March 20, 2006 issue - Then I heard the voice of the Lord saying, "Whom shall I send? And who will go for us?" And I said, "Here I am. Send me!"...........................
His friends told him he was crazy, and his wife, a pediatrician nine months pregnant with their first child, was none too happy. But in the summer of 2004, five days after the birth of his child, Commander Jadick shipped out for Iraq. On the plane, he sat behind a gunnery staff sergeant named Ryan P. Shane. A 250-pound weight lifter, the massive Shane turned in his seat to look at Jadick. Slowly taking the measure of the 5-foot-10, 200-pound Jadick, the gunnery sergeant said, "So you're our new surgeon. That's one job I wouldn't want to have with the place where we're going." That night Jadick e-mailed his wife, "What have I gotten myself into?"
The place they were going was Fallujah. In Sunni territory west of Baghdad, the city seethed with insurgents. Jihadists had strung up the burned bodies of American contractors in the spring of 2004, and chaos had reigned ever since. By November, the United States was tired of waiting for the enemy to give up or clear out. "Over the past five months, [we] have been attacked by a faceless enemy. But the enemy has got a face. He's called Satan. He lives in Fallujah. And we're going to destroy him," said Marine Lt. Col. Gary Brandl on the eve of the attack. Jadick's regiment, the 1/8, was ordered to take what was, in effect, the Main Street of the city. For Jadick, who speaks in a gentle, matter-of-fact voice, occasionally strained by memories of the men he saved and lost, it was to be a journey to the other side of hell.
The night before the assault, Jadick hopped into a command Humvee taking a reconnaissance mission from the headquarters base outside the city. He wanted to see what he was up against. In treating traumatic injuries, there is something known as the golden hour. A badly injured person who gets to the hospital within an hour is much more likely to be saved. But Jadick knew that in combat the "golden hour" doesn't exist. Left unaided, said Jadick, the wounded "could die in 15 minutes, and there are some things that could kill them in six minutes. If they had an arterial bleed, it could be three minutes."
Jadick knew that helicopter evacuations were out of the question: there was too great a risk the choppers would get shot down. Casualties would have to be driven out of the city. It took Jadick 45 minutes to drive from the base hospital, where he would normally be stationed, to the city. Not close enough. Jadick wanted to push closer to the action.
Jadick, along with 54 Navy corpsmen, his young, sometimes teenage medical assistants, moved to the edge of the city as the assault began; the night sky was lit by tracers and rocket fire. The next morning a call came over the radio. A Navy SEAL with a sucking chest wound needed evacuation. A weapons company was heading in to rescue the man. Lacking much military training, doctors normally stay back in the rear area. But ex-Marine Jadick decided to go to the fight. As shots rang out around them, the weapons company ran and dodged down narrow alleyways toward the building where the SEAL lay wounded. Jadick was armed only with a small 9mm pistol. He thought: "If anyone actually gets close to me, I'm going to have to throw it at him." He felt slightly ridiculous, remembering a "MASH" episode in which Alan Alda tried to scare away the enemy.
In the rubble of a shot-up building, he found the SEAL conscious but bleeding badly. "Get me out of here," the man said. Helping to carry the man on a stretcher down the stairs, Jadick could hear rocket fire and shooting. The air was thick with fine dust and a familiar smell: cordite, from gunpowder. He had smelled cordite before at rifle ranges, but never like this. "It just hung in the air," he recalled.
The radio squawked. Two Marines had been wounded in an ambush in the center of the city. Jadick wanted to get his wounded SEAL back to base camp. But the voices on the radio were insisting that the two men down in the ambush were in even worse shape. It was Jadick's call. He loaded the SEAL into an armored ambulance and set off in the vehicle toward the scene of the shooting. He could hear the firing intensify. Jadick wondered, anxiously, if a rocket-propelled grenade could punch right through the ambulance's metal sides.
The ambulance stopped and Jadick peered out at the first real fire fight of his life. There were not two wounded men, but seven. As a middle-class kid growing up in upstate New York, Jadick had avidly read about war, and even applied to West Point. But he flunked the physical—poor depth perception—and went to Ithaca College on an ROTC scholarship instead. He had served as a communications officer in the Marines, but left the corps after seven years, bitter that he had been left out of the fighting in 1991. Attending medical school on a Navy scholarship, he had never seen or experienced real war—the kind of urban combat that can leave 30 to 40 percent of a unit wounded or dead.
"I can't tell you how scared I was," he recalled. "My legs wanted to stay in that vehicle, but I had to get off. I wanted to go back into that vehicle and lie under something and cry. I felt like a coward. I felt like it took me hours to make the decision to go."
But he got up and went. He felt as though he were "walking through water." Desperately seeking cover, he ran to a three-foot wall where the most badly wounded soldier lay. He lifted the man over the wall to safety. "I put him down on the ground, and he was looking at me," Jadick recalled. The man had a gaping wound in his groin. Jadick tried to "pack" the wound, stuffing sterile gauze packages into the hole torn by an AK-47 round, but he couldn't stop the bleeding. Jadick was forced to make the first of a thousand wretched decisions. "I knew I had six other people that I had to work on. So I don't know ..." Jadick paused in the retelling. "I stopped and went on to someone else." It was Jadick's first experience in battlefield triage—forget the mortally or lightly wounded, save the rest—a concept easier to philosophize about than to practice.
Bullets were hissing around him. Afraid of dying, more afraid of failing his comrades, Jadick managed to treat the wounded, to stabilize them and stop the bleeding. As he began loading men into the ambulance, an RPG screamed in—and glanced off the roof without exploding. A second RPG slammed into the wall next to them; it didn't go off, either.
One of the wounded was Ryan Shane—the massive gunnery sergeant Jadick had met on the plane. Shane's abdomen was all shot up. Jadick was unable to lift him, so the sergeant had to crawl into the ambulance by himself. "I made room for him underneath the stretchers," Jadick recalled. But he had to turn away another Marine who had been shot in the foot. There was no more room..........................
Sometimes the corpsmen behaved like the 18- and 19-year-olds they were. Jadick was miffed at one young clerk, in charge of keeping proper records, who had apparently wandered off. Unable to find the man, Jadick began cursing him, when the clerk appeared around the corner. "Where were you?" Jadick angrily demanded. "Well," the clerk said, "some guys were trying to come across through the open gate, so I shot them." Jadick laughed as he recalled the story. "That's a pretty good excuse, so I'll let you go this time," he told the man...........................
The laughs were few and far between. A Marine arrived with a chest wound. Jadick had seen the man, Lance Cpl. Demarkus Brown, a few days before, when he showed up with a lip sliced by shrapnel. "Doc, do I get a Purple Heart for this?" Brown had asked. Jadick had assured him that he would, sewed up the lip, and sent him back to the fight. Now the man did not seem too badly wounded. He was breathing and his eyes were open. Still, Jadick was unable to get a breathing tube down his throat. For a moment, Brown seemed to perk up when Jadick inserted a needle in his chest for a tube, but suddenly the blood began to pulse out. A major blood vessel had ruptured inside him. The man's blood pressure was so low that Jadick couldn't get an IV line working.
The wounded kept coming. One hero was Matthew Palacios. Injured, he saw a grenade land beside him. Somehow, he had the presence of mind to fling it back, saving the men around him. Increasingly, the wounded were Marines ripped by booby traps and suicide bombers. The KIAs (Killed in Action) were so mangled that Jadick decided to build a morgue, so his young corpsmen wouldn't have to see the shattered bodies piling up.
The one injury Jadick did not see much of was posttraumatic stress disorder. One Marine had to be sent to the rear, and plenty of men complained that they didn't want to go back out and fight—but they did. The PTSD, Jadick knows, will show up for some men only after they're back home, safe but haunted by flashbacks and memories. "We all had PTSD at some level," said Jadick, who nevertheless has not sought treatment.
Jadick was awarded a Bronze Star with a Combat V for valor. (The medal, pinned onto Jadick in January, is the only Combat V awarded a Navy doctor thus far in the Iraq war.) His commanding officer, Lt. Col. Mark Winn, estimated that without Jadick at the front, the Marines would have lost an additional 30 men. Of the hundreds of men treated by Jadick, only one died after reaching a hospital. "I have never seen a doctor display the kind of courage and bravery that Rich did during Fallujah," said Winn. Jadick still owes the Navy a couple of years as a doctor. He's thinking of staying in beyond that. "Being a battalion surgeon is one of the greatest jobs there is," he says, in his low-key way. "So, sure, I would do it again, yeah."