Olin E. Teague Veterans' Center

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Paulette Smith-Kimble, RN, ICU nurse manager in Olin E. Teague Veterans’ Center in Temple, Texas, kept a war journal detailing the awful scenes she saw during her deployment at an Army hospital in Landstuhl, Germany, one of the interim destinations for wounded coalition forces flown out of Iraq and Afghanistan. Here, she attends to patient Woodrow Sledge of Taylor, Texas, at the Teague Veterans’ Center.

Paulette Smith-Kimble, RN, has a war journal, one that spares few details of the awful scenes she saw from the war in Iraq. The Army Reserve captain, who was deployed for a year at a military hospital in Germany, wrote about soldiers who had severe shrapnel wounds on their arms and legs — when they hadn’t already been lost to bombs or mortar fire. She wrote about the helicopter arriving with five or six critical care cases at once. She also experienced the daily toll of helping soldiers cope with the emotional trauma from witnessing horrifying scenes of death.

Writing down these scenes, and telling them to others, helps Smith-Kimble handle her own ordeal and suffering, through the toll that war brings to health care workers treating and saving the lives of the wounded.

“I was fortunate enough to care for one of the POWs, and she was very sick,” Smith-Kimble says. “But it wasn’t until 12 or 14 hours later that I was able to think about it, to process all her injuries, and think about how she could have sustained them.

“I just prayed that she wouldn’t remember it,” Smith-Kimble says.

From Gettysburg to Iwo Jima, from Vietnam to Iraq, American health care professionals have answered the call to serve during wartime. Weaponry and tactics change, but the toll taken on the wounded, and on those who care for them, remains the same.

Smith-Kimble, who was deployed from her position as ICU nurse manager in Olin E. Teague Veterans’ Center in Temple, Texas, spent a year at the Army hospital in Landstuhl, Germany, one of the interim destinations for wounded coalition forces flown out of Iraq and Afghanistan.

Keeping the journal helped her immensely, especially upon her recent return, as she is better able to share the experiences with others. The journal, along with a presentation, provides her cathartic therapy to the devastating scenes she witnessed as soldiers arrived from field hospitals in Iraq.

“I was reading some of it to my husband, and it still brings a tear, brings back all you were feeling when you were caring for a specific soldier, it brings back all the senses, the smells,” she says. She tells listeners at her presentations at the Teague Center that “we may be working hard here, but it’s a lot worse over there. When the chopper lands and you get five or six critical care patients at once, you have to work until they’re all taken care of.”

“I’m trying to bring to them the realities of what it’s like over there,” Smith-Kimble says.

Over there

Clara Moses, RN, knows the reality. An Army Reserve major and a surgical charge nurse with the JPS Health Network in Fort Worth, Texas, she says her yearlong deployment was a life-changing experience, despite having medical experience in a combat setting.

“When I was deployed for the 1991 war, I worked postop and didn’t see the kinds of injuries I saw this time,” Moses says. “The burns and loss of limbs, sometimes multiple limbs, were terrible.”

She personally cared for about 400 soldiers at Landstuhl, and found them to be selfless and endearing. “They never asked for anything, but I tried to get little things for them, socks or a magazine. One young man asked for a Popular Mechanics, and he was so happy when I brought it,” Moses says.

“They were all like my sons, and I would tell them I was going to be their mom while they were there.”

In her presentation, Smith-Kimble methodically describes how soldiers receive their treatment after suffering combat wounds. They are air lifted to a field hospital close to the front for emergency aid, before a helicopter flies them to a hospital outside the combat area for additional treatment and surgery, including amputations and suturing. The soldiers are kept until they are stable enough for the four- to five-hour flight to a combat support hospital in Germany or Spain. If necessary, they receive more surgery, and remain until they are strong enough for the flight back to the United States.

Most are sent to Walter Reed Army Medical Center in Washington, D.C., or the National Naval Medical Center in Bethesda, Md., but burn cases are flown directly to Brooke Army Medical Center in San Antonio.

Because the troops wear body armor, “the majority of the injuries we saw were to the extremities due to shrapnel,” Smith-Kimble says.

“We saw a lot of amputations due to the blasts. We also saw quite a few emotionally distraught individuals. A lot of the soldiers were in close proximity of either seeing their comrades receive major injuries or actually killed.”