John Nelson has a small hunk of shrapnel that needs to be cut out of his neck, and it probably will be in a few weeks. Other flecks of ball-bearing-gauge metal float in the flesh on his shoulder blades like tiny steel pins, so numerous and difficult for surgeons to find and remove that they’ll probably stay in him for the rest of his life.

A torn tendon aches in his right shoulder, another painful reminder of the terrorist detonation that threw him and a lunch table he had been sitting at about 10 feet. His ears continually ring, and he has lost about 40 percent of the hearing in his left ear.

But the small, blood-red scar dug into his forehead?

“That’s just running into something and not having hair. It’s really a pain in the ass, not having hair,” Nelson said. “I used to have hair, but then I had children.”

Sitting earlier this week behind a desk at his compact, neat real estate management office on West Broadway in Lincoln, Nelson, a major doing detached service with the 133rd Engineer Battalion, had come a long way from the battlefields of Mosul, Iraq.

The Maine Army National Guardsman was just sitting down to his favorite lunch – a chili and cheese hotdog with onions – in his unit’s mess tent on Dec. 21 when a suicide bomber wearing a vest laced with ball bearings and plastic explosives set himself off.

Nelson was about 30 feet from the human bomb.

“There was no bang. You never hear the one that gets you,” Nelson said. “I saw this huge red flash, but it stayed there in my eyes. I felt this heat on the back of my neck, and I thought to myself, ‘We’ve been hit.'”

When Nelson came to, he found himself under the lunch table with his ears ringing and his left ear in pain. Although he might not have realized it at the time, he was about to see just how well the mass-casualty medical response plan he helped devise actually worked.

As a casualty.

‘A passion for variety’

From Nelson’s resume, one can draw a picture of a man and mind as varied as the places he has been.

Born 52 years ago in Big Stone Gap, Va., Nelson has gone to Vietnam trying to help recover POW-MIA remains and served in Iraq during the first Gulf War, Alaska, California, Georgia, New York and Maine during his nearly 28 years in the service. He has college degrees in business administration, civil engineering technology, forestry and wildlife, earning at least a 3.2 grade point average.

Trained as a physician’s assistant at the University of Oklahoma, Nelson has dealt with everything from emergency medical care at Redington Fairview General Hospital in Skowhegan to workers compensation claims and rehabilitation at the Occupational Health and Rehabilitation Center in Bangor. He has directed medical training, serving as a flight surgeon and overseeing preventative sanitation as part of the Army National Guard’s 112th Medical Co. in Bangor.

His hobbies include forensic science, carpentry and polishing rock. He has been a scoutmaster and a scoutmaster instructor for the Boy Scouts of America, a coal miner, and a Sunday school teacher for the United Methodist Church.

“I like to learn,” Nelson said simply, his Southern accent pronounced but pleasant.

“He is just a kind of curious soul who likes to get into a lot of different things,” Col. Steve Schlieper of the Maine National Guard’s Joint Task Force Headquarters, one of Nelson’s commanding officers, said. “He has a passion for variety.”

Hung with the universal nickname for medics, “Doc” Nelson has an amiability and wry humor that masks a great deal of drive, principle and a tremendous passion for detail, said Schlieper, who has served with Nelson for about three years.

“He does enjoy a good joke every once in a while, and he can take a good joke, but he doesn’t hesitate to tell somebody something if he thinks they’re wrong,” Schlieper said.

When many of Nelson’s wounded soldiers returned from Iraq, Nelson worked strenuously to ensure that they got the best medical care from army or civilian doctors. He was not afraid to tell off those soldiers if their medical-care choices wouldn’t fit the bill, Schlieper said.

“A lot of people found him brusque, but I think he just has the soldiers’ best concerns at heart,” Schlieper said.

“He is a great big bundle of energy,” Ingrid Dolley, a receptionist at his office, said. “He cares deeply for people. He was the PA that took care of my mom when she had colon cancer. He treated her like she was his mom … I could call him at home, and he was just always there for us. He was like a big brother.”

“He is no one’s fool. He doesn’t put up with a lot of tomfoolery,” Schlieper said.

Back in his office in Lincoln, a town in which he, his wife and five children have lived since 1995, Nelson seemed to enjoy the stir of managing several things at once.

His talk of his Iraq experience was interspersed with bantering with his wife, Hattie Lynn, as she worked to manage the property management agency’s computer files.

“The thing I am proudest of is how my medics responded to the explosion,” Nelson said. “There’s no greater satisfaction in life than watching people who knew nothing take charge of a scene and handle it.

“They really did a great job,” he said. “They’d holler for Doc, but they had it under control. They were even telling other medics from other units what to do. They are my heroes.”

‘A lot of death’

When the bomb went off, Nelson was knocked unconscious for a few minutes. When he came to, his first thought was that it might have been a 122-mm rocket. Iraqi insurgents had been firing regularly upon the forward operating base, or FOB, but Nelson noticed that the bomb explosion area had coated the area with a sticky fluid, like cooking oil, the first clue that the explosive was plastic.

Nelson set to work immediately.

“Once I found I was able to get up, all I treated were airway problems, bleeding and breathing,” Nelson said. “I was determined that I was going to save as many men as I could and that they were not going to kill us.”

People who didn’t need immediate first aid Nelson turned over onto their left sides to help them keep their airways opened, he said.

Some victims needed more. For one, a soldier with a large gaping hole in his thigh, Nelson stuffed a large wad of paper table napkins into the wound, bandaged it with a shirt sleeve and had a nearby soldier, a colonel Nelson reported to, put pressure on it.

Another soldier was bleeding from the neck. Nelson crushed the flesh around the wound to stem the blood, then used plastic food wrap to help close the 10 to 15 wounds in the man’s chest and abdomen.

“I had to use what was there,” Nelson said. “I pulled a ‘MacGyver’.”

Nelson saw a soldier, apparently in shock, standing some distance away with a radio, and ordered the man to call for help. All around him were soldiers wounded or in shock and the ruined chairs and tables of the explosion. The ball bearings had torn holes in flesh and the tent and riddled steel oven covers over nearby grills.

Nelson’s wounds came from shrapnel that probably would have killed one of his best friends, Capt. David Sirvet, a chaplain, had it not hit Nelson, he said. Eventually they forced him to stop caring for others.

“There was a lot of death,” Nelson said. “Had it been a hard building, we would have all been dead.”

Bombers videotaped selves

Prior to the explosion, Nelson said he made sure that his team of eight medics, which handled the medical care of about 600 engineers, were drilled thoroughly to handle any kind of mass-casualty emergency and that the tent where the bomb exploded was one of the designated treatment centers.

Nelson and his staff sergeant, Patrick Labrie of New Gloucester, thought an attack like the bombing would occur and identified the tent as a potential target.

“One of the weaknesses I identified right away was the tent because it was so huge, not a hard structure, and so close to a highway. Right off the bat it kind of scared me in a way,” Labrie said, “and he listened. He’s a very detailed soldier. He expects efficiency.”

The tent’s vulnerability – and the fact that most medics didn’t take their gear with them to lunch – was among the reasons it was stocked with about 13 boxes packed with medical supplies, Labrie said.

Nelson and Labrie had examined several potential scenarios, including suicide bombers, artillery attacks, mortar rounds, and a gate crasher similar to the attack on the Marine barracks and French embassy in Lebanon in 1983.

Several areas around the base were designated mass-casualty treatment centers, he said, and Nelson had the engineers totally renovate a ramshackle Iraqi aid center and build a new aid station for his medics.

“We had drugs and supplies stored to handle every possibility,” he said.

As the emergency continued and more help arrived, medics set up a triage area to treat casualties. The insurgents mortared the area, forcing the medical teams and victims to take shelter.

That’s why Nelson feels such pride about his medics’ accomplishments and credits Labrie, among others, with helping make it happen, he said.

“We led the way in responding to that event,” Nelson said. “We set a standard for the delivery of medical care that was outstanding.”

Nelson recalled: “We used to tell the medics all the time, ‘Trust your training, learn as much as you can and always take care of your fellow soldier.’ Staff Sgt. Labrie would always tell them, ‘If you don’t learn what we teach you today, your enemy will teach you on the battlefield, and the outcome will not be the same.'”

Of the 128 people involved in the explosion, 19 were killed instantly, Nelson said. Three others died of their wounds later. In all, 106 people were saved, including 61 evacuees to the combat support hospital. All of the emergency medical supply boxes were used.

For himself, the explosion had lingering effects, he said. Over the next several days he felt like his entire body had been badly bruised.

“It’s harder to recover at my age,” he said. “The body doesn’t bounce back as fast.”

The emotional impact came as well. Nelson remembers feeling shock and deep anger about the attack.

“For a soldier to die from a cowardly act, that’s just wrong. [Terrorists] are all cowards,” he said.

Those feelings manifested themselves again when a medic passed him a CD-ROM disc of videotape taken by one of the suicide bombers showing the black-masked bomber wrapping himself in explosive for the attack and the attack itself as seen from a van on the highway outside the tent.

“They filmed all of their stuff, let me tell you,” he said. “They want to create fear among the populace.”

The video helped Nelson and other medics prepare a basic forensic report on the explosion, including the placement of victims, the approximate 20- to 30-foot blast killing radius, and the bomber himself.

“They didn’t have anybody else who could do the basic studies that needed to be done in that situation,” he said.

Nelson’s job was to prove or disprove that a fifth man, the bomber, was sitting near a group of four other Iraqi soldiers at the bomber’s own table in the mess tent, said Nelson, who had assisted police with forensic work as a medical officer stationed at Alaska’s Fort Wainwright.

“They had no idea who he was or they wouldn’t have been there,” Nelson said of the Iraqi soldiers. “We learned later that he was a Saudi Arabian that had been dressed as an Iraqi soldier.”

Nelson’s table was about 30 feet from the bomber, he said. The explosion threw ball bearings as far as 150 feet from the initial blast point.

“You don’t trust anybody when you’re in a combat zone. You look for anything out of the ordinary or that should not be there,” Nelson said. “I looked at them, but I didn’t see anything out of the ordinary. They were dressed as soldiers.”

His work earned him a teasing accolade from his troops. Somebody sent him a computer-generated logo from the TV show “CSI: Crime Scene Investigation” featuring the cast. His logo has Nelson next to comely actress Marg Helgenberger. He keeps the artwork in his computer.

“One of my medics sent me that,” Nelson said with mock disdain. “Wonderful people aren’t they? Oh yeah.”

Protecting Iraq

Vietnam veterans had a saying about going home. They called it “going back to the world.” Almost two months after his return, Nelson said he understands what they meant.

“You always carry the combat edge with you. You sleep with one eye open. You’re constantly reading and reacting to things,” Nelson said, “but when I saw my kids, I felt like I was safe. It was nice to be back to the world. You lose an awful lot of life when you’re gone for a year-and-a-half.”

One of the shocks he felt upon his return was seeing how the Iraq war is being portrayed by the media, he said. While some good reporting is done on the relief efforts troops provide to the Iraqi people, most accounts focus too much on the fighting, making it seem more common than it is.

“We’re not over there fighting a war for Iraq,” Nelson said. “We’re over there to protect the Iraqi people until they have a police force and a military and can do it for themselves. The war is on terrorism.”

Media doesn’t portray much of the good work soldiers do over in Iraq building roads, hospitals and schools. Nor do they devote much coverage to the huge weapons caches Allied soldiers often find buried in Iraq, said Nelson.

“These people understand democracy, and they want it,” Nelson said. “The older generations who were around 50 years ago when Iraq had elected governments remember democracy, and they want it.”

Comparing the Iraqi democratic movement to this country’s post-Revolutionary War history, Nelson predicts that it will be two or three generations before democracy is truly entrenched in Iraq, and American troops will likely have to remain there for several more years.

As for himself, Nelson has received a Bronze Star – his second – and a Purple Heart for his Iraq tour. He is listed on active duty undergoing medical treatment, he said. Surgery will repair the shoulder and remove the shrapnel in his neck, and he speculates that eventually he might be posted to Afghanistan.

He and his family will travel to Orlando this weekend so he can receive the Uniformed Services Physician Assistant of the Year award from the Veterans Caucus of the American Academy of Physician Assistants for what members called “his incredible efforts caring for his wounded fellow soldiers during the bombing of the mess hall at Mosul.”

A Maine Public Broadcasting TV documentary on his experience is in the works. His daughter Jennifer recently announced that she will be joining the Army to become a medic.

“Dumb girl. I don’t know what I am going to do with her,” Nelson said.

Her father, too, has army ambitions.

“I’m hopeful that I will get a chance for promotion to better help prepare other physician’s assistants and to help train medics for the job ahead of them,” Nelson said.

One other thing.

“I want to give up chili and cheese hotdogs,” Nelson said. He paused.

“Actually, I’m hoping someday to develop another taste for them. I haven’t had one since I got back. Ever since the explosion, I haven’t wanted one.”