Nurse saves lives during Afghanistan deployment

by Chris McCann
JBER Public Affiairs

12/19/2014 - JOINT BASE ELMENDORF-RICHARDSON, Alaska -- The improvised explosive device detonated early - in his hand.

The 16-year-old Afghan boy was rushed to the Craig Joint Hospital on Bagram Air Field, missing a hand, an eye, and a lot of blood. Third-degree burns covered nearly half of his body.

Air Force Capt. Tania Leonard, an intensive-care nurse, was ready.

"He was an angry little fellow," she said. "But after a while, he became the most polite kid. I may not have reached the masses in Afghanistan, but I hope in his village, he'll tell people how we took care of him."

Leonard joined the Air Force hoping to be an ICU nurse. Her first assignment, however, was at the pediatric unit at Landstuhl Regional Medical Center, Germany. She was disappointed, but that billet prepared her for the future.

After that assignment, an Air Force fellowship in nursing at Walter Reed National Military Medical Center in Bethesda, Maryland, and a four-week rotation in a Baltimore hospital ICU treating trauma, she moved to Joint Base Elmendorf-Richardson in 2012. In June of 2014, she went to Afghanistan, where it all came together.

American personnel spend very little time in intensive care in deployed locations; as soon as they are stable enough to fly to Landstuhl, they're gone - often within hours.
The lion's share of patients were coalition forces, Afghan troops, and local civilians - including infants.

"We treated a lot of infants," she said. "There were a lot of them with hydrocephalus (a condition in which too much cerebrospinal fluid builds up in the skull); we had to put in shunts."

In an area with so little access to modern medical facilities, Leonard and her compatriots' skills were in demand.

"We removed kidney stones, we did brain surgery. We did twelve-hour surgeries on local nationals - if we had the surgeons available to do it, we did it."

One Afghan man had suffered a blast injury and had a metal plate replacing part of his skull; while Leonard was at Craig, the man returned - the wound was infected. They cleaned him up and replaced the titanium plate.

"You don't want an infection in your brain," she said. "That usually doesn't end well."
Allied forces personnel also required care.

A Czech sergeant major patrolling near the base was severely wounded by a suicide bomber in July, she said. "We got him stable enough to fly - not as stable as we would've wanted, but we worked pretty hard on him.

"Because of his injuries, we had to do vascular surgery to re-route blood flow in his arm," she said. The next day, while making her morning rounds, she was unable to find a pulse in his arm; the surgery had not been as successful as they'd hoped.

"He needed surgery again, and it was critical. So we scrambled, did another surgery to get him stable. It was pretty challenging. We got him packaged up - that was challenging, too, because he was going back to the Czech Republic, and they have different medications and different equipment. So we had to get things matched up and packaged to get him safely to his destination."

Unfortunately, the sergeant major succumbed to his injuries a few days later in a Prague hospital.

"It was very unfortunate," Leonard said. "But we got him home, back with his family."
She said there were no forgettable days.

"The hardest part was realizing 'We're in Bagram, Afghanistan, and we've done all we can'," she said. "We don't like to say that. [We] think we can heal the world, but we can't. There's a point where we have to say 'He's not going to get any better.'"
Fortunately, she said, that didn't happen often.

An unexpected motivation came in a care package from a friend - a jar of pickled okra. The Jacksonville, Florida, native said she was ecstatic to get such a creature comfort.
"That was the best day ever," she said. "I was taking pictures with the okra. Oh, and there were crab legs Fridays. I was on the hunt Fridays - I've got to have crab legs. I love seafood. And those little comforts were just great."

When times got tough, she had a strong support network to boost her spirits.

Her father retired from the Army and was a listening ear on the other end of the phone as often as she had time to call, she said, and fellow Airmen - one from JBER and another she met while working in Baltimore - were a tight-knit group.

"I worked with a great group," she said. "We could talk about things, bounce things off each other." An officer she'd worked with during her ICU fellowship was her commander on Bagram.

"And I have a strong, strong faith in God," she added.

The rockets overhead did not dissuade her from the work, although occasionally, if she was moving a patient, she would have to maneuver them both to cover and get her body armor and helmet.

"Day in and day out, you just do your job, do what you can," she said. "And you learn to love and see the beauty in the C-RAMs (counter-rocket, artillery and mortar weapons)."

She left with a renewed sense of what the military presence in Afghanistan is doing.

"Seeing your efforts make an impact - on a child, on Afghan soldiers - is awesome. If you've never been [deployed], you might wonder if we're doing any good.

"When you've been there, you know we are."