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CNN PRESENTS

Devil Docs

Aired May 18, 2003 - 20:00   ET

THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.

(BEGIN VIDEOTAPE)
CNN ANNOUNCER: Physicians on the front lines.

UNIDENTIFIED MALE: It's unbelievable to operate here. I would never think that I'd be operating with a dirt floor.

ANNOUNCER: Closer to the fight than ever before.

Struggling with the ethics of the battlefield.

UNIDENTIFIED MALE: You got a gun in one hand, a stethoscope and blood pressure in the other.

ANNOUNCER: The Devil Docs. Dr. Sanjay Gupta takes you inside their war in this special edition of CNN PRESENTS.

DR. SANJAY GUPTA, CNN MEDICAL CORRESPONDENT: They are not your ordinary doctors. They are combat surgeons. More than 1,000 naval men and women chasing the frontlines, bringing urgent medical care to the edges of war.

Welcome to a special edition of CNN PRESENTS. I'm Dr. Sanjay Gupta.

The Marines who call themselves the "devil dogs" have dubbed the doctors who save their lives the "Devil Docs."

In Iraq, they operated under the very real threat of attack. Sometimes armed only with scalpels and light weapons.

Not since Vietnam has the military placed a group of combat doctors and nurses so close to the frontline.

I spent six weeks covering the Devil Docs for CNN, and this is their story. A warning, however, before we begin.

This program does contain material of a graphic nature relating to war. Viewer discretion is advised.

These are the sights and sounds of war. But behind each explosion are stories most people turn away from. Stories of the injured, maimed, and killed.

These stories are not often told, wounds too terrible to remember, and often too vivid to forget. LT. THOMAS OLSON, PHYSICIAN ASSISTANT, U.S. NAVY: Some of the things I've seen here you don't see anywhere in the States, even working inner-city hospitals. Large caliber wounds.

GUPTA: These doctors and nurses staff what's called a forward resuscitative surgical system. That's the equivalent of an operating room and six-bed emergency room. They traveled to within 20 miles of the frontlines.

In the last gulf war, it took an average of two hours to get the wounded to hospitals in the rear. The Devil Docs with their mobile units have cut that transport time by more than half.

About ten to fifteen percent of war causalities need immediate treatment to stay alive. For them, the Devil Docs are the difference between life and death.

Here, doctors, nurses and medics don't have the luxury of being able to look the other way. In order to do their jobs effectively, they have to look at sights that would otherwise be unimaginable.

High-powered rifle and land mine wounds and even worse. On adults and on children.

SHAILENDRA JAIN, U.S. NAVY: On a little boy they brought in just now, his whole face was blown off. It's pretty painful to see all that. It's really bad.

GUPTA: This young Iraqi father is about to see his son's injuries for the first time. He slowly registers the effects of shrapnel on a young child.

The boy no longer has a face, yet he still cries. His father remembers how beautiful the boy once was and now only a small row of bottom teeth identifies him.

The Devil Docs have sprung into action to save his life. For them, this is the reality of war.

They not only see the human cost of war, but hear the stories that go with it. Often for the first time. This young corporal is anxious to tell his story, an assault on an Iraqi location.

UNIDENTIFIED MALE: I had never been inside the building, I got hit before...

GUPTA: He, like many Marines, was brought here by helicopter.

The doctors here remember the stories as much as the wounds. Hospital medic Sonya Hemrick (ph) has been in the military for 13 years. A mother of two young girls, this is Hemrick's first experience on the frontlines of combat.

UNIDENTIFIED FEMALE: I just love their stories; I love how they tell me about their wives, their families; the fact that they're going to live, where they're from. Last night I held a first sergeant's hand as he passed away and that to me is a story -- I mean -- although he couldn't tell me where he was from, what he was doing, I could just feel it.

And I stayed with him and he's a story I'll take with me forever. I'll always think about him; he'll become my story in my journal.

GUPTA: Some stories they'd like to forget. Dr. John Uecker is a Lieutenant Commander in the Navy and a general surgeon. As a father of a three year old, his experiences in the operating room sometimes become personal.

LT. CMDR. JOHN UECKER, GENERAL SURGEON, U.S. NAVY: Probably the worst for me there was a group of people that were brought in at once that were all causalities of a land mine injury. They were all adults, but in the middle of that was a 2-year-old child with both of his legs blown off.

And looking very much in shock and very critical, so we tried to resuscitate and so forth, which was a challenge because we don't have any pediatric equipment. But that was the one that hit me the most because a little kid obviously an innocent bystander -- by stander -- and unfortunately subsequently died after he was with us for several hours.

So -- and I have a child that's about the same age as this child was so certainly hit home with me.

GUPTA: The stories hit home with everyone. Stories of lives lost and of lives saved. Dr. Mark Fontana, a general surgeon, has been in the military for fifteen years.

CMD. MARK FONTANA, GENERAL SURGEON, U.S. NAVY: One is the Iraqi soldier we operated on last night who had a gunshot wound to the abdomen, and I kind of demonstrated with my hands what we were going to do, open up his belly and fix him and he understood and said yes.

And then when he woke up from the anesthesia he looked at me and made the same motion -- you know -- surgery on his belly and did I do it. I said yes I did do it and he did a kind of a kissing motion and a thank you.

GUPTA: The Devil Docs have a way of providing emotional solace as well as physical repair. This little girl finding comfort in the arms of a warrior.

Most of the wounded are Iraqi. Patients and prisoners. All of this in the middle of a war zone. And while they hear their patient's battle stories, they are living their own, a journey was not easy.

UNIDENTIFIED MALE: Keep drinking water; going to need it today.

GUPTA: As the battle for Baghdad grows increasingly intense, the Devil Docs are not far behind. Once again, on the move.

But without their own transport, they have to catch a ride when they can.

FONTANA: We flew into a forward airfield that's even farther forward than this.

GUPTA: They fly perilously close to the ground and then drop into an area just behind the front lines onto a makeshift runway that was once a highway leading directly into Baghdad.

FONTANA: And then had to drive back in a convoy that went into the nighttime. Convoy operations are dangerous times, especially in this conflict. There's a lot of reports of convoys having sniper fire. Mostly it's the unknown, you know, is someone going to shoot at our convoy -- will this vehicle be the one vehicle that's picked out.

GUPTA: That night a firefight on the horizon.

OLSON: We were stopped for like four damn hours.

GUPTA: Finally, attack helicopters clearing the way, creating disasters in the desert that these doctors would soon be cleaning up.

After traveling up to seventeen hours in the convoy, the Devil Docs are expected to operate immediately.

No rest after a long and arduous journey.

Under the best of conditions, their work would be difficult. But here in the desert...

FONTANA: It's unbelievable to operate here. I would never think that I'd be operating with a dirt floor, sometimes helicopters coming in right overhead. You know, some of the rules of the antisepsis and sterile procedure, obviously, go out the window, literally.

You know, the heat in the operating room 110 degrees sometimes. It's unbelievable. Just -- in fact, it's amazing we can do it sometimes.

GUPTA: And because of the constant chemical threats, these docs often wore gas masks during the heat of the day while still doing their jobs.

Like saving the life of the 6-year-old boy. Surgeons and soldiers, medicine and the military. For some, the lines may be blurring but not for these Devil Docs. They are an important part of the story of war.

UECKER: Yes, every now and then I sit back and think that probably ten years down the road, twenty years down the road, certainly, it's something that's remembered and something that's talked bout.

ANNOUNCER: Coming up, mobile and moving forward fast. The Devil Docs hit the front lines where damage control takes on a whole new meaning.

UNIDENTIFIED MALE: What happened to this patient?

(COMMERCIAL BREAK)

UNIDENTIFIED MALE: We are here with the Devil Docs in a rival surgical company and you are witnessing one of the medical marvels of this military campaign, a completely mobile operating room. Dirt floors, tents above us, 60-watt light bulbs and operations going on right behind us.

GUPTA: In the history of medicine on the battlefield, this is a pivotal moment.

UNIDENTIFIED MALE: You know what we have to do, let's do it.

GUPTA: A mobile operating room called the forward resuscitative surgical system is being used for the first time ever in the war at Iraq.

CAPT. H.R BOWMAN: This is actually the OR and...

GUPTA: Not like the OR back home, is it?

BOWMAN: Not at all. However, it does function and functions well.

GUPTA: Captain H.R. Bowman is one of the Devil Docs. He's also the surgeon who helped design this, an operating room in the middle of the desert.

The tents, operating lights, oxygen compressors, and x-ray cases can be broken down in one hour and loaded onto trucks by the Devil Docs themselves.

BOWMAN: OK, listen up. As we are very flexible, we're moving north.

GUPTA: This mobile unit can be set up in two hours and is designed to travel forward with the front line troops.

BOWMAN: The first priority is OR Number One.

UNIDENTIFIED FEMALE: OR One (UNINTELLIGIBLE).

UNIDENTIFIED MALE: As the Marines are moving rapidly forward and you get farther and farther away from surgical care, your evacuation times become (UNINTELLIGIBLE).

GUPTA: They have learned from past history.

UNIDENTIFIED MALE: During the Gulf War, evac time back to surgical capability was well over two hours. That's when we said we've got to have some way to keep up.

GUPTA: Instead of taking the injured back to the rear for definitive care, they bring the definitive care forward, increasing the chance of getting to a patient during the critical first 30 to 60 minutes -- what doctors call the golden hour.

This isn't the first time a significant medical advance has been made at wartime. During the Civil War, with many hospital units idle, the decision was made to attach doctors to the regiments that were engaged in battle.

In Korea, field hospitals popped up, makeshift treatment centers that were close to full service and closer to the field of battle.

A decade later, Vietnam made rapid access in the evacuation of wounded soldiers to hospitals a top priority. It was a precursor to our peacetime system of trauma centers.

But with each advance, the death rate for battlefield wounds refused to budge. Since the Civil War, one of every five wounded soldiers has died. Operation Iraqi Freedom may change that.

Not only have these doctors brought the OR to the front lines, but they are armed with lessons learned from a different kind of war.

DR. WILLIAM SCHWAB: During the epidemic of firearm injury which started around 1988 in urban America, we started to see a gunshot wound a day -- it got up to sometimes two to three gunshot wounds a day.

GUPTA: Big city trauma centers were facing a new challenge.

SCHWAB: The patient's would arrive alive, we'd take them to surgery, we'd fix all of the injuries, and lo and behold the patient would wind up dying anyway.

GUPTA: At the University of Pennsylvania, Dr. William Schwab and his team grew frustrated.

SCHWAB: We said to ourselves, maybe the combination of severe injury and trying to do traditional surgery doesn't work.

GUPTA: They started to practice a kind of surgery they called damage control, a term Schwab came across in the Navy.

SCHWAB: And it means that a ship can take damage or take some type of hit from a shell or torpedo and yet what happens is that the ship is kept afloat by any means.

GUPTA: There was a military procedure that they applied to civilian injuries. Stabilize the patient first, worry about fine-tune repairs later.

SCHWAB: You do abbreviated surgery, you do non-traditional approaches, but you keep the patient alive at any cost. And you do that, especially the first day or the night right after the wounding so that you can fight another day, and by that I mean so that you can repair things another day.

GUPTA: With damage control, when the body had time to rest and an opportunity to heal itself before final surgeries, the rate of survival rose from close to zero to 90 percent.

The military took notice. Today, damage control is standard practice in the deserts of Iraq.

UNIDENTIFIED MALE: What happened tot his patient?

UNIDENTIFIED MALE: (UNINTELLIGIBLE).

GUPTA: That free fluid is blood and in the doctrine of damage control, bleeding is enemy number one.

UNIDENTIFIED MALE: He's got at least a liter of blood in here. Yes, he's got -- can we have two more units left please?

GUPTA: Of the soldiers who have died on the battlefield, 50 percent have bled to death.

For the first time, surgeons are treating severe trauma wounds on the front line. Once damage control is achieved and patients are stabilized, they re shipped to field hospitals, or military bases for their follow-up operations and care.

These mobile surgical teams also aim to counter another enemy and that is time. More than half of all battlefield deaths occur within 30 minutes to an hour, the golden hour. This time around, they are winning the battle.

FONTANA: That one hour difference of us doing the surgery here, this far forward, versus someone farther back, is what really made the difference.

GUPTA: Of course, no matter how sophisticated, a tent in the desert in the middle of a war is not the hospital most people are used to seeing.

UNIDENTIFIED MALE: Please proceed with surgery.

UECKER: We're obviously operating in tents, with helicopters flying overhead. Sometimes we can hear booms in the background. It's frequently very sandy and windy around here and probably the biggest thing that is difficult for us is the temperature.

The other day I was operating and it was 98 degrees in our tent.

GUPTA: These operating rooms in the desert have been years in the making, from city streets to Iraqi battlefields. A civilian military collaboration that is saving lives and changing medicine forever.

SCHWAB: And I think that's the natural evolution of advanced medical techniques. Hippocrates said and I'm paraphrasing if you want to be a surgeon, go to war.

ANNOUNCER: Coming up, sidearms and scalpels. As the enemy becomes the patient.

OLSON: I have reservations at times about it, about using our supplies. I'm going what are you doing here, pal?

(COMMERCIAL BREAK)

GUPTA: When the time comes, the Devil Docs ask no questions and do not hesitate and offer the same respect, dignity and care for every patient.

But on March 23rd, their job got harder. Listening to international radio reports, the Devil Docs hear that four Americans have been captured and were believed to have been executed.

Within moments of hearing this news, they carry a 43-year-old soldier to the operating room. He is Iraqi.

UNIDENTIFIED MALE: We're going to take a look at your abdomen again.

GUPTA: They are doctors and they are American soldiers and in their very first operation, they are treating the enemy.

OLSON: I have reservations at times about it, about using our supplies. And, I'm going what are you doing here, pal? But we help them anyway.

TAMMY J. DEVRIES, CHIEF PETTY OFFICER, U.S. NAVY: It's not always easy and we're not here to make policy, we're here to do what we came to do and if that's what they want us to do then that's what we'll do.

GUPTA: The Iraqi soldier has significant injuries and time is key. Awake but likely to die without his operation. Vital information is clearly marked with ink on his forehead and his chest.

Ten milligrams of morphine to show that the pain medication has already been given, and GSW to the abd, gunshot wound to the abdomen. AS best they can, the surgeons explain what they'll be doing.

UNIDENTIFIED MALE: We're getting the medicine ready to get you to sleep.

GUPTA: As they prepare for the operation, one devil doc says we're operating on their guys at the same time they are killing ours.

The wound is obvious, a bullet entry site on the skin. Seemingly small, it shows little sign of the significant bleeding going on inside.

Typical of a high-caliber bullet wound, a small entry has wreaked havoc. As quickly as the blood is given, it is bleeding out into the abdomen and then into the suction devices. Surgeons try desperately to stave off the bleeding using packed towels, blood soaked, and starting to add up.

Finally, after an hour, things are under control. The operation performed as if it had been any American patient, is now over. But the controversy is just beginning. Dr. Persavali (ph), the lead surgeon, spoke with me minutes after finishing the operation. For him, the decision of who to treat and when is medical not political.

UNIDENTIFIED MALE: Our decisions are going to be made based on medical -- it'll be a medical decision based on the patient's physiology and their wounds. That's how we decide who goes first.

GUPTA: It's more than medical common sense. The care of prisoners of war is steeped in history.

ART CAPLAN, BIOMEDICAL ETHICS, UNIVERSITY OF PENNSYLVANIA: We've already got an international agreement that tells us what to do, the Geneva Convention, and there are specific sections in that law that say once somebody is out of combat if they're injured or hurt we're supposed to do what we can to fix them.

But you can't always do that, sometimes you don't have the skills, sometimes you don't have the supplies -- but to the extent you can, you should.

GUPTA: But at some point, what it really comes down to is resources, such as that last pint of blood.

CAPLAN: There is no doubt that you're going to treat your own soldiers first, but assuming that's done and out of the way if you have injured Iraqi soldiers you're going to treat the injured Iraqi soldiers. Your job as a doctor isn't to figure out who's a good guy or a bad guy and sometimes you don't know. You treat them all.

GUPTA: For the most part, the Devil Docs agree. 80 percent of the patients they treated were Iraqis.

FONTANA: I know that a lot of these people may be forced to fight, I don' know. We're in their country and what we're getting from them actually is gratitude for doing it.

GUPTA: The battlefield was split into us and them. But not for the Devil Docs.

UECKER: We kind of had the luxury of not having to worry about who's good and who's bad because we can just use our medical training and use those criteria who to operate on and who not. In the overall picture I think we have the easier job than trying to figure out who to shoot and who not to shoot because we can just take care of everybody who is brought to us.

GUPTA: Chief Petty Officer Tammi DeVries says this is exactly what her years of training were for.

DEVRIES: A patient is a patient. I need to recognize that I'm trained to take care of a human life. You have to put those differences aside. You have to.

GUPTA: the conflict inherent in being a combat doctor is on display here. Marines pointing their M-16s at Iraqi combatants until they are stripped and searched and the enemy becomes the patient.

OLSON: You got a gun in one hand, a stethoscope and blood pressure in the other, and you -- that's how you deal with it.

GUPTA: The chance to be a small enclave of humanity amidst all the death and destruction.

UNIDENTIFIED FEMALE: They're human. They have hearts just like us and they fear and they hurt. Just like us.

ANNOUNCER: Coming up, the Devil Docs. Far from home, far from family. Why do they do it?

(COMMERCIAL BREAK)

(NEWSBREAK)

GUPTA: Comforting an injured child in the desert of Iraq is not easy -- especially for 33-year-old Sonia Hamrit (ph), one of the Devil Docs and a mother of two. At times like these, she thinks of her children more than ever. It's been three months since she said goodbye.

UNIDENTIFIED FEMALE: The day I left, it was pretty sad for me. I didn't take my kids out of school. I actually went to school. I didn't want to mess with their routine. Kissed them goodbye.

My five-year-old said, "I'm done, Mommy. Can I go back to lunch?"

"You can go back to lunch."

We didn't have any tears. We decided there would be no tears cause I was coming over for a good cause. This wasn't a bad thing. I was here to help people that needed to help our country.

So got on the bus. Cried a little. So, in a way, we went to Kuwait. So -- we're here.

GUPTA (on camera): Have there been tears since then?

UNIDENTIFIED FEMALE: There have been lots of tears. Lots of tears.

GUPTA (voice-over): But the tears can't get in the way of the work they have to do.

Chief Petty Officer Tammy DeVries is in charge of setting up and supplying the field hospital. She runs a very tight operation.

DEVRIES: I'm pretty tough. Yes. They like to think I'm the cool chief but I can be pretty tough when I have to be. And then, my daughters would say the same thing -- "You're mean."

I'm fair. I'm firm. My motto is the same as the Navy's -- honor, courage, and commitment. Each one of my guys and gals in my surgical platoon eat, breathe, and drink that philosophy.

GUPTA: The Devil Docs have traded in their pristine operating rooms and high-tech equipment back home for dust, dirt, and danger.

UNIDENTIFIED FEMALE: You understand that that is a risk. There are places that are not as secure.

Convoys are always dangerous. You're traveling at night -- using night-vision goggles. We did witness a fire fight. It was a few miles up the road from us. That's dangerous.

And then the (UNINTELLIGIBLE) alert. You're in danger. You're in a war zone. You're going to be in some danger.

Getting to the front lines means being under fire. The Devil Docs knew that going in. But Mark Fontana, who's been a surgeon for three years, is seeing combat for the first time.

FONTANA: We were scared when we got here. The first night, I don't think anybody slept. I didn't sleep well at all.

UNIDENTIFIED FEMALE: Everyone's scared. You've got to have courage. and the ability to overcome fear and complete the mission. I think of that every day. I wake up with courage and overcome that fear. Take care of my patients.

GUPTA: It helps to focus on the mission -- repairing the wounds of war.

UNIDENTIFIED MALE: We know what our job is. Our job here is to save lives. We're saving American lives, Iraqi lives, women, and children. I think it's a different role, and we understand it.

GUPTA: Back home, they save lives too. But there, at the end of the day, they go home to their families.

UNIDENTIFIED FEMALE: I miss my daughter's smiles. I miss my daughter Taylor walking up to me -- "Dance with me, Mommy." I miss dancing with Taylor. I miss wrestling with Alex.

UNIDENTIFIED MALE: I miss my wife and my kids. My wife's a pediatrician -- working and taking care of my three kids. Her name's Kristi (ph), and my biggest boy is Anthony. He is seven. Miss him a lot. He's having his first communion coming up pretty soon. And I heard he scored three goals in soccer last week, which is really a big thing.

(BEGIN VIDEO CLIP)

UNIDENTIFIED FEMALE: Hi, (UNINTELLIGIBLE) and Joey -- wave.

(END VIDEO CLIP)

UNIDENTIFIED MALE: And I have twins -- two three-year-olds, Joey and Isabel (ph), and they're learning to ride bikes right now -- two- wheelers -- which I'm really proud of. Miss that. And I just really miss talking to them and seeing them.

GUPTA: Tammy, along with the other Devil Docs, has been in the desert for months with few phone calls and little mail -- half a world away from home.

UNIDENTIFIED FEMALE: Those are my daughters. That's my oldest, Tanya (ph). She's the 16-year-old. And then that's Andrea. They're with Grandma. They're very well taken care of.

I miss them.

My oldest is -- she has her first prom this Saturday. So that's very hard. I cannot be there for her.

GUPTA: For now, Sonia and the Devil Docs are trading in their lives for the lives of others. They may be at war, but they are menders -- not warriors. For them, that's what matters most.

UNIDENTIFIED FEMALE: I do think that I made a difference -- even if it was just to make a person smile. Knowing that they might have went through the worst thing that could imagine happening to them in their whole lives. And I held their hand and told them that they're going home now and they'll be okay. And they smiled.

So, yes. Even -- only -- a smile, I made a difference.

GUPTA: Coming up -- duty and dilemma.

UNIDENTIFIED MALE: Who knows what's next?

GUPTA: As the reporter becomes the story.

(COMMERCIAL BREAK)

GUPTA (on camera): As a CNN correspondent in Iraq, I was a doctor on a deadline, there to observe and to report. But on April 3, fate intervened in a way I did not expect, in a way that transformed me from journalist back to neurosurgeon.

This may be the strangest standup I've ever done, but I can assure you this is no joke. This is for real. This is the fourth bunker call in as many hours. As you can see, we are wearing our masks, our kevlar and our helmets. That's because we were instructed to do so, as we were instructed also to be here in this bunker. We've seen missiles flying overhead, we've heard Scuds all around us, we've heard sirens as well. Who knows what's next.

I think these guys were really scared about what they might see out there. It's really hard to understand what these doctors went through and still have to perform surgery after, you know, almost a day's worth of travel. Immediately hit the ground, pitched the tents, and we'll be open for business. Like any other day over there, we -- there was a busy day, a lot of patients coming and out by helicopter. I was actually in the process of doing some stories, doing some live shots, and one of the other doctors had come up to me -- and they knew I was a neurosurgeon, and they asked me if I would go and take a look at this child who had been shot in the head. There was no one else there that had this particular skill set.

Emotional stuff comes afterwards, I think, for most of us. We never stop being doctors, 24 hours a day, seven days a week, and when we see an injury that we've seen before that we know how to handle, we pounce upon it. We start to do our work, especially if we're asked to, as I was in this particular situation.

The moment that I can't get out of my head was when I was operating on the brain, and I had turned the corner, in terms of -- we call it turning the corner in an operation, where I knew I had succeeded, got the blood clot out, the brain was nicely decompressed, it looked like it was a healthier brain again, and I looked out, and the orthopedic surgeon is working, and I realized that the kid did not have hands. And I thought to myself, this is interminable. This doesn't end. This isn't turning the corner. What kind of life is this going to have, even if he does live? His parents are both dead. And just this sort of just overwhelming moment of desperation, I was just like, gosh, this, oh, you don't turn the corner by doing something as relatively simple as what I did, when I thought I'd done something, you know, just great, this was a war.

This kid had been really beaten up. It was a last-ditch effort to try and save his life. But despite the fact that we did CPR on him for a couple of hours afterwards, he died.

WOLF BLITZER, CNN ANCHOR: Our medical correspondent, Dr. Sanjay Gupta, found himself in an extraordinary situation earlier today.

DARYN KAGAN, CNN ANCHOR: Sanjay Gupta has helped perform another surgery, with the Navy doctors known as the Devil Docs.

UNIDENTIFIED MALE: Sanjay Gupta no ordinary war correspondent reporting live to us from the frontlines, the Devil Docs, and turning in a brain surgery or two.

GUPTA: I didn't think really a lot about journalism at that moment. In fact, I was surprised when people started asking me a lot about it from a journalistic standpoint. Didn't really even into my mind that I was crossing a kind of line or anything there. I mean, they asked me to do it, medically and morally it was the right thing to do. I didn't go there to be the story, I wanted to report the story, but I just didn't even think twice about it.

BOB STEELE, DIRECTOR, ETHICS PROGRAM, POYNTER INSTITUTE: He clearly brings specialized knowledge to his reporting, and it's important, but it does put him in a situation in which he has competing loyalties, where he is both a professional journalist and a professional physician.

FONTANA: I believe one or two of those patients would have been made expectant, meaning that they would have died, they would have been allowed to die. He performed a craniotomy -- craniotomies on a couple of patients, and evacuated hematoma (ph) or a blood clot. That allowed those people more time to get to higher levels of care. The expertise we have here, we wouldn't have been able to do that surgery, so I think he saved lives.

GUPTA: I talked to a lot of people, after I got back, about it, and I realized some of the concerns that some people had about being a journalist out there who may have crossed the line.

STEELE: I do accept and respect that Dr. Gupta had an obligation as a physician to step in in those life-threatening situations and to do his very best when somebody was in a very critical condition. The question becomes, when it doesn't meet that threshold, does Dr. Gupta step out of his journalistic role into his physician's role to assist the Devil Docs? And is he then able to be a vigorous, rigorous reporter in other situations when he's also had this participant role with the Devil Docs?

CAPLAN: I think the answer to that is very clear. You have to put your stethoscope before your pen. You're a doctor first and a journalist second. If we had been in a situation where a journalist has the ability to save a life, and I don't care if it's opening the door of the fire, or trying to perform an operation on a baby, because you're the only person that knows how to do it, I think that's what you have to do.

GUPTA: Putting a press pass on is not a bar to your humanity. And I think that that was sort of the bottom line for me.

After all was said and done, I ended up doing five operations, three of them on Iraqis, two on Marines. I did not know that I was going to be doing this sort of thing, but I felt prepared.

The goodbyes were really hard with these docs. You feel guilty in a way. They are still out there today, doing their work, and of course, we came home. And they are going to be out there working until the work is done. Maybe a long time.

ANNOUNCER: Coming up, the fighting may be over, but the job isn't done. After Saddam, the battle to save lives in Iraq goes on.

(COMMERCIAL BREAK)

UNIDENTIFIED MALE: It looks like his eyes were spared. His cornea doesn't look too bad.

GUPTA (voice-over): For the Devil Docs, the war is not over. While the bombs and bullets have stopped, the battle to save lives continues.

UNIDENTIFIED MALE: I'm not exactly sure what this is they put on him. It's some kind of home remedy. It's this black stuff. You can see the top layer of his skin is going to come right off. It's second-degree burn.

UNIDENTIFIED FEMALE: Did you want some (UNINTELLIGIBLE)?

UNIDENTIFIED MALE: No, just saline. UNIDENTIFIED FEMALE: Just plain saline?

UNIDENTIFIED MALE: And then if we could get some (UNINTELLIGIBLE).

UNIDENTIFIED FEMALE: Yes. You're going to put it all over?

UNIDENTIFIED MALE: Pretty much all over. Yes.

GUPTA: Today's mission -- treating an Iraqi family, all of them burned badly in a house fire.

UNIDENTIFIED MALE: Sorry, son.

UNIDENTIFIED FEMALE: We're still seeing patients, taking care of illnesses. And as you've seen today, accidents keep occurring. Whatever it takes to get the job done beyond the war. There are still a lot of things that are happening other than gunshots that we're taking care of here.

The war's not over until the plane's up and the wheels are up and we're on our way home.

GUPTA: Not time to go home yet but quieter now for sure. Finally, some down time in the desert. Nothing like the frenetic days of war. Sporadic combat injuries and even a few more common ailments.

UNIDENTIFIED MALE: We had a patient come in with a heart attack recently. Non-surgical patients -- we do what we can with them, but this is truly a surgical company.

UNIDENTIFIED MALE: Just want to see how you're doing. I'm Dr. Fontana (ph).

Feeling a little better? Getting up and around now?

UNIDENTIFIED MALE: Our role now is contingency -- to take care of trauma that happens from accidents and injuries.

GUPTA: While the accidents and injuries will continue for some time, eventually these doctors will go home.

UNIDENTIFIED MALE: As far as what we'll do afterward, we'll go back to our hospitals in The United States -- some in Marine Corps bases, others at Navy bases -- and, hopefully, pick right up where we left off.

GUPTA: But re-entry may be difficult for the Devil Docs. Their lives have been changed by what they've seen of war.

Sonia Hamrit says she'll stay out of emergency rooms for awhile.

UNIDENTIFIED FEMALE: We've seen a lot of things that the majority of the world -- the medical profession -- will never see. And some of those things I took really to heart, and I'd rather not see them again. If necessary, I would see them all over again, and I'd take care of the patients and do what I need to do to get them home, but reality is I'll stay away from the blood and the guts and the glory for awhile.

GUPTA: If the soldiers were the guts and glory of this war, then these Devil Docs were the heart and soul.

UNIDENTIFIED MALE: There's a lot of adrenalin when we're working -- a lot of excitement. And so you get caught up in that. It's after the fact when you think about what you saw and what you did -- especially when it's civilians and children.

GUPTA: And as in battles past, lessons have been learned.

UNIDENTIFIED MALE: I think that this group performed as well as any group could ever perform. What I would have liked was possibly a little bit more advanced technology as far as what we could have surgically here.

I think that technique is going to be refined -- you know -- for the next conflict.

GUPTA: Fontana says they were expecting mostly limb injuries in this war and adult patients.

What they found instead were more head, chest, and abdominal wounds and more children. Pediatric equipment will be on the list next time.

While already planning for the future, the Devil Docs want little recognition for their performance in this conflict.

UNIDENTIFIED FEMALE: We'll probably get medals but to me -- and I'm sure for the rest of my people here -- it's all about personal pride. And regardless of the medals we get or the glory we get when we get back home, we know we did a wonderful job.

DEVRIES: The recognition comes from the thank yous -- the knowing the mothers and fathers, the sisters and brothers back home are counting on you -- to save that dad or brother or husband.

We know that they would say thank you if they were here. And I think that's the recognition that we like to keep in our hearts.

GUPTA: Memories etched in the minds and the hearts of these menders forever.

UNIDENTIFIED FEMALE: When you're just about ready to go to sleep, you have snapshots of things that have happened to you. And it's amazing what you remember in those few moments before you sleep. It may be the person reaching for your hand. It could be seeing a patient in an ambulance going somewhere to say thank you.

I think those moments I will not forget. All the training that we've done works. We know it works. GUPTA (on camera): As of the first of May, the Devil Docs have treated more than 550 patients in Iraq. They are, however, hoping to go home by the beginning of June.

As for those mobile surgical units, it'll take months for the military to decide if they were a success.

Well, that's it for a special edition of CNN PRESENTS. For Aaron Brown, I'm Dr. Sanjay Gupta. Thanks for watching. Hope to see you again next week.

(COMMERCIAL BREAK)

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