Ruck Up: Military slang meaning to get through a particularly challenging or stressful situation

Chapter 86: Ruck Up Hunt

April and Owen were adjusting to the incredibly hot temperatures of Sudan. Having moved from an area of Kuwait that ranged in temperatures of 50-60 degrees Fahrenheit, Sudan's 90 degree plus temperatures were nearly unbearable. Kepner and Hunt were serving in an FOB - makeshift hospital outside of Darfur and advising UNAMID (the United Nations-African military in Darfur peacekeeping efforts) on emergency medicine. The trip was intended to be brief while the Pentagon figured out where they wanted to post Owen next for the final six weeks of his stint. The unit had limited leadership, so Owen focused on training the team to work cooperatively and collaboratively. In addition to the UN peacekeeping soldiers, the main medical staff at the outpost were First Lieutenant Risa Strauss who served in the US Army, Master Chief Antoine Dupree who served in the French Navy, and Lieutenant Maria Carvalo who served in the Brazilian Army. Because of its location and temporary status, staffing was skeletal. The goal was to provide emergent life-saving care while awaiting rescue choppers or a rare rescue from a C-130. The patients were then transferred into the care of flight nurses and doctors.

Oftentimes, when UN troops did not need medical care, the staff was able to provide basic care to the local villagers. On January 4, three members of the team worked together to save the life of a young boy. The surgery was performed with limited resources and flickering lighting.

"How in the world can someone become so desperate, so impassioned about a cause that killing a child seems appropriate?" Owen grieved as he and Kepner operated on the little boy who appeared to be about 4 or 5. Sudanese soldiers had driven through his village, shot a handful of children in front of their mothers, and raped a number of young girls. Their patient was the only child who had been shot and survived.

"It's tragic. Unbelievable, Chief. I wish I could make sense of the violence here," April mourned as she began closing the little boy's abdomen. "I have no doubt that it is possible for this patient to recover. The questions become (a) will the soldiers come back and harm him again? And (b) will the necessary antibiotics make it here in time that infection can be prevented?" The team was running low on medicine. The Sudanese soldiers had confiscated a recent shipment, causing pharmaceutical strain.

First Lt. Risa Strauss, the nurse assisting the surgeons, whispered, "There were additional attacks this morning in Katum and Kuma. I'm not sure how long we'll be able to maintain camp here. The gunfire is all around us."

"Let's not go there, Strauss," Owen prodded the nurse. "The CO for the peacekeepers and I are in constant touch with HQ. We'll let you know what you need to know when you need to know it." April and the nurse exchanged glances of concern. "Instead of worrying about all that, keep an eye on this dressing and let me know how often you're replacing it. I created a loose closure for the drain and for anticipated swelling. If it's seeping too strongly, I'll need to come up with another plan," Owen ordered and explained before stepping away.

While cleaning up Owen's surgical tools, towels, and area, the nurse looked desperately at Kepner. She whispered, "Dr. Kepner, the situation is dangerous. As a civilian, if you have any choice, get the hell out of here yesterday. We've dealt with shootings, we've seen soldiers harass villagers, but the latest attacks are more intense than we've ever seen."

"As long as the Major is here, I'm here," April declared. "But I appreciate your concern. I really do."

After working on the little boy who had been shot, Owen stepped into his tent which doubled as an office. Using a secure line, he called in his afternoon report to the UN officer in charge, Ban Ki-moon, "Before the shootings, we were preparing for the upcoming rainy season before the shootings. I'd say the project is 75% complete. We have supplies on site to treat most waterborne diseases, but very few supplies to help prevent contamination. The prevention supplies have been confiscated more than once by the Sudanese from what I can gather."

The UN officer responded, "I appreciate your report, Hunt. The project will be aborted in its current state. Violent attacks on international peacekeepers are increasing in Nyala, El Daein, and Gereida. That's far too close to you. We've had 7 attacks aimed directly at UNAMID in the last 10 days. We plan to vacate your premises tomorrow at 0500. Worst case scenario, we'll send in a bird to extricate all personnel. Keep your personnel close by, soldiers have been arresting UNAMID men and mistreating UNAMID women. We are trying to reach you sooner, but we need to focus to the south in the current attack areas first."

"I understand, Sir," Owen responded. "I'll gather our crew and order delicate and subtle preparations. We'll be ready within 2 hours."

"Well done, Hunt. We'll be in touch," the UN chief promised. "The plan is to send in four US Marines in civilian Sudanese garb. They'll call you to the entrance of your hospital and pretend to harass you about your efforts. The obvious leader, Jenkins, will visually regard you from head to toe repeatedly – that will be his signal that they are UNAMID. Let them burst in without putting up a fight, follow them inside, and follow their lead. Confirm that your soldiers are all armed as well."

After speaking with the local peacekeeping CO, Owen quietly called his personnel together to share the news. The peacekeeping soldiers would be remaining in the area for an additional day or two but would be hiding offsite until after the medical team was safely removed. The plan was to coordinate efforts so that the peacekeepers left just before the Marines arrived.

Owen emphasized to his staff that absolutely no contact with outside countries was allowed. All efforts would be scrambled. The risk of having the transmissions picked up by the Sudanese was too great. Everyone needed to be ready to leave at a moment's notice. This meant that everything not stowed inside the uniform each man was currently wearing could be left behind. If time allowed, soldiers would have a very brief opportunity to gather more than they carried in their pockets. They were ordered to gather those items in backpacks and set them in a specific place, knowing that what they placed there might end up left behind, nonetheless.

Owen asked Kepner to stay behind after he'd dismissed the others. He explained that many surgical tools, medicines, and medical supplies would be abandoned. A solider had been tasked with destroying certain prescription narcotics and with placing any tools that could double as weapons in a less accessible space in case an attack occurred before they vacated the premises. He encouraged April to stow minimal surgical supplies on her person and to gather a similar set that he could carry. Further, Owen informed her about the undercover Marines that would be arriving anytime between the present moment and 0500 the next day. He shared how they would confirm identity.

"I'm deeply sorry, April. This is not what you signed up for," Owen apologized.

April grimaced slightly and offered resolutely, "Can't be changed. God will take care of us, Chief." Owen nodded, somewhat bemused by her faith in God's intervention.

After providing very specific parameters and instructions, Owen allowed Kepner to plan a to call Jackson. She would not be able to allude whatsoever to their location, upcoming movement, recent surgeries, or the Sudanese military actions; however, she could chat with her husband as if it were any other day and could set a time no sooner than 48 hours to be in touch again. The call would take place at 1930 Sudan time, which would catch Jackson at home at 0530 his time.

April stepped out, impressing Owen with her solid as a rock demeanor, and headed to the OR. She tried as best as she could to remain calm. As she prepared the surgical tool sets that would leave the camp in her pockets, April remained in doctor-mode. Risa, now aware of the latest news, assisted April. Conversation was minimal as both woman sought to be emotionless.

Owen stayed in his tent and gathered his own items into his pockets. Given his position, he would also carry a camo backpack out of the area if at all possible. Inside it, he packed the satellite laptop, a few communications devices, and classified documents that had not yet been destroyed. Owen's and the CO's backpacks were green-black-light green camo while the soldiers (and Kepner's) backpacks were green-brown-black-light green. As he entered the OR to check on Kepner and the others, Owen set his backpack in a specific and easily accessible location.

"How's it going?" Owen asked Kepner softly as he placed a concerned hand on her shoulder.

"Good. Everything is ready. Here's your kit," she reported, handing him a minimal collection of surgical supplies wrapped in a thick bandana. Owen placed them immediately into one of the pockets in his pants.

After inviting the nurse and two others over, Owen instructed, "At times like this, hearts beat fast and brains stems take over with fight or flight reactions. Let's try to stave that off. Keep level heads, stay hydrated, and focus strongly on consistent deep breathing. Since we're in here, let's prepare the room using standard protocol as if tomorrow was going to be any other day. Go about your work slowly and deliberately. There's no reason to rush. Going through this will help keep us steady and will help pass time."

The team of 5 quietly began working on the room, cleaning, changing sheets, and organizing supplies. Each step was completed with standard military expectations in mind. At 1930, Owen guided Kepner to a particular area across the room and reminded her she had 2 minutes to speak with Jackson. She dialed the number and waited for her husband to wake up and answer the phone.