Book Review: A Pediatric Surgeon in Iraq

Before Dr. Coppola crossed over the wire into private medicine, he was LTC Christopher Coppola of the US Air Force, who served two tours of duty in Operation Iraqi Freedom. A pediatric surgeon, Dr. Coppola provided critically needed skills to not only the soldiers, but the local population as well.

His book, Coppola, A Pediatric Surgeon In Iraq hits the ground running in chapter one and never lets up. Coppola takes the reader into the thick of the trauma room, in a way that no TV show ever could.

"The techs wheel the patient into the trauma bay and flip out legs from the gurney to support the head and feet of the litter. I move in and look down at the patient lying on the stretcher. It is a child who looks to be about two years old. I had expected to see a soldier or at least an adult, and the sight of a child is jarring."

Injured, mangled, bloodied, and sick children in war is knowledge that exists along the periphery for those outside the experience. But few within have ever presented the topic like Coppola. The surgeon not only tells of the unending caseload, but makes a very good case for military units in combat zones to include pediatric surgeons and also be properly supplied. In his published study, "Children Treated In An Expeditionary Military Hospital In Iraq," (included in this book), eighty-five pediatric cases over a seventeen month period were evaluated. This eighty five made up 5% of the total number of cases seen during that period at the military hospital in Balad.

While the medical units are mainly set up to tend to soldiers, there's a large number of locals along with children who are routinely treated. Coppola writes the obvious but often overlooked: that modern warfare is conducted in urban settings. As its victims, it will include the unfortunate who could not get out. Children are sometimes used as shields, fall victim to IED's, or household accidents caused by using flammable oils for cooking. Local hospitals are either rendered non-existent or operate with a combination of well meaning personnel, with both a lack of experience and equipment. Hence, the worst cases, and most especially children are often sent to the military hospitals. Coppola writes that while it's acknowledged this happens, more can be done to prepare for them.

This is the war stripped down to flesh and bones. He writes a harrowing account of MASCAL, an acronym for mass casualties. The readers are introduced to two year old burn patient named Leila, the victim of a vengeful firebombing on her house perpetrated by insurgents getting back at her father who worked for the Iraqi National Guard. Two-thirds of her body is burned, and much of this third degree. The dilemma always posed is that while she requires of four hour operation, injured soldiers might come through the trauma unit. It's a game of constantly shifting and balancing time.


Leila becomes one of the unit's success stories. They finally get her to smile, they learn about her favorite doll. They do that one thing that all health care providers often do --they fall in love with their patient. He writes:

"I knew her long enough to learn that her favorite stuffed animal was a pink bear, she loved chips and snacks, and her giggles brought joy to her mother and father."

But Leila becomes the confirmation of all that's wrong with war: violence, retribution, poverty, and death.

Coppola also writes of the medics, techs, nurses and other staff who work tirelessly to bring sanity and caring to a war zone. Are they heroes? Most of them would say no, they're just doing their jobs. However, few health professionals would ever cross the line to work in a war zone --not once, but many times. Yet, their efforts to restore life are seen each day in the number of wounded warriors who make it home.

We also learn about his efforts to bring a touch of home to his hooch by growing sunflowers, herbs, tomatoes, peppers and beans along the base of sandbags piled against it. He tells us of an invitation from the interpreters to break bread with them in their living quarters. While it isn't standard, and is widely frowned upon, Coppola notes that commanders said they'd learned nothing about the local populace until they got out of their Humvees and went inside to have tea. Hence, Coppola shows up with a ziploc bag of cilantro at the tent of Kasim and Majid for a meal of lamb spine stew. "For me, sharing a meal with friends is more important that obeying the letter of the law," he wisely writes.

A Pediatric Surgeon In Iraq presents a different side of the war. Coppola is at his best when presenting a convincing case to make allowances for the care of the youngest victims of war. Now in private practice, this surgeon will forever carry with him the experience of war as he goes forth as a surgeon in a large urban medical practice on the east coast. (Note that ten percent of all book sales will go to War Child, a registered charity dedicated to providing urgently needed humanitarian assistance to war-affected children around the world).