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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
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