To fight a war, you need a good soldier. To keep that soldier alive, you need a good medic.

The United States Army learned the hard way that combat medicine is essential not just for troop survival, but the success of a campaign. In the Second World War, a U.S. Army infantry division contained about a thousand medical personnel—organized into a medical battalion that supported medics and aid stations at the unit level. Army medical support greatly evolved through Korea, Vietnam, and the Gulf War with transport, a hierarchy of field hospitals, and good lines of patient evacuation, but the medic remained at the forefront.

Tracey Burke, now Tracey Burke Shea, served as a medic in Iraq during Operation Iraqi Freedom. She had originally joined the U.S. Army on a dare. For moral support, she had accompanied her boyfriend to see a National Guard recruiter at the armory in Quincy, Massachusetts—the city south of Boston where Burke was born and raised.

At first, she was reluctant to talk with the recruiters. “What about you, ma’am?” one of them inquired of her. “You want to sign up for the Army?”

She politely refused, to which the recruiter said, “You know what? You’re right. I’ll bet you can’t do it anyways.”

As Tracey explained it, her “Irish” promptly switched on, and she called his bluff. She betted that she could do the job even better than her boyfriend and signed her recruitment papers. The young woman returned home with contract in hand. “Guess what?” she proudly exclaimed to her parents. “I joined the Army!” Her mother ended up in tears. It was not the response Burke expected, but the choice to enlist made sense to her at the time. She had no immediate plans for a career or college. Her decision was the same for many Americans. Burke even joined up with a girl who lived up the street from her.

She left the Bay State in January 1999 for nine weeks of basic training in Missouri followed by another nine weeks of medical training in Texas. The transition from civilian to soldier was tough. Tracey was homesick, and the other recruits made fun of her Boston accent. Still, at five-foot-two and 120 pounds, she “did the work that a huge guy could do but I felt pretty proud of myself.” When she finally came home to Massachusetts, she was much more appreciative of all she had achieved.

Patriot Med

Burke was enrolled at a liberal arts college when the U.S. Armed Forces conducted a full-scale invasion of Iraq. Her National Guard unit, Company A of the 118th Area Support Medical Battalion (ASMB), was going to the Middle East. The 118th ASMB was a medley group at the time with a headquarters company in Connecticut and personnel in Massachusetts, Ohio, and Wisconsin. Burke recalled how the soldiers were “all from the same battalion but it’s funny how close we got to each other.”

The battalion shipped to Kuwait first, but split up in Iraq. The Headquarters Company was posted in Baghdad. Bravo Company set up outside the capital in “a hotbed of terrorists and bombings.” Charlie Company went to Mosul on the northern border of Iraq where the Army was constantly attacked by insurgents with gunfire and bombs. A rocket-propelled grenade (RPG) flew right into the medics’ lunchroom. One of Burke’s sergeants received a purple heart in Mosul.

Burke’s Alfa Company, with the call sign “Patriot Med”, had different scenery. They set up shop in a corner of the Al-Taji airfield approximately sixteen miles northwest of Baghdad. Taji, as it was later referred to by Burke and her fellow troops, was once a former Republican Guard base that “looks like shit because it was pretty much blown up from the Gulf War. There were bomb craters and bullet holes.” More than a dozen targets were attacked at Taji in 1998. The medics had to sleep together in a supply building with a nasty, lingering chemical smell. One source noted that Taji had manufactured chemical weapons, and that occupying forces discovered 6,000 canisters meant for holding chemical weapons in 122-millimeter rockets.

Burke’s commanding officer hired some local carpenters to fix up the buildings with plumbing and electricity. These informal contractors needed the work, despite being targeted by insurgents. They were paid in American cash, which was a plus since the Iraqi dinar was virtually useless after the invasion. Unfortunately, some of the work was substandard. Burke and her comrades often received a mild zap from the shower faucets.

Zapping faucets were only one problem. Walking back to camp after a shower, Burke and her friends encountered a roving pack of wild dogs. The canines were everywhere. “It’s not like having a nice soft Labrador in America,” she recounted. “These dogs are ferocious and wild … We didn’t have our weapons. Doesn’t anybody have an M-16 or anything? We ran our asses back to camp.”

The medical facilities were supposed to be clean, but sandstorms were frequent, and the company triage station had to be mopped up daily. The local water supply came from the Tigris, but when Company A got to Taji in February 2004, insurgents were dumping dead bodies in the river. Personnel used baby wipes to clean themselves. A Kuwaiti supplier eventually shipped large quantities of bottled water to the base for use by personnel.

Company A had mechanics and a motor pool to keep their ambulances gassed up and in working order. Burke’s treatment platoon lived and worked with cooks, IT technicians, communications people, military police, and even a nuclear-biological-chemical (NBC) specialist. Burke and her Massachusetts friends were excited to find that the transport company across the airfield was from another Quincy, in Illinois.

When it came down to food, the medics could eat MREs (Meals Ready to Eat) or get fresh meals from a mess tent down the road. They had to conserve fuel for their vehicles and walked there, but since the tent itself was open and not very secure, they were compelled to east fast and return to their station.

Shrapnel, shrapnel, and more shrapnel

Company A had its own Humvee ambulances but was more likely to receive visits from the ambulances in other units. The medical station at Taji was easy to find, what with the big red crosses painted on all sides of the building. A cross was also painted on the roof to guide an inbound MEDEVAC (medical evacuation) helicopter. Burke’s sergeant, a fire captain from Ashland, Massachusetts, painted “Patriot Med, 118th ASMB” on the nearby landing strip.

Ambulances backed up to the station, opened up, and transferred patients inside for treatment. The medics would cut open their patients’ ruined battle fatigues, tend to their wounds, and do what they could. Injuries sustained from shrapnel were quite common. A soldier from Texas was hit by an improvised explosive device (IED) and lost his foot. The medics performed an amputation, put the severed body part on ice, and arranged for a MEDEVAC to Germany. “God bless you soldiers for saving me,” the man cried in the emergency room before his departure. Burke recalled that doctors outside the theater managed to reattach his foot. Once more, the efficiency and skill of military medical specialists in and outside a theater of operations is well proven: in a 2014 report by the Congressional Budget Office, Matthew S. Goldberg estimated that less than three percent of all wounded-in-action (WIA) personnel and nine percent of medically-evacuated WIAs from Iraq and Afghanistan experienced the major loss of a limb.

Another patient, a specialist from a transport company, was also hit by an IED on her way from Baghdad to Taji. The bomb shrapnel entered her left thigh and genitalia. Sent to Patriot Med, the patient was stabilized, packed with gauze, and shipped out to Germany for surgery.

There were moments when not even the best medics could help in a situation beyond their reach. One evening, a family of Iraqis got lost during curfew and drove toward a checkpoint manned by U.S. infantry. The soldiers, Burke recalled, “ripped that car up.” The parents in the car were killed, but the two children were rushed to Taji. The daughter did not survive her injuries. Medics “told the older brother and he just cried and cried. She was only four.”

When an American soldier died, the body was transported to the air base in Germany and then on to the States. In Iraq, the custom was to bury the dead promptly. A local ambulance came to take the body away. “Nobody really talked about that for a couple of days,” said Burke. “That’s the best we could have done. She was practically dead on arrival.”

Beware of camels

Every unit in wartime has experienced shortages of one kind or another, and the 118th ASMB was no exception. Company A was limited in stock to morphine, ibuprofen, and muscle relaxers. The battalion’s scattered units were resupplied by army aviation by Fall 2004, but in the months beforehand, logistical support had to be conducted by ground.

Burke and her team would set off to resupply other companies in a four-truck convoy with military police (MP) escort. To avoid insurgent attacks, the medics left Taji at night. They drove with their headlamps off and made use of night-vision goggles borrowed from another company. The highly useful gadgets, she noted, “were expensive as hell so if we broke one we were so screwed.”

The road to Mosul, she remembered, was long and hazardous. The team kept their eyes open in all directions. Tracey was usually at the wheel because of her lead foot and skills as a Boston driver, but the Humvees could only go so fast. Her mother’s late aunt, a nun who taught at Saint Ann’s in Quincy, once presented Tracey with a Saint Michael medal and other religious trinkets blessed by the priests. Burke pinned them under her uniform and kept a rosary in her pocket for good measure.

Bathroom stops required a 360-degree safety perimeter on the roadside, complete with armed guards. As Burke described the experience, “Nobody cares if you’re a girl or a boy. I had like three guys guarding me while I took a squat. God forbid I got shot. We did the same for dudes.”

Iraq, like other countries in the Middle East, was known for its camels. None of those camels were appreciative of the U.S. Army, nor were they quick to make way for a military convoy. They loitered on the road, and this was a concern for the soldiers: “If they don’t move, they were hit. We couldn’t risk that a camel had a bomb. So we just kind of ran ’em off the road.”

The burn victim

One day, an MP phoned Burke to report that a little boy outside of Taji had been burned very badly from a hot tea kettle. Medics were not allowed to leave the base to respond to a civilian emergency, but no one was willing to leave the child without help. The boy and his father were brought to the treatment platoon where the child was examined and sedated. His burns were quite serious and ran from his head to his chest.

The father was crying and didn’t know what to do. He was quite thankful when the boy was finally released. Every day for the next six weeks, military police escorted the child from his home by the Tigris to Taji where the treatment platoon prescribed their little patient antibiotics and offered additional treatment. He returned with flowers for the team. The medics were interviewed by the Worcester Telegram & Gazette. The boy got married after the war. As Tracey later recalled,

Men in Iraq don’t have a lot of respect for women but you could tell the father was very grateful. The mother had passed away, she was killed in an explosion. The father had only one eye. I remember that. Every time my friends get together we always talk about that moment. It was just a sad thing. The father keeps in contact with my CO … It was just amazing to do something like that, but I think a lot of children. That was their life.

Today, Tracey Burke Shea lives in Quincy with her husband Joe and her boy Liam. She works in family medicine and aspires to become a medical administrator. Army life had given her a chance to do far more than what she ever thought was possible: “As a female in the military, I think it gave me more confidence to do anything. I think that’s why I want to get thing done the way I am today. I just feel a lot more confident in myself.”