Doing the right thing

The last three days of work were very hard; I had little Feisl die and then sent Iman home to die with his family and on the third day when I came in, I was given yet another pediatric patient.  This patient was significantly different.  He was 15 and had a gunshot wound to his shoulder which severed the artery and broke his arm.  What made this child different was the fact he had just pushed the button that set off a bomb and killed five service members; the one surviving was in the bay next door to his room.

I thought about this boy and decided yes, he did a horrible thing but he was still my patient.  The other members of the battalion kept trying to go in his room and I made it pretty clear they needed to stay out.  I let his guards also know there was to be no one in the room other than hospital staff, unless I said so.

This boy was frightened.  The story is his father set the bomb and told him to push the button.  It isn't any different than the U.S. father in teaching his child to hate.  I took care of this boy with my heart.  I bathed him, redressed his wounds and washed his hair.  I found a laceration in the back of his head that required staples and we took care of that.  I was angered by other members of the hospital staff who were full of hate.  I can totally understand their feelings, but I wish they would remember he is a child who hans't completely mentally developed. 

While I was caring for him, he asked his guards "Why is she being so nice to me?"  I replied "I don't like what you did, but you are my patient and I will take care of you."  Maybe I am wearing rose colored glasses but I'd like to think I made a difference to this child.  Maybe the next time someone asks him to blow up Americans, he'll remember the kindness he was shown and refuse.

Iman

Today we sent little Iman home to be with his parents during his final days.  This poor kid, for every step forward he took in recovering, he took three backward.  He came in with a head injury due to a taxi cab running him over.  Then we discovered he had a multi-drug resistant e. coli in his sputum, so we treated that.  Then we couldn't get him off the ventilator, we succeeded in that yesterday.  Last night they found candidis in his blood, not good.  This morning I tried to get him to eat and he couldn't swallow or suck, no good.  Prior to discussing options with his parents, we found he had another fungus growing in his lungs. 

His mother finally came to see him (because we're in a war zone, it's very difficult for family members to visit regularly).  She showed up in her burka and when she saw him lying in the bed, she pulled the burka back and climbed next to him in bed, trying to wake him.  It was a heart-breaking moment.

Regardless of what we did, we were not going to get this kid on his feet.  I dressed him gently and placed him on the gurney so the ambulance could take him to the gate.  I have lost another kid, but this one wasn't as traumatic as little Feisl. 

We work so hard to get these kids back on their feet but the downside is this country does not have the medical capabilities needed to care for these kinds of injuries.  I know people complain about the health care system in America, but really, you need to experience being in a third world country before you complain. 

We are a 13 bed trauma ICU and we take care of so much more than trauma.  We, unfortunately do not have the resources to take care of everyone and sometimes difficult decisions have to be made regarding continuance of care, such as Feisl and Iman.

I worked at Creighton for about two years before coming in the Air Force and I distinctly remember a drug addict getting an implanted defibrillator.  Because of her drug abuse her heart would go into very dangerous arrythmias and without this implated device, she would die.  This device costs about $30,000.00 and she received it for FREE, because she was on medicaid.  Not a bad health system considering these people here can't even get the medications they need to cure a simple infection.  Our military will go home and receive artificial limbs and get tons of help to recover.  These people will have a limb amputated and there is no system to give them artificial limbs or rehabilitation.  It's a shame and it makes me so sad.  I wish we could do more, but I know we can't save the world when we're drowning ourselves.

Redeployment Ceremony

This morning was our redeployment ceremony where everyone who was going home during June and July gathered to receive their medals and recognition for all the work we've done to save lives.  As I stood there with my peers, I felt such a sense of pride and accomplishment; one that I had never felt before.  We have done so many wonderful things as a medical community.  Because of the care we provide, we were able to send 99% of our wounded home to their families and are recovering!  For those that we couldn't save, we stood at the entrance of the plane and honored them.  We witnessed over 300 Purple Hearts awarded to the injured warrior and we've worked hard to save the innocent victims of this war.  During this deployment there have been many ups and downs, many hardships to endure but the sense of pride I felt this morning outside of the ER and receiving my medal was one that I will not forget. 

I was reading a news story how the war in Afghanistan is becoming increasingly unpopular at home.  For those of you reading this, please stop listening to the media.  It is skewed in order to meet the agendas of their desire.  If we leave this country before we have finished the job, and that job is to help stabilize the 30 years of war these people have endured; we will be back and it will be worse.  Of all the military and local people I have helped to nurse over these last six months, there is nothing but pride in what we’re doing here.  Many of my patients are disappointed they have to leave and can't continue to help.  I am a little bit torn.  I want to stay and help but I want to be home with my family.  I can't imagine I'll do anything this meaningful again...until my next deployment.

Annoyed!

I have never worked with a bunch of insecure women in my life!  After the horrible day yesterday, Shafer is in charge and she decides to give me another kid they are going to withdraw care on!!  What in God's name is she thinking!!  Oh yes, this is her payback.

She is always putting herself in the same bay as Tovar, probably because he's the ONLY one who can tolerate her.  She is a smart nurse but she has such an awful personality that no one listens to her.  Everyone is stupid except for her, she's the only one who can do anything and she is very bossy towards people.  She has no finesse.  No wonder she's alone and can stay deployed for nearly a year.

I know Annie said I should have her change my assignment but this is Shafer's way of retalliation.  It's funny, we have to do TeamSTEPPS (how to be a better team) at the END of our deployement; when everyone is so bitter and personalities are out there.  I know that I will never be this person's friend and I am done with her. 

On the better side, although no one knows what the outcome of this child will be neurologically, he did extubate well and was doing ok at the end of my shift.  I honestly hope we can keep him off the ventilator so he can go home to his family and either pass with them or live.  His father explained to me what happened to him.  First, his name is Iman.  He is a pre-teen.  He was near the road and a taxi cab hit him.  The father was so upset, he jumped off the roof he was working on and ran to his child.  His mother ran and picked him up; when Iman didn't answer she screamed and fainted.  His father sat next to his bed and prayed for his child today.  Yes, this is such savage behavior (I hope you realize this is sarcasm). 

I am still having a difficult time with the passing of Feisl yesterday.  I sat with Dr. Peterson and had a long chat with him.  I don't have a problem understanding we're in austere conditions and we don't have all the amenities of home medicine.  I understand this child's outcome was probably not positive and that withdraw of care was the most logicial option.  I am angry he suffocated.  Why didn't we put oxygen on him when he was maintaining his sats?  Why wasn't he more medicated?  Why did I see his eyes in my sleep last night and wake up in tears again this morning? 

I surely didn't appreciate the chaplain stating she didn't think I should work in Pediatrics.  She doesn't know me, she has never spent adequate time with me and when I went to her for spiritual guidance she angered me more with her flippant answer.  She stated once when we were putting together the Resiliancy program for the hospital that she didn't want to be bothered with people's personal problems.  At that moment I decided she was not someone I wanted to share things.  The second encounter was when I went to her with the horrible death of Gull Akbar and she made the flippant comment "Well maybe this will teach you not to be angry."  What the hell?  Of course I will get angry, tired, happy, sad, depressed....hello, I'm human!

Yes, this is another ranting but I can't share with anyone here so thank you for reading.

Mass Cal

Today started somewhat normal; got up at 0330, went to the gym, showered for work.  I got done early enough I was able to run to the laundry and start my clothes before shift.  I even had time to run to the DFAC for breakfast with Tovar.  I should have known something was amiss.

 I got to work and then found out the water had been turned off to the hospital so my clothes were not done before I started work.  I had two patients; a little boy who was hit with shrapnel and an Afghan National Army soldier who was shot in the head.  I thought, no worries easy breezy.  Again, I should have known something was amiss.

I was super busy with both of these patients, the day flew by.  One would think this is a good thing (and actually it is because the faster the days go, the faster I get to home) but it was exhausting.  The little boy had pain issues and the soldier had breathing issues.   My tech was having some emotional issues so I was left alone quite a bit and had to jump between the two. 

After shift, I was kind of looking forward to dinner.  The last time I had eaten in the day was 0600, breakfast and it was now 1900.  Yes, Tovar insists I had a banana but it wasn’t THAT filling.  We were roped into going to a discussion group regarding the care of EPWs. 

Maybe I’m jaded or I have learned to compartmentalize.  I do have issues taking care of EPWs; I also have issues taking care of soldiers who go out and kill innocent people for sport, or the abusive spouse and etc.  It’s the same for me; it just takes twice the amount of energy.   I made the comment that this is the time I request dobhoffs or rectal tubes for the patient (and I wasn’t kidding, medical care can be WAY more torturous than water-boarding and it’s socially acceptable).

FINALLY after an hour and a half (Tovar promised only 20 minutes) I was finally going to get to eat dinner.  We ate and the food was the same and we just relaxed.  I came home to go to bed early and had just fallen asleep when my roommate told me we were being attacked…again.  We went into the hall and sat until we were called into work for a mass cal. 

I was of course in my pajamas and ran to put some scrubs on.  Funny, but when you are called to do your job you don’t care that your hair is a mess and everyone will see you as you just roll out of bed.  No one cares you’re not wearing a bra; you’re just there participating with the rest of the team to care for the injured. 

Thankfully we only had five injured and their injuries were not life or limb-threatening.  For as many times as I complain about the abuse a nurse has to put up with, it’s really awesome to be a part of something so much bigger than I can ever imagine.

Admirable Ladies



Red Bird



I met Col McNeill at the Norfolk airport as we were boarding our plane.  A great impression I made on her when she introduced herself and asked me my  name.  For whatever reason, I couldn't remember so I looked at my name tag.  That's when I found out she was to be my Flight Commander!  She is a very special and unique woman.  She has her PhD in Nursing, is one of the most intelligent and secure women I have ever met.  I admire her with all my being and would do anything for her.  The other day, a few weeks ago, she was assisting Dr. Gerlach with a  swan, and it was beautiful and smooth.  Watching her gave me a sense of pride and admiration.  She is very forward and works really hard to make sure we're ok.  She didn't take a day off work for the first 79 days...she even worked for one of the nurses on call so he didn't have to be called in when we had a very busy day.  She emulates all I would like to be in a nurse and Air Force officer.  


 A funny story about Col McNeill.  One day she and I were sitting together in the nurse's station.  Tovar said "Hey red, get over here and help me."  She walked over and said "I certainly hope you were not referring to me."  He got so red...so part of our resiliancy program is having silly name tapes; she ea  rned the name "Red Bird"

Big Bird

Another woman that I admire is Col Hughes, our Chief Nurse.  She is the example of a Chief Nurse that I look up to as well.  She takes time to check on her people, assists them with their career goals and what's more is that she only has us for a snapshot in time.  She treats us like we belong to her and really tries to help us out.  She comes up with fun stuff to do and when she mentors, she doesn't make you feel bad, just makes you realize how you can be better.  She, like Col Mcneill is not afraid of getting her hands dirty...she was in the OR most of the day working in scrubs, like a regular nurse.  We gave her the name "Big Bird".





Dr. Veesart and I after
redeployment ceremony



Jan Veesart is another woman I admire.  She is one of the ER docs and prior to that she was a ROCKET SCIENTIST for the Air Force!  She got bored after a while and decided that medicine would be fun.  She took a cut in her rank and went from a Major to a 2nd Lt.  I hang out with her periodically on my days off and she's interesting.  I have worked with her in the ER during trauma calls and she is one of those docs that maintains calm and focus.  She is the one I'd choose to lead a code.  After she retires, she wants to go work in Austrailia through a program for docs.  Oh, and this was my doc when my cyst burst.  Great lady!



Dr. Hight after a long
night of surgeries



Dr. Hight is another lady I have come to admire.  She was our trauma czar until recently.  She worked  tirelessly to save a life or limb, treated the nursing staff with dignity and respect and always tried to make things better.  Sometimes we would not understand why she would do so much for our less desireable patients but it was her commitment to saving lives and the hope that the less desireable patient would provide information to help us in our fight.  She fought really hard to save Sabid but also knew when it was time to give up and let her die with her family.  I enjoyed our conversations and she is one of the few docs that can provide me care.

What I admire most about these women is their tireless effort and commitment to their professions.  None of these women had  a day off, could call in sick and had to be ready to perform at a moments notice.  They offered mentoring and did not make you feel like you were less than you were.  Thank you ladies for all the great lessons you have taught me.

Yesterday was probably the worst day being here, that I can remember.  Anything that could go wrong did and I was in tears most of the day...not from being sad but from being so angry.  The docs do not listen to the nursing staff nor do they include us in their plans for the patients and we get caught off guard.  Our docs on the day shift don't want to work, so they don't make decisions and are constantly deferring to someone else.  If one had made a decision the day before regarding my child, he probably wouldn't have extubated himself during a coughing spell!  They also had the nerve to ask if he was salivating so much and my response was "I told you that YESTERDAY and asked for some medication to help dry him out!" 

I had one doc yell at me for not checking my orders, yeah so I'll ask my patient to please not go into respiratory distress from his coughing spells because I didn't get the x-ray on the other patient.  I don't know, maybe the doc could have been a little more helpful and called x-ray himself...seeing I was pretty tied up with saving my patient?  Nope, he's only good at being a retarded ass.

Our enlisted leadership have spent much time coming up with new rules on the cleaning of the dorms.  We have contracted employees who are supposed to clean the dorms and if they don't show up then it becomes our responsibility...Thanks.  So on the day I have to do my bay orderly I guess I'm supposed to just leave my patient for three hours to come clean the dorm.

I am off today and I plan on hiding out in my room all alone and just taking care of me.  I need to because yesterday was so bad.  Hopefully tomorrow I'll have a different perspective.

Things I miss

It's getting closer to my redeployment and I am so excited and a little nervous.  We are being told that because our lives have been a perpetual Ground Hog day for the last six months, life at home for our loved ones and friends have continued.    I feel confident that I won't go home and start making changes right away but there are some things that I miss.

One thing I miss is having a telephone that I can pick up and call my friends to just talk.  I miss having someone to REALLY talk to and who will listen.  I have found that I have been pushing my emotions aside so I won't feel anything because there is no one here I can talk to.  Some people have found that connection, I have not.

Another thing I miss is food in general.  I am so sick of fat, salt ladened food that is tasteless.  I can't believe the military wants me to be "Fit to Fight" yet I am forced to eat such crap.  I haven't lost any weight which is really annoying considering I go to the gym every day.  Being fit is 80% food, 20% exercise.

Alone time.  This is something else, I am NEVER alone and for a huge extrovert this is a big deal.  I can't stand being around people right now, there are so many.  Imagine you're at Disneyland and waiting for a ride everywhere you go and bumping into people left and right...even in your living space and do this for six months.  It becomes quite annoying.

I miss driving my car and just hearing the music and zoning into it. 

I miss my family.  I miss the simple things like Konner sneaking into my bed or Kodi just sitting to talk to me.  I miss sitting in the chair and snuggling with one on either side of me.  I miss being able to go with Tom and the boys to do something together as a family or just being in the house watching t.v. while the boys are outside playing.  I miss being able to cook a meal and sitting around the table talking about the day.

I miss clothes.  I've worn the same thing everyday for the last six months and I'm tired of wearing it.  I want to put on a sundress and sandles.

These are the things I miss and the closer I get the more I miss them.

TeamSTEPPS

Today was our first day for TeamSTEPPS training.  This training is to teach people to work together as a team so there are fewer mishaps.  This concept for this training came from the Crew Resource Management training, yes that I got to  be on the ground floor for developing for the Air Force. 

I like the concept of CRM or TeamSTEPPS (the medical version) but the concept works when everyone is on board.  Unfortunately I don't think that will happen for some time in the medical field.  First, the surgeons need to listen to the nurses and understand we spend at least 12 hours with the patient.  They see them at a glance.  Second, nurses need to quit stepping on each other and stabbing each other in the back.

For example, this morning when I took report on my little boy I did his neuro assessment and noticed his pupils were different from the day before.  When I asked the nurse who took care of him overnight if this was a change to her, she stated his pupils had been like that all night.  I immediately went to find the doctor to let him know. 

This nurse kept telling me his status hadn't changed and I repeatedly stated it was different from when I had him so it was a change.  She took this to mean I was accusing her of not properly assessing her patient and ran to tell the Colonel I was rude and accusatory to her.  She had also stated I had done this in the past (which is not true).  This particular nurse and I have had some issues from our previous base. 

After the Colonel spoke to me regarding the situation, I resolved it with doing an over the bed check with her during our evening shift change.   I'm sure she'll have a tale for the Colonel and there will be another discussion.  Sometimes when people get defensive there are reasons, and thankfully those at my home base are aware of her reasons.

I really am starting to become very angry with so many silly things right now.  I am tired of people and putting up with their ridiculous habits.  It seems the closer it gets to going home, the less tolerant I am becoming.  I REALLY need to work on that because I don't want to lose my mind and fly off the handle for no reason.  I just need to bide my time so maybe on my days off I'll hole up alone on my bed and close the blankets around me and recharge.

Ramble

As my time here is coming to an end, things are picking up.  This morning when I got up to go to the gym at 0330, I heard the giant voice "IDF on BAF, don IBA!"  So I woke up my roommates and we put on our battle rattle and went into the hallway.  I was thinking "just five more minutes and I would have been outside on my way to the gym.  A scary realization. 

As we were standing in the hall they were calling for the various folks; ER, OR, anesthesia...  We had a report of a mass cal that was to take place and I guess it happened today.  Thankfully there were only three injured, one death; an Afghan employee.

The day went as usual, I had two patients.  A very elderly Afghan man and a small three-year old child.  I have become attached to the children.  This adorable little boy was crossing the road when a taxi hit him.  I am thankful that we accepted him.  Right now he's in a a coma and I've been praying he'll wake up, no luck yet.  I asked Dr. Braxton to please fix him today because if this child dies, my heart will certainly break.  I don't know if it's the mother in me wanting to protect these little guys or if I just miss mine so much I've adopted them all in my heart.  His name is Fisel and he's so precious, so please say a prayer for him. 

His brother is his guardian and when he talks to Fisel, I see him respond hemodynamically.  This afternoon, a friend of the family showed up to gather information on him.  He said his parents are worried sick about his condition.  I gave them the only information I could, stable but not waking up.  The concern of the family and the love on the brother's face makes me want to gather anyone who thinks these people are "savages" and show them they are just like us!  

This post seems like a lot of rambling but my thoughts are jumbled today.  I keep thinking how much I want to be home, how much I want to have some alone time, I want to eat some normal food, take a bath, wear something different, how much I want the docs to quit thinking they are the only ones healing these people.  But on the other hand, I want to stay and do this wonderful work we're accomplishing over here.

I am so annoyed with anti-war protestors.  Do they think we want war?  Idiots, no one wants war it's just part of the human race.  I know what we're doing here is good, and we're showing these people that we care, maybe our time here will prevent the next bin Laden. 

Sorry for the rambling, just can't organize my thoughts today.

Lord of the Flies

I recently read an article in Rolling Stone about the Army Battalion "Kill Team".  These soldiers were sadistic and took it upon themselves to go out and just kill Afghans.  At first, I felt like it was a bunch of media hype and then after reading the article, my heart sank.  These soldiers were so bent on killing someone they sought innocent people and not only killed them but mutiliated their bodies for trophies.  Their "reasoning" behind these killings is that these people are savages.  Reminds you of another time in our history, doesn't it.

The six months I have been here, I have seen these people as kind, warm and loving.  I don't see the "savage" side of these people.  Their culture has been destroyed by war.  The majority of Afghans I have met are grateful and generous.  They are so appreciative of the care we give them and I have fallen in love with so many of the children. 

I had a female patient the other day who was shot by the Iranian police when she tried to cross the border to see her mother.  This child is 16 and has now lost her leg.  She is a beautiful girl and I asked her how she felt about what had happened.  She said "I don't deserve this, I'm only 16."  My eyes welled up with tears and I sat there and held her hand in silence for a while.  Although we don't speak the same language I think she understood my heart was breaking for her.

I hate what these wars have done to these people but I honestly believe with my heart we can help mend this country.  I just wish there weren't incidents of our military acting like the savages they claim to hate.

I am angry the media posted this story because it puts the majority of us who are not sadistic in danger.  I'm more angry with this Army Battalion for allowing this kind of activity to happenlook down upon us as a military.  Please when you read those acts of savagry of our military, remember they are the few and get the attention.  The majroity rest of us are working our tails off to make things better, it just doesn't make good news.

Saturday the 14th

Before I begin this post, please remember I am an ICU nurse and without sick patients I cannot hone my skills.  I don't wish anyone ill, it's just the job. 

Today started out a little slow.  We had six patients, two of which would transfer to the ward after rounds and two in the CCATT bay (this is where we keep our injured Americans and coalition forces).  After rounds, my patient transferred and Tovar's went to the OR.  Around 1200, I got word we were getting a patient from the ward.  This patient had a dissecting aortic aneurysm, from the right carotid to the left iliac artery (picture a beauty queen's sash)!

We got the patient and hooked him up the monitors.  His systolic pressure was over 200 (this is VERY bad) and his heart rate was in the 80 (not good).  As we were getting him going, I started to feel like I was in my element again.  I told the docs we needed an art line, central line and told my tech to get a foley in the patient.  The patient asked if he could go to the bathroom and I said "You are not to get out of bed, we will get you a bed pan."  His next question was "Is it really that bad?"  How could I tell him he's a ticking time bomb just waiting to go off!  My response was a simple "Yes."

After we got him hooked up, I started getting the meds ready to titrate.  They were hanging on the other side of the docs, who were sterile.  So I did the only thing I could do, crawled underneath and between their legs.  Yes, I'm sure it was quite the site. 

I got the meds going and started to titrate, I don't think I've ever run esmolol and nipride at such high rates before but after about an hour, we got his pressure down but not the heart rate.  This patient was so critical we had to air evac him out of the country like yesterday.  Our flight med folks were working on the flight, one was generated to leave in four hours.

When the CCATT team showed up, my patient's mental status started to diminish (again, not good).  The team intubated him right there in the bay and then had to go to the next patient to put in a chest tube...it was CRAZY busy!

I think what upsets me most is the fact this person knew he had this condition before he deployed and his civilian doctor (from the information I am gathering) knew he had it and cleared him to be deployed.  This guy is not out of the woods.  If his aneurysm completely dissects, it doesn't matter where he is all you can do is watch them die.  My big question is was it worth it...my answer is NO.  We'll have to see what happens, he's in the air and for his sake I hope he makes it.

The Biggest Frustration

I think my biggest frustration with being deployed and a nurse is the lack of consideration for others. I honestly believe in the core values we have, but it is so hard to maintain on that track when there are so
many people around you who do not.  For example, my roommate.  She continues to be inconsiderate keeps me up at night, so I am sleep deprived.  Then I have to come into work, a stressful situation at times and try to be on my best game.  Today did not work out so well.

I have a patient who has anoxic brain injury.  He was the victim of a rocket blast and then a mud house fell on him and they were not able to recover him for four hours.  He suffered anoxic brain injury.  He came in with a GCS of 3 (a dead person can have a GCS of 3) and his best has been 8.  Eight is not a good number.  He continues to deteriorate despite treatment.  Today we had an ethics committee regarding withdrawal of care.  I thought the docs were all on board with this until the neurosurgeon stepped in and made the comment that his encephalopathy may be related to his new pneumonia.  WHAT?!  His neuro status has declined, whereas he was at first purposeful and now only withdraws to pain.  Not only that but what chance does this man have in this country with NO REHABILITATION HOSPITALS AND HE WAS LIVING IN A MUD HUT?!  Do they think his family is going to be able to care for him?  So we are to give him 48 hours of antibiotics and see if he improves his neurological status.  I have never heard of vancomycin improving a neuro injury, but who am I, just a nurse.  I wish I had been awake to open my mouth and say something.  I don't know if the military or what but I am not as vocal or as strong as a patient advocate as I'd like to be.

I think I'll quit trying to be so politically correct and just say to hell with political correctness and just start being a better nurse.  I need to remember how I used to be and get back there quick.  I was a better, smarter nurse before I came in.  I find advocating for my patients to be a mute point because most of the doctors don't care or listen.  I think it's because they don't fear reprisal from lawsuits.  I used to think that was ok, but maybe they should be subjected to lawsuits; maybe they would CARE a little more.

I am also frustrated with the wastefulness I see.  We are in a war zone and have LIMITED supplies and to see or hear someone say "Well, it's free" or "it's not like it costs anything" makes me want to hit them in the head.  It's OUR tax dollars so yes it does cost something.  Maybe when we don't get a paycheck they'll reconsider.

Mother's Day

This morning started with a bang, literally.  Tovar, Col McNeill and I were walking to the gym at 0330 this morning when we heard a loud "bang".  We quickly ran for the cover of the bunkers, only there were no bunkers to be found.  We didn't hear the alarm and no one else was running so we decided it must have been an MRAP backfiring.  Later when we were walking back from the gym, we heard a loud explosion. Col McNeill and I just looked at each other and decided it was a controlled det, and we weren't notified. 

Unbeknownst to us, it was an IED.  Two Air Force members found it this morning while patrolling the perimeter.  They didn't find it without injury.  Both members are ok but both had amputations. A third victim I just learned was the dog.  Apparently, we here at CJTH will also care for the military working dogs if they suffer injuries during battle.

I'm sure PETA would be very proud!

The day was going as normal and then I tried to advocate for my patient because the doc I was working with was much too involved with his phone to listen to me.  A patient we had been monitoring all day for an aortic aneurysm was going to fly unmonitored to Germany.  Not only was he going to fly unmonitored but they wanted to start him on a new cardiac med he had never taken.  I had an issue with that and after going through the gamut of docs passing the buck, one finally said "d/c the Toprol."  So I didn't give it to him.  The original doc was angry and I had to remind him of the conversation we had while he was playing with his phone. 

So I went to dinner and had the usual meal, and the Fluor lady was passing out Mother's Day packages...mine had a box of Kotex in it!  Karma maybe?

I don't think I will forget this Mother's Day in particular.  I did, however, get to talk to the boys and they are so looking forward to snuggles when I get home and that's what I will have on my mind tonight when I close my eyes to sleep.  Happy Mother's Day to all my friends.

Retaliation

So last night I was skyping with Ashlee and suddenly I hear rockets.  We all gather in the hall in our IBA and we were held there for a couple of hours.  We are pretty fortunate to have the type of building we have so we're fairly safe.  I know we were laughing and joking, like usual, but there was a difference.  When we couldn't find one of our techs, it was stressful.  We were hoping and praying he was ok.  He was.  I however, was very stylish in my pajamas and gear...oh yes and with my weapon.

We now have three EPWs on our floor, one is 15.  Hard to believe these young kids are part of this war but that's what happens when a country is so poor it's inhabitants will do anything for money or to save their families.  Who knows what the motivation was for this kid, right now he's our patient. 

I have serious doubts about O/Usama Bin Laden's death.  I am not into conspiracies created by our government...I am probably very naive.  I want to believe our government officials do what they do for the benefit of it's people rather than their own self fulfillment, but I am beginning to believe I am incorrect.  I hope the death of this terrorist was not a media plant in order for President Obama to raise his ratings, if so, he did it too soon because if the economy is as bad as it is now, people will forget May 2nd.  I just find it odd that he was buried at sea and no pictures.  I don't know, just skeptical right now.

More missed special events

When the Air Force said "You'll miss a birthday or a Christmas", I didn't realize I would miss all of them at once.  I have missed every event from Christmas to Mother's day and all the birthdays and anniversary's in between.  Today is Easter Sunday and I am here in Afghanistan wishing I had been home dying eggs.  Fortunately I did get to spend the day with a few kids.  These are Army kids and while they were here exercising their right to defend their belief, they were shot (at least these fellas have their limbs, they're just broken and bruised right now). 

First I'll talk about Scott.  He was shot in the arm, I think it's becasue he was waving at the Taliban and trying to be friends.  Okay, not really but that's my story and I'm sticking to it.  This kid is 22 and has a three year old.  Everytime I changed his bandages he kept saying "Ow!"  I had to put it in perspective for him, which was worse, pulling the hairs with the tape or getting shot in the arm.   Getting shot always won, imagine that!  He was pretty great.  We chatted for a while and told some stories and then the CCATT team came and whisked him away to Germany.  Bye Scott, it was great knowing you.

My other kid is Zach.  Zach was playing Army out in the desert when a helicopter went down and his platoon was sent in to save the pilot!  Pretty incredible, like BlackHawk Down!  Anyway, Zack puffed his chest out to the bad guys and practically dared them to shoot him...so they did.  He's ok, very minor damage and he'll need a little rehab but he's going to be ok.  I asked him to not tell me what really happened because I didn't want to have to be debriefed (and I don't mean in the good way).   Zach had a lot of visitors, especially his two buddies, Cody and Taylor.  I'll post their pics a little later, because as we all know, posting pics on this service takes too long.

I can't wait to get home and make up for all the holidays that I've missed and be able to tell some cool stories while I'm at it.  I agree six months is much too long for being away from your familly,

The Death of Osama

Why does U/Osama Bin Laden, the mastermind behind the attacks on 9/11...the reason we are here get his own post in my blog.  Because even in his death he instills fear in me.  First, I found out about his death via Facebook!  As I saw the posting, I searched the news sites on the web and found nothing.  As the day started to unfold it was on the new sites and television and it felt surreal. 

As the folks in the United States celebrate his death, those of us here in theater are a little more cautious because we know that with his death comes retaliation.  The Taliban have already proven themselves to be patient and tenacious.  They dug a hole 1,000 ft under a prison with spoons to release 400 of their brethern, so what makes us think they are not plotting something because we killed their leader?  Because Bin Laden is dead means we're in more danger.

The base has stepped up security and I was VERY hesitant to be happy in front of the local nationals who work in the hospital along side us and I'm suddenly more suspicious of them.  For the first time in the five months I've been here, I am feeling actual fear.  I wasn't afraid the first time they shot rockets at us or the first time I saw the result of their deadly IEDs.  Today, I feel it. 
I am afraid of the aftermath.  The Taliban had threatened that they were starting their spring offensive on 1 May and today their leader has been killed by U.S. Forces (good on the SEALS and good intel).  I think President Obama also felt a little fear today because he used the word "God" three times in his address to the country.  I cannot recall a time he used the word "God" in any of his speeches.

So as my friends and family celebrate the death of this horrible man in the U.S. I know I have to keep my head low, eyes open and guard up more than before; and that is the reason he gets a post.