Duty Calls a Doctor From Rural Calm to War’s Chaos

In a small farming town 180 miles east of here, a country doctor named James Irwin has placed two duffel bags by the front door. On Monday, he ships out, first to Camp Pendleton and then to the battlefront in Iraq.

It will be Irwin’s first time in Iraq, first time in a war and first time dealing with shrapnel and bullet wounds. And all of this newness will come at an age when most of his peers are planning their retirement.

Irwin is 62. He is the main surgeon in the town of Moses Lake, a flat, arid, mostly agricultural community of 15,000, best known as a pit stop between Seattle and Spokane. In nine months Irwin, a captain, would have retired from the Naval Reserves with 20 years under his belt and a monthly $1,400 military pension. Now he’ll have to put off retirement until his 12-month tour of duty is over.

His unit was called up two weeks ago, and Irwin was assigned to be part of a mobile surgical team, working out of “a mini-MASH facility,” as close to front-line fighting as any medical personnel will get.

Irwin will leave his wife of 38 years, two grown sons, eight Arabian horses and nine idyllic acres of farmland, not to mention a private practice that performs 60% of the town’s surgeries. His 61-year-old wife, Frances, a nurse and the manager of their practice, is frantically looking for a temporary surgeon to replace him.

“It’ll be hard to fill those Size 15 shoes,” she said plaintively in a phone interview. “Come Monday morning, when I bid him goodbye, I know he may not return. It’s not going to be easy. It’s not going to be easy at all.”

Irwin himself said his deep faith has kept him calm and will serve him well on the battlefront, but he doesn’t plan any heroics. “I’m very definitely proud to serve in the armed forces,” he said, explaining his support for the war and for President Bush. “But I have no desire to come home with a Purple Heart or a limp.”

“A cowboy at heart” is how friend and colleague Scott Campbell describes Irwin, who wears a military crew cut and cowboy boots. Campbell, an administrator at Samaritan Hospital, where Irwin has performed surgeries for three decades, says the doctor is so respected in the community that he is seen by some as larger than life. And, at 6-foot-4, 240 pounds, he is larger than most.

Irwin expresses confidence that he can endure the physical rigors of life on the front. He works out three times a week with weights and on a treadmill and, for the last two decades, has been active in a little-known sport called “endurance riding,” in which participants ride horseback for up to 100 miles.

His wife sees a more vulnerable figure. She said her husband has a history of heart problems and two years ago underwent bypass surgery. She worries about his heart under the pressures of battle, but concedes that he’s fit.

Irwin spent two years on active duty in the early 1970s and has had some involvement with the Navy for three decades. He said it’s rare for someone his age to be sent so close to the front lines. But he knows of one doctor who was 67 when he served in the 1991 Persian Gulf War.

“I’ll definitely be one of the older guys,” Irwin said.

His new assignment will also take him into new territory as a surgeon. In Moses Lake, his work primarily entails routine surgeries: appendectomies, hernia repairs and gallbladder removals. He typically performs 18 to 20 surgeries a week.

In Iraq, he said, he will most likely be dealing with bullet and shrapnel wounds, amputations, and various injuries to the extremities. Irwin said that with U.S. soldiers wearing protective vests, three-fourths of the wounds will be on arms and legs. But based on reports from the front, Irwin might find himself treating many more Iraqi soldiers and civilians than GIs.

On Friday at Tilltil Airfield in southern Iraq, an American medical team working in a mobile setup treated more than 100 people in 24 hours. The vast majority of them were Iraqis.

Irwin said that packed in one of his duffel bags is a metal box with pictures of his family, including his three grandchildren, and eight horses. His favorite way of spending free time, he said, is riding his horse Melzon on a trail that loops around nearby O’Sullivan Lake before cutting through an area of giant sand dunes. He said he’s hoping to take one last ride this weekend but doubted he will be able to, because “of all the activity” of preparing and saying goodbye.

“I’m not afraid of going,” Irwin said Saturday. “You risk your life whatever you do. There’s no rhyme or reason in who gets hurt and who doesn’t, who dies and who doesn’t. You just have to live your life.”