Aid and Comfort to the Enemy: A Surgeon's View of the War in Iraq

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Aid and Comfort to the Enemy an orthopaedic surgeon practicing in


Idaho. Dr. Floyd holds academic appointments at the Johns the

Hopkins University and

University of Washington Schools of

Medicine. He has authored numerous scientific articles as well as a novel, Yellow


He continues to serve his country in the Idaho Air National Guard.

aid and comfort to the enemy

Native Floridian Charles Timothy Floyd is

Aid and Comfort to the Enemy is the story of the

934th Forward

Surgical Team’s remarkable journey into and through Iraq during the first and second phases of

Operation Iraqi

Freedom. Through photographs, diary entries, and personal narrative the unit’s orthopaedic surgeon provides an intimate view of the lives and events of the early, conventional stage of the war while examining issues of morality, patriotism, and duty.

timothy floyd

A Surgeon’s View of the War in Iraq timothy floyd

Aid and Comfort to the Enemy A Surgeon’s View of the War in Iraq


photographs and narrative by

Timothy Floyd, MD FACS




Deployment: Kuwait and Camps Wolf and Virginia


Moving North: An Najef and Camp Spartan


Weapons of Mass Destruction: Karbala and Camp Dogwood


Sunni Triangle: Balad, Baqubah, and Camp Ashraf


Whiskey Bravo: Tikrit and Camp Speicher


Coming Home


War Photography


Epilogue: Lessons Learned




that one time. It was a circuitous path on numerous rural roads, some of them one-lane dirt roads, through small villages, with lots of turns to the compound. We did this in order to avoid attack on main roads. Although the Special Ops guys had GPS, we didn’t have so much as a map, but I took notes during the drive over to Ashraf and back to Balad, as well as numerous digital photographs that I would later use to assist in navigation. It was about eighty miles each way and passed through some of the most hostile territory in Iraq, including Baqubah that would become a center for the insurgency. In fact, the route we drove passed within four kilometers of the farmhouse in Hibhib where Abu Musab Al-Zarqawi, the leader of Al Qaeda in Iraq, was killed in an airstrike on 8 June 2006. Security inside the compound was another issue. Although the MEK were heavily armed with automatic weapons, we surrendered our pistols while we were inside the hospital. As the only Americans within at least fifty miles, we easily could have been taken prisoners, or worse. Instead, we were treated as honored guests. I decided to take with me about one third of our personnel, and I tried to rotate them for each trip. A few declined to go. We took half of the orthopedic equipment and half of our external fixators, as well as general surgical supplies. We traveled light, in two humvees that we modified for the mission. I made several more trips to Camp Ashraf in addition to that first trip. By the end of the mission, all of the patients had been treated and their wounds were healing nicely. One patient needed an artificial hip replacement because of a fracture sustained in a blast, but we did not have any prostheses of that sophistication nor was the facility sterile enough to permit such an operation. The 21st Combat Support Hospital arrived in Balad toward the end of this operation, so I took two of their surgeons with me on one occasion. When we returned we tried to convince their commander to assume the mission, but he declined on the grounds that it lacked orders. Later, when we were in Tikrit, command became interested and asked me to lead a convoy so that our higher command could establish contact with their leadership. 27 April I led a group to the Iranian compound today (Camp Ashraf ). Didn’t sleep well because I stayed up late studying the map, planning contingencies, making check lists, etc. Fitful night of sleep because of my anxiety over the trip, hot night, lots of noise, eaten alive by bugs of all kinds including mosquitoes (faithfully taking my doxycycline). The falcons that have a nest on one of the doors to this bunker screeched in the very early hours of the morning. I got up about 5 and started dressing etc at 6. We didn’t get started until 0915 for a variety of reasons. We were slow, had to pack, fuel vehicles, etc. And there was a huge thunderstorm this morning that turned into another ferocious windstorm in the afternoon. The gravity of the responsibility of the mission really took hold of me and I felt very responsible and in control of the convoy, starting with the briefing. We set up for two simple surgeries to see how it would go, and things

Despite the impending violence in Diyalah Province, many people – especially children – seemed to welcome our presence.


were slow because of power, communication, turnaround, etc. The people were very accommodating as usual. All who went were pretty euphoric about it, including Robert. He was very positive about it. We arrived here about 1830 and the colonel had sent someone out to look for us even though we had called the 30th med brigade and left a message. Ray, one of the SF guys, stopped by the hospital and asked if any of the female soldiers at Balad were giving any up. I told him I had no idea then he smiled and motioned me to come outside. I had mentioned to them that it would be nice to have some beer and/or cigars. He had two MRE boxes full of tall Turkish beer. When I asked him where in the hell he found beer in the middle of war-torn Iraq, he said, “A target opportunity presented itself.” We ate sardines (Florio got a package), beer nuts from Rob and drank outside, then went up on the roof of the bunker to see the sun set. Monson told us we were going to jump north which was a disappointment for us. Today was the first day we have been in an up, positive, almost euphoric mood. The beer certainly helped with fellowship and bonding tonight. We are all excited about working on these wounded Iranians, our mail is starting to arrive, there will be laundry service any day now, and some showers are up. And now we jump to Tikrit. I really think we need to go stay at the Iranian compound to do the work for several days, then jump. Tonight, while we were watching Tombstone, a huge firefight erupted just a few hundred yards from our bunker. We are on the northeast corner, right at the perimeter of this compound. In fact, you just go out from our bunker, take a left, and you are outside the compound. Farmers are right out there working their fields. We can clearly


hear the daily prayers. All of a sudden we heard fire and saw tracers flying all over the place, then flares. I tried to take a time exposure with the Hasselblad. The M1 Abrams tanks that are parked right next to us rolled out and their Bradleys started firing as well. It lasted about 90 minutes and we were all standing outside watching it, fascinated at the firefight. I don’t think the Fourth of July fireworks are ever going to be the same after this. Tomorrow is Saddam’s birthday and a warning had been issued about a possible assault on our area. Quite an interesting day. 28 April Found out that 7 Iraqis were killed and 20 captured last night. Went out to Iraqi family today with Hal Walker and three APCs that blew up some cluster bomb UXO. Tom Joseph (PMR) really was much more help to them than I was. He got excited about building a wheelchair for the teenaged girl out of scraps he could find around the base. Tonight we packed for departure on the 30th. Told we are going to Tikrit airfield and that this will probably be our last jump.

This was another amazing experience. As mentioned above, the Iraqis moved their MIGs out of the bunkers on the airfield and into the country, often parked right next to a house in hopes that we would not bomb them for fear of damaging private homes or wounding or killing civilians. However, our strikes were so precise that we were able to destroy the aircraft without inflicting collateral damage most of the time. At one farmhouse a piece of flying shrapnel from a bombed MIG struck an adolescent boy, inflicting a small wound in the

Firefight at perimeter of Balad Airbase (Anaconda), 27 April. This happened on the eve of Saddam Hussein’s birthday at the northern portion of Balad Airbase. Our FST was set up essentially between the airbase and the city of Balad which would become a haven for the insurgency in later years of the war. Seven insurgents were killed in this battle. We suffered no coalition casualties.


skin of his chest wall. It was a minor injury, but one for which the U. S. Army took responsibility. Hal Walker, a flight surgeon for a helicopter squadron, asked us to accompany him to the farmhouse where this boy and his extended family lived. Hal looked after the boy while we looked after the others. Another aspect of this mission was the destruction of UXO by our ordnance experts. The Iraqis had placed mines under roads and in farm fields. There were several mines at this farm that needed to be destroyed. This was also my first and only exposure to a combat lawyer. The Army places attorneys right at the front lines to help commanders with the nuances of dealing with local Nationals. The aspect of this trip that struck me the deepest was how similar to, rather than different than, these people we are. This was a very large extended family living in one large farmhouse in the fields outside the Balad Airfield. Like the peasant Sunnis we met in southern Iraq, these people seemed very genuine and human. The children were all happy, running around like little maniacs, playing. Even the two children with cerebral palsy were well cared for. The various uncles and aunts, the patriarch and matriarch, all seemed like people that only wanted to live their lives without interference or oppression. I’m sure their most pressing concerns involved the welfare of their children – food, water, clothing, shelter, and education. They were good people and reminded me of a typical American family. 82

29 April Back early to Ashraf compound, took Clark Searle (orthopod from 21st CSH) and Joe Enrizzi (urologist). Joe is the nephew of Austin Cushman, a highly regarded general surgeon in Boise. Small world. Large convoy today with lots of people. Of course, we had the welcome orange juice and pastries, then I went to the OR with Clark while Borrego, Florio and Enrizzi rounded. It took a few hours to set up and do two external fixators and for those guys to round on the men. Then we had another delicious lunch (spaghetti this time) and finished the third ext fix in the afternoon. On the 27th the patients were Fariba (infected BKA) and Nahid (open elbow). Today they were Ahmed (open R elbow and R supracondylar femur), Siawosh (femoral shaft fx), and Mostafa (plated femoral fx). Either applied or reinforced ext fixators. After that I took my first shower since Virginia (a disgusting shower there) although this was more of a mist than anything else. At the end, Dr. Zohreh asked to see me alone with an interpreter and the man who is in charge of the hospital who doesn’t speak English but who seems to give the most information (propaganda?). Met with them for at least 30 minutes where, once again, they explained their position politically. She seems to think that I have some political clout, wants me to talk to people in Washington. I tried to explain but to no avail. They were also very concerned about follow-up and further care for their patients since we have been tasked to move north. I explained to them that the request has to go up to the generals and then down to the CSH since their commander cannot take the initiative on his own to help them (really not equipped to go out there anyway, and don’t know if those patients can be brought to our Balad base). As Clark had said, it has to go up the black chain and down the white chain. Joe seemed to think it had to go all the way up to Tommy Franks. I also explained to them the fact


that our government considers the MEK a terrorist organization and that officially and personally it was illegal for us to help them, although I am sure that humanitarian help for wounded people would be allowed. Wahid showed me an x-ray of a man with a two-week-old displaced femoral neck fracture. I told him I thought it needed an endoprosthesis, but Wahid was concerned that it should be fixed. Clark and I tried to explain to him the likelihood of AVN and subsequent reoperation, but he still was concerned. He knew however what we wanted, and called it FR Thompson, which shows the level of orthopedic care they have since these are hard to find anymore. Came back in the evening and finished packing for move tomorrow.

The U. S. Army continuously protected the MEK until 1 January 2009 when protection was turned over to the Iraqi forces as part of the drawdown of U. S. forces in Iraq. Nuri al-Maliki, the Prime Minister, declared that the MEK would not be allowed to remain in Iraq, nor to conduct operations against Iran from their compound, and that they were no longer welcome in Iraq. In late July, 2009, about 2,000 armed Iraqis stormed the Iranians at Camp Ashraf. Allegedly, these were Shia Iraqis sympathetic to and supported by the Iranian government that the MEK opposed. Five to eleven people were killed (reports vary) and many more wounded, including Dr. Zohreh who was critically wounded. As of the time of this writing I have been unable to ascertain her fate. The enemy of my enemy is my friend. 84



During a “house-call� to a farmhouse near Balad we unexpectedly found children with a variety of afflictions, including cerebral palsy.




Major Hal Walker examines the boy with cerebral palsy. When we initially saw these children, the physicians were excited that we would be able to perform simple surgical procedures to help them move around better. Then we realized that we did not have wheelchairs to enable them to use their improved limbs. I later learned from Hal that Major Tom Joseph fabricated wheelchairs for them out of scrap material he found laying around at Balad Airbase.

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