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I was born in Northern Virginia near Washington D.C. and raised in Southern California in the city of Irvine. When not in Iraq I'm stationed at Ft. Hood, Texas, and work at Darnall Army Community Hospital in the Emergency Department.

So much has changed at the 21st CSH since being filmed last spring. July 3 marked the first time that mortars landed on our compound, less than 700 feet away from the hospital. Once you've heard one you will never forget the sound—a whoosh that ends in a big boom that shakes everything around you. The loud boom woke most of us up that evening, causing us to don our Kevlar and flak vests and take immediate shelter in our MILVANS until the all clear was called.

That night the mortar attack produced 16 casualties. We worked all night and early into the next day taking care of our patients. That night, reality hit for many of us. The major combat operations may be over, but we are still at war; we are still a target. It brought true meaning to the words "combat nurse." Since then the mortars have continued to be a presence in our camp, some months more than others (and some months we have none at all).

In addition to the mortar attacks we have seen an increase in patient casualties from shrapnel by Improvised Explosive Devices (IEDs), Rocket-Propelled Grenades (RPGs), gun shot wounds, mortars, and other injuries and non-battle wounds and illnesses. To see the damage that shrapnel from an IED can yield in a patient can be horrific at times.

The 21st CSH has taken part in treating casualties from the U.N. bombing in Baghdad, the Chinook that was shot down, and numerous other significant events that have occurred here in Iraq. The EMT [Emergency Medical Treatment, equivalent of Emergency Room] has taken care of more than 6,000 patients from the end of April to mid-January 2004.

The high points have been the friendships and bonds you make when you go through an experience like this. Also, when you save someone's life that you know would be lost if there wasn't any medical care available to that person. The following is an experience I had with one of the patients we treated at the CSH EMT. It comes from an article I published in the military edition of Nursing Spectrum on September 1, 2003, entitled "Army Nurse in Iraq Learns 'We Are Still at War'":

[A]s I returned to the EMT tent after taking a patient to the clinic, I found myself looking at a 23-year-old American soldier who had received shrapnel wounds from an RPG while on a convoy. The first thing I noticed was a tourniquet and a blown-up leg that was severed in two places. As I looked at the leg, I knew it would be lost.

As the staff worked on the patient, I saw him lose color and become paler. I placed an IV in his hand and I started talking to him, feeling he shouldn't be alone at a time like this. We talked about the town he was from, his family, and a few other minor things.

He grew paler, and I knew he had lost a lot of blood before he arrived at the CSH. I became worried we might also lose him. When they rolled him into the OR, I couldn't help the tears that poured out; and I wondered why this happened to such a young boy, one who was willing to sacrifice his life for his country.

That evening he came out of surgery with an above-the-knee amputation. I visited him the next morning in the ICU. He told me, "I remember you, ma'am. Thanks for talking to me. I may not have all my pieces anymore, but I am doing all right."

I will never forget the smile on his face that day, knowing that our efforts, combined with his presence of mind to place a tourniquet on his own leg, saved him from certain death.*

There are so many stories like this that have happened at the CSH that make you smile because you know that we made the difference in the patient's outcome. The unique people you meet along the way, the soldiers who are out there everyday risking their lives patrolling, delivering supplies, and who still have a smile on their face and a positive attitude—they lift your spirits up.

As for low points, one is definitely being away from your family for a whole year. This is an extremely long time, because you know life has gone on without you back at home and only stands still in Iraq. It puts a large strain on all relationships. Also, you find yourself missing the simple comforts of home that so many people take for granted until you have barely anything in Iraq.

Whether you agree with us being here or not, please don't ever forget the soldiers that have given their lives for you, the American people.

The holidays during December were a particular low point for many of us in the CSH, because we were away from our loved ones. We also experienced a few deaths over that time, which made it very hard on all of us in the EMT. It was the realization that the soldiers' families would now remember the holidays as a time of loss, that those left behind would never get the chance to share another holiday season together again. It's also hard to think of those people left behind—the spouses, the children, the parents.

Overall it has been a great opportunity to work with so many different people in the CSH. The EMT—not to mention all other sections of the hospital—is made up of an amazing team of doctors, nurses, and medics. Everyone has brought a unique talent or skill that has made a difference while caring for the many patients we've seen. Without each of the key players, the CSH would not function. Each and every one of the staff gave 110 percent to every patient who came through our doors. I am very proud of each and every one of them. We learned so much from each other, and I would gladly entrust my life to them if I was ever hurt or sick.

As one of the EMT nurses, Lt. Shrope, puts it, "The world out here is indescribable. You only know what it's like if you live it." I think Maj. Cuccinelli sums things up in his article entitled "Saving Specialist Gray," which can be found at the following Web address:

http://frontlinevoices.org/archives/006413.html

Specialist Gray took part in a convoy that delivered food to his battalion headquarters. On the way back to his truck he was injured by shrapnel from a mortar that landed close by his vehicle. He suffered shrapnel wounds to his body but sustained a life-threatening injury to his leg that bled profusely. A tourniquet was placed, and he was medevac'd to the 21st CSH. "By all accounts, SPC Gray should not have survived," Maj. Cuccinelli writes. He lost almost all of his blood. Through the many blood transfusions and trips to the OR, and because of the staff who fought for him, he survived.

During his treatment we were reminded that, as Maj. Cuccinelli writes:

There are many people involved in keeping us [soldiers] alive and working for freedom in Iraq that are never seen. The Army's doctors, nurses, medics, pilots, crews, lab techs, National Guard soldiers, and airmen are, more often than not, in a combat support role, much like SPC Gray. They too risk their lives, left their families and friends, and sacrifice. They are not likely to be the ones who find Saddam. They do not man the checkpoints or conduct the raids, but they do see the casulaties. They understand truly that "Freedom isn't free" and witness its price. They can only stare at the daily horrors of the war and negotiate for a lower price. They spend all day, every day, attempting to get all the "SPC Grays" home to their families, alive and well.

It has been a long year with many mixed emotions. I will never forget what has happened in this country. I will never forget those who were hurt, or the lives that were lost. I know that the 21st CSH was needed in Iraq. We are here because of the soldiers, the ones that keep us free. Whether you agree with us being here or not, please don't ever forget the soldiers that have given their lives for you, the American people. Not everyone is willing to do what they do, and because of that they hold a very special place in my heart.

I was here in Iraq as a nurse to take care of your husband or wife, your father or mother, your daughter or son, your niece or nephew, or just someone in your family. I am here to make sure they have a fighting chance. I'm here to make sure that they receive the best medical care possible. I'm here to hold their hand when they are scared or to stroke their head when you cannot be there for them. We are here to give them all we have and more so we can attempt to get them home to their loved ones.

I am not the same person I was when this adventure started because of the experiences I've shared with so many other people. I am a changed person.

*This excerpt copyright 2003 by Nursing Spectrum Nurse Wire (www.nursingspectrum.com). All rights reserved. Used with permission.