I had seen nothing sacred, and the things that were glorious had no glory and the sacrifices were like the stockyards at Chicago if nothing was done with the meat except to bury it. There were many words that you could not stand to hear and finally only the names of the places had dignity.
—Ernest Hemingway, A Farewell to Arms
The Presidio of Monterey sits on a bluff jutting north into Monterey Bay. Rolling hills, mature cypress and pine trees, and a healthy deer population are among its pleasures. To the south a few miles is Carmel-by-the-Sea, where Clint Eastwood was mayor during the last half of the 1980s. Further south is the rugged Big Sur coastline. Despite its breathtaking views and proximity to some highly coveted real estate, this garrison started as a rugged Spanish outpost in the late 1760s. The United States took control of the fort in 1846 during the Mexican-American War. Today the Presidio of Monterey hosts the Defense Language Institute Foreign Language Center, where the Department of Defense and other federal agencies prep need-to-know types in languages and cultures that might come in handy during treaty negotiations, drug wars, Middle Eastern adventures, and other such matters. The Presidio, with its postcard-ready vistas, feels more like a college campus than a military base.
Any way you look at it, it’s a long way from Iraq. But Iraq is never far from Dave Ramos. He served two tours there as a combat medic—a 68W, or 68 Whiskey as they are known—and the experience, especially his second deployment, has bled into every aspect of his life.
“It was the entire spectrum, the best and the worst,” says Ramos of that brutal second tour. “I saw the most inhumane and I did the most inhumane. I saw the most amazing, and I did the most amazing. I completely fucked up my marriage and I witnessed many gruesome acts of dismemberment and death.”
Ramos recalls, in particular, the kid who died in his arms while he was stationed in Al Qayara.
A fellow medic was trying to do an emergency cricothyroidotomy, a procedure in which a hole is cut in the throat and a tube stuck through it so the patient can breathe.
“The kid, an Iraqi, must have been pretty close to the blast because his face was bashed and battered,” says Ramos. “He was probably my age. You couldn’t tell, he was that bad. His nasal and oral passages were meshed and mashed.”
Though now a civilian, Ramos is still muscled the way soldiers tend to be—their bodies built up as if to compensate for tolls taken by kicking down doors and dealing with waves of casualties. He pauses and pushes back from his desk at the Presidio’s Army Health Care Clinic, where he’s worked since he returned from Iraq.
“The kid is covered in mud, blood, and disaster. I start bagging him, giving him the breaths. And we’re trying to calm him, relax him, and he’s screaming and yelling because he has no idea what’s going on. But the breaths are going into his stomach. It’s not working. He’s circling. … The doc says, you guys need to stop and go work on somebody who you know is going to make it.”
So Ramos starts for another patient. But when he looks back, he sees the kid still gasping for life. The body jerking, arms flailing. He goes back to him, tries to breathe for the kid again. “I watched his eyes roll back into his head and the doc says again—find somebody who will make it.”
This is what a 68 Whiskey is trained to do—calculate and categorize casualties on the IDME scale:
I: immediate—the ones who need transport now; every second counts if the patient is going to live.
D: delayed—they’ve got time before they need to be operated on.
M: minimal—they’ve got upward of twenty-four hours; they’ll get a Purple Heart, but they might get back to the line.
E: expectant—they’re circling the drain, ready to die.
In his emails to his son, Milo, his then wife, Carmia, and other family members and friends at home, Ramos tried to relieve some of the stress of war.
“I’m just glad they don’t speak English,” he writes in one message. “If I heard some dude screaming and crying about his wife, kids, anything like that, I’d totally breakdown … they are casualties, patients, victims. I can’t handle the thought that they are fathers, husbands, brothers, sons.”
In another, he confesses, “I still miss Milo and Carmia. I still hate Iraq. I still want to go home.”
Though thousands of miles and more than three years now separate Ramos from that second tour, he concedes that “those fifteen months are, as of today, just being ironed out.”
Bus Stops: A Memoir
Sep 15, 08:41 AMPurchase or Subscribe to Slake: Los Angeles
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