Good Medicine, Hard Times: Memoir of a Combat Physician in Iraq

Good ​Medicine, Hard Times is the moving memoir of one of the most senior-ranking combat physicians to have served on the battlefields of the second Iraq war. Former US Army Colonel Edward P. Horvath, MD, brings readers through the intricacies of war as he relates stories of working to save the lives of soldiers, enemies, and civilians alike and shares the moral dilemmas faced by medical professionals during war. Enlisting in the Army as a fifty-nine-year-old physician, Dr. Horvath knew that he had a greater calling in life: to save the “neighbor’s kid”—no matter who that neighbor or the kid might be. Over his three deployments, he strived to do that amid cultural clashes, insurgent attacks, military controversy, and the suffering of children caught in the crossfire. In his clear-eyed, empathetic, and unforgettable account, he shows what it means to provide compassionate care in the most trying of circumstances, always keeping in mind that every person he cares for is someone’s child.

“[Good Medicine, Hard Times] is valuable for its on-the-ground details about the Iraq conflict, its granular evocation of day-to-day life during wartime, but even more so for its witness to the selflessness of emergency doctoring. The world would be a better place if we all treated each another with the concern, compassion and caring that Dr. Horvath prescribes.” —Samuel Sweeney, Wall Street Journal

“A compelling story of the professionalism, compassion, and life-saving capacity our Army doctors bring to the battlefield—and of the lasting burdens they bear.” —General George W. Casey Jr., US Army (Ret.)

“An uncommon story of a physician-soldier with an unwavering commitment to serve America’s sons and daughters on the battlefield.” —Brigadier General Lisa L. Doumont, US Army (Ret.)

“What happened in the wars America has fought should never be forgotten. Colonel Horvath’s memoir of the Iraq War—a doctor’s chronicle of saving lives at the precipices of dying—is a must-read testament to acts of valor in one of our hardest wars.” —Daniel Henninger, Deputy Editorial Page Editor, Wall Street Journal

“An intimate recollection of daily life in a US Army combat support hospital by a physician-soldier in Iraq. Dr. Horvath’s words capture the meaning of service: commitment, dedication to duty, and intense love of country.” —Colonel James S. Wu, MD

“In this brilliant, engaging, and deeply moving book, Dr. Horvath shares stories of joy and sorrow, tragedy and triumph, displaying extraordinary compassion toward his fellow human beings—be they friend or foe. In a world of cynicism and despair, readers will be inspired by what selflessness can accomplish.” —Stjepan G. Mestrovic, author of “The Good Soldier” on Trial

Edward P. Horvath, MD, is a veteran of the US Army Reserve Medical Corps. In 2011, he was Task Force Deputy Commander and Chief of Clinical Services for a combat support hospital near Tikrit, Iraq. Previously, he staffed the emergency room and outpatient clinic at the same base. Colonel Horvath was awarded the Bronze Star Medal and later received one of the nation’s highest military honors, the Legion of Merit. In 2013, he received the American Red Cross Hero Award for extraordinary courage in saving lives. He is a primary care physician at the Veterans Affairs Medical Center in Cleveland, Ohio.

I watched as the families arrived in groups, quietly taking their assigned places on one side of the fence. There were about two dozen families in all, kids and women ranging widely in age. The older women wore the traditional black abaya, covering all but their face and hands, some donning hijabs that left only their eyes visible, their hands covered with long black gloves. But surprisingly to me, the younger adult women were dressed in contemporary Western-style clothing. The school-age youngsters were in neatly attired clothing, the girls wearing full-length dresses, or skirts and knit tops, and most with brightly colored bows nestled in their dark hair. The boys had on khaki slacks or jeans, with turtleneck tops or dress shirts.

Everyone appeared to be apprehensive. Children fidgeted on their bench seats; adults spoke in hushed tones. Being on an American military base where their fathers, sons, or husbands were imprisoned was doubtless an intimidating experience.

The bus eventually arrived with the group of about thirty detainees, who quickly disembarked. The men wore clean clothing and had neatly trimmed beards. Although they were under the watchful eyes of MPs, they were otherwise unrestricted. On entering the visitation building, their pace quickened as they eagerly sought their families. What followed was an emotional scene with mothers embracing their sons, wives hugging their husbands, and children holding onto their fathers. There were many tears and kisses. Faces that only moments before had borne troubled expressions were now smiling. There was even the sound of laughter.

This happy scene did not last long. After five minutes, the guards announced the contact visit ending, with detainees required to move to the opposite side of the dividing fence. The adults complied. The younger children were another matter, holding fast to their fathers, refusing to let go. Many of them looked panic-stricken, no doubt fearful of never seeing their fathers again. The young MPs had to physically pry them from their fathers' arms. Most of the children were now crying or screaming, and many of the MPs were tearful as well, some perhaps thinking of younger brothers and sisters back home. I stepped outside, burying my face in my hands. Never before had I witnessed a scene as heartbreaking as this, and for a moment, I felt ashamed of what we were doing in Iraq.

After regaining my composure, I went back inside, doing my best to console the families, especially the children, though my efforts were mostly unsuccessful. Recalling that my main purpose was to address any concerns family members had about the health of their loved ones, I walked around with an interpreter who introduced me as "tabib amriki," an American doctor. Cautiously at first, I was approached by a few of the women who asked about their husbands or sons. To the extent possible, I conducted my conversation with them at the dividing fence so their loved ones could participate.

As the families began to depart, I tried to catch the dark eyes of some as they passed, especially the women otherwise veiled behind hajibs. I was hoping my kindness bought us some goodwill, but all I saw were eyes ablaze with hatred-hatred for us, hatred for me.