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