In the first few moments of the documentary film "Baghdad ER," we see a man dressed in hospital scrubs carrying a bloodied arm that has been amputated above the elbow. He deposits it in a large red plastic bag.
This HBO production is reality television with a vengeance — warfare as it really is. And while it is frightening, harrowing and deeply painful to watch, it should be required viewing for all but the youngest Americans. It will premiere May 21.
For two months in 2005, the directors Jon Alpert and Matthew O'Neill were given unprecedented access by the Army to the 86th Combat Support Hospital in the Green Zone in Baghdad.
Working 12-hour shifts, they watched — and taped — the heroic struggle of doctors, nurses and other medical personnel to salvage as many lives as possible from what amounted to a nonstop conveyor belt of bloodied, broken and burned G.I.'s.
At one point in the film, a specialist who survived a roadside bomb attack murmurs from a stretcher, "It was the worst thing I ever saw in my life, sir."
"What was that?" he is asked.
Recalling his last view of a buddy who was killed in the attack, he says, "My friend didn't have a face."
The movie is neither pro-war nor anti-war. It is simply a searing record of the ferocious toll that combat takes on real human beings.
In an interview, Mr. Alpert described "the shock of seeing human beings twisted into these horrible shapes, with parts missing and parts being detached from them."
In the first couple of hours after he and Mr. O'Neill had arrived at the hospital, he said, "We had already seen two amputations and they were prepping someone else for another one."
Before long, he said, the effort to document the daily activities became psychologically grueling because "you just knew that every single day that door was going to open up, that the helicopter was going to land, and they were just going to bring in something that looked like hamburger instead of a human being."
Above all else, war is about the suffering of individuals. The suffering is endured mostly by the young, and these days the government and the media are careful to keep the worst of it out of the sight of the average American. That way we can worry in peace about the cost of the gasoline we need to get us to the mall.
"Baghdad ER" is going to tell us right in the comfort of our living rooms that there is really horrible stuff going on over there in Iraq, and whether we think this is a good war or a bad war, we need to be paying closer attention to the human consequences.
"We tried to put a human face on the war," said Sheila Nevins, the head of documentary programming at HBO. "It's a part of the story that hasn't really been told."
Capt. Glenna Greene, an operating room nurse, says in the film:
"It just kills me, because these kids are, you know — I'm old enough to be their mom. And just to see them hurt, it's very difficult."
She said she tries to comfort those who are seriously wounded and about to be evacuated to Germany.
"I always try to tell them before they go to sleep: 'You'll wake up in Germany. Have a beer for us.' " And then she laughed. "Some of them aren't even old enough to drink," she said.
The medical personnel do an extraordinary job. The film tells us right at the beginning that 90 percent of the troops wounded in Iraq survive, which is the highest survival rate in U.S. history.
But many of the more than 17,000 who have survived their wounds will face a lifetime of physical and mental struggle.
A member of the operating room team, commenting on the amputation of a soldier's thumb and the partial amputation of his ring finger, says that the patient who immediately preceded him "lost his left arm and his right leg above the knee.
And, you know, there was a couple of marines in here the other day, one lost both his arms, the other lost both his legs. And this is a bad injury, but certainly could have been worse."
The movie does not shrink from those instances in which the G.I.'s do not survive. We see doctors all but begging the patient to make it. We see buddies weeping. We see a chaplain speaking softly to a mortally wounded marine:
"We don't want you to go. We want you to fight. ... But if you can't, it's O.K. to go. It's O.K. to go. But we'll be right with you. If you get better, or if you go."
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