Diary of An Afgahnistan Pizza

Pizza Man & CPT T

Why do I call this "Diary of An Afghanistan Pizza"? Heck.... I don't know. Its just what hit me and I put it down. CPT J sent me these photos and it has some story to tell beyond the obvious. I don't know exactly what it tells... but I'm going to make it up as I look at each photo. Below will represent flights of thoughts as they come out of my fingertips.

Pizza Man, CPT T & CPT J

CPT T loves to cook. You know it, because she is always smiling when she is cooking AND even more so when she is grabbing you to come over and eat. CPT J is like her long lost twin brother... they made FOB Shank a better place because they cared about making others happy (CPT T has made it home. CPT J is still on the FOB making life better for everyone around).

Pizza ready for fire oven

Another subplot sits within the story of our pizza chef, AKA the pizza man. I don't know the pizza man. I vaguely remember seeing him on the FOB. I only went to the "Afghan Restaurant" twice during my time on FOB Shank. Although, this may be the Afghan Bakery ... which I never went to... partly out of fear ... I wasn't all that keen on increasing my food-borne illness risk. But I like the series of photographs of the pizza man. I'm a bit intrigued by his eyes and expressions. Notice how they change, and relax through the series.

Pizza in fire oven

A final subplot is the pizza itself. It starts simple. Just the bread with a few ingredients around. It gets a bunch of attention and the pieces all come together. It is guided into the fire... just right.. And it comes out perfect!.. You could make a whole literary allegory around just the pizza!

CPT T, Pizza Man, CPT J

Finally, our protagonists come together in a fantastic portrait of friendship. The pizza man is relaxed and smiling. I don't think that CPT J had any particular intention to tell a story with these photos. I think he took them as a simple diary of images. But I found at least 3 heart warming stories within these pictures. But that's just me :)..  Thanks CPT J! ..

Picture Of The Day - 30 OCT 2010 "Boss"

30 OCT 2010 - Boss

909th ATLS NCOIC  SSG "D" is the boss (can't you tell by this photo from CPT J?)..... Members of the 909th relax on the sun-porch, outside the FST, waiting for a MedEvac to come in. The ATLS section is just to the right of the photo, where patients are examined and resuscitated. The operating room is connected to the ATLS section and seen in the background (green tent). The ICU/Postop section is connected to the operating room area and obscured by the bunker. These 3 sections are what makes up the primary functions of a Forward Surgical Team.

Picture Of The Day - 29 OCT 2010 "Medic"

29 OCT 2010 - Medic

909th Medic SPC "D" performs moulage training with Czech Republic soldiers in the photo above. The sun is shining bright in the background of this photo... which goes against the well known Army slogan, "If it ain't rainin', we ain't trainin'." Nonetheless, it's a great photo from CPT J, showing us that if the team isn't busy doing "the real thing", then they're preparing for it.

Picture Of The Day - 28 OCT 2010 "Boys"

28 OCT 2010 - Boys

The title isn't pejorative or derogatory.... It's meant with all the honest goodness that's seen in the photo. Boys of the 909th is a heart warming photo by CPT J. Thanks CPT J... we love to see these photos of our favorite FST men!

PS.... That's COL "G" in the background... yes.... the famous COL "G" of "CRNA in The 'Stan". Go check out his blog of the 909th. He's there right now... I'm just following from back home and counting the days until they all come home.

Picture Of The Day - 27 OCT 2010 "Horizon"

27 OCT 2010 - Horizon

I've been asked many times for my opinion on what will become of our involvement in Afghanistan. My response is typically, "I'm just a simple country doctor". Really... what the heck do I know about war and politics, let alone the future. The only thing I do know is it was rewarding to have served alongside the 909th and 173d. That's it.

Picture Of The Day - 26 OCT 2010 "Homeward Bound"

26 OCT 2010 - Homeward Bound

Approximately 13 hours ago, photos of "Main Body One" arriving home were posted on the 173d Facebook page. 10th Mountain has taken over the area of operations. The photo above is of the dynamic duo of CPTs J & L (CPT J in the foreground -- staying in theater for a bit longer). CPT L is the physical therapist of Charlie Med, providing indispensable care to the multitude of soldiers with a smorgasbord of musculoskeletal complaints. The care that these two officers provided couldn't be topped anywhere.

Picture Of The Day - 25 OCT 2010 "Sky Soldiers"

25 OCT 2010 - "Sky Soldiers"

Above is a couple of happy, awesome, and just plain good 'ol people of the 173d Charlie Med Co. The 173d Airborne is well into the process of gettin' the heck outta Dodge.... Hoooah! Here's to gettin' home fast.

Three Cups Of Tea

Greg Mortenson (photo from website www.gregmortenson.com)

If you've never read the book "Three Cups of Tea", go ahead and put it on your list. It's a fascinating account of one man overcoming odds as insurmountable as K2. As noted by Tom Brokaw, Mortenson is “one ordinary person, with the right combination of character and determination, who is really changing the world”. Greg Mortenson's singular focus has been to provide opportunities for education where none has previously existed. Just as important, he has been determined to direct that focus to the education of young Muslim girls.

But one man really can't do it all. And education is the pathway to opportunity and freedom. Our men and women of the US military as well as the Czech Republic PRT in Logar, Afghanistan have been working hard to help provide this opportunity to the people of Afghanistan.

Members of Czech Republic PRT - Photo Courtesy of CPT JL

The Czech Republic makes up the Provincial Reconstruction Team in the Logar Province, Afghanistan. They are providing security, public works projects and recently they are in the news with helping to improve learning conditions in Logar.

Photo of village boys - Courtesy of CPT JL

You may imagine.... without education what else is there to do? You can farm. You can learn a trade. Or you may find yourself with not much to do but walk around. As momma said, "Idle hands are the devil's workshop".

Photo of village boys - Courtesy of CPT JL

So, it seems obvious to me and probably everyone out there, that education is key. In fact, education and work is what everyone in the entire world wants and needs. The people who have driven this era of terrorism under the banner of Islam know this too. That's why thousands upon thousands of madrassas have been created in Pakistan and Afghanistan. These "places of education" have been an breeding ground for Al Qaeda and other terrorist groups.

Schoolhouse - Photo courtesy of Chaplain "Z"

It stands to reason that the children should be our main focus. We don't need to convert them to Christianity. That should not be our goal, and in fact, would be the worst thing we could do. We simply need to provide them with the opportunity to hear the truth. Recognize this... the Taliban and other insurgent groups are part of the local population. They continually spread lies that we are here to convert them to Christianity. They lie and tell them we are in Afghanistan to take their women and rob their country. This disinformation war is exceedingly effective and they hold the home ground. Education is our best weapon against their lies.

Photo courtesy of Chaplain "Z"

It really doesn't take much. Read "Three Cups of Tea". Holy cow! Greg Mortenson built entire schools for less than $10,0000.00! ...

School children line up for donated school supplies - Photo Courtesy of Chaplain "Z"

Right now, much of what I've seen has been from pictures of Chaplain Z who routinely went out to the villages in the Logar province. The children are getting school supplies via charitable donations. They come from large charities and small individual charities. They come from personal projects like the one put together by LTC Aldridge during his deployment to FOB Shank.

School boys receive donated supplies - Photo by Chaplain Z

These photos from Chaplain Z, were taken earlier this year. The supplies are donated by Americans. They are handed out by the Afghan National Army. This is an attempt to build bonds of trust with the local villagers.

Photo courtesy of Chaplain Z

Playing in the school yard - Photo courtesy of Chaplain Z

Can you imagine the photo above ever being seen if the Taliban take back this country? I mean... every single time I look at this photo, that is exactly what I think. This is the way I believe life should be like for the people of Afghanistan. They should be able to work, study AND play. That's freedom, and it has nothing to do with what religion you practice.

Dogs of war - Photo Courtesy of CPT JL

CPT JL from the Czech Republic took the above photo during a village medical operation. Think about this. If you cared for these puppies, educated them, gave them a job to do, and actually sent a little love their way.. then maybe they would turn out to be incredible friends. Now, think about the alternative.

Kind of a Big Deal

One of the most fun quotes to use is from "Anchorman: The Legend of Ron Burgundy".

Ron Burgundy: I don't know how to put this, but I'm kind of a big deal.

Veronica Corningstone: Really.

Ron Burgundy: People know me.

Veronica Corningstone: Well, I'm very happy for you.

It's hilarious stuff... but the guy who pulls off the first line the best (and the most) is our own CPT J.

CPT J - FOB Shank, Logar Province, Afghanistan

CPT J has submitted many photos for the FaST Surgeon blog, and runs his own blog "OT Army Guy.Com". But this summer has been an overwhelmingly busy one, and thus... we've heard very little from our favorite Occupational Therapist as of late.

CPT J - FOB Shank, Logar Province, Afghanistan

So, I will use my powers of persuasion to re-invigorate the self proclaimed "big deal"... by posting some of my favorite photos of him. Unfortunately, these photos will also serve to remind both of us that his precious Canon camera went belly up a couple months ago. This has contributed to the lack of new photos.

CPT J - FOB Shank, Logar Province, Afghanistan

The photo above and below were taken during my last days at Shank. CPT J and I finally got time to walk around the FOB with our cameras at the ready. Unfortunately, the dust and lighting for the day made photography a bit difficult. As well, there wasn't much to shoot. I caught a C130 taxiing ... but I was too far to take a good photo of it lifting off. But... I did catch my nemesis... Yes.... The Djin....El Diablo... The Dust Devil.

Dust Devil - FOB Shank, Logar Province, Afghanistan

So... here's a hat tip to you, my friend! ... The 173d and all the soldiers at FOB Shank are lucky that you're there. Thanks for all your hard work.

Picture Of The Day - 20 OCT 2010 "Smokin"

20 OCT 2010 - Smokin

Medics from the 173d Airborne Charlie Med take a little break... Soon they will all be heading home!

Picture Of The Day - 19 OCT 2010 "Tender Moments"

19 OCT 2010 - Tender Moments

This photo is from June, 2010 and is interesting to me for its beauty along with the contrasting tragedy of a wounded child. SPC B is a great representative of 173 Airborne medics. They are smart, motivated, strong, tough and tender when the time calls for it.

Leishmaniasis Outbrake Reported In Herat, Afghanistan

CPT T Photo of 173d Airborne Medics during Village Medical Operation in Logar, Afghanistan 2010

 This post is a little off the beaten path for FaST Surgeon... but since we now have the awesome "CRNA In The 'Stan" to keep us posted on the most current happenings of the 909th, we can rest easy and do a little teaching today.

Apparently it turns out that there is an outbreak of a disease called Cutaneous Leishmaniasis  in Herat, Afghanistan as reported by The Hindu:

"Cutaneous leishmanisis is a parasitic disease transmitted by the female phlebotomine sand fly, an insect only 2-3 millimeters long that requires the blood of humans or animals so its eggs can develop. Treatable with medication and not life-threatening, cutaneous leishmanisis can leave severe scars on the bodies of victims."

CPT T Photo during Village Medical Operation in Logar Province, Afghanistan

 "The disease threatens 13 million people in Afghanistan, the World Health Organization said, and many impoverished Afghan victims can’t afford the medication to treat it.

In Kabul, described by the WHO as “the world capital of cutaneous leishmaniasis, the number of cases jumped from an estimated 17,000 a year in the early 2000s to 65,000 in 2009, WHO said. "

... Read More

Cutaneous Leishmaniasis

If you're around Afghanistan long enough, you will most certainly see this disease. Although I never saw it on our military personnel, there are reports of soldiers having been afflicted by the disease in the Persian Gulf. CPT T took the photo above of an Afghan woman during a village medical operation. I also saw other locals with this during my time down in Orgune. Fortunately, this is a treatable infection with antimicrobials. But, getting the antimicrobials to the people is the hard part.

Sacrifice - By CRNA In The 'Stan

Wounded Arriving on UH-60 Black Hawk Medevac - FOB Shank, Logar Province Afghanistan

CRNA In The 'Stan puts it all in perspective with his recent posting on sacrifice. His post comes on the heels of a letter I received from a mother ("CM") of an Army Lieutenant deployed to FOB Shank. She had informed me about the ultimate sacrifice of a soldier well known to her son. But of note, she and her husband (a Vietnam era veteran) sacrificed their time (of which was significant) to be present to receive this hero, along with 3 others killed that same day in different areas, as they arrived home. She writes:

"We had taken a dozen + red roses in water vials that we were able to offer the families if they wished.  People did come up to us and thanked us for being there, for being supportive, etc.  But my "mother's" heart was breaking.  When I asked the moms to tell me about their sons, they were kids I'd never met, but knew: Eagle Scouts, always wanted to serve.  Knowing some soldiers, I told the moms and dads that they had raised heroes.  They were remembering the little boys who grew up to be men who honored God and country, who had allegiance to their brothers in arms, who were able to face hardship and adversity with courage and tenacity.  They gave their sons roots and wings and the ability to meet their life long goals: to be a soldier.  How many people can say that?  After knowing some soldiers that have been WIA, you know they would do it all over again. 

It was one of the most worthwhile, most emotionally draining, most challenging things I have ever done.  Somehow let the team know that we are carrying on their work here."

Mrs CM also provided a link to a poignant song... I've included it below. Mrs CM... Thank you and your husband and all the people here at home that sacrifice just as much as any of us.

CRNA In The 'Stan

909th Wolfpack Lair

Can it be true???? Is there finally a new photographer / writer for the 909th! I'm all a tizzy with excitement. Christmas has come early! Little Timmy will finally get a new pair of crutches! Go and see for yourself - Check out CRNA In The 'Stan. THANK YOU !

Picture Of The Day - 11 OCT 2010 "Party CPT"

11 OCT 2010 - Party CPT

Every unit should have one of these.... A party captain!. CPT "T" has put more smiles on more faces by performing her secondary MOS as the official Charlie Med organizer of all things food and fun. Thank you for all your extra work. CPT T.... You should get a medal for making everyone around you smile more!

Picture Of The Day - 10 OCT 2010 "Charlie's Angels"

10 OCT 2010 - Charlie's Angles

Well... Maybe Charlie has gone blind and lost all sense of reality.. or these are really DJ's Angels. Or its just LTC "J" and CPT "M". The dynamic duo were out on the FOB Shank small arms range. 

FOB Shank Small Arms Range Dedicated to SPC Matthew K Swanson

Now this might seem odd or counter-intuitive to some of my readers, but all members of a Forward Surgical Team (FST) are required to maintain proficiency with their personal weapon. For most, that means that they have qualified with either the M16/M4 and / or the M9 pistol. This is important, because by doctrine, the FST is designed to move with a combat brigade during battle. Two examples of this: The 250th FST (Airborne) actually performed a combat jump into Basra, Iraq with the 173d Airborne during the opening invasion of OIF in 2003. Additionally, during that same year the 555th FST was involved in numerous enemy engagements. One event even required them to take 7 enemy prisoners of war.

The times have changed and the battlefields of Afghanistan and Iraq have "matured". FSTs are, for all intents and purposes, stationary and protected inside of Forward Operating Bases (FOBs). The personnel don't participate in activities outside the FOB and are thus much safer than our predecessors.

Picture Of The Day - 09 OCT 2010 "Brawler"

09 OCT 2010 "Brawler"

I only just noticed that I was living in the future yesterday.... I mean, I labeled yesterday's PoD "09 OCT 2010"... So I went back and corrected yesterday's date. I hope I didn't cause a flood in New Guinea via the "Butterfly Effect". ;)

Good news!... The 909th has a full bird colonel that actually knows how to use a digital camera and computer! In other news, the Taliban have begun to fly kites, Al-Qaeda is spreading the word of peace and tolerance, dogs and cats are living together and the Pakistani ISI are helping Afghanistan's ISAF. For proof (of at least the first claim) go and see the very latest 909th team photo at CRNA In The 'Stan.

Picture Of The Day - 08 OCT 2010 "Pilots"

08 OCT 2010 "Pilots"

A UH60 Black Hawk MedEvac prepares to liftoff from FOB Shank, Logar Province - Afghanistan.

1910 USA Factoids

Outside The Wire

People want to believe that Afghanistan is too "backward" of a nation to be helped.... For sure, there are areas that truly look like biblical times. The photo above was taken by me of a village just west of FOB Shank in Logar, Afghanistan. 

Well... take a look at America just 100 years ago:

The average life expectancy for men was 47 years.
Only 14 percent of the homes had a bathtub.
Only 8 percent of the homes had a telephone.
There were only 8,000 cars and only 144 miles of paved roads.
More than 95 percent of all births took place at HOME .
Most women only washed their hair once a month, and used Borax or egg yolks for shampoo.
The leading causes of death were: 1. Pneumonia and influenza 2. Tuberculosis 3. Diarrhea
The population of Las Vegas , Nevada , was only 30!!!!
Two out of every 10 adults couldn't read or write and
Only 6 percent of all Americans had graduated from high school..
Marijuana, heroin, and morphine were all available over the counter at the local corner drugstores.
There were about 230 reported murders in the ENTIRE U.S.A. !

Picture Of The Day - 07 OCT 2010 "Boys"

07 OCT 2010 - Boys

Every boy loves a girl with a gun! Especially if she's an Army captain and a nurse to boot. :) .... 

This photo comes from the vault of CPT "T". The boys are perpetual fixtures at the heavy weapons range in the area and they love to pose for the camera. They also like to pick your pocket when given the opportunity. I almost lost my camera to a 6 year old jack rabbit. 

The boys are on the range to collect the brass that can be sold for a relatively good price. Although, I doubt that they see any of the money. My impression was, they looked like poor orphan boys with no place to live. In reality, I have no idea where they came from or if they had family at all. As best as I can surmise, this was there only means of subsisting.

Picture Of The Day - 06 OCT 2010 "Whirlwind"

06 OCT 2010 - Whirlwind

Whirlwind of activity... a flurry of movement..controlled chaos... When wounded arrive, there is a rapid acceleration of movement with a parallel increase of helpful people. What is surprising about the whole process is the lack of noise. The team knows what to do and when to do it. You step in, do your job, and step out. It is a coordinated activity by the team leader who manages the entire process. This patient was triaged, examined, resuscitated and in the operating room within minutes. He recovered very well.

Picture Of The Day - 05 OCT 2010 "Busy"

05 OCT 2010 - Busy

This is what it looks like when times are busy at an FST. In the above photo, medical teams are moving patients to multiple MedEvac helicopters for their flight to the next level of care. As best as I can tell, the team is busier than ever. Let's pray that it slows down soon.

Picture Of The Day - 04 OCT 2010 "Chase Bird "

04 OCT 2010 - Chase Bird

Did you know that with every MedEvac goes a "chase bird"? The chase bird come with dual 7.62mm machine guns affixed to either side to provide fire support. It also serves a CasEvac role when necessary. I think that its a pretty cool site to look at it dead on.

Picture Of The Day - 03 OCT 2010 "Big Windy"

03 OCT 2010 - Big Windy

CPT "T" sends us a photo of a CH-47 moving a 155mm Howitzer. Time and location unrevealed... Just a really cool photo.

Picture Of The Day - 02 OCT 2010 "Smiles"

02 OCT 2010 - Smiles

This is the team that I will always remember. Keep rockin' those smiles Wolfpack!

Picture Of The Day - 01 OCT 2010 "Jitter"

01 OCT 2010 - Jitter

In 2001, the US military was called upon to place large numbers of servicemen and women in harms way. Its medical leadership recognized that much work needed to be done to meet with the standards that had been developed over the previous 30 years in the US Trauma system. Thus the development of a "Joint Theater Trauma System" (JTTS) was initiated and patterned after its civilian counterpart. This was an enormous undertaking and much too complicated to be adequately explained in this small space. However, suffice it to say that the effort has lead to the most sophisticated delivery of advanced medical and surgical care ever in the history of our military.

A huge part of this effort lies in the collection and analysis of the data concerning the wounding and subsequent treatment of our soldiers. The U.S. Army Institute of Surgical Research, under the leadership of Col. John B. Holcomb (now retired), developed the Joint Theater Trauma Registry (JTTR AKA "jitter"). This information is thoughtfully reviewed and has become the backbone of military medical advances in battlefield casualty management, in the same way that hospital, system, regional, state and national registries are in the civilian sector. All of this analysis starts with the information collected by our medical teams as seen in the photo above. Your work IS important!