Memorial Day 2010

Today was Memorial Day in Afghanistan.  From the looks of the Facebook updates of my friends, it appears the US spent the day Barbeque'ing.  That did not happen here.  We had a 10K run this AM which I ran and got my shirt.  There was a memorial service and the flag was half staff until 1200.  But for the most part, it was business as usual in the business of saving people from being honored today.  I'm sure someone has been added today to the rolls of those who gave all.  Being here and seeing the broken bodies of the men (and one woman) who have been mangled by this war gives this day a whole new meaning for me.

Today there were several articles in the media about women in war.  I've included one here, as well as the photos that go with it.  I definitely have mixed feelings about the issue.  I think that women ought to be able to do the same things men do, but at the same time, most women cannot carry a 80-100 pound ruck.  Nor can they fight hand to hand in the same way.  And a man's instinct is often to protect a woman, perhaps when he should be fighting.  The article I attached is a good example of how women can be useful on a similar playing field as men.  A few weeks ago, we had a female soldier on the ward who had lost her leg.  She was pretty, with blond hair.   She still had her make-up on when she came to us.  She had been attacked with an IED and  had lost her leg just below the knee.  Her presence was very hard on the the staff.  I think they get used to seeing young men and foreign men, but they are definitely not used to seeing a woman.  Everyone can picture their mother or sister in that young woman and that makes it personal for them.  It's the same way with kids- those are very difficult for the staff.  maybe more so, because they were usually playing when they stepped on the mine or were hit by a flying bullet.  It has really made me appreciate my family and how lucky I am that we are all OK.

http://www.nytimes.com/2010/05/30/world/asia/30marines.html
http://www.nytimes.com/slideshow/2010/05/29/world/0529MARINES.html

I hope you all have a relaxing day today.  Please say a prayer for the families of those heroes who gave all so that we can continue to live our lives as free citizens.

SCARY!!!

Holy crap.  I had decided earlier today that I wanted to watch a scary movie tonight that I've had for a few days.  I love scary movies and I love scary Steven King movies the most.  I've had "1408" sitting in my room for about a week waiting for a good night to watch it.  I got back to my room at about 1000 after being out doing some stuff and wasn't too tired so I decided to watch it.  I made some popcorn and settled in.  With the light off.  What the heck was I thinking?  Well, after the ghosts started popping up and then a scene made me jump and yelp (!) I turned a small light on.  There's brave and then there's stupid, OK?  AND....I'm under the sheets while watching and everyone knows they can't get you if you're under the sheets.  But only my bottom half was under and I wasn't taking any chances.

Anyway,  it's at a scary part...(the movie is all about him being haunted and he can't tell if it's really a haunting or if he's hallucinating)... and I hear a knock that sounds like it came from my door!  I 'bout jumped out of my skin!  Then I thought it was part of the movie because sometimes it did that thing where the sound only comes out of one ear phone, so I thought maybe it was a knock on the door in the movie.  Then it happened again.  Then I started to get worried.  What if it was a ghost at my door trying to freak me out?!?!?  IT WAS DOING A GOOD JOB!!!!!!   So I said, "Who is it?" and I didn't hear anything.  So I said it again and heard a little noise outside like a voice.  It's after midnight and no one has ever knocked on my door that late unless there was a bomb.  I hadn't heard any bombs.  (I say that so casually....  like, we didn't have any bombs today, how interesting.  I suppose that feeling/concept is beyond most normal people's experience.)
So I get up and tentatively answer the door feeling like the bimbo in a Halloween movie or something when you're screaming, "Don't answer the door you idiot!! It's the KILLER!!!!!"  But I'm telling myself it's probably not a ghost or a killer because this is Afghanistan and all we have is the Taliban.  And they don't knock.  They rocket or blow themselves up or hide and blow people up from afar.  They don't knock.  Anyway, I'm thinking the odds are in my favor that I probably won't die if I answer the door.

I didn't die and it wasn't a ghost.  It was just a couple of my nurses needing a form signed urgently for a patient. She was a Lieutenant and I think she was afraid I'd be mad to be woken up because she seemed as relieved that I was already awake as I was that she wasn't a ghost!  I told her the story and how I thought she might be a ghostly killer and we had a good laugh before I signed the paper.

Oh my goodness.  What a night.  Now I can't turn my light off.  I knew this would happen....

Rockets and Small Arms Fire

Wow.  We got hit by our first complex attack since I've been here.  That when the enemy uses more than one method.  I'll tell you a bit about it, but I can't go into some details for security reasons. I'll tell you what I can.  Early in the morning, I was alerted that there had been a rocket attack.  We usually take cover when that happens.  The hospital goes straight to work in case we get casualties. As we were getting our stuff on to go out the door someone heard machine gun fire, so we sat tight.  I was in my room when I heard it and got down on the floor to put my vest and helmet on.  It sounded like it was right outside my room on the street!  Turns out it was a helicopter right overhead firing at some bad guys and the news reports say they got about 5 of them.  That's the first time my heart rate has really gotten up since I got here.  All I kept thinking was "Get 'em, guys!"   You can read in the paper that about 7-10 insurgents were killed (I can't tell you which number is right), some of them with suicide vests and that 7-9 good guys were hurt (can't confirm which of those numbers might be right either), and one contractor was killed (that's right).  And one building that was pretty close to the hospital got hit by a rocket.  The spokeswoman said it was not of strategic importance- that's definitely true!   After the shooting stopped, we went next door to the hospital and got everything ready to accept casualties. 

I was so proud of all my people.  I have brand new docs in the ER and new surgeons.  I got to watch my new guys in action in the ER and they were outstanding.  Very calm, very collected.  Then I followed several patients to the OR where I watched my surgeons calmly go to work.  One guy had 3 specialists working on him at the same time.  When one of the ortho docs had to go, I offered to take his place (he was doing some minor debriding- that's cleaning out a wound) and he said OK!  So I got to do a bit of surgery and interact with my new surgeons on their own turf.  I like surgeons.  it's like herding feral cats, but they don;t do anything just because someone says so.  You've got to have a good reason.  And even then they don;t always want to get with the program.  They remind me of myself, except that now I sort of have to get with the program.  but I digress...

My airmen were thinking for themselves- problem solving quickly and coming up with solutions to issues. No one felt like they had to run everything past me before they could make a decision.  I love that they know their jobs so well that they just do them and problem solve creative solutions along the way without my input.  

I was also very glad that the bad guys let us sleep last night!  I'm sure they have more planned as things have been relatively quiet here for awhile and I think maybe they were saving their stuff up.  Security is tighter of course, and there are some things we can;t do that we did before.  My running will be a bit inhibited for awhile since my route ran past the past the perimeter fence.  Maybe not a good idea for a little while.

This is one of the most accurate news articles:

http://news.yahoo.com/s/ap/20100519/ap_on_re_as/as_afghanistan

Raised by Wolves

OK.  I just do not see how hard it is to clean up after yourself, to think about other people, to think that people might be sleeping and maybe you should close the door quietly.    We live in tight quarters here.  In the dorm rooms, there are 6-7 people to a room.  Luckily, I have a room by myself, though!  But my troops are 6-7 to a room in the dorms.  There are 4 sinks and 4 toilets that are shared by 50-60 people.  All of our water is trucked in, as there are no sewers or water pipes here.  We take 3 minute showers so that everyone has hot water.  People work all kinds of shifts and there are day sleepers mixed in with night sleepers.   Even if you are a night sleeper, you may still be asleep at 0630-0730 when the night shift is coming home.  So answer me this!  How come people can’t figure out how to close a door quietly, flush a toilet, follow simple instructions to make sure the toilet stops running, wipe down the sink, get their disgusting hair out of the shower, and wipe their tooth paste spots off the faucet?!?!?!     GAH-ROSS!!!! 

There are signs up in the bathrooms explaining how to pull the cord and then jiggle the cord to stop the water running.  I know because I do it to AT LEAST one toilet EVERY SINGLE TIME I got to the bathroom!  It is completely disgusting that I wash my hands or brush my teeth in a sink where there are toothpaste spots all over the faucet.  Hair in the shower.  I just cannot get over the fact that people cannot figure out that they are not the only ones who use these facilities.  There are signs asking people to wipe down the sink and faucet.  About 1 in 10 does, I think.

And where do I place the blame?  On the mothers.  It’s a mother’s job to make sure her kids know how to keep things clean and to think of others (OK, it’s the dad’s job to make sure boys know how to hold doors for women!).  But it’s the mom’s job to make sure kids do their chores, to check behind them and to make sure they are doing them right.  It’s the mom’s job to help kids realize they are not the only ones in the world and to help kids see the world from other people’s eyes.  Think about who might be sleeping when you slam that door or who might be coming behind you and using that sink.  And in my opinion, there are a whole bunch of mothers out there who have not done their jobs with the women who live in my building!!  They've been raised by wolves.

OK.  I’m done. 

Bright Sides and Other Hands

I am a Bright Side type of person!    Likewise, I'm a On the Other Hand person.  Whenever something bad or yucky happens, I have a negative thought.  Negative thoughts come very naturally to me, but then it is usually followed quickly by looking on the bright side.  this hit me like a ton of bricks yesterday when I was walking in the wind and thinking how windy and dry it was.  On the other hand, that means it's not rainy and muddy.  When it's raining, there's mud, but on the bright side, it could be snowing in the mountains and slowing down the Taliban.  AND......there's no dust!

Negative people really bring me down and then it makes me kind of grouchy.  So imagine how difficult it must be to have a husband and a daughter who are pessimists. One of the things that Jack does that bothers me the most (beside the fact that he is incapable of opening a door quietly despite me trying to teach him for 20 yrs) is the fact that whenever I have an idea, his first reaction is all the reasons why it won't work or can't or shouldn't be done. My reaction is virtually always, "How can I say Yes?"  Obviously we are complete opposites in that regard.  It used to just annoy me, but since I have noticed it over the last two years or so, it just makes me mad.  Partly because it's so predictable.

But back to the topic of the bright side.  I love that there's a bright side to most things. And I think that people who can look on the other hand tend to be happier and more successful than those who don't.  Michael J Fox is an optimist and has actually looked at the research on this topic.  Optimists are healthier and happier than chronic pessimists.  I think that's pretty cool.  And for me...I wouldn't have it any other way.

the Good, the Bad, and the Ugly

This morning I was thinking of a couple of people here that drive me crazy and it got me to thinking about tolerance and appreciating people.  Both irk me for similar reasons, yet also have similar qualities that I respect.  They are good at what they do, everyone knows they are good at what they do, and they know they are good at what they do.  But in the knowing, it's just that...knowing.  It's not arrogance.  It's just knowing as a fact.  they are both very hard workers.  And I don't think either one does things for personal gain.  They have the best interest of the patient or their people at heart.  The problem is, frequently, they are abrasive.  One is flat out abusive and has been talked to several times.  The only thing that makes them remotely tolerable is that I think they have good hearts.

Having a good heart and meaning well covers over a lot of sins in my book.  It doesn't excuse them, but it makes them easier to tolerate.

A Price to Pay 24 March at 9:39PM

Today started out well enough.  Went to rounds and then to the gym.  Somewhere around 1100 my morning calm was shattered.  I can’t talk about the details, of course.  Even idiots deserve their privacy.  But what I can say is that all is takes is one reckless idiot to ruin a perfectly good day.

I had four sessions with the squadron last week to be sure that everyone could attend one.  I laid out my expectations.  I told them what I liked and what I didn’t like.  I told them what I would not punish (a mistake) and what I would always punish (a crime).  Less than a week later, I have someone violate the most basic of all deployed orders.  It’s called General Order Number One (GO1) and it covers a whole host of things.  No gambling, pornography, taking souvenirs, going into mosques.  No alcohol, no going into the quarters of the opposite sex.  No keeping animals as mascots or pets.  No leaving your weapon unattended.  The list is long, but they all make sense.  Everyone is briefed when they get here.  Some of the rules might be a surprise when someone gets here, and might not make sense right away (no mascots?!), but when you think about it, they make perfect sense (yeah- RABIES!). 

When someone violates GO1, they put not only themselves at risk, but they put others at risk.  It could cause an international incident and jeopardize peace.  If a person is drunk, they can’t defend themselves and they cause other people to have to defend them.  If they hang out in each other’s rooms and someone gets pregnant (which about 120 women every year DO!), they get sent home and their unit has to replace them.

I was unbelievably clear that there will be no tolerance for not maintaining standards and that everyone needed to watch out for everyone else.  So how, less than a week later, does a person go and FLAGRANTLY violate GO1, within the presence of at least two other people who should have stopped it, and at least one who facilitated it?  This person’s career will be ruined.  They will probably not get promoted.  They will go home in shame.  They may to have to stay here longer to see it all through, depending on how long it would take.  What a waste. 

For the life of me, I will never understand what gets into people sometimes.  This is one of the reasons I try so hard to help my kids understand how important it is to do the right thing.   You can’t just make up your own rules and there are consequences when rules are violated.  Sometimes devastating consequences.  This wore me out today.  But if I don’t take a stand on this one, then someone else may do worse and someone could get hurt or killed.  Now I know why they used to just shoot people back in the day.  Not that this person warrants shooting, mind you, but harsh punishment certainly serves as a warning to the rest of the troops.   The sacrifice of one may lead to the saving of many.  At least that’s what helps me sleep at night.

Afterward- 3 May 2010-

                The officer in question had to stay here 3 extra weeks while we got this worked out.  Turns out on of my junior officers was also involved.  Along with two enlisted members from across base and one enlisted member from the hospital not in my squadron.  My more senior officer got an Article 15- a Reprimand and suspension of half a month pay for two months.  The junior officer got a Reprimand and the promotion that was due this fall will be delayed by 6 months.  That one will be able to recover since they are otherwise an excellent clinician and officer, but had some very bad judgment.  It’s now a month after all the disciplinary stuff when I first got here (5 in three weeks!)  Had one more unattended weapon since then, but overall, the drama is down considerably- even the surgeons are behaving!