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We were on the way to church when we heard the news: a few hours earlier, on 20 January, a U.S. Army Black Hawk helicopter had been shot down north of Baghdad, killing all 12 soldiers. “There but for the grace of God …” was my first thought, as I had just returned from a tour of duty there and had often flown in a Black Hawk.

Then it became clear that one of the soldiers was Col. Brian Allgood, a West Point graduate and Ranger-turned-surgeon, whose spotless record as a military medical leader had taken him from the operating room to the fast track for general. He was the fourth American colonel, and highest-ranking doctor, to die in Operation Iraqi Freedom.

As Gen. George W. Casey Jr.’s command surgeon for Multinational Force-Iraq, Brian oversaw the care of coalition troops, but he also had responsibility for the coalition’s support of Iraqi health care. He and I (serving as the coalition’s health policy liaison to U.S. Ambassador Zalmay Khalilzad) spent many hours together last summer and fall in Iraq, struggling to understand what we could do to help Iraqi leaders and doctors improve Iraq’s health care. …

Not knowing when or if the fighting might abate, we debated whether we could somehow persuade Iraq’s Ministry of Health (which would not agree to meet with us) to crack down on corruption, or even to spend its “rainy day” funds, matching them with ours, though little remained of either. Or should the focus be on repairs to hospitals, to the ancient water and sanitation systems, or on training doctors, nurses and managers, and developing functioning supply, engineering and information systems? Should we assume the coalition involvement will last for six months, one year, and five years? Since reconstruction had never been attempted before the end of hostilities, there was no road map.

Not surprisingly, these vexing questions did not elicit agreement among health policy leaders within Multinational Force-Iraq, the U.S. departments of State and Health and Human Services, much less with the Ministry of Health or the World Health Organization.

Into this maze came Col. Allgood. He had the effortless grace of officers whose mental and physical fitness set them apart. He was direct, and did not kiss up or kick down, swear, yell or threaten. He said little, promised less, learned fast and acted faster: Within months his above-the-fray example had calmed the infighting of U.S. government agencies, enabling him to put together a health plan — for coalition troops and for coalition assistance to Iraqi health — as comprehensive as that of any professor or government official, but with the practicality of a surgeon who having heard all the opinions set the plan with every confidence his staff would give it all they had.

His command presence led even older officers to treat him with deference, but when I kidded him about it he said only that the thing he liked least about the Army was returning all the salutes. Other than that, I never once heard him complain, not even about the absolute ban on alcohol. He expected a lot, and so did not micromanage or coddle his staff, and he set a high standard for things like combat medals. But he reviewed proposed missions to be sure the goals were worth the risk. And, true to the Army tradition of “first out of the foxhole, last in the chow line,” he led many of those missions himself, and offered me his own roomy quarters when I complained about mine. Embarrassed, I declined.

Far from home, working in close quarters 18 hours a day, seven days a week, bombed and shot at, yet Col. Allgood was able to maintain the distance that avoids even the appearance of favoritism, the distance that charges soldiers to find strength in themselves, to stay in touch with their families, and — at least in Col. Allgood’s case — with God, but not to mention it.

Why God ordains, or permits, the loss of a great leader, with so much yet to give, is as mysterious as why the enemy shoots at helicopters painted with a red cross. As soldiers say, it is “above my pay grade,” like whether we should be in Iraq at all: Soldiers, who know better than anyone the costs of war, may debate and advise, but once the mission is set, they carry it out in accordance with regulations.

In response to our letters over the past several years, Congress and President Bush increased in 2006 the combat death benefit from $8,000 to $100,000, with more insurance (up to $400,000) for those who subscribe, and up to $788 per month for college. Bills to further improve benefits are before Congress, but for today it is enough to note how blessed we are by the example of Col. Allgood.

May all Iraqis learn that one of our best gave his life on their behalf, and ours.

May we never forget him, or neglect the mission. And may we, his friends and country, look after his family, as he looked after those in his command.

Dr. (Col.) S. Ward Casscells is in the Army Reserve and is John Edward Tyson distinguished professor of medicine, cardiology and public health and vice president for biotechnology at University of Texas Health Science Center at Houston.


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