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September 16 2011

15:03

Corinne Reilly on trauma medicine in Afghanistan, after a decade of war

Our latest Editors’ Roundtable looks at Corinne Reilly’s print series “A Chance in Hell.” Part of a multimedia project from The Virginian-Pilot, the series brings readers snapshots from the lives of combat hospital staff in Kandahar. Reilly covers the military for the Pilot and joined the paper in 2009 after four years working at the Merced (Calif.) Sun-Star. She has reported from Iraq, Afghanistan and Haiti. In these excerpts from our conversation, she discusses finding a different story than the one she had planned to tell, putting the reader in her shoes, and fighting war fatigue at home.

You had to go halfway around the world to report “A Chance in Hell.” What conversations did you have with your editors about the story before you left the U.S.?

I went to Iraq last summer with the photographer who went with me on this trip, Ross Taylor. That was his first experience embedded with the military, and as soon as he got back, he wanted to do it again.

I started broadly looking at what local units would be in Afghanistan at the time that we were talking about making the trip. A combat hospital was not even on our radar at first, but then we thought that something related to Navy medicine could be compelling. We’re a Navy town, and Navy medicine is kind of a big thing. They provide all the medical service for the entire Marine Corps.

I called over to the local Navy hospital that’s here, and that’s how we found out about the hospital. As soon as we started talking to people who had served there, we all knew that this was the story we wanted to go there for.

We had some meetings with my direct editor, and also her direct boss, and then also Maria [Carrillo]*, our managing editor, and our top editor Denis Finley, and came up with a plan for a topical series. I knew they treated members of the Taliban, or suspected members of the Taliban and enemy combatants. I thought that was really compelling and could be a story. I thought maybe there was also something general on combat medicine and the way it’s changed over the last 10 years of war.

But as soon as we got there and realized the power of the place and the access we would have, I immediately knew that our plan wouldn’t do justice to what was in front of us. So maybe the second day I realized I needed an entirely new plan.

So you knew you had to change the way you were approaching the project. How did you make that shift?

What really triggered it was the access we were given. Obviously, it’s a medical setting, so there are all kinds of privacy considerations to take into account. We just weren’t really sure what it would be, but it ended up being much wider access than Ross or I ever imagined.

That first and second day, I would meet patients or talk to patients, and it was not fitting into the plan that I came with. But it was so incredibly powerful, and I just thought, “The best way to tell this story is maybe just to tell it all, and it doesn’t have to be this neat topical series.” The way I think of the story is almost as one long narrative.

It took me a couple days of mulling it over in my head before it gelled that it could be a series of scenes, meeting a series of different people, with bigger-picture stuff thrown in at the right points to guide the reader. I’d exchanged emails with my editor, and we had one phone conversation where we decided that was the path we were going to take.

How long were you there?

We were at the hospital for two weeks – 14 days.

How do you report for narrative in that situation? What did you make sure to get while you were right there?

A lot of the particulars I kind of knocked out in the first couple days – things like how many people worked there, the lay of the land, what are the different departments, what are the different jobs. Once I had that, felt like I understood this place from that perspective. Then I literally wrote down everything. Anytime a patient came in that I thought could be a compelling part of the story, I tried to see that patient all the way through until they left the hospital.

I usually got to the hospital around 8 or 9 in the morning and then stayed until 8 or 9 at night, and then I would go back, and before bed, I would take a few hours to organize my notes. By maybe the fifth or sixth day, I had an idea of who I had met so far, and I had identified a few people I thought could be key characters. And then subsequent days, I would go back and spend more time with those doctors to fill in their stories.

You got a lot of sensory detail in there.

I feel like this story was very unique in that so many of the details in and of themselves were striking. Whatever struck me, I wrote down. There were definitely times I went back and used Ross’ photos, and he also took a lot of video, so I could use it to fill in. For instance I had a detail of a physician’s assistant wiping blood off of a patient’s face, and I couldn’t remember the color of the cloth she was using, but I wanted that in the story, so I went back and looked at photos for things like that.

But certainly things like smells I was trying to write down – even thoughts that were going through my mind. There’s a section where I kind of expand on “who is this person on the table?” You’re noticing details about him, and you’re wondering who he is. Those were my own thoughts in the moment.

It’s interesting that you brought that up, because it’s an unusual mid-story shift to the second person. Had you also seen the wounded soldier in the gym, as is mentioned in the story, or was that a shift to the doctor’s perspective?

I had not seen him in the gym. I guess that “you” was a hybrid of my thoughts and even conversations I had with Ross when we were standing there while they were prepping the guy for surgery – we almost had that conversation: “I wonder who that guy is. I wonder how long he’s staying here. I wonder when he’s going to get to go home.”

And then part of it was also conversations with doctors afterward. A lot of them said things like, “We keep these patients for 36 hours, and then we never see them again. We never get to know who they are or see them again after.” Once in a while they do, but so many patients come through that they don’t get to follow up with once they leave the hospital.

Certainly when that physician’s assistant said that she’d seen him at the gym, I thought that was incredibly striking.

When you got back, you had all this stuff. At that point, did you already have the story segregated into pieces in your mind? How did you approach dividing the material into separate stories?

I definitely wrote large pieces of it while I was there. I would come back after a day at the hospital to the place where we slept. A first I started out organizing my notes and my thoughts. I would say by the fifth or sixth day I had a plan for what I wanted the story to look like, and I actually started writing scenes. So if I witnessed something that day that I knew would be a significant scene in the story, I would write a first draft of it that night before going to bed. I felt like that was really essential to showing what it really felt like to be there.

So in terms of breaking it into a five-part series, that didn’t happen until much later. I just sent everything I had written to my editor, Meredith Kruse, and we talked about an order and piecing them together, and how many parts do we need – we figured that out together. We literally laid the pieces out and kind of outlined it. And then she said, “This is what I still think is still needed here.” And I went back and wrote the entire second section of the first chapter, the one that pulls back and says “This is where we are.” Those were the parts where I didn’t feel like I would lose details if I waited until I got back to write.

You’re playing an educational role in getting a lot of information across to your readers. How did you think about balancing facts with the more scene-based parts of the story?

I wasn’t terribly deliberate, but I definitely didn’t want the bits with the facts – things I might consider drier pieces of information – to weigh down everything else, to weigh down the people, and the emotion and the real meaning of the place. I tried to convey as much as I could about the place through the people who were there and their stories, so you don’t even have to come back and say, “We are at a combat hospital. We are in Afghanistan. We are in Kandahar.” By the time you get through that first scene with Cpl. Ward, you already kind of understand what this place is. I wanted to make it so that you need as little additional information as possible.

You tucked in a few graphic details, but not a lot. How did you approach pacing the use of sensory detail and the most graphic material?

I think through all of it, with the writing and the whole package, we were really worried. It’s a very fine line. You want people to see it the way it really is, but you also don’t want people to turn away and stop reading. I tried to include details that might be graphic if I thought they served a purpose other than simply being graphic.

Did you start with more of those details in and then took some out, or did you go back and add things in?

There were a few cases where I did take things out, because I thought they were too graphic, so I would say it was a little of both. When I was actually in Afghanistan, I did err on the side of putting more in, because not everything makes it into your notebook and it’s only going to last in your memory so long. So I thought I should do it while it’s fresh in my mind, and if it comes out later, fine.

We’ve been at war a long time. People have seen a lot of war scenes, and they’re also pretty conversant with medical stories. What were your strategies for making sure they paid attention?

I did think from the very beginning that was going to be one of the key challenges with this story. We’ve been at war for 10 years; people know that. One of the biggest challenges of this story was getting people’s attention and finding a way to say “this is why this matters now,” even though this story could have been written five years ago.

The second little part of the first chapter where I quote one of the main characters in the story, Ron Bolen, saying, “You know, I know this is old news and that what we’re talking about now is winding down.” The reason I chose to put that there so high in the story was because I thought, “Let’s just address that. Let’s get it out there.” Yes, this has been happening a long time, but I thought I could almost flip it and say maybe that makes it more important now. It’s kind of saying, “We acknowledge that, but look, they’re still here; they’re still showing up every day.”

*Maria Carrillo is a member of our Editors’ Roundtable but did not select this story for discussion and was not involved in any aspect of our coverage of it.

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