comicposting

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Question from Reddit

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What medical treatment and government insight do we think Tony would've experienced after the events of Afghanistan?

I'm writing a Marvel re-write/canon divergence of sorts, and I'm trying to make Tony's experience being rescued as accurate as can be post-Afghanistan. So, as the title states, what treatment do we think Tony would've received? Obviously, he would've been very dehydrated and malnourished, but what vitamins and minerals would be most obviously low based on his circumstances? What tests would have been run? What treatment do we think he was likely to of undergone, and how long would he of had to take them?

Further, what kind of questions do we think he would've been grilled on by those who rescued him? Or would that come later? (I'm specifically asking about government organisations that aren't S.H.I.E.L.D)

Would love if anyone (whether in the medical or military field) has any guidance on answers to these questions, as I'm struggling to find the correct info online and I'd like to be as accurate as can be (though I'll obviously take liberties in some places for the sake of the story).

TIA

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Accuracy in a comic book media, huh? Actually, you've wrote “arc reactor” in comments so I'm guessing you're going the MCU route, but I applaud you nonetheless. I love accuracy in fics, especially in this arena. Delicious food indeed.

As a side note, you're gonna LOVE this [from @koalablu]. Enjoy the whump fuel. God, Tony's life must've sucked with that thing in. No wonder 616 Tony was such a woe-is-me-depressed-and-serious-is-my-middle-name in the comics. Well. It's certainly one of the many reasons anyway. Also explains why MCU Tony went off the rails in IM2 too I guess; just wish they would’ve shown it more, even if it wouldn’t have been great action-superhero-film footage for the average cinema goer.

Another side note: I have no idea why everyone immediately assumes Tony would’ve hid the arc reactor from medical professionals, mostly because he wouldn’t have been in mindset to be able to in the first place but also because the damage would’ve already been done and he had outrageously good (and numerous) lawyers to advocate and enforce on his behalf anyway. No, that’s a lie, I do know why. We have the benefit of hindsight and knowing how the film, comics, and shows go. Tony didn’t.

Also, you have to remember that he didn’t know it was an inside job at this point and he did believe he was the only person on the planet who could miniaturize a reactor, so what did it matter if they eyeballed it? It wasn’t like Dr Joe Schmo from Cardiology could replicate the most advanced battery on the literal planet, you know?

Anyway, time for my soapbox with an obligatory “source is my whole-ass career”. You said you wanted realistic and accurate, so I'm gonna give you realistic and accurate. Sorry about the thesis of a reply but 1) I’m a writer; 2) I don’t know how to shut the fuck up; and 3) and this is my area of expertise LOL. I was a 1N0 in the United States Air Force for a Very Long Time and would still be doing it if, well, I wasn’t a national security threat to the current political whims of the current U.S. administration (i.e. part of the LGBTQ+ community). In any case, as part of my job, I worked with every branch of the U.S. military, NATO, and allied nations in Combat Search and Rescue (CSAR) operations, including in Iraq (IRQ) and Afghanistan (AFG), and while 2008 was before my time in service, the checklists haven’t really changed in all that time and remain pretty much the same, barring a few of the standard name and contractor changes. Os gonna O because OPR season.

Anywho, I'm gonna tailor this to the MCU instead of 616. If you'd prefer 616, let me know, since it's absolutely different how 616 Tony would've reacted to both medical help and a U.S. Government (USG) debrief after...well, actually, 616 Tony flew himself to a U.S. outpost and didn't crash in the desert/jungle, but 616 Tony is a different breed of character.  My point is that they are two absolutely different characters, particularly post-kidnapping, and have to be addressed as such.

That being said, most of the information is going to translate to both 616 and MCU Tony, i.e. medical care and the USG’s focus on acquiring intelligence from a U.S. citizen’s time in captivity.  The only major difference is how each Tony would’ve reacted to the medical confinement, the intense debriefing by the USG, and their personal feelings about the military industrial complex at the time period.  For instance, 616 Tony continued to sell weapons to the USG for a significant period of time after his captivity, especially prior to the Vietnam-to-AFG retcon to account for Marvel’s sliding timeline; MCU Tony, on the other hand, immediately noped out of that shit.

So this is how the whole thing would've gone. Probably. Within reason. There’s a saying in the military: it depends. And in this situation, the human factor (not to mention the comic/film element of wand-wavy everything) is going to result in some ‘it depends’ in the realism department because people like Tony Stark don’t exist. Gotta suspend some elements of belief to have a compelling story because real life is bureaucratic as fuck, especially when it comes to this particular bureaucratic machine. Trust me on this one.

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ONE:

He would've been given immediate care from a combat medic in the HH-60 PAVE HAWK helicopter (what we in the U.S. Air Force would generally call a rotary-wing ‘helo’).

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At this point, especially if in a delusional mental state brought about by heat, pain, adrenaline crash, and sheer relief, Tony might have freaked out and refused treatment from anyone, maybe even Rhodey, because of the arc reactor and the lack of space to hide it from the rest of the crew. More realistically though, he wouldn’t have freaked out. Between the hormone dump and subsequent exhaustion of being rescued, his almost certain lack of concern that any aircrew on board would be able to replicate the reactor or were responsible for his captivity in the first place, and the lack of space to enable a full-body examination, he wouldn’t have been too concerned about being looked over by a medic.

They probably would’ve stripped his shirt, yes, and examined the device, but 1) Stark lawyers are scary; 2) no one in those classified CSAR ops is going to lose their status/job/clearance/etc by blabbing about their target’s medical issues to anyone outside of official military debrief anyway; and 3) MCU Tony might’ve said something about ‘glorified pacemaker’ to stave off questions if he was awake at this point, which honestly is very unlikely. The aircrew would’ve mentioned it to their intel team, yes, and we’ll get to that in a sec, but otherwise, they’re keeping their mouth shut. They would’ve never made the cut for their particular job(s) to begin with if they had loose tongues and Tony would know that even in a delusional mental state, which he didn’t even seem to be in.

If he had freaked out though, the combat medic, almost certainly with Rhodey’s consent (as his probable emergency medical proxy via Stark Industries when he began his hunt on SI’s behalf on loan) in the face of Tony looking like he did, would’ve stabbed Tony with a sedative and treated him anyway. Nothing Tony can do to stop that, even in court with his money and his expensive, insanely competent army of lawyers. Besides, Tony almost certainly wouldn’t remember it anyway with the type of drugs medics are carrying, especially in combination with morphine injections that come standard in every med kit.

The treatment would've been for heat stroke, heat exhaustion, any contusions (he clearly had those), broken bones (he probably would have had those and was powering through on pure adrenaline, though the film seemed to hand-wave it away tbh), and other things that are considered life threatening or potentially maiming, i.e. things that are emergency issues that need to be patched up en route to a hospital until the doctors can address it in a sterile environment. It goes in order of necessity: take care of the sucking chest wound, then the head wound, then the broken leg, then the knife sticking out of the back, then the burns on your arm, then the cuts on your face, then-then-then, y’know? Eventually, the medic either 1) runs out of things to slap a metaphorical bandage on, 2) the injured service member (SM) gets to a hospital, or 3) the injured SM dies. Standard shit in a combat zone, especially in AFG and IRQ.

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TWO:

Tony’s helo would arrive at Craig Joint Theater Hospital (CJTH) at Bagram for treatment.

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The Ten Rings wanted MCU Tony working on the Jericho and Yinsen was, in fact, a pretty good doctor that kept him functional, so Tony was in good shape despite the asskicking his body took during the escape and the reactor itself. He would not have been malnourished or deficient of any vitamins, minerals, calories, etc. As shown in the suit construction montage, MCU Tony was physically very healthy prior to his escape despite the early beginnings of palladium poisoning (that he probably didn’t even realize was happening) and the reactor side effects themselves such as increased risk of infections and asthma (see the link given above for more).

After his escape, the only thing he would’ve been dealing with based off subsequent scenes in IM1 and pure logic were contusions, burns, and lacerations of various severity; a probable dislocated shoulder; probable dehydration; probable electrolyte deficiency from the hike through the desert, and probable heat exhaustion and/or possible heat stroke. And, y’know, PTSD, but I digress on that front.

We know it wasn’t anything worse than this because when he gets off the C-130 in California to meet Pepper, all he had was a sling that he practically ripped off immediately after, some sutures, a lot of butterfly bandages, bruises, and a slight limp that practically disappeared soon enough too. Anything worse and we would’ve seen casts, wheelchair use, more sutures, and stuff like that. Or conversely, we would’ve seen no injuries at all because he’d been held in recovery at a hospital like Landstuhl in Germany, which is where everyone is taken when local military hospitals can’t treat SMs or military-associated civilians/contractors, for longer.

(Though I think he probably would have had fractures in at least his feet and legs because reality reasons but comic book/film hand-wavy stuff fixed that apparently because we see no casts and he wasn’t walking like he had broken ribs, but then again, he’d actually probably be dead from a crash like that so I’ll let it go LOL)

So anyway, for a timeline on this sort of minimal treatment, CJTH would’ve been able to treat Tony well enough without an airlift to Landstuhl and it would’ve only taken about a few hours total to treat the overall fluids, shoulder, sutures etc, and also run bloodwork, CTs, MRIs, full body scans, and all that shit to make sure he wasn’t bleeding into his brain or whatever. Gotta protect that brain and body, y’know? Then, once they were sure he wasn’t gonna die from internal bleeding or something, they would’ve kept him overnight for observation and to monitor his fluids, resting capability, and trauma response.

Of course, it’s theoretically possible he could’ve been taken to a civilian hospital but, yeah, that’s not gonna happen in the real world. Not before he’s debriefed by everyone and their grandmothers anyway, but we’ll get to that in a second. First, the USG and their loyal attack dogs, the Department of Defense (DoD), have to make sure their primary defense contractor isn’t going to croak before giving them the juicy intel they want, y’know? That’s all the DoD and USG gives a shit about, especially since the MCU’s USG is secretly infested with HYDRA at this time: they’re gonna want to know what Tony might’ve figured out ASAP.

So they gotta get him bandaged and hydrated, check his levels, do his bloodwork, pump him full of fluids and shit, and yeah, they’re gonna do that in a military hospital where the USG and DoD and can keep all their eyes on him at all times. Docs are also gonna keep him as cognizant as possible because 1) he didn’t seem too injured when he was stumbling through the desert, though that might’ve just been pure stubborn adrenaline; and 2) intel and USG officials are gonna wanna drill the fuck out of him. Again, we wanna know what he knows, for good or for ill depending on who’s reading the reports.

I doubt Tony would’ve really lawyered up here but he might’ve threatened it if his reactor was being poked at by doctors at this point, where he was mentally and hormonally stable. And you know what? The USG wouldn’t have cared a single iota about fighting him on it. Bro was mentally there, his cuts and burns were being treated, no broken bones that were obvious on screen (unless the editing team did an oopsie), and all that, and like I said, we really prioritize getting intel. Every nation does. That’s, like, how geopolitics works. So if Tony’s medically stable and starting to get a little obstinate about this little one thing, might as well move on if it means keeping him calm and cooperative, especially if it gets the USG (and by extension HYDRA) to the intel faster.

And from what we were shown and told by the film, that’s exactly what happened. He wasn’t throwing a fit or threatening lawsuits or talking about shutting down weapons until that impromptu press conference back stateside, so obviously Tony was playing ball with the brass and wasn’t rocking the boat. He was doing what he was told, playing the game, and all that jazz. Tony wouldn’t have been allowed to return to the continental U.S. (CONUS) no matter how much money or lawyers he had unless he was debriefed period so he clearly did the debriefs. There’s no way he didn’t. It’s...literally impossible.

Yet another side note, but S.H.I.E.L.D. WAS IN THESE DEBRIEFS!!! Actually, it was probably Coulson who was in the room, considering Fury and IM1, and 1) Tony probably didn’t remember him because MCU Tony and 2) Pepper hadn’t been in AFG to recognize him. Anyway, S.H.I.E.L.D. simply wanted a second, more in-depth brief with Tony post-CONUS return specifically tailored to the Iron Man suit, since the USG/DoD clearly hadn’t been privy to that detail of Tony’s escape and Fury & Co hadn’t wanted to divulge their knowledge of said detail. Fury hoards shit like that.

Though how the USG/DoD didn’t know about it, I have no idea, and that’s all I’ll say about that.

A third side note: at this time, Rhodey and the rest of the aircrew/medics/personnel that were on the rescue mission are going through their own debriefs with intel, just like Tony will soon be with the same folks. Rhodey’s not gonna be chilling at Tony’s bedside, advocating on his behalf or anything—he’s gonna be stuck inside a debriefing room eating Bagram snacks, probably in his sweaty ass flight suit because they wouldn’t have allowed him to shower or change because that’s Standard Operating Procedure (SOP). Tony’s going to be completely and totally alone here in his hospital bed, probably on some nice non-opioid painkillers to keep his mind clear and to allow him to be his own medical proxy.

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THIRD:

Tony is officially discharged and goes immediately to debrief, which is done by intelligence personnel.

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Please note that for obvious reasons, I’m going to tailor this to an appropriate classification level that you can find and assess for yourself via information from any open-source medium, so please keep that in mind as you continue reading the following information. In reality in the military/intelligence apparatus, there is going to be some variation but I can’t go into additional detail.

Now, Tony’s debriefs are the same type of debriefs that Rhodey, the aircrew of the helo, the combat medic(s), the PJs/SEALs/Rangers/blah attached, the JTACs that were probably supporting the op, and so on are doing. Literally everyone associated with this op is gonna give a debrief to the intelligence apparatus, which is going to be written up into a product called a Mission Report (MISREP), which itself is gonna be passed to everyone and their grandmothers in their respective government. Including HYDRA in the MCU, undoubtedly.

We, i.e. the intel personnel asking the questions during debrief, will be a compilation of all U.S. military branches (USA, USAF, USN, and USMC) + U.S. alphabet agencies (DIA, FBI, NSA, CIA, NRO, and other U.S. smaller agencies that will probably sit in with the bigger kids). In addition, there may be a FVEY (Canada, UK, New Zealand, and Australia) and NATO folks, military and civilian/contractor, that could get their own debrief with U.S. escort, depending on how you want your story to go, but we’ll get to that at the end.

This is a long, exhaustive process that makes the aircrew/SMs being debriefed want to die a painful death but at least there are (usually) snacks and (occasionally) booze to make the process slightly less of a nightmare. If you can think of a question, we’re asking it. How it would work in this situation is, if I was the intel body debriefing Tony, I’d sit his ass down and say, “Alright Mr Stark, start literally from the second you landed on the tarmac at Bagram on [date and time].”

And I’d ask him what he did, ate, drank, who he talked to, what route he took in the convoy, how many HMMWVs in the convoy, who was in the HMMWV with him, what they were talking about, what time it was when the IED hit, what side of the road it blew, how many enemy bodies opened fire, what the arms were, how long was he out, what did he see, what was the temp of the cave, what did the cave look like and describe the network of tunnels, describe the combatants, describe the languages he heard, tell me any phrases and words he heard, describe the people he saw, tell me the weapons he saw, yes I know you destroyed it but you don’t know if they removed anything prior to destroying it so tell me anyway, tell me about Raza, tell me about Yinsen, where was he from, what was his family like, what did you eat, what did you wear, what did the water taste like, what was the entertainment like, did they tell you where they got your weapons, how many weapons, how did the weapons get transported to that area, what heavy equipment did they have, what was their road system like, what infrastructure did they have outside the caves, what type of tent structure did they have, what was their electric like, what was their petrol and oil like, what was their water and sanitation like, how many people were there, did they have money influx or were they in poverty situation, did they have sufficient food and water influx, did they have excess food stores, did they have animals, did they have medical access outside of Yinsen, did the troops use Yinsen or did they have separate medical care, did they have animals for transport or did they use vehicles or other transport, etc etc.

There’s a metric fuck ton of shit we ask about and I could be here literally all day giving you examples. There is no detail too small or seemingly insignificant. We try to make it easier by asking the SM, civilian, or contractor we’re grilling to tell it like a day-by-day story, which as you can imagine in Tony’s case would be long. We take notes as they go and ask a barrage of questions at the end for clarification or extra details.

Our major focus in the military is, obviously, weapons and weapons depots, infrastructure (transportation, power networks, soft ‘centers of gravity’ like hospitals/schools/gyms/homes/things like that, military and intelligence nodes, etc) and stuff like that. Other agencies or nations will have other priorities. Point is, a debrief can take literal hours. Longest debrief I ever personally gave was nine hours, poor bastards, and both the aircrew I was debriefing and my intel team had been awake for about 86 hours at that point, and that was nothing like Tony’s situation. So it’s a fucking process and it’s genuinely not fun, but it’s also really fucking important when it comes to a combat zone. We gotta make sure that shit doesn’t happen again, you know?

And yes, some of this will be proprietary information, or near-proprietary anyway. The USG/DoD has a classification level that covers this sort of thing called Special Access Programs, or SAPs. Rhodey, as the Stark Industries liaison, is undoubtedly covered under that classification in the MCU. Any engineer, maintenance troop, or military body who regularly operates or uses any SI product would need to be read into a SAP as well, and so do the intel personnel who would need to debrief those experts too because we need to know what the fuck they’re talking about when we’re relaying that info to the DoD and USG policymakers, if that makes sense?

Anyway, SI stuff would be covered under these SAPs, and Tony would know this. His legal team (and lbr Obadiah himself, not to mention Howard) at SI would have required it before selling to the USG and NATO in the first place. I seriously doubt he’d go into excruciating detail and would keep some things/suspicions close to chest but he definitely wouldn’t bother with hiding the fact that the Ten Rings had SI weapons. Military would’ve found that out at the convoy site, not to mention the wreckage of the cave site itself lol. Tony’s not stupid enough to lie about that shit.

Now, the debriefing process as a whole is based on classification level. In Tony’s case, he’s going to go in for debrief with intel bodies at the highest classification first, specifically a debrief with U.S.-only TS//SCI with the Stark Industries-related SAP-cleared bodies mentioned earlier. That’s probably gonna be in a hot-ass, too-tiny SAP-cleared SCIF that is crammed with way too many people for Tony’s comfort, but not as many people as you’d think. Not a lot of people get that sort of clearance. Maybe about 25-30x total would be in the room with Tony, generally 6-10x from the U.S. military and the rest from the alphabet U.S. agencies, and it’ll take an hour or two at minimum. Considering how long he was captive and the nature of Tony’s job/captivity, probably a lot longer.

Then, once he’s finished with that long-ass TS//SCI//SAP debrief, they’ll ‘downgrade’ the SCIF (let people who aren’t SAP-cleared in) or move to a bigger SCIF (more likely at Bagram tbh) so they can do the next debrief. This debrief will be literally the same thing for Tony, except this time it won’t include the SAP stuff. They’ll talk about the weapons but they won’t go into crazy detail about near-proprietary stuff, naturally.

In any case, there will be a fuckton more people here from a lot more U.S. agencies and the U.S. military since it’s a lot easier, comparatively speaking, to get a TS//SCI clearance without a SAP qualifier. This means a lot more time and questions in a perfect world, but at this point, Tony’s probably feeling pretty obstinate like most people I’ve debriefed or watched get debriefed at this point. Answers get short, snippy, and frustrated even with food, booze, and/or drugs, and most people in the intel community realize that if they don’t wrap it up ASAP, the person/people getting debriefed is/are gonna vault over the table and rip your balls off, probably with their actual fucking teeth.

In case you were wondering, this is where the intel community and their associated orgs get annoyed with each other. No one likes to share and everyone likes to hoard their info because fuck everyone else, we’ve got the info and you don’t hahaha you losers, get a sexy clearance like the rest of us awesome intel pros. Which isn’t fair because getting clearances usually comes down to getting Congress to allocate funding, acquiring appropriate advocacy, national priorities, kissing ass, what party’s in charge of the White House, and other such trivialities. Still, it does cause problems because if the right people don’t talk to each other and share info, then it causes Big Problems. But anyway, I’ll leave that there.

So roughly the same questions are being asked as the first debrief, and if some SAP questions are asked by intel bodies without them knowing they’re SAP questions, Tony can say “yeah, no, not answering that, sorry bud” and the intel body who asked the question can kiss Tony’s entire ass about it. Other people can also tell the question-asker to pound sand, because there will be others in the room who’ll know what questions or answers are off limits too, probably at least one SI lawyer at this point since the initial TS//SCI//SAP brief probably took enough time to get a corporate international SI attorney from Europe to Bagram, but at least two intel bodies read into that sort of thing who missed the SAP-specific debrief. But I digress.

Anyway, after the U.S.-only TS//SCI debriefing is finished, in which Tony’s patience is probably non-existent, everyone will filter out, Tony will get a break to sleep, eat, and decompress because our allies in FVEY and NATO aren’t an immediate priority. Plus he needs time to talk to his legal team, put together his travel plans for CONUS return (probably will fly from Bagram to Germany and then to the U.S., for the record), and internally scheme about shutting down weapons production.

This is where it’ll get iffy based on where you want to drive the debriefs and tone of your story. If you want Tony a bit more injured, maybe to the point of needing to be airlifted to Landstuhl and spend a few weeks to a month in Germany recovering and doing debriefs there instead of at Bagram AB, then Tony would definitely give a FVEY and NATO debrief. He would’ve had the time to do so, not to mention he would’ve been in close proximity to Ramstein and Stuttgart, the command node for most NATO and FVEY operations in Europe, Africa, and the Middle East. So there’s no realistic reason why he would’ve refused to give a debrief at a downgraded level for our allies, especially since they would’ve been helping to fight the Ten Rings.

If he was minimally injured, though, and had just trudged through reliving the worst fucking moment of his life to the most minute, clinical amount of detail by a bunch of intel guys, gals, and pals, I can definitely see Tony telling the USG/DoD to go fuck themselves. And intel teams can definitely work with that by going through our information, downgrading the info ourselves, and releasing it at a classification appropriate for our allies. It takes a lot longer even whenever we’re rushing it like a mofo (and it took even longer back in the day lol) but it can be done.

So yeah, once he’s finished with debrief, he’s cleared to go. He has to be available for any post-op questions—and there will definitely be post-op questions, though at this point MCU Tony’s in a battle of wills with the entire USG/DoD and SI’s Board of Directors so his give-a-fuck factor about post-op questions is in the negatives, though 616 Tony would’ve been totally on board if that’s something that matters to you—but he’s cleared to go.

Another reason why I think MCU Tony was minimally injured and cooperative about debriefs is because he was in a C-130 when he disembarked in California. If he’d been an asshole and dug his heels in, he would’ve been in yet another black hole (this time a legal one to Obadiah’s glee) until he talked to intel, but instead he metaphorically skipped his happy ass off a military big boy with all his recent injuries on display, including shallow cuts that would’ve healed if he’d been obstinate.

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To conclude

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So. Anyway. That’s my spiel. I’m here for any follow-up questions I guess? I am so sorry for the length and any SPaG errors that may be littered here. Didn’t expect to ramble this much but also I should’ve known better because I’m a wordy bastard. Feel free to DM me or just comment for any other questions and I’ll answer. Love this topic and I’m so here for this!

Looking forward to your fic and hope this helps???

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