Monday, 30 July 2007

Week 26--A Look Back.

As we pass the midpoint of this 12-month tour, it seems like a good time to look back on where we came from and what we’ve experienced in the last six months.

In January the 396th CSH (FWD) left Camp Atterbury, IN enroute to Afghanistan in support of Operation Enduring Freedom VIII. After three months at Camp Atterbury our journey took us by bus to Pope AFB, then by air to Bucarest, Romania, Manas Airbase and finally Bagram Airbase before we separated to our three locations in Afghanistan.

The flight was an adventure, with a three day layover in Romania due to bad weather at Manas AB.

By the time we arrived at FOB Salerno we were tired and disoriented but ready to get started on our new adventure. In just one week we completed the right seat/left seat ride with the 14th CSH and we were ready for the change of command and transition of authority (RIP/TOA).
Finally, we were running the hospital!

Unfortunately, the honeymoon did not last long, as a suicide bomber hit the front gate of the FOB the same day the 14th CSH personnel departed.

We did well, but it was a bit overwhelming dealing with so many casualties, both dead and dying, on our very first day. It was a rude introduction to life in Afghanistan, particularly for our first-time deployers.

At the same time we were learning our jobs, we were meeting our USAF partners. The USAF medical personnel rotate every 120 days, so we will have the opportunity to meet and work with four different groups of USAF medical professionals.

And besides our core missions of patient care in the Emergency Room, Operating Room, Intensive Care Ward, Pharmacy, Laboratory, X-Ray, Medical Supply and Hospital Headquarters we had to learn other new skills.

Very soon we learned how to work with MEDEVAC aircraft, both sending and receiving patients, and with USAF Air Evacuation aircraft, usually C-130s. It would have been nice to practice some of these skills at the mobilization station, instead of waiting until we were here, in Afghanistan, dealing with real, live patients!

And there were other new experiences, like flying in UH-60s over the Afghan countryside. Flying in 20th Century aircraft over mud homes and ancient farmlands is quite a contrast.

Over time, all these things have become routine. We can hardly remember Camp Atterbury, but we will be glad to get back there on our way home. We receive casualties almost every day now, some with terrible injuries, but that too has become routine. We evacuate patients on fixed wing and rotary aircraft weekly, if not daily. We jump in UH-60s or STOL aircraft or C-130s like they are taxis or buses, without a second thought. We look forward to the next change of command and RIP//TOA since that will be our ticket home. We’ve become used to transitions and turbulence since our USAF personnel rotate every 120 days, our USAR surgeon and CRNA rotate every 90 days and our 365-day Soldiers are always leaving on or returning from R&R.

Finally, we are looking forward to seeing the clear, cold days of winter and the snow on the distant mountains. Summer here is hazy, so the distant mountains are rarely visible.
The clear views will indicate our imminent departure, our return home and our reunion with our families and friends.

As always, thanks for reading this blog, praying for us and supporting your troops.

Phillips, out.

Wednesday, 25 July 2007

Don't You Just Love It When a Plan Comes Together?

Thanks to help from a patient support team, I now have my comment button back.

Any comments on the new look?

I'll be back posting soon.

Phillips, out.

Saturday, 21 July 2007

Week 25--A Typical Day

There is no typical day at a forward surgical hospital. It's like working in a big city emergency room/trauma center 24/7/365. There are slow days where I get to the gym and the bazaar and hang out with the guys. There are other days where it is busy from dawn until late at night with traumas and surgeries and patients on the ward. And there are lots of days in-between. But every day is an adventure.

This week was crazy. Lots of days with lots of traumas. A few deaths. And a few quiet days.

There was one landmark today; Our longest-stay patient, Azad, has moved to our Afghan surgical hospital. He's doing very well and his family is visiting him now. His youngest sister in 17 days old. His family is looking forward to going back home. Their gratitude is overwhelming. The gratitude of all our Afghani patients is overwhelming.


And we continue to improve the current hospital, even as we build a new one right next door. Last week we had a flood in the ER. So, we replaced the floor in the ER, raising it enough to so the next flood will go below, not above, the floor.

And every day the new hospital gets a little closer to completion. Soon, we'll be out of the tents and into a hardened structure.

No, there is no typical day here at the Salerno Hospital, but there are few boring days. Overall, it's a great place to serve Soldiers. If you like taking care of patients, there's no place better.

I'll try to be a more reliable blogger.

I'm sorry to the lack of a comment button. It went away, and I don't know how to get it back! :-(

The comment button is back. Thanks for all the advice.
Don't you just love it when a plan comes together?

Phillips, out.

Wednesday, 11 July 2007

Week 24--NSTR

NSTR--Nothing Significant To Report. It's a term we use on reports when there is nothing else to say. It always reminds me of the movie "All Quiet on the Western Front". If you've never seen the movie I'll just sum up by saying that in a war, even when nothing is happening, there is always a lot going on.

This last week was quiet. But I guess my standard of quiet has changed over time. When I think about the week I try to remember all the patients that have come through the hospital:
Two patients with gunshot wounds to the chest, one patient with shrapnel wounds to the neck, one patient with a traumatic amputation to the lower leg, one patient with a skull fracture and C-Spine injury from falling out of a truck and four patients from a vehicle accident, all with various cuts, scrapes, bumps and bruises. And those are just the trauma patients that come to mind right now. And that does not include the various scheduled cases in the OR; spleens and thyroids mainly, but also various abdominal and breast masses. And to facilitate all this patient care are the numerous MEDEVACs and Air Evacs for patients coming and going from the FOB. And all the training, in between patients arriving, to prepare for the next case. When all is said and done, even a quiet week around her is very busy.

And the good news continues. Azad, our current long-term patient is getting better every day. He's transitioned from a somber, sad patient into a little boy. He smiles now, and enjoys the attention from our staff. He particularly enjoys trips outside to watch the helicopters come and go and the trucks drive by the hospital.

And I got to see another FOB recently, where I found a Walmart. Those things pop up in the strangest places!

The movie details the events of one day and how much impact they have on the individuals involved, and how those same events are viewed from headquarters. I guess the significance of any event is dependent upon your perspective, and how much it affects you personally. But more on that in a future blog.

Phillips, Out.

Wednesday, 4 July 2007

A Correction

In the interest of full disclosure, I'd like to point out that the mother and baby I referred to in my Week 23 post were actually treated initially at the 541st FST. They delivered the baby, a healthy 5 and 3/4 pound baby boy. We received the patients after the delivery and continued the care of both until we transferred them to a Afghan children's hospital in Kabul.

It was truly a team effort, one worthy of being told correctly. Many hands played a part in that good outcome, but it all begins at the first point a patient enters into our system, in this case the 541st FST.

I meant no offense to my esteemed colleagues and I am happy to set the record straight.

Phillips, out.

Tuesday, 3 July 2007

Week 23--Soldier On

During these slow weeks it's hard to think about anything to say in the blog. No drama and just the regular trauma, another hot summer week in FOB Salerno, Khowst Province, Afghanistan. It's weeks like this where we just Soldier On, doing our jobs and waiting for that magical day when we can redeploy.

Most of us spend an inordinate amount of time planning our redeployment, our return home. No matter how many times the Chaplain tells us not to idealize things back home, we do it anyway. When you are separated from home and family it's easy to remember everything through rose-colored glasses. It's great for getting through the deployment, but it can make things harder when you actually get home. Despite the fantasy, life goes on at home just as before; children grow up, spouses become independent, coworkers and friends move on. As we idealize life back home, and as life goes on back home, the gap between the fantasy and the reality grows larger and the transition becomes more jarring. It's all just part of the hidden stresses of war. Not all wounds are visible. Not all pain is obvious. Not all casualties of war are Soldiers.

But as we Soldier On we find ways to mark the passage of time. For me, I watch the new hospital construction and think about the day when we have a clean, dust free work environment...and indoor plumbing! It continues to progress quickly, and I continue to be amazed at how hard the host nation crew works every day in the heat and dust and rain and mud.

And even in the heat, there's always a fire, and kettle, and tea. Chai tea is popular in the US (at least it was when I left, almost 6 months ago!) but here it is just part of the diet; everyday fare. Whenever I eat with the locals, tea is on the menu. Even at the construction site, tea is served!

And of course, we always have our patients. Azad has been with us for almost two months. Wounded by shrapnel from a mortar round, he spend 6 weeks in our ICU. Now that he has recovered from his wounds he must now recover from the ICU. I never knew how hard it is to recover from being in the ICU; on a ventilator, paralyzed and sedated. Our nursing staff has done wonders with his rehabilitiation. We are not set up to manage these patients, but we do it anyway. My nursing staff is second to none when it comes to compassion and caring and competence. And Azad is a special case. His family is from a Kuchi tribe, a nomad tribe. His family raises sheep and moves between the mountains and the valleys, depending on the seasons and the weather. It has made for some interesting challenges; Azad has never used a western toilet, he cries if you try to make him. He prefers to squat in the trees. He eats with his fingers. He's not used to toys, so he mostly just stares at all the toys we give him. But he loves his father and he can't wait to go home. I guess some things are universal.

And finally, I decided to try some local clothing options. Here, I am dressed as a traditional Afghani man. Not the hat and vest over the loose-fitting pants and shirt. But, unlike almost every Afghani adult male I have seen, I have no beard or mustache. A definate mistake if you are trying to blend in with the locals. I guess I'll never be sent into town on an undercover job!

As I approach six months on this deployment, and almost 9 months away from home, I know there are many more opportunities for me to Soldier On, and for my family to hang in there waiting for my return. I'll keep blogging, even during the slow times, so you can see what we are experiencing here and in all the places where Soldiers, Sailors, Airmen and Marines are serving this great country of ours.

Happy 4th of July! Happy Birthday USA!

Phillips, out.