A U.S. soldier from the Ist Battalion, 32nd Regiment of the 10th Mountain Division greets a boy as soldiers patrol near Camp Florida in eastern Afghanistan.
Associated Press
A U.S. soldier from the Ist Battalion, 32nd Regiment of the 10th Mountain Division greets a boy as soldiers patrol near Camp Florida in eastern Afghanistan.


Col. Tom Frank
Col. Tom Frank

Call him doctor or call him colonel, W. Tom Frank has come a long way from Weymouth.

Last fall, the 45-year-old physician-soldier was sent to New Orleans to provide emergency medical care to victims of Hurricane Katrina.

Then the Army sent him to Afghanistan to run the only full-service U.S. hospital in the country.

He thought he had seen it all, but nothing prepared him for what he experienced last Sunday, when a hospital clerk walked into his office looking for help.

Afghanistan casualties

Since the U.S.-led invasion of Afghanistan on Oct. 7, 2002, 333 American troops and 138 troops from other coalition countries have been killed.

There are 15,000 U.S. troops in Afghanistan and 20,000 troops in the NATO-led International Security Assistance Force.

NATO's leaders have been denied their request for 2,500 more troops to fight the Taliban in Afghanistan.

 PART I: Published Sept. 16, 2006 
READ PART II

A stark look
at the war from an Army doctor

It's Sunday in Afghanistan. I was sitting - completing some clerical task or other - when the patient administration clerk stood at the door. "Sir, mortuary affairs needs a doctor."

"What?" I replied. "The last place they should need a doctor is mortuary affairs."

"No, sir. They need a doctor to sign some death certificates."

Usually on a Sunday I can finish my work a little early and take some time off in my hooch - watch a movie, read or nap. I was eager to do so now.

I walked to the ER to see if the doc there was busy. If not, he could do this. This is a task that would usually fall upon the ER doc, but I suspected he was engaged. The tell-tale sound of a chopper outside suggested more business was at hand. The doc in the ER was working on a wounded American soldier.

"All right, I'll go," I muttered, an irritated edge in my voice.

The mortuary affairs sergeant picked me up in his white van - unmarked except for a white placard in the window that declared "Mortuary Affairs" for all to see. We drove up the ironically named "Disney Drive" - which is in fact named for a dead American soldier rather than for the fairy tale king - until we came to the little plywood hut that is mortuary affairs.

Outside were several stacks of oblong aluminum boxes labeled "head" on one end and "feet" on the other. Inside the building was cool and it had a tiled floor - a distinctly unusual feature for these field buildings. The tile here of course has a purpose. It can be easily washed, and there is a drain in the center.

Col. Tom Frank is chief physician at the 14th Combat Support Hospital, the only full-service U.S. medical facility in Afghanistan. Frank, who grew up in Weymouth, volunteered to serve in Afghanistan in 2005.
Photo courtesy of Col. Tom Frank
Col. Tom Frank is chief physician at the 14th Combat Support Hospital, the only full-service U.S. medical facility in Afghanistan. Frank, who grew up in Weymouth, volunteered to serve in Afghanistan in 2005.

In the middle of the room were three stretchers on stretcher stands. On each stretcher was a body bag.

"Here you go," said a soldier who handed me a clipboard with a piece of paper on it. A death certificate.

Adventure sent him from home, to Army

Doctor calls Afghanistan most rewarding assignment

Now 45, Tom Frank was born in Boston and grew up on Lake Shore Drive in Weymouth. He graduated from Weymouth North High School in 1979 and then, "afflicted by wanderlust," headed to New Orleans to attend Tulane University on a four-year Army ROTC scholarship.

He spent his junior year at the University of Aberdeen in Scotland, graduated from Tulane in 1983, and was commissioned a second lieutenant, but never saw the inside of a tank. He received a master's degree in molecular biology in 1985 and a medical degree from Tulane Medical School in 1989.

He met his future wife, a nurse named Susan Marie Smith, at Tulane. The couple live in El Paso, Texas, and have a 9-year-old daughter, Samantha.

After medical school, Frank was promoted to captain and became an intern at Brooke Army Medical Center in San Antonio, Texas. He spent a year as a field surgeon in Korea with the 43rd M.A.S.H., the unit on which the movie and TV series were based, and then returned to Texas to complete a residency in internal medicine.

For the next six years, he served at the U.S. Army Hospital in Heidelberg, Germany, and became chief of the department of primary care in 1999.

He completed a fellowship in allergy and immunology at the Walter Reed Army Medical Center in 2001.

"I had never expected to stay in the Army this long, but I was enjoying practicing medicine without pecuniary concerns - and besides, I was having fun," he said in an e-mail this week to The Patriot Ledger.

He was appointed clinical assistant professor of medicine at Texas Tech University School of Medicine in 2003 and in 2004 was named chief of the department of medicine at William Beaumont Army Medical Center.

In 2005, he volunteered to serve in Afghanistan and was appointed chief physician of the 14th Combat Support Hospital, based out of Fort Benning, Ga. The medical team was planning to go to Louisiana for training when Hurricane Katrina hit.

"The unit quickly assembled and set up a field hospital first at the New Orleans International Airport and later at the notorious and filthy Convention Center to provide stop-gap emergency care for a city without an infrastructure," he said.

"I think I can speak for every doctor, nurse, medic and soldier who was present, however, in saying that it was exceedingly gratifying to be able to render some assistance to the beleaguered city and her people. New Orleans was still on her knees when we left in October, but life had begun to return to the streets of the French Quarter, and I knew that the city would eventually recover."

Frank returned to Texas to enjoy a couple of months with his family before leaving for a one-year tour of duty in Afghanistan - "a place few of us knew anything about and which none of us will ever forget." He calls it the most rewarding assignment of his career.

"The 14th Combat Support Hospital is the only full-service U.S. medical facility in Afghanistan, but it is nothing like a hospital most civilians would recognize," he said. "The entire structure is made of plywood - but the passion, dedication, commitment and roller coaster of emotions is like nothing I've ever witnessed among physicians, nurses and medics in the 17 years I have been a doctor.

"World class health care from a plywood building in a gravel parking lot in Afghanistan - that about sums it up."

Frank said he has great admiration for the Afghan doctors and nurses.

"Our first taste of the harvest of war was nauseating. Although the care of U.S., coalition and Afghan soldiers is our first priority, we also provide care to Afghan civilians with life, limb or eyesight threatening conditions. Most distressing are the maimed and injured children. The children, the tiny innocents - to see their limbs torn asunder or their flesh melted from their scrawny bodies - it is heart-rending.

"The doctors and nurses here work tirelessly. There are no days off in wartime. Yet despite the hard work, sometimes grueling hours, and ever present fatigue, there is a palpable passion and pride - a passion fueled by every success, and there are many.

"There is a pride born of the knowledge that we are making a difference - and the certainty that we are doing the right thing.

"Each of us will return to our homes and our families with a deeper appreciation of all we have and all we have taken for granted."

Frank, who is scheduled to return to the United States in February, still has strong family ties to the South Shore. His mother, Ruth MacKay, lives in Hingham and a sister, Brenda Frank Charrier, lives in Scituate. He also has a sister, Sara Frank in Westminster.

Frank calls Afghanistan "a place few of us knew anything about and which none of us will ever forget."

He walked over to the first bag and, without flourish, unzipped it and pulled it open. Before me lay a young man perhaps 19 or 20. His eyes closed. His uniform in tatters. The flesh of his face and torso seared a brown color but not blackened.

Across his chest and flanks, large patches of flesh hung off in loose swatches. There was a large wound in his lower left leg.

I picked up the clipboard and stared blankly at the form. "Cause of death." What was it? That wound clearly wasn't the cause.

I asked the soldier to lift the head of the corpse so I would know if there was any obvious brain injury. No. The head was intact. His mouth and nose were clearly burned however. The last gulps of air he took into his lungs were on fire. He died of "burns."

Casualty totals graphic

The next bag was unzipped. I stepped back. It was a woman. Black. I hadn't expected a woman.

Her arms were reaching up in front of her, her fingers having a grasping aspect - as if they were trying steal back life from the lifeless air around her.

Where her head should have been there was only a chin. On top of the chin, a wadded mass mixed with black wooly hair. Her uniform blouse was pulled up a bit revealing a regulation brown T-shirt tucked into her trousers.

Her belt, I noted, was exactly like mine. A store-bought non-issue variety. It was pulled tight - just the way she had done it yesterday morning. Tomorrow someone else would loosen it.

I picked up the clipboard. "Cause of death." I obviously couldn't write "head blown off." I thought for a minute - "Traumatic brain injury." I first printed then signed my name.

In the clerk's office of this girl's hometown - three pieces of paper would likely summarize her life - a birth certificate, a marriage certificate and a death certificate.

She, like one of the other dead soldiers, had been a medic. So I might have once seen her in life. But I never noticed her. Now my name would be forever linked to hers - on her death certificate.

Now the third bag was opened. This soldier looked younger. His face was less altered by death. Aside from a few places where his skin was scorched, his face looked like that of one asleep.

Strange, I thought. He looks a little like me.

Below his neck his uniform was in disarray. His skin was burnt - crispy in places. There was a large defect in his groin where his thigh joined the hip, both legs nearly separated below the knees. "Cause of death - burns."

I stood back. It was so quiet. A poet once referred to a corpse as "quiet clay." How odd, I thought when I first read it. How true, I thought as I looked upon these three dead American soldiers. It is never this quiet where there is life.

A lot went through my mind as I stood there. Three dead American soldiers. They never expected to die. Given a choice they would not be dead now.

They, like me, had read each day the names and number of the day's dead in our newspaper, Stars and Stripes. They, like me, never thought their names would one day appear. They were driving down the road yesterday. They never saw the blast. Their vehicle was engulfed in flames. One had died in the explosion - instantly - the top of her head cleaved-off and crushed. Two jumped out - on fire.

They weren't in this room. They came to us last night at the hospital - 50 percent of their bodies burned. If they survive, they will be horribly disfigured. A new life began for them yesterday. The other two could not get out before being consumed by the fire. So now there were three dead American soldiers.

They were dealt a bad hand. Today I considered something I had never before given much thought - the fact that I, too, am playing at the same table.

I have six more months of hands to play. Six more months of hands to be dealt. Like me, they too were married. They too had daughters. They too expected to return to their lives again. When they pulled their belts tight ... they expected to loosen them again. Now someone else will loosen them.

I felt some shame for the frustration I had expressed before coming here.

The driver took me back to the hospital. The duty physician and a couple of other docs were still working on our fresh casualties in the ER.

I finished my work at my desk without much heart and was surprised when the "Giant Voice" - a loudspeaker system that is heard all over the base - announced that there would be a "fallen comrade ceremony" in one hour. The bodies would be flown out today. I hadn't expected that.

At the appointed time, I joined the commander and the sergeant major and we drove out to the airfield where a C-117 was waiting with the ramp down. The senior officers of the installation stood on the tarmac nearest the airplane - as they always do for these occasions.

All along the road for a mile or so - from mortuary affairs to the airfield - soldiers lined up to pay their respects to the "quiet clay" as it proceeded to the airfield. For these few minutes most, I suspect, were aware that we are all playing at the same table - and every day each of us is dealt a new hand. Soon we were called to attention and then to the strains of the dead march, the colors passed by and the aluminum boxes were carried past, now draped in flags - the words "head" and "feet" no longer visible.

I go to ceremonies like this at least once or twice a week. But today was different. I had seen these soldiers - I knew what was in those boxes. I had seen their mangled flesh.

Usually, once the coffins have been brought up the ramp, we stand at attention on the tarmac - while the generals and a few of those who served with the dead go up the ramp of the airplane and pay respects at the boxes themselves. Today we went into the airplane, too, because two of them were medics.

Each person in the plane walked passed the coffins and knelt - most in prayer. I rested my hand on each box and said to myself, "I'm sorry this happened to you." We left the airplane and walked silently back to our vehicle.

Tomorrow when I cinch my belt, I will think of three dead American soldiers and I will think of my wife and my daughter and of home.

Villagers walk down to receive materials being distributed by the U.S. Army in Kandagal, Afghanistan, on Sept. 10. An Army team distributed essential materials and held a medical camp in Kandagal.
Associated Press
Villagers walk down to receive materials being distributed by the U.S. Army in Kandagal, Afghanistan, on Sept. 10. An Army team distributed essential materials and held a medical camp in Kandagal.

Afghans look at the wreckage of a vehicle in Kabul, Afghanistan, on Aug. 2. Violence in the country has escalated in recent weeks.
Associated Press
Afghans look at the wreckage of a vehicle in Kabul, Afghanistan, on Aug. 2. Violence in the country has escalated in recent weeks.

READ PART II