The Brave

SoldierNurse22, BSN, RN

I was late.

My mind locked back onto the road before me, a mess of brake lights glowing in the twilight ahead. I had an hour to get to Baltimore, but first, I had to stop through work. Not in this traffic, I thought, mentally reworking my route north as I fussed at my dress, a most unusual attire for me to be wearing on my way to my workplace. At this rate, I'll barely make Laurel by midnight.

Sirens lit up my rearview mirror. I looked behind me, my ears picking up a distinct sound as the familiar ambulance neared. I reflexively pulled out of traffic to the far left lane, clearing the center lane for the approaching vehicle.

The Walter Reed Bethesda ambulance, a white semi-truck set up like an ICU on wheels in its trailer, raced by a few seconds later. On its side, the new Walter Reed Bethesda logo and the original Walter Reed logo vied for attention. I caught a glimpse of curtains and empty beds through the back door as the ambulance stopped oncoming traffic long enough to make a left turn across three lanes of northbound rus hhour traffic into the main gates.

With traffic momentarily paralyzed, I found myself able to slip into the turn lane behind the ambulance and follow its path through the main gate. The MPs at the front were waiting as usual.

I rolled down my window and provided the sailor with my ID. His eyes scanned my picture, then my face. "Lieutenant." He said with a salute.

"Thanks, sailor. Have a good one." I returned his salute and drove onto base.

Down the road and to the right, I passed the ER entrance on my way to the garage. The ambulance was parked, a crowd of uniforms mingled with the civilian clothing of family members waited for its passengers at the entrance to the ER. More uniforms rolled the stretchers off the ambulance, down to the parking lot and into the hands of waiting medics, corpsmen, nurses, doctors and family members.

I paused to watch the med evacs unload, the procession to the front door of the ER only the beginning of their new journey. They had left the rage of war overseas. The sounds of mortars, rifle fire and IEDs were an ocean and a continent behind them.

I parked and headed into the hospital via the skyway. The elevators that lead to my floor chimed. I boarded and caught a glimpse of the line of gurneys making their way into the ER just as the elevator doors closed. Soon those gurneys would be in this very elevator, on their way to floors where they might stay for half a year or more. For many of the service members returning home, getting back to the States was enough of a challenge in and of itself. But here, a new challenge begins. A new battle is to be fought. And it is at that point, as they emerge off the elevators, borne by the hands of our battle buddies, that their stories meet mine.

I have taken my fair share of med-evacs. The introduction is almost always the same: a young man or woman, completely out of their element and typically in desperate need of pain and nausea medication, finds him or herself in the sorry position of being completely dependent on me, a nurse and an officer. It is a nightmare that most cannot believe they are living. In addition to being physically disabled, a first for many of them, they are also struggling to accept their often permanent injuries, the way those injuries alter their appearance, the unfamiliar environment of the hospital, the rough interpersonal waters of encroaching families and friends, and the uncertainty that an injury in the military represents. Their self-image and their careers are on the line. And that's just the wounded warriors.

My oncology med-evacs deal with many of the same issues: appearance-altering illness, debilitating symptoms of cancer, difficult family members, intense and occasionally fatal treatments, and the haunting echoes of war. In addition, many face rare disease processes at abnormally young ages and the decent odds that a good number of them will succumb to their disease long before any one of their age should be contemplating death. While a return home to a major military medical center is often the beginning of healing for the wounded, my oncology patients are usually a few months out from their darkest days, their worst pain and the most intense illness they will ever experience when their feet land on American soil. Chemotherapy, radiation, surgery and the consequences therein await them in the maze of buildings where the people who will try to save them will likely make them sicker before making them better. The tragedy of their story is that while the wounded are met with ample resources to assist them in coping, my oncology patients are met with little more than a hello.

The incidence of certain types of cancer in the armed services are statistically higher than the general population. It is believed that in the line of duty, service members are exposed to toxins, viruses and substances overseas that put them at a higher risk of developing cancer. Sometimes the consequences of these exposures are swift--the course of their lives at war is interrupted by a spattering of strange symptoms that send them flying over the Atlantic back to American soil for a rushed workup and treatment. Others will not feel the after affects until much later in their lives, long after their uniforms are retired and their combat boots reside in the quiet confines of a dark closet, having seemingly escaped the dangers and ravages of war.

Stars visit the wounded warriors. They are showered with thanks and praise for their service, which is nothing short of what they deserve. They are heroes in no uncertain terms and it is not my intent to diminish that. All I want is for the celebrities and big names that circulate the 4th deck of my hospital to recognize that men and women of equal caliber-- Soldiers, Sailors, Airmen, Coasties and Marines who fight a battle of equal intensity--and a population of service members that are often overlooked are engaged in a life-or-death struggle a floor above. And those patients who courageously battle the enemy within their own cells are worthy of just as much respect, support and praise as their brothers and sisters downstairs.

They don't have the Wounded Warriors Project to bring them blankets, sweaters and a plethora of support options. Politicians and pop stars don't pencil my patients into their schedules. The media doesn't visit to check on their progress and report human interest stories to a drama-obsessed mainstream culture. Indeed, their below-the-radar status certainly has some benefits, but unfortunately, these overlooked heroes often suffer in silence, their sacrifice typically unnoticed and unacknowledged by the military, much less the American public.

When I first got to Walter Reed, I dreamed of caring for the wounded. I wanted to be where the heroes were. I was acutely disappointed when I was assigned to oncology. It took me almost a year to realize that even though there were no cameras peering or spotlights shining on my patients, I was among some of the greatest, strongest and most heroic men and women I'll ever be privileged enough to meet. They are humble, duty-driven and unwavering in their commitment to their nation--so much so that they weather some of the most unforgiving regimens in oncology in hopes of getting better and returning to their lives of service. And after nearly two years of caring for them, I bristle at the indifference people suddenly show when I tell them I don't work with wounded warriors every day. I readily rise to advocate for and brag about the courage my patients display on a daily basis. And though I am soon to move to a new base where different challenges will surely await me, I wouldn't leave their bedsides for all the prestige in the world. I am content to tend the forgotten and heal the ignored.

You will not find me where the cameras flash and the lights shine, but make no mistake--I am still to be found at the bedside of the Brave.