No Place To Hide: A Brain Surgeon’s Journey Home From The Iraq War

W. Lee Warren, M.D. No Place To Hide: A Brain Surgeon’s Journey
Home From The Iraq War. Michigan: Zondervan, 2014
As reviewed by Ted Odenwald

noplacetohideI’m not sure if this book is a part of the author’s therapy for PTSD — or if it’s a testimony to the redemptive power of faith in unbelievably stressful times. I suspect that this memoir is both: the recollections of a military neurosurgeon immersed for four months in the horrors of war in an emergency medical unit in Iraq. MAJ Warren, a highly trained and skilled surgeon, arrived in the combat zone and discovered that he would be working in primitive conditions, with limited surgical equipment, and with frequent influxes of mass casualties—all in extremely grave condition.

Accustomed to highly equipped operating suites back in the states, MAJ Warren found that he had access to only four sets of basically old surgical equipment—and only four sterilizing units, each of which ran in four hour cycles. If there were more than four patients needing brain surgery, triage would then become a very tricky business. Warren learned a great deal about the military’s emergency surgical procedures.  One involved inserting a tube to relieve pressure on the brain. This method was practiced back in the states, but only when the closely monitored patient showed a pressure build-up. In Iraq, with many patients and not enough people free to watch each patient, this “extreme” measure was considered preventative. Another practice involved surgically implanting pieces of a patient’s skull in his side so that when the wounded individual was out of immediate danger, a surgeon could replace the victim’s own skull sections with screw and steel plates. At times he sewed up a hole in a hopeless victim’s skull, insuring brain swelling and mercifully speeding up the inevitable death process.

Warren’s assignment to Iraq could not have come at a worse time; his 17-year marriage was falling apart, and his brother had been stricken by a severe stroke. His fears of the war-zone environment were intensified by his concern that his children would view the divorce and his assigned departure as abandonment.

His arrival at the base was also unsettling as he ran into an “…inefficient traffic jam” in the hospital. The military’s procedure was to replace entire staffs at once, leaving little or no time for the practical wisdom of departing doctors to share with the newcomers. He encountered a collection of “…differing philosophies,…biases, and egos vying for their own specialty-specific goals or pulling rank-over-experience power plays.” He now recognizes that he had been one of the trouble-makers, set in his beliefs and condescending to officers who had learned the “tricks” for handling mass casualties. He sees that that he had been a “control maniac,” who eventually understood the benefits of the procedures implemented by a long series of predecessors.

Repeated arrivals of head wound casualties requiring surgery, the difficulty of sleeping when the nerves are overcharged in this stressful situation, frequent rocket and mortar attacks, the constant pressure of monitoring the recovery of his patients—all of these issues created a tremendous amount of stress for all of the medical staff. Though Warren talks the reader through several of his most poignant cases, it is apparent that he is showing how he had grown in his surgical skills, in his humaneness towards his patients, and his respect for his equally challenged peers. He attributes the salvaging of his sanity to the strengthening of his faith through prayer, performance in a worship band, the comforting support of a very wise chaplain, and also through “finding a measure of peace in helping others seek the ‘healing presence of God.’” He was impressed by the military’s willingness to treat not just its own troops, but also wounded and sick civilians, and even enemy troops. A patient was a patient who would receive the doctor’s full attention. His main lifeline was also inspirational; he was in frequent contact through e-mails to and from thousands of family, friends, and strangers, who were back in the USA, providing him with incredible understanding and encouragement.

Four months does not sound like a long assignment, but for this 35-year –old surgeon, it was a compressed lifetime of horrifying, challenging,  gratifying, and spiritually enriching experiences which prepared him to face the extreme changes in his personal and professional life.

tedTed Odenwald and his wife, Shirley have lived in Oakland for 43 years. He taught HS English at Glen Rock High School for all of those years plus one more. Now he is enjoying time spent with his family, singing in the North Jersey Chorus and quenching his wanderlust. Ted is also the Worship Leader at the Ramapo Valley Baptist Church in Oakland.