I know I’ve published a sunset basketball picture before… but I just think this one really is cool. So, sorry but I just had to push this one out for the picture-of-the-day. The weather was cooler and the air was much nicer today. We had a nice breeze and a pretty good day with just a little bit of work. I shot this photo with my simple point-and-shoot. Those little cameras do a darn nice job in a pinch, and I always try to carry it with me to catch “targets of opportunity”. Hope you enjoy.
Thursday, May 31, 2012
Wednesday, May 30, 2012
This is are northern-ish view from FOB Salerno out towards Pakistan the way way out to Jalalabad. The snow is nearly melted from the mountains as the weather continues to heat up considerably. Today it was nearly 105 degrees in Khost, Afghanistan. The shot was from earlier in the month. Today the sky was ugly and the mountains weren’t visible at all. I’m told it will get even hotter. I don’t think this indoor dog will be going out much anymore :) ….
Tuesday, May 29, 2012
Monday, May 28, 2012
LTC C has been a war surgeon for sometime now and has known many fallen heroes. Today, on memorial day, she paid tribute to SFC Brian Woods and others she has known. We took care of the wounded today, loaded them safely on DustOff and remembered.
Memorial Day, an American holiday observed on the last Monday of May, honors men and women who died while serving in the U.S. military. Originally known as Decoration Day, it originated in the years following the Civil War and became an official federal holiday in 1971.*
Early Observances of Memorial Day*
The Civil War claimed more lives than any conflict in U.S. history, requiring the establishment of the country’s first national cemeteries. By the late 1860s Americans in various towns and cities had begun holding springtime tributes to these countless fallen soldiers, decorating their graves with flowers and reciting prayers.
It is unclear where exactly this tradition originated; numerous different communities may have independently initiated the memorial gatherings. Nevertheless, in 1966 the federal government declared Waterloo, New York, the official birthplace of Memorial Day. Waterloo—which had first celebrated the day on May 5, 1866—was chosen because it hosted an annual, community-wide event, during which businesses closed and residents decorated the graves of soldiers with flowers and flags.*
On May 5, 1862, General John A. Logan, leader of an organization for Northern Civil War veterans, called for a nationwide day of remembrance later that month. “The 30th of May, 1868, is designated for the purpose of strewing with flowers, or otherwise decorating the graves of comrades who died in defense of their country during the late rebellion, and whose bodies now lie in almost every city, village and hamlet churchyard in the land,” he proclaimed. The date of Decoration Day, as he called it, was chosen because it wasn’t the anniversary of any particular battle.
On the first Decoration Day, General James Garfield made a speech at Arlington National Cemetery, and 5,000 participants decorated the graves of the 20,000 Union and Confederate soldiers buried there. Many Northern states held similar commemorative events and reprised the tradition in subsequent years; by 1890 each one had made Decoration Day an official state holiday. Many Southern states, on the other hand, continued to honor their dead on separate days until after World War I.*
Evolution of Memorial Day*
Memorial Day, as Decoration Day gradually came to be known, originally honored only those lost while fighting in the Civil War. But during World War I the United States found itself embroiled in another major conflict, and the holiday evolved to commemorate American military personnel who died in all wars.
For decades, Memorial Day continued to be observed on May 30, the date Logan had selected for the first Decoration Day. But in 1968 Congress passed the Uniform Monday Holiday Act, which established Memorial Day as the last Monday in May in order to create a three-day weekend for federal employees; the change went into effect in 1971. The same law also declared Memorial Day a federal holiday.*
Memorial Day Traditions*
Cities and towns across the United States host Memorial Day parades each year, often incorporating military personnel and members of veterans’ organizations. Some of the largest parades take place in Chicago, New York and Washington, D.C. Americans also observe Memorial Day by visiting cemeteries and memorials. On a less somber note, many people throw parties and barbecues on the holiday, perhaps because it unofficially marks the beginning of summer.
On Sunday, we all had a great day together. Playing volleyball and spending time together at our end-of-month BBQ (photos above). But today, this post is in honor of all our fallen heroes. For myself and those great men and women of the 173d Airborne, we pay special remembrance to our friend, SGT Raymond C Alcarez, who was killed in action with his fellow soldiers SSG Vinson Adkinson III, SPC Mathew George and SPC James Page on August 31, 2010 in Logar Province, Afghanistan.
Sunday, May 27, 2012
At some point, long ago, this chicken was put up in the Salerno hospital operating room. I’m told it’s been here since 2004. If anyone has a story about this chicken to tell… please comment. I assume it’s some Chinese symbol of good luck or prosperity. No matter… at the very least it’s pretty funny :).
The Best in Show honorees will be recognized in Washington D.C. this Fall with images crafted into video artwork by renowned artist Lincoln Schatz that will be displayed at a private reception on the evening of November 30 at the Smithsonian American Art Museum. The exhibit will then travel to the Pentagon, the U.S. Embassy in Kabul, and other prominent national and international locations.
Above is one of my favorite photos taken during my deployment in Logar, Afghanistan – FOB Shank. This photo (converted to a color pencil sketch) was submitted in it’s original form (part of the rules of the contest – no cropping or image manipulation). I had taken thousands of photos, making it very hard to choose what to submit. To be honest, I would find it kind of cool to be named best in show. I have never entered a photo contest before, and the only photos I take at home are of my family. So… this is likely the one chance I will get to see if a professional photographer/editor thinks that I’ve captured something well of film (well…. digital “film”).
Below is a compilation of what I thought were the best photos I took in 2010. From this group, I had to trim it down further and submit 10 to the photo contest. Unfortunately, I don’t remember which 10 I submitted. Anyhow, as I looked back through my photos, I realized that there were some that I liked, most likely because I knew the back-story behind the photo. I found that other folks liked completely different photos – one’s that I didn’t think all that much about. So, ultimately, beauty is in the eye of the beholder.
Saturday, May 26, 2012
I guess this fella is a Yankees fan. He is part of a local workforce that is completing an addition on the hospital. It’s always a bit interesting to me to see cultures merge through fashion. I wonder what Afghanistan will look like in twenty years?
Thursday, May 24, 2012
The Army Reserves’ 66Hotels (Medical-Surgical Nursing) are the topic of today. Another special breed of folks who take on added responsibilities usually well outside their day to day practices. Some of these nurses may or may not have ICU/Trauma experience. But many come from all walks of life. Some practice in basic wards, others in post-anesthesia recovery units, while still others are pediatric nurses. But they all step up to the plate to take on the role of critical care / trauma nurses… and they do it all well.
Above, our chief nurse tackles the task of loading a patient on a BlackHawk for evacuation. She will fly with that patient, and provide care for the patient all the way to the next echelon.
The nursing staff provides care in the trauma bay as well as the ICU.
Fortunately, it’s not all work all the time. Although we have an excellent facility, we now function as a Forward Surgical Team. So, as soon as we can, we evacuation patients to the north and prepare our ICU for the next wave of patients. This gives our limited number of folks some time for relaxation. Above, our nurses (Air Force to the left and Army to the right) play a game of cribbage. That’s a bit sophisticated for a simple surgeon like me… being that it’s a game for kings :)
Wednesday, May 23, 2012
Today we’re hoping for a little rest and recovery. Some days you just need a lift up. I, for one, and still trying to wake up after a rather lengthy bit of work. This morning I seem to be vacillating between fits of energy and malaise. So these photos seem to be a good photographic allegory for what I need.
In reality this is training. Not for us (FaST members), but for the MedEvac pilots and crew. They need to maintain their skillset of hoist extractions.
So how do we fit in? Well, they need people to hoist of course! I would surmise that in most training events, there aren’t that many folks who necessarily go out of their way to volunteer to be participate as patients. But for this….. I bet there are people who darn near tackle each other to get in front of the line.
Heck! This is probably better than any ride at a theme park. All you need to do is accept a full-expense paid ticket to greater Afghanistan. Then, find your way to the MedEvac ticket booth. Then Bam! You have yourself strapped on a piece of metal attached to a cable, that is attached to a helicopter, that will fly you around for a few fun minutes. They hoist you up to the bay, then you get to lean out with the wind blowing in your face as they fly a circle back to the drop off. Finally, they lower you back to a gentle touch down on you buttocks, only to leave you wanting another ride. But, only one ride per customer. Like I said. There’s no lack of volunteers. :)
Monday, May 21, 2012
Believe it or not. I’m not known as one of the best communicators in the world. Most of the time, I simply am happy to keep things to myself. I enjoy a good conversation and hanging out. I’m not completely socially unacceptable. But I don’t tend to have that drive to go out and start up a conversation de novo. So how the heck did I get into this blogging thing? Well, it really just started as a way to communicate with my family back home. But it seems like some other people dig it. So here we are…. Today I couldn’t pick a photo, until just now. And I will give you a bit of a story with it to describe a slice of life for a FaST team and how I got this photo (If this is too long, you can skip to the end).
It starts yesterday. – Morning Time
We got to bed around 1:30 AM after a late night of trauma. That’s not really all that common. Many nights are relatively peaceful for us. But trauma is a fickle bitch, and she has no problem waking you up when she’s mad. Anyhow, sleep was fine, but the morning came and waking up was tough. I didn’t even hear my 6AM alarm. So I woke at 7:30AM to the walkie-talkie radio traffic. Enough time to meet everyone at the morning briefing. Nothing for me to do. The patients were evacuated… so I needed to tend to other business. I stripped my bed for fear of possible bed bugs! Ukk. I dumped my mattress and got a new (used) one with the help of my first sergeant. Then went to the laundry (we have great laundry facilities at Salerno). Next, I went to the finance people. Guess what? I haven’t received any pay due for being in a war zone. Seems that the Army forgot I was here for the past 2 months. To get paid, I needed to give them a copy of my deployment orders, a copy of my temporary change of station and a DD Form 4187 signed by the unit commander that tells them I am actually here. I moved on to complete the edits on a journal article submission (2 months behind schedule). That got me to lunch.
We tend to move as a small gaggle of docs. BBQ burger for me please. Then off on a walk with my orthopod buddy to talk with the MRAP people and see the damage done by IEDs. Here we put together a picture of why some soldiers may have been wounded, while others weren’t. Not CSI by any means. Just a couple of docs trying to get some understanding of what is happening around them. We continued our walk, and the day grew a bit hotter than expected. We passed by the fence line and grave yards of the local people. No one was out to throw rocks at us today. No matter… they find it challenging to get anything through the two rows of fencing and concertina wire. By the time we got back to the hospital, I was hotter than heck and dripping with sweat. Just enough time to cool off and sit down. Then it’s time to receive trauma. No problem. Simple single wound. Quick operation. Patient is fine. But it all takes time.
We are treated with some nice cooling off outside. The sky is filled with clouds, and storms are happening all around the mountains. Helicopter passes go “red” and nothing except dire emergencies will get the birds to fly (if possible). So dinner is relaxing. We see one of our Chinook crew chiefs and I get my favorite meal – chicken fingers. I pick up laundry (did I tell you we have great laundry facilities here), buy a new pillow and begin to make my new, no-longer bug infested, bed. My Air Force surgeon buddy and I decide it’s a good night to shoot things. So obviously, we load up…… the Play Station for a round of Modern Warfare 3. Being that we’re both excellent war fighters, we have a grand time defeating the enemy. Just in time for….
Oops.. it’s not bed time. It’s trauma time. The bitch is back for more. This patient needs some real help. The team descends on him like ants protecting the queen’s eggs. Lot’s of activity, and in quick time we have someone who wasn’t right for this world, back to stability. Lot’s to do still, getting everything checked and re-checked and move to our ICU. The next thing I know, it’s 1:30AM again. How the heck did this happen? But I am ready for bed – NEW clean sheets and pillows and stuff… but what the heck!? There’s something in my bed! Not a snake or spider (someone recently captured a camel spider) thank God. But an LMA under my fitted sheet. Thanks MAJ “K”. Funny stuff. For some reason, I have the worst nightmares ever (hasn’t happened in years). Sleep is horrible (rather no sleep). And then it’s 4:15AM – the mountain passes are green and the MedEvac crew is ready to load patients for evacuation out of here. We bundle them up like burritos for the flight. As I’m moving out to the flight line, I am surprised to see that it’s light outside. Holy cow! It’s 4:40AM and the sun is coming up. I head back to my hooch, brew a quick cup of “Black Tiger”, grab my camera and head to the roof. Shoot, Darn, Dangit (or other colorful language is expelled from my mouth)! My memory card is still in my computer. Running (wearing my OR clogs) down the stairs, over the rocks, back to the hooch, back through the rocks, up the stairs… just in time to see the sun already over the Pakistan mountains to the east. And above is about the only half decent shot I got. I sure wish I had a tripod and some real lessons on how to shoot a good sunrise.
Sunday, May 20, 2012
To round out the OR I leave you with MAJ C, Air Force Anesthesiologist. In the Army, we designate them 60 Novembers. I have no idea if the Air Force uses such designators. I told you that the Air Force will send their MDs out to the forward bases. Although, to be honest, I think they only do it in places that actually have 4 real walls and a roof . The Air Force doesn’t really dig tents and port-a-johns. They’re smart!
For those Air Force folks out there, please don’t send me hate mail. I love the Air Force…. and if I just had had good eyesight when I was younger, I would have done anything to become an F-15 Eagle pilot. But, alas, I was a blurry eyed scrawny kid. So I joined the Army instead, and somehow ended up being a regular ground pounder. As the years went on, I somehow made it through the education system to become that which I am today. Although I could have easily become an Air Force surgeon, I just couldn’t leave my beloved Army. So, I guess all those years of education didn’t make me much smarter. I’m back in green and for some reason am happy to be in a tent, operating for the troops.
(note… FOB Salerno is all hard buildings. No tents here anymore)
Final note… I am trying out Windows Live Writer 3. I hope this helps me solve three issues that I have had with blogging and Facebook. First, I hope the picture shows up in Facebook. Second, I hope that the body text shows up correctly. Finally, I am hoping to publish the post AND have it show up in Facebook seamlessly.
|94th CSH (FWD) CRNA CPT "C" - 66F|
CRNAs are registered nurses with advanced professional schooling and experience. In addition to being registered nurses, they must have their bachelor's degree (typically in nursing). They also must typically complete at least 1 year of clinical experience in an ICU environment, followed by successful completion of their master's degree in nursing anesthesia. That's quite a bit of training, and for good reason. These folks have the responsibility of providing critical, life saving care. So.. another big salute out to our 66Foxtrots - Army CRNA!
Saturday, May 19, 2012
|FaST Surgeon with CPT "T" in FOB Salerno Operating Room, Khost Afghanistan|
I'll stick with the Operating Room theme today. Yesterday we learned a little bit about the Army scrub tech / operating room specialist. Today I present to you the person who really is in charge of the operating room...... and believe it or not... it ain't me (although I often fantasize that I am).
I present to you the Army's 66 Echo - Operating Room Nurse. This Registered Nurse is responsible for everything that happens in the OR. Period. Or, said another way... responsible for keeping FaST Surgeon under control. It's a tough job. But CPT "T" really loves it.
These folks are advanced trained professionals. They have at least their RN degree along with 3 years of OR experience. Additionally, they are accredited by the CNOR program. CNOR is a definition not an acronym. CNOR certification is defined as: "the documented validation of the professional achievement of identified standards of practice by an individual registered nurse providing care for patients before, during and after surgery." To get this certification, they can go to school for one year (in addition to nursing school), followed by another year of mentorship and then sit for the examination. In other words, they have a heck of a strong knowledge base combined with strong experience.
So today, we throw another respectful salute to all the 66 Echos out there.
Thursday, May 17, 2012
|OR Team Prepares For Emergent Operation - Performing Instrument Count|
Army Reserves Scrub Techs range from a variety of backgrounds. I've have had scrub techs that owned nail salons, or are college students, or fire fighters, or uniformed police officers. We call upon them to step into a world that isn't necessarily all that familiar to them. Yes, they have gone through school and have been through training. But then, they are thrust into the high tempo environment of war surgery. This is a daunting task. Yet, each and every time these folks have stepped up to the plate and hit home runs. A big salute to all the 68 Deltas (Operating Room Specialist) out there!
|Trauma Surgeons of the 94th CSH (FWD)|
Tuesday, May 15, 2012
|94th CSH (FWD) Team|
The combined efforts of US Special Forces, State Department, Agriculture and Medical teams have begun to lend a sense of community to the population centers along the valley floor. It starts with enabling the Afghans to provide their own security by soldiers who are interested in more than lining their own pockets or just getting a visa to move on. That has happened here, but they are in a violent struggle to protect their local politicians, teachers, physicians etc from assassination by the Taliban and other "Warring Factions" who profit from continued chaos and destruction. Not even the "'World's Greatest Military" can win or hold the remote regions without mass extermination, and to what end? Its best to build a stable, safe life in pockets, run by honest folks with a sense of nation.......no small task anywhere.....but unbelievably, it may be more likely in this exhausted, war-torn country than in our own comfortable nation.
Ok, so maybe I have to much time to reflect...........Anyways, I think we finally understand that this has to be delivered by the Afghans..........with our help. If pockets of safety and stability can be achieved, the militants will either stay to themselves or come down and join the "Good Life"................its gonna take some time, but I believe its possible because I am finally meeting some people here who "really want it".......but what do I know? I live behind a fence.........maybe they got me fooled, but I want to see it happen cause the other options seem awfully bloody.
Monday, May 14, 2012
Saturday, May 12, 2012
|94th CHS(FWD) team transport patient from flight line into Salerno Hospital via rickshaw|
Rickshaws were seen in Japan sometime around 1868. The word is derived from the Japanese word jinirikisha, which literally means "human-powered vehicle". We use "riskshaws" to more easily transport patients on litters to and from the flight line. It's a real back saver, especially when you have a 200 pound soldier still wearing 40 plus more pounds of IOTV.
This picture from MAJ K was taken during the Pat Tillman run on 21 APR 2012 at FOB Salerno. A great time had by all... since we had some significant rain the night before, the race coordinators decided to add a little more to the competition ... who can get the muddiest. I don't have the photo of the winner, but these troops we likely good competition. BTW.. I ran again this year (second time running in Afghanistan). I may have to change my name to SLOW surgeon. I'm just happy to have participated.
Friday, May 11, 2012
|Rainbow over Khost|
It's actually a double rainbow, but the one just off the right upper corner was fading away as I took this shot from a simple point-and-shoot pocket camera. I can't believe how much it rains down here. In Logar, there was little rain comparatively, and a lot more wind.
|Radar Hill... looking towards Pakistan mountains|
This post is late.. as my Internet connectivity is really suboptimal. I keep trying to find interesting photos that don't involve trauma. But, there is usually a haze around here, and the rains come nearly everyday, making good scenery shots a bit of a challenge.
Wednesday, May 9, 2012
Tuesday, May 8, 2012
|LTC C at lunch with our host|
|Our mean of long rice with raisins, meat and traditional Afghan bread.|
|CPT L enjoying lunch with our Afghan rug vendor|
|Our host preparing fresh melons|