Capt. Shawn Rickett lay in his bed in the post-operation ward of the hospital, recuperating from surgery to his arm.
From his bed, the patient could see monitoring devices, charts, medications and nurses at work. Meanwhile, the yellow walls of the hospital moved in concert with the wind blowing outside.
This was a scene recently inside the 21st Combat Support Hospital, also known as CSH (pronounced "cash"), of the 1st Medical Group, 13th Corps Support Command.
The mobile hospital is a superstructure of tents and trailers set up between a corps and division to take care of soldiers and civilians wounded in combat.
"I am well taken care of," Rickett said. Despite his surgery an hour earlier, his spirits were up, and his sense of humor was intact. "They are all catering to me," he said.
The hospital was set up in a field recently in preparation for the Fort Hood-based unit's training at the Joint National Training Center at Fort Polk, La.
The 84-bed CSH was set up and fully operational in 31/2 days.
Part of the just-completed training mission was to conduct surgery, as performed on Rickett. The hospital's commander, Col. Lydia Coffman, said that in wartime, patients normally would come to CSH after being stabilized elsewhere. But the hospital's emergency room staff is prepared to deal with any wounds, including chest injuries.
The 84-bed setup represented only one-third of the hospital's potential size. "We can set it up in any configuration, depending on what the mission is," Coffman said.
In the latest exercise, more than 20 tents were attached to the two main tents.
The operating room, laboratory, pharmacy and X-ray lab are set up in the trailers. Everything else, including the kitchen, is in tents.
Equipment used in the hospital is specially designed or adapted for transport. The sterilization equipment, for instance, can be operated with power from a generator or burners in the event the generators go out, Coffman explained.
Entry to the various areas is through tent flaps. Upon entering, one thing that becomes obvious is the absence of the typical hospital smell from antibacterial cleaning solutions.
"No one I know of has been able to show that this makes for increased cases of infection," Coffman said about the absence of a sterile environment in most parts of the hospital. "Is it a concern? Yes, but what that means is that you adjust and pay more attention to detail."
The operating room, with its solid walls and floors, is regularly scrubbed to cut down on the potential for contamination.
Coffman said the operating room has two operating tables compared with the one that would be found in a civilian hospital.
A civilian hospital also does not have to concern itself too much with a possible strike from nuclear, biological or chemical weapons. And although removed from the battlefield, staffers at the CSH train to be prepared for such attacks.
"That is a primary threat to our forces," said Maj. Richard Cournoyer, executive officer of the hospital. On one day, the entire crew conducted business wearing full protective gear for two hours-including gas masks, rubber gloves and protective shoes.
"Stressful," is the way Cournoyer summed up the experience. "When a patient comes in you take his weapon and secure him, but you never take his gas mask away," Coffman said.
Members of the hospital staff bring a variety of service experiences.
Coffman was in El Salvador practicing medicine and conducting surgery in field hospitals.
Cournoyer was deployed with the 1st Medical Group to Bosnia.
There, he said, staff gained firsthand experience with the victims of exploding mines. "It was a stark realization that that occurs," he said.
An important aspect of the hospital training operation is to introduce military families to the facility. The briefings help families have confidence in the Army's medical treatment, said Lt. Col. Gail Ford, CSH chief nurse.
And even in field exercises, the combat environment is duplicated with the sound of distant artillery and gunshots. "When you assess a patient, your assessment skills need to be focused on that patient to really track his progress," regardless of what is going on outside the hospital, Ford said.
"You still need to have situational awareness of what is going on around you, but not have it be so disruptive to where you lose track of what you are doing with the patient," Coffman added.