Tag Archives: Iraq War

Essaying: Jon Kerstetter’s “Triage”

(Jon Kerstetter‘s “Triage” is included in  Best American Essays 2013; it originally appeared in issue 13.2 of River Teeth.)

One powerful tool available to essayists–and other writers–is the section break. It can provide the reader with a chance to pause and absorb what she or he has just read. It can turn the essay on its ear and take the reader in a whole new direction, one that may not seem to relate to what has come before. It can allow the writer to explore what has already been written from a new angle, telescoping the lens farther from or closer to the subject and providing a new perspective.

In “Triage,” Jon Kerstetter breaks his essay into six distinct sections, most just a couple of pages long. He starts at a combat surgical hospital in Baghdad during October 2003. It’s filled with soldiers who have been injured in IED attacks throughout the city. Most of the soldiers followed the conventional path of surgery to post-op to ICU. Medical staff are exhausted but moving as fast and efficiently as possible. There’s one soldier in triage. He was expectant, meaning no one knew what to do to help him, and everyone expected him to die. The essay goes from there to explore what puts one patient on the list for immediate surgery and another patient in the category of “expectant” and waiting quietly in the triage room.

The second section begins with the dictionary definition of triage, a move that makes writing instructors like me cringe, but he delves deep into the definition, works through its etymological history, and exposes the fraught meanings behind it. He describes the two weeks he spent in a Combat Casualty Care Course designed to teach medical officers how to decide which patients go into one room and which go into another. Then there’s a section that details the different categories the military uses to classify patients. The penultimate section is where he reflects upon the relationship between what he was taught to do on the battlefield and what it actually means to decide someone is beyond hope. The final, brief section shows Kerstetter today, still struggling but well aware he is alive when others are not.

At a writing conference, I once heard a writer say that section breaks were a sign of a lazy writer. I was immediately offended. He argued that the best essayists know how to weave everything together into a cohesive unit. Perhaps because I began writing as a poet, the idea of a section or stanza break does not seem to be a sign of a weak writer but is just another tool, one that can be used with a heavy hand or one that can be wielded deftly. Kerstetter’s “Triage” is an example of deftness.

Some lines to ponder:

“The captain in charge of the expectant soldier’s unit told the general and me that this was their first soldier to be killed–then he corrected himself and said this was the first soldier in their unit to be assigned to triage” (124).

“In the end, it was decided that my decision to shoot, while potentially serving a greater need, may have been a bit aggressive, but that it was in fact my decision, and my decision met the needs of the mission. All ethical considerations aside, I felt that I understood the necessity and the theory of triage. I understood it as part of my job” (127).

“If the triage officer calculates that a patient falls into the expectant category, treatment is withheld in order to allow medical teams to concentrate more efficiently on those soldiers with potentially survivable injuries. Preserving the fighting force is the central tenet of the process” (127).

“Saving lives is the endpoint of all triage. Let one life go, save three others, or five, or maybe ten. The ratios don’t matter, the benefits do. And a benefit in war always comes at a cost” (128).