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Tuesday, November 24, 2009
Thursday, November 19, 2009
Half-way Home
Hi everyone,
Last night I made it to Manas, Kyrgistan which was a major obstacle in getting me home. Last week they told me I'd likely be flying home on the 25th. Then last Friday they said they were going to try to get me moved up the the 20th since my replacement got to Bagram a bit early. On Sunday night they confirmed that they got me (and another 10 docs trying to get out) confirmed on a flight out of Manas on the 20th but told us that we were "on our own" for getting to Manas from Bagram. When we went to the military airport on Bagram they told us that we would need to come every night to the airport with all of our gear and wait "Space Available" to see if we could get on a flight out. They were not certain that they would be able to get us out all week and we were told that if we didn't get out by Wednesday night we would miss our flight out of Manas on the 20th and then we were not booked for any flight at all (not even the 25th) and would have to wait for "space available" flights out of Manas which are only once a week. Talk about stress! It is amazing how hard they work to get you down range, but it is of no priority to them to get you home.
So on Monday after I finished packing up all of my stuff I stopped by the hospital real quick before I was going to finally sleep (for the first time in 24 hours.) I found out that there had been an explosion at a marketplace 20 minutes from the base and that they were bringing a bunch of casualties in. So I threw a gown on over my physical training uniform and tennis shoes (which I had managed to keep clean for 6 months) in case they needed a hand. We ended up getting 12 afghanis that had been blown up, half were kids. Two hours (and 2 intubations, 2 surgical central lines and 2 chest tubes later) I was covered in blood and all of my patients were in the Operating room or ICU. What was amazing was that we happened to have 5 ER doctors there (2 of the new guys and all 3 of the old ones) so we had one last Hurrah to manage all of these very sick patients all at once. Several patients went straight to the OR so we lost all but one of our surgeons so it was just the ER docs to stabilize everyone and do the emergency operative procedures. It was probably the worst acuity mass casualty incident that we've had here in 6 months, but we were the best staffed with ER docs that we ever could be. It was the perfect "goodbye". I was able to retrieve my back up tennis shoes (that I had donated to the Chaplain a few days before) as my bloody tennis shoes went straight into the garbage. Of course, I was not able to sleep at all after all of that drama so I moved out of my room and that night I got all of my gear (4 military duffel bags, body armor and helmet) the 1 mile to the terminal. I waited with the other docs for a while and then we were told that there was no room on the flight, to try again the next day. So we took all of our stuff back to the hospital to store it in a room and we all found a place to sleep for a few hours.
Tuesday night we dragged all of out stuff up again and we got lucky, one of the units that was confirmed on the flight had cancelled and they had room for all of us! It was about 9 hours from when we got to the airport until we actually left. Customs leaving is terrible. You have to empty every piece of luggage and they go through all of your stuff by hand before you repack it. You get a full body scan to make sure you don't have anything hidden on your person...not sure what they think you want to bring out of this country! We then flew out on a military aircraft (C-17) in full body armor, sitting in jump seats packed like sardines. Not such a comfortable 2 hour flight but I would have flown out on the back of a large crow if it would have gotten me out of Afghanistan! After we arrived in Kyrgistan I had the pleasure of turning in my body armor, helmet and chemical warfare gear...nice to know I shouldn't be needing ANY of those things ever again! I then took a sleeping pill and benadryl and slept all day. First time I'd slept more than 4 hours in 4 or 5 days. It's freezing cold here and the facilities are much like camping, but again, I'd be happy to be sleeping on the rocks if it meant getting me out of here and getting me home! Tomorrow we'll start the process of dragging our bags to the terminal here and waiting for our flight. If all goes as planned I'll fly from here to Adana, Turkey, to Ramstein, Germany then home to Baltimore. I'll be arriving around 4:40 pm local time. My mom is still in town until Saturday so I'll be able to see her in addition to Ashraf, maryam and Layla. I still can't believe that I should be home in two days. It is all too surreal. I am feeling much better from my bout with the flu and am just left with a bad cough.
Thanks for the encouraging emails, I'll let you all know when I am safely at home with my two lovely girls crawling all over me!
Angie
Last night I made it to Manas, Kyrgistan which was a major obstacle in getting me home. Last week they told me I'd likely be flying home on the 25th. Then last Friday they said they were going to try to get me moved up the the 20th since my replacement got to Bagram a bit early. On Sunday night they confirmed that they got me (and another 10 docs trying to get out) confirmed on a flight out of Manas on the 20th but told us that we were "on our own" for getting to Manas from Bagram. When we went to the military airport on Bagram they told us that we would need to come every night to the airport with all of our gear and wait "Space Available" to see if we could get on a flight out. They were not certain that they would be able to get us out all week and we were told that if we didn't get out by Wednesday night we would miss our flight out of Manas on the 20th and then we were not booked for any flight at all (not even the 25th) and would have to wait for "space available" flights out of Manas which are only once a week. Talk about stress! It is amazing how hard they work to get you down range, but it is of no priority to them to get you home.
So on Monday after I finished packing up all of my stuff I stopped by the hospital real quick before I was going to finally sleep (for the first time in 24 hours.) I found out that there had been an explosion at a marketplace 20 minutes from the base and that they were bringing a bunch of casualties in. So I threw a gown on over my physical training uniform and tennis shoes (which I had managed to keep clean for 6 months) in case they needed a hand. We ended up getting 12 afghanis that had been blown up, half were kids. Two hours (and 2 intubations, 2 surgical central lines and 2 chest tubes later) I was covered in blood and all of my patients were in the Operating room or ICU. What was amazing was that we happened to have 5 ER doctors there (2 of the new guys and all 3 of the old ones) so we had one last Hurrah to manage all of these very sick patients all at once. Several patients went straight to the OR so we lost all but one of our surgeons so it was just the ER docs to stabilize everyone and do the emergency operative procedures. It was probably the worst acuity mass casualty incident that we've had here in 6 months, but we were the best staffed with ER docs that we ever could be. It was the perfect "goodbye". I was able to retrieve my back up tennis shoes (that I had donated to the Chaplain a few days before) as my bloody tennis shoes went straight into the garbage. Of course, I was not able to sleep at all after all of that drama so I moved out of my room and that night I got all of my gear (4 military duffel bags, body armor and helmet) the 1 mile to the terminal. I waited with the other docs for a while and then we were told that there was no room on the flight, to try again the next day. So we took all of our stuff back to the hospital to store it in a room and we all found a place to sleep for a few hours.
Tuesday night we dragged all of out stuff up again and we got lucky, one of the units that was confirmed on the flight had cancelled and they had room for all of us! It was about 9 hours from when we got to the airport until we actually left. Customs leaving is terrible. You have to empty every piece of luggage and they go through all of your stuff by hand before you repack it. You get a full body scan to make sure you don't have anything hidden on your person...not sure what they think you want to bring out of this country! We then flew out on a military aircraft (C-17) in full body armor, sitting in jump seats packed like sardines. Not such a comfortable 2 hour flight but I would have flown out on the back of a large crow if it would have gotten me out of Afghanistan! After we arrived in Kyrgistan I had the pleasure of turning in my body armor, helmet and chemical warfare gear...nice to know I shouldn't be needing ANY of those things ever again! I then took a sleeping pill and benadryl and slept all day. First time I'd slept more than 4 hours in 4 or 5 days. It's freezing cold here and the facilities are much like camping, but again, I'd be happy to be sleeping on the rocks if it meant getting me out of here and getting me home! Tomorrow we'll start the process of dragging our bags to the terminal here and waiting for our flight. If all goes as planned I'll fly from here to Adana, Turkey, to Ramstein, Germany then home to Baltimore. I'll be arriving around 4:40 pm local time. My mom is still in town until Saturday so I'll be able to see her in addition to Ashraf, maryam and Layla. I still can't believe that I should be home in two days. It is all too surreal. I am feeling much better from my bout with the flu and am just left with a bad cough.
Thanks for the encouraging emails, I'll let you all know when I am safely at home with my two lovely girls crawling all over me!
Angie
Wednesday, November 18, 2009
Prayers for Angie
Hi everyone,
It's Marge-Angies mom. I am writing again for one last request. You all received her last email and know that she has been sick and that her time at Bagram has come to an end. Well, there is a good chance she may be home next Friday, the 20th which is earlier than we had thought. This is what she needs to do: Starting tomorrow, she needs to lug all her bags down to the landing strip to wait for several hours to see if there is room for her and her stuff on one of the planes. This would take her to Mansa (Krysicsan (sp) where she would wait until Fri. She does have a flight booked for her out of Mansa on Fri. which would bring her into Baltimore late that afternoon. This will only happen if she can get a flight out of Bagram in the next couple of days, which she is not assured will happen. It all depends on if there is room for her. I think of her dragging her bags each night between 12:00-4:a.m. while we are sleeping and she is in a weeker state due to being sick. But I know Angela....she has such determination, I am so proud of her. If you believe in the power of prayer, please start praying for Angela that she will be able to make this flight on Friday and that with each day she is feeling better and stronger. Once again, thank you for supporting my daughter. I know it has helped her.
Fingers crossed
Hello everyone,
My replacement arrived 2 days ago. Tonight was supposed to be my last shift working, instead I ended up as a patient with the swine flu. I've had a very miserable past 24 hrs, but at least I'm getting it done with now so that I'm not sick on my way home or worse, as soon as I get home. That would have been awful. I'm tentatively scheduled to return to Baltimore on the 25th of November; however, in true military fashion it could be later, and a small chance it could be earlier. We'll see. Hopefully I'll know more in the next few days. Right now I'm focussing on trying to get better, getting my outprocessing stuff done and packing. I'll write more when I have more info.
Keep your fingers crossed that I get out of here easily!
Angie
Monday, November 2, 2009
Dateline Afghanistan
Hello Everyone,
With just under 2 weeks until my replacement arrives I'm 90% of the way done here at Bagram. Still no official date on when I'll be coming home but I've still got hopes of getting home just in time for Thanksgiving. I am getting so antsy for the days to pass quickly. Of the 3 women that I was such good friends with here only one still remains...one left a week ago the other 3 weeks ago. My remaining good friend is leaving this Thursday. By now anyone that was here before me has left and we're the next group to go out. I at least still have my ED crew who are all very nice, but I can't do much with the other two ED docs outside of the hospital as one of us is always working and one of us is usually sleeping. I'm starting to pack up my things and have shipped a few boxes home. We have a bazaar every Friday and I've bought quite a few needless, but interesting, little souvenier items to bring home. I've gotten some cute Afghani dresses, shoes and purses for the girls. A few of us in the ED have also gotten a bit hooked on buying Afghani gems. We now have some connections (mainly interpretors in the hospital) that bring us a bunch of gems to look at and we set up shop in our office at about midnight to start our wheeling and dealing. They have diamonds, emeralds, sapphires, rubies and alexandrite to mention a few. The main stone of interest to most of us has been Tanzanite, which is a gem that is only mined in one location in the world and they predict will be completely mined out within the next 10 years. So the thought is that it might be worth a lot in 20 years. Several people are buying them to make jewelry for wives/daughters or as an investment strategy. It's something to do to pass the time. I'm amazed at how beautiful it still is during the day...mid 70's and sunny; however, it gets so cold at night the the mountains surrounding us are already snow-capped.
As many of you have probably read, this month has proved to be the deadliest for American troops since the war started in 2001. Last week we got 14 patients from one of the helicopter accidents in the region. I had only been asleep 2 hours when I got called back in to help. I took care of another soldier several days ago who was the sole survivor in his vehicle from an IED explosion, the other 7 soldiers in the vehicle were killed. He had only two small cuts to his face. There seems to be no rhyme or reason as to how some people can survive and how some don't. We have had two earthquakes here in the past 2 weeks. The first was a 6.2 the second a 6.0. I was working for both and with the first one my initial thought was, "ok who's messing with me and rocking my office?" When I realized that this was impossible my next thought was that we were being attacked, but I realized that there were no loud boombs. Then I finally realized that it must be an earthquake. We were all nervous/excited as this was the first large earthquake that many of us have been in (those of us from the eastcoast or midwest anyways.) By the second earthquake a week later we were all much more casual...more like "what is that? Oh earthquake, I wonder how big it was? Back to work!" Each lasted about 30 seconds. No real damage to the base though and more importantly no real injuries.
We celebrated Halloween here with decorations and way too much candy. A few brave people made or ordered costumes. Ashraf and my mom took the girls out trick-or-treating. Maryam was Dorothy from Wizard of Oz and Layla was a duck. I attached a few pics. They all had a great time. Maryam is getting very excited to know that I am coming home soon. She is working very hard with Layla trying to get her to say "Mama". The most she'll say is "Ma!", she's getting there. I am quite confident that Maryam will be very friendly to me when I get home and will come running to me, we talk almost every night. I'm not too sure what Layla's reaction will be. She's definately excited when we all talk on the computer, but she now only knows me as a voice on the computer and a face on the pictures plastered all over the house. I've been gone more than 5 1/2 months...a long time for a 14 month old. I'm hoping that it won't take long to reform the bond when I get home.
I'll have a good 2 weeks off when I get home to spend time with the girls and get settled before I need to return to work. I don't know how I'll react to returning to the hospital and hearing about people's Emergency sore throats and stubbed toes after what I've seen for the past 6 months. I've seen guys with there feet amputated who rate their pain as an 8 out of 10. On the other hand, back home it is not unusual for a person with a sore throat to tell me that their pain is a 15 out of 10. Seeing blown up body parts sure puts a new perspective on pain scales "with 1 being minimal pain and 10 being the worst pain imaginable." It's getting harder to see the severely injured troops and imagine their shattered lives when I've got so little time left here and will soon be returning to my life fully intact (God willing). You really have to work hard to detach or it will drag you down. As much as I can't wait to not have the sights, sounds, and smells of the horrific injuries here, I also think that I will miss being a part of something so huge and important. I have never felt so much like an Emergency Department Physician as I do here. Back home I feel much more like a primary care physician, most of my patients would be fine if they never saw any doctor let alone an ED doctor. Here it's different. You are part of this team of health care professionals that literally hold these young guys lives in your hands. And, unlike in the civilian world, these are not 90 year old people that we're "tuning up" to return to the nursing home...these are 20 year old boys and sons, 30 year old husbands and fathers. If we save their life or improve their quality of life we are maintaing a family unit. We are giving the young people the opportunity to fall in love and have children. We are returning mothers and fathers so that children can have a parent and spouses can have someone to grow old with. I really feel out here like what I do makes a difference...and that I think is what has made it possible for me to work for 168 days in a row without a break, and for me to miss 6 months of my children's lives. That all being said, I can't wait to come home! I've been working for a long time and I'm tired. I want to mindlessly sit on the couch and flip through 60 channels on the tv just because I can. I want to take a 20 minute HOT shower and not have to wear flip flops and fear a part of my body touching the dirty wall. I want to wear real clothes...a pair of jeans and a sweater would be great. Most of all I want to walk holding my husbands hand in the crisp fall air and watch my girls trot along ahead of us chasing leaves. It is depressing to bear witness to all of the men and women out here who probably have similar dreams which will never come to fruition; however, it is gratifying to know that because of the work we do here there are soldiers who will be able to return home to their families when several years ago they would have died of their wounds.
Thanks again for all of your support. Please don't send any postal correspondence my way after this week as I'll hopefully be out of here before it would have a chance to reach me.
Miss you all and hope you had a Happy Halloween,
Angie
With just under 2 weeks until my replacement arrives I'm 90% of the way done here at Bagram. Still no official date on when I'll be coming home but I've still got hopes of getting home just in time for Thanksgiving. I am getting so antsy for the days to pass quickly. Of the 3 women that I was such good friends with here only one still remains...one left a week ago the other 3 weeks ago. My remaining good friend is leaving this Thursday. By now anyone that was here before me has left and we're the next group to go out. I at least still have my ED crew who are all very nice, but I can't do much with the other two ED docs outside of the hospital as one of us is always working and one of us is usually sleeping. I'm starting to pack up my things and have shipped a few boxes home. We have a bazaar every Friday and I've bought quite a few needless, but interesting, little souvenier items to bring home. I've gotten some cute Afghani dresses, shoes and purses for the girls. A few of us in the ED have also gotten a bit hooked on buying Afghani gems. We now have some connections (mainly interpretors in the hospital) that bring us a bunch of gems to look at and we set up shop in our office at about midnight to start our wheeling and dealing. They have diamonds, emeralds, sapphires, rubies and alexandrite to mention a few. The main stone of interest to most of us has been Tanzanite, which is a gem that is only mined in one location in the world and they predict will be completely mined out within the next 10 years. So the thought is that it might be worth a lot in 20 years. Several people are buying them to make jewelry for wives/daughters or as an investment strategy. It's something to do to pass the time. I'm amazed at how beautiful it still is during the day...mid 70's and sunny; however, it gets so cold at night the the mountains surrounding us are already snow-capped.
As many of you have probably read, this month has proved to be the deadliest for American troops since the war started in 2001. Last week we got 14 patients from one of the helicopter accidents in the region. I had only been asleep 2 hours when I got called back in to help. I took care of another soldier several days ago who was the sole survivor in his vehicle from an IED explosion, the other 7 soldiers in the vehicle were killed. He had only two small cuts to his face. There seems to be no rhyme or reason as to how some people can survive and how some don't. We have had two earthquakes here in the past 2 weeks. The first was a 6.2 the second a 6.0. I was working for both and with the first one my initial thought was, "ok who's messing with me and rocking my office?" When I realized that this was impossible my next thought was that we were being attacked, but I realized that there were no loud boombs. Then I finally realized that it must be an earthquake. We were all nervous/excited as this was the first large earthquake that many of us have been in (those of us from the eastcoast or midwest anyways.) By the second earthquake a week later we were all much more casual...more like "what is that? Oh earthquake, I wonder how big it was? Back to work!" Each lasted about 30 seconds. No real damage to the base though and more importantly no real injuries.
We celebrated Halloween here with decorations and way too much candy. A few brave people made or ordered costumes. Ashraf and my mom took the girls out trick-or-treating. Maryam was Dorothy from Wizard of Oz and Layla was a duck. I attached a few pics. They all had a great time. Maryam is getting very excited to know that I am coming home soon. She is working very hard with Layla trying to get her to say "Mama". The most she'll say is "Ma!", she's getting there. I am quite confident that Maryam will be very friendly to me when I get home and will come running to me, we talk almost every night. I'm not too sure what Layla's reaction will be. She's definately excited when we all talk on the computer, but she now only knows me as a voice on the computer and a face on the pictures plastered all over the house. I've been gone more than 5 1/2 months...a long time for a 14 month old. I'm hoping that it won't take long to reform the bond when I get home.
I'll have a good 2 weeks off when I get home to spend time with the girls and get settled before I need to return to work. I don't know how I'll react to returning to the hospital and hearing about people's Emergency sore throats and stubbed toes after what I've seen for the past 6 months. I've seen guys with there feet amputated who rate their pain as an 8 out of 10. On the other hand, back home it is not unusual for a person with a sore throat to tell me that their pain is a 15 out of 10. Seeing blown up body parts sure puts a new perspective on pain scales "with 1 being minimal pain and 10 being the worst pain imaginable." It's getting harder to see the severely injured troops and imagine their shattered lives when I've got so little time left here and will soon be returning to my life fully intact (God willing). You really have to work hard to detach or it will drag you down. As much as I can't wait to not have the sights, sounds, and smells of the horrific injuries here, I also think that I will miss being a part of something so huge and important. I have never felt so much like an Emergency Department Physician as I do here. Back home I feel much more like a primary care physician, most of my patients would be fine if they never saw any doctor let alone an ED doctor. Here it's different. You are part of this team of health care professionals that literally hold these young guys lives in your hands. And, unlike in the civilian world, these are not 90 year old people that we're "tuning up" to return to the nursing home...these are 20 year old boys and sons, 30 year old husbands and fathers. If we save their life or improve their quality of life we are maintaing a family unit. We are giving the young people the opportunity to fall in love and have children. We are returning mothers and fathers so that children can have a parent and spouses can have someone to grow old with. I really feel out here like what I do makes a difference...and that I think is what has made it possible for me to work for 168 days in a row without a break, and for me to miss 6 months of my children's lives. That all being said, I can't wait to come home! I've been working for a long time and I'm tired. I want to mindlessly sit on the couch and flip through 60 channels on the tv just because I can. I want to take a 20 minute HOT shower and not have to wear flip flops and fear a part of my body touching the dirty wall. I want to wear real clothes...a pair of jeans and a sweater would be great. Most of all I want to walk holding my husbands hand in the crisp fall air and watch my girls trot along ahead of us chasing leaves. It is depressing to bear witness to all of the men and women out here who probably have similar dreams which will never come to fruition; however, it is gratifying to know that because of the work we do here there are soldiers who will be able to return home to their families when several years ago they would have died of their wounds.
Thanks again for all of your support. Please don't send any postal correspondence my way after this week as I'll hopefully be out of here before it would have a chance to reach me.
Miss you all and hope you had a Happy Halloween,
Angie
Monday, August 24, 2009
Three letters
Sorry for delay in posting letters but I've been on vacation. Three of Angie's letters follow.
BZ
Baby Steps
Hi Everyone,
I am now half way done, 13 weeks down. I hope this second half goes by even quicker than the first! We continue to be very busy here; with each month we are setting records for the largest number of trauma admissions seen at this hospital since it opened. August is looking like it will not be any different. We had 17 traumas yesterday...of those 6 were intubated (on a ventilator). We had one Marine with burns to 90% of his body, the only areas not burned were the back of his head, the bottoms of his feet and a part of his leg. His birthday is today...29 years old, he was flown to Germany this morning.
Maryam enjoyed her birthday last week, 4 years old now. While we were chatting on the computer she opened the doll house that I had bought and wrapped for her before I left home. Of all the nights, the webcam wasn't working so we couldn't see each other, we had to settle for just hearing one another. She loved the gift and has been playing with it every day. She cut a piece of her cake and had my mom put it in the freezer for me...I have a feeling I'm going to have to eat a lot of cake when I return! A few of the neighbors came over with their little boys, Maryam seemed to like the attention. It was very hard for me not to be there with her as she was preparing little goodie bags to give to her class and as Ashraf was decorating the house for her birthday...but it's one more milestone down and one step closer to me returning home.
In 2 weeks I'll go through all of the emotions again as Layla celebrates her 1st birthday. Yesterday she took 5 steps by herself. I wish I could say that I was thrilled to hear that she took her first steps, but once again, it was very painful to not be there to see it myself. I feel very selfish to say that I had hoped that she'd be a later walker like Maryam and that those first steps would happen closer to when I came home. But I'm also glad to see that she's developing normally and is not slowed down by my absence. I guess she'll be running by the time I return.
A week ago Ashraf, very bravely, took the two girls camping...tent, s'mores and all. They all loved it and I think Ashraf was very proud of himself. Maryam told him that she had a great time and that it was a lot of fun, then she added, "but not as much fun as when Mama is with us". Glad to know I'm missed.
I've attached some pics...the girls camping, Maryam's birthday and me with the medical evacuation helicopter (the female with me is an Army neonatologist that was sent here as an adult intensive care unit doc, the guy with me is the afternoon ER doc).
Take Care,
Angie
Ground Hog Day
Hi everyone,
I'm slowly approaching half way but it is not soon enough! I'm really looking forward to passing that mark as it signifies more of Afghanistan behind me than in front of me! The days are just dragging on, one merging into the next. The patients are starting to blur into a few big blobs of patients...the multitude of young men with nausea vomitting and diarrhea in one clump, the many kidney stones and appendicitis patients in another clump, and the IED (improvised explosive device) blown up patients in the third clump. If I added up those three categories I would have 90% of what I see here. It truly is "Ground Hog's Day" over and over...played out now for 81 days straight.
The time is starting to wear on Maryam too. She had been doing pretty well most of the time up until this past week. She's really been missing me and it's shown. She's been acting out more and much more emotional. A few days ago she fell and hurt her hand, she ran into the house crying that she just wanted "Mama". She laid on my sweater stuffed with a pillow, sucked her thumb and cried herself to sleep. The next day Ashraf walked into the room and found Maryam dressed in my clothes chasing after Layla (who was probably a bit scared) saying, "but don't you recognize me? I'm your Mama, I've come back from being far away! I've missed you so much baby let me give you a hug!" The next day she asked her dad if she could take his cellphone with her to school in case I called so that I could reach her at anytime. Finally, this morning she told her preschool teacher that she was very sad today because she was missing Mama. I'm talking to her every night and she seems to enjoy it. But she is still having a hard time and is acting out much more as well. I'm really hoping that it's just a phase and that it will pass...we still have quite a ways to go! Knowing that Maryam is having such a hard time makes it harder on me as well. Layla, on the other hand, seems to be doing fine. Maybe the excitement of her birthday next Tuesday will make it a better week for her, we'll see.
Not much else to report here. Hopefully I'll have some new pics with my next update.
I hope everyone is well!
Angie
Hi Everyone,
I've now got 10 weeks behind me! 72 days down, about 114 to go. I still don't know when I'll be leaving, but I do know that my replacement should be here around November 16th (one of my good friends at Andrew's will be coming). There will be an overlap of 3-6 days before I can leave, then it will take me 2-5 days to get home. So assuming there are no major delays, I could be home anywhere from the 21st to the 27th of November...I would LOVE to be home for Thanksgiving, we'll see. After a while here you start to obsess over exactly when you might be leaving. I guess I've got a while to go either way.
My mom's birthday was a few days ago and we talked over skype while everyone in Maryland ate cake and ice cream. Maryam asked my mom to cut me a piece and put it in the freezer...she said we would do this with everyone's birthday (my mom's, Maryam's, Layla's, Ashraf's and mine) so that when I came home I could eat a piece of cake from all of the birthday's that I missed. She offered that she would help me to eat them all of course. I ordered online some decorations for Maryam's birthday, 2 weeks from now. Ashraf and my mom are just having a small party at the house and inviting a couple of little neighbor boys that she plays with, she's very excited. Maryam has found a new partner in crime....her little sister Layla. She loves having this little baby who will copy everything she does, the more dangerous the better. Layla now can make it up the stairs in a few seconds; Maryam will follow behind her then later tell Ashraf not to worry, that she is prepared to catch her if she falls. My mom found the two of them last night in their room, Layla standing on the seat of a small rocking chair, Maryam on the seat of the large rocking chair, both holding on to the top and rocking back and forth laughing and laughing. God protect them both...luckily I'm well connected to the ER on base!
Work's been steady, the trauma picked up again for the past three nights (after a week long slow down.) I've also seen a major bolus in the number of non-trauma medical patients. I guess that is inevitable as the numbers of troops in Afghanistan keeps growing and growing.
I've grown so tired of the same food day after day...I haven't eaten in the cafeteria for the past 4 days. For dinner last night I ate beef jerky and mixed nuts from my stash. For lunch I feasted on some Indian food that my brother sent me for a change of pace. It felt like a gourmet meal! It has been quite hot here, about 100 degrees for the past few weeks. It's also very windy and dusty...but at least not humid. Every Sunday I walk 8 miles with "the girls" as a stress break, on Fridays we have "Surf and Turf" at the dining facility and if we're lucky they serve up Lobster Tails (usually overcooked but who's going to complain, it's Lobster in the desert...can't beat that!) Those are my two big days of the week, the only thing that differentiates one day from the next..."what day is today?" "Well we ate at 'Red Lobster' yesterday so it must be Saturday".
The big news here is that our main gym is being moved to "the other side of base"...everyone is upset about that. We have 3 gyms here...The Clamshell (known as "Venice Beach"-it's in a tent that is open at the ends and all of the huge body builder guys work out there...you can hear the free weights clanking together when you walk by), The Rock (known as the "Communist Gym"-they're very strict there, if you shirt becomes untucked while exercising you get yelled at to tuck it in, you get kicked off the cardio equipment right at 30 minutes, God help you if you forget to wipe down your equipment...just picture the Seinfeld Soup Nazi episode..."No Stairclimber for you! Come back 1 year!") and finally the North Gym (known as "Average Joe's"-it's for the average person, a bit soft in the middle, that just wants to firm up a bit). So they've closed Average Joe's which means I now have to go to the communist gym. That's about all for major news here. Like I said, the same thing day after day so you look for the little things to talk about or make your day different.
I hope you're all doing well, stay tuned for next weeks update on my exciting life at Bagram!
Angie
I've now got 10 weeks behind me! 72 days down, about 114 to go. I still don't know when I'll be leaving, but I do know that my replacement should be here around November 16th (one of my good friends at Andrew's will be coming). There will be an overlap of 3-6 days before I can leave, then it will take me 2-5 days to get home. So assuming there are no major delays, I could be home anywhere from the 21st to the 27th of November...I would LOVE to be home for Thanksgiving, we'll see. After a while here you start to obsess over exactly when you might be leaving. I guess I've got a while to go either way.
My mom's birthday was a few days ago and we talked over skype while everyone in Maryland ate cake and ice cream. Maryam asked my mom to cut me a piece and put it in the freezer...she said we would do this with everyone's birthday (my mom's, Maryam's, Layla's, Ashraf's and mine) so that when I came home I could eat a piece of cake from all of the birthday's that I missed. She offered that she would help me to eat them all of course. I ordered online some decorations for Maryam's birthday, 2 weeks from now. Ashraf and my mom are just having a small party at the house and inviting a couple of little neighbor boys that she plays with, she's very excited. Maryam has found a new partner in crime....her little sister Layla. She loves having this little baby who will copy everything she does, the more dangerous the better. Layla now can make it up the stairs in a few seconds; Maryam will follow behind her then later tell Ashraf not to worry, that she is prepared to catch her if she falls. My mom found the two of them last night in their room, Layla standing on the seat of a small rocking chair, Maryam on the seat of the large rocking chair, both holding on to the top and rocking back and forth laughing and laughing. God protect them both...luckily I'm well connected to the ER on base!
Work's been steady, the trauma picked up again for the past three nights (after a week long slow down.) I've also seen a major bolus in the number of non-trauma medical patients. I guess that is inevitable as the numbers of troops in Afghanistan keeps growing and growing.
I've grown so tired of the same food day after day...I haven't eaten in the cafeteria for the past 4 days. For dinner last night I ate beef jerky and mixed nuts from my stash. For lunch I feasted on some Indian food that my brother sent me for a change of pace. It felt like a gourmet meal! It has been quite hot here, about 100 degrees for the past few weeks. It's also very windy and dusty...but at least not humid. Every Sunday I walk 8 miles with "the girls" as a stress break, on Fridays we have "Surf and Turf" at the dining facility and if we're lucky they serve up Lobster Tails (usually overcooked but who's going to complain, it's Lobster in the desert...can't beat that!) Those are my two big days of the week, the only thing that differentiates one day from the next..."what day is today?" "Well we ate at 'Red Lobster' yesterday so it must be Saturday".
The big news here is that our main gym is being moved to "the other side of base"...everyone is upset about that. We have 3 gyms here...The Clamshell (known as "Venice Beach"-it's in a tent that is open at the ends and all of the huge body builder guys work out there...you can hear the free weights clanking together when you walk by), The Rock (known as the "Communist Gym"-they're very strict there, if you shirt becomes untucked while exercising you get yelled at to tuck it in, you get kicked off the cardio equipment right at 30 minutes, God help you if you forget to wipe down your equipment...just picture the Seinfeld Soup Nazi episode..."No Stairclimber for you! Come back 1 year!") and finally the North Gym (known as "Average Joe's"-it's for the average person, a bit soft in the middle, that just wants to firm up a bit). So they've closed Average Joe's which means I now have to go to the communist gym. That's about all for major news here. Like I said, the same thing day after day so you look for the little things to talk about or make your day different.
I hope you're all doing well, stay tuned for next weeks update on my exciting life at Bagram!
Angie
Tuesday, July 28, 2009
Life and ... in the ER
Hello everyone!
This week I’ve had some busy shifts in the ER so I’m a bit late on my weekly update. As my social life is not changing much I’ll tell everyone about my work. I work 10pm-7am as the only doctor in the ER. I’ve got one nurse and several technicians that work with me. We see quite a variety of patients here, both medical and trauma. I’ve seen patients with heart attack (60 year old American citizen in Afghanistan to visit family), kidney stones, drug overdose, vomitting and diarrhea (a lot of these), newly diagnosed pregnancy (yep, even here) and a few other medical type problems. I’ve seen minor traumas such as lacerations from the razor wire fences here, ankle sprains from walking on the rocks that are everywhere, and sports injuries.
We get a variety of serious trauma patients such as IED (improvised explosive device) blasts, rocket propelled grenade injuries, land mine injuries, rolled Humvee injuries, gunshot wounds, and what I call red-neck injuries which are usually military members that squirt flammable fuel on an already lit barbecue or bonfire and the flame flashes back on them. Often when the serious traumas come in there are several injured guys that are flown in together from a FOB (forward operating base) somewhere in Afghanistan. We overhead a call and page a “trauma” and I usually have several surgeons that come, orthopedic surgeons, ICU doctor, nurses and technicians. So we usually have plenty of help unless there are more than 3-4 very sick patients at a time…then it’s a bit crazy. I usually take the sickest patient and run the show with him and the other docs will manage the other patients. Often times the patient has already had some kind of surgery done at the FOB and are already on ventilators. If the trauma happens closer to the base then they come in “fresh” and we start from scratch. We stabilize them, make sure no injuries are missed and decide what further testing (X rays and CT scans) are needed and where to send them from the ER (Ct scanner, Operating room or ICU.)
For the wounded American soldiers, they are usually only kept her about 24 hrs then are flown to Landstuhl, Germany where they are further stabilized and assessed; then they are sent Andrews AFB, Maryland(what a coincidence…) where they are either transferred to Walter Reed or Bethesda hospital or sent back to a military hospital by their hometown. We also treat soldiers from the other coalitions forces (Polish, French, etc.) and they eventually go back to their own countries. We also treat Afghani National Army soldiers, Afghani police officers, Afghani civilians (both adult and child) and “Enemies of Peace”—previously called Insurgents or Enemy Combatants. We can also see both Afghani and American civilian contractors that work on base and Afghani prisoners from the jail that is on base.
I’ve had a couple of guys come in with their legs blown off, fingers missing, one guy with his genitals gone (from a rocket), multiple guys with severe chest, head and abdominal injuries, bad burns; all of these injuries I had expected and as awful as they are, they aren’t as upsetting as some of the unexpected things I’ve encountered. We’ve had 2 suicides, 1 intentional drug overdose where the guy died, 1 suspicious drug overdose where the guy died, a dead premature baby found on base that I had to pronounce dead (and I later had the “pleasure” of treating the mother that dumped the baby), sexual assault cases. Two nights ago I had a 20 year old guy that had a cardiac arrest in his room (drug/alcohol related), I was able to resuscitate him only to have him declared brain dead yesterday. Most of the soldiers that die of combatant injuries are dead before they get to us…we had 5 last week, 3 the week before. Every time someone dies they have a “fallen comrade ceremony” where they bring the flag-draped casket down the main street of base on the way to an airplane that them “home.” The street is lined with hundreds of military in uniform saluting as the casket passes. It’s very touching…and depressing. On a lighter, note if you make it to us alive you 95-99% chance (depends on the stats that month) of surviving to make it back to the states! I’m working with a good bunch of docs and medics here…it’s amazing how the consultants don’t mind coming in to help out when then their commute is only 3 minutes from their room and they have nothing else to do (no family outings, no golf, no cruising on the boat). So that’s pretty much my work, day after day…at least it’s not boring, that’s for sure. I look forward to the fairly slow nights (like last night) where I can email and buy something for my kids online.
As always, thanks for everyone’s well wishes. I’ll keep the emails coming until you tell me to stop!
Thursday, July 23, 2009
Mother's Milk
Fri 7/10/09 9:55 PM
Hey Everyone,
Looks like your prayer and cold well-wishes helped! After 3 1/2 days the milk arrived home mostly in good shape. I was quite anxious as it got stuck in the UK for 1 1/2 days and my calls to DHL did not give me any answers. I didn't know if the cooler was kept in a cool place or not. The milk traveled from Bagram to Bahrain, then London, then East Midlands, UK then to Ohio, then Maryland then D.C. It was taken by courier from D.C. to the house.
I sent 50 6 ounce bags, about 1/2 arrived at least half frozen and were put in the freezer; the other half was mostly thawed but still very cold and was put in the fridge. Only 1 bag leaked. The plan is to get L. to drink as much of the fridge milk as possible over the next few days. Hopefully, she'll be able to use about 80-90% of what I sent. Next time I think I'll arrange the bags a bit differently in the cooler and I've ordered some reusable "like dry ice" heavy duty ice packs to add as well. This should help with the next shipment. I'm also sure that if it hadn't sat for a day and a half in the UK many more bags would have arrived frozen. But for a first attempt, not bad. This shipment should get her 2-3 weeks closer to that 1 year goal. Another 2 good shipments and we should make it. I'm very relieved as I had feared that it would all arive thawed and unusable. Breastfeeding your baby from a combat zone over 6000 miles away...who would've thought it possible? Miracles do happen!
So preparing for, worrying about, and tracking this shipment has pretty much been my week. I'm almost at 8 weeks now. I've attached my "Wheel of Despair" which I use to track my time here. I hope you're all doing well, and thanks again for all of your well wishes.
Monday, July 20, 2009
Hey all you Ladies and Moms, I need a bunch of prayers coming my way to help me with the final stretch of something I've been trying to do since I left. I was so upset about leaving both of the girls but especially L...knowing that I would miss so many milestones. I was also very upset that I would have to stop breastfeeding much earlier than I wanted to and 4 months earlier than the recomended "at least a year" that the American Academy of Pediatrics recommends to help boost immunity and to decrease the chances of many childhood and adult diseases like obesity, diabetes, allergies/asthma, and various cancers. So in my grieving of all that I would be missing out on with L I sort of grabbed ahold of the breastfeeding and thought that if I could somehow continue to get her breastmilk until at least a year I could put myself back in control and remove one thing from the growing list of "what L and I would be missing". So I became determined (maybe obsessed is a better way to word it) to see if there was any way for L to keep breastfeeding until a year (don't worry, I'm not looking for wet nurses!) I was able to pump and freeze enough extra milk throughout her early infancy to last the first two months that I was gone, and I've continued pumping and freezing since I left. It's been very hard, logistically, as I had to "pump and dump" for the 5 days until I got here, and I've had to figure out where to stash the frozen milk, wash the pump parts, etc. My supply has dwindled quite a bit, but over the past 7 weeks I pumped and froze 60 6ounce bags which will get us 1 month closer to that 1 year goal if I can just get it to the states. There is a DHL here on base that said they'll "try" to keep it in a cool part of the plane and it should make it to Maryland in 2-3 days. So, yesterday the cooler that I ordered finally arrived and I modified it a bit with some added styrofoam to the lid and bubble wrap around the inside. I packed up my milk this morning and jogged (carrying a 30 pound cooler) 1/2 a mile to the DHL and got a shoulder shrug when I asked if they thought it would arrive frozen. We have no dry ice or anything here so I'm just praying that all of the frozen bags packed together will keep each other mostly frozen. I just need all of you to send ice cold thoughts my way in hopes that this milk will get to L still frozen. It's probably a silly thing to cling to but despite the hassle that pumping/washing/freezing brings it has made me continue to feel like a mom and if this crazy plan works out I can at least let go of some of the guilt that I am carrying about being away from such a young baby. And if it doesn't work out, I'll at least know that I did absolutely everything that I could to make it work, it's out of my hands now. It's funny because I didn't realize how huge of a deal it was to me as I got into the routine of pumping/washing, etc. until I actually handed the cooler over to the guy that looked at me like I was crazy...."you're sending what?!" I am now all wound up worrying about this liquid gold that I've spent 7 weeks laboring over. So please keep my shipment in your thoughts/prayers and in a few days you'll get an update. I tell you what, being a mother is much harder than any other job that I've ever, or ever will have! Thanks for listening girls,
Sunday, July 19, 2009
Hey Everyone!
I passed the 1/3 of the way done mark, two months down! Sometimes it feels like it's good progress, other times I don't know how I'll make it another 4 months...my whole time here twice more. One day seems to merge into the next. Still the same old stuff, day after day. Work has been okay, really busy one night then not bad at all the next. It's nice to be busy sometimes as the time passes so quickly; however, it's nice to be slow because I can catch up on emails and most importantly slow means no one's getting hurt!
We've had a lot of pediatric patients the last few weeks. Most of them are doing well, I take them little toys and coloring books which they seem to like. We have a 3 year old little girl in the ICU that is just a bit smaller than my daughter...that's kind of hard. We had a 12 year old girl die of her injuries a few days ago and they wanted a female physician to help prepare her body to give back to the family. I spent over an hour getting her into a better shape and cleaning her up so that her father could take her home to bury. That was pretty awful...it reminded me that my job is not always done when the patients heart stops. I was just greatful that she was not the same age as one of my girls, otherwise I don't know that I could've handled it. Last week I had a 12 year old boy that came in severly injured by shrapnel and he looked just terrified. I had the translator tell him that he would go to the operating room and that we would take care of him and he'd be just fine, I then talked to him softly and stroked his head while we gave him medication to put him to sleep, then I intubated him. As we rushed him to the OR I held my hands over his abdomen as he was pouring out blood, when we got into the OR and the surgeons opened him up they saw the extent of his injuries and one said, "this may not be a survivable injury". He was in a really rough shape for a few days and I was worried that the last words that he heard (that he'd be fine) may not come true. But thank God, he did well, is no longer on life support and I saw him up and walking in the hall yesterday. On the other hand, we had a 25 year old healthy troop die from pneumonia last week. It's really strange here...people die from things that they shouldn't and others survive injuries that seem unsurvivable. It all goes to show you that when it is your time, it's your time. When it isn't, it just isn't. It sounds so obvious but I see it played out over and over.
Everyone back home is doing okay. The girls are doing fine and M. is talking to me on the computer longer and longer each time. Sometimes her and I talk for 30 minutes straight which is a really long time to hold a 3 year old's attention. She really seems to miss me and I think it helps that we talk almost every night. She went to work with A. on Friday and they had lunch together, she really loved the individual attention. L. still screams and gets excited when she hears my voice or sees me on skype. Her and M. are playing together more, they chase each other around the house and she wants to copy everything that M. does. She even wants to drink most of her milk from a regular plastic cup as that's what she sees M. doing. She only takes a bottle at night! Who knows, maybe M. can potty train her in a year! A. is doing well and my Mom is continuing to do just fine. So we all are continuing on cruise control for now.
I hope you are all well, Miss you!
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