Miracles and Frustrations

Recently, we have had several reporters from various newspapers here at the Role 3, however, we have yet to see many worthwhile articles on what we are doing here. I’m not quite sure if it’s because what we are doing here isn’t news worthy or because it’s not controversial enough. We recently had a soldier who was shot through his lung and, in order to save him, our surgeons spent 5 hours operating on him. They eventually determined that the only way to possibly keep him alive was to remove half of his lung. Amazingly, the patient survived the operation and came to the ICU afterwards. In the ICU, our nurses and doctors spent the next 14-16 hours, carefully monitoring and treating him, keeping him alive and waiting for a team from Germany to arrive with a special heart-lung bypass machine which performs ECMO, or extracorporeal membrane oxygenation. In the past, this device has been primarily used on neonates and children and seldom on adults. During ECMO, the blood is removed from the body and circulated through a machine outside of the body where the blood is re-oxygenated and then is infused back into the body. The blood completely bypasses the heart and lungs.

Here, at KAF, was the first time they have ever brought ECMO into the combat zone, so this case will make the medical history books. And if this patient survives, he will be a miracle. Unfortunately, the article (http://www.stripes.com/news/a-breath-of-life-u-s-medical-team-uses-new-method-to-save-soldier-s-life-1.122727) says that the team from Germany operated on the patient for 5 hours, when it was really our surgeons who operated on him before the medevac team even arrived. I know that I shouldn’t be upset, because the most important thing is that this soldier will most likely survive. I’m just frustrated because we have yet to have a really good article about what we are doing here despite so many reporters coming through.

I have also been dealing with another frustrating situation, one that is heartbreaking for our unit. I have been caring for a 3 year old Afghan girl for the past few weeks who was injured when her family’s vehicle hit an IED. Not only are coalition troops being injured by the Taliban’s IEDs, but so are innocent civilians. Unfortunately, this little girl suffered not only two fractured legs which now lie flaccid with large external fixators protruding out from her skin, but she suffered brain damage as well. She will occasionally open her eyes, but she does not focus on anything and she only barely lifts her arms in response to stimulation.

Despite this little girl’s poor prognosis for any recovery from her brain injury, we have done everything possible to make sure that she is comfortable and well cared for. Sadly, we had to send her out to the local Mir Weis hospital because there was nothing more we could do for her. We hope that she will receive the care necessary to prevent her death, but they have limited resources and the staff does not have the same work ethic as medical staff in our country (they only show up for work when they feel like it). There, patients are only fed if the family comes in to feed them and the family has to bathe the patients and do the dressing changes as well. The nurses provide very limited care and they do not always have the oxygen and tube feedings available that this little girl will require.

The Role 3 hospital here at KAF is a combat trauma hospital whose main mission is to care for the injured coalition forces. Our admission of these children and all the surgical procedures and nursing care that we provide is purely humanitarian in the hopes of winning the hearts and minds of the people. Which I believe we are doing, even if it is just one Afghan civilian at a time. The parents of these children are very grateful for the care that we provide. One of our translators was telling us that they are glad to have the coalition forces here doing what they are doing because the majority of the people really do want democracy. As more and more civilian casualties are reported daily and more and more children are brought in to our unit, I hope the Afghan people continue to feel that way.

I have signed up for another 5K run. There is at least one a month around here, because there is nothing else to do. This next one is to celebrate the Marine Corps birthday. As part of this run, each person is given the name of a Marine whom has lost his/her life here in Afghanistan since the war has started. I will be running in honor of 1^st Lieutenant Trevor Yurista, a 33 year old from Pleasant Valley, NY. Yurista was a ground intelligence officer with the 5^th Marine Regiment, 1^stMarine Division out of Camp Pendelton, CA. He was killed Oct 27, 2008 by an IED. Just last month, an intelligence compound at Camp Leatherneck here in Afghanistan was dedicated and named after him. I am honored to be running in memory of this Marine.

Navy Birthday

Happy Birthday Navy!

Today we celebrated the 235^th birthday of the United States Navy. The U.S. Navy began as the Continental Navy , which the Continental Congress established on October 13, 1775 and consisted of two whole ships which were utilized to search for munitions ships supplying the British Army during the War of Independence. In 1972, Chief of Naval Operations (CNO) Admiral Elmo R. Zumwalt authorized October 13 as the official day of recognition for the Navy’s birthday. Every year since then, the current CNO has ensured that the tradition of celebrating the Navy’s birthday has been carried on.

Part of that tradition involves the cutting of the birthday cake by the most “seasoned” (oldest) member of your unit along with the youngest member of the unit. And, it is also tradition to reveal what year they were born! Our most seasoned member was born in 1949 and our youngest in 1990.

Can you believe they mad such a beautiful cake here at KAF? It was made by the ice cream shop on the Boardwalk! After the cutting and eating of the cake, each department of the hospital gathered together for group photos that will go into a Cruise Book which is like a High School Yearbook and will capture our experience here.

Today we also said goodbye to one of our ICU doctors as he is being moved to one of the Forward Operating Bases. We are really sad to see him go as he has been with us since we all met up for training at Ft. Dix. I know he will do a great job running the ICU where he is going, but he will be missed here at Role 3.

 

Care Packages and Letters

Moon over hockey at the Boardwalk

 

 

I just wanted to say thank you to everyone who has sent me care packages. I have received a lot of wonderful things to make life easier here! Recently, I have especially enjoyed the Halloween decorations from my Bellingham neighborhood. Most of the decorations are currently hanging in the ICU and they look great! I have also received lots of yummy Halloween candy that I have been sharing with my coworkers, making everyone very happy.

I have received a couple packages as well as letters from people involved with the Soldiers’ Angels organization. This organization is a non-profit, volunteer-led organization whose moto is “May no soldier go unloved.” Anyone can adopt a soldier through this organization. Thomas signed me up and I have now been adopted by a young Croatian woman who is working on her graduate degree in Cairo, Egypt. I have also received letters of support and encouragement from several other people associated with Soldiers’ Angels as well as a package directly from the Soldiers’ Angels headquarters and one from a young woman in Michigan. If you are interested in adopting a soldier or finding out more about the organization their website is www.soldiersangels.org.

Two days ago I received a package from my sister and in it were approximately 30 letters from her 5^th and 6^th grade students. They arrived on a morning right after we had just packed up three injured American soldiers and sent them on their way to Landstuhl for further surgery and care. The staff was in much need of a pick-me-up when I opened the package and discovered the letters. I started reading one letter after another to two people sitting near me, and the next thing you know, I had a significant gathering of people listening to the letters. Some of questions in the letters indicated a morbid fascination with shooting and death by some of the children, mostly boys, but most of the letters were very entertaining and put a smile on our faces. The most common question among the letters pertained to what I eat or how I eat.

Below are some of the most entertaining quotes from the letters I received:

“Do you miss the taste of gum?”

“Have you flown a jet?”

“When there’s a war do people have to wake up fast? Are some people lazy?”

“How much do they pay you?”

“In what country do you live in outside the arited estate?

“Do you even like your lunch over there?”

“If you know someone is sick, what kind of soup do you make?”

“Your sister looks too pretty to be a teacher but she is.”

“One time when my mom was pregnant before I was born, my brother was born first.”

“My name is Chris, but I’m not the one that gets in trouble all the time.”

“Man, I bet your brave by going over there in the Jungle! Your lucky because maybe you could take some pictures of the jungle!”

“How is it in Afghanistan? I have heard that it has been a pretty chaotic war. Do you like Taylor Lautner?” (Taylor Lautner plays Jacob in the Twilight vampire movies, for those who don’t know.)

“Is the nurse thing huge or small and do you guys have a soda machine?”

“Do you think you would ever come here. It will be fun. I will sit up in front. I will help you out.”

“I hope you like this letter.”

Thank you, Jessica, for having your students write those letters. My co-workers and I have thoroughly enjoyed reading them several times over and they have put many smiles on many faces.

 

Mohhamed

Mohammad is a 6 year old boy whom has been with us for several weeks now. He was walking with his friend to a local market to buy new shoes for the three day event that occurs to celebrate the end of Ramadan. They were following behind a group of Canadian troops because the locals think it is safe to be close to the military. Unfortunately, a Taliban member, wearing a suicide vest, rode up to the military unit on a donkey and blew himself up. It was the children that were injured, not the Canadian troops.

Mohammad suffered a broken leg, a lacerated kidney and some other internal abdominal damage. He is an amazing little kid. He is so well behaved and very stoic for his age. I have begun to realize that the children of the Afghan culture are much less needy and even seem more independent than American children of the same age. He does everything we ask him to do even if it is painful or uncomfortable, like practicing deep breathing exercises, putting weight on his injured leg to rebuild his strength and letting us stick a suction tube down his nose into his lungs when he gets too congested.

I have cared for children in the U.S. when I worked in an Emergency Department and it was a much different experience than it is caring for children here. I frequently encountered tantrums, either as a result of a child being spoiled or because the child was outright scared to death. Here, I have only seen one tantrum and that was probably the result of the child experiencing what we call the “ketamine crazies.” Ketamine is a medication that is frequently used as part of anesthesia during surgery. Unfortunately, there are a few people who have psychological reactions to the medication including anxiety, disorientation, hallucinations and even occasional psychotic-type episodes. We think that the little girl who began throwing a tantrum and flailing her body all over the place was experiencing some of these side effects, because once it wore off, she was fine.

Despite the fact that these children wake up in a big place surrounded by tubes and wires, full of people with a different colored skin, speaking a different language, the Afghan children never start crying or even seem scared. Instead they look around at everything, with wide brown eyes, and cooperate with everything we do to them. They quickly learn how to point to what they want or need and, never once, have I had to tie down their arms to keep them from pulling out any tubes or lines. It’s almost like they know that it is important to leave everything alone. Now, the American soldiers, on the other hand, have to be held down and tied down frequently because they like to try to pull out everything and anything!

Mohammad has been very sick with infections and high fevers, so we have been trying to do whatever we can to help him feel better. He now has a cool t-shirt and his own pair of sunglasses! He likes to go for rides in the wheelchair around the hospital. He will point in the direction hewants to go. Even when he has just finished vomiting, he still wants to go for his ride down the hallways. I asked his grandfather permission to take his photograph and his grandfather told the translator to tell me, “Only if I can be in the photograph too.” I am working on getting the photograph printed so that I can give it to the grandfather. I showed Mohammad the picture on my digital camera after I took it and he started laughing. It was good to see a smile on his face!

He is transferring out to the Ward today, which is good because he is doing so much better, but we will miss caring for him and playing with him everyday. Today, just before we moved him out of ICU, I gave him a box of crayons and a coloring book. He pushed the Winnie The Pooh coloring book away, but took the crayons. He then proceeded to dump the entire box of crayons out on his bed and looked at me with a little smile at the crook of his mouth. I tried handing him a Mickey Mouse coloring book, just in case he had something against Winnie The Pooh, but he again pushed it away. Instead, he started picking up one crayon at a time and putting it back in the box. Once the last crayon had been returned to its home, he closed up the box and handed it back to me. I think we might have to teach him how to color, but it was interesting to see how the he was entertained, not by the function of the crayons as a coloring tool, but by the task of organizing and putting them away. I am learning a lot here about children as well as many things about the Afghan culture and the difference and similarities between parent-child relationships.

Entertaining Myself

The past several days, I have been making a point to try to find things to keep it entertaining around here. I was actually pretty sick for about 4 days and spent most of those 4 days in bed. By the time I started feeling better, I was so sick of being holed up in my room with the fluorescent lighting, I thought I was going to go crazy. So, on Tuesday, the 28^th, I started by going to explore the new USO complex.

The United Services Organization (USO) is a non-profit organization whose mission it is to provide morale and recreational services to members of the United States military service. Theorganization just completed a brand new facility, here a KAF, where they provide all sorts of free services. United Through Reading is a program the USO offers where parents can pick a book to read on video and the USO will then send the video with a copy of the book to the child. They also have Operation Phone Home where military service members get 30 minutes free to call anywhere in the U.S. from a table full of telephones.

There are many people here at KAF that are living in tents with 40-80 other people, so they do not have the luxury of having access to the internet and Skype like we do in the NATO dorms, so they have computers with internet access available at the USO complex as well and each person is also entitled to 30 minutes free per day. This is a real nice program that allows them to communicate with their family members. There are also multiple gaming stations set up with Wii, Xbox and PS2 throughout the USO complex. They offer free coffee and hot chocolate and a few snacks in an area that looks like a café where there is a large screen television on the wall that shows the news. There are two other large screen televisions in the complex, each surrounded with several comfy chairs and couches to lounge in. When I was there, one television was showing a soap opera and the other was showing football. There are a couple private music rooms where people can practice playing their musical instruments as well. And last but not least, there is a movie theater with reclining leather seats; they were showing Iron Man II at the time I was there, but it was already half way through, so I didn’t stay to watch. I just relaxed in one of the comfy chairs while my room mate read a book to her son.

Tonight, Friday the 1^st, I actually got to leave work early. I was so excited because I never get Friday nights off and Friday nights is Movie Night at the Dorms. Some of the IT (Information Technology) geeks here have rigged a system of extension cords in order to set up a really nice sound system with large speakers and projector from their laptop so that we can watch movies. A large piece of plywood with a white sheet stretched over it, serves as the movie screen as it leans up against the brick wall of one of the Dorms.

People bring out their folding chairs that they have ordered online (some people actually brought them from the States, squeezed into their duffle bag), while others sit on wooden benches or the ground. Some people brought snacks to share; my dad sent me popcorn from the Popcorn Factory, so I brought that out to share with everyone! They were all excited for the different flavors and the best part is what is printed on the side of the can, “Extreme Survival Kit.” Thanks Dad! Everyone loved it!

Tonight’s movie was The Expendables, an action film starring all the great action stars, Sylvester Stallone, Jet Li, Mickey Rourke, Jason Statham, Steve Austin, Dolph Lundgren and cameo appearances by the Governator, Arnold Swarzenegger, and Bruce Willis. It is definitely a movie my husband would have loved, lots of action and violence! There were some funny lines in it too. At least it was entertaining!