text by Neil Shea
photos by Jim Nachtwey

this is an excerpt from a story that appeared in National Geographic Magazine (December 2006). Read the entire piece, view Jim Nachtwey's photos, and more at NGM's web site.



Part One: Front Lines

The war is on hold. The soldiers of Charlie 2-4 sprawl on battered chairs and couches in dust-lined rooms that stink of sweat and half-eaten meals. They stare at pirated DVDs, thumbing through gun magazines, car magazines, even copies of Glamour. Some wrestle like brothers cooped in a snowbound house, boots clomping past stacked rifles, insults riding over radio static. For 12 hours, nothing has happened. The men, crews of one of the busiest medevac helicopter units in Iraq, have fought only boredom. A feeling gathers that something is coming, that they're due. No one mentions it. That would break taboo.

Outside, a sea of stars spreads above the trailers and shipping containers that compose this base. The lights of Baghdad bloom on the horizon, making the place feel removed, safe, although insurgents have lately been lobbing mortars over the 20-foot (six-meter) walls. Elsewhere, infantry units roll out on patrols or return for midnight meals. Generators hum. Spring-armed doors clap shut as soldiers go to shower away the day's dust.

The men of Charlie 2-4 fly Black Hawks over a landscape too dangerous, too wrecked for road travel. They fly into the hot, violent cities, the mud-brick towns, the nowhere stretches of desert, picking up American and Iraqi soldiers, civilians, and, sometimes, enemy fighters. For medevac crews, there are missions, and the space in between. Earlier today, Charlie 2-4 rescued three Iraqi boys wounded in a bomb blast in a rural field. Blood and mud caked their bodies, stubs of straw clung to their bare backs like a pelt. The mission reset the clock, the psychic countdown. Now comes a rush of static and an anxious, tinny voice on the radio: Insurgents have attacked a U.S. Army patrol somewhere on a highway south of Baghdad. One of the soldiers is badly wounded.

A four-man crew sprints to the flight line, loose gear bouncing on shoulders. They stow their rifles, slip on sweat-greased helmets. The pilot and copilot spin up the Black Hawk's rotors and speed through the preflight checklists. A sweet, dizzying breath of fuel washes over them. David Mitchell, the flight medic, scans the cabin: litter pans for stretchers, four of them, jut from the sides of the helicopter like berths on a ship. Oxygen tanks, heart monitors, bandages, bags of saline, all of it ready, wedged into crooks, compartments.

The crew tenses, especially Mitchell. The tall, 29-year-old sergeant is earnest and usually quiet, a polite southern boy. Excited or nervous, his eyes widen and he curses more, a habit he's trying to curb. As he sorts the last of his gear, he swears, a single word, the sound of it lost in the clatter of rotor blades.

The helo slides loud and low over the desert. In the cockpit, the pilots scan for muzzle flashes, tracers, warning each other of low-hanging wires. In back, Mitchell thinks through scenarios. He decides where he will put the patient. He imagines what might go wrong, what he will do. Medics learn quickly to solve problems, or at least keep them from worsening. Much of their job comes down to plumbing: Plug the leaks, stop the bleeding. Speed is key. If medics hold fluids in, if the helicopter moves fast enough, the wounded win time.

Mitchell is from Waldo, Arkansas, population 1,600, in the southwest corner of the state. The Where's Waldo? jokes no longer amuse him. He is a father of four boys and was married on September 11, 2001. On every mission he carries three good-luck charms. One is a gift from his parents, a crucifix inscribed with the letters K.O.S.S.—Keep Our Son Safe. The others, a black rubber wrist bracelet and a single dog tag pressed with his nickname, Deucez, and those of two buddies, Skyzap and Spyder. It is only his first tour in Iraq—some of his colleagues have done three—but Mitchell has become a character in the superstition surrounding the unit's endless days. He is called a "mission magnet": Whenever he's on duty, something happens. Tonight the proof piles up.

It is near midnight when we arrive on the scene, circling while the pilots inspect what's below. Humvee headlights carve out a landing zone on an empty road. Soldiers aim their weapons into the blackness beyond, watching for an ambush. We bump down in a cloud of hot dust. The injured man has been laid on a litter and stripped to the waist. Four or five of his comrades run the litter to the helicopter and clumsily, frantically, shove him inside. He has no pulse. Mitchell begins CPR. The helo lifts off for Baghdad.

The soldier is perhaps 20. He is lanky, with knobby shoulders—a boy's shoulders. Green cabin lights wash across his chest, his right arm flops off the litter. Mitchell moves like a piston above him. "Come on, buddy," he says. "COME ON, BUDDY." Sweat pours off him in long beads. Even with the windows open, the helo racing 200 feet (60 meters) above the ground, it is well over a hundred degrees (38°C). The heat, the weight of his body armor, and the frantic pace drain him. He's exhausted, losing effectiveness. After ten minutes, crew chief Erik Burns makes Mitchell get out of the way. Then Burns waves me in, a fresh set of arms.

Medics must use any resource available to them, and tonight I am one. I shove down 15 compressions. The soldier's chest feels ready to crack. I sink all my weight into it, right over his heart, his ribs buckling beneath my hands. My head pounds. Mitchell slumps beside me. We're gonna save this kid, I think. I will it true. We fly on toward Baghdad, over the flat fields, the pinprick lights, the sleeping country. The last minutes to the hospital blur past, a manic, sweat-soaked dream.

We touch down on a landing pad outside Ibn Sina Hospital in Baghdad. A nurse and medic duck across the pad, their scrubs flapping in the rotor wash. They haul the soldier into the trauma room. Doctors and nurses swarm him. Someone continues CPR, others slide tubes down his throat, measure blood oxygen levels, check his pupils with a flashlight. Mitchell stands nearby, helmet tucked under his arm, downloading what he knows to a nurse. His bald head shines with sweat. Monitors beep, there is the gasp of breathing machines, the tear of bandages.

"I got blood coming out his ears!" a doctor is saying.

"Hey! I got a pulse!" another shouts. It's been five minutes since we arrived.

Mitchell grits his teeth in a tight smile and pumps his fist. Yes.

"I told you," he says, bouncing on his feet. "No one dies in my helicopter."

Then the mood shifts. Something is suddenly understood, it appears on the faces of the doctors. There is a pulse, nothing more. The soldier doesn't react to stimuli, shows no signs of life. There is a question about what to do. But Mitchell must leave, speed dictates, and we fly back to base to wait for the next call.

On the ground we learn the soldier's fate. Doctors discovered a metal fragment embedded deep in his brain. They decided an operation would be futile. The only hospital equipped to do that kind of brain surgery was too far away, in another part of Iraq. They pumped in pain meds, just in case, and waited for his heart to stop. For Mitchell, the flare of triumph dies. He looks at me blankly, then walks away, saying nothing. It doesn't always end like this. But these are the days the crews must get used to, the ones they never forget.

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Neil Shea is a staff writer at National Geographic magazine. He is founding editor of Inversion Magazine.

Jim Nachtwey is an acclaimed documentary photographer. He has covered war for more than 20 years.