I Curse Sir Walter Raleigh

Business has certainly picked up for the FST here at FOB Lagman. We have been getting bombarded with multiple casualties; all from.....you guessed it - IEDs. I'm guessing this is most likely how it is going to be for the remainder of the deployment. It's now 2100 and we've been going strong since 0930 this morning. We received two different sets of Afghan Army casualties, two at 0930 and another four at 1430, all with critical injuries. It’s amazing how long a 40 year old body can go, especially considering it was pounding out High Intensity Intervals on the treadmill at 0530 this morning. We also had a nice Sand Storm that caused a delay in getting the first two patients transported to the Role 3. It’s something you can't plan for that ends up eating resources and wearing out your personnel. Although, I think I've described this team enough in this blog for you to know that we are willing to do whatever it takes to provide the highest quality care possible to ANY patient that comes through our doors. MVP of the day goes to our Orthopedic Surgeon, Sharese White, who had to take one patient from each of the evolutions to the OR, both cases lasted several hours.

The high point of my day was that I was able to take a 10 minute break and call Judi. Most of us missed lunch, but I did get my Saturday "cheat day" dessert in - God I love caramel! Here are some photos from the day and a link to the video that inspired the title of this blog. I think Barbie will appreciate it.

Take care,

John

http://www.youtube.com/watch?v=Sg6X28CThik&feature=related

p.s. while I was waiting for the pictures to load I walked to the ICU to make sure the second OR case was transferred to Kandahar and was informed that he may be staying the night because Kandahar is receiving incoming rocket attacks. I'll call tomorrow to check on RK.

Those Aren't Clouds Behind the Flags, It's Sand

Sharese, Between Cases, Telling me I'm #1

The OR at the End of a Long Day

The Jinx

I should have known better than to actually write down last night that I hoped I could spend today watching Reno 911! and not caring for casualties. Medical professionals are a superstitious bunch and I broke the cardinal rule. I was awakened at 0530 this morning to a radio call for everyone to report to the FST. Another IED blast with more Afghan men missing extremities. We finished up at about 1200 after transferring 2 patients to the Role 3 in Kandahar. Below is a pic of me at the end of this event. FYI, we finally got wireless internet so now I can use my laptop in my room and am not limited to 30 minutes at the MWR.

Once again, Happy Birthday to my beautiful wife, Judi!

Take care,

John

HAPPY BIRTHDAY!!! Or is it BIRTHMONTH???

This week was up and down for the FST. We had a couple days with no patients and a couple that were somewhat busy. We continue to get patients who were victims of IED blasts, more now than when we first arrived. I had a conversation over dinner last night with Shane Lawson, one of our two CRNAs, who has been deployed several times and he mentioned that most of the injuries he saw in Iraq in 2004 were from high-velocity weapons and were not as severe compared to the injuries we are currently seeing in Afghanistan. We took care of two Afghan men this who injured by an IED. They both had fractures of there calcaneus (heel) bones, which take an incredible amount of force to break. One also had fractures to both bones in his lower legs. He was transferred to the Role 3 in Kandahar where his left foot was amputated the following day. I spent today taking care of another Afghani who was also a passenger in a pickup truck that hit an IED. His right foot was mangled (an actual Orthopedic diagnosis I found out) and was amputated in our OR. It may seem that we are becoming apathetic towards some of these injuries, but we are not. Many simply seem the same.

The highlight of the week was Thursday, which was the 102nd birthday of the Navy Nurse Corps. The Nurse Corps was established in 1908 with the first women to serve in the Navy known as "The Sacred Twenty". It is tradition to have a cake-cutting ceremony where a chaplain performs a "blessing of the hands" and the most-junior and most-senior nurse cut the cake. This FOB does not have a full-time chaplain, so Doc Z substituted. I had the baker at the dining facility make us a cake and we had a small ceremony. Here is a picture:

Pictured left to right; LCDR John Eckenrode, LT Shannan Cook, LCDR Sue Howell, LCDR Robbie Ladd, LT Shane Lawson


Following the cake-cutting ceremony was another special event - the shaving of LCDR Robbie Ladd's head. In an attempt to raise money for our MWR Fund (Moral, Welfare and Recreation) we had a silent auction to shave Robbie's head. What's the big deal, you ask? Robbie loves his hair. The running gag throughout this deployment was how long it takesRobbie to do his hair and how much "product" he uses in it. The winning bid was $150 from our Orthopedic Surgeon, LCDR Sharese White. She fronted the money and then let the corpsmen do the shaving. They really had fun with it and Robbie was an excellent sport, plus he looks pretty good with a shaved head. Here are some pics from the event.

Sharese turning over the money to Robbie. Check out that 'do. Who wouldn't want to shave it?

Is Zo enjoying that or what?

The Aftermath

I'm publishing this post on the eve of what is the most anticipated day in the John and Judi Eckenrode household - Judi's Birthday. Once again, my birthday was not all that important to me growing up, but for Judi it's quite the opposite. As a matter of fact, not only do we celebrate Judi's birth DAY, but we celebrate Judi's birth MONTH. I'm sad that I won't be able to spend her birthday with her, but she will get to spend it with her entire family and I think they will be able to make it special for her. Hopefully I can spend the day watching reruns of Reno 911! and NOT treating casualties. I was able to send her a gift from the bazaar (it was Cowher's idea). I wanted to get her something big, but she recommended I save it for the Vegas trip and who can argue with that?

HAPPY BIRTHDAY JUDI!!!!

Oh yeah, I almost forgot. 16 May also marks the half-way point for this deployment. What a nice coincidence that it also falls on Judi's birthday.

Take care,

John

I Was Overcome

Another date that will be forever etched in my mind is Thursday, 6 May 2010. I had just returned from the gym. It was about 1330 when I walked into the FST building expecting to see what I normally see at that time of day, a few folks sitting in the ICU area reading, bullshitting or on the computers. There was no one there, which was odd, but I could hear some voices in the ATLS area (where our trauma patients enter our facility), so I realized we must have received a patient. What I didn’t realize was that I was about to be involved in the care of a patient with the most horrific and devastating injuries our team may ever see. Now, we typically are notified by telephone or radio when patients will be arriving, but in this case there was no “heads-up”. There was a medic on this patient’s team who performed some initial life-saving interventions at the scene and then had him driven directly to us since we were the closest medical facility. He had vital signs (blood pressure and heart beat) until he got to the front gate of the FOB, less than a minute’s drive to the FST.

I walked in just minutes after his arrival, amazed at what I saw. I watched as HM2 Gavin Rampertaap was performing CPR. I watched HM3 Kevin Hines assisting the patient’s breathing with a bag-valve mask through a breathing tube inserted by the medic (I don’t know how he placed the tube; you could barely see where the patient’s mouth was on his face). I watched HM2 Alonzo (I call him Zo) Shields running to the OR to get equipment. I watched HM3 Hasan Hafiz and HN John Hitchcock cutting off the patient’s pants from what was left of his legs – both were mangled. I watched HM2 Patrick Malveda applying a tourniquet to what was left of the patient’s right arm. I watched Doc Z, bald head and all, inserting a large bore IV into a big vein in the patient’s chest so I could start transfusing blood. I watched LCDR Sue Howell documenting everything that was being done to the patient while at the same time trying to get information about the incident from the medic who brought him to us. I watched CDR Charlie Godinez directing the entire team as he pondered his next intervention; which happened to be another emergency thoracotomy (see earlier post Birthday Cakes and Bombs). After all of the above interventions failed to get the patient’s heart to beat again, he was pronounced dead. This resuscitation was different for me. I had a different perspective. Maybe it was because I was only transfusing blood – I don’t know. I kind of stood back and watched the expressions on the other team member’s faces as they worked. It was surreal, like I wasn’t really there.

We decided early on in this mission that we would debrief as a group after every resuscitation – to talk about what we did well, or not-so-well, and to provide “lessons learned” in the event we have a similar patient in the future. Whoever led the trauma resuscitation leads the debrief then proceeds around the room asking for input from every member of the team who was involved. So, CDR Godinez started and when he was through he went around the trauma bay asking for comments; I was somewhere near the middle of the group, but I wasn’t really listening to what anyone was saying. I just kept thinking about the effort those young corpsmen just put into trying to save that man’s life. I’m almost certain none of them ever saw anything so shocking in their lives. Any one of them could have easily thought the situation was too overwhelming for them and just walked out, and everyone else there would have understood. But, they didn’t. They pressed on, without missing a beat. The next thing I know I hear CDR Godinez say my name, but I found myself unable to speak. I was so overcome I was crying – tears and snot running down my face. I simply shook my head side-to-side. I wasn’t crying because a great American just died in front of me with injuries that would make almost anyone else vomit. I was crying because I was overwhelmed with pride; I was proud to be a part of this outstanding team, doing incredible things, under austere conditions, in a fourth-world country. But mostly I was proud of the corpsmen. They are all between 22 and 29 years old. Many are married and most have children. They don’t get paid a lot and the most junior often get some of the worst taskings here, but when the shit hits the fan like it did on this day, you know they are going to be there, doing what they do, and it’s an unbelievable thing to witness. I am honored to know, and get to work with, every one of them!

THE FST NINE

Front Row Left to Right; HN John Hitchcock, HM2 Zo Shields, HM2 Tommy Turtle, HN Anthony Funk
Back Row Left to Right; HM3 Hasan Hafiz, HM2 Gavin Rampertaap, HM2 Shamica Wilson, HM2 Patrick Malveda, HM3 Kevin Hines

One of the greatest bands in America, Live (from Pennsylvania, of course), released a song called "Overcome" that became synonymous with the terrorist attacks of September 11, 2001. It’s been almost 9 years since I first heard that song and I am still overcome. Here is a link to a great performance of that song.

http://www.youtube.com/watch?v=0XzJYjZ6Cio&feature=related

Enjoy!

I usually try to end my posts on a good note, so here goes.

After the debrief I didn’t want anyone to see me crying any more so I went back to my hooch (slang here for living quarters, I didn’t use it at first, but it’s grown on me). Shortly after I sat down there was a knock on my door. My first thought was, Motherfuc$! Who is that? Then I hear LCDR Robbie Ladd, one of our CRNAs, say, “There’s someone here you have to see”. I’m thinking, unless its Judi there can’t possibly be anyone I want to see right now, but he pressed the issue. So, I come out of my hooch and he leads me out the front door of the FST and there in front of me is this beautiful dog. Not just any dog, but an actual working dog – a bomb sniffer – and since she’s a working dog you are allowed to interact with her. Turns out just that afternoon 9 working dogs reported to the FOB. When Robbie saw this one he yelled to her handler and actually chased them down to have him bring the dog back to the FST because he knew I’m a dog-lover and seeing her might cheer me up. Boy was he right. I played with her for nearly half an hour. Her name is Sonya. She’s no Cowher, mind you, but she’s an excellent substitute.

Me and my new best friend on the FOB, Sonya.

Take Care,

John

It’s Like Déjà vu All Over Again

Sorry I haven’t blogged in some time, I’ve been lacking inspiration. Every day seems to bleed (no pun intended) into the next. We haven’t had a mass casualty situation since the Osprey crash and probably had more than most year-long deployments with the two that we worked through so far. We continue to receive casualties, mostly Afghans, one and two at a time and they all seem to have the same types of injuries and even look the same with their faces covered with blood. I can’t post the pictures I’ve taken (they are for educating medical personnel when I return to the states), but I was going through them last week and had to start putting special captions on them because I was having trouble distinguishing one casualty from another. It’s getting to be like Groundhog Day, without all the laughs from Bill Murray.

One thing that broke up the monotony last week was a visit from a Navy Psychiatrist. He travels around Afghanistan to assess Navy deployer’s psychological well-being. He’s been researching care for the caregiver for several years and has a lot of experience in this arena. He spent three days at FOB Lagman just walking around the FST engaging folks in casual conversation. Then he provided a short presentation on caregiver stress and had the FST complete a survey. It was eerily similar to Dr Sidney Friedman’s visits on the TV show MASH. His visit didn’t do much for me, I kinda knew what he was up to, but I do think he was helpful for some of our other team members. The biggest thing I took home from his presentation was that, in his experience, medical personnel from small teams like ours will "destroy" each other long before the “bad guys” ever will; and it usually starts to occur around the half-way point of the deployment which is right around the corner for us. I can sort of see it starting, but I think we are too good of a team to let it happen. I know I’ll do my best to not let it happen. One of our goals from the beginning was that everyone, EVERYONE, will cross the finish line together.

Also one of our Surgeons, Dr. Henry “Hank” Zielinski (a proud Pole Judeburger), celebrated his 60th birthday on 29 April. That’s not a misprint, he turned 60! The guy is amazing. Followers of this blog might remember me writing about the days of training we went through at Fort Jackson - much of it wearing that damn IBA, and me complaining about it along with many other things. Well I don’t remember Doc Z, as he’s commonly referred, complaining once…about anything…ever! And he’s freakin’ 60 years old! Oh yeah, and he volunteered for this mission. He really has been an inspiration to everyone on the team. In a show of rebellion against his aging Doc Z decided he was going to shave his head so he could look more like his “hero” John Eckenrode – his words, not mine. When I presented him his birthday card at morning muster that day I, of course, used a Steelers reference. A couple of years ago, it may have been at Media Day for Super Bowl XLIII, I can’t remember exactly, Coach Tomlin was talking about the Steelers’ tight end Heath Miller, #83. A reporter asked him if Miller was the most low-maintenance player on the Steelers team and Coach Tomlin, without missing a beat, replied, “Low-maintenance? He’s no-maintenance.” And that’s Doc Z, no-maintenance. An interesting final note about Doc Z is that he is actually a Knight. He was dubbed Sir Henry Zielinski by The Order of Malta. Here is a link about the order if you are interested:

http://www.orderofmalta.org/site/knights_malta.asp?idlingua=5



Not that he didn’t look great with hair, but how cool does Sir Henry look bald?!?!?!

I got another care package from Judi with some things I needed and, of course, a few surprises. This time she sent a 43 T-shirt and magnet. Below is a pic of me in the shirt. Gotta love her!!! And thanks to Barbie for the Wasabi Soy almonds – love ‘em!

Some of you may not be aware that poor Cowher doggie had some swelling in one of his paws that was causing him to limp. Judi took him to the vet who said he just had some shoulder arthritis and prescribed an anti-inflammatory medicine. He’s much better now.

I want to wish a Happy Mother’s Day to all the mom’s out there, especially Judi and my mother, Ginger. It a Mother’s Day tradition that my family takes Ging to one of her favorite restaurants – Luigi’s in Clymer, PA. Sorry I can’t make it this year, maybe when I get back in September.

Take care,

John