Princess Salerno

Original Publication at Michael Yon Online Magazine - "Princess Salerno" 22 MAR 2010

Salerno child, Paktya Province, Afghanistan - 2003
Photo Courtesy of SFC Dan Biesiadecki

The 909th FST saw many children during their first deployment of 2002-2003 in Salerno, Afghanistan, Paktya province, but one beautiful child gripped their hearts. Anyone who saw her then, or sees her image now can't help but feel driven to care for her, and the 909th did just that with all their heart. They waited on her hand and foot - A pattern that lead the FST to crown her "Princess Salerno".

The young princess had a broken leg. The local treatment was to smear egg-whites all over her body and wrap her leg in what appeared to be something much like a tiny picket fence. Such is the level of medical treatment in the deep rural areas of Afghanistan.

There are cities in Afghanistan with at least a modicum of adequate facilities to take care of the population. However, getting to the hospital from a remote village is a challenging prospect. Notwithstanding the fact that getting to a hospital does not mean that there will be anyone there that has the ability to treat you.

Orgune father with baby girl - Paktika Province, Afghanistan 2010

Fast forward 7 years. Fortunately for the people in and around Orgune, Afghanistan, the hospital is unable to treat the problem, then they can send the patient to FOB Orgun-E. At present time there is a consistent flow of injured children. Most injuries are not battle related.

The first day I arrived a young baby was brought in to see us after a week with colic and vomiting. The parents went to the local bazaar and collected at least 7 different medicines ranging from simethicone to antibiotics to extremely dangerous medicines like phenobarbitol. What the baby had was an incarcerated inguinal hernia and needed emergency surgery. Fortunately, the incarcerated bowel was not permanently damaged and the baby recovered quite well. Without our intervention, the baby would have likely died in a matter of days.

Orgune boy - Paktika Province, Afghanistan 2010

"They don't cry", LTC Randy Hoeppner, noted from his previous deployment in Iraq. I see the same pattern continue with the children of Afghanistan. I don't understand why it is that these young boys and girls don't cry like American children would normally do. They seem to be too young for it to be a cultural influence. It is somewhat disturbing. This Orgune boy had a large cut to his left ankle, reportedly from a dog bite. It took him 5 days to make it to the hospital, who then sent him to us. I did not see any clear evidence consistent with a dog bite. There was a 4cm long laceration across his ankle. There is no way of telling what actually happened. We simply provided the best medical care that we could and hoped that they would return if there were any problems.

Medic from the 541st removes bandage from Orgune boy's ankle - Paktika Province, Afghanistan 2010

There are many injuries these children are at risk for and it shows given that the average life expectancy for an Afghan is only 46 years. In the two weeks I spent at FOB Orgune-E, in addition to the above patients, we saw 2 children with femur fractures from reported falls, a child with a hand fracture, a baby with soft tissue infection and 2 children with burns. Burns are especially prominent in this population. The Afghans have bread ovens that are dug into the ground, and it is not uncommon for a child to fall into these pits.

Soviet PFM-1 antipersonnel mine

Unfortunately, the children are also subject to injuries of war. There are still incidents of children being injured or killed due to mines. The Soviets had indiscriminately littered the Afghan countryside with a myriad of different mines. One of the most common is the PFM-1. This mine doesn't even look like a weapon. It is small and meant to be picked up and played with. You can fold one of its wings, clicking it back and forth, all the while not realizing that you're simply playing Russian roulette. Children are especially vulnerable to these mines and the FST at FOB Orgun-E has seen the impact they wreak on the children.

SSG Neumann, 909th FST comforts a young girl from local village, Logar Province, Afghanistan 2010

It’s also easy to just be in the wrong place at the wrong time. The Taliban have no rules of engagement (ROE) and they certainly have no regard for life, no matter how young, innocent or precious. The young girl above (approximately 8 years old) and the young boy below (approximately 6 years old) were playing near coalition soldiers that were dismounted in a local village just outside FOB Shank, Logar Province. Someone in the village tossed a grenade over the mud wall sending grenade fragments into these young children. (note: no-one knows their age in rural Afghanistan - they guesstimate based on the crop cycles)

Young boy from local village, Logar Province, Afghanistan 2010

Despite having been injured by a grenade, neither of these two children cried. The girl had a large grenade fragment embedded into her ankle. The boy had a fragment penetrate his abdomen, causing life-threatening injuries.

LTC Mike Bruce (L) and MAJ Joe Sucher (R) during operation on Afghan boy
FOB Shank, Logar Province, Afghanistan 2010

Both children required multiple operations due to their injuries. Dr. Bruce and I explored the abdomen of the young boy, repairing the damage done. Dr. Baier operated on the young girl, removing the grenade fragment and cleaning the fractured bone and soft tissues.

LTC James, LTC Hoeppner, SGT Anderson (background) and MAJ Aitchison provide postoperative ICU care
for young boy - FOB Shank, Logar Province, Afghanistan 2010

The children are recovering well as I type this post. The young boy will require at least 7-12 days of hospital care. He will recover fully and be playing in a matter of weeks. The young girl’s recovery will be longer, as the grenade fragments injured the bones of her ankle. She will be able to walk well, but will have permanent difficulty with running.

Afghan child recovering from grenade blast with older brother at her bedside
FOB Shank, Logar Province, Afghanistan 2010

The 909th FST, along with the “Charlie Med” team of the 173rd will hold on to these children until they have completely recovered. There is nowhere else for them to go and get this level of medical care. They are the now the Prince and Princess of Logar.

Princess Salerno - 2003
Photo Courtesy of SFC Dan Biesiadecki

Princess Salerno recovered from her broken leg and became a favorite memory of the 909th after their return home in 2003. There is no way of knowing what has become of her over the ensuing 7 years. The team would rather just simply think of her just as she remains in these photos. A beautiful, innocent, princess child.
This is the Afghanistan that we should focus upon. The children are growing up under generations of war. It is no wonder why it is so easy for them to be turned into radical Islamists. They are indoctrinated via the madrassas that had exploded in numbers during the 1980s through 1990s. This country has been manipulated into this radical culture from outside influences. In my humble opinion, if we are to win the battle against radical Islam and terrorism, then we will need to invest in multiple generations. This is a marathon, not a sprint. Anything less than this full, long-term effort will only result in what we have now. History will repeat itself.

Original Publication at Michael Yon Online Magazine - "Princess Salerno" 22 MAR 2010

Strongmen of the Sky

On March 26th, the 173d Airborne Brigade Combat Team held it's Strongman Competition. Soldiers from Alpha Company, Bravo Company, Charlie Med and HHC all participated as five man teams.

The teams participated in six events; Bench Press, Squats, Military Press, Dead Lift, Situps and the Jerrycan carry.

The weight lifting and situp events were scored based on the amount of reps performed at a set weight. All the soldiers lifted the same weight regardless of body size. The Jerrycan carry required the soldier to carry two cans of water up a hill for a total of three trips.

The 909th participated with two of it's strongest men, SPC Thompson Nguyen filling out the team of Alpha Co., and SGT Brian Anderson as part of Charlie Med Co.

SPC Nguyen from Chicago, IL; 909th Forward Surgical Team

SPC Nguyen is a personal trainer in Chicago, IL and serves as one of two surgical technicians with the 909th. This is his first deployment.

SPC Nguyen from Chicago, IL; 909th Forward Surgical Team

SPC Nguyen has a love for high intensity exercise. During the squat competition he needed to perform a second set due to injury sustained by one of his team-mates.

SGT Guzman performs multiple repetitions of squats with 225lbs of weight

The education, physical and combat training never cease, despite being deployed in a combat zone. This competition is just one of many ways that the soldiers maintain a high level of proficiency through well spirited competition.

SGT Anderson from Chicago, IL; 909th Forward Surgical Team

SGT Anderson is a police officer in the Chicago area and serves in the Army as a medic and an critical care licenced practical nurse.

SPC Hall is encouraged by his teammates, SGT Mullins (squatting) and SGT Anderson (far right)

SPC Hall is a radiology technician for the 173d. Above he performs multiple reps of bench presses with 185 lbs of weight.

SGT Robert Mullins, 173d Charlie Med Team performing bench press.

SGT Mullins is a 68W, combat medic, for the 173d. He plans to attend the special forces school after this deployment.

CPT Lesher looks on as SGT Wojcik performs multiple reps of dead lift with 185lbs

MAJ Tom Baier attends to injured soldier

This was a serious competition. Airborne soldiers are highly motivated and extremely competitive individuals. The competition was not without injuries. Fortunately, they were all mild. Dr. Tom Baier served as the defacto sports medicine doctor on the scene.

SPC Nguyen performs multiple reps of military press with 105lbs of weight.

The weather was perfect on the morning of the competition. The skies were mostly blue, and the air was cool with only a very occasional slight breeze.

SGT Guzman performing military press

SGT Whitcomb performing squats at the 173d BCT Strongman Competition. FOB Shank West Gymnasium

The west-side gym is still not quite open. It looks like it will be the largest gym on the FOB. Our east-side gym is packed during the early morning and late afternoon hours. This gym will be more than 4 times the size of our current gym.

CPT Nicholas Nussdorfer - Jerrycan carry event
FOB Shank - 173d Strongman Competition

This west hill leads up to the Czech Republic guard tower. It has a great view of Baraki Barak and the main supply route leading south of FOB Shank. CPT Nussdorfer of preventitive medicine had the fastest time in the Jerrycan carry event.

SGT Anderson being encouraged by members of the 909th. SGT Beisiadecki (L) and SGT Neumman (R)

The 909th FST members had an excellent turn out for the competition. They provided encouragement, and even helped to carry water to the competitors.

SGT Adkinson of Alpha Company completes his Jerrycan carry

SPC Nguyen from 909th FST heads back for more Jerrycans during the 173d BCT Strongman competition.

SFC Beisiadecki of the 909th provides encouragement to CPT Nussdorfer of the 173d Charlie Med Company.

LT Prosko of the 173d Charlie Med company and MAJ Provenzano of 909th FST encourage SGT Mullins (combat medic)
during the last event of the 173d BCT Strongman competition.

Combat medics are some of the best conditioned soldiers in uniform. They have to be. Their fellow soldiers depend on them in the worst of times to quite literally pick them up and get them to safety.

The members of the Charlie Med team provide added encouragement for SGT Mullins during the Jerrycan carry

EXHAUSTION

SGT Adkison

SGT Mullins

SPC Nguyen

The Charlie Med team was ultimately victorious in the Strongman competition of the 173d Airborne Brigade. All the soldiers performed to their limits. They were an inspiration to watch and we were proud of them all.

Shoulder Anatomy

The 173rd Airborne Bridgade Combat Team has honored the 909th Forward Surgical Team with the distinction of wearing their unit patch on our right shoulder in a ceremony held on the medical helicopter landing zone, 25 MARCH 2010.

MAJ Hamilton (far right) of the 173d Airborne BCT addresses the 909th FST
FOB Shank, Afghanistan, Logar Province

The 909th is a free standing medical unit at FOB Shank and thus came with no direct ties to the maneuvering element of Task Force Bayonet - 173d Airborne Brigade Combat Team based in Germany and Italy. The 173d arrived to take over Regional Command East from the 10th Mountain Division in November, 2009. The 909th arrived at FOB Shank and replaced the 8th FST at the end of January, 2010.

First Seargent Brooks (right foreground) of the 173d Airborne BCT removes previous combat patch of SFC Beisiadecki in preparation of bestowing the 173d unit patch - FOB Shank, Afghanistan, Logar Province

It is customary to place a unit patch on a soldier's right shoulder after 30 days in a combat zone. Therefore, this patch is termed the "Combat Patch" and serves as a source of pride for the soldier that wears it. It outwardly binds the soldier to that combat unit. 

MAJ John "Mark" Provenzano (Commander, 909th FST) "slaps" the 173d unit patch onto MAJ Joe Sucher
FOB Shank, Afghanistan, Logar Province

When I was enlisted in 1984, maybe 5% of soldiers had the distinction of being able to wear a combat patch on their right sleeve. Now, with nearly a decade of war in Iraq and Afghanistan, it is a routine sight and probably over 70% of soldiers in the Army wear a combat patch (deployed to a combat zone at least one time). Despite the higher numbers, it remains a source of great pride to wear a patch on your right shoulder.

MAJ Provenzano removing previous combat patch (82d Airborne) from LTC James
FOB Shank, Afghanistan, Logar Province

The 909th was first deployed in 2002-2003 in FOB Salerno, Afghanistan. They were attached to the 82d Airborne Division during that deployment and have worn that patch on their right shoulder until today.

MAJ Provenzano places new 173d Airborne unit patch onto LTC James
FOB Shank, Afghanistan, Logar Province

We are honored to wear the patch of the 173d. They have a long and honorable history. You can read about their history on wikipedia.

MAJ Tom Baier (Left - Orthopedic Surgeon), SGT Brian Anderson (Background - ICU LPN) and MAJ Pam Aitchison (Right - ICU RN) provide followup care for young Afghan girl - FOB Shank, Afghanistan, Logar Province

There are other patches to describe on the uniform of Army soldiers. The left shoulder holds your current unit patch. Above we see MAJ Baier and MAJ Aitchison with the patch of the 330th. This is the reserve unit they are assigned to in Chicago, IL. I wear the patch of the Army Medical Command on my left shoulder, as I am not assigned to any one particular unit back home. Also noted on the left shoulder is the ISAF patch. This is worn only in Afghanistan by personnel under the command of ISAF (Read "Help and Cooperation").

LTC Sam Aldridge (Right - Vascular Surgeon) jokingly stares down SPC Tompson Nguyen (Left - Surgical Technician)
FOB Shank, Afghanistan, Logar Province

Finally, the backward appearance of the U.S. flag on the SPC Nguyen's sleeve in this picture is not a mistake or anomaly. As the military newspaper Stars & Stripes explained, the flag patch worn on the right shoulder of a U.S. soldier's uniform is deliberately reversed:

Why do American soldiers wear the U.S. flag insignia "backwards" on the right shoulder of their utility uniforms, with the canton (the rectangle with the stars) on an observer's right? It's a question that soldiers hear frequently as they travel through civilian airports, or talk to members of other services. And it does look "wrong," because U.S. federal code calls for the canton to always be positioned to the left. The soldiers aren't wrong, however, and neither are their tailors, Lt. Col. Stanley Heath, an Army spokesman, explained in a Friday telephone interview. The Army actually has two authorized flag patches, one to be worn on the left shoulder, with the canton facing left, and another "reverse field" patch worn on the right, with the canton facing right.
The two different orientations are mandated because Army regulations call for the flag "to be worn so that to observers, it looks as if the flag is flying against a breeze," Heath said. What does a stiff wind have to do with this custom?
In fact, the rule is a nod to the U.S. Army's early history, when wars were fought as a series of carefully choreographed battles — two armies meeting on a field, clashing head-on until one side emerged victorious. In those battles, both mounted cavalry and infantry units would always designate one soldier as "standard bearer," to carry the Colors into the fight. As the standard bearer charged, his rapid forward momentum would cause the flag to stream back. And since the Stars and Stripes is mounted with the canton closest to the pole, that section would always be forward.
So if a soldier is charging into the battle, the flag would give the appearance of forward motion. For the right shoulder, the flag only appears "backward." And that's why soldiers wear the flag patches on the right shoulder "backward." Because retreat in battle, as any soldier will tell you, is not the Army way.

173D Airborne Brigade Unit Patch

Sky Soldiers!

A Few Good Men - How Marines Create Army Surgeons

Mike Baier with his father Dr. Tom Baier at Marine graduation

Dr. Tom Baier was your typical Midwestern, mild mannered, orthopedic surgeon. In 2006,  at the age of 52, he enjoyed a busy practice, had great partners, a wife, three sons and one daughter. But life as he knew it was about to change radically.

His middle son, Mike had enough of college life and decided that the Marine Corps was where he needed to be. Dr. Baier attended his son's graduation ceremony and was moved beyond description. He immediately knew that he had to serve his nation by donating his time and expertise.

Dr. Michael Bruce with family in Fresno, California - Winter 2009

Dr. Michael Bruce is a Texas native who moved to Fresno, CA in 1986 and developed a respected general surgery and colorectal specialty practice. He is the chief of medical services and president-elect at his hospital.

Like Dr. Baier, his children were grown and making their way into adult life. Coincidentally, Dr. Bruce's middle son, James joined the Marine Corps in 2004. Similar to Dr. Baire, his son's call to duty was one factor in his decision to donate his talents to the Army.

MAJ Tom Baier in Mosul, Iraq - 2008

In 2007 Dr. Baier became Major Tom Baier, Army Reserves Doctor. By July, 2008 MAJ Baier found himself on an active duty deployment in Mosul, Iraq, performing orthopedic surgery with the 86th Combat Support Hospital (CSH).

LTC Mike Bruce with 909th FST, FOB Shank, Afghanistan, Logar Province - 2010

On February 14th, 2008, Dr. Bruce was commissioned Lieutenant Colonel Bruce, Army Reserves surgeon. By this point, his son, James, had served 3 years in the U.S. Marine Corps and had deployed twice to Iraq. James Bruce is now serving a second term with the Marines in Camp Pendleton, California. LTC Michael Bruce is now on active duty with the 909th Forward Surgical Team (FST) in Afghanistan's Logar Province.

Mike Baier get visit from father Tom Baier in Al Asad, Iraq - October, 2008

During MAJ Baier's first deployment, he managed to visit his son in Al Asad, Iraq. To get to his son required getting permissions from both the Army and Marine commands, designing a travel plan from Mosul to Al Asad and a whole bunch of luck. MAJ Baier's luck came in the form of making friends with the special forces (SF) folks (always a good idea, as the "guys in beards" tend to get whatever they want). Instead of making his way through multiple planned "hops", he hitched a ride with the SF guys, without any particular knowledge of where he was going to land. As luck would have it, the first landing they hit just happened to be Al Asad, Iraq. MAJ Baier jumped off the C130 and found a bus to the Marine barracks at 1:30AM. As is typical, the young Marines were still awake playing poker. He was able to spend two great days with his son and the rest of the Marines, even getting to go to the small arms range and shoot with them.

Marine Matt Baier with father Tom Baier at graduation - San Diego, CA - Spring 2009

After returning home from Iraq, MAJ Baier became a father of a second Marine. Matt Baier, the oldest son, has joined the Marine Reserves in 2009. Matt Baier will continue with advanced training this year as part of his duty with a Marine Recon unit. In all likelihood, Matt will deploy on active duty late this year or early in 2011.
Mike Baier has subsequently completed his active duty obligations and has returned to college.

James Bruce with his daughter

Marine SGT James Bruce entered service in 2004 out of high school and has deployed twice to Iraq. He is stationed at Camp Pendleton and is married with two sons and a daughter. He may not have played a direct role in his father's decision to join the Army Reserves, but he certainly has made his father proud. This pride in his son's accomplishments in the military has positively affected Dr. Bruce's life and has given him new adventures to pursue.

MAJ Tom Baier, SGT Mike Baier, PFC Matt Baier - July, 2009

Tom, Mike and Matt having a Baiery good time - July, 2009

MAJ Baier, and LTC Bruce are now deployed on active duty with the 909th FST at FOB Shank, Logar Province, Afghanistan. Like all reserve physicians, they will serve a 90-day rotation, or "boots on the ground" (BOG).


The total deployment time for reserve MD's, CRNA's, PA's, dentists and veterinarians may extend up to, but not exceed 120 days. This may seem like a small period of time to those accustomed to hearing of deployments for 6 months to over a year. However, this has been a very successful program to ensure that the physician resource pool remains strong, by reducing the impact that a deployment has on a physician's civilian practice. Prior to Desert Storm, the Army made no such concessions. Reserve physicians deployed during Desert Storm for 6 months to a year had to face the possibility of needing to completely close their practices, thus losing everything they had built. Additionally, all the people that the physician employed (nurses, secretaries, billing staff, etc.) potentially all had to seek new employment. With the 90 day BOG deployment, doctors have found the ability to donate their expertise, while being able to reduce the impact on their civilian practice.

That is the story of how Marines can create Army surgeons. It's actually not a unique story, as evidence by the fact that these two surgeons are serving together in the same FST at the same time. I have also met another orthopedic surgeon at FOB Orgun-E, MAJ Colin McKenzie, who's son is a combat engineer in the Army. They're all fantastic surgeons and I've had a great time learning from them.


So, what do the wives thing about their husbands joining the military and deploying to Iraq and Afghanistan? They are proud (and possibly happy to get rid of these old fellas for a bit ;) ) 

Mrs. Nancy Baier - Armed Forces Day 2009