Prologue
June 20th, 2010
Commander (CDR) Cole Ryan sat surveying the hot desert around him while sipping a cold non-alcoholic beer. “Jesus it’s hot out here. I don’t remember it being this hot the last time around.”
“Well, last time we were here it was in the fall and winter so I honestly can say that I prefer the hot to that bone chilling cold and rain.” Lieutenant Commander (LCDR) April Bowles said.
This was Cole and April’s second tour in Afghanistan. As a gynecological oncologist, Cole still felt out of his realm. His focus in life was to remove cancer, not deal with removing bullets and operating on traumatic wartime injuries. Cole couldn’t remember the last time he operated on a male since his last deployment, and even though they were three months into this seven-month deployment cycle Cole couldn’t wait for the end to be here. He knew that when this deployment was over he’d finally be able to ask April to marry him.
They had been together for two years now since they met on their last deployment. Fortunately, they discovered that they were from the same area and began to date after their return. Cole had never been in love before, but he fell hard for the blue eyed brunette staring back at him every day over the surgical mask. Cole was intrigued at first by her eyes, but he kept noticing this lock of hair that kept slipping out of her surgical cap and the ghosted smiles she passed him under her mask. Even though there was a strict no dating and especially no sex rule while in Afghanistan, the conversations they were able to have over dinner and while hanging out allowed them to really get to know each other. Cole knew he was in love with April before they even had their first date.
Grabbing a slice of pizza Cole said, “You know, at least they have Pizza Hut here now. It’s a little slice of home.”
“I know you enjoy this pizza and that semblance of beer, but have you looked at the food prep area? Two foreigners sitting on milk crates cutting up vegetables without washing their hands is just asking for Hepatitis A, not to mention high cholesterol.” April laughed.
“It’s a risk I’m willing to take for a little piece of mind. So, did you talk to Jennifer today? I sent her an email to say hello and let her know I was looking out for you, making sure you weren’t getting into any trouble.” Cole asked.
“Yes, I talked to her this morning, but what’s this me getting into trouble? If it were up to you we’d be in trouble every day sneaking off and having sex.” April said with a smile. “I hate that I’m going to miss her birthday next month, but I already ordered her presents so at least it’ll be like I’m there. I can’t believe she’ll be twelve already. It seems like just yesterday that I was bringing her home from the hospital.”
“How is your sister doing in Atlanta?”
“Sissy’s doing well. I exchanged emails with her this morning. She’s been holding down the fort for her boss. He’s been on a sabbatical trying to find himself and ease his pain. She’s beginning to wonder if he’ll ever make it back.”
“That sucks having to deal with other people’s issues; I’m glad she’s doing well. I assume she’s still running the office and keeping everybody in line?”
“Yes, she’s cracking the whip and making sure everything runs smoothly.” April said with a smirk. “One day she’ll probably be in charge of the whole damn place.”
Cole continued eating and listening to April. He couldn’t help but think about the bond he had forged with Jennifer and hoped that when he married April she would want him to adopt her also. She’d had a hard life given the fact that her father died from leukemia when she was three, but April had done a great job raising her by herself, but Cole wanted to help her so that she no longer had to carry all of the burdens of parenthood by herself.
“Cole. Cole!”
Cole looked up, “What?”
“Are you okay? You had this blank look on your face and seemed to be lost to the world.”
“I was just thinking about Jennifer and what an exceptional young woman she is. How is she holding up?”
“She’s doing fine. She’s going to spend a few weeks with Sissy in Atlanta next week and then she’s off to golf camp for three weeks. She’s been going to the same place for the last few years and really enjoys it, I usually miss her, but this year I’m relieved that she’ll have some place to go.”
Cole finished off his pizza and took April’s hand in his. He knew he couldn’t wait any longer. He had to know if April wanted to spend the rest of her life with him. Even though he was 35 years old and this was the first time he had ever been in love, he knew this was right and he couldn’t imagine his life without her and Jennifer in it for the rest of his days. Looking into her eyes Cole said, “April, we’ve been together for almost two years now. I feel like you and I and Jennifer have created a great life together. You’re the first thing I think about when I wake up and the last thing I think about before I go to sleep. The time we’ve been here has been extremely difficult because I long to touch you and have you sleep next to me. I realize that you may think this is strange, and it wasn’t how I intended to do this but I love you and can’t imagine spending my life without you and Jennifer. I know that I don’t have a ring but will you marry me?”
April was so shocked by Cole’s statement, the first reaction she had was for tears to well up and stream down her face. She had difficulty catching her breath and couldn’t speak. When she finally found her words, she looked into Cole’s eyes and said, “I can’t imagine my life without you. I know that you’ll make a wonderful husband and excellent father. So, my answer is…”
April’s answer was interrupted by the sound of their trauma pagers going off and an announcement over the 1-MC overhead speaker for all trauma staff to report to the hospital to receive incoming patients. Because of the seriousness of the discussion, it took April a minute to realize Cole was pulling her up and taking off towards the hospital, but she stopped short and pulled Cole back. “Wait for a second. I didn’t get to answer your question. The answer is YES! CDR Ryan I’d love to marry you.”
Cole grabbed April, kissing her in the middle of the British compound for all the world to see. They took off to the hospital to receive the incoming wounded soldiers. Just as they arrived, the Blackhawks touched down with multiple patients injured in an Improvised Explosive Device (IED) attack.
“CDR Ryan, we have six incoming patients. Two critical, two expectant and two routine. You and LCDR Bowles will be in Operating Room (OR) 1. The patient has multiple injuries including a complete amputation of the right leg and multiple abdominal traumas. The right leg bleeding is controlled, but they radioed in from the chopper with concerns over the inability to control the abdominal hemorrhaging.” Said Staff Sargent (SSgt) Ramirez.
“Thank you, SSgt.” Cole said as he walked toward the changing rooms. “April, we have a very critical patient. Make sure we have six units of O-negative blood and the rapid infuser set up. He’s already received two Liters of lactated ringers and five-hundred ml of Hespan. This is going to be messy, and we may not have a lot of time to explore the wound. We’ll need to find the bleeders and stop them quickly before we can explore more thoroughly.”
“Okay boss. You give the orders, and we’ll do everything we can to save this guy, but it sounds like he may be too far gone to save.”
Cole scrubbed in and stood in the operating room waiting for the patient to arrive. He looked over at his now fiancé and thought about the love he felt for her as her stared into her blue eyes and saw that lock of hair escaping her surgical cap.
“All right team. Everybody ready? Anesthesia, scrub nurses, surgical techs?”
Everyone signaled ready as the patient was wheeled into the OR. Cole quickly assessed the situation, noting where he needed to begin and what the most pressing priority was. “Okay everyone. The leg is as stable as it is going to get. The blood loss has stopped and he is going to need a femur revision after we amputate. We’ll leave that to the orthopedic guys in Landstuhl. The abdomen is a mess. I see three open wounds and a lot of blood. Someone get suction in here and hand me a 10 blade.” Cole made an incision down the midline and retracted the skin. Adding multiple lap pads, he was able to see the major bleeding area. He had a lacerated spleen, mesenteric artery and a liver laceration. After clamping the splenic artery and the mesenteric artery, he moved onto the liver laceration. “Three-oh vicryl and four-oh prolene ties.”
Cole ran the OR with the precision of a master surgeon. He was in charge but never afraid to take a suggestion from those he worked with. Cole loved the OR because he liked being in charge, but times like this were stressful and unlike his day job where he rarely worried about a patient dying in surgery, he knew that the slightest delay in treatment could easily cost the patient their life. Cole was in the process of removing the spleen when the air raid siren started going off. Cole looked around and was instantly fitted with his flak jacket while he continued working on the patient. “Everyone out now!” Cole shouted. “Go to the bunkers and report in. Now!”
Everyone left the room except April. “I’m not leaving you alone Cole. You can’t do all of this by yourself. Someone has to help you out. I don’t care that you’re my superior. I won’t leave.” April said donning her flak jacket. She had barely returned to the table when the first mortars started falling around them.
“Get out now April. I love you but I won’t risk you to save this guy’s life.”
Before she could respond an earth-shattering explosion occurred throwing Cole and April to the ground. Cole was stunned but he crawled around the table, finding April on the ground bleeding. He looked up on the table and realized the patient had been hit in the chest and head from the shrapnel and had been killed. Turning his attention back to April he turned her over and saw that she was bleeding profusely from a neck wound. Holding her in his arms he applied pressure the wound but he knew there was nothing that could be done.
April knew what was about to happen. She had very little time left and with tears in her eyes and barely able to speak she looked into Cole’s eyes and said, “I… I love you. Next to Jennifer you were the best thing that ever-happened t-to me. Please tell Jennifer I love her, and I-I am sorry I wo-w-won’t be coming home. Oh…look at that beautiful cardinal.” April said with her last breath collapsing in Cole’s blood soaked arms.
Cole pressed his lips to April’s saying, “I love you. I don’t know how I’ll be able to go on without you. You can’t die on me dammit. I have a lot of plans for us.” Cole sat there, looking into April’s lifeless eyes and began to cry. Forty-minutes later the hospital CO found Cole holding April’s lifeless body and crying.
“CDR Ryan.” Lieutenant Colonel (LtCol) “Hutch” Hutchinson said, “Son, we need to take her now. I’m so sorry. I know you loved her, but there was nothing you could’ve done to save her.”
Cole looked up with tears still streaming down his face, “I can’t let her go sir. She just told me she would marry me and she was my whole world. Now I have nothing.” Cole watched as they took April’s body away and felt like his heart had been ripped out of chest; he couldn’t breathe.
“Cole, I’m taking you off the schedule for the next week. I want you to see the chaplain and try to get some rest. If you need anything… wait, you’re bleeding. Where did you get hit?” Hutch asked.
“I don’t know. I never even felt the shrapnel hit me. I guess it’s in my left arm.”
“Let me look at it. You need to go to the ER and have this taken care of.”
As Cole sat in the ER, the reality of what had happened hit him like a ton of bricks landing on his chest, constricting his breathing. It finally hit Cole that he was being selfish. How could this happen to Jennifer? How was he going to tell her? What was going to happen to Jennifer? Would he ever see her again? Just as he was getting his breath back, Hutch came walking into the cubicle.
“We’re sending you to Landstuhl for further treatment. It appears that you severed the biceps tendon. After you’ve recovered, they’ll send you back here and then we’ll get you home.”
“Fine.” Cole said with less military bearing than he should have afforded his superior. “I need to get something from April’s room first.”
“Sorry, Cole, we have a C-17 Nightingale leaving in thirty minutes and you will be on that plane, but I could probably arrange from the ambulance to stop by on the way.”
“Thank you, sir.” Cole said as he tried to stand, but his legs gave out and the world turned black.
***