Christopher P. Coppola, M.D., HS ’01, didn’t get much sleep during the four months he spent as a surgeon at Balad Air Base about 40 miles north of Baghdad.

The injured would arrive without warning. For instance, soon after Coppola, an Air Force major in the 332nd Expeditionary Medical Group, arrived in January 2005, insurgents attacked a police graduation ceremony in the nearby city of Baqubah. Six surgical teams, including Coppola’s, rushed to Balad’s tent-and-shipping-crate hospital as one helicopter after another delivered gruesomely injured policemen.

On other days—and nights—the burned and wounded who kept Coppola from his rest were American troops, Iraqi National Guard soldiers, children caught in the cross-fire and men and women hurt in fights or accidents on the base that housed 25,000 American troops and 7,000 civilian employees of Halliburton subsidiary KBR. Frequent mortar attacks led soldiers to nickname the base “Mortaritaville,” Coppola said, but many of the insurgents’ decades-old shells failed to detonate. “When they did go off, they would startle me and I usually couldn’t sleep for the rest of the night,” he said.

Coppola did relax a bit when the violence abated. On those days, his only responsibilities were scheduled procedures—inserting stomach tubes, cleaning wounds. But going back to his hooch to catch up on sleep provided the unwelcome opportunity to reflect on his situation. “When you’re cut-ting off someone’s leg, you just do it, because they’re going to die if you don’t,” Coppola explained in an interview from Lackland Air Force Base near San Antonio, Texas, where he now works. “When you have nothing to do, you start thinking about it. So I couldn’t sleep.”

The 37-year-old Coppola used some of his restless nights to write long letters to family and friends. His wife, Meredith, has assembled them in a self-published book, Made a Difference for That One: A Surgeon’s Letters Home From Iraq.

Coppola described in the letters how he distracted himself from missing Meredith and their three sons and from the despair he felt about the suffering surrounding him. He ran for exercise, always wearing 35 pounds of armor and a helmet, occasionally waving to shepherds just beyond the fence; planted cilantro and sunflowers in the sandbags banked against his sleeping quarters; and earned modest fame in a moustache-growing competition. To make edible such meals as “tan stuff over rice,” Coppola assembled an arsenal of sauces. In March, for instance, faced with an entree of “meat chunks ... diluted with unmentionable adulterants,” he saluted St. Patrick’s Day by dousing it with Goodall’s of Dublin Irish Steak Sauce.

Coppola owed the Air Force six years of service in exchange for stipends while training in pediatric surgery at Children’s National Medical Center and for medical school tuition at Johns Hopkins. He did his general surgery residency at Yale, serving as chief resident in 2000-2001. Although he worked as an all-purpose trauma surgeon at Balad, word got around that he was a pediatric surgeon, and Iraqis brought their children to him for care: a girl with kidney failure, a boy with a prolapsed bowel. Coppola also treated children hurt in the war, including two sisters burned when their house was fire-bombed. One child recovered, but the other died. Soon after, Coppola discovered that he had unknowingly saved the life of the man who threw the bomb. “I instantly conceived of a variety of ways I could have meted justice on him with my own hands,” Coppola wrote. “I’ve taken care of drunks who have plowed into a family of five on the highway, in the bed next to the parents whose children were killed in the crash, but nothing prior had been as difficult as this. I was thankful I didn’t know who he was while he was here.”

Coppola recalled becoming inured to the carnage, only to be shocked yet again. “You feel like you’ve seen it all, but you haven’t. There’s always something worse around the corner.”

Coppola opposes the war. “I want out of there, yesterday. I can’t see how any father or any doctor could feel differently.” And yet the work itself was rewarding. In Texas, Coppola knows that if he does not care for a patient, someone else will. In Iraq, he said, “I had the privilege of feeling that if I wasn’t there, the person would probably die.” And although he believes the war hurts American interests more than it helps, “If there were Americans shot at, that was the place I had to be. Trying to get those guys and women home to their families is probably the most rewarding thing I’ll ever do.”

Coppola expects to be sent back to Iraq this September.

Made a Difference for That One is sold by online booksellers and also on www.iuniverse.com. Profits go to Fisher House Foundation, which provides housing for family members of military personnel getting treatment at military medical centers.