“The Hidden Scars” by Augustina Mushale

Working as a medical technician during my stateside deployment in 2005 meant eight- to sixteen-hour shifts, when I took care of wounded soldiers at the Contingency Air Staging Facility, or CASF. Some of them would be there for a day or two, while others might stay longer, depending on their condition. As a medical professional, it was easier for me to see the physical wounds and overlook the emotional and psychological struggles. On each mission to transport soldiers from the flight line, we would get our AmBuses ready, depending on the size of the mission, which could range from eight to forty patients. The officer in charge would lay out the plans for transporting the patients back to the CASF.

On this fateful day, we recovered soldiers from the flight line, some with severe leg wounds like external fixators, and others with massive abdominal wounds. Some of them who could walk from the aircraft to the ambus didn’t seem to have any visible wounds. As we traveled back to the CASF, I paid closer attention to the soldiers with the physical and severe wounds.

I noticed one soldier whom I will never forget. He did not have any obvious wounds and he could walk independently. I wondered what had brought him from the Area of Operation to us. As medical technicians, and not nurses, we were unable to see the medical charts. In the beginning, this soldier would pace the halls of the unit and could not engage in any conversation with the staff. He stayed at the CASF for a few days, during which time we developed a rapport, and he revealed some of the issues he was dealing with. His wife had withdrawn all his money from the bank while he was overseas and had called to say she was divorcing him. His mother was terminally ill.

I felt I lacked the training to help my patient deal with this tough situation. He was prescribed some medication to help calm him, but I knew that untreated, these issues would leave hidden scars in his life. This incident has stayed with me throughout my military service, and especially during my nursing career. As a nurse, I now see the importance of acknowledging the totality of the soldier’s suffering, which might not be obvious. As a graduate student in nursing, I am focusing on the importance of understanding the many factors of military life that affect the health of veterans.


Augustina Mushale served thirteen years on active duty in the United States Air Force. She was deployed with the 386th Air Evacuation Wing in support of Operation Iraqi/Enduring Freedom from May-Sept 2007. She is from Delta State, Nigeria, and is currently pursuing her Masters in Nursing Leadership and Management at the University of California, Davis.