So the point of the last month has been to support the Marine Corps in one of their exercises.  This one has been held in the Philippines, on the island of Luzon, in a place called Crow Valley.  

 

Here’s a picture of the valley up above.  Interestingly,  the valley has changed over time.  Can you see how there are the mountains and then see how flat, like a table top, all the land between them is?  That is because of what is not pictured, Mount Pinatubo, which is a volcano.  About 20- 25 yrs ago it went off and dumped lava and ash everywhere.  One of the U.S.M.C. officers remembers 25 yrs ago prior to this and  he described the valley being a normal valley, and when we spoke to some of the locals they described what it was like to be there when it erupted:  they were running for their lives when it happened.   You can absolutely see how the valley filled up with liquid lava, which then changed phase into a solid as it cooled off.  Also there’s ash everywhere.  Geology in action. Pretty interesting.

What really is a military exercise?  It’s a staged practice ground in which one military visits another (and there might be other, maybe many, nations involved), and they practice shooting weapons, landing on beaches, navigating through mountains or whatever.  Nephew 1st Lieutenant (name intentionally left blank) just finished an  exercise in Norway in which they practiced cold weather ops. This one, called “Balikatan,” has been held in the PI where we’re practicing hot (95 degrees + 95% humidity), humid, buggy ops.

The participating militaries do a dress rehearsal of sorts for real events, and also familiarize themselves with their old weapon systems, practice with new ones, and importantly they get to work together with the militaries of other participating nations and become tighter, more functional allies.  They do these every year here, in Australia, Thailand, Korea, and loads of other places around the world and around the calendar.  Army, Navy, Marines, Air Force, they go from exercise to exercise and train up for trouble in case it ever visits.

Our relationship with the Philippines is of great strategic and political importance.  It’s in a key area of the world, adjacent to shipping lanes as well, and the nation itself is important to us.  As a country it’s pretty unique:  7,000 islands, many different cultures and influences.  It’s got an elected, representative form of government, and economically and infra-structurally it would probably be classified as an “emerging nation” status.

The Navy and the Marine Corps are like fraternal twins… very tight.  Marine corps has Infantry, Logistics, and Aviation, that’s it; no medical, dental, nursing, etc.  That’s where our group came in.

We initially staged in Okinawa because that’s where 3rd Medical Battalion is housed (ref: last update).  We were supposed to take this contracted vessel 1,500 km over the South China Sea from Oki to the PI.  The boat is called a “High Speed Vessel” but the troops have nicknamed it “the Vomit Comet” because unless the seas are very calm it is a rocky ride, but the seas were too rough for that and so we had to fly over instead.  Rather than a 36 hr ride on a shallow-hulled boat we got a two hour ride on a Boeing 767.  The change in transpo offers me a lot less to write about with respect to the trip out, but I’ll take the deal.  Plus, as a “Captain” I got to sit in one of the first class seats, which was tres bonne.

We landed at Clarke AFB (Air Force Base) which is now a Philippine Air Force Base and I don’t know if they’ve changed the name or not.  Of course it had to be in the middle of the night.  Why does it always have to be in the middle of the night?  It’s useful to think of ourselves as so many pieces of gear, and pieces of gear don’t care if they’re flying in the day or in the night or whenever it might be.

We grabbed our real gear and loaded it into the trucks you see on the left of the photo up above, which were parked for us right outside the hangar.  Then we took a bus for a two hours’ journey out to Crow Valley.  The first hour was highway, the second hour was a road to the military base.

That road was a two-lane jobbie with a shoulder on either side of at least ten centimeters, and a sidewalk.  It had the usual assortment of third-world sharp turns and we had a third-world bus driver who negotiated the turns at a decent clip.  The street was for everybody, not just busses and cars but bikes, pedestrians, stray dogs, and people up at all hours.  It was a lifeline, kind of how a river might be, and there were small storefronts all along the way selling anything from chips and fruit to bicycle parts and auto repair shops.

We got to the camp and de-bussed, married back up with our gear, got our brief specifying the usual behavior expectations such as no drinking no etc, etc, and lugged our gear into our tents and by this point it was 0400  hrs.  We were up by 0630 hrs or so, the sky brightening, the roosters crowing (they don’t just crow once like in the movies, they do it over and over, and over, and over), trucks driving outside our tents, radios blaring with philippine radio announcers and music.  Time to brush my teeth, have a breakfast (a prepackaged thing called an “MRE” which stands for “Meals, Ready to Eat” in military parlance), lay on my mat again for a short spell, and be up again and ready to muster at 0900.

For the first few days the camp was busy getting set up.  Literally, they had finished bulldozing the area maybe a week or two prior and all the white  tents were erected by contractors after that and before our arrival, but all the gear that the U.S.M.C. and the Army (U.S.A.) were going to use, the trucks, light armor, tanks, ammunition, supplies, that all needed to be brought in.  So day and night trucks were arriving, unloading, and departing, snorting and beeping like it was a shipyard.

There are about 1,200 people here now so for the most part quarters are pretty tight.  At first I was alone and also had no cot (none of us did) and so slept on the plywood floor.  Being tired enough it wasn’t such a problem.  I strung a bit of 550 chord across the corner to hang clothes and blankets on to dry out, and did not snack in the room as that would bring bugs which would bring mice which would bring snakes which would scare the crap out of me.  No communication with home at all the first five days, and only a very brief text with them about once a week since.  Every day I take my malaria tablet.  Fortunately I’ve not seen any female anopheles mosquitoes (the kind that deliver malaria) but there’s also Dengue Fever, chichumunga, Typhoid fever, leishmaniasis, amebiasis to keep an eye out for (we haven’t had any snakes or rats or anything else, so far).  The biggest risk is the heat and the humidity of the air, and the E. coli of the water.

Our medical tents arrived the day before the exercise was to start, actually it was the evening, so we were up most of the night setting them up so as to be ready for business in time for the next day.  We did it!  (I’m there in blue)

Fortunately, no major injuries throughout the whole exercise, just some heat-related illness and one water-buffalo that got accidentally blown to smithereens.  Did I mention it’s hot?  Yes it’s hot. Tropical hot.  Latitude we’re 15 deg north of the equator (and 120 deg east of Greenwich line longitude) and right across the South China Sea from Viet Nam.  Anyway we sweat like beasts (up top is a pic of a beast – it’s a water buffalo, lots of those around these parts).  Base had no showers the first five or so days, so it got pretty funky.  However you get used to it.   We have an ER tent, an OR tent, a Patient Holding tent, and a Dental tent.  They’re all connected to one another and we have power and A/C.  All the gear comes in pre-arranged boxes, called AMOL’s, and these are loaded into big Conex boxes, and we unload the AMOLS and in them are all the  gear we  need for operating and seeing emergency patients. The medicines are in cloth suitcases that unzip and we hang off 550 chord strung around the circumference of the inner aspect of the tent.  The OR table is a metal frame upon which we lay the stretchers and then can operate, stabilize and transport.

We did a number of drills to get everyone ready and build up our team, and they’ve gone better every time.  I’m impressed with our “OIC” (Officer in Charge) and how well she’s organized this entire thing and got all 33 of us working together, and with our fellow officers and especially our Corpsmen.  I cannot tell you how great it is to get to know them and to work with them.   The photo below is just a MEDEVAC exercise we did in conjunction with some Army medics.  The “patient” will be flown out in the Army helicopter (photo up above).

After about four days the cots finally arrived, more people arrived, and then for a few days I shared my tent with a few Marine Colonels and one Sergeant Major who were really interesting, pleasant guys, affable, gentlemanly, I can’t say enough positive things about them.  What I found most interesting was listening them speak with one another and within the context of their conversations they habitually wove in references to all their junior officers and enlisted consistently making mention of their juniors’ professional development.  Their culture of continuous attention being paid to the development of their juniors is second nature with them.  It’s unlike anything I’ve  ever seen in other aspects of the professional world and one of my favorite aspects of the Marines.

Anyhow, that’s probably about enough on the exercise for now.  Will update later, as needed.  All the best,

PBR

 

It’s been a year and a half since the last post and there are some reasons for that, the most important being it really wasn’t okay to update much about our hospital in Kandahar:  I couldn’t talk about the base or the missions or even daily life without producing info that could give our enemies insight or ideas (and we all assumed the base was infiltrated so such concerns weren’t a far off).  But in time that deployment ended. Many great things to say but too late to talk about it now.

We got reunited as a family,

and now a year and a half later I’m on a trip from Chicago to Okinawa and the Philippines to participate in an exercise called “Balikatan.”  This one is public knowledge and I can discuss it.

(I’m not sure what Cessna would take 10 hrs & 15 min to do this.)

Officially the Okinawan Islands (or Ryukyu Islands) are 150 associated islands made of lava-rock in the West Pacific, about two thousand kilometers south-southwest of Tokyo, the largest one is itself named “Okinawa” and is covered with lovely green forests and grasses and 1.4 million Okinawans and about 60,000 US troops.  Okinawa is an island near the tropics (my watch says my exact latitude/longitude is N 26˚ 17’58.3″ & E 127˚ 46′ 51.6″meanwhile a map of the Earth says the Tropic of Cancer is at N 23°26′13.9″).  Okinawa is becoming a vacation destination for the Japanese like Hawaii is for us and the Japanese.

Okinawa was one of the MAJOR battles of the Pacific in WWII. Borrowed from “history.com,” Okinawa was “Last and biggest of the Pacific island battles of World War II, the Okinawa campaign (April 1—June 22, 1945) involved the 287,000 troops of the U.S. Tenth Army against 130,000 soldiers of the Japanese Thirty-second Army. At stake were air bases vital to the projected invasion of Japan. By the end of the 82-day campaign, Japan had lost more than 77,000 soldiers and the Allies had suffered more than 65,000 casualties—including 14,000 dead…. The commanding generals on both sides died in the course of this battle: American general Simon B. Buckner by artillery fire, Japanese general Ushijima Mitsuru by suicide. Other U.S. losses in ground combat included 7,374 killed, 31,807 wounded, and 239 missing in action. The navy suffered 4,907 killed or missing aboard 34 ships sunk and 368 damaged; 763 aircraft were lost. At sea and in the air, the Japanese expended roughly 2,800 aircraft, plus a battleship, a light cruiser, and four destroyers, with losses that can be estimated at upwards of 10,000.”

Okinawa’s history is that of an independent place that is smack in the middle of shipping lanes between mainland Japan and Taiwan/China, and about 600’s AD seems to be the reach of what I can find on its [known] past.  Being in a strategic location the territory was contested between opposite sides over the centuries, Chinese dynasties, Japanese Shoguns, all the way to WWII.

It’s peaceful now but what lesson I take out of it is that “peace” is achieved. It’s not a natural state of affairs.

It may also be worth mentioning this is not my first trip to Okinawa:  Megan, Helen, and I were here 1n 1996.  Helen was two months old then, and now she’s in college.

Where Okinawa fits into our (Meg & Paul’s) lives has changed since then.  In 1996 I was 29, Meg was younger than that. I had finished Internship and Flight Surgery school and was coming out for my first independent job with the Navy, and Meg was pregnant with with our first child, Helen.  We were new at being married and once Helen arrived and Meg came out here new at being parents, and new at exploring the world.  Nowadays almost two decades on we have three “babies” (not so “baby-like” any longer) and thanks to the Navy have lived and worked in lots of places.   Where once Okinawa was the start of my Navy career, Oki is now perhaps a fond farewell to it –or at least I’m on the last lap of it, I hope.

It’s been a long time since those charmed early days.  Today is Sunday, March 20, 2016, and at 0700 hrs the sun was out, the air about 65 degrees, and aside from the swish of trees swaying in gentle Spring zephyrs there were few if any sounds.  It was quiet in my BOQ room and quiet outside the long, squat, concrete Bachelor Officers Quarters (BOQ).  The morning sky was clear, the parking lot asleep, the Marine Corps base peaceful, and if it was keeping out anything at all, the 8 foot high perimeter fence was likely only a problem for would-be infiltrating Okinawan bunnies or such but not for any human enemies –not like our Hesco barriers and barbed-wire fences in Afghanistan were, and not like those fearsome defense lines were back in the battle of Okinawa in 1945 back when we Americans were the enemies.

The first thing I remembered when waking up was a sense of loneliness I felt upon arriving here in 1996.  Something about Okinawa itself, the air, the solitude brought that old feeling back.  The thing was reminiscent like a taste or a scent is reminiscent and the loneliness of those first weeks or months in 1996 was a different loneliness from any other I’ve known in other places at other times. It was the loneliness of one’s first day on the job.

After years and years of preparations (college, med school, internship, flight surgery school) the first day of the rest of my life had arrived, and what a bitter embarrassment it would be to me and all my backers if I turned out to be useless.  Not only were the Marine Corps intimidating but they expected and deserved a decent doctor for their troops, and I’d better deliver.

Meanwhile, Meg at home in the States was busy with a lonely and intensely consequential occupation of her own, carrying and someday delivering baby #1.  I missed her so much and felt wrong about being apart but at least we had no real choice about the matter.  The situation was what it was.  There was no arguing with either Mother Nature or the U.S.M.C.  So we carried on.

In Okinawa in 1996-97 I served as a “flight doc” for HMM-265 (rein), a Marine helicopter squadron that was the air combat element (the “ACE”) for the 31st Marine Expeditionary Unit (MEU).  We were “special operations qualified (SOQ).  LCOL G.C. O’Neal was our squadron commanding officer, a U.S.N.A. grad, personable, intimidating, muscles on top of muscles and his call sign was “Conan.”

My “flight surgeon” role with them was conceptually simple:  tend to all the guys and their families and ensure every last person was either “mission ready” or being taken care of properly in order to get them back to “mission ready.”  Beyond that a flight surgeon was an aviation safety officer, and a primary investigator for any aviation mishaps (we had one / nobody injured).  Also I was the Commanding Officer’s eyes and ears, and the pilot’s and air-crew’s personal confidant.  And also one does sick call for 4 hrs every morning for the squadron and the camp.

We had our squadron, HMM-265, which was the CH-46 E helicopters you see in the photo above (nicknamed “Phrogs”), plus all the maintenance and support crews, but for being the ACE of the 31st MEU, HMM-265 was also reinforced with a whole bunch of other aircraft, Hueys (UH-1’s), Cobras (AH-1’s), Sea Stallions (CH-53’s, which we called “Shitters”), and Harrier jets (AV-8B’s), and ALL their men and supplies.  So it was a lot of people and a lot of action.

The “MEU” is the President’s mechanism for dealing with anything “that absolutely, positively, has to be blown up overnight.”  It’s a self-contained, fully operational unit that includes enough Infantry (men + trucks + tanks + artillery) and Aviation (us) and Logistics (“beans, bullets, and band-aids”) to receive a phone call from PODUS (President of the United States) and immediately be on the go to wherever it needs to be (hence its close affiliation with Navy ships) to fight whatever needs to be fought.  The 31st MEU was that for the Pacific Theater at that time. That ocean was our ocean, or at least that’s how we felt about it.

Damn I wanted to do a good job.  I learned quickly that every individual within that big squadron was essential and any one person failing in their jobs could jeopardize our guy’s lives, and my life too (I flew with them oftentimes).  Y’see helicopters (and Harrier jump-jets, which are single engine aircraft) don’t so much fly as they fool physics for long enough to get from point A to point B in the air instead of over the ground, and it takes a ton of grease and hard work to keep the lie in place and functional.

Our big squadron was intense.  Conan had everyone working their tuckus’ off, probably because the MEU commander Colonel Umpdesquat above him demanded it, too.  But in addition to Conan we had an awesome XO (Major Turner) & OpsO, in fact awesome Marine officers all the way down the line, and loads of awesome, hardworking, tough, enlisted Marines who fixed and tuned-up those birds and who flew in them and did every kind of job required for keeping the squadron humming from before dawn to after dusk.

He and his squadron exemplified the best leadership, mission accomplishment, camaraderie and morale that I’ve known before or since.  To a person we shared and believed in the same mission and gave ourselves over to it.  Our squadron went out on several deployments to places like Korea, Australia, Vladivostok (well actually I was grounded for Vladivostok – got in a wee bit of trouble) (but all’s well that ends well), and whenever not sailing about the Pacific we had time here on this island.

One essential bit of sanity for me here on the island was a friend I made named “Clancy,” and he introduced me to what became our running / drinking club called The Hash House Harriers (incidentally not the source of the “wee bit of trouble” so cryptically referred to up above. That trouble if you must know stemmed from flying in a medevac helicopter off a ship in the Sea of Japan and into South Korea with an injured patient and subsequently hanging out in Seoul for 4-5 days rather than trucking it back to the coastal city called Pohang, and therefore missing my ship’s movement out of the theater, because I believed the dopes in the Navy liaison office in Seoul who kept telling me every day “Nope, no word from them yet, stay here another day and we’ll try again tomorrow” meanwhile the ACE was sending aircraft to Pohang to pick me up) (I’m still mad at those dopes)  [Anyway] Whenever Meg and Helen weren’t here I’d hang with Clancy almost every day and about three times a week we’d go running with “the Hash” and after each run, being sanguineous Irish-Americans Clancy and I would celebrate with a party. Celebrate what?  Life, Okinawa, Meg, whatever needed celebratin’.  Sometimes we never did find a good reason but that didn’t stop the celebrations.

Here you can see Clancy (white t-shirt) doing what he did better than any man or woman I have met before or since which was to be a gracious, inclusive, welcoming host, making certain everyone had food and a drink and always looking out that they had a great time.  On the right is a photo with a few of the Okinawans after a run –this little social club was the only way we got to meet them.  As you can probably tell they were delightful people.

So this morning I got up and went for a run off the base and down past Clancy’s old place, down along the seashore, and wasn’t that glorious.  There are parks along the seashore and many Okinawans were up exercising.  One family of five was particularly interesting, the Dad had on pads and the Mom was kicking and punching the crap out of them (she was really good) while the three little kids were playing near by, and on my way back I saw Mom playing with a kid while now one of the tiny ones was having her turn to practice.

At the very top of this update you see a photo of three old Okinawan men on the sand practicing Karate with their staffs.  One of the old guys had to be in his 70’s.  Karate was invented here, don’t you know?  Another group of women was up doing yoga on the beach.  There was a big race as well, a “Race for Peace,” and not to get too stereotypical but take a look at the flags that were up… hilarious.  Like Speed Racer or Pokemon.

Well, that’s more than enough for one update.  God Bless us all and if you’ve made it this far, thanks for your interest!  Paul

 

 

Dear Family and friends,

Greetings from Kandahar Air Field!

I know it’s been a few months since my last posting, and I apologize for that.  There has been a reason for the radio silence which in short is that the rules regarding internet and blogging, once in the country, are different.  It’s important for “OPSEC” reasons (meaning “OPerational SECurity”) that we don’t violate any of a lot of restrictions.  For instance there are no photos allowed of the base, nor photos of patients or of operations, no photos of the flight line, no discussing military maneuvers on the internet, or mentioning base functionalities, or personnel issues….  And then there are the standard restrictions as well, such as don’t discuss colleagues or allies or enemies or patients, bosses, or great ideas you might have for how to make the war go better.  Probably a good idea not to discuss any issues around religion.  Hmm… What does that sort of thing leave a would-be blogger with?  Silence!

But on top of the external restrictions there is also a formidable internal one:  There is this great difficulty to initiate anything that takes hold of you after just a few weeks of being here.  It’s not depression and it’s not ennui; I think it’s like this, while at home it is normal to be things like “busy” and “productive” and if you are being those things that is well and good and in keeping with the environment and with everyone around you, but out here instead it is such a void and a vacuum that being “busy” and “productive” are notions as anomalous and crazy as, say, preparing for snow.  It just doesn’t make any sense.  There is a peculiar malaise that takes over when here; as my friend out here Dave describes it, “being here is like taking Morphine for the soul.”

Well, at least initially.  Because although it took a few months to settle in here, I can now see past my initial shock and find a couple of things that might be interesting to relate that don’t compromise security or pose any threats.  The things that I would wish to express to you are the normal items, such as friendships, day-to-day, missing people at home, et-cetera.

Getting here was the usual drag, and adjusting to being deployed has been a two-fold thing.  Phase I is familiarizing yourself with your new environment and assimilating your various duties and roles into a cohesive pattern; it is a busy first month but you get it all under your belt by week 4 or 8 and from there you are on cruise control for the rest of the tour, with occasional hiccoughs but more or less steady-state. Phase II is a bigger deal and involves assimilating the fact of being away, of missing your spouse and children and family and friends and neighborhood and country.  And by “assimilating” I mean adjusting to the fact that they’re not present in your immediate environment, and you’re not present in theirs.  Keeping them always present in your thoughts and heart is a bit like holding open a pew at church during Christmas or Easter:  the place progressively fills up around you, and you’re steadfastly preventing any of the other assholes from stealing your pew that you’re holding open waiting for your family to arrive and occupy.  This one (Phase II) kicks into gear perhaps at a different time for everybody, but for me it was like week 3-5 where it started, and not nearly so short-lived as Phase I it lasts the whole damn time, with a waxing and waning, undulating scope.  For a week or two you after it launches it hurts so much you can’t even believe you’re apart and are destined to remain so for a long while, but then somehow the sadness and loneliness gets less intense and then you feel good about life for a few weeks.  But then it recurs and I wonder how everyone else gets by; but then it goes away again, mercifully, only to come back later and so forth.

The story of the Phase I has recently been written, it’s called “Citizen-Surgeon,” and I’m tempted to just self-publish it so it can go straight to the middle of Amazon eBooks “minimal sellers” list, however, I think this one actually might be able to get published so I’m holding out for a trial of that.  Crikey, there’s a new book out on the working dogs of the Navy SEALS; if that can get published, I’m thinking “Cit-Surg” ought to have at least a fighting chance.  Nevertheless when my attempt to out-press the Navy dogs fails, it’ll be available on eBooks for very little money.

So what I can blog about I think might be issues within and around the “Phase II.”

Dealing with that involves getting creative.  My advice to my eldest child, Helen, as she preps for college in the not-too-distant-future, has been to go ahead and focus hard on the “STEM” subjects (Science, Technology, Engineering, and Math) so that you can get a job, but to also balance those studies with an equal focus on the arts, so that you can stand it.  And I’ve had to hear my own advice in that regard in order to dig myself out of my malaise.

So what I did is start the “Kandahar Air Field Artist’s Workshop” in which we’re focusing on a number of disciplines each month:  April (Creative Writing), May (Photography), June (Music), July (Art), August (Performing Arts), and September (History & Culture).  We’ve also started a book club, and this month’s is Hemmingway’s “A Farewell to Arms.” My personal creative writing project is a short story, “The Singular Adventures of Euphestus Dubios,” and if I can beat it into shape, it’ll be the next post in another month or so.

One of the best things of all so far was Easter.  I’ve made some good Romanian friends, two Intel guys, and got invited to midnight mass at their compound, where they had built their own Eastern Orthodox church, and it was a great night!  I understood even less of mass than usual –on account of Romanian language sounding nothing like American– but I got the overall gist of it.  We stood the whole time, had real candles (which I think is done to force concentration upon all of us so as not to set alight one-another, or burn the wooden church down), we walked inside and outside and inside and outside, and around the church several times, and all in all it was a great mass.

Hugely important out here has been the physical fitness factor.  At home life is so busy it is difficult to get in shape, and it feels like you’re always cutting out of other things (like, family time, or personal time, or work) to engage in it.  But here there is this great expanse of time with nothing else to fill it, like, like the Central Asian steppes, and so adding fitness is a breeze.  I’ve found the “Kandahar Crossfit” community, which is filled with a whole bunch of fitness fanatics of all nationalities, and it’s been a long, slow ramping up but I’m finally at the point where I can finish most of the drills.  I am always last, and always with the least weight of anybody, but just being here is one for the “win” column. Not a lot of blokes get to rub elbows in an outdoor, concrete gym with Slovaks, Belgians, Danish, British, and Yankee guys of all types, special forces guys, and really great fitness coaches who travel all the way out here to live with us and run the thing.  Also in addition to the Crossfit “box” we’ve a lovely NATO indoor gym which has the best air (it has big air filters) on the whole base. So, these are in place of prozac, and have been absolutely fundamental to our emotional survival, working amazingly well.  Today’s workout was in honor of the 5 British airmen and soldiers who died last week in the helo crash out here.  Brutally sad, actually; I never met them but of course all the Brits in the gym were quite close with them.

I got to operate on a working dog the other day!  She hadn’t been herself for several months and on investigation (X-ray and CT scan) the Vet found a big goomba of a tumor immediately beneath her liver and gave us a call.  It was about a two hour operation; if I had any familiarity with the “canine” territory I think I could have gotten it out in an hour, but as it was we simply took our time and all went well.  A few hours later she was up on all fours, breathing heavily but able to walk out of there (imagine any human patient doing that?!?) and I’ll get to see her in another week to take out her staples.  It has been a real highlight!  Look where her i.v,’s were on her little forelegs.  (Sorry about the freaky face I’m making! Can’t fix ugly.)

 

Okay family and friends, that’s enough for now.  Until the next one!

Roach out.

 

So last we spoke we were at NAIACT getting trained up on Army principles.  During that course we had two ice storms and an earthquake (4.4 on Richter Scale). So the weather wasn’t great but so what?

We had one glorious night at the bar on our camp.  Concrete block walls and no frills, but no matter.  Seven hours.  Snow outside, nothing else to do, no where else to be.  It was all quite necessary really for troop cohesion and morale: After all, we WERE heading overseas in the immediate future, right?

We finished up on our weapons training, said our goodbyes to the Drill Instructors, and climbed on a series of planes headed for Afghanistan.  Along the way, one of the stops was in Qatar, an Air Base we use for moving loads of troops though the Middle East, or, as we call it in the military, CENTCOM (“Central Command”).  That was nice because we got to hang out for a night, shower, eat, chat, have a beer, get some rest, and collect our wits before our final leg.

That last leg was aboard a troop transport airplane called a C-17, and whereas I had girded myself for a hideous flight (last time I came in it was), this time it was a total snap. Only 50 or so of us, and wide open seating, clear skies, we were in the lap of luxury.

We landed at Kandahar Air Field, collected our bags, and loaded them onto a truck.  It was real at this point, and I thought with a component of dismay, “here we go again.”

The building on the airfield into which we were ushered was the self-same building in which the Taliban had their last stand in Kandahar before they’d been driven out by our Marines.  I cannot imagine the dramatic events that occurred within these chambers, but I could sense them when inside.  You can feel the fact that you are walking upon hallowed ground.

The first few days here have been exhausting, primarily because of the 10.5 hrs time difference from home.  But to our delight we have a gorgeous hospital in which to work, and gorgeous accommodations.

Whereas last deployment was spent almost entirely in tents for berthing and for hospital, this time we are living large in brick buildings, make-shop stores and restaurants, amidst a huge base (~30,000 people).  I hope I don’t have to leave this base at all.

My first day on call is tomorrow. Wish us luck.

The Navy is not a natural pick for service in Afghanistan because Afghanistan is a land-locked nation, one which would be lucky to have a lake much less an ocean.  But Afghanistan has been a very big job and for many years the Army has needed extra bodies to help with it, so over this time in both Iraq and Afg they have been graciously “inviting” us Navy swabbies to come in and assist.  Those people assisting are called “Individual Augmentees.” Have I ever heard of Army guys “augmenting” the Navy? Nooo….  Anyway, I digress.

Naval Individual Augmentee Combat Training exists for us Navy IA types to get familiarized with Army terms, protocols, weapons, tactics, and platforms.  The NIACT course is conducted at Camp McCrady, South Carolina, just adjacent to Fort Jackson, which is an enormous Army base where ~1,000  recruits are trained each week.  Below is a picture of a lo-ong line (large majority of it not included in photo) of recruits going on a ~10 mile march (or “hump”) with their #30 lb backpacks, in the rain, in 35 degree weather.  In short, that’s why we joined the Navy, right?

The weather here has been cold-ish, from 15 degrees to mid 40’s, the facilities have been excellent and our accommodations have been a little spartan but actually just fine.  Personally I’ve been lucky –even though I’m only an “O-5” or “Commander” I was put into an “O-6’s” (“Captain’s”) berthing.  Almost all of the other guys and non-guys (the wo-men) are in barracks but lucky me I’ve a room to myself, a desk, a locker and a fridge: Sometimes you win, sometimes you don’t.  (Fiona and Maeve, you can see that my little travel buddies, Ming-ming and Skinny Bear, found the bed first.)

NIACT has been a fabulous course of training.  Whereas San Diego (NMPS: Naval Mobilization Processing Station) was all of the administrative and in-processing concerns we needed to deal with, and NEMTI (in Camp Pendleton) was focused exclusively on the medical preparation specific to our upcoming mission, these weeks here have been dedicated entirely toward weapons and tactics and components of Army combat training.

Every day we’ve had early mornings and late evenings, with specific and detailed instruction on pistols, rifles, radios, IED’s, convoy execution, urban assault tactics, Afghan cultural awareness, green-on-blue awareness, forward operating base security, machine gun familiarization… and every step of every one of those subjects has been monitored and directed by a cadre of  outstanding Army Drill Instructors. They have not been as hard on us as they would on recruits; they say they like having us medical companies because since we’re pretty rank-heavy we already know how to do basic things like tie our own shoes, sit politely in rows, and the like; in return they have not had to stomp and holler as they might do with the recruits.  Below is a picture of one of our favorite DI’s (we have a bunch of favorites):

I can’t say enough great things about our DI’s:  These Drill Instructor men and women are up even before we are and they go home after we finish every day, they’ve been absolutely solidly professional and cordial, and they have been completely dedicated toward making our group –most of whom have had none or only limited training with weapons– safe enough to carry them and competent enough to use them, should the need ever arise. As a result of their training we all feel a lot less vulnerable and a lot more capable with respect to where we are headed, and we are most grateful for this training.

On arrival we got issued a shit-ton of gear in addition to a 9mm pistol and an M-4 semi-automatic rifle. The first efforts of the NIACT course were primarily dedicated toward things like muzzle awareness, safety procedures, and expunging any bad habits with respect to weapons handling.  Although if you intentionally or accidentally launch an M-4 rifle’s high velocity round it travels thousands of meters before it runs out of steam,  to me the pistol seems to be much more dangerous to carry about: the M-4 is big and it’s easy to keep track of, but the pistol is small and it is phenomenally easy to flex your wrist or elbow and point that muzzle somewhere it ought not to point.  It has taken concentrated practice underneath deliberate oversight in order to learn how maintain it safely at all times and every circumstance.

At first we just carried around blanks in our magazines, with stern admonitions that accidentally firing off a blank is still viewed in the gravest of terms, one for which the perp and the entire class as well as our instructors all suffer.  Once we got to the firing ranges we exchanged our blanks for real bullets:  It was a sickening feeling for me to have real bullets in real guns.  Having treated so many people after their gunshots, it was daunting potentially to be on the front end of such a process.  One regrettable mistake and… you can’t go get that bullet back after it leaves the muzzle.  Cannot reclaim it.  It’s long gone, off to put a hole into whatever it can find. Now multiply that times x100 because that’s how many of us were in the class.

Range days have been awesome.  Up at 0430, home at 2030, and loading into busses wearing all #40 lbs of our “battle-rattle” (kevlar helmet; huge bullet-proof vests; elbow and knee pads; eye and ear protection; etc), and firing guns all day.  The weather was typically 35-40 degrees and rainy, but you cannot let that bother you. One must “soldier on.”

I didn’t think it was going to be as exciting at the range as it was.  I was certainly anxious about being there: with 100 people firing in total several thousand rounds of ammo all day, chances for problems -serious problems-  exist. But with weeks of stern and serious preparation performed up front, simulations executed in advance of the real thing, hawk-like oversight by the many “Rizzos” (Range Safety Officers) and with an extremely well controlled series of instructions and movements, things proceeded very smoothly, and to date, no one has accidentally shot nobody.

We have had a lot of other training as well, such as on how to plan and execute a convoy; or the basic principles of engaging in urban combat.  That particular class has had me thinking and thinking of the Battles of Fallujah and Ramadi and the fights in Baghdad in Iraq, and of all the innumerable similar missions throughout Afghanistan all these years, and it has made me admire those who went through these events even more than I already did.

We also went through the “rollover” simulators: massive setups where all dressed in our #40lbs of armor we climbed into the frames of the military vehicles and they simulated rollovers by spinning us around like in a washing machine.  We’d end up upside down or sideways and have to exit the vehicles and post for post-rollover security.  May sounds easy but wasn’t.  And the simulation could only be a fraction of the experience of the real thing.

So far  as well we have also learned some infantry fundamentals, Improvised Explosive Device fundamentals, and a few other things. All of these combat lessons I hopefully won’t ever require to develop further or express in reality, us being posted into a hospital and without any intention of leaving it; but, although we are many leagues away from being a Ranger or a Sniper or any other Infantry profession, it has been extremely comforting to be getting exposed to these elements, it will help us work with our Army colleagues,  as well as help us better empathize with our patient population.

At the moment we are on a 24 hr liberty (rare), and so last night our Neurosurgeon, our Chaplain, and I went into town to a Brazilian BBQ restaurant.  (Unbelievable food and heart-smart.  Wait, not so much “heart-smart.”)  While we were talking over a steak, beef, salmon, chicken, and pork dinner, an interesting concept came up:  At what point does one stop being a physician or a chaplain first / a military officer second, and convert into being a military officer first who happens to be a physician or a chaplain?  Where, when, and how does that transformation occur?  We decided we didn’t know for certain, but agreed that the transformation absolutely does happen. I for one think it’s when either we move our families overseas, or when we deploy.  At such points the person and their family really understand that the one profession has overtaken the other.  Why does it happen?  Because you identify with the mission and with the troops who will be carrying it out.  Nothing helps you identify like walking a mile in their moccasins.

I suppose I am proud of the fact that of my entire medical school class only one other person was on a military scholarship, and I’m not sure but I don’t think she is still in the Navy.  There weren’t any military students in the year above or below me, either.  I guess it is proud of being crazy, right?  But nevertheless, as the the world’s most famous sailor “Popeye” used to say, “I yam what I yam.”

Last week we spent in San Diego, “in-processing,” which means we were having all of our orders checked, our medical and dental status’ re-checked, getting fit for uniforms, ensuring (as best as possible) our pay accounts were up to date, polishing off any legal issues, and just getting to know one another,

This week has been spent in Camp Pendleton, doing medical training that is appropriate for our work out in Afghanistan.  We’re practicing as a team / as many small teams for the bomb blasts (IED’s), the high-velocity gunshots, etc.

It’s been a very valuable week for all of us: not only have we gotten to know one another much better than before, we’ve been able to practice in these facilities (excellent facilities) exactly the maneuvers and scenarios we’ll be encountering in the field.  Having done this once before, I can attest that the classes and exercises have been “spot-on,” and that it’s been a very valuable rehearsal for all of us.

The living quarters have been fine:  You’re not in the Marriott, but last time I did this we were in tents in the field.  This time we’re in “sea-huts” which are a lot nicer.

There’s my little bed, and my two little travel-buddies (“Ming-ming” and “Skinny Bear”) resting on it.  Those little guys go with me everywhere.  I didn’t like the spring cot so it’s folded against the wall.

We’re on a Marine base so the the helicopters are flying overhead at all hours, the howitzers have been going off all afternoon, there are “tank crossing” signs, and the chow hall is chock full of young Marines all training and working toward their futures.

The particular gang I’m with here are excellent:  they’re the finest Americans there are.  I’m proud to be part of this group, and as daunting a prospect as it might be to go into Afghanistan with a company of individuals and live, eat, work, and sleep with them (sleep in the same huts, not, well, never-mind!) for the next 8 months, I am really confident that with this crowd it’s going to go well.