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Filtering by Category: Army

10 years

ago we were marking time in a small encampment we had established about two weeks prior. We were waiting on the word to move north. We knew it would come soon, and we were ready. The call came around mid day and by that night we had moved to a spot just south of the Iraq/Kuwait border. We were part of one of 13 columns (IIRC) that 3ID formed for the invasion, near the far west side. We were composed of elements of an Infantry and Combat Engineer Battalion. Our FAS (Forward Aid Station) was composed of my 577 Treatment track, as well as a command vehicle and a couple of ambulance tracks. Heavy bombardment of thousands of predetermined enemy targets had already begun the night before, and we got the command to move forward sometime after midnight although I don't remember the specific time.

It was a strange feeling crossing that border. I know I felt we had crossed not only a geographical line, but an historical line that after which we could not stop events from playing out, whether positive or negative. In some ways it seems longer than 10 years, in others not. Many question what we wrought with that invasion. Was it worth it? I'm not sure we'll ever know, and it will probably be up to historians to debate as they have all wars in the past. The only thing I do know is I'm very fortunate to have made it out alive and essentially unscathed. 

I am being sorely tested...

by all involved parties. First we get smoked by our walkins today (3x the usual number) and then our staff is doing their best to give the exponentially enlarging snowball an extra kick before it gets to me. I love the fact that people who are not ultimately responsible to care for a patient are more than willing to sign them in when they don't have an appointment since it's my responsibility to take care of them. Soon I will be in a job that doesn't have walkins and I won't have subordinate personnel who can arbitrarily add to my workload.

Being a provider with a schedule of patients is an occupational experience that most people don't comprehend. When you have a schedule, you are locked into that schedule. Your day is dictated by the schedule and you must stick to it or suffer complaints and backlash from patients and staff alike. As a provider I accept this, because it's what I get paid to do. Where I get really frustrated is when other people through ambivalence, naivete or outright intention add to or otherwise complicate my schedule. I don't mind a busy, fully booked schedule. The busier I am at work, the faster the day goes by. I pride myself on staying ahead of my schedule, finishing my notes in a timely manner, and getting all the time sensitive issues handled as soon as safely possible. When it's up to me, this is very rarely a problem. The only time I typically fall behind is through the action or inaction of others.

Today we had 15 people signed in for sick call, and we only have 90 minutes to see them before appointments start. The frustrating thing is that most of these people don't truly have acute medical issues. Most of our sick call patients are here because they don't want to wait for an appointment, or they are trying to get out of work. Rarely do I see a patient on sick call that I think "It's good you came in when you did, because this was a serious issue". Most of the time I think "Why would anyone ever seek medical treatment for this issue?" This gets back to my fundamental problem with most clinic visits by soldiers which is that they get free healthcare and have the secondary gain of time away from work, duty modification, etc.

The NCOs responsible for triaging the acute patients are not very good at what they do. They have a tendency to not want to enforce sick call complaints to acute only, and if the patient argues with them or insists on being seen, they sign them in. Military patients essentially have no negative reinforcement system for spurious complaints. The worst thing that happens to them is being told they are normal or their issue doesn't require any more workup or treatment. Even in those cases, they were at least able to get out of pt and work for a few hours. Patients can no-show, malinger, drug seek, or engage in a multitude of fraudulent or exaggerative behaviors and they very rarely get held accountable. This is one of the reasons I have sought employment elsewhere. The secondary gain issue is fairly common with the normal active duty population, but it's the modus operandi of the meb patient. I don't know how any competent provider with military experience could tolerate long term employment with this population. "Never has so much been done for so few who are so less deserving" - this should be the clinic motto. I find myself less and less proud to be an American citizen and retired soldier the more of these types of patients I am exposed to. There is a significant portion of the young population who look at the world as a set of entitlements with no requirement to work or produce for those entitlements.

I'm rambling now. Rant over. I expect my relative attitude will improve here shortly.

Back in the USA

I’ve been back going on 36 hours now and I’m quickly transitioning into the stateside way of living again. The next few weeks will be comprised of required training and processing as well as an adequate amount of time off. I’m still trying to adjust my circadian rhythm back to central standard time and that will probably take another week or so.  Life is really good now with the feeling I won’t have to participate in any extended Army vacations again since I will be retiring in October of next year.  I’m just enjoying being home with Aeyoung and our dogs right now.

It’s just a blast here…

at sunny Bagram Airfield in Afghanistan. I’m into my third week of conducting post deployment health assessments on returning soldiers and otherwise trying to get the time to pass as fast as possible (which it isn’t).  Just to keep things exciting we had a rocket attack two nights ago that killed two soldiers and injured six others. This was the most deadly attack in about two years at Bagram. The rockets landed about a quarter mile from where we sleep so they woke me up but it was basically over by the time I realized what was happening. Just the thing to keep us on our toes for the next few weeks. I’m due to leave around the first or so of July.

Drawing Down

It’s June and most likely the last calendar month for yours truly in good ‘ole A-Stan. I’ve got about another week here at beautiful FOB Blessing and then I’ll be headed to Bagram Airbase for a couple of days or weeks (depending) to take care of medical outprocessing. Mentally I’m already back at home playing my guitar at loud volumes.

Recent developments

Time is slowly chugging along here at FOB Blessing. Nothing of great import has transpired since last update with the exception of my removal from ADVON which means I will be coming home in late June or early July as opposed to late May. That change has its pros and cons with the main negative being more time away from home but almost everything else is positive. The ADVON providers have to setup the medical footprint and get everyone at home ready for the return of the brigade so it’s a lot of coordination that can be somewhat of a pain. The other positive is that it will be one or two more months of the extra combat pays so that will come in handy.

Of most significant import on the musical front is that yesterday we got tickets to see Yes with Asia (Steve Howe will be pulling double duty) July 15th at Bass Performance Hall in Fort Worth. Of all the concerts and musicians I have been able to see over the years, there are still a couple of my all time favorites that I have never seen live and Steve Howe is at the top of the list.  I was able to catch Yes on the 90125 tour with Trevor Rabin (a fantastic show and I was very happy to see that lineup) but I have always felt I missed a great opportunity to see Steve Howe with the classic lineup, playing the more classic era song list. Unfortunately (depending on your viewpoint) Jon Anderson & Rick Wakeman have both had some medical issues that have kept them from performing so Steve Howe, Chris Squire and Alan White have enlisted the duties of Oliver Wakeman (Rick’s son) on keyboards and Benoit David (a Yes tribute band member) on vocals. According to reviews from a short tour last winter, David sounds like the Jon Anderson of the 70’s and does an incredible job on the old tunes. Another benefit of this lineup is that they can perform tunes from Drama which Jon Anderson always refused to do. So it’s possible this set list will be about the most varied and interesting they have performed in a long time. I’m fairly sure they will perform Close to the Edge in entirety and that’s worth the price of admission alone. I’m really looking forward to Machine Messiah or pretty much anything from Drama.

But if that wasn’t enough, they are being joined by Asia with the original lineup and they should be able to draw tunes from the first two albums as well as the most recent studio album “Phoenix” which was released a couple of years ago. Asia comes from a unique genre in that it’s the closest thing to Progressive Pop, definitely the most successful next to the 90125 Yes of that era. The nice thing is that the “Phoenix” is actually a great album in their catalog and it seems like the album they should have released after the first two. Asia had many forgettable lineups and albums in the intervening years between “Alpha” and “Phoenix” but this tour is shaping up to very promising.

In fact, Germany it isn’t…

After much discussion, Aeyoung and I have decided that parting ways with the Army (at least the active duty portion) is the best decision for us.  I was really on the fence but when I pressed her to state her real preference she was strongly for retirement.  Now that we made the decision I realize it’s the best move.  I have asked my branch to send me to San Antonio where we plan to spend my last year in the Army settling into a new house and looking for my first new job in 23 years.

Germany it is

Shortly after receiving the last sentinel event email, I received another one of those “check the calendar and make sure it’s not April 1st” emails.  My branch followed up the Germany offer with a note that the OH position at Tripler Army Medical Center in Hawaii was also going to be vacant at the end of the year. Aeyoung was even more excited at the prospect of Hawaii so we seriously considered that job for about twenty four hours before deciding on Germany. Hawaii would be great at least for awhile, but the cost of living is prohibitive and we both felt that the novelty would wear off after awhile and we might feel stuck there.  Having been to Europe and always wanting to go back to travel, I was confident that we would both love our time over there.  There are dozens if not hundreds of places in Europe that immediately spring to mind when I think of travel.  Not to mention that I love the European vibe : history, culture, food, architecture, women, wine, song, lions, tigers, ligers, etc.

Belated Ides of March Updates

Well, Folks. It’s mid March here in sunny Afghanistan and we are counting down the days, oh yes we are. Most of the crew here has taken their R&R leave and we are on the downhill slope to deployment’s end. I don’t know exactly how much time I have left but it’s a range of between 45-75 days. I should be heading back to Texas in May so the end is in sight at least. I got one of those sentinel event emails last night from my career manager in which she offered me a job that was often considered just a rumor. Since graduating from the OU School of Public Health I have had my eyes on a position with USACHPPM which is the Army’s Preventive Medicine agency. There are very few active duty slots in the entire organization, and even fewer slots for PA’s. Especially if you didn’t learn the secret handshake (and/or have incriminating evidence against the career manager by which to blackmail). I have been offered the CHPPM PA job in Europe which technically isn’t a real job as they have never created an official position although people have been assigned to those duties for several years. This is as close to my dream assignment as I can get in the Army (until they create an official position that entails testing of vintage guitars, beer tasting, and application of lubricants and other skin products to visiting cheerleader squads). Taking this job will give me a chance to get back into occupational medicine with a focus on research, prevention, health promotion and education. Not to mention that it’s in a very nice part of Germany which will allow Aeyoung and I to travel all over Europe and the Mediterranean for three years.  I’m still anxiously awaiting the new bonus program announcements which are due in the next month or two, but I’m probably going to take this job regardless as it’s worth the investment in extra years from both a personal and professional standpoint. I sign off with thoughts of Egypt, Greece, Turkey, Italy, Spain, England, Ireland, Scotland, France, Belgium, Holland, Germany, Russia, etc. dancing in my head…


Not a lot new to report. We’re getting to the end of February, and it’s been a mostly cold and wet month. I’m on the cusp of “double-digit-midgetdom” which is a state of having less than 100 days left in country. This comes from the tradition that started when I was in Korea in which people refer to themselves as short as they get near their departure date, hence midget. Not to disparage the short of stature, mind. We have now entered into a period of watchful waiting as it will be March or April before I find out about how big of a hit the personnel programs will take under President Obama’s budget. This will have a significant bearing on whether I retire in October 2010 when eligible or if I sign up for the new bonuses that are rumored.

Back at Blessing

I was gone for nearly a month, and a few things have changed while I was away. For starters, they apparently have decided to follow the American infrastructure model by paving the entire FOB.  I exaggerate slightly, but they have laid down about half a basketball court worth of new concrete.  In addition, they opened up a new MWR facility where the mess hall used to be and it’s pretty nice. They have a projector showing movies, several phones and internet connections. The movie area has some plush couches and you can play your own movies on a first come first served basis. This won’t replace movie night at the aid station (got HD?) but it’s nice the soldiers have this outlet now. 

On other matters, I was quite relieved and surprised when I checked my weight this morning after over 3 weeks of complete disregard to my diet and exercise regimen.  I actually am the same weight I was when I left which in some books would count as not making progress, but as bloated as I felt coming back off leave I was pretty happy. I still have a ways to go to reach my end deployment goal, but now that I’m back on Blessing I can get back on track.

Nearly back to A-stan

I’m sitting in Kuwait, waiting for my flight to Bagram Airbase in Afghanistan in a few hours. It’s been a couple of days of false starts here and hopefully we won’t go through another night of “come back in 3 hours” repeated ad nauseum.  R&R was great, but it went by faster than any leave I can remember. The good news is that I have less time ahead than behind in this deployment.

A brief respite

I type this post from the MWR center in Kuwait. It's Saturday, the third of January 2009 and I'm waiting to fly home on midtour leave shortly. I don't know my flight schedule as of yet, but I have to check in tomorrow morning at which time I will get my itinerary. I don't know if that means I'm leaving tomorrow or not. Probably within a few days at the worst.

I spent a night in Bagram Airbase in Afghanistan before flying here and although it's no surprise, these people at the bigger bases have an exponentially higher standard of living than the guys out at the tip of the spear. It's the nature of the beast that the farther you are from the supply hubs, the less comforts you will have but it should be the opposite.  It's nice to eat in a fully stocked mess hall and have access to the PX, Burger King, etc. but it also makes you kind of mad to see what these people have when they have never even heard a shot fired in anger much less been injured themselves or seen one of their friends die in front of their eyes.

I plan to spend a restful two weeks with my wife and our dogs and don't plan on doing anything involving a lot of driving or work…

December milestones and musings…

Hey there sports fans.  For the irretrievably bored (at work, most likely) I'll tick off a few more dates of significance.  December 3rd marked my 21st year in the Army, and December 11th marked the 5th month here in Afghanistan.  Here around the FOB we're trying to get into the Christmas spirit, myself mostly with Aeyoung's help. She has sent alot of Christmas themed decorations and the like and she also sent a couple boxes full of little presents to give to the local kids. I had one of the medics divide the gifts up into boxes for girls and boys and we've been handing them out. These kids love to get anything so they have been universally appreciative.  Here's a snap of a few kids that were in yesterday:

A bit past four months…

I'm a little late to the four month mark party, but feel compelled to mark these countdown milestones.  The last month has seen a few good developments, not the least of which is a fairly significant downturn in enemy activity in the last few days. It's been colder here for a few days and that may be the main reason. Since the last countdown milestone they have fixed the dryers in the laundry which has somewhat improved our laundry turn around time (there's no fix for the ambivalent workers employed there); and most significantly they repaired two of the treadmill belts so now I can run again.

I was a bit overly optimistic the first day and ran 5 miles in my rekindled trotting exuberance.  I paid the price of pain for several days afterwards. Luckily, my legs have been convinced that it's in everyone's best interest if they don't sit the rest of the season out and I was able to run 3 miles on Friday and feel like doing 3 or 4 today.

Another significant improvement was the arrival of my PS3 (thanks to my better half) and a modest home theater speaker system I had ordered online. We now have a high def, surround sound capable theater and video game room in the aid station. I'll upload pictures of movie night in action here in the future. We christened the new setup with the Blu Ray version of the most recent Incredible Hulk movie with Edward Norton. Watching a high def movie on a 70 inch screen with surround sound is quite sublime considering.

On the same mail truck I also received a nice desk chair for my room that has made the extended keyboard/guitar practice sessions much more forgiving to my sitting points of contact (use your imagination). With the gradual improvements it has become almost livable here. Knowing the Army, it's way past time to bring the suck to our happy home here if at all possible.  Until then, I'm going to enjoy our new standard of living.

3 Months

Depending on how you measure it, it's been 3 months since I left the US.  In some ways the time has gone by fast, but at times it does drag a bit. Hopefully the change in the weather will force the insurgents to scale back their efforts significantly. Rumours abound (they always do) that the enemy is intending to carry the fight through the winter which would be a change in strategy for them.  For a rag tag group of fighters who typically go barefoot or wear sandals, it will be quite an accomplishment just to move around outdoors here in about 4-6 weeks. Time will tell. 

The next 3 months includes Aeyoung's birthday (coming shortly), the holidays, and the start of a new year.  My plans for the next quarter are to continue working on getting better at medicine, music, and I'm going to reapply myself to finally learning my wife's native tongue (that will take considerably longer than 3 months, but I've got to start sometime).  I've got a book coming in the mail and I'm going to try and devote time each day to study. 

Hopefully the end of the next quarter will signify the halfway point of the rotation. The end of the quarter will also coincide with the arrival of another brigade and the redistribution of some of our battle space. Hopefully that will go smoothly, although I'd be surprised if it did.

October's Gone, and a Presidential Milestone…

I'm a few days late with this, but October has passed us by. It was a tumultuous month to say the least.  Things have been a little quieter the last few days. Summer is still holding on here with daily temps into the 80s although it's colder in the evening.  They finally finished the new dining facility although the quality of the food remains unchanged. November 11th is the four month mark so we're nearing 1/3rd of the tour complete. November will hopefully mark a decrease in enemy activity as the weather continues to get colder.

Back in the US yesterday, we elected our first African American president, Barack Obama.  This is obviously one of the most significant events in American history, easily the most significant political event in the last generation.  He goes into office with a democratic majority in Congress and arguably the hardest presidential task in history. He's going to have to deal with the ongoing war on terror and the wars in Iraq and Afghanistan; this will probably pale in comparison to the task of turning the economy around. It's a very optimistic time in our political landscape, hopefully the optimism will be justified.

I'm currently trying to negotiate my next assignment whilst deciding about my long term career options. In October word came out about the new bonus program for the Army PA's and it's very significant if it comes to pass. Final approval is predicted for next spring, and for retirement eligible PA's (yours truly) the amount will be substantial. With the creation of the CSRB bonus program in 2006, I had initially considered signing another contract at the expiration of the first which would lock me in until 27 years active duty. 

However, after nearly a year with a regular unit I was all but dead set against remaining any longer in the Army. Now, after being deployed for four months I have begun to feel different. Most of my dissatisfaction last year had to do with the typical primary care and predeployment mission that dominates stateside military healthcare operations.  The overwhelming majority of patients we treat in the states either don't need medical attention, or are trying to use a medical issue as a means to avoid doing their real job. That will never go away, but after practicing real medicine on a predominately truly sick and injured patient population, I have garnered a new appreciation for my work.

That experience, combined with the changing political landscape and the tentatively planned troop reductions in Iraq have actually got me feeling optimistic about the Army again.  The ongoing struggle here in Afghanistan and the likelihood of continued (albeit decreased) violence in Iraq essentially guarantees that combat deployments will be a regular part of Army life for years to come. However, the optempo may very well decrease to the frequency of one deployment every 3 or 4 years (or even longer) if the positive gains continue. 

My current contract expires in October 2010, when I would be eligible to retire with nearly 23 years active duty.  I can stay in without doing anything since I have to request retirement for it to actually happen.  I'll have essentially one year to think about it after returning from this deployment. The Army typically recommends requesting retirement a year ahead, but no less than 90 days. I'm hopeful that a lot of uncertainty about the next several years (for the military) will be cleared up after President Obama completes his first year in office.  If things continue to improve, I might decide to stick around for another four years.

The return of the tubular…

Our favorite thoracic shrapnel patient returned after about a month in the hospital for a check up.  He is the patient that I put the chest tube in and then shamelessly hammed it up for the after picture. He is doing very well with no residual pain or loss of pulmonary function.  The scar is still impressive enough for him to get sympathy dates, though. Not sure if he's tried it yet. 

Chest Tube after web

A really bad 24 hours…

We lost our civilian doctor, Dr. Rahullah who had been an integral part of our clinic here. He is on my left, explaining the patient’s prognosis to her father. He apparently was killed because of an inter-family rivalry although that isn’t confirmed. He was a man who had risen so far above his upbringing and spent seven years of his life in medical school and had been working in our clinic for less than a year. As unique as doctors are in the states, they are even more special here in Afghanistan. This is a typical outcome for those who put their lives on the line to help the people of Afghanistan.


A Brief Video Tour of Camp Blessing

What follows is a very scrunched and degraded version of a few clips of my current home. I'm limited by bandwidth and the fact I'm using a military network. You will probably need Quicktime to watch this. More professional (read, interesting) clips will be put together in the future, but I don't know if I'll ever be able to upload them while deployed. They'll probably be put together after I return to the states. The best part is, I'm putting them on this website as opposed to forcing everyone to watch them during the holidays. See, I am thoughtful.