Team Taliban

Sunday 27 December 2009

This has been a fairly atypical Christmas Day, which I suppose is pretty typical for a war zone.

A few weeks back, one of my team members had a syncopal episode, losing consciousness in the hospital and suffering a pretty good head bonk upon floor impact. The end result was an impressive pool of blood on the floor, some of which managed to trickle under a nearby Christmas tree in the small "dining area" of the hospital, followed by a few staples in the scalp laceration. Today, in the spirit of celebration, another friend of mine performed a song during our team meeting that was written and inspired by the event. The song was entitled "Blood under the Christmas tree" and was a smashing success. I'm not sure that it will replace "Silent Night" as a Christmas classic, but it has a pretty catchy tune, great lyrics, and is certainly original.

Here’s another Christmas story, albeit one you won’t likely want to share with the children fireside. During a village medical outreach mission about a month ago, intelligence came in that the Taliban was going to attack the team. As the security team spread out to the perimeter in order to form a hasty defense, the group of female Afghan interpreters, joined by my female team member, barricaded themselves into the place where they were staying and immediately starting dressing up and putting on make-up. I should add that having a female health care provider in that environment is critical, since Afghan women in most villages will only consent to be seen and treated by women. At any rate, when my female team member inquired as to why they were getting dressed up for the attack, they recounted that their survival strategy was to get dolled up so that if they were captured, they could become hookers for the Taliban. They were very pleased as my team member, who has a light complexion, began to get cleaned and dressed up as well, and they would now be able to offer the Taliban a variety of skin tones from which to choose.

A photo was taken of the potential Taliban hooker team, and my friend actually forwarded it to her husband back home. He then sent it to her father, not recounting the story for the inspiration of the photo. The proud father now displays the photo on his fireplace. The perfect gift for my team member this Christmas, of course, was make-up.

Christmas

For every boot that tramped in battle,

every cloak rolled in blood,

will be burned as fuel for flames.

For a child is born to us, a son is given us;

upon his shoulder dominion rests.

They name him Wonder-Counselor, God-Hero,

Father-Forever, Prince of Peace.

- Isaiah 9, 4-5

Merry Christmas.

The potency of medicine

The first photo shows the face of Afghanistan, at least one of them. The second shows one of my team members during a village medical outreach mission. She is literally reaching out to an Afghan child. The mother's crinkled eyes show that she is smiling under the veil. Even a burka can't hide that.

Logar Province.

This is a photo of Logar Province that I took the day after spending my night of penance for poor judgement. Highway 1, the aorta of Afghanistan, is in the foreground. You can see typical walled-off Afghan compounds on the plain.

Distinctions

Wednesday 16 December 2009

Fieldcraft tip #3: When moving around a combat zone, always travel light. Except during winter in Afghanistan.

I remain humbled at the incredible number of lessons that I continue to learn and relearn as time and life passes. That’s a polite way of saying that I’m amazed at what a dumbass I can occasionally be. One important truism of life in a deployed environment is that it is critical to travel light, since whether you are an E-3 or an O-6, you will eventually be carrying whatever you decide to bring with you on your back. In general, it’s easier to suffer a little bit from the absence of something than it is to consistently carry too much stuff. This has been reinforced through my experiences time and again as I have traveled throughout the combat zone. One critical exception, however, applies when the equipment is necessary to keep you alive. That’s where I made my mistake.

I recently traveled to a forward operating base that is located at over 6,500 feet. I knew that the temperatures at night would hover around 10 degrees F and that I would be staying in a tent, but I figured that since I would be one of the three highest ranking officers on the FOB, the tent would be a “VIP” tent, and certainly heated. I had experienced nights at higher altitudes and colder temperatures in the recent past and been just fine. (Sidenote- if you ever hear an explanation of someone’s reasoning that is this long, it is a guaranteed admission of guilt.) Accordingly, I brought my lighter sleeping bag, a Snugpak Jungle Pack. It is compact, light, sturdy, and totally appropriate for, well… a jungle. Surviving through the night during an Afghan winter, not so much.

That, of course, was exactly the issue. The heater in the tent failed to work, and it seemed that the tent miraculously managed to actually lower the inside temperature below that of the ambient temperature outside. After nightfall, as I transitioned through the uncomfortable phase, passed through misery, and stumbled upon desperation, I finally admitted to myself that an intervention was necessary. I picked up my sleeping bag, which was easy with it being so light and all, and trudged down to an E-6 tent, which had more people, so I figured it would be warm enough to let me survive the night. Fortunately, the soldiers took pity on, or at least indifference to, the idiot officer with a sleeping bag that had mosquito netting sewn around the head end.

I obviously survived the night and am now left to ponder the fact that good rules are only good until they’re not. More importantly, I will now remember to contemplate the often subtle distinction between being savvy and being lazy when making a decision.

The enemy within

Sunday 13 December 2009

Thankfully, the clinical pace at the hospital has slowed down quite a bit. There are, however, quite a few “enemies of peace” that are being cared for in our medical facility. “Enemies of peace” is the new, politically correct term for the forces that fight against the Afghan government and Coalition Forces. Personally, I consider constipation to be an “enemy of peace.” These guys are something different. It is interesting to look into their eyes and know that prior to receiving world class medical care in our hospital, they were trying to kill our friends and peers. Most people, fortunately, rarely get to see that look. Well, except maybe for the resident a few years back who claimed during a quarterly review session that I sometimes “looked like I wanted to kill the residents.” Totally untrue. Maybe just hurt them a little. If any residents or members of the Residency Review Committee are reading this, that was totally a joke- an effort to instill comic relief into a piece that I should probably not have posted.

It’s no secret that we provide medical care not only to our friends and allies, but also to enemy forces that are injured in combat. It is, however, an incredible thing that our medical personnel really do deliver the same quality of care to our enemies that we do to our own forces, without hesitation or resentment. I was recently up on the roof of the hospital discussing the matter with a trauma surgeon and he mentioned that he had just finished a pretty amazing and complex surgery on an injured “enemy of peace.” He said, “It’s funny, I’ve done some of my best work on these guys.” At least that’s what I think he said, since we were conversing through gaps between our neck gators and fleece caps that were exactly the diameter of a cigar. The truth is, they really do get our very best.

Pressure

Thursday 10 December 2009

We had our first snow today here at Bagram. Actually, it was a slushy, icy, 33 degree F, muddifying, Afghanistan version of snow, not the beautifying mountain kind of snow. It was sort of the weather equivalent of learning to snow ski at West Point. That place could even suck the joy out of something as fun as skiing. I still have an image of a heap of bodies (most of them from Southern states) piled at the exit of the ski lift at the top of the ski slope at West Point.

“You bunch of monkeys look like a goddamn Rossignol yard sale!” That comment from the compassionate instructor assigned to the Department of Physical Education would have been funnier had I known at the time that Rossignol was a brand of ski equipment. The fact that his boss was officially titled “The Master of the Sword” should tell you something. It was a fairly accurate portrayal of the situation, however, given the tangle of skis, poles, and various items of inappropriate clothing that lay strewn about. At the time, we had to wear cotton sweat pants and our felt jackets as the uniform for ski class. That, too, is funnier in retrospect because we must have looked like a bunch of snowballs as we caromed down what we considered our “ski mountain.” You can probably imagine the end result of setting loose a bunch of cooped up, late teen/early-20’s adrenaline junkies who have no idea that snow + gravity = danger onto an icy mountain in New York state.

Truthfully, any kind of change is a welcome distraction here and I haven’t heard a “this sucks” in over 2 days. There’s kind of a feeling of anticipation in the air, most likely due to the expectation of more troops arriving and the predictions about whether the optempo will actually slow down this winter, as it has during past winters in this country. The consensus is that it will not, especially given GEN McChrystal’s recent testimony that “victory will result from the prolonged application of pressure.” I guess that’s us.

Other side of the world

"Remember those times on the telephone line,

trying to break through to you.

I'm on the other side of this world,

I wish I was there with you.

All these days and all these nights,

thinking about you my friend,

I can't wait to get back home..."

- Donavon Frankenreiter, So Far Away

Until I do get back home, I will do my best to record and share some of my experiences on this journey. I have recently returned from a trip that I will remember for a lifetime. I spent some time at the old Taliban barracks in the picture, above, which is now a coalition medical facility. The operating room is the first door to the right, the trauma room is the first door on the left. This is one of the two or three busiest trauma stabilization sites in Afghanistan. The site is guarded by some Hazaris (like in Kite Runner), which is a good thing because they really hate the Taliban and seem to have an uncanny ability to sniff them out.

My interactions with the Polish Army at this site were moving and memorable. I know that I am completely biased, but I am left with an incredible fondness for the people with whom I worked and interacted. I am fortunate to have worked with some fantastic people, both Polish and American, and I take away memories of laughter echoing off of walls that formerly encompassed scenes of tragedy and terror. I will also remember the sound and feeling of the mournful hymns of a Polish Sunday mass, filled with words that I couldn't understand but a message that was clear.

During the trip, I spent a good deal of time with two American surgeons, a trauma surgeon from the University of Pittsburgh and an orthopod from east Tennessee, about 30 miles from where I grew up. What a small world it is here on the other side of the world.