Lamb was involved in the push for the new “circadian-friendly” watchbill. There has been, as there always is, some resistance. Sixes is how it’s been done for fifty years. “As flawed as it is, we’d perfected it,” commanding officer Bohner said one morning as we sat in his stateroom. “Now we’re going to shake the ball and throw the pieces back down again.” I tried to picture what game that might be.
The problem resides mainly with the midnight to 8:00 a.m. shift—the dreaded “mids.” You come off watch and instead of sitting down to dinner, you’re having breakfast. You’re sleeping from 4:00 p.m. to 10:00 p.m., when there’s often, despite Nathan Murray’s best efforts, something that you have to get out of bed for. To more fairly distribute the suck, the crew swap watch schedules every other week. Instead of flying to Paris every day, it’s every two weeks. The switchover happens on a Sunday, its being normally—that is, when riders are not coming aboard creating extra work for everyone—the quietest day of the week.
Today is that Sunday. Lieutenant Kedrowski, the man on the periscope platform, the officer of the deck, is switching to mids. It’s his birthday. Happy birthday, Kedrowski. You get to scramble your circadian rhythms and get three hours sleep—in a rack that smells like someone else, because you had to give yours up to some writer from California.
“I’m really sorry, by the way.” I would have been happy to sleep among the warheads.
“It’s no problem,” says Kedrowski, with unforced bonhomie. Almost everyone I’ve met down here has been easygoing and upbeat, especially given how tired they must be. I am, to quote the Dole banana carton in the galley pantry, “hanging with a cool bunch.” If everyone in the world did a stint in the Navy, we wouldn’t need a Navy.
Up above Kedrowski’s head, a red light is flashing. Kedrowski explained this alarm box earlier. It’s the one that goes off if the President of the United States orders a nuclear missile launch.
“So this is another drill then?”
“No.” Kedrowski finishes writing something in a three-ring binder and looks over at the box. “It’s kind of broken.” He puts down his pen and listens. “They’re supposed to say, ‘Disregard alarm.’” They don’t, and soon it stops. “They need to fix that,” he says.
The missile alarm is mildly unnerving (good god, what if?) but not particularly frightening. In the queer logic of war in general and nuclear conflagration in specific, five hundred feet underwater on an undetectable Trident submarine is the safest place you could possibly be. The crew of the modern ballistic missile submarine endures long hours and grueling tedium, homesickness, horniness, and canned lima beans, but they are spared the thing that keeps most of us out of the military: the nagging awareness that you could be shot or blown up at almost any moment. Better dead-tired than dead.
14. FEEDBACK FROM THE FALLEN
How the Dead Help the Living Stay That Way
IT IS NOT THE blood in news photos of people shot dead or killed by bombs that gets to me. It’s the clothing. Here’s a man who got up in the morning and went to the closet with no inkling he was pulling on his socks for the last time, or adjusting his tie for the coroner. The clothing becomes a snapshot of a person’s final, poignantly ordinary day on Earth. You see at once the death and the life. In autopsy photographs of US military dead, you also see what came between the two. Defense Department policy is to leave all life-saving equipment in place on a body. You see the urgent work of medics and surgeons—the pushing back at death with tourniquet and tube.
In military autopsies, medical hardware is examined alongside the software of organs and flesh. The idea is to provide feedback to the men and women who worked on these patients. Did, say, the new supraglottic airway device work the way the manufacturer promised? Was it placed correctly? Could anything have been done differently? The feedback happens via a monthly combat mortality teleconference, part of the Armed Forces Medical Examiner System (AFMES) program Feedback to the Field. In the past, solid, quantified feedback took the form of published papers. In the time it takes to have a study peer-reviewed and published in a medical journal, a lot of lives can be lost. This is so much better.
The System comprises two low tan brick buildings, mortuary and morgue. The mortuary being the one with the lovelier landscaping. Which is not to say that the morgue is bleak or depressing. It isn’t (certainly not by comparison with what you have driven through to reach it: Dover Liquor Warehouse, Super 8 Motel, Chik-fil-A, Applebee’s, Adult Probation and Parole, McDonald’s, Wendy’s, New Direction Addiction Treatment, Boston Market, and a giant blow-up rat advertising extermination services). A walkway connects the two buildings, but an ID badge is needed to open the door from one into the other. You don’t want family members to take a wrong turn and end up in the autopsy suite.
Or, this morning, the conference room. The 7th Combat Mortality Conference is just getting under way. Eighty teleconnected individuals are taking part: thirty or so here at AFMES, about an equal number phoning in from Afghanistan and Iraq, and a few in San Antonio, Texas, at the US Army Institute of Surgical Research. They interact by audio only. There is a video screen, but it is used to display not the speakers but the soldiers being spoken about.
The body in the photograph on the screen is on its back. Black bars have been added over the eyes and groin. I want a third one to hide the feet, which are flopped strangely, wrongly, off to the same side. They’re like feet in an ancient Egyptian frieze or under the bedding at one of those hotels where the maids aggressively tuck the sheets. A man speaking from Afghanistan recites the prehospital care scenario. “CPR was in progress when he arrived. Treatment included JETT tourniquet, sternal intraosseous IV, plasma, two doses epinephrine. Upon arrival at the medical treatment facility, no cardiac activity was noted. CPR was ceased. Over.” Over is of course the military man’s habit of denoting the end of a radio communication, not, as I at first heard it, a dramatic editorial flourish.
The medical examiner (or ME) who performed the autopsy delivers his summary next. “…Extensive head injuries, skull fractures. Laceration of the brain stem. Hemorrhages. Multiple facial fractures. Extensive injuries to the upper extremities. Also fractures of both his tibiae and fibulae. Facially again, his maxilla and mandible are fractured.” The blood has been cleaned away, so most of what I’m hearing doesn’t register visually. What registers is this: His mustache is on crooked. It calls to mind the old slapstick gag—the false mustache slipping its glue and hanging askew on the actor’s face. It wasn’t that funny then, and it’s very much not so now.
Like a sensitive editor, the medical examiner begins his feedback with positives. “Crike was performed adequately and perfectly placed.” Crike is short for cricothyrotomy—puncturing an emergency airway through the cricothyroid membrane. The ME moves on. “Placement of JETT.” The Junctional Emergency Treatment Tool is a new type of tourniquet for compressing the femoral arteries at the junction of the leg and the torso. “JETT was possibly moved in transport…” This is polite shorthand for the fact that it is not where it should be. Great care is taken at these meetings with how things are phrased. The medical examiners don’t want to lay blame or criticize the people who provided the care. Rather than refer to them by name or classification, they say “the user of the device.”