Paul Roach is a Navy surgeon who has been deployed to Afghanistan twice in the last six years, the latest ending in October 2014. While stationed in that forbidding and dangerous place, he missed his family in Forest Park. When he returned home, he missed the camaraderie and the work that felt incredibly important — bringing the shattered bodies of soldiers and civilians back from the brink of death to life.

Captain Roach has written a memoir, Citizen Surgeon, which recounts his experiences in his first deployment as part of the Marine Corps 1st Medical Battalion’s Alpha Company in Helmand Province. The memoir helps explain how he came to love such a demanding, lonely and sometimes depressing job in a very dangerous place.

Roach is clear in the book that his deployment was hard on him. He writes, “I am home now, but memories of the deployment keep finding me: standing inside a poorly lit tent in a foreign place, a ragged, muddy blast victim on a stretcher shrieks in agony and scratches at life with desperate, shredded limbs; an Afghan child struck by a Hellfire missile, skin bleeding head to toe from shrapnel wounds … but Death steals her abruptly; lonely, homesick, waiting in a cold line outside a phone tent to call my family at Christmas.”

He describes how being a citizen surgeon in Afghanistan was a strange mixture of horror on the one hand and meaningful purpose on the other: “Sadness and camaraderie were mixed together in a daily draught from which we drank; the shock of battle and the sense of mission; the investment, the great, big, lifetime investment that we all made into this God-forsaken effort, and that investment’s convoluted sense of loss and reward.”

On the day he was to return home, Roach visited the tent in which he had tried to put so many broken bodies back together. 

“Standing in the silent O.R. tent looking about,” he writes, “I had the sense that soon I wouldn’t be this important ever again — at least not professionally. Plus, this was the finest, most deserving patient population on the planet.”

On the flight back home, his plane stopped to refuel at a base in Kyrgystan. During the layover, Roach and a buddy named Mike sat on the deck of a little bar called Pete’s trying to emotionally digest what they had just gone through. He recalled, “Being at Pete’s Place on the wooden deck prepping to head home was to be in a state of grace: our mission was accomplished, and this was the last bit of calm before we reentered the familiar world, that storm of Western life.”

The words “storm of Western life” jump off the page, since most assume the storm is where military personnel are coming from, but Roach said it’s hard for someone who hasn’t been there to understand, but just as part of the citizen surgeon remained in Forest Park with his wife and daughters as he deployed, so another part of him remained in Afghanistan even as he hugged and kissed his wife and children after being separated for nine months.

Make no mistake, it was wonderful to be home, he writes. 

“I will always remember with gratitude and relief the crystal moment when my darling wife, the devoted mother of our children, my inspiration and best friend on Earth, was there in Camp Pendleton after a long, difficult year to welcome me back to my country, my family, and to my life.”

The citizen surgeon has been living in two worlds, really. He writes, “There is the one world that is a seething place in which things are rough and vicious and raw, where horrible things happen and you deal with them; and there is that other world, the one of happiness, sensibility and logic, where your daughters have pretty summer dresses, your pets are groomed, and art and perfume and family gatherings and retirement strategies make sense. Which of these worlds is right? Which is the real one?

“They say it takes a full year for a family to recover,” he continued. “I have some personal issues to iron out; I haven’t returned home yet in my own head or in my heart. It’s like the intensity and the sharpness of the experience carved channels in my mind. I need some time, some regular living to fill those channels back up so that things can get back their proper patterns. But I don’t know if they’ll ever get back to ‘normal,’ whatever that was.

“Being back with my family reminds me that I’ve already promised my life to something, to somebody: to them. And it is not for me to give that life away to anything else. They remind me with the same intensity as the war tried to express that this world at home, the one with a spouse and my own children, it is also real; that the happy and joyful times are no more a fiction or less a truth than the sorrowful ones; that there may be death, but there is also life.”

Citizen Surgeon is not yet available in hard copy. Look for it at in electronic format.