In Country EMS: An American Medic in Iraq

Greg Shadwick, NREMT-P, works for Grandview EMS in Jasper, TN, a small town about 10 miles north of the Alabama and Georgia lines. He’s also a member of a National Guard unit based in Knoxville, TN. Since November 2004, combat medic Shadwick has been stationed in Iraq. EMS Magazine recently spoke with Shadwick about his day-to-day responsibilities and experiences serving in Iraq.

EMS: How do you happen to be in Iraq? Did you enlist or were you recruited as a medic?

Shadwick: I enlisted in the U.S. Marine Corps in 1985 and was a truck driver for the First Tank Battalion, First Marine Division for four years of active duty. When I got out, I joined the National Guard and served as a field artillery crewman from 1990–1997, which included service in Iraq for Desert Storm. In 1997, I rejoined, transferring into the medical field. We were called to federal active duty in June 2004 to support Operation Iraqi Freedom.

EMS: What’s your specific assignment and what kind of special training were you given to prepare for it?

Shadwick: I am assigned to an ambulance platoon—our mission is to medically support all military units in our area of operation. We pick up the sick and injured and bring them to our troop medical clinic (TMC) for treatment. During what we call MASCAS (mass casualty), I move over to the treatment platoon, where we treat and evacuate patients. Some lifesaving surgeries are done right here; but then we get patients to the closest higher level of care by helicopter. Medics learn to suture most wounds, so the MDs can go on to the next patient.

Many healthcare fields are represented in our unit, including several RNs who also work in the field back home, four physician’s assistants, one pathologist, an ob/gyn MD and several family practice docs. There are two ambulance crews and a treatment squad in the TMC 24 hours a day. I’m the only one who does EMS back home.

Before shipping to Iraq, we trained for five months of basic at Camp Shelby in Hattiesburg, MS, on such things as convoy operations and weapons—M-16 assault rifles, 9mm pistols, 50-caliber machine guns, squad-automatic-weapons and M-60 machine guns. We also had an NREMT refresher course with trauma-related stuff for the main types of injuries combat medics were expected to see.

EMS: Can you describe a typical day for a combat medic?

Shadwick: We get up and eat breakfast at about 0530, do physical training for about an hour and a half, then we head to work. We inspect the ambulances and restock them, if necessary. Then we pull sick call from 8–11 a.m., when soldiers who are sick come in for treatment. We take lunch in shifts because you never know when something may happen. After lunch, we have classes until 3 p.m. They range from basic first aid to cardiac emergencies to suturing wounds and such. A few of us go over to the Iraqi side of the base and teach them first aid and treatment of theater-specific wounds.

At 3, sick call starts again. At 5, we clean up the TMC and have make-up classes for those who missed the first set. Shift change is at 7 p.m. We work a 12-hour shift and then are off for 12 hours. In the ambulance platoon, we get every Sunday off; I’m not sure what the treatment platoon’s schedule is. Sometimes things happen the whole 24 hours.

I just came back from a mission to escort Iraqi police recruits up north, so they could finish their training and get out in the field. Medics ride along to care for the injuries, if need be. Anytime we are outside, we are to wear body armor and helmets, and we have our weapons at all times. It can be scary at times, due to not really knowing who the enemy is.

EMS: Tell us about the injuries you’re seeing. Are there any innovations we can expect to see at home down the road?

Shadwick: We deal with much of the same situations here as back home except for the trauma stuff. The trauma is mostly abdominal, head and chest wounds, along with total amputations of one or more body parts at a time. A lot of patients are surviving mainly due to a great invention called QuikClot.

QuikClot is an agent that you pour directly on or in the wound, right from the package. Then you put a pressure dressing on top. Within seconds the bleeding stops. More amputees are surviving because of it. Every family wants to see their loved one return alive, and every soldier wants the exact same thing. It is greatly applauded here and I expect to see it on the streets when I return.

We don’t treat ABDs with QuikClot, though, because of potential complications in that region. We treat them almost the same way as back home, except we use dry dressings instead of wet ones, due to the length of time it may be before the patient reaches level-1 care.

How are you dealing with the emotional and professional stresses of war and seeing war injuries?

Shadwick: Being a medic back home has helped in the fact that I’ve seen some of the same injuries from gunshot wounds and car wrecks. Many of us from the healthcare field cope with the sights somewhat easier than those who are new to it. Consequently, we pull a lot of duty helping the others deal with them. We have a Combat Stress Team (CST) that closely mimics CISD (critical incident stress debriefing) and has the same goals. It can be quite challenging at times—a lot of added stress—but at the same time very rewarding to see that you have helped one of your buddies cope. We also have chaplains and their assistants, who help a lot.

EMS: What do you do during the downtimes?

Shadwick: There are two big gyms for us to use. Also we have an MWR (morale, welfare and recreation) tent set up for dances, softball and volleyball tournaments, and horseshoes. You can always watch sports and movies on a big-screen TV. There are a couple “hodgie” shops run by local people, where you can buy souvenirs and things of that nature.

EMS: Is there anything else you’d like to mention?

Shadwick: I’m a family man. I have a wife whose name is Meshelle, three daughters and one son. I love them all a lot and am looking forward to seeing them all upon my return. We have been in country for about four months now and still have about nine or 10 to go. It will not go by fast enough.

Combat medic Greg Shadwick can be e-mailed at gregshadwick@yahoo.com, or write to him at George G. (Greg) Shadwick, 91w10/NREMT-P; Co. C, Medical RSS 278th RCT, Camp Caldwell, Iraq, APO AE 09374.