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War experience feeds book by combat psych

During the last week of her seven-month deployment to Iraq in the fall of 2004, psychologist Cmdr. Heidi Squier Kraft and a second Navy psychologist passed a group of young Marines headed for breakfast.

“Ooh-rah, ma’am,” they shouted in unison.

“Aren’t you going to miss that?” Kraft asked her colleague. When Kraft got back to her room, she told him she was going to start a list of things she would miss about Iraq — and another list of things she would not.

“He said, ‘That is going to be a lopsided list.’”

But when Kraft, who has since left the Navy and works as a civilian psychologist at Naval Medical Center San Diego, finished the list, it was not as lopsided as her friend thought it would be, and it had grown into a poem of sorts.

Its wide range — from the vivid redness of the Iraqi sunset, to the frustration caused by random power outages at the hospital, to the sight of a Marine colonel sobbing at a hospital because one of his leathernecks was wounded — captured both the horror and the emotional complexities of war from the perspective of someone uniquely equipped to deal with it.

Kraft e-mailed the list to several family members and friends who passed it along to other friends and family, and soon it caught the attention of Otto Lehrak, a retired Marine colonel who had written a Pulitzer Prize-winning account of his infantry unit’s actions during the Vietnam War.

When Kraft returned home at the end of her deployment, Lehrak got in touch with her and encouraged her to expand the poem into a book. Kraft, struggling to connect with civilian patients whose concerns seemed trivial in comparison to the combat Marines she had treated, had never considered writing what would be the only account of the Iraq War so far from the perspective of a psychologist.

“I was very ambivalent at first, but 250 pages and one year later, it ended up being very good therapy for me,” she told Marine Corps Times. “I felt like I got back to being myself.”

An event that occurred one afternoon, about a month after she got to Iraq, managed to be something Kraft remembered both fondly and with anguish. That’s when her hospital received its first mass casualty — 14 Marines wounded in a firefight with insurgents.

“One of them had a very significant brain injury,” she said, adding that his wounds made it unlikely that he would survive. “In a case like that, [doctors] have to triage them ‘expectant.’ That’s something that’s very hard for American doctors to do. We moved them to a place called an expectant ward, where they are able to give them medication, fluids and emotional support until the person died.”

Dentists and dental technicians were normally assigned to the duty, Kraft said, but she walked into the small room in the hospital’s basement that had served as a laundry room to discover a young muscular Marine lying on a gurney surrounded by several sailors.

Kraft did not know at the time, but the wounded Marine was Cpl. Jason Dunham. He would later receive the Medal of Honor, posthumously, for using his body and helmet to protect two of his comrades from an exploding hand grenade. She only knew that the dog tag in his boot said his name was J.L. Dunham, that he was a Methodist, and that trauma surgeons had decided that there was nothing they could do to save him.

“I was very drawn to him,” Kraft said. “Once I started to hold his hand, I didn’t want to leave. I spoke to him. I told him the Marine Corps was proud of him. I told him it was OK if he was ready to let go if he wanted to.”

But then Dunham squeezed her hand, and seconds later he squeezed again. She said she wondered whether what she felt was a reflex, so she leaned close to his ear and told him to squeeze her hand if he heard her. Dunham squeezed again. Kraft called doctors.

“He moved his toes to command,” she said. “He moved his hands to command. His eyes moved in response to light. He was holding onto my hand so tight that I actually had to pry his fingers off.”

He was flown to Baghdad, then to Germany, and finally to the National Naval Medical Center at Bethesda, Md. Kraft allowed herself to believe that the Marine with the fierce will to survive would pull through.

But about a week later, a chief came to tell her Dunham had died the night before.

“I just wept,” Kraft said. “I sat down and started sobbing. It was the one and only time I allowed myself to cry during deployment.”

Dunham’s mother got the call in middle of the night that her son was critically wounded, Kraft said. His mother prayed that he would make it. “Then, halfway through the night, for a reason she said she didn’t fully understand, she changed her words. She prayed that her son would not be alone.”

“[Dunham’s mother] believes that he fought to get home because he promised her he would come home. She believes that he heard her voice in mine,” Kraft said.

Dunham’s mother invited Kraft to the White House ceremony in January.

Over the next six months, Kraft dealt with more challenges: poisonous spiders; a suicidal Marine private and another suicidal Iraqi detainee; blistering heat; weeks without fresh fruit or vegetables; a young, deranged Marine who pointed his rifle inches away from her because, she said, he wanted to “fillet” her; and a gunnery sergeant who lost both legs and an arm to a roadside bomb but still kept people in the operating room entertained with jokes.

But the biggest challenge to Kraft was being away from her 15-month-old twins, whom she had left in the care of her husband, a former Marine AV-8B Harrier pilot, along with her father and mother. She said she was sure the children were being well cared for, but spending seven months away from them was still agonizing. She feared that agony would begin to affect the care she gave to Marines.

“I had to make a conscious decision to not be a mother out there because if I let them be at the forefront of my mind, I wasn’t going to be effective,” she said. “I put all their pictures away and I was a combat psych and not a mother.

“I think I am a better mother now because I prioritize them above everything else, and I always will.”

Rule Number Two: Lessons I Learned in a Combat Hospital. By Heidi Squier Kraft. Little, Brown and Company. 240 pages. $23.99.

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