The Luck of the.......Afghans?

Things have been going ok at FOB Lagman as we wind down our deployment. We’ve been getting a few patients here and there and when we don’t have patients the time sure drags. Well, the past 24 hours have NOT been dragging. We’ve had several patients and there is one in particular I would like to tell you about.

I returned from dinner last night and, as usual, after watching some guys throw a few darts (no body armor this time) I went to my room with the hopes of getting to finish watching Galaxy Quest that I started watching earlier that day (Judi loved it and I still haven’t seen it from beginning to end). Well, that plan was foiled when I overheard one of our corpsmen say, “we’re getting an urgent patient in two minutes!” Another one of those Afghanistan surprises. So, I jumped out of my bed and headed for the FST wondering what was in store for us now. I overheard some folks outside the door mumbling something about an 8 month old being shot in the face. Wonderful! When you hear the words “8 month old” and “shot in the face” the things that run through your mind are not good. She arrived with a dressing covering her entire face with blood on the outside (oh, shit), but appeared to be otherwise well. The first news is that she is actually 3 years old, not 8 months, and she did not have any other wounds that we could see. So, after looking her over and getting her vital signs it was time to take off the dressing. While we began to cut the dressing off I started thinking to myself, “this is going to look horrible.” To my surprise she had only two small holes in her check (assumed to be entrance and exit wounds). It appeared the bullet entered just in front of her ear and exited the middle of her cheek, not even piercing into the inside of her mouth. It was really unbelievable. What a lucky young girl to have such small wounds from a gunshot to the face. A half an inch one way and the bullet hits major arteries and/or veins and a half inch the other way and it's in her brain - neither of those scenarios ends well. I’m hoping some of that luck rubbed off onto us. Similar to a previous young girl we cared for, I don’t recall her crying much either.

After I realized that she was going to be alright I started thinking about how this would play out back home if it happened to one of my neices who are about the same age and I can't imagine it. But here, in Afghanistan, its not that big of a deal. This little girl was accompanied by her twenty-something older brother and he showed absolutely zero emotion throughout the entire ordeal. It's really an odd dynamic and one I am glad I won't have to endure much longer.

Since I mentioned darts, here is a picture of the new dart board backing the commissioner and assistant commissioner recently purchased and plan to leave as a memento for the team that relieves us.

Left to Right; Dart Commissioner Cheuk Hong and Assistant Dart Commissioner Shane Lawson

We also have a new addition to our team. Last week we welcomed 7 new Air Force personnel, 3 nurses and 4 medics, and they have been nothing short of fantastic. They "hit the deck running" as we say in the Navy and have jumped right into caring for the casualties and assuming many of the additional duties the Navy team had been performing. I am a big fan. Below is a picture.

Left to Right; SRA Anderson, SSGT Sneed, SRA Murtagh, MAJ Clark, TSGT Cole, MAJ Garcia, and CPT Cox

I want to wish my mother, Ginger, a happy birthday. She turned seventy-something yesterday.

Finally, I can't remember being this excited about the start of NFL training camp. Casualties-permitting I will be immersed in everything NFL, I just wish I didn't have to rely on Ed Bouchette and Gerry Dulac for the majority of my Steelers news.

Take Care,

John

The Ultimate Sacrifice

I just returned from a heart-wrenching memorial service for soldiers who died while supporting combat operations this week here in Afghanistan. I didn’t know these men, or even recognize their faces or names, but the least I could do was attend their memorial service and pay my last respect. This is the second of these services I’ve attended here, both of them for soldiers from the same company. I feel for them all.

I sent a detailed e-mail to my wife, Judi, a couple of weeks ago describing how I have become much more emotional after serving on this deployment. I find myself unable to hold back tears when I witness, or even hear or read about, the outstanding things our soldiers, sailors, marines and airmen are doing in this war. I held it together throughout most of the ceremony today; even through all the stories, recounted by their fellow soldiers, about what great men they were – true American Heroes. It wasn’t until the end of the ceremony, when they do the “roll call”, that my emotions got the best of me. In the roll call, the unit of the fallen soldiers stands at attention in formation when the Company First Sergeant begins calling random names of the company and they reply with a hearty “here First Sergeant!” The First Sergeant then calls for one of the fallen and it goes something like this:

First Sergeant: Specialist Doe!
No response
First Sergeant (after a short pause): Specialist John Doe!
No response
First Sergeant (again, after a pause): Specialist John Andrew Doe!
No Response

You then hear the Final Volleys (21-Gun Salute), followed by the playing of Taps, and then everyone in attendance approaches the helmet, boots and rifle of the fallen to give one “final salute” for giving the ULTIMATE SACRIFICE. May God bless the families of these great men.

I hope I never have to attend another one of these ceremonies.

Take care,

John

THE FINAL SALUTE

Kellen Winslow Jr is No Soldier

I know I just posted yesterday, but I feel the need to tell this soldier’s story while it’s fresh in my mind. I came back from breakfast today to the report of a soldier coming to the FST who was involved in an IED blast. He arrived stable and alert complaining of pain in his right arm and right leg, both were still attached – thank God. He was dismounted (out of his vehicle) when an IED went off, striking him on the right side of his body. He had significant soft-tissue injuries to his right arm and leg, but not much bleeding or other trauma. While I’m assessing his injuries and getting a history he tells me this is the second time he’s been “blown up”. He was also hit with a grenade in Iraq in 2008. Now I’m thinking, that is a phrase I hope I never have to utter….”blown up a second time”. Oh, I forgot to mention, he followed that statement with, “fucking Taliban”! Fucking Taliban is right, brother.

I felt compelled to tell this young man’s story (he’s 23) because I’m sure there are so many more like it that American’s DON’T hear about. I started thinking how many other American heroes are out there who have been “blown up” multiple times and have lived to tell about it? I don’t think enough of them are telling their stories. This kid is 23 years old and has served in two different combat environments, risking his life so that other American kids can be free. He will return to the states and receive his second Purple Heart which will go unnoticed to most of America and that, my friends, is a crying shame. If you’re reading this blog you need to tell this soldier’s story to as many people as you can. There is something seriously wrong in a world where Lebron “Fucking” James gets an hour of the spotlight on national television to talk about his signing of a bajillion dollar contract to play basketball while the story about a kid around his age who gets “blown up” for a second time fighting for his country will go unreported. Ok, I’m off my soap box, but seriously the toughness of these young men is remarkable and I LOVE them all. And if I ever saw Kellen Winslow Jr I would give him an earful. He’s no soldier! And he has no idea what war is…no idea. This young man is the epitome of a SOLDIER! For those of you unfamiliar with the Kellen Winslow reference here is a link:

http://www.youtube.com/watch?v=I82BPA5QAaQ&feature=related

So, right before this soldier goes back to the OR he looks at me and asks, “If they find any shrapnel in my arm or leg can you save it for me?” My answer, “you bet your ass I will!” In case you’re wondering, we did find plenty and I tucked it in his boot as he went out the door for his helicopter ride to the Role 3.

As is customary for this blog, I like to end on a lighter note so here is a link to a great Second City Television skit about getting “blowed up”. Enjoy!

http://www.youtube.com/watch?v=_dfoVqhQVyQ

Take care,

John

RO-Medical to the Rescue

I mentioned in a previous post that we share the FOB, and the FST facilities, with the Romanian Army. They are a wonderful group of men and women and we have grown quite close with the Romanian Medical team who share our building. The team consists of two Romanian Family Practice Physicians, Dr Adrian and Dr Daniel, a dentist, Dr Chris and numerous medics – they go by first names as their last names are typically very difficult to pronounce with lots of consonants.

Earlier this week we had a minor (minor for us) mass casualty event after a bus crashed in Qalat city. We had very little notice, not surprising, and ended up receiving 5 seriously injured Afghan locals. The first two required intubation (placing a tube into their lungs so to assist breathing) which our CRNA’s managed expertly. Seriously, the Nurse Anesthetists we have, Shane Lawson and Robbie Ladd, are two of the best I have ever known. Their skill level is at or better than many stateside Anesthesiologists. They have managed some of the most difficult airways and made it look routine. We have had at least 5, maybe more, patients with unbelievable facial trauma and blood coming from every orifice on their face and Shane and Robbie step to the head of the bed and insert an endotracheal tube with ease. It’s pretty cool to watch. The other three patients had broken and dislocated bones and a pneumothorax (collapsed lung), but nothing really life-threatening. One of them had to be taken to the OR to fix his dislocated knee, which is why I mentioned the Romanian Medical team. Because of the seriousness of the first two patients we were a little short-staffed so the Romanian’s stepped up to help out and they ended up caring for the patient who required surgery. Even Doc Chris, the freakin’ dentist, was in the ICU helping with the two intubated patients. They will be leaving the FOB soon and asked for a group photo with us wearing the Navy FST -shirts we gave them. They will be missed.

From left; Dr Adrian, Lodin the Interpreter, Dr Daniel and Dr Chris (I have no idea what Lodin is trying to do with his fingers. Perhaps its an Afghan gang sign. Or he's a confused University of Texas fan). Check out their scrub caps. Is that NATO at its finest or what?

The Group Photo

The day prior to the bus crash we had a US soldier come to us with blunt trauma injuries from an IED blast. He arrived to the FST without a pulse and we were unable to save him. Another tough day.

The day before that we had a 9 year old boy brought to the FST after the donkey he was riding on (you only get stories like this in Afghanistan) walk over an IED. He was severely injured and required extensive surgery on all 4 extremities. We were able to save them all, but he lost the pulse in his right arm just prior to transfer. We found out he had to have that arm amputated the following day – very sad.

July has been a busy month for us thus far and I anticipate it will stay that way until Ramadan starts in early August. For those of you not aware, Ramadan is the Islamic month of fasting, in which participating Muslims refrain from eating and drinking from dawn until sunset and they offer more prayer to Allah. It is my hope that because of the fasting and the praying that they also stop the fighting and the bombing. I think it starts 11 August, just a few weeks before we are due to leave. It would be a nice going-away present.

My beautiful wife and I celebrated our 13th Wedding Anniversary on 5 July and I posted a video I made for her on Facebook. I am also going to try to post it here just to see if I can do it. She will be going on vacation with her family tomorrow to the Outer Banks in North Carolina. I wish I could be there with her. I miss you Judi.

John

The One Where He Lacks Inspiration

Once again, I have had no inspiration to write. With each passing day the end of this deployment nears and the team is beginning to focus on what they will do when they return. The discussions range from the first thing folks will eat (my favorite is Sharese White’s a hamburger and a Guinness) and where they will vacation to the simpler desires of Shannan Cook’s just wanting to use actual plates and silverware. Me? I am most looking forward to taking a nap under my Steeler Blankie (yes, I have a Steeler Blankie and I’m not afraid to admit it. I got it from Suzi Brannock and it is one of the best gifts I have ever received) with Judi in my arms and Cowher Doggie resting his chin across one of my legs. It’s probably my second favorite thing to do. Then I want to take Judi to Las Vegas. I know I’ve mentioned it before in this blog, but I can’t tell you just how much Judi and I love Las Vegas. I have been looking at the suites at the Venetian every day and checking out what shows we might want to see. Right now there couldn’t be two lamer comedians performing at the Venetian – David Spade (sorry Jordo I know you loved him as Finch in Just Shoot Me) and Wayne Brady. I hope that schedule changes. Ok, enough about home, time to refocus.

We continue to receive casualties and they continue to be mostly Afghans. Over the past few weeks it has been feast or famine. We may go two or three days without a patient (talk about looooooong days) and then we will get three or eight. Yesterday we had four – three from an IED (one gentleman died in the FST) and a young Afghan child who got her hand caught in a machine that makes bread. The young girl did not have any fractures, but she had a very complicated injury (her skin and soft tissues were severely torn) that required washout and repair in the OR. Had we not been here to treat her she would not have received the care she needed in this country. Our surgeons did an unbelievable job cleaning and closing her wound. She should go on to live a normal life. It’s a feel-good story and one that makes being here worthwhile. I almost forgot to mention that she was probably in the FST for 3 or 4 hours and I never heard her cry. She was very tough, but it comes with the territory. You kind of have to be to grow up in Afghanistan.

Speaking of the war, I’m not sure what to make of the "shake-up" at the top. I hear that some of the Rules of Engagement may change with General Petreus now running the show. Not exactly sure what that means for our team, but it may mean less casualties and that is always good.

To end on a high note, I received some good news this week when I was informed I was selected for promotion to Commander (Lieutenant Colonel for those familiar with ranks of the “other” services). The promotion, of course, comes with a bigger paycheck but it also comes with greater responsibilities. Judi and I are very excited about the opportunity. When my recruiter, HM1 William Jones (I still remember his name), came into my nursing class at IUP in 1993 and gave his spiel about all the Navy had to offer I thought it was an excellent opportunity and figured I would do my four years and come back to PA. But the longer we stayed the more we enjoyed it. I’m not sure how I was able to stay in for 15 years, but I’m certain I could not have done it without Judi. Thanks Baby! We are in for at least 5 more.

Finally, if you happen to be driving past 119 South Main Street in Carrolltown please don’t be alarmed. That isn’t a new zoo. It’s just Judi and her sister Becky showing their love for animals by taking care of eight, yes eight, stray cats in addition to the two dogs they already have.

Take Care,

John

p.s. thank god soccer is over! Only "33" Merril Hoge days until the Steelers open camp - can't wait!

Cowher Under The Steeler Blankie

Combat Darts Anyone?

***Editor's Note***

John's Blog is back. He had to make some minor changes to previous posts and comments in order to adhere to certain operational security and confidentiality rules. He would like to apologize to the followers of his blog for the brief hiatus and is happy to be back...bitches.

Every Thursday the FST has a "game night" as long as we don't have patients. Typically we have a dart tournament, play texas hold 'em, board games, or play x-box. We've been doing this since the beginning of the deployment and darts is, by far, the most popular event. Many of the team members have been getting pretty good at darts (not me) so last week I just threw out the idea of making it more challenging by forcing everyone to wear their body armor while throwing (never thinking that anyone would go for it). Well, everyone thought it was a great idea so this week's tournament was called "Combat Darts".

Just to give you an idea of how popular darts has become here we actually have a commissioner, Cheuk Hong, and Assistant Commissioner, Shane Lawson, and they have set some basic ground rules (see photo below). Even the Romanian Dentist, Doc Cris, plays.

Take special note of violation 2, hitting the wall. People often miss the entire board (especially me) and 5 pushups really isn't that big of a deal. However, imagine those 5 pushups with 40 or 50 pounds of body armor...not so easy.

Me Doing One of My Many Pushups

We also have a trophy that goes to the winner of each tournament. It's one trophy and it works sort of like Lord Stanley's Cup in that it is passed from winner to winner. As you can see from the pictures, Doc Z was the winner of the last tournament and he came to this week's tourney proudly displaying the trophy. Although, he had to give it up to the new Champion, Shane Lawson.

Z

Z Presenting Trophy to Shane

Doc Funk Action Shot (note the commish observing in the background)

Speaking of Lord Stanley's Cup, what a great final game - ay? Too bad the Flyers couldn't have pulled it off. I wanted to poke fun at Jeremy Roenick for sobbing post-game, but I've bawled here much worse than that, so he gets a pass from me.

I also wanted to mention a very touching act from one of our corpsmen, Doc Funk. I mentioned in a previous blog how little the Afghans have and how guilty I feel about having to cut off their clothes. Well, apparently Doc Funk felt the same way so he petitioned a t-shirt company, "80's Tees" to donate shirts for the Afghans who have theirs cut off. The shirts arrived yesterday in the middle of a short lull between the 8 trauma patients we received and one of them was this awesome Steelers t-shirt. We were having a rough day so as soon as I saw the shirt, and how small it was, I knew I had to try it on; 1)Because it was a Steelers shirt and 2) Because I thought it would bring a smile to our teams faces. Here are a couple of pics.

When I wake up tomorrow I will only have 89 days until I see my beautiful wife and loveable dog again. Judi, I am too excited to sleep! And I love you more than you can imagine.

Take Care,

John

p.s. please pray for my brother Scott. He's a Captain in the US Army who has served his country honorably for the past 18 years and is going through a very rough time in his life right now.

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