. It’s all good. You gotta have someone here to keep the lights on and there aren’t many company clerks sporting a combat Ranger scroll!”
Jeff’s laughter joined Montoya’s. The laughter stopped when a gruff, compact man limped into the office. Montoya snapped to parade rest again and this time Jeff followed suit.
“Good morning, Sergeant Major!” called the company clerk. The older man grunted but that was all. He unlocked his office, stepped in, and all but slammed the door behind him.
“Sergeant Major Springer,” Montoya whispered. “He’s less than thrilled he isn’t overseas with the rest of the unit.”
Jeff nodded but didn’t say anything. He knew too well how sensitive people’s hearing could be at the worst possible times. Montoya showed him where things were on a map of Fort Benning and answered a few of his questions before a first lieutenant entered the office. He was the senior officer present in the battalion and the headquarters company XO. The LT acknowledged Jeff’s reporting in and cut him loose so he could head to the barracks and get squared away there. Jeff joined part of 3d Battalion’s stateside presence for lunch at the nearby DFAC later. Benny Montoya handled introducing him around.
“So how’d it go over at Regiment?” Montoya asked.
Jeff shrugged. “Well, with me here I can conduct battalion sick call, at least until I leave for Bragg.”
“‘Battalion?’” snorted Rafael ‘Rafe’ Figueroa, a wheeled vehicle mechanic. “Platoon is more like it.”
Jeff shrugged again. “It’ll be good practice for when I get back here. I certainly didn’t do that kind of work as a civilian paramedic. Not on a regular basis that is.”
“You were a medic before you joined?” asked Bert Norfolk, another member of the battalion’s office staff.
“I’ve been in EMS since I got out of the Army in ‘91.” Jeff replied while chewing his sandwich.
“And you came back?”
“Yeah. Gave up an operations manager’s position, too. Some things are more important.” He looked around before he lowered his voice. “Now, what’s the deal with the sergeant major?”
“He caught three bullets in his right thigh about three months ago. One of them cracked the thigh bone just enough to keep him sidelined,” Benny Montoya whispered back. “He’s been grumpy as a bear since he got back here. Babysitting those who don’t deploy, isn’t high on the list of things he joined the Rangers for. It’s a shame he’s closed himself off, too, because he’s hands down the best gunfighter in the battalion and a role model to most of the enlisted soldiers. He used to be more outgoing and approachable.”
“When does he need to be back up to speed?”
“He’s got a little less than six months to get back in fighting trim or he might be RFS’ed. He’s been in the Regiment a looong time, which is another reason why he’s not very happy. He doesn’t want to leave yet.”
Jeff searched his memory for the acronym Benny used. “RFS? Released for ... standards?”
“Right. I suppose it might technically be RFM, released for medical, but it’ll be the same either way: he’ll be out of the Regiment if he can’t perform. If the battalion weren’t deployed he’d already be out.”
“So they stuck him here instead of cutting him loose?”
“Yeah. Could be worse.”
Only two more weeks and I’ll be headed to Bragg, Jeff thought to himself. I wonder how Donal’s doing at RIP?
3d Battalion’s area is across the vast expanse of Fort Benning from where RIP is held. There is no contact with the Regiment for the soldiers in the program. RIP graduation would be next week. Jeff wouldn’t know if his friend would graduate until a few days before the ceremony.
Jeff finished squaring himself away after breakfast and walked over to the battalion office. Benny asked him to stop by to finish up his paperwork for SOCM. His slot was guaranteed, but a couple of forms still needed filling out.
Jeff rolled his eyes when thinking about spending time in the same office as Sergeant Major Springer. Everyone else in the battalion welcomed him three weeks ago. Even the LT made a point of greeting Jeff whenever he was in the office, but the senior enlisted man’s attitude was noticeably colder than before. Jeff guessed the man’s rehab was not progressing well.
“Hey, Sarge,” Benny Montoya waved when Jeff stepped into the outer office.
The younger man stepped away from his desk with a file in his hand, but the ringing phone made him walk back to it. Bert Norfolk wasn’t in the office so there wasn’t anyone else to answer. Benny answered while looking at Jeff and waving the file at the sergeant major’s office. Jeff caught Benny’s question and nodded, carrying the file to SGM Springer’s door. He raised his hand to knock on the door frame but froze before he could.
SGM Springer sat at his desk sweating, white as a sheet, and slumped in his chair. Jeff darted into the office without hesitation. Feeling for a pulse in SGM Springer’s wrist he barely found one and it felt irregular. The one in his neck was stronger but not by much. Jeff noted the distended veins in Springer’s neck. Both pulses seemed to weaken when Springer took a breath. Jeff hauled the older combat soldier out of his chair and laid him on the carpet. He tipped that chair over and draped the man’s legs over it to keep them elevated.
“Chest pain?” Jeff asked. Springer nodded with fear in his eyes. “Show me. Point with one finger where it hurts.” After the man pointed to the center of his chest, Jeff asked, “How long?” Springer held up five fingers. “Minutes?” Another nod this time. “Any pain in your back? Between your shoulder blades or in that area?” Yet another nod. Jeff saw the line in-use indicator on the phone wink out.
“BENNY!” he bellowed. The younger man was in the office in less than a second. “Call an ambulance for the sergeant major, tell them it’s a heart attack, then run down to the office I’ve been working in and grab my bag, please?” Jeff looked to the sergeant major but still felt Benny in the room. He looked back. “Benny, GO!”
While Benny retrieved Jeff’s medic bag, Jeff worked Springer’s BDU shirt off. He folded it and placed it under the man’s head. He looked around and spied a large rucksack next to the couch behind him.
“Sar’Major, is there a poncho liner in your ruck?”
Jeff opened the ruck after another nod and pulled out the thin, polyester-filled blanket. Benny returned to the room while Jeff dashed back to the sergeant major. Jeff tore open his medic bag after telling Benny to wrap the sergeant major in the blanket. He pulled IV start equipment and a liter bag of fluid out of it after checking Springer’s blood pressure and lung sounds. Benny hesitated.
“Sarge, he’s sweating.”
“He’s sweating because his pressure’s in the toilet. Where’s that ambulance?” Jeff asked while starting the IV. Once finished he looked for the cardiac monitor ... the one he didn’t have. Dammit! Time for a WAG... Bert Norfolk wandered into the office.
“There you guys are. Where’s the ambulance headed?” he asked while waving at the medics behind him.
“Over here!” Jeff flicked the IV flow control wide open. “Right-sided IMI,” he told the medics. “Get him packaged up? I’m gonna call Martin.” Jeff grabbed Benny and pulled him out to the main office. “Can you get me the ER at Martin? Ask for either the charge nurse or the attending physician. I need to give one of them a report so they can have things ready for the Sergeant Major when we get there.” Benny nodded.
Jeff returned to Springer’s office, knowing Benny would be a few minutes. Springer’s poncho liner sat bundled on the desk chair; Jeff shook it out and draped it over his patient again. Bert made the same observation Benny had earlier.
“Guys,” Jeff answered, “he has all the signs of a right-sided inferior-wall MI, which includes low blood pressure and increased vagus nerve stimulation. Either of those can cause you to sweat but the combination of the two sucks. Low blood pressure also means he can’t get heat out to his extremities well, so the sergeant major needs to be kept warm. I’m calling Martin to give them the heads-up we’re on our way. I’ll meet you at the ambulance.”
I’m gonna wear a path in the carpet... Jeff thought while returning to Benny’s desk again.
“Yes, ma’am ... Yes, ma’am ... He’s right here.” Benny handed Jeff the phone. “Captain Withers, ER charge nurse,” he whispered.
Jeff nodded. “Ma’am?”
“What is so vitally important that you drag me out of my office and keep me waiting on the phone, Sergeant?” an irritated voice asked.
“A forty-six year-old male experiencing five minutes of increasing sub-sternal chest pain which radiates through to the right scapula, who has an irregular bradycardic pulse, is hypotensive, diaphoretic, nauseous, short of breath, and exhibits pulsus paradoxus and JVD. My main differential diagnosis is inferior-wall MI with right ventricular involvement.”
Stunned silence came from the other end of the line which was broken a second later by a simple “Oh...” The captain at Martin Army Medical Center’s ER repeated back most of what Jeff reported. He clarified a few points and hung up. On his way out of the office he nearly bowled over the XO, 1LT Bridges.
“Sergeant, what’s going on?”
“Sergeant Major Springer’s having a heart attack, sir. We’re headed to Martin.” With that explanation Jeff was gone.
Riding with the ambulance crew Jeff slowed the drip rate of the IV to KVO, a slow rate designed to keep fluid moving and prevent clotting in the catheter. The half-liter fluid challenge seemed to work. Springer’s blood pressure and color both improved. The fifteen minute ride to the hospital allowed Jeff to gather the sergeant major’s medical history.
In a scene reminiscent of many he’d been part of over the years, Jeff gave his report to the ER staff while they began treating his patient. He made sure the staff knew the whole story of the event before stepping out of the treatment room. He ran into the medics who helped him in the hallway.
“Hey, guys, sorry to take over your call like that,” he said.
“Are you kidding, Sergeant?” one of them asked, a specialist named Franks. “It would have taken us two or three minutes on scene before we were up to speed on what was happening. Instead the patient is already in a bed here getting treatment. You must see a lot of patients as a medic for the Rangers, huh?”
Jeff chuckled. “Fellas, how old are you guys?” Both admitted they were under twenty. “I’ve been doing this since you were in grade school, since late ‘91, but the sergeant major’s my first patient in the Army. Ever.”
“Huh?”
“I was an infantry soldier my first time in and reenlisted after September 11th. for the ten years I was out I was a paramedic outside Boston. I should just have business cards made up with my story printed on them, since I’m telling it so much lately.”
“So that’s how you knew what was wrong so fast?”
“Well, partially, but it was mostly a WAG. Until he went on the monitor here I wasn’t totally certain.”
“‘WAG?’”
“A wild-assed guess.”
Franks laughed and held up Jeff’s medic bag. “We replaced the stuff you used and put it where your labels inside said it should go, but I’m sure you’ll want to check that when you get a second.” He glanced behind Jeff before he stiffened and called “Ah-ten-SHUN!” Jeff spun around.
A woman in Army nursing whites stood in the hallway behind him. Her nameplate read ’WITHERS.’ Jeff sighed mentally. Oh, joy. Here comes my first Article Fifteen...
“As you were,” the captain said. “Franks, Souza, give the sergeant and I a moment, would you?” she asked without taking her eyes off Jeff. They muttered a “yes, ma’am” before telling Jeff they would be outside with his bag. They left a vapor trail they moved so fast.
“Sergeant Knox,” she said in a low voice, “your tone with me on the phone came dangerously close to insubordination.”
“Yes, ma’am.” He had been a little short with her.
“It was also the exact tone necessary to focus my attention where it was needed, that being on your patient’s condition and what he would require upon his arrival here. Because of that the TPA he’s already gotten was waiting for him to arrive rather than the other way around. The sergeant major’s condition is improving already because he received fibrinolytics so quickly. Because of your initial assessment and treatment he stands a very good chance of walking out of here. Well done, Sergeant.”
“Thank you, ma’am.”
