ABOARD THE USNS COMFORT - Cruising in the northern Persian Gulf, this one-time oil tanker turned Navy hospital ship has taken on about 20 injured coalition troops and Iraqi prisoners and civilians - some with severe bullet and shrapnel wounds that have required repeated surgery.
The first casualties arrived by helicopter Friday night, though the busiest day was Monday, when eight wounded were flown in. Sandstorms on the mainland that reduced visibility to zero blocked any flights from Iraq yesterday.
Officers on the Baltimore-based ship said they could not disclose how many of the injured were American, British or Iraqi or how many were civilians. A common refrain was that the distinction mattered little - the staff treats patients equally and deals with the most urgent cases first, even if that means attending to an Iraqi before a coalition soldier.
"We are treating these people as humans with full dignity like we do our own brothers in arms," said Lt. Cmdr. Michael Verdolin, an anesthesiologist from Laurel who has assisted in several operations.
Sailors fluent in Arabic served as translators in the 50-bed emergency room, which is said to be larger than any land-based one in the United States. Nurses in the emergency room, the first stop for new arrivals, said the prisoners appeared grateful to be away from battle and in the hands of medical personnel. Though some were groggy from pain medication, others managed smiles and appeared fascinated by their surroundings. Some were still dressed in camouflage battle fatigues, while others had been changed into hospital scrubs.
"They were amazingly calm," said Lt. Karen Ritchie, 33, a nurse from Baltimore. "I tried to put myself in their shoes, but it's really hard. And they are treated just like American soldiers, no preference to either side."
Corpsman Charity Ann Grable, a 24-year-old nurse from San Diego, said one prisoner looked up from his gurney and spoke what she thinks might have been the only English he knew: "`Pretty eyes, pretty eyes.'"
Docked in Canton during peacetime, the Comfort is one of two nearly identical Navy hospital ships and the only one called to the war. It is the length of three football fields and has 1,000 beds, more than many urban hospitals do. The ship, painted in hospital white that shimmers in the sun, was mobilized during the 1991 Persian Gulf war, though it received no battlefield casualties.
Many of the patients aboard suffered fractures and open wounds to their arms and legs. Though most had penetrating wounds - caused by bullets and shrapnel that can remain stuck in tissue or exit from the other side - a few broke bones after explosions threw them to the ground.
Several with severe fractures have undergone reconstructive surgery in which doctors have pieced bones together and screwed them to external "fixators" that resemble a child's Erector Set, said Verdolin. At least one person lost fingers in a battlefield explosion and had stumps repaired on the ship.
Many of the doctors and nurses trained in city hospitals including Johns Hopkins Hospital, Bayview Medical Center and the Maryland Shock Trauma Center and agree that the injuries are similar to but more complicated than those caused by urban violence.
Lt. Cmdr. Scott Martin, an orthopedic surgeon who trained at Howard University in Washington, noted that military weapons deliver larger-caliber bullets at faster speeds, resulting often in large open wounds, exposed fractures and contamination from shredded clothing, desert sand and shrapnel. "Most orthopedic surgeons can go through their entire career and never see what we're seeing," he said.
In cases of severe contamination, surgeons might have to operate several times to cleanse the injured tissue before making needed repairs.
"The worst case we had was probably a patient who had a gunshot to his buttocks that penetrated the rectum and pelvis and hip," said Martin, who has operated on five patients. "This is not your typical .45-caliber bullet, it's anti-tank [weaponry] - it's huge."
"He's not even fixed yet," he said of the patient, whose nationality he would not disclose. "We're decontaminating his wounds."
No patient has died aboard the ship, and all are doing well, said Martin.
Many of the Comfort's patients were treated first at mobile field hospitals that have moved with the troops during the Iraq invasion. Doctors near the front do what's necessary to quickly evaluate and stabilize the wounded so they can survive evacuation to hospitals, including the Comfort, farther from the fighting.
Stepping out of a shipboard operating room yesterday, Capt. Charles Blankenship said he was impressed by the surgical care the patient he had just seen received at a field hospital. Surgeons had cleaned out a severe bowel injury, stopped bleeding and reconnected severed tissue before sending the patient to the ship.
Some aboard the Comfort noted with disgust the images of wounded and, in some cases, dead Americans that were broadcast on Arab television. "Fortunately, we are providing humanitarian treatment," said Verdolin. "It makes me sad not to see that happen on the other side."