Tuesday 20 October 2009
“There are dinner jackets, then there are dinner jackets.
That…. is a dinner jacket.”
-Vesper, Casino Royale
I used to think that a deployment was pretty much a deployment. I saw them as a binary thing; either you had been deployed, or you hadn’t. I now see that there is an infinite variety of deployments. Your experience depends on where you are, what your job is, the timing of the deployment, and multiple other variables. The experience of my colleagues here at Balad is really in no way similar to that of my colleagues at Bagram. Both, honestly, are valuable, life-altering experiences, but in incredibly different ways. I couldn’t comprehend that variability before this deployment, and the unique opportunity to travel extensively throughout Afghanistan and fairly widely in the Iraq theatre has been an insightful experience.
I smoked a cigar up on the roof of the Balad Hospital last night with a group of friends. I’ve done this throughout Afghanistan and Iraq, and the “smoke shacks” on top of the various hospitals are as diverse as the deployment experiences, themselves. All have been both unique and enjoyable. The Balad smoke shack is nicknamed “OR-5” (the hospital actually has 4 OR’s) and is probably the most famous of the cigar smoking areas in theatre, having been featured in an Article in Men’s Health. It is sort of a deployed surgeons’ tradition to gather for a cigar in the evening after surgical cases. Balad’s smoke shack is actually more of an attractive lanai than a shack, with a well-built deck, walls, and chairs. It accurately mirrors the mature nature of the hospital. Bagram’s smoke shack is just that, some rough lumber that has been nailed together and covered with camoflauged netting. Again, appropriate for its environment. Balad’s lanai was largely built, incidentally, by a general surgeon who is now stationed at Bagram. What a great legacy he left behind here at Balad. I’m sure it is just one of many.
By the way, while my perfect day generally involves one in which I never have to don a shirt, I kind of miss the dinner jacket. It is appropriate attire for a dinner with Vesper.
Sunday 18 October 2009
I’m sitting in the laundry trailer at Camp Sather, Baghdad, Iraq attempting to remove some of the travel filth from my clothes. Don’t worry, Barbara, I’m sure that this skill, along with the ability to set an alarm clock and determine the directionality of artillery/mortar fire, will dissipate soon after my return. This has been a pretty outstanding trip, so far. I’m here to essentially close down the medical research efforts in Iraq as the medical system redeploys out of this war zone. The plans are already in motion for the redeployment of our medical forces, down to the single man level of detail, but I don’t want to get ahead of myself. Redeploy, by the way, is army-speak for deployment in reverse, ie- getting out of the country. Kind of like ‘retrograde attack’ means retreat. Not sure why we talk this way.
It took us two days to get out of Bagram/Afghanistan. It’s hard to really put that into perspective for you. Rather than spending time on the phone with a travel agent trying to arrange the perfect flight, this means humping your body armor, ruck, helmet, weapon, and whatever you might need for a two week trip to Iraq about a mile to the PAX (travel) terminal for every possible flight, three hours in advance of every flight time, which isn’t released until 2300 the night before. We did this 5 times on the first day, to no avail. Finally on the second day, we were able to catch a flight to Al Udeid, Quatar. I should mention that I am traveling with an O-6, which is usually the equivalent of a wartime, golden hall pass. An O-6 can pretty much get whatever he wants in theatre, and whatever he says usually goes. Except for travel out of country. R&R and combat missions take priority, and both happen to be quite in vogue in Afghanistan, right now.
We landed at Al Udeid about midnight and found our tents. Since it is an Air Force base, they have an O-6 tent, then an everybody-else tent. I think the U.S. Air Force is the last vestige of communism. Anyway, I of course managed to sneak my way into the O-6 tent for the night, which was a great upgrade. Heck, it's not that much of a stretch, I figure I’ll be one, someday. Ooh, inspiration for another fieldcraft piece. I’m not actually sure that the folks at Al Udeid know that there is a war going on, but it was amazing- everything is clean, there is wi-fi internet, they even took away our weapons, which was disconcerting. I haven’t walked around without one for over two months. I found myself constantly checking my hip with my hand as I used to do with my pager in a former life. I got a good 4 hours of sleep, then loaded up for the flight to Iraq.
This being the deployed environment, if not a war zone, our plane malfunctioned while on the runway and we got to sit in a sweltering C-17 for about two hours while they worked on it. Pretty standard, combat zone stuff. Of course we are in Quatar, which is in the Middle East, which is hot. Squiggly vision, Koran chants echoing from the top of minarets, hot. The problem was that they couldn’t get their power to work while on the ground. If the engines were running, there wasn’t a problem. The challenge would come, of course, when they had to stop the engines and drop off their cargo in Tikrit, Iraq before heading on to Baghdad (my destination). How would they get the engines restarted? The answer seemed fairly obvious- keep the engines running while you offload the equipment. It wouldn’t have been so dramatic, but the cargo happened to be a full fuel truck and two full, 5000 lb liquid oxygen containers. No problem, they decided to drive on. Apparently, you can’t smoke a cigarette within 50 feet of either a fuel truck or an O2 container, but 4 jet engines in direct proximity to the flammables don’t pose much of a risk. Got it- I’m ok with that. Besides, I need to get to Baghad. By the way, it worked.
Landing in Baghdad, I was once again amongst my Army brethren. Our camp consists of tents with the requisite amount of dust/dirt and eau de port-a-potty. Perfect. I’m back home. I spent the morning at the 10th Combat Support Hospital, where I ran into a bunch of friends from Tripler. Dwight Kellicut, a vascular surgeon from TAMC, is here. He’s lost 49 pounds during this deployment, so far. Our CT surgeon from TAMC is also here along with an OB/GYN from Tripler. They’re doing well. Iraq is incredibly quiet. No real American traumas, thank God. Everyone is spending their time planning the draw-down and listening to the reports from Afghanistan. I wish I could describe the looks I get when they hear I’m at Bagram. Priceless- I actually love it. I’ll self-analyze my reaction at some point in the future. We’re quite close to Baghdad Int’l Airport, by the way, which was well depicted in a battle scene in the HBO mini-series “Generation Kill.”
I spent the afternoon at Al Faw palace, one of Sadam’s former homes. It is quite stunning and is now Multi-National Corps- Iraq HQ. I had to meet with the top Army medical staff in Iraq to discuss the drawdown plans for medicine and research in Iraq. The MNC-I surgeon (top doc in theatre) is Dallas Homas, a former colleague from Tripler, and his deputy is Wilma Larsen, former Dept Chair of Ob/Gyn at Tripler. I think we’re supporting this war out of the Pink Palace, sometimes. Either that, or I’m just getting older and have been around for too long. The meetings lasted for a few hours and went great, we’re all on the same page with our plans. I am very impressed with the medical war plans that I hear about. These people are on it. Mostly, I’m glad that there is essentially no trauma in Iraq and we are really winding down in this theatre.
I head up to Balad tonight to finish up business, here. I hear Balad has a pool and is no longer deserving of the title “Mortaritaville.” Excellent. I’ve kind of felt like I’m on R&R in Iraq. How strange to write that sentence. I think my stuff is ready for the dryer.
18 October 2009, cont.- PAX terminal, Baghdad
I was on a bus last night from Al Faw Palace back to Sather and had the joy of eavesdropping on the philosophical contemplations of some young soldiers. These were the same guys that I listened to on the airplane to Kuwait, except that they were different people. The bus was dark, about half-full, and idling at the stop, waiting for departure. The dust is slowly swirling in the dark outside the curtained windows. It’s still about 96 degrees outside, and the hum of the air conditioner is lulling us all to sleep.
“Belks, your ever heard of that saying, ‘money can’t buy happiness.”
“Of course, dumb shit, I’m not stupid.”
“Well, that’s bullshit.”
This is a verbatim transcript of the conversation to the best of my recollection. I wanted to write it down to guarantee accuracy, but it was too dark to see. While these were different people from the plane flight pair, young soldiers are apparently at that age where they are testing and defining the boundaries and truths of their universe.
“Man, I’m tired…I don’t want no theory, right now.”
“Seriously, I mean, whenever I’ve got money, I’m happy as hell. What kind of dumbass would have money and not be happy?”
Maybe these guys are smarter than I realized.
Sunday 11 October 2009
Winston Churchill tops my all-time favorite list of writers, wordsmiths, and politician/orators. He was a connoisseur of cigars, scotch, and sarcasm; man, I would have loved to sit out on my back lanai and share a stogie and finger of single malt with him. I think he was such an effective leader of his nation during WW II because he had known personal defeat and he had experienced war as a young officer during WW I. He realized the price of victory in war as well as the cost of not achieving it. His writing and spontaneous quotations, however, are my favorite part of his legacy. Apparently, he had a famous hate/hate relationship with Lady Astor, and during a dinner party at which they were seated alongside one another, and during which he had consumed a healthy quantity of scotch, she apparently told him, “Sir Winston, if I were your wife, I would put arsenic in your tea.” He calmly and dispassionately responded, “Lady Astor, if I were your husband, I would drink it.” Well played.
I recently came across another somewhat jaded quotation of his with which I had not been familiar.
“Men occasionally stumble over the truth, but most of them pick themselves up and hurry off as if nothing happened.”
I think he was talking about me. I often stumble across a truth or opportunity, and only later does the importance or profundity of the moment strike me. Such has been the case with my job. I knew upon receiving the assignment that it would potentially offer a nice balance of clinical medicine and academic challenge. I recently stumbled across an opportunity with our team, however, that I hadn’t envisioned, but seems so incredible, in retrospect. Late last week, while I was performing an administrative dance with some CENTCOM leaders, which did offer a fair share of staring, blinking, and entertaining gut checks, my team was doing something far more important. They met with a provincial reconstruction team that is attempting to grow a crop in Afghanistan that would potentially become a foodsource that could address much of the malnutrition in this country, the most significant enedemic health care crisis in Afghanistan. I didn’t realize it until I was safely away from the opportunity to make any impact whatsoever, but the concept is brilliant. It addresses the three most fundamental needs in this nation, to my simple mind. You grow a crop, creating an indiginous agricultural economy. The product alleviates malnutrition, the greatest health care concern in country, and at the same time provides an alternative to poppy/opium production, depriving the Taliban of their source of income. Brilliant. It is a cool opportunity to make a difference, but even more importantly, it allows the Afghanis to help themselves.
By the way, credits to John Cusack in Hi Fidelity for perfecting the all-time greatest, all-time greatest lists.
