Before the story of my surgical trip to Africa can continue, I need to explain something about what made me a suitable choice to be part of this effort. My story must go backwards a bit before we can move forward.

My Mom wanted me to be self-sufficient in a way that seemed entirely unmanly at the time. I did not come from a moneyed home, and if I tore my jeans, the reality was that I would not get new ones. Sewing was a lesson I learned early on from her, and as a bit of a ruffian who was in a fair number of scuffles that began in my playground days, and remained a theme in my life for many years, I was set on a course that would see a constant flow of more than one or two torn shirts and pants in my wardrobe at any given point in time. Each repair built my skills with needle and thread a bit, aligning edges of jagged tears, finding ways to make them less visible when done, and becoming creative in how a rip with a piece missing, might be put back together so as not to appear lacking in material…… funny how things you learn in one area might be applied to a skill you need in another. Perhaps sewing, when you apply a different name to it, is not such a sissified activity.

There wasn’t much distance between those youthful times, to the day in my last year as a teenager, when I stepped off a plane onto the hot tarmac in Danang, Vietnam. It was a sweltering, muggy day, and within minutes sweat drenched my uniform. It ran down from my neck along my spine. The front of my BDU blouse sprouted dark spots of moisture as every pore opened. It was not yet the sweat that accompanies fear…. that would eventually come, and I didn’t know enough to fear where I was yet. I had been transported from the mild Southern California beaches to a world where the oppressive weather enveloped you, the heaviness of the humid air was palpable in every breath. The weight of it all brought back the same sensation experienced when as a small child, I put on my grandfather’s giant wool overcoat, and almost lost my balance from its weight upon me. Toto, we are definitely not in Kansas anymore…. Torn jeans were going to be the least of my concerns for quite some time. However, there were new tears for repair, and the fabric they were in was something far removed from denim.

Trauma, the kind that occurs in conflict zones around the world, creates wounds unlike what those lucky enough not to be near them, nor one of those sent to engage in them, ever see. Great writers have described those harms in detail and with poignant words, and said it better than I have skill to do. But suffice it to say that it is a kind of physical damage unequaled by many other assaults our body endures. There are injuries that approach it, or equal the intensity of it…. horrible accidents when flying machines succumb to gravity, those perhaps yield something similar. However, as a species we have really worked hard at developing creative ways to maim and kill our fellow man, and torn flesh is the bloody currency of those endeavors. The resulting wounds are often a creative collage of crimson pieces, little resembling the limb or smooth skin that existed only a few moments before. Lesser ones, jagged lacerations from a flying piece of metal, seldom have a linear and precise edge, nor are they free of missing parts. As a corpsman, or “doc” to my marines, I would be the one, at least when in a rear area environment, that would apply my training, both mom’s and the military’s, to closing up what violence had opened. Sewing was now suturing…… and because of repetition and necessity I became good at it. I am confident that the scars I left while permanent, would fade with time. Scars are remembrances. If you own one it marks a particular point in time, accompanied by the memory of its acquisition. Things as simple as learning to ride a bicycle the first time, to medical procedures endured, and then a long list of really dark causes leave them upon us. They will be our lifelong companions. Some will be the subject of bragging rights and war stories told over beers with companions that have their own. Others will be shared by septuagenarians, sitting on a park bench with a crowd of uninterested pigeons at t